ST. MARY’S SCHOOL EARLY EDUCATION PROGRAM SOCIAL DEVELOPMENT & TEMPERAMENT Temperament describes how a child approaches and reacts to the world. It is their personal "style." The following questions will allow us to better understand your child as an individual.
Activity Level:
moving and doing something
slow more relaxed style
Rhythmicity:
regular and routine habits
spontaneous somewhat
Approach/Withdrawal:
outgoing and friendly
slow to warm, shy
Adaptability:
adjust to changes in routines or plans easily resist transitions and have difficulty adjusting
Intensity:
reacts strongly to situations, either positive or negative reacts calmly and quietly
Mood:
Persistence:
often express a negative outlook
generally a positive person
mood shift frequently
usually even-tempered
gives up as soon as a problem arises with a task keeps on trying until the problem is solved
Attention:
can stick with an activity over an age appropriate period of time mind tends to wander and jumps around for variety
Distractibility:
easily distracted can shut out external distractions and focus
Sensory threshold:
bothered by external stimuli (noises, bright lights, or food textures) does not have any issues with sensory experiences
How does your child respond to stressful situations? Does your child have any fears? What seems to help your child feel comforted? Does your child have a security object? (Blanket, pacifier, bear, etc.): What are your child's favorite toys or activities? What are your child's areas of interest? What method of discipline do you use or find most effective? Has your child attended school before? If yes where /teacher name? May we contact your current school? Yes / No What would you like your child to gain from his/her ECE experience?
What do you consider your child’s greatest strength? What do you consider your child’s area for growth? Has your child ever received outside services or testing? (Speech test, OT, IQ, & IEP etc.) Please attach all copies.
Please attach Family Photo
Ethnicity: European (White not Hispanic)
Asian
African American
Persian (White not Middle Eastern)
Pacific Islander
Native American/American Indian/Alaska Native
Hispanic or Latino
Middle Eastern
Multi-Racial – Other
Languages other than English spoken by the child: Languages other than English spoken in the home: Religious Affiliation or Spiritual Beliefs: Siblings- (names & ages): Family pets- (names / types): Is there any other information about your family’s composition that you would like to share:
HEALTH HISTORY Current Health Status:
Health Needs:
Allergies: Medications: Does your child wear:
Glasses:
Hearing Aid:
Other:
Sleep/Rest Routine: Where does your child sleep? Does your child sleep in a crib or other secure space? If yes, please elaborate: Does your child take a nap?
AM Rise:
Toileting: Is your child toilet trained? For urine
Nap Time:
for bowels
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Bed Time:
How many days?
How does your child communicate toilet needs?
NUTRITIONAL PATTERNS Typical meal times: Breakfast:
AM Snack:
Lunch:
PM Snack:
Dinner:
Does your child sit in a booster or highchair for meals? Food/Diet Preferences (i.e. vegan, gluten free, etc.) Is there anything else we should know about your child’s eating habits?
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