Child Health Questionnaire Checklist
4.8/5 with 90 votes
Table of Contents
What's included
Save all 103 symptoms, or select only the ones you need.
All 103 symptoms included
- Behavior and temperament
- Prefers to play alone
- Better with one on one interaction
- Does not smile as often
- Seems depressed
- Is anxious
- Hyperactive or restless
- Unable to disregard unimportant stimuli
- Impulsive
- Disruptive
- Easily distracted
- Forgetful
- Physically abusive
- Verbally abusive
- Frequent tantrums
- Mood swings for no reason
- Short attention span
- Uncomfortable in crowds
- Becomes easily annoyed
- Bothered by loud noises
- Bothered by bright lights
- Shows little remorse
- Emotionally unstable
- Little interest or pleasure in doing things
- Jekyll-and-Hyde type of personality
- Autistic tendencies (if applicable)
- Shows little to no eye contact
- Speech is literal
- Content and happier to be alone
- Seems to be in “own world”
- Lacks displays of affection
- Lacks response from others
- Does not point out objects of interest to others
- Indifferent to surroundings
- Lacks interest in toys
- Marked reduction in activity level
- Increase in activity level
- Over-sensitive to pain
- Under-sensitive to pain
- Undeveloped motor skills
- Does not understand consequences
- Lines things up
- Loves patterns
- Color coordinated objects
- Inappropriate attachment to objects
- Displays daily obsessive routines
- Medication side effects
- Behavior changes
- Stomach upset/aches
- Mouth burns
- Leg / calf cramps
- Drowsiness
- Confusion
- Clumsiness
- Nausea
- Unresponsive at times
- Mental confusion
- Lethargic
- Tired or tense a lot
- Learning and cognition
- IQ lower than average
- Unable to process new information
- Unable to retain new information
- Has trouble performing daily tasks
- Needs constant reminders
- Does not carry on full conversation
- Repeats sentences
- Talks to himself
- Delay in academic achievement
- Lacks common sense
- Is a slow starter
- Moves slowly
- Speaks slowly
- Other questions of interest
- Eyes are “glazed over”
- Breaks out in rashes/hives
- Has eczema
- Fidgety or restless
- Is vomiting a problem
- Has recurrent colds
- Eating or not eating affects behavior
- Facial color is pale
- Dark circles under eyes
- Headaches
- Stomach viruses often
- Wets the bed or self
- Constipated often
- Diarrhea often
- Craves certain foods
- Has ear infections
- Poor appetite
- Gets car sick
- Odor or fumes make them sick
- Loves the smell of gas or paint
- Trouble going to sleep
- Would steal chocolate
- Has food cravings like milk, peanut butter, eggs
- Asthma
- Tonsillitis, strep throat
- Very ticklish
- Clears throat a lot
- Walks on tip toes
- Has dry skin
Download or Print this Child Health Questionnaire Checklist
Get a printable version of this checklist in your preferred format: PDF, Word, Excel, or print directly from your browser.
Presented by:
Laura Cooper Peterson
Stats
Views
90
Views: 90
Uses
2
Uses: 2
Tasks
103
Tasks: 103
Who it's for
This Child Health Questionnaire Checklist is for anyone who wants a simple, practical way to get things done without missing steps.
- Avoid forgetting - keep all your Child Health Questionnaire essentials in one place (external memory)
- Save time - start from a proven Child Health Questionnaire structure instead of a blank page
- Stay on track - track progress, come back later, and keep momentum
- Coordinate with others - share the list and divide responsibilities
- Learn the process - follow the steps in a sensible order, even if it's your first time
How to use it
How to use this Child Health Questionnaire Checklist
- Save Child Health Questionnaire Checklist to your free Checklist account so your progress is saved and synced across devices.
- Customize it in the app: remove anything that does not apply, then add your own details for Child Health Questionnaire (dates, sizes, addresses, notes).
- If others are involved, invite them to collaborate and divide responsibilities.
- Work through the list: check items off as you go, and set reminders for time-sensitive steps.
Rate this Checklist
5 stars
Scores 4.80 with 90 votes