SCALED SCORE INTERPRETATION

1-3 Suggest significant delay in overall development

4-6 Suggest slight delayed in overall development
7-13 Average Development Republic of the Philippines
Department of Education
14-16 Suggest Advanced Development Region VIII
17-19 Suggest Highly Advanced Development DIVISION OF SAMAR
District of Almagro
TONGA – TONGA ELEMENTARY SCHOOL
STANDARD SCORE INTERPRETATION
69 & BELOW Suggest significant delay in overall development
70-79 Suggest slight delayed in overall development
80-119 Average Development
120- 129 Suggest Advanced Development Early childhood CARE development (eccd)
130 ABOVE Suggest Highly Advanced Development checklist

Summary
S

SOCIO DEMOGRAPHIC PROFILE

DOMAIN Raw Score Scaled Score S.Y. 2017 – 2018
GROSS MOTOR

FINE MOTOR
SELF- HELP Learner’s Reference Number (LRN): ____________________________________
RECEPTIVE LANGUAGE Child’s Name: _____________________________________ Sex: ____________
Date of Birth: ______________________ Date of Exam: ____________________
EXPRESSIVE LANGUAGE
Address: __________________________________________________________
COGNITIVE (Barangay Municipality/City Province)
SOCIAL- EMOTIONAL Birth Order: (Check) ________1st ________2nd ________3rd ________ Others
Child’s Handedness: (Check) _________right _________left _________both
Sum of Scaled Score Is the child presently studying? (Check) _________Yes __________No
Standard Score If yes, write name of child’s school/learning center/day care ___________________
Date Tested __________________________________________________________________
Father’s Name: _________________________________ Father’s Age:__________
Father’s Occupation: _______________ Educational Attainment:_______________
Mother’s Name: _________________________________ Mother’s Age: ________
Prepared by: Mother’s Occupation: _______________ Educational Attainment: ______________
Age of the mother when she had the child: ________ Number of Children:________
MA. JESSICA N. ALLEQUER
Adviser
Approved by:

LOURDES S. CAIRO
Head Teacher I
 Revised eccd checklist
st nd rd
GROSS MOTOR DOMAIN 1 2 3 COMME
NTS 1st 2nd 3rd COMME
NTS 1st 2nd 3rd COMME
NTS

1. Climbs on chair or other elevated piece furniture like a

19. Informs the adult only after he has already urinated 16. States what common household items are used for
bed without a help
(peed) or moved his bowels (poohed) in his underpants.
2. Walks backwards 17. Can assemble simple puzzles
3. Runs without tripping or falling. 20. Informs adult of need to urinate (pee) or move bowels 18. Demonstrates an understanding of opposites by
4. Walks downstairs, 2 feet on each step with one hand (pooh-pooh) so he can be brought to a designated place completing a statement (e.g. Ang aso ay malaki, ang
held (e.g. comfort room) daga ay _____)
21. Goes to the designated place to urinate (pee) or move
5. Walks upstairs holding handrail, 2 feet on each step bowels (pooh) but sometimes still does this in his 19. Points left and right sides of body)
underpants
22. Goes to the designated place to urinate (pee) or move 20. With pictures (e.g. Can state what is silly or wrong
6. Walks upstairs with alternate feet without handrail
bowels (pooh) and never does this in his underpants (e.g. Ano ang mali sa larawang ito?”)
7. Walks downstairs with alternate feet without handrail anymore 21. Matches upper and lower case letters
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
12. umps and turn 27. Bathes without any help anxiety or shyness
13. Dances patterns / joins groups TOTAL 3. Plays alone but likes to be near familiar adults or
TOTAL RECEPTIVE LANGUAGE DOMAIN brothers and sisters
FINE MOTOR DOMAIN 1. Points to family member when asked to do so 4. Laughs or squeals aloud in play
1. Uses all 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
4. Follows one – step instructions that include simple
3. Displays definite hand reference 7. Hugs or cuddles toys
prepositions (e.g. in, on, under etc)
8. Demonstrate respect for elders using terms like “po”
4. Puts small objects in/out containers 5. Follows 2-step instructions
and “opo”
5. Holds crayon with all the fingers of his hand making a
TOTAL 9. Shares toys with others
fist (i.e. palmer grasp)
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 of others
8. Scribbles vertical and horizontal lines 2. Uses pronouns (e.g. I, me, ako, akin) 12. Appropriately uses cultural gestures of greeting
9. Draws circle purposely 3. Use 2-3 words verb – noun combinations 9e.g. hingil) without much prompting (e.g. mano, bless, kiss, etc)
10. Draws a human figure (head, eyes, trunk, arms, hand,
4. Names objects in pictures 13. Comfort playmates / siblings in distress
fingers)
11. Draws a house using geometric forms 5. Speaks in grammatically correct 2-3 word sentences 14. Persist when faced with a problem or obstacle to his
TOTAL 6. Asks “what” questions wants
SELF – HELP DOMAIN 7. Asks “who” and “why” questions
15. Helps with family chores (e.g. wiping tables, watering
1. Feeds self with finger food (e.g. biscuits, bread) using 8. Gives account of recent experiences (with prompting) in plants, etc.)
fingers order of occurrence using past tense
16. Curious about environment but knows when to stop
2. Feeds self-using fingers TOTAL
asking questions 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
5. Feeds self-using spoon without spillage 2. Looks for partially hidden objects another
6. Eats without need for spoon feeding 3. Imitates behavior just seen a few minutes earlier 19. Defends possessions with determination
7. Helps hold cup for drinking 4. Offers object but will not release it 20. Plays organized games fairly (e.g. does not cheat in
8. Drinks from cup without spillage 5. Looks for completely hidden objects order to win
9. Drinks from cup unassisted 6. Exhibits simple pretend play 21. Can talk about difficult feelings (e.g. anger, sadness,
10. Gets drink for self-unassisted 7. Matches objects worry) he experience
11. Pours from pitcher without spillage 8. Matches 2-3 colors 22. Honors a simple bargain with caregiver (e.g. can play
12. Prepares own food / snack 9. Matches Pictures outside only after cleaning / finishing his room)
13. Prepares meals for younger siblings / family members
10. Sorts based on shapes
when no adult is around 23. Watches responsibly over younger siblings / family
14. Participates when being dressed (e.g. raises arms or members
11. Sorts objects based on 2 attributes (e.g. size and color)
lifts leg)
24. Cooperates with adults and peers in group situation
15. Pulls down gartered short pants 12. Arranges objects according
to minimize quarrels and conflicts
16. Removes sando 13. Names 4-6 colors TOTAL
17. Dresses without assistance except for buttons and
14. Copies shapes
tying
18. Dresses without assistance including buttons and tying 15. Names 3 animals or vegetables when asked