11. Did your on their toys, etc? ‘mouth’ 12. At what age was your toilet trained? 13. Which of these words would describe your child as an infant: (tick as appropriate) Alert Quiet Good sleep patterns Irregular sleep patterns Cried at first/fussy/irritable Non-demanding being held Resisted being held Medical and health history: Yes No 1. Does your child have a diagnosis to describe some of their difficulties? If so, what? 2. Does your child wear glasses or have any visual problems 3. Does your child have hearing difficulties or has suffered with lots of ear infections? 4. Has your child had any significant childhood illnesses? If so, what? 5. Is your child on any medication? If so, what? 6. Has your had any surgery or tests carried out and if so, what? 7. Is your child being seen by a Paediatrician; and if so whom? School staff please complete the questions on this page – Educational history:
11. Did your ‘mouth’ on their toys, etc? 12. At what age was your toilet trained? 13. Which of these words would describe your child as an infant: (tick as appropriate) Alert Quiet Good sleep patterns Irregular sleep patterns Cried at first/fussy/irritable Non-demanding being held Resisted being held Medical and health history: Yes No 1. Does your child have a diagnosis to describe some of their difficulties? If so, what? 2. Does your child wear glasses or have any visual problems 3. Does your child have hearing difficulties or has suffered with lots of ear infections? 4. Has your child had any significant childhood illnesses? If so, what? 5. Is your child on any medication? If so, what? 6. Has your had any surgery or tests carried out and if so, what? 7. Is your child being seen by a Paediatrician; and if so whom? School staff – please complete the questions on this page Educational history:
Devon_OT_School_age_children_form.docx