Home Communication Questionnaire

Dear Parent/Caregiver:

This questionnaire will help us learn about your child’s communication skills. The questionnaire includes communication behaviors for children age birth to 2 ½ years. There are two parts. The questions in Part 1 ask about who your child spends time with and how he or she spends the time. Questions in Part 2 ask about your child’s communication and play behaviors.

Complete the questionnaire. Check all behaviors that your child has previously exhibited or currently exhibits.

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