Area(s) of Strength:
Area(s) of Need:
Parent Concerns/Comments:
Recommendations:
Resources (attach additional resources if appropriate):
Below Average Average Above Average
Physical Development
Language Development
Academic Skills/Cognitive Development
Self-help Skills
Social-Emotional Development
Screen
ing Results for the
BRIGANCE
®
Screen III
Child’s Name: _______________________________________________________________________
Parent Name(s): _____________________________________________________________________
Date of Screening: __________________________ Date of Conference: __________________________
Teacher Name and Contact Information:
__________________________________________________________________________________
Developmental screening is an important part of early childhood education. The purpose of a developmental screen is to
determine a child’s strengths and needs and to make appropriate instructional decisions for the child. Together, we can use
the results of the screening to make sure your child is getting the support he or she needs to be as successful as possible.
Results of the BRIGANCE
®
Screen:
Score Compared to Cutoffs: Below Cutoff Above Cutoff Well Above Cutoff
Domain levels:
