Child Questionnaire

X and Y Screening Questionnaire (XYSQ)

Questionnaire - The Focus Foundation

If you have answered YES to three or more questions, please consider speaking to your primary care provider about having a chromosomal analysis to determine if your child has an X or Y Chromosomal Variation.

1. My baby was quiet and demanded little attention                                                                                             Yes | No

2. By 9 months, my baby was not saying “ma-ma”, “da-da” or “ba-ba” in a turn taking game with me                 Yes | No

3. My child was on the late side for walking (after 16 months)                                                                              Yes | No

4. My child struggled with “latching on” to the breast                                                                                            Yes | No

5. My child cried for several weeks when beginning Day Care, Preschool or Kindergarten                                 Yes | No

6. My child is shy with other children but talks very well with me and familiar adults                                            Yes | No

7. My child seems clumsy in comparison to his age group                                                                                    Yes | No

8. My child has flat feet                                                                                                                                           Yes | No

9. My child has a shortened attention span for his/her age                                                                                    Yes | No

10. My child “worries” about events, people or what might happen                                                                        Yes | No

11. My child seems very good at puzzles or computers                                                                                          Yes | No

12. My child has angry outbursts over minor events                                                                                               Yes | No

13. My child seems “a step behind” when compared to his peers in speech and language skills                          Yes | No

14. My child struggles with reading                                                                                                                         Yes | No

15. My child shows fear or increased discomfort with loud noises, vacuum cleaners or in crowded places          Yes | No

16. My child seems to have soft muscles sometimes called low muscle tonus                                                      Yes | No

17. My child is taller than his/her peers                                                                                                                   Yes | No

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    The Forgotten Children

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    100 100%
    Boys with 49,XXXXY
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    Dyspraxia Children

    What You Can Do Now

    If you have had a prenatal diagnosis or feel you may have a child with developmental delays or developmental dysfunction the following options are designed to help you towards the next step in treatment or early diagnosis.

    Questionnaire - The Focus Foundation


    Review Our Research



    Learn About Chromosomal Microarray

    Chromosomal Testing


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