• Is your baby currently in any other muscular dystrophy registry?
• If other, please specify
• Treatment (RxNorm)
• Name of drug/trial:
• Participant Current Trial Participation
• Participant Future Trial Participation
• Participant Previous Trial Participation
• Evaluation date:
• Age at this evaluation: (months)
• Name of the Evaluator/Therapist:
• Gross Motor raw score:
• Gross Motor scaled score:
• Gross Motor developmental age equivalent:
• Fine Motor raw score:
• Fine Motor scaled score:
• Fine Motor developmental age equivalent:
• Receptive Communication raw score:
• Receptive Communication scaled score:
• Receptive Communication developmental age equivalent:
• Expressive Communication raw score: