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Development
Name of the Child
*
Name of the Father / Mother
*
Contact Number
*
Date of Birth
*
Gender of the child & previous diagnosis by Psychiatrist or Psychologist
*
1. “crows”; laughs* (Vocalizes inarticulately (other than crying or fretting). Spontaneously gurgles or coos. Laughs spontaneously or when stimulated)
Yes
Partially
No
0 To 1 Year
2. Balances Head
Yes
Partially
No
3. Grasps object within reach
Yes
Partially
No
4. Reaches for familiar persons
Yes
Partially
No
5. Rolls over (unassisted)
Yes
Partially
No
6. Reaches for nearby objects* (Attempts to obtain objects nearby but beyond reach)
Yes
Partially
No
7. Occupies self unattended* (Plays with rattle or simple objects, for quarter hour or longer without need of attention)
Yes
Partially
No
8. Sits unsupported
Yes
Partially
No
9. Pulls self upright
Yes
Partially
No
10. “Talks”; imitates sounds
Yes
Partially
No
11. Drinks from cup or glass assisted
Yes
Partially
No
12. Moves about on floor (creeping, crawling)
Yes
Partially
No
13. Grasps with thumb and finger
Yes
Partially
No
14. Demands personal attention* (Indicates desire to be ‘talked’ to or beyond mere handling or care for physical needs)
Yes
Partially
No
15. Stands alone.
Yes
Partially
No
16. Does not drool* (Has established control of saliva so that mouth or chin does not require wiping except when eating)
Yes
Partially
No
17. Follows simple instructions* (Comes when called; points to particular objects in pictures when asked; in general cooperates on verbal request in very simple activities)
Yes
Partially
No
18. Walks about room unattended
Yes
Partially
No
1 to 2 Years
19. Marks with pencil or crayon
Yes
Partially
No
20. Masticates (chews) solid or semi-solid food
Yes
Partially
No
21. Removes shoes or sandals, pulls off socks
Yes
Partially
No
22. Transfers objects* (Pors from one vessel to another without messing; removes, transfers, replaces objects in somewhat purposeful manner).
Yes
Partially
No
23. Overcomes simple obstacles* (Open closed doors; climbs up on chair; uses stool for reaching; removing simple impediments)
Yes
Partially
No
24. Fetches or carries familiar objects
Yes
Partially
No
25. Drinks from cup or glass unassisted
Yes
Partially
No
26. Walks or uses a go-cart for walking* (“go – cart” walks by pushing a cart on wheels)
Yes
Partially
No
27. Plays with other children* (Activity is individual rather than cooperative, when he “gets along” with other children)
Yes
Partially
No
28. Eats with own hands* (eats things like biscuit or bread holding in his own hand or uses spoon to eat from bowl, cup, plate)
Yes
Partially
No
29. Goes about house or yard
Yes
Partially
No
30. Discriminates edible substances from non-edibles
Yes
Partially
No
31. Uses names of familiar objects
Yes
Partially
No
32. Walks up stairs unassisted
Yes
Partially
No
33. Unwraps sweets, chocolates
Yes
Partially
No
34. Talks in short sentences
Yes
Partially
No
35. Signals to go to toilet* (By actions or speech expresses to go to urinate or ease himself. May be assisted at same)
Yes
Partially
No
2 to 3 Years
36. Initiates own play activities* (Occupies self at play such as drawing or colouring with pencil, looking at books or pictures)
Yes
Partially
No
37. Removes shirt or frock if unbuttoned
Yes
Partially
No
38. Eats with spoon
Yes
Partially
No
39. Gets drink (water) unassisted
Yes
Partially
No
40. Dries own hands
Yes
Partially
No
41. Avoids simple hazards* (Comes in out of rain. Shows some caution regarding strangers; is careful as regards falling on stairs)
Yes
Partially
No
42. Puts on shirt or frock unassisted (need not button)
Yes
Partially
No
43. Can do paper folding
Yes
Partially
No
44. Relates experiences* (Gives simple accounts of experiences or tells stories)
Yes
Partially
No
45. Walks down stairs, one step at a time
Yes
Partially
No
3 to 4 Years
46. Plays co-operatively at kindergarten level* (Participates in coordinated group activity as Kindergarten circle games, cooking group play)
Yes
Partially
No
47. Buttons shirt or frock
Yes
Partially
No
48. Helps at little household tasks
Yes
Partially
No
49. “Performs” for others* (Entertains others, as reciting, singing, dancing, something more than being “cute”)
Yes
Partially
No
50. Washes hands unaided
Yes
Partially
No
51. Cares for self at toilet
Yes
Partially
No
4 to 5 Years
52. Washes face unassisted
Yes
Partially
No
53. Goes about neighbourhood unattended
Yes
Partially
No
54. Dresses self except for tying
Yes
Partially
No
55. Uses pencils or crayon for drawing* (Draws forms like man, house, tree, animal etc)
Yes
Partially
No
56. Plays competitive exercise games* (Engages in tag, hide and seek, jumping rope, tops skipping, marbles)
Yes
Partially
No
57. Uses hoops, flies kites, rides tricycles* (Hoops i.e. ring pushed by hand or stick, cycle tyres)
