Name: ______________________________________________ Date of Birth: ___________________

EARLY CARE AND DEVELOPMENT (ECD) CHECKLIST Age of Learner:

Date conducted:
GROSS MOTOR DOMAIN Pre Post
1. Climbs on chair or other elevated piece of furniture like a bed without help
2. Walks backwards
3. Runs without tripping or falling
4. Walks upstairs,2 feet on each step with one hand held
5. Walks down stairs,2 feet on each step with one hand held
6. Walks upstairs with alternate feet without holding handrail
7. Walks downstairs with alternate feet without holding handrail
8. Moves body parts as directed
9. Jumps up
10. Throws ball overhead with direction
11. Hops 1 to 3 steps on preferred foot
12. Jumps and turns
13. Dances patterns/joins group movement activities
TOTAL

FINE MOTOR DOMAIN Pre Post

1. Uses all 5 fingers to get food/toys placed on flat surface
2. Picks up objects with thumb and inbox finger
3. Displays a definite hand preference
4. Puts small objects in/out of containers
5. Holds crayon with all the fingers of his hand making a fist (e.g., palmar grasp)
6. Unscrews lid container or unwraps food
7. Scribbles spontaneously
8. Scribbles vertical and horizontal lines
9. Draws circle purposely
10. Draws a human figure (head, eyes, trunk, arms, hands/fingers)
11. Draws a house using geometric forms
TOTAL

SELF-HELP DOMAIN Pre Post

1. Feeds self with finger food (e.g., biscuits, breads using fingers)
2. Feeds self using finger with spillage
3. Feeds self using spoon with spillage
4. Feeds self using finger without spillage
5. Feeds self using spoon without spillage
6. Eats without need for spoon feeding during any meal
7. Helps hold cup for drinking
8. Drinks from cup with spillage
9. Drinks from cup unassisted
10. Gets drink for self unassisted
11. Pours from pitcher without spillage
12. Prepares own food/snack
13. Prepares meals for younger siblings/family members when no adult is around
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 buttons and tying
18. Dresses without assistance including buttons and tying
19. Informs the adult only after he has already urinated (peed) or moved his bowels (poohed) in his underpants
20. Informs adult of need to urinate (pee) or move bowels (pooh-pooh) so he can be brought to a designated place (e.g.,
comfort room)
21. Goes to the designated place to urinate (pee) or move bowels (pooh) but sometimes still does this in his underpants
22. Goes to the designated place to urinate (pee) or move bowels (pooh) and never does this in his underpants anymore
23. Wipes/Cleans self after bowel movement (pooh)
24. Participates when bathing (e.g., rubbing arms with soap)
25. Washes and dries hands without any help
26. Washes face without any help
27. Bathes without any help
TOTAL

RECEPTIVE LANGUAGE DOMAIN Pre Post

1. Points to family member when asked to do so
2. Points to 5 body on himself when asked to do so
3. Points to 5 named picture objects when asked to do so
4. Follows one-step instructions that include simple prepositions (e.g, in, on, under, etc.)
5. Follows 2-step instructions that include simple preposition
TOTAL
EXPRESSIVE LANGUAGE DOMAIN Pre Post
1. Uses 5-20 recognizable words
2. Uses pronouns (e.g. I, me, ako, akin)
3. Uses 2-3 words verb-noun correct 2-3 word sentences
4. Names objects in picture
5. Speaks in grammatically correct 2-3 word sentences
6. Asks "what" questions
7. Asks "who" and "why" questions
8. Gives account of recent experience (with prompting) in order of occurrence using past tense
TOTAL

COGNITIVE DOMAIN Pre Post

1. Looks at direction of fallen object
2. Looks for partially hidden objects
3. Imitates behavior just seen a few minutes earlier
4. Offers objects but will not release it
5. Looks for completely hidden object
6. Exhibits simple pretend play (feed, put doll to sleep
7. Matches objects
8. Matches 2-3 colors
9. Matches pictures
10. Sorts based on shapes
11. Sorts objects based on 2 attributes (e.g. size and color)
12. Arranges objects according to size from smallest to biggest
13. Names 4-6 colors
14. Copies shapes
15. Names 3 animals or vegetables when asked
16. States what common household items are used for
17. Can assemble simple puzzles
18. Demonstrates an understanding of opposites by completing a statement (e.g. Ang aso ay malaki, ang daga ay ___)
19. Points to left and right sides of body
20. Can state what is silly or wrong with pictures (e.g Ano ang mali sa larawang ito?)
21. Matches upper and lower case letters
TOTAL

SOCIAL-EMOTIONAL DOMAIN Pre Post

1. Enjoys watching activities of nearby people of animals
2. Friendly with strangers but initially may show slight anxiety or rhymes
3. Plays alone but likes to be near familiar adults or brothers and sisters
4. Laughs or squeals aloud in play
5. Plays peek-a-boo (bulaga)
6. Rolls ball interactively with caregiver/examiner
7. Hugs or cuddles toys
8. Demonstrates respect for elders using terms like "po' and "upo"
9. Shares Toys with others
10. Imitates adult activities (e.g. cooking, washing)
11. Identifies feelings in others
12. Appropriately uses cultural gesture of greeting without much prompting (e.g. mano, bless, kiss, etc.)
13. Comforts playmates/siblings in distress
14. Persists when faced with a problem or obstacle to his wants
15. Helps with family chores (e.g. wiping tables, watering plants, etc.)
16. Curious about environment but knows when to stop asking questions of adults
17. Waits for turn
18. Asks permission to play with toy being used by another
19. Defends possessions with determination
20. Plays organized group games fairly (e.g., does not cheat in order to win)
21. Can talk about difficult feelings (e.g., anger, sadness, worry) he experiences
22. Honors a simple bargain with caregiver (e.g., can play outside only after cleaning/fixing his room
23. Watches responsibly over younger siblings/family members
24. Cooperates with adults and peers in group situations to minimize quarrels and conflicts
TOTAL

SUMMARY

Raw Score Scaled Score Interpretation Legend for the Interpretation:

DOMAINS
Pre Post Pre Post Pre Post
1 - Suggested significant delay
GROSS MOTOR 2 - Suggested slightly delay
FINE MOTOR 3 - Average development
SELF HELP 4 - Suggested slightly advanced
RECEPTIVE development
EXPRESSIVE ` 5 - Suggested highly advanced
COGNITIVE development
SOCIO-EMOTIONAL
Scale Scores
Standard Score