1. Does the child have any eating difficulties? If so, what are they?
2. Is the child a picky eater or does the child overeat?
3. What are the child's special likes and dislikes?
4. How have the child's eating habits changed since being in placement?
5. What does the child like to eat or drink when the child is sick?

1. What time does the child usually go to bed?
2. Does the child resist going to bed?
3. How difficult is it for the child to go to sleep?
4. Does the child sleep with a special object?
5. Does the child sleep with a light on?
6. Does the child share a bedroom? With whom?
7. Does the child have nightmares? How frequently? Under what circumstances?
8. Does the child wake at night, wander?
9. Does the child wet the bed? How frequently? Under what circumstances?
10. What time does the child wake up?
11. Is it hard for the child to get up?
12. What kind of mood is the child in when he/she awakens?
13. Does the child take a nap?

1. Does the child dress himself/herself?
2. Does the child pick up his/her own clothing?
3. Does the child straighten his/her room?
4. Does the child need help in bathing, shampooing, and brushing teeth?
5. Is the child toilet trained? Does the child go to the bathroom by himself/herself?
6. Is the child dry during the day?
7. Does the child do chores? What kind?
8. Does the child receive an allowance? How much? Does the child have to earn it?

1. What does the child like to do with his/her spare time?
2. How well does the child play alone? How well does the child play with others?
3. What kinds of play does the child like?
4. What kinds of play does the child avoid?
5. What are the child's special interests?
6. What are the child's favorite toys?
7. How much television does the child watch? Which are the child's favorite shows?
8. Does the child prefer to play inside or outside?

1. How does the child get along with other children in the family?
2. How does the child get along with other children in the neighborhood?
3. Does the child prefer to play with children who are older, younger, the same age, the
same or other sex?
4. Who are the child's special playmates? Name them:

1. Does the child like school? What does the child like best? What does the child like least?
2. How well does the child do academically?
3. How well does the child get along with people in authority?
4. How does the child get along with children in school?
5. Is the child used to being helped with homework?
6. What school problems has there been, if any?
7. What has been done to help the child with them?
8. Is the child in any special program?

1. Does the child attend church and/or any religious instruction on a regular basis? If so, at what church?
2. How important is this to the child?
3. Does the child participate in any other on-going religious activities?
4. Has the child experienced any significant religious milestones such as baptism, first
communion, or confirmation?
5. How does the child behave in church?

1. How has the child adjusted to the family/facility?
2. How does the child respond to reasonable requests? Does every issue become a battle?
3. How does the child handle routine chores and expectations?
4. How is the child disciplined? What has been successful? What has not been
successful?
5. How does the child react to expressions of affection such as touching, hugging, etc.? Is the child able to give affection? Is it superficial?
6. Does the child relate better to men or women? What behavior illustrates this? Do you know the reason for this?
7. Who are the people most important to the child?
8. Does the child need a lot of approval? In what form?
9. Do you like this child? Why or why not?

1. Has the child ever had temper tantrums?
2. Has the child ever soiled? How often? What has been done to correct this? How does the child react to soiling?
3. Has the child ever lied? Under what circumstances?
4. Has the child ever stolen? What and how often?
5. Has the child ever set fires?
6. Has the child ever been violent? What does the child do?
7. How does the child treat his possessions and those of other?
8. What animals is the child used to? How does the child get along with them?

1. What has the child been told?
2. What does the child say he/she knows?
3. What is the child's sexual awareness?
4. Has the child ever acted out sexually? How?

1. What specific things or situations is the child afraid of?
2. How does the child handle these fears?

1. What kind of feelings does the child have about himself/herself?
2. How does the child make you aware of his/her feelings of failure, anger, anxiety, happiness, success, pain, disappointment, sadness, stress, change?
3. What does the child understand about why the extended family could not keep him/her?
4. What does the child understand about the reasons for termination of parental rights?
5. What does the child understand about the foster care/facility?
6. What does the child understand about the reason for his/her being in this placement?
7. What does the child understand about the reasons for leaving previous placements?
8. Does the child have a Life Book?
9. Has the child been receiving therapy? If so, with whom?
10. What does the child understand about moving into adoption?