Assessments go better when you arrive with notes. This page is built to be printed (use your browser's Print), filled in at the kitchen table, and brought to the health centre, the ward, or your first visit to us. Count across all your child's languages — that is the number that matters for a bilingual child.
Child's name / nickname · date of birth · age todayLanguages spoken at home, and by whom (e.g. "English — mother; Japanese — father; Tagalog — grandmother")Languages at daycare / kindergarten, and since whenRoughly how much of the day your child hears each language
| Area | Check 1 | Check 2 | Check 3 |
|---|---|---|---|
| Understanding | Follows simple requests ("give me", "come here") in our home language | Follows simple requests in Japanese (if exposed to it) | Turns when called by name |
| Words | Number of words we can count in our home language: ______ | Number of words in Japanese: ______ | Total across all languages: ______ |
| Putting words together | Two-word combinations in any language (e.g. "more juice", "mama go") | Mixes languages in one sentence (this is normal) | Sentences are getting longer over time |
| Using language | Points, shows things, brings things to share | Asks for help or asks questions in some way | Plays back-and-forth with us (rolling a ball, peekaboo, pretend play) |
| Speech sounds | Family can understand most of what our child says | Strangers can understand about half | Sounds are getting clearer over time |
| Hearing | Responds to quiet sounds from behind | Has had a hearing check (date: ______) | Frequent ear infections / colds (note) |
| Group life | Manages daycare or playgroup routines | Transitions between activities without major distress | Plays near or with other children |
| Other things we notice | Sits for a short story or activity | Strong reactions to sounds, textures, lights (note) | Tantrums that are long, frequent or frightening (note) |
What made us start wondering, and whenWhat has changed in the last three monthsWhat our child loves, and is good atHealth-check findings, doctor's comments, consultations so far (dates)Our questions
Bring this sheet to: the 18-month or 3-year health check at your ward's public health centre; the ward's child development support centre (in Shinjuku, "Aiai", 03-6273-8701); or your first visit to us. The rule of thumb from the speech-language profession: if a communication difficulty is real, it shows up in all the child's languages — so the totals across languages are what an assessor wants to see. If there is any doubt about hearing, ask your paediatrician for a hearing check first.
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You do not need a diagnosis, a certificate, or fluent Japanese to take the first step. Send us a message in English, tell us your child's age and what you are noticing about their speech and language, and we will take it from there.
