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Dear parents of ____________________ !

By now we have come to know your child rather well. We have noticed that your child shows interests and abilities that are somewhat different from his/her peers in age. For a better understanding of your child’s developmental stage and his/her special educational needs we ask you to fill in the following questionaire. The information you are giving to us shall be very helpful in fostering your child adequately in our daily work. All particulars given to us will be handled confidentially.

Subsequently we would like to confer with you in order to give you an account of our impressions and to discuss how we can accommodate an optimal development for your child in our kindergarten.

The questions:

Date of answering: _______________

The child´s age: ________________

1) What / with what does your child like to play at home the most?

_______________________________________________

_______________________________________________

_______________________________________________

2) What are presently your child’s foremost interests?

_______________________________________________

_______________________________________________

_______________________________________________

3) Does your child presently have a favourite songbook, audio-cassette, CD or DVD? If so, which?

_______________________________________________

_______________________________________________

_______________________________________________

4) Is there any children’s TV programme your child likes to watch and wants to see ever new sequels of ?

O Yes. O No.

If yes, which?

_______________________________________________

_______________________________________________

5) What are your child’s strong points?

_______________________________________________

_______________________________________________

_______________________________________________

6) Do you think that your child is

O more independent than

O as independent as

O less independent than

his / her peers in age?

7) Does your child mostly enjoy going to kindergarten?

O Yes. O No.

8 ) Does your child talk about what he/she has been experiencing in kindergarten?

O Yes. O No.

9) Does your child tell you, with whom he/she has been playing?

O Yes. O No.

10) Does your child tell you what he/she has learned in kindergarten?

O Yes. O No.

11) Would your child often prefer not to go to kindergarten?

If so: Does he/she say why?

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

12) Whom does your child prefer to play with?

O children of about the same age

O notedly younger children

O notedly older children

13) Is there a child in kindergarten whom your child would like as a friend?

O Yes, his/her name is: ______________. O No.

14) According to your impression, what does your child dislike the most about kindergarten?

1. ________________________________________________

2. ________________________________________________

3. ________________________________________________

15) Do you think that your child displays a different conduct in kindergarten as compared to at home? What differences do you see?

_______________________________________________

_______________________________________________

_______________________________________________

16) Does your child display behavourial patterns which you are concerned about?

O No. O Yes, these are:

_______________________________________________

_______________________________________________

_______________________________________________

17) What is your child’s maximum attention span when strongly immersed in something?

_______________________________________________

_______________________________________________

18) Which activities are the most binding for your child’s concentration?

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

19) When at home – does your child display interest in

O numbers?

O characters (alphabet)?

O learning how to read?

O learning how to write?

20) What is your child’s opinion about school?

(several choices possible)

O He/she has been conveyed certain ideas about school by an older sibling.

O He/she is not really interested in the issue of school yet.

O He/she is eager to go to school.

O He/she thinks of school with a degree of unease.

O He/she (still) has rather unrealistic ideas about school.

21) What is your evaluation of your child’s vocabulary –

21 a) in German?

O average

O smaller than that of his/her peers in age

O greater than that of his/her peers in age

21b) in his/her native language, if this is not German?

O average

O smaller than that of his/her peers in age

O greater than that of his/her peers in age

22) What is your evaluation of your child’s intellectual power?

O average

O below average

O above average

23) What topic does presently raise a great many questions for your child? Could you give an example of one such question?

_______________________________________________

_______________________________________________

_______________________________________________

24) What makes your child laugh?

_______________________________________________

_______________________________________________

_______________________________________________

25) What is your evaluation of your child’s self-confidence?

O He/she tends to be less self-confident when facing the following demands:

______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

O He/she tends to be very self-confident when facing the following demands:

______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

26) Is there something, which your child does not think he/she could handle, while you do think he/she could?

O No. O Yes:

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________


27) Do you sometimes encounter utterances or behaviour by your child which really surprise you?

O No. O Yes:

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

28) Would you like to ask us something?

O No. O Yes, I would like to know:

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

Thank you very much for answering these questions.

____________________

Developed und ©by Hanna Vock, Director of IHVO Bonn; 2006.

Translation: Arno Zucknick, Berlin.

VG Wort Zählmarke