REVISED ECCD CHECKLIST

GROSS MOTOR DOMAIN PRE PRE POST COMMENTS PRE POST COMMENTS PRE POST COMMENTS
Informs the adult only after he has already urinated (peed) or
Climbs on chair or other elevated piece furniture like a bed without a help
1 19 moved his bowels (poohed) in his underpants. 16 Stakes what common household items are used for
2 Walks backwards 17 Can assemble simple puzzles
Informs adult of need to urinate (pee) or move bowels (pooh-pooh) Demonstrates an understanding of opposites by completing a
3 Runs without tripping or falling. 20 so he can be brought to a designated place (e.g. comfort room 18 statement (pg. Ang aso ay malaki, ang daga
4 Walks downstairs, 2 feet on each step with one hand held
Goes to the designated place to urinate (pee) or move bowels
5 Walks upstairs holding handrail, 2 feet on each step 21 (pooh) but sometimes still does this in his underpants 19 Points left and right sides of body
Goes to the designated place to urinate (pee) or move bowels Can state what is silly or wrong with pictures (e.g.
6 Walks upstairs with alternate feet without holding handrail 22 (pooh) and never does this in his underpants anymore 20 Anoangmalisalarawangitor)
7 Walks downstairs with alternate feet without holding handrail 21 Matches upper and lower case fetters
8 Moves body parts as directed 23 Wipes / cleans self after a bowel movement (pooh) TOTAL
9 Jumps up 24 Participates when bathing (e.g. rubbings arms with soap) SOCIAL - EMOTIONAL DOMAIN
10 Throws ball overhead with direction 25 Washes and dries hands without any help 1 Enjoys watching activities of nearby people or animals
11 Hops 1 to 3 steps on preferred foot 26 Washes face without any help 2 Friendly with strangers but initially may show slight anxiety or shyness
12 Jumps and turns 27 Bathes without any help
13 Dances patterns / joins group movement activities TOTAL 3 Plays alone but likes to be near familiar adults or brothers and sisters
Total RECEPTIVE LANGUAGE DOMAIN
FINE MOTOR DOMAIN 1 Points to family member when asked to do so 4 Laughs or squeals aloud in play
1 Uses all 5 fingers to get food / toys placed on flat surface 2 Points to 5 body parts on himself when asked to do so 5 Plays peek a - boo (bulaga)
2 Picks up objects with thumb and index finger 3 Points to 5 named pictured objects when asked to do so 6 Rolls ball interactively with caregiver / examiner
Follows one -step instructions that include simple prepositions (e.g.
3 Displays a definite hand preference 4 in, on, under etc) 7 Hugs or cuddles toys
4 Puts small objects in/out of containers 5 Follows 2-step instructions that include prepositions 8 Demonstrate respect for elders using terms like 'po" and 'opo"
Holds crayon with all the fingers of his hand making a fist (i.e. palmar
5 grasp) TOTAL 9 Shares toys with others
6 Unscrews lid of container or unwraps food EXPRESSIVE LANGUAGE DOMAIN 10 Imitates adult activities (e.g. cooking, washing)
7 Scribbles spontaneously 1 Uses 5-20 recognizable words 11 Identifies feelings in others
Appropriately uses cultural gestures of greeting without
8 Scribbles vertical and horizontal lines 2 Uses pronouns (e.g, I, me, ako, akin) 12 much .prompting (e.g. mane, bless, kiss, etc.)
9 Draws circle purposely 3 Use 2-3 words verb - noun combinations (e.g. hingigatas )
10 Draws a human figure (head, eyes, trunk, arms, hand,/fingers) 4 Names objects in pictures 13 Comfort playmates / siblings in distress
11 Draws a house using geometric forms 5 Speaks in grammatically correct 2-3 word sentences 14 Persists when faced with a problem or obstacle to his wants
Total 6 Asks "what" questions
SELF - HELP DOMAIN 7 Asks "who" and 'why" questions 15 Helps with family chores (e.g. wiping tables, watering plants, etc.)
