Subscription – language stimulation, Yellow group Questionnaire ANGLAIS - YELLOW Group language stimulation Informations générales et coordonnées Child's full name * gender * girl boy Age at registration (month and/or year) * Date of birth * Full name of parent filling out form * City of origin * e-mail address * phone number * registration date * I would like to register for the YELLOW level workshop (1-2 years) Vaudreuil- Dorion : Thursdays, November 23rd to December 14th, 9 h Habiletés de communication et de langage- questionnaire My child shows interest in other people * Yes No My child demonstrates an interest in communicating * Yes No My child uses many ways to be understood (pointing, gestures) * Yes No My child starts to say 2 words together (e.g. more cookie) * Yes No My child understands simple questions and basic concepts * * Yes No Simple questions: What, Where, Who, Whose, What is he doing, Which one / Concepts: words of dimension, quantity, location, color, quality, space, time, etc. My child expresses their desires and needs verbally * Yes No My child uses a variety of words (people, objects, actions, adjectives) * Yes No My child makes sentences of 3 to 4 words * Yes No My child pronounces quite well most words of 2 syllables * Yes No My child understands 2-part directions and different concepts * * Yes No * 2-part directions: give me the ball and the duck… / put the duck in the basket My child comments, asks questions, answers questions * Yes No My child uses an accurate and varied vocabulary * Yes No My child makes sentences of 6 words or more * Yes No My child is easily understood by family * Yes No My child understands long and complex sentences or directives * Yes No My child participates in conversations, tells stories * Yes No My child uses a specific vocabulary, categories of words * Yes No My child is easily understood by others (non-family) * Yes No My child speaks fluently, without hesitation Yes No My child conjugates verbs well when speaking * Yes No My child maintains a conversation for several speaking rounds on the same topic * Yes No My child tells a story with complex sentences, while respecting the order of events * Yes No My child understands more complex and precise instructions such as "circle the smallest square" * Yes No My child makes complex associations between different concepts * Yes No Other comments or details Consent An e-mail confirming receipt of the form will be sent to you. You will then be contacted by one of our representatives to confirm your registration. * I understand MEMBERSHIP: Become a member of the Maison de la Famille and contribute to its development! Your membership card gives you access to all our free or reduced-rate services, and entitles you to attend the AGM. I would like to become a member for $10 https://www.maisondelafamillevs.ca/membres/formulaire-adhesion/ NEWSLETTER: Receive the latest news about our services and activities by subscribing to the Maison de la Famille monthly newsletter. Subscribe to newsletter PHOTO AUTHORIZATION: I authorize the distribution of any image or video of my minor child, in whole or in part, individually or with other images or videos on the La Maison de la Famille website and other official websites, as well as for media purposes, including promotional presentations and advertising campaigns. I also authorize the distribution and use of any media material created by my child. I am over 18 years of age and the child's parent or legal guardian. * yes no I authorize the Maison de la Famille de Vaudreuil-Soulanges and the CISSSMO-CLSC de Vaudreuil-Soulanges to share the information necessary for the language stimulation workshops concerning my child. * yes No Captcha Si vous êtes un humain, ne remplissez pas ce champ.
