1. Does your child try to look at you and maintain eye contact for a few seconds?
2. Does your child smile when approached by you?
3. Does your child laugh in response to play?
4. Does your child respond to your attempts to calm them when they cry?
5. Does your child try to manipulate and explore objects?
6. Does your child play peek a boo?
7. Does your child clap when prompted?
8. Does your child spontaneously lift their arms to you?
9. Does your child spontaneously extend their toys to you or to others?
10. Does your child show clear response to facial expressions?
11. Does your child try to imitate yours or any other adult’s actions?
12. Do you speak with your child throughout the day, describing what you are doing and seen?
13. Does your family set time aside to play together with your child? Cuddling, Tickling, Peekaboo?

Please select an answer for each question