10-months to 1-year-old Child Developmental Checklist

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Name of parent家长姓名* This field is required.

First Name

Last Name

2

Name of child孩子姓名* This field is required.

First Name

Last Name

3

Email电邮地址

example@example.com

4

Date of birth of child孩子出生日期* This field is required.

Date

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Q1:Does your child explore things in different ways, like shaking, banging, throwing?您的孩子是否能够用不同的方式探索事物，例如摇晃，敲打和扔？* This field is required.

YESNO

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Q2:Can your kid recognise familiar people at 6 metres?您的孩子能够在6米的距离认得熟悉的人吗？* This field is required.

YESNO

8

Q3:Does your child find hidden things easily?您的孩子是否很轻易地就找出被藏起来的东西？* This field is required.

YESNO

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Q4:Does your kid look at the right picture or thing when it’s named?您的孩子是否会看着被念出名字的图片或事物？* This field is required.

YESNO

10

Q5:Is he/she able to copy gestures?他/她是否能够模仿肢体动作呢？* This field is required.

YESNO

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Q6:Is your child start to use things correctly, like drink from cup, brush hair with comb?您的孩子是否正确地使用物品，例如用杯子喝水或用梳子梳头发？* This field is required.

YESNO

12

Q7:Is your child able to bang two things together?您的孩子是否能让两个物品相碰撞？* This field is required.

YESNO

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Q8:Is your child able to put things in a container, takes things out of a container?您的孩子是否能够把东西放进容器或从容器中把东西拿出来？* This field is required.

YESNO

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Q9:Does your kid let things go without help?您的孩子是否可以不需要帮助就能放开东西？* This field is required.

YESNO

15

Q10:Does he/she poke with index (pointer) finger?他/她是否能够有食指戳东西？* This field is required.

YESNO

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Q11:Is your child able to follow simple directions like “pick up the toy”?您的孩子是否能够跟从简单指使例如“捡起玩具”？* This field is required.

YESNO

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Q12:Does he/she know own name?他/她是否知道自己的名字？* This field is required.

YESNO

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Q13:Does your child respond to simple spoken requests?您的孩子是否能够对简单的口语要求作出回应？* This field is required.

YESNO

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Q14:Does your kid use simple gestures, like shaking head “no” or waving “bye-bye”?您的孩子是否可以做出简单的肢体动作例如挥手或是摇头？* This field is required.

YESNO

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Q15:Is your kid able to make sounds with changes in tone (sounds more like speech)?您的孩子是否能够做出语调上的改变（声似演讲）？* This field is required.

YESNO

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Q16:Is he/she able to say “mama” and “dada” and exclamations like “uh-oh!”?他/她是否可以说“妈妈”和“达达”以及诸如“嗯！”之类的感叹词？* This field is required.

YESNO

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Q17:Does your kid try to say words you say?您的孩子是否尝试想说出你所说的话？* This field is required.

YESNO

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Q18:Is your child able to get to a sitting position without help?您的孩子是否能够不需要帮助就能坐着？* This field is required.

YESNO

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Q19:Is he/she able to pull up to stand, walks holding on to furniture (“cruising”)?他/她是否能够站立，并且扶着家具走？* This field is required.

YESNO

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Q20：Could your child take a few steps without holding on?您的孩子是否能够不需要扶着就能够走出几步？* This field is required.

YESNO

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Q21:May he/she stand alone?他/她能够独自站立吗？* This field is required.

YESNO

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Q22:Is she/he shy or nervous with strangers?孩子是否对陌生人感到害羞或是紧张？* This field is required.

YESNO

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Q23:Does your child cry when mom or dad leaves?您的孩子在父母离开之后是否会哭？* This field is required.

YESNO

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Q24:Does your child has favourite things and people?您的孩子是否有喜欢的人或物品？* This field is required.

YESNO

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Q25:Does your child show fear in some situations?您的孩子在一些情形下会表现出害怕？* This field is required.

YESNO

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Q26:Could your child hand you a book when he wants to hear a story?当孩子要听故事，她是否能够交给你一本书？* This field is required.

YESNO

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Q27:Does he/she repeat sounds or actions to get attention?她是否会重复一个声音或动作来吸引他人的注意？* This field is required.

YESNO

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Q28:Is he/she able to put out arm or leg to help with dressing?她是否能够在穿脱衣服时拉出手或脚来协助他自己？* This field is required.

YESNO

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Q29:Does your kid play games such as “peek-a-boo” and “pat-a-cake”?您的孩子是否会玩"peek-a-boo"和“pat-a-cake"的游戏？* This field is required.

YESNO

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Top 3 problems of your child that you have faced during this journey您在教育孩子的路上遇到的三个问题* This field is required.This is important to us as we are strived to be the parental problem solver. Please feel free to tell us if you do not mind to have an ear to listen your story. The more detailed, the more we can help :) Your problems will be kept in confidential with our assurance.请放心地把问题告诉我们，因为您的问题将会被保密。您可以放心地把烦恼与我们分享因为我们希望能够成为你教育路上的伙伴～请详尽地描述，因为那有助于我们更快地整理出适合您的方案。

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Phone Number* This field is required.Please leave your contact below as we are going to review your child development performance and send you the result and advice if any. Thank you.请留下您的联络方式因为我们会把依据您孩子发展能力的检测结果和意见发送给您。

Area Code

Phone Number