Gives account of recent experiences (with prompting) in order of
1 Feeds self with finger food (e.g. biscuits, bread) using fingers 8 occurrence using past tense
Curious about environment but knows when to stop asking questions
2 Feeds self-using fingers with spillage Feeds self-using spoon with spillage TOTAL 16 of adults
3 Feeds self-using spoon with spillage COGNITIVE DOMAIN 17 Waits for turn
4 Feeds self-using fingers without spillage 1 Looks at direction of fallen objects 18 Asks permission to play with toy being used by another
5 Feeds self-using spoon without spillage 2 Looks for partially hidden objects
6 Eats without need for spoon feeding during any meal 3 Imitates behavior just seen a few minutes earlier 19 Defends possessions with determination
Plays organized group games fairly (e.g. does not cheat in order to
7 Helps hold cup for drinking 4 Offers object but will not release it 20 win
8 Drinks from cup with spillage 5 Looks for completely hidden objects
Can talk about difficult feelings (e.g. anger, sadness, worry) he
9 Drinks from cup unassisted 6 Exhibits simple pretend play (feed, put doll to sleep ) 21 experiences
10 Gets drink for self-unassisted 7 Matches objects
Honors a simple bargain with caregiver (e.g. can play outside only
11 Pours from pitcher without spillage. 8 Matches 2-3 colors 22 after cleaning/fixing his room.
12 Prepares own food / snack 9 Matches Pictures
Prepares meals for younger siblings / family members when no adult is
13 around 10 Sorts based on shapes 23 Watches responsibly over younger siblings / family members
Cooperates with adults and peers in group situation to minimize
14 Participates when being dressed (e.g. raises arms or lifts leg) 11 Sorts objects based on 2 attributes (e.g. size and color) 24 quarrels and conflicts
15 Pulls down gartered short pants 12 Arranges objects according to size from smallest to biggest TOTAL
16 Removes sando 13 Names 4-6 colors
17 Dresses without assistance except for buttons and tying 14 Copies shapes
18 Dresses without assistance including buttons and tying 15 Names 3 animals or vegetables when asked
 INTERPRETATION OF THE SCALED SCORE
1-3 Suggest significant delay in overall development Republic of the Philippines
4-6 Suggest slight delay in overall development Department of Education
Region VII
7 - 13 Average Development
DIVISION CEBU PROVINCE
14 - 16 Suggest Slightly Advanced Development CATMON DISTRICT
17 - 19 Suggest Highly Advanced Development ST. WILLAM COOPERATIVE SCHOOL
INTERPRETATION OF STANDARD SCORE
69 AND BELOW Suggest significant delay in overall development EARLY CHILDHOOD CARE AND DEVELOPMENT CHECKLIST
70 - 79 Suggest slight delay in overall development (ECCD)S.Y. 2022-2023
80-119 Average overall Development SOCIODEMOGRAPHIC: PROFILE
120 -129 Suggests Slightly Advanced Development LEARNERS REFERENCE NUMBER (LR.N):
130 AND ABOVE Suggest Highly Advanced Development Child's Name: Sex:
Date of Birth:
SUMMARY OF RESULTS Address:
POST Evaluation (Barangay)(Municipality/ City)(Province)(Region)
PRE Evaluation
DOMAIN Raw Scaled Raw Scaled Child's Handedness: (check)______Right______Left_______Both not yet established
Score Score Score Score
GROSS MOTOR Father's Name:______________________________________Father's Age:__________________
FINE MOTOR Father's Occupation:
SELF- HELP Father's Educational Attainment:
RECEPTIVE LANGUAGE Mother's Name:______________________________________Mother's Age:__________________
EXPRESSIVE LANGUAGE Mother's Occupation:
COGNITIVE Mother's Educational Attainment:
SOCIAL- EMOTIONAL Child's Number of Siblings:____________________Child's Birth Order:______________________
Sum of Scaled Score
Standard Score COMPUTATION OF CHILD'S AGE
Interpretation
Date Tested YEAR MONTH DAY
Date Tested
Prepared by: ANNE LORAINE J. MAYOL Pre Evaluation Child's Date of Birth
Kinder Adviser Child's Age
Approved by:
Post Evaluation Date Tested
NILA N. GARCIA Child's Date of Birth
School Principal Child's Age