The Checklist is divided in 7 DOMAