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, Pathologies observées Non ! Oui ! (si oui, préciser) : Maladie pulmonaire chronique : Non ! Oui ! (si oui, préciser) : chronique : Non ! Oui ! (si oui
Ig anti VRS : Non ! Oui ! Examens et dépistages sensoriels Bilan auditif entre 12 et 15 mois : Non fait ! Normal ! Anormal ! A contrôler ! ,
, Normale ! Anormale ! (Si anormale, préciser) : Obtention : Facile ! Difficile ! Absente ! Limitation : Aucune ! Bilatérale ! D ! G ! Bilan visuel : Non fait ! Normal ! Anormal !
,
,
, ! 0-2 : risque faible ! 3-7 : risque moyen " surveillance et réévaluation par test de suivi ! ? 8 : risque élevé
, Désigne au moins 2 images -Vocabulaire de 10 à 20 mots -Associe 2 mots Comportement : Normal ! Anormal ! (si anormal, préciser) : Endormissement facile : Non ! Oui ! Réveils nocturnes : Non ! Oui ! Participation à l'examen : Normale ! Difficile ! S'oppose : Non ! Oui !, vol.24