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Early words Tick the words your child says on his or her own (without copying anyone). The words don’t need to be completely correct as long as you know what your child means. People Mummy

Grandma

Baby

Daddy

Grandad

Me

Any other family members’ names ___________________________ Any friends’ names _____________________ Any pets’ names

_____________________

Any TV characters’ names _____________________ Food Drink Dinner

Water Pop

Banana Bread

Yoghurt Toast

Juice

Biscuit

Any other drink or food _______________________ Body Parts Eyes Nose

Mouth Hair

Hands Feet

Toes Tummy

Any other part of the body _______________________ Clothes Coat Top

Trousers Nappy

Pants/Knickers Shoes

Socks Jumper

Any other clothes/ footwear ________________________ Toys Ball

Teddy

Duck

Car

Doll

Any other toy/ plaything _________________________

Book


Animals Cat

Bird

Cow

Horse

Dog

Any other animal ____________________________ Home Telly Phone/Mobile Remote

Bed Bath Chair

Pram/Buggy Dummy Brush

Spoon Bottle Cup

Anything else around the house ___________________________ Actions Kick Throw Eat

Sleep Want Go

Sit Stand Walk

Run Look Cuddle

Any other action words _______________________________ Other Yes No

Ta/Thank you Please

Bye Bye/ Ta Ta Hello/ Hiya

More Gone

Again

Any others __________________________________ Does your child say two words together? E.g.

Often

More juice Grandma gone Go car Sometimes

Want mummy Kick ball Occasionally

Not yet

(Please circle)

Can you give us any examples of your own? ________________________ How do you feel about your child’s speech or language development? Happy

Not sure

A bit worried

(Please circle)

http://www.kirklees.nhs.uk/fileadmin/documents/publications/questionnaire  
http://www.kirklees.nhs.uk/fileadmin/documents/publications/questionnaire  

http://www.kirklees.nhs.uk/fileadmin/documents/publications/questionnaire.doc

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