Developmental Milestone Checklist (Parent / Caregiver Version)Name: Milestone Quick CheckAges: 2–5 Child's First Name *Child's Last Name *Age *Date of Birth *School Attends *Parent InformationFirst Name *Last Name *Phone *Email Address *Examiner *Instructions: Please answer YES or NO for each skill based on what your child can do right now.Q1. Speaks in short sentences by age 3 *YesNoQ2. Can follow simple 2-step directions by age 3 *YesNoQ3. Plays pretend or make-believe games by age 4 *YesNoQ4. Uses a spoon and cup without much spilling by age 3 *YesNoQ5. Names colors or shapes by age 4 *YesNoQ6. Can jump with both feet by age 4 *YesNoQ7. Enjoys playing with other children by age 4 *YesNoQ8. Tells stories or talks about past events by age 5 *YesNoQ9. Can dress and undress with some help by age 5 *YesNoQ10. Recognizes own name in print by age 5 *YesNoTotal ScoreSubmit
