Developmental History Checklist™ for Children

Use the Developmental History Checklist for Children as an Intake Form

This checklist asks questions about a child's developmental history and current life.

Features and benefits

• 136-item survey
• Designed to be completed by parents and guardians of children ages 5–12 years.
• Helps clinicians learn more about a child’s developmental history.
• Written at a seventh-grade reading level.
• Intended as a review of traditional developmental topics such as personal and family background, family history, developmental history, medical history and health status, educational history, current behavior and more.
• It is useful as an intake form or as a way to gather information for documentation.