Describe how to fill out form

1. Ages & Stages Questionnaires
Cheryl Bulat

2. Basic Instructions
• 1. Did you message me with your age of the
child you will be observing and receive the
Ages & Stages for that age?
• 2. You will have to print off the document and
fill it out and then scan it and send back or put
it in my mailbox or send it through the mail.
• 3. Make sure to include a page where you
have written 3 next goals and activities that
you would do with your child.

3. Scoring Sections

4. Summary Page

5. Summary Page

6. Summary Page

7. Next Developmental Activities
• For the last part of this assignment you need
to add an extra page and pick 3 things that
your child cannot completely do and figure
out an activity that you could do with the child
to help them complete that goal. Look at the
rubrics connected to this assignment.

8. Need Help
• Questions, call or email me!