Yes
Partially
No
5 to 6 Years
58. Prints (writes) simple words
Yes
Partially
No
59. Plays simple table games* (Games with others requiring taking turns, observing rues without undue dissension; caroms, drafts snakes and ladder, ludo)
Yes
Partially
No
60. Is trusted with money* (Is responsible with small sums of money when sent to make payments or explicit purchases)
Yes
Partially
No
61. Goes to school unattended
Yes
Partially
No
62. Mixes rice “properly” unassisted
Yes
Partially
No
6 to 7 Years
63. Uses pencil for writing* (Writes (not print+) legibly with pencil a dozen or more simple words with correct spelling)
Yes
Partially
No
64. Bathes self assisted
Yes
Partially
No
65. Goes to bed unassisted* (Performs bedtime operations without help; goes to room alone, undresses, turns out light)
Yes
Partially
No
66. Tells time to quarter hour
Yes
Partially
No
7 to 8 Years
67. Helps himself during meals* (After first serving of meals, helps himself to more according to need)
Yes
Partially
No
68. Refuses to believe in magic and fairy tales* ((Rejects intellectually action done by magic. Also fairies and personification of objects and events)
Yes
Partially
No
69. Participates in pre-adolescent play* ((Boys: games not requiring definite skill and with only loose rules such as unorganized hockey, football khokho, follow – the - leader, takes hikes or bicycles rides. Girsl: Engages in dramatic play symbolizing domestic or social situations such as playing house, school, doctor – nurse. NOTE: Sex differentiation in play at this stage and shift in girls play to more sedentary type. However credit item regardless of sex if this differentiation has not yet been established)
Yes
Partially
No
70. Combs or brushes hair
Yes
Partially
No
71. Uses tools or utensils.* (Makes some practical use of hammer, screw driver, house hold, sewing and garden tools)
Yes
Partially
No
8 to 9 Years
72. Does routine household tasks.* (Helps effectively at simple tasks for which some continuous responsibility is assumed, dusting, arranging, cleaning, washing – dishes, making bed)
Yes
Partially
No
73. Reads on own initiative* (reads comic strips, movie titles, simple stories, notes simple instructions, elementary news items; for own entertainment or information)
Yes
Partially
No
74. Bathes self unaided
Yes
Partially
No
75. Cares for self at table (meals)
Yes
Partially
No
9 to 10 Years
76. Makes minor purchases. * (Buys useful articles, exercises some choice or discretion, in so doing, and is responsible for safety of articles, money and correct change)
Yes
Partially
No
77. Goes about home town freely
Yes
Partially
No
78. Writes occasional short letters to friends
Yes
Partially
No
10 to 11 Years
79. Makes independent choice of shops.* (Able to decide for self which shop to go for purchasing different articles)
Yes
Partially
No
80. Does small remunerative work; makes articles.* (Makes articles for self use, e.g. making simple garments, stitching, buttons, preparing tea for self, doing small repairs, taking care of own cabinet, table and room or performs occasional work on own initiative such as odd jobs house work, helping in care of children, sewing, selling magazines, caring newspapers for which some money is paid)
Yes
Partially
No
81. Answers ads; writes letter for information.* (Writes letters to get information regarding some books, magazines or toys)
Yes
Partially
No
82. Does simple creative work.* (Makes useful articles; cooks, bakes, raises pets, writes simple stories or poems; produces simple drawings or paintings)
Yes
Partially
No
11 to 12 Years
83. Is left to care for self or others.* (is sometimes left alone and is successful in looking after own immediate needs or those of others who may be left in his care)
Yes
Partially
No
84. Enjoys reading books, newspapers, magazines
Yes
Partially
No
85. Plays difficult games* (Participates in skilled games and sports as card games, Basket ball, tennis, hockey, badminton, understanding rules and methods of scoring)
Yes
Partially
No
12 to 15 Years
86. Exercises complete care of dress.* (Includes washing and drying hair, care of nails, proper selection of clothing according to occasion and weather)
Yes
Partially
No
87. Buys own clothing accessories* (Selects and purchases minor articles of personal clothing with regard for appropriateness, cost and fit, such as ribbons, underwear, linen, shoes etc)
Yes
Partially
No
88. Engages in adolescent group activities.* (Is an active member of a cooperative group, athletic team, club, social or literary organization. Plans or participates in picnic trips, outdoor sports, etc.)
Yes
Partially
No
89. Performs responsible routine chores.* (Such as assisting in house – work, caring for garden cleaning car, washing window, waiting at table, bringing water.)
Yes
Partially
No
3 Months - 1. Birth cry present (Speech item)
Yes
Partially
No
3 Months - 2. Equal bilateral movements
Yes
Partially
No
3 Months - 3. Responds to bell
Yes
Partially
No
3 Months - 4. Vocalises sound (Speech item)
Yes
Partially
No
3 Months - 5. Smiles spontaneously
Yes
Partially
No
3 Months - 6. Eyes follow moving object
Yes
Partially
No
3 Months - 7. Head steady
Yes
Partially
No
6 Months - 8. Reaches for objects
Yes
Partially
No
6 Months - 9. Laughs aloud (Speech item)
Yes
Partially
No
6 Months - 10. Recognises mother
Yes
Partially
No
6 Months - 11. Vocalises for pleasure / babbles (Speech item)
Yes
Partially
No
6 Months - 12. Carries objects to mouth
Yes
Partially
No
6 Months - 13. Rolls over
Yes
Partially
No
9 Months - 14. Imitates speech sounds (Speech item)
Yes
Partially
No
9 Months - 15. Sits by self
Yes
Partially
No
9 Months - 16. Thumb finger grasp
Yes
Partially
No
9 Months - 17. Shows curiosity
Yes
Partially
No
1 Year - 18. Says 3 words, ‘dada’, ‘mama’ etc (Speech item)
Yes
Partially
No
1 Year - 19. Stands alone well
Yes
Partially
No
1 Year - 20. Follows simple instructions (Speech item)
Yes
Partially
No
1 Year - 21. Cooperates for dressing
Yes
Partially
No
1 Year 6 Months- 22. Many intelligible words (Speech item)
Yes
Partially
No
1 Year 6 Months - 23. Walks, runs well
Yes
Partially
No
1 Year 6 Months - 24. Indicates wants
Yes
Partially
No
1 Year 6 Months - 25. Scribbles spontaneously
Yes
Partially
No
2 Years - 26. Says sentences of 2/3 words (Speech item)
Yes
Partially
No
2 Years - 27. Points out objects in pictures
Yes
Partially
No
2 Years - 28. Shows body parts
Yes
Partially
No
2 Years - 29. Participates in play
Yes
Partially
No
3 Years - 30. Copies 0
Yes
Partially
No
3 Years - 31. Relates experiences (Speech item)
Yes
Partially
No
3 Years - 32. Knows names, uses of common objects
Yes
Partially
No
3 Years - 33. Begins to ask ‘why’?
Yes
Partially
No
3 Years - 34. Takes food by self
Yes
Partially
No
3 Years - 35. Toilet control present
Yes
Partially
No
4 Years - 36. Buttons up
Yes
Partially
No
4 Years - 37. Comprehends ‘hunger’, ‘cold’
Yes
Partially
No
4 Years - 38. Plays cooperatively with children
Yes
Partially
No
4 Years - 39. Repeats 3 digits (Speech item)
Yes
Partially
No
4 Years - 40. Tells stories (Speech item)
Yes
Partially
No
5 Years - 41. Defines words (Speech item)
Yes
Partially
No
5 Years - 42. Makes simple drawings
Yes
Partially
No
5 Years - 43. Dresses with no supervision
Yes
Partially
No
5 Years - 44. Describes actions in pictures (Speech item)
Yes
Partially
No
5 Years - 45. Gives sensible answers to questions (Speech item)
Yes
Partially
No
5 Years - 46. Goes about neighbourhood
Yes
Partially
