The child screening questionnaire consists of 5 parts as follows:
- General Information
- Neurology
- Schooling
- Nutrition
- Madaule Auditory Screening
Please complete the questionnaire and submit it for evaluation; alternatively print the questionnaire and mail it to the following address:
Sue Hyland
110 West Town Lane
Bristol BS4 5DT
UK
When submitted the questionnaire is transmitted in a non-readable form to protect your privacy and is treated confidentially once received.
The Questionnaire is in PDF format. You will need Adobe Reader to view and print this. If you do not have a copy of Adobe Reader you can down load one from:
Please note that part of the screening questionnaire was externally validated for INPP. A score of 7 or more on specific questions (asterisked) confirms a 98% probability of retention of Primitive Reflexes. Retention of Primitive Reflexes being the primary cause of neuro-developmental delay.