Childs Full Name
Your Child's Independence
Getting dressed alone or need assistance
Feed them Self or need assistance
Does your child bathe themselves?
Does your child clean up after them selves?
Personal notes on your child's Independence
With Some Assistance
Does your child help prepare meals
Does your child follow 2 & 3 step directions
Does your child discuss stories by looking at images
Can you child identify number, colors, shapes in her every day environment
Personal notes on your child needing some assistance
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