Does your child have any of the following:

1. Ongoing poor weight gain (dropping percentiles on the growth curve) or weight loss?
2. Ongoing choking, gagging, or coughing during meals?
3. Problems with (continuous) vomiting?
4. Avoid all foods in a specific texture (wet, squishy, crunchy, wtc.) or nutrition group (meat, vegetables, starches, fruits, etc)?
5. Have fewer than 20 foods that they are able to eat consistently? (Especially if foods are being dropped over time with no new foods replacing those that are lost.)

Has your child had:

1. More than one incident of nasal reflux (vomiting or spitting up out their nose)?
2. A traumatic choking incident, where the child choked on something and then subsequently stopped eating certain foods?
3. A history of eating and breathing coordination problems, with ongoing respiratory issues?

Was your child unable to:

1. Transition to baby food purees by 10 months of age?
2. Accept any table food solids by 12 months of age?
3. Transition from the breast/bottle to a cup by 16 months of age?
4. Wean off of baby foods by 16 months of age?

Have you (as a parent or caregiver):

1. Reported the child as being picky at 2 or more child wellness checks?
2. Reported that your infant cries and/or arches at most meals?
3. Felt like mealtimes are a battle, and that you are always fighting about food with your child?
4. Reported that your child is difficult for everyone to feed?

Two or more answers selected on this questionnaire may indicate the need for a formal feeding evaluation.

Ask you child’s doctor for a referral or contact our office for more information at 270-478-1014.

Gross motor skills are activities that use large muscles to move the trunk or limbs and control posture to maintain balance. Examples of gross motor skills include waving an arm, walking, hopping, and running. See if your child has the appropriate skills by clicking on their age in the tabs below.

*If you notice your child typically walks on his/her toes AT ANY AGE and cannot bring their heels down to the ground,this could indicate a need for a referral for physical therapy*

**If your child is not able to complete the activities listed for their age in sections below or have concerns about your child’s gross motor development, please contact our office at 270-478-1014 to discuss your concerns **

1. Can hold head up and begins to push up
   when lying on tummy
2. Turning head in both directions equally

1.  Hold head steady, unsupported
2. Pushes down on legs when feet are on a hard surface
3. May be able to roll over from tummy to back
4. Can hold a toy and shake it and swing at dangling toys
5. Brings hands to mouth
6. When lying on their stomach, pushes up on elbows

1. Rolls over in both directions (front to back, back to front)
2. Begin to sit without support
3. When standing, supports weight on legs and may bounce
4. Rocks back and forth, sometimes crawling backwards before moving forwards

1. Stands, holding on
2. Can get into a sitting position
3. Sits without support
4. Pulls to stand
5. Crawls

1. Gets to a sitting position without help
2. Pulls to stand, walks holding onto furniture
3. May take a few steps without holding on
4. May stand alone

1. Walks alone
2. May walk up steps and run
3. Pulls toys while walking

1. Stands on tiptoes
2. Kicks a ball
3. Begins to run
4. Climbs onto and down from furniture without help
5. Walks up and down stairs holding on
6. Throws a ball overhand
7. Jumps off a small step

1. Climbs well
2. Runs easily
3. Pedals a tricycle
4. Walks up and down stairs, one foot on each step
5. Jumps over small objects

1. Hops and stands on one foot up to 2 seconds
2. Catches a bounced ball most of the time
3. Gallops

1. Hop 8-10 times on one foot
2. Hit a target with a ball from 10 feet
3. Balance on one foot for 10 seconds
4. Skip and Gallop
5. Walk on a balance beam
6. Alternate feet when descending the stairs
7. Throw a ball overhand and catch the ball