No
6 Years - 47. Can name primary colours
Yes
Partially
No
6 Years - 48. Plays games governed by rules
Yes
Partially
No
6 Years - 49. Writes simple words (Speech item)
Yes
Partially
No
6 Years - 50. Gains admission to school
Yes
Partially
No
6 Years - 51. Enjoys constructive play
Yes
Partially
No
7 Years - 52. Adapts to home school
Yes
Partially
No
7 Years - 53. Tells differences of objects
Yes
Partially
No
7 Years - 54. Spells, reads, writes simple words (Speech item)
Yes
Partially
No
7 Years - 55. Enjoys group play
Yes
Partially
No
7 Years - 56. Knows comparative value of coins
Yes
Partially
No
8 Years - 57. Combs hair by self
Yes
Partially
No
8 Years - 58. Makes small purchases
Yes
Partially
No
8 Years - 59. Competition in school / play
Yes
Partially
No
8 Years - 60. Tells time
Yes
Partially
No
9 Years - 61. Tells day, month year (Speech item)
Yes
Partially
No
9 Years - 62. Reads on own initiative (Speech item)
Yes
Partially
No
9 Years - 63. Recognised property rights
Yes
Partially
No
9 Years - 64. Favourite of fairy tales (Speech item)
Yes
Partially
No
9 Years - 65. Muscle coordination games (marbles)
Yes
Partially
No
9 Years - 66. Bathes self unaided
Yes
Partially
No
10 Years - 67. Cooperates keenly with companions
Yes
Partially
No
10 Years - 68. Has various hobbies, collections
Yes
Partially
No
10 Years - 69. Goes about town freely
Yes
Partially
No
10 Years - 70. Sex differences in play become marked
Yes
Partially
No
10 Years - 71. Can stay away from home (camps)
Yes
Partially
No
11 Years - 72. Writes occasional short letters (Speech item)
Yes
Partially
No
11 Years - 73. Comprehends social situations
Yes
Partially
No
11 Years - 74. Physical feats liked
Yes
Partially
No
11 Years - 75. Able to discuss problems (Speech item)
Yes
Partially
No
12 Years - 76. Enjoys books, newspapers, magazines (Speech item)
Yes
Partially
No
12 Years - 77. More independent in spending
Yes
Partially
No
12 Years - 78. Capable of self criticism
Yes
Partially
No
13 Years - 79. Shows foresight, planning, judgement
Yes
Partially
No
13 Years - 80. Learns from experience
Yes
Partially
No
13 Years - 81. Plays difficult games
Yes
Partially
No
13 Years - 82. Interested in dressing up
Yes
Partially
No
13 Years - 83. Understands abstract ideas (justice)
Yes
Partially
No
15+ Years - 84. Makes sensible plans for future (job)
Yes
Partially
No
15+ Years - 85. Follows current events (Speech item)
Yes
Partially
No
15+ Years - 86. Buys own clothing
Yes
Partially
No
15+ Years - 87. Systematises own work
Yes
Partially
No
15+ Years - 88. Purchases for others
Yes
Partially
No
VSMS - Social Age
DST - Developmental Age
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