Name
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First Name
Last Name
Email
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Purpose
This screening device identifies individuals, aged 7 years and over, that would likely benefit from the INPP Program. It identifies children that are at risk "of developing later problems and identifies underlying physical factors (immature primitive and postural reflexes) in children, and in adults already experiencing difficulties" (Goddard-Blyth, 2017, p. 149). The questionnaire is not designed to identify causes for NMI, moreover, it is concerned with obtaining a profile of the genetic, epigenetic, nutritional, neuromotor, and sensory maturity of the individual.
If you have a diagnosis please provide a brief outline below.
Family History
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Is there a history of learning difficulties in your immediate family?
Maternal History
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Were there any medical problems during the pregnancy?
E.g. high-blood pressure, maternal stress, hyperemesis (excessive vomiting), the threat of miscarriage: requiring bed rest.
Birth process
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Was the birth process unusual or prolonged in any way?
E.g. assisted birth including c-section, use of forceps or vacuum; breech presentation, signs of foetal distress
Gestation
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Was the gestational period within the normal range of term: 37-41 weeks gestation?
Birth weight
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Was the weight at birth below 5lbs or 2.27kg?
Birth presentation
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Was the birth presentation unusual?
A normal APGAR is between 7-10: appearance, pulse, grimace, activity, and respiration
Early feeding
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Was there any difficulty feeding in the first weeks of life, or difficulty keeping food down?
Early behaviour
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Was the child very active and demanding or fussy in the first 6 months of life?
Crawling and creeping
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Did the child omit the motor developmental stage of crawling on the tummy (commando crawl) and creeping (crawling) on all fours?
Walking
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Was the child early (before 10 months) or late (after 16 months) at learning to walk?
Talking
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Was the child late learning to talk?
2 to 3-word phrases at 18 months would be considered delayed.
Getting dressed
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Did the child have difficulty learning to dress themself, for example, do up buttons or tie shoelaces beyond the age of 6-7 years?
Thumb sucking
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Did the child suck their thumb beyond the age of 5 years?
Bed wetting
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Did the child wet the bed (albeit occasionally) above the age of five years?
Riding a bike
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Did the child have an unusual degree of difficulty learning to ride a bicycle?
Coordination
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Did/does the child have difficulty catching a ball, doing rolls or somersaults or difficulties with coordination when playing sports or exercising?
Sitting still
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Did/does the child have difficulty sitting still for even a short period?
Sound sensitivity
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If there is a sudden unexpected noise, does the child over-react?
Childhood health
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Did/do they suffer from allergies?
Childhood health
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Did/do they suffer from travel sickness?
Childhood health
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Did they suffer from frequent ENT (ear, nose or throat) infections during any early stages of development (0 to 3-4 years)?
Childhood health
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In the first three years of life, did the child suffer from any illness involving extremely high temperatures, delirium or convulsion?
Childhood cognition
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Difficulties reading?
Childhood cognition
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Difficulties writing and or spelling?
Childhood cognition
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Difficulties transposing or copying information frow a display, whiteboard or book?
