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Milestone Check List

Online Screening for 3 Years

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Step 1 of 3

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Age Selected from Online Screening

Questions:

Yes

No

Speaks 3-word utterances*

Yes

No

Has a 400 word vocabulary*

Yes

No

Multiple ear infections*

Yes

No

Is making friends*

Yes

No

Lateral or frontal lisp*

Yes

No

Produces final sounds of words*

Yes

No

Able to catch a ball*

Yes

No

Able to stand on 1 foot for at least 3 seconds*

Yes

No

Able to fasten large buttons or unzip jacket*

Yes

No

Able to put on loose pants or jacket*

Yes

No

Able to drink from an open cup held by caregiver*

Yes

No

Able to eat with a fork*

Yes

No

Tolerates grooming tasks such as brushing teeth and hair, fingernail trimming, etc.*

Yes

No

Interacts with other children during play*

Yes

No

Practices in pretend play*

Yes

No

Following simple routines and following 2-step directions*

Yes

No

Able to turn one page at a time in a book*

Yes

No

Able to draw a circle*

Yes

No

Able to snip paper or cut a straight line*

Yes

No

Screening Result

Speech Therapy Result

Speech Therapy Result

Physical Therapy Result

Physical Therapy Result

Occupational Therapy Result

Occupational Therapy Result

Please note that results from this form may differ from those obtained during an in-person screening.

Would you like to schedule an in-person evaluation at one of our neighborhood Therapy Centers?

Yes

No

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Address*

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Phone*

Email*

Where did you hear about MetroEHS Pediatric Therapy*

Message

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Contact

Email Info@MetroEHS.com
Phone 313-278-4601
Fax 313-347-1652
Main Office 44670 Ann Arbor Road, Suite 130, Plymouth, MI 48170

Locations

Bloomfield Hills
Brownstown
Clarkston
Davison
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Dearborn Heights
Detroit
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Rochester Hills
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Services

ABA Therapy
Speech Therapy
Occupational Therapy
Feeding Therapy
Physical Therapy
Mental Health Services
Lactation Services
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Free Screening Events

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