Risk Factors Protective Factors Hearing or vision impaired No physical/mental health issues History of seizures Received care for identified mental health issues Medical diagnosis requiring life sustaining measure Receives care for identified medical issues Medical diagnosis requiring ongoing care Up to date on immunizations Medical issues (asthma, broken arm, severe allergy) Mental health diagnosis ongoing medications Physical disability Requires psychotropic meds to function No Risk Factors Child Development/Education (check all that apply) Risk Factors Protective Factors Developmentally delayed Able to dress/bath self Difficulty communicating needs Child receiving services for delay Educationally delayed/IEP not utilized Developmentally on track Is not potty trained or unable to use toilet Educationally on track Lack of muscle control, motor skills Good social skills/peer relations Limited verbal ability or non-verbal Secure attachment to adult caregiver Non-mobile or limited mobility Not attached to adult caregiver Poor social skills/peer relations Requires assistance for dressing/bathing No risk factors Child Behaviors (check all that apply)
Risk Factors Hearing or vision impaired History of seizures Medical diagnosis requiring life sustaining measure Medical diagnosis requiring ongoing care Medical issues (asthma, broken arm, severe allergy) Mental health diagnosis ongoing medications Physical disability Requires psychotropic meds to function No Risk Factors Protective Factors No physical/mental health issues Received care for identified mental health issues Receives care for identified medical issues Up to date on immunizations Child Development/Education (check all that apply) Risk Factors Developmentally delayed Difficulty communicating needs Educationally delayed/IEP not utilized Is not potty trained or unable to use toilet Lack of muscle control, motor skills Limited verbal ability or non-verbal Non-mobile or limited mobility Not attached to adult caregiver Poor social skills/peer relations Requires assistance for dressing/bathing No risk factors Protective Factors Able to dress/bath self Child receiving services for delay Developmentally on track Educationally on track Good social skills/peer relations Secure attachment to adult caregiver Child Behaviors (check all that apply)
ADT%20CPS%20Assessment%20for%20Abuse%20or%20Neglect.docx