Questionnaires and Checklists

Questionnaires and Checklists from parents, health, allied health and education professionals can be helpful in identifying symptoms affecting a child's development. These questionnaires/checklists are often used in conjunction with formal evaluation and treatment plans.

Pediatric Neuropsychology Initial Consultation/History Checklist (PDF)
Pediatric ABC Autism Behavior Checklist- Early Identification:
Pediatric Autism and Related Disorders Behavior Checklist (ages 18-48 months) (PDF)
Pediatric Neuropsychology Attention Deficit Disorders/ Learning Disorders Parent-Teacher Checklist (PDF)
Preschool Behavior Checklist (PDF)
Symptom Checklist for Learning Difficulties (PDF)
Pediatric Sleep Questionnaire (PDF)
Nutrition Questionnaire (PDF)
Brains that are Ready to Read/Dyslexia Checklist (PDF)

Pediatric Neuropsychology Diagnostic Center
Century Medical Park
16001 S. 108th Ave., Ste. B
Orland Park, IL 60467
708-403-9000
ndcbrain@gmail.com
www.ndcbrain.com

"Share your knowledge. It is a way to achieve immortality."
- Dalai Lama XIV