This rating describes the child’s ability to use all senses including vision, hearing, smell, touch, taste, and kinesthetics.

0 | The child’s sensory functioning appears normal. There is no reason to believe that the child has any problems with sensory functioning.

1 | The child has mild impairment on a single sense (e.g. mild hearing deficits, correctable vision problems).

2 | The child has moderate impairment on a single sense or mild impairment on multiple senses (e.g. difficulties with sensory integration, diagnosed need for occupational therapy).

3 | The child has significant impairment on one or more senses (e.g. profound hearing or vision loss).

N/A | Not applicable

This rating describes the child’s ability to communicate through any medium including all spontaneous vocalizations and articulations.

0 | Child’s receptive and expressive communication appears developmentally appropriate. There is no reason to believe that the child has any problems communicating.

1 | Child’s receptive abilities are intact, but child has limited expressive capabilities (e.g. if the child is an infant, he or she engages in limited vocalizations; if older than 24 months, he or she can understand verbal communication, but others have unusual difficulty understanding child).

2 | Child has limited receptive and expressive capabilities.

3 | Child is unable to communicate in any way, including pointing or grunting.

N/A | Not applicable

Symptoms of failure to thrive focus on normal physical development such as growth and weight gain.

0 | The child does not appear to have any problems with regard to weight gain or development. There is no evidence of failure to thrive.

1 | The child has mild delays in physical development (e.g. is below the 25th percentile in terms of height or weight).

2 | The child has significant delays in physical development that could be described as failure to thrive (e.g. is below the 10th percentile in terms of height or weight).

3 | The child has severe problems with physical development that puts his/her life at risk (e.g. is at or beneath the 1st percentile in height or weight).

N/A | Not applicable

This category refers to all dimensions of eating and/or elimination. Pica would be rated here.

0 | Child does not appear to have any problems with feeding or elimination.

1 | Child has mild problems with feeding and/or elimination (e.g. picky eating).

2 | Child has moderate to severe problems with feeding and/or elimination. Problems are interfering with functioning in at least one area.

3 | Child has profound problems with feeding and/or elimination.

N/A | Not applicable

This dimension describes the child’s weight as compared to normal development.

0 | Child is within normal range for weight and has been since birth. A child with a birth weight of 2500 grams (5.5 pounds) or greater would be rated here.

1 | Child was born under weight but is now within normal range or child is slightly beneath normal range. A child with a birth weight of between 1500 grams (3.3 pounds) and 2499 grams would be rated here.

2 | Child is considerably under weight to the point of presenting a development risk to the child. A child with a birth weight of 1000 grams (2.2 pounds) to 1499 grams would be rated here.

3 | Child is extremely under weight to the point where the child’s life is threatened. A child with a birth weight of less than 1000 grams (2.2 pounds) would be rated here.

U | Unknown

N/A | Not applicable

This dimension refers to the health care and birth circumstances experienced by the child in utero.

0 | Child’s biological mother had adequate prenatal care (e.g. 10 or more planned visits to a physician) that began in the first trimester. Child’s mother did not experience any pregnancy-related illnesses.

1 | Child’s biological mother had some short-comings in prenatal care, or had a mild form of a pregnancy-related illness. A child whose mother had 6 or fewer planned visits to a physician would be rated here (her care must have begun in the first or early second trimester). A child whose mother had a mild or well-controlled form of pregnancy-related illness such as gestational diabetes, or who had an uncomplicated high-risk pregnancy, would be rated here.

2 | Child’s biological mother received poor prenatal care, initiated only in the last trimester, or had a moderate form of pregnancy-related illness. A child whose mother had 4 or fewer planned visits to a physician would be rated here. A mother who experienced a high-risk pregnancy with some complications would be rated here.

3 | Child’s biological mother had no prenatal care, or had a severe form of pregnancy-related illness. A mother who had toxemia/preeclampsia would be rated here.

U | Unknown

N/A | Not applicable

This dimension describes the child’s exposure to substance use and abuse both before and after birth.

0 | Child had no in utero exposure to alcohol or drugs, and there is currently no exposure in the home.

1 | Child had either mild in utero exposure (e.g. mother ingested alcohol or tobacco in small amounts fewer than four times during pregnancy), or there is current alcohol and/or drug use in the home.

2 | Child was exposed to significant alcohol or drugs in utero. Any ingestion of illegal drugs during pregnancy (e.g. heroin, cocaine, methamphetamine), or use of alcohol or tobacco, would be rated here.

3 | Child was exposed to alcohol or drugs in utero and continues to be exposed in the home. Any child who evidenced symptoms of substance withdrawal at birth (e.g. crankiness, feeding problems, tremors, weak and continual crying) would be rated here.

U | Unknown

N/A | Not applicable

This dimension refers to conditions associated with, and consequences arising from complications in labor and delivery of the child.

0 | Child and biological mother had normal labor and delivery. A child who received an Apgar score of 7-10 at birth would be rated here.

1 | Child or mother had some mild problems during delivery, but child does not appear to be affected by these problems. An emergency C-Section or a delivery-related physical injury (e.g. shoulder displacement) to the child would be rated here.

