Handout 8a: Parent/guardian questionnaire
Please download the Word document and complete
The Word document includes the following questions:
Your concerns:
- What concerns do you have about your child?
- How long have you had these concerns?
- Which of these are you most concerned about?
Home and family
- Who lives at home at the moment?
- Any other family members who are important to your child?
- What languages are spoken at home? What other languages does your child hear regularly? Which language are they most confident with?
- Is there any family history of speech and language difficulties? Who and what difficulties?
- Is there any family history of anxiety or shyness? Please describe.
Speaking habits
- How much is your child able to speak to close family members at home? Are you concerned about their language skills at home?
- Who does your child speak to freely and easily?
- Is there anyone they talk to a little bit?
- Anyone they cannot talk to at all?
- Are they aware that they have a problem?
How concerned are you about your child’s confidence in speaking on a scale from 0-10 (where 10 is most concerned) 0 1 2 3 4 5 6 7 8 9 10
Is there anything else you want to add?
Please note this form must be submitted alongside the standard referral form and the staff questionnaire if the child is in a setting https://www.buckshealthcare.nhs.uk/cyp/referrals/ OR if there are other SLCN concerns presented at school advice session