Copy of 0-3 Months Developmental Screener Question Title * 1. Your Name, Your Child's Name, Child's Date of Birth, Name of Daycare OK Question Title * 2. Type your name if you consent to Thrive Speech Therapy screening your child OK Question Title * 3. Your Phone Number and e-mail address OK Question Title * 4. Your Child's Gender Female Male Rather Not Say OK Question Title * 5. Does your child startle to loud sounds? Yes No OK Question Title * 6. Does your child quiet down or smile and seem to recognize familiar voices when spoken to? Yes No OK Question Title * 7. Does your child decrease or increase sucking behavior in response to sound? Yes No OK Question Title * 8. Does your child make pleasure sounds (cooing/gooing)? Yes No OK Question Title * 9. Does your child cry differently for different needs? Yes No OK Question Title * 10. Does your child smile when they see a familiar person? Yes No OK SUBMIT