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Special Needs Assessment Quiz
Please complete the following questionnaire concerning your child development. We will contact you on the following working day once we received your application.
Academic
Reading
Emotion
Focus
Profile
Does your child currently taking an education?
Yes
No
Type of school your child attends.
Formal School
Special School
Does your child able to follow this formal education?
Yes
Moderately
No
Does your child assisted by a shadow teacher?
Yes
No
Does your child has speech ability?
Yes
Little
No
Does your child able to say a regular sentence?
Yes
Little
No
How often does your child mispronounce (or used to) only certain words (e.g., says amunul for animal, poothtaste for toothpaste)?
Never
Rarely
Sometimes
Frequently
Always
Have difficulty reading unfamiliar words or guess at them?
Never
Rarely
Sometimes
Frequently
Always
How does your child's socialization with his friends?
Yes
Little
No
Does your child able to control his emotions?
Yes
Little
No
What is the state of your child's focus ability?
Good
Less
None
Does your child can perform two-ways communication?
Yes
Little
No
Does your child able to understand and listen to instructions in general without help?
Yes
Little
No
Child profile
Child Name
Gender
Male
Female
Age
Select age...
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21+
You (adult profile)
Your Name
Your Email
Your Phone
Relationship with the child
Parent
Guardian/adoptive parents
Teacher
I agree to the terms of service, privacy policy and to be contacted.
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