Speech and Language Development Screener (7-12 Months)
The following questions are based on the milestone guidelines set by the National Institute on Deafness and Other Communication Disorders. Answering "no" to a question does not mean that your child has a speech or language delay or disorder, answering "no" to many or most of the questions may mean that further evaluation or a free in-person screener at Spark Therapies may be recommended to ensure your child is developing as they should be.

Please answer Yes or No to the following questions
Email address *
Your Name *
Your answer
What are voice, speech, and language?

Voice, speech, and language are the tools we use to communicate with each other.

Voice is the sound we make as air from our lungs is pushed between vocal folds in our larynx, causing them to vibrate.

Speech is talking, which is one way to express language. It involves the precisely coordinated muscle actions of the tongue, lips, jaw, and vocal tract to produce the recognizable sounds that make up language.

Language is a set of shared rules that allow people to express their ideas in a meaningful way. Language may be expressed verbally or by writing, signing, or making other gestures, such as eye blinking or mouth movements.
Receptive Language Section
Receptive Language is the ability to understand words and language.
Enjoys playing peek-a-boo and pat-a-cake *
Turns and looks in the direction of sounds *
Listens when spoken to *
Understands words for common items such as “cup,” “shoe,” or “juice” *
Responds to requests (“Come here” or "Look!") *
Expressive Language Section
Expressive Language is how a person communicates their wants and needs.
Babbles using long and short groups of sounds (“tata", "upup", "bibibi”)
Babbles to get and keep attention
Communicates using gestures such as waving or holding up arms
Imitates different speech sounds
Has one or two words (“Hi,” “dog,” “Dada,” or “Mama”) by first birthday
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Spark Therapies. Report Abuse