Philippine Early Childhood Development Checklist Form 2 (3.0 – 5.11 years old)
Child’s Name: ______________________________________________ Birthdate: ___________ Age: ________ as of _________
Sex: _____
Child’s Name: ______________________________________________________
15.
Province: ____________Municipality/City: ___________ Barangay:___________ Sex: _______ Male
Handedness: __________ Right
_______ Female
16.
__________ Left
To the Parents: The Philippine Early Childhood Development Checklist (Form 2) contains knowledge, skills and attitudes of children 3 – 5.11 years old. This may be used as a guide in knowing your child and consequently give appropriate care and teaching to guide their growth and development. Content:
17. 18. 19. 20.
Every page contains different domains of development with their corresponding total scores: - Gross Motor Domain has 13 items - Fine Motor Domain has 11 items - Self-help Domain has 27 items - Receptive Language Domain has 5 items
- Expressive Language Domain has 8 items - Cognitive Domain has 21 items - Social-Emotional Domain has 24 items
Each item observed are recorded three time within a year: 1) at the start of the year, 2) at the middle of the year, and 3) at the end of the year. Columns: P – Present or the child can do the task O – Observed or the child was observed doing the task R – Report given by the parents/caregiver about the skill
21.
22.
23.
24.
SOCIAL EMOTIONAL DOMAIN Helps with family chores (e.g., wiping tables, watering plants, etc.) Curious about environment but knows when to stop asking questions of adults Waits for turn Asks permission to play with toy being used by another Defends possessions with determination Plays organized group games fairly (e. g., does not cheat in order to win) Can talk about difficult feelings (e.g., anger, sadness, worry) he experiences. Honors a simple bargain with caregiver (e.g., can play outside only after cleaning/finishing his room) Watches responsibly over younger siblings/family members Cooperates with adults and peers in group situations to minimize quarrels and conflicts TOTAL SCORE:
Score:
P
O R COMMENTS
P
O R COMMENTS
P
O R COMMENTS
(√ ) Present or child is able to do the task
cultural gestures of greetings without much prompting (e.g., mano, bless, kiss, etc.)
( - ) Skill is not present or child does not respond 13.
( -9) no opportunity to observe the skill
14.
SOCIAL-EMOTIONAL DOMAIN
A. 3.1 – 5.0 Years 1. 2.
3.
4. 5. 6. 7.
8. 9. 10. 11. 12.
SOCIAL - EMOTIONAL DOMAIN enjoys watching activities of nearby people or animals Friendly with strangers but initially may show slight anxiety or shyness Plays alone but likes to be near familiar adults or brothers and sisters SOCIAL - EMOTIONAL DOMAIN Laughs or squeals aloud in play Plays peek-a-boo (bulaga) Rolls ball interactively with caregiver/examiner Hugs or cuddles toys B. 5.1 – 5.11 Years SOCIAL - EMOTIONAL DOMAIN Demonstrates respect for elders using terms like “po” and “opo” Shares toys with others Imitates adult activities (e.g., cooking, washing) Identifies feelings in others Appropriately uses
P O R
COMMENTS
P O R COMMENTS
A. P O
R COMMENTS
1.
Comforts playmates/siblings in distress Persists when faced with a problem or obstacle to his wants GROSS MOTOR DOMAIN 3.1 – 4.0 Years Gross Motor Climbs on chair or other elevated piece of furniture like a bed without help
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
2. B. 3. P O R
COMMENTS
P O R COMMENTS
P O
R COMMENTS
4.
5. 6.
P O R COMMENTS
P
O R COMMENTS
P
O R COMMENTS
7.
8. 9. 10. C.
Walks backwards 4.1 – 5.0 Gross Motor Runs without tripping or falling Walks down stairs, 2 feet on each step, with one hand held Walks upstairs holding handrail, 2 feet on each step Walks upstairs with alternate feet without holding handrail Walks downstairs with alternate feet without holding handrail Moves body part as directed Jumps up Throws ball overhead with direction .1 – 5.11
FINE MOTOR DOMAIN
A. 3.1 – 4.0 Years Fine Motor 1. 2. 3. 4. 5.
7. 8.
11.
O R COMMENTS
P O R
COMMENTS
P
O R
COMME NTS
Draws circle purposely Draws a human figure (head, eyes, trunk, arms, hands/fingers) Draws a house using geometric forms TOTAL SCORE:
11. 12. 13.
Gross Motor Throws ball overhead with direction Hops 1 to 3 steps on preferred foot Jumps and turns Dances patterns/joins group movement activities TOTAL SCORE:
P O R COMMENTS
A. 3.1 – 4.0 Years COGNITIVE DOMAIN
P O R COMMENT S
P
O R COMMENTS
P O R COMM ENTS
Unscrews lid of container or unwraps food Scribbles spontaneously Scribbles vertical and horizontal lines C. 5.1 – 5.11 Fine Motor
9. 10.
P
Uses all 5 fingers to get food/toys placed on flat surface Picks up objects with thumbs and index finger Displays a definite hand preference Puts small objects in/out of containers Holds crayon with all fingers of his hand making a fist (I.e., palmar grasp)
B. 4.1 – 5.0 Year Fine Motor 6.
10.
6.
Exhibits simple pretend play(feed, put doll to sleep)
7.
Matches objects
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
B. 4.1 – 5.0 Years 8. 9. 10. 11. P O R COMMENTS
P O R COMMENTS
P O R COMM ENTS
12. 13. 14. 15. 16.
COGNITIVE DOMAIN Matches 2-3 colors Matches pictures Sorts based on shapes Sorts objects based on 2 attributes (e.g., size and color) Arranges objects according to size from smallest to biggest Names 4-6 colors Copies shapes Names 3 animals or vegetables when asked States what common household items are used for
C. 5.1 – 5.11 Years 17.
COGNITIVE DOMAIN Cam assemble simple puzzles
18.
19. 20.
21
D.
Demonstrates an understanding of opposites by completing a statement (e.g., Ang aso ay malaki, ang daga _____”) Points to left and right sides of body Can state what is silly or wrong with pictures (e.g. Ano ang mali sa larawang ito? Matches upper and lower case letters TOTAL SCORE:
1. 2. 3. 4. 5.
A. 3.1 – 4.0 Years
EXPRESSIVE LANGUAGE DOMAIN 1.
A. 3.1 – 5.0 Years 1. 2. 3. 4.
EXPRESSIVE LANGUAGE DOMAIN Uses 5-20 recognizable words Uses pronouns (e.g. I, me, ako, akin) Uses 2-3 words verbnoun combinations (e.g. hingi gatas) Names objects in pictures
P O R COMMENTS
P O R
COMMENTS
P O R COMMENTS
2. 3. 4. 5.
B. 5.1 – 5.11 Years
5. 6. 7. 8.
EXPRESSIVE LANGUAGE DOMAIN Speaks in grammatically correct 2-3 word sentences Asks “what”questions Asks “who” and “why” questions Gives account of recent experiences (with prompting) in order of occurrence using past tense TOTAL SCORE:
P O R COMMENTS
P O R
COMMENTS
P O R COMMENTS
6. 7. 8.
9. COGNITIVE DOMAIN
3.1 – 4.0 Years
COGNITIVE DOMAIN Looks at direction of fallen object Looks for partially object hidden Imitates behavior just seen a few minutes earlier Offers object but will not release it Looks for completely hidden object
SELF-HELP Feeds self with finger food (e.g. biscuits, bread) using fingers Feeds self using fingers with spillage Feeds self using spoon with spillage Feeds self using fingers without spillage Feeds self using spoon without spillage B. 4.1 – 5.0 Years SELF-HELP Eats without need for spoon feeding during any meal Helps hold cup for drinking Drinks from cup with spillage C. 5.1 – 5.11Years SELF-HELP Drinks from cup unassisted
P O R COMMENTS
P O R
COMMENTS
P O R COMMENTS
SELF-HELP DOMAIN P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
10. 11. 12. 13.
Gets drink for self unassisted Pours from pitcher without spillage Prepares own food/snack Prepares meals for younger siblings/family members when no adult is around
designated place to urinate (pee) or move bowels (pooh) and never does this is his underpants anymore
22. SELF-HELP Dressing Sub-Domain 14. Participates when being dressed (e.g. raises arms or lifts leg) 15.
Pulls down gartered short pants
16.
Removes sando
17.
Dresses without assistance except for buttons and tying Dresses without assistance including buttons and tying
18.
Toilet Training sub-domain 19. Informs the adult only after he has already urinated (peed) or moved his bowels (poohed) in his underpants 20.
21.
Informs adult of need to urinate (pee) or move bowels (poohpooh) so he can be brought to a designated place (e.g. comfort room) Goes to the
P O
R COMMENTS
P O R
COMMENTS
P O R COMMENTS
23. 24. 25. 26. 27.
SELF-HELP Goes to the designated place to urinate (pee) or move bowels (pooh) and never does this is his underpants anymore
2.
3.
P O R COMMENTS
P O R COMMENTS
Wipes/Cleans self after a bowel movement (pooh) Participates when bathing (e.g. rubbing arms with soap) Washes and dries hands without any help Washes face without any help Bathes without any help TOTAL SCORE:
A. 3.1 – 5.11 Years
1.
P O R COMMENTS
RECEPTIVE LANGUAGE DOMAIN Points to family member when asked to do so Points to 5 body parts on himself when asked to do so Points to 5 named pictured objects when asked to do so
RECEPTIVE LANGUAGE DOMAIN P O R COMMENTS
P O R COMMENTS
P O R COMMENTS
4.
5.
Follows one-step instructions that include simple prepositions Follows 2-step instructions that include simple prepositions TOTAL SCORE:
