Philippine Early Childhood

Development Checklist
Form 2
(3.0 5.11 years old)

Childs Name: ______________________________________________

Birthdate: ___________ Age: ________ as of _________

Sex: _____

( - ) Skill is not present or child does not respond

( -9) no opportunity to observe the skill

Childs Name: ______________________________________________________

15.

Province: ____________Municipality/City: ___________ Barangay:___________

Sex: _______ Male

Handedness: __________ Right

_______ Female

__________ 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:
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

16.

- Expressive Language Domain has 8

items
- Cognitive Domain has 21 items
- Social-Emotional Domain has 24 items

17.
18.
19.
20.

21.

22.

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.

23.

Columns:

24.

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
Score:
( ) Present or child is able to do the task

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:

O R COMMENTS

O R COMMENTS

O R COMMENTS

SOCIAL-EMOTIONAL DOMAIN
A.

1.
2.

3.

4.
5.
6.
7.

8.
9.
10.
11.
12.

13.
14.

A. 3.1 4.0 Years

3.1 5.0 Years

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
cultural gestures of
greetings without much
prompting (e.g., mano,
bless, kiss, etc.)
Comforts
playmates/siblings in
distress
Persists when faced with
a problem or obstacle to
his wants

P O R

COMMENTS

P O R COMMENTS

P O

R COMMENTS

1.

Gross Motor
Climbs on chair or
other elevated piece
of furniture like a
bed without help

GROSS MOTOR DOMAIN

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

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
C. .1 5.11

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

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

P O R COMMENTS

P O R COMMENTS

2.
Walks backwards
B. 4.1 5.0
3.
P O R

COMMENTS

P O R COMMENTS

P O

R COMMENTS

4.

5.
6.

P O R COMMENTS

O R COMMENTS

O R COMMENTS

7.

8.
9.
10.

10.
11.
12.
13.

FINE MOTOR DOMAIN

A. 3.1 4.0 Years
COGNITIVE DOMAIN

A. 3.1 4.0 Years

Fine Motor
1.
2.
3.
4.
5.

O R COMMENTS

P O R

COMMENTS

O R

COMME
NTS

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)

6.
7.
8.

9.
10.
11.

Draws circle purposely

Draws a human figure
(head, eyes, trunk, arms,
hands/fingers)
Draws a house using
geometric forms
TOTAL SCORE:

7.

Matches objects

12.
P O R COMMENT
S

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

Exhibits simple pretend

play(feed, put doll to
sleep)

8.
9.
10.
11.

B. 4.1 5.0 Year

Fine Motor

6.

13.
14.
15.
16.

P O R COMMENTS

P O R COMMENTS

P O R COMM
ENTS

17.
18.

19.
20.

21

P O R COMMENTS

B. 4.1 5.0 Years

COGNITIVE DOMAIN
P O R COMMENTS
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
COGNITIVE DOMAIN
P O R COMMENTS
Cam assemble simple
puzzles
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:

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

5.

Looks for completely

hidden object

EXPRESSIVE LANGUAGE DOMAIN

1
.
2
.
3
.
4
.

5.
6.
7.
8.

A. 3.1 5.0 Years

P
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
B. 5.1 5.11 Years
P
EXPRESSIVE
LANGUAGE
DOMAIN
Speaks in
grammatically correct
2-3 word sentences
Asks whatquestions
Asks who and why
questions
Gives account of
recent experiences
(with prompting) in
order of occurrence
using past tense
TOTAL SCORE:

SELF-HELP DOMAIN

A. 3.1 4.0 Years

O R COMMENT
S

P O R

COMMENTS

P O R COMMENTS

2.
3.
4.
5.
O R COMMENT
S

P O R

COMMENTS

P O R COMMENTS

6.
7.
8.

9.

COGNITIVE DOMAIN
D.

1.
2.
3.
4.

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

1.

P O R COMMENT
S

P O R

COMMENTS

P O R COMMENTS

10.
11.
12.
13.

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
Gets drink for self
unassisted
Pours from pitcher
without spillage
Prepares own
food/snack
Prepares meals for
younger
siblings/family
members when no

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

adult is around

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
designated place to
urinate (pee) or move
bowels (pooh) and
never does this is his
underpants anymore

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

P O R COMMENTS

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:
RECEPTIVE LANGUAGE DOMAIN

1.
2.

3.
4.

5.

A. 3.1 5.11 Years

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
Follows one-step
instructions that
include simple
prepositions
Follows 2-step
instructions that
include simple
prepositions

P O R COMMENTS

P O R COMMENTS

P O R COMMENTS

TOTAL SCORE: