Early Intervention Centre (EIC) Questions Early Interventions Centre Questions Parent DetailsFirst NameLast NameEmailPhone/Mobile PreviousNextIs your child struggling to meet milestones compared to children of the same age? Yes NoMy child is toilet trained Yes NoIs your child able to follow simple instructions e.g. “fetch your shoes”? Yes NoDoes your child display any sensory difficulties e.g. avoids getting hands messy, oblivious to bruises, seems clumsy, seems overly active? Yes NoDoes your child scream or lash out when they can’t get their own way? Yes NoMy child is non-verbal Yes NoMy child makes his/her needs known by one or two words Yes NoMy child can formulate short sentences Yes No Previous Submit Form Back to Survey Questions
