Speech & Language Therapy Questionnaire| Connections Therapy Center

Child's Name *

Parent's Name *

Parent's Email *

Can you, and others that interact with your child, understand what your child says a majority of the time?

Does your child communicate to have his/her wants and needs met? (Could be with words, gestures, AAC, or sign)

Does your child understand what you and others say to him/her?

Does your child stutter, have trouble with feeding or social relationships?

* Human Verification:

Speech & Language Therapy Questionnaire