2 | Child or mother had problems during delivery that resulted in temporary functional difficulties for the child or mother. Extended fetal distress, postpartum hemorrhage, or uterine rupture would be rated here. A child who received an Apgar score of 4-7, or who needed some resuscitative measures at birth, would be rated here.

3 | Child had severe problems during delivery that have long-term implications for development (e.g. extensive oxygen deprivation, brain damage). A child who received an Apgar score of 3 or lower, or who needed immediate or extensive resuscitative measures at birth, would be rated here.

U | Unknown

N/A | Not applicable

This dimension describes how this child’s parents and older siblings have done/are doing in their respective developments.

0 | The child’s parents have no developmental disabilities. The child has no siblings, or existing siblings are not experiencing any developmental or behavioral problems

1 | The child’s parents have no developmental disabilities. The child has siblings who are experiencing some mild developmental or behavioral problems (e.g. Attention Deficit, Oppositional Defiant, or Conduct Disorders). It may be that child has at least one healthy sibling.

2 | The child’s parents have no developmental disabilities. The child has a sibling who is experiencing a significant developmental or behavioral problem (e.g. a severe version of any of the disorders cited above, or any developmental disorder).

3 | One or both of the child’s parents have been diagnosed with a developmental disability, or the child has multiple siblings who are experiencing significant developmental or behavioral problems (all siblings must have some problems).

U | Unknown

N/A | Not applicable

**LOOK OUT**

This item looks at whether the child has a sibling or parent who has developmental delays. This item is not rating interpersonal or other conflicts in the family. This item can be rated for any child, regardless of age.

This dimension addresses the primary caretaker’s emotional and physical availability to the child in the weeks immediately following the birth. Rate maternal availability up until 3 months (12 weeks) post-partum.

0 | The child’s mother/primary caretaker was emotionally and physically available to the child in the weeks following the birth.

1 | The primary caretaker experienced some minor or transient stressors which made her slightly less available to the child (e.g. another child in the house under two years of age, an ill family member for whom the caretaker had responsibility, a return to work before the child reached six weeks of age).

2 | The primary caretaker experienced a moderate level of stress sufficient to make him/her significantly less emotionally and physically available to the child in the weeks following the birth (e.g. major marital conflict, significant post-partum recuperation issues or chronic pain, two or more children in the house under four years of age).

3 | The primary caretaker was unavailable to the child to such an extent that the child’s emotional or physical well-being was severely compromised (e.g. a psychiatric hospitalization, a clinical diagnosis of severe Post-Partum Depression, any hospitalization for medical reasons which separated caretaker and child for an extended period of time, divorce or abandonment).

U | Unknown

N/A | Not applicable

**LOOK OUT**

This item is rating the mother’s availability to the child only in their first 12 weeks of life (post-partum period). This item can be rated for any child, regardless of age, if their mother was not available to them during this time period.

This rating describes the child’s self-initiated efforts to discover his/her world.

0 | This level indicates a child with exceptional curiosity. Infants display mouthing and banging of objects within grasp; older children crawl or walk to objects of interest.

1 | This level indicates a child with good curiosity. An ambulatory child who does not walk to interesting objects, but who will actively explore them when presented to him/her, would be rated here.

2 | This level indicates a child with limited curiosity. Child may be hesitant to seek out new information or environments, or reluctant to explore even presented objects.

3 | This level indicates a child with very limited or no observable curiosity. Child may seem frightened of new information or environments.

N/A | Not applicable

This rating describes the child’s enjoyment of play alone and with others.

0 | This level indicates a child with substantial ability to play with self and others. Child enjoys play, and if old enough, regularly engages in symbolic and means-end play. If still an infant, child displays changing facial expressions in response to different play objects.

1 | This level indicates a child with good play abilities. Child may enjoy play only with self or only with others, or may enjoy play with a limited selection of toys.

2 | This level indicates a child with limited ability to enjoy play. Child may remain preoccupied with other children or adults to the exclusion of engaging in play, or may exhibit impoverished or unimaginative play.

3 | This level indicates a child who has significant problems with play both by his/her self and with others. Child does not engage in symbolic or means-end play, although he or she will handle and manipulate toys.

U | Unknown

N/A | Not applicable

This rating describes the child’s general mood state and ability to be soothed.

0 | This level indicates a child with an easy temperament. S/he is easily calmed or distracted when angry or upset

1 | This level indicates a child with some mild problems being calmed, soothed, or distracted when angry or upset. Child may have occasional episodes or extended crying or tantrums.

2 | This level indicates a child with a difficult temperament. Child has difficulty being calmed, soothed, or distracted. Persistent episodes of crying, tantrums, or other difficult behaviors are observed.

3 | This level indicates a child who has significant difficulties being calmed, soothed, or distracted when angry or upset. Repeated and extreme persistent episodes of crying, tantrums, or other difficult behaviors are observed when the child is angry or upset.

N/A | Not applicable

0 | This level indicates a child with no problems in day care or preschool environments.

1 | This level indicates a child with mild problems in day care of school environments.

2 | This level indicates a child who has difficulties in day care or preschool environments. These problems may include things such as separation anxiety or difficult behavior.

3 | This level indicates a child who has significant problems in day care or preschool environments. Child may have recently been asked to stop attending.

N/A | Not applicable