Primary School Background Information

Student’s Name:

Date of Birth:

Native Language:

How does your child feel about moving to Rio de Janeiro and beginning school at RIS (e.g., excited, anxious etc.) ?

In general, how does your child adjust to new situations (e.g., easily, enthusiastically, cautiously, reluctantly, etc.) ?

Briefly describe your child’s first experience with language:

• When did your child say his/her first words?

• In which language?

• Were there any concerns about early language development (eg., late to start talking, distorting sounds, problems being understood, et.)?

Is your child a native English speaker?

Yes

What is your impression of your child’s general level of language skill?

+ (Strong Ability) X (Growing Proficiency) – (Weak Ability)

English | Listening:

Reading:

Speaking:

Writing:

Native Language | Listening:

Reading:

Speaking:

Writing:

To what extent will you be able to help your child with homework in English?

Not at all

Very little

Some

A lot

Were there any illnesses, accidents, or complications associated with your child’s birth or prenatal development?

Yes

Please comment:

No Did your child experience any significant health, learning or other difculties during his/her first five years of live?

Yes

Please comment:

Has your child experienced difficulties with fine or gross motor development which limit his/her activity?

Yes

Please comment:

IN SCHOOL

Yes

OUT OF SCHOOL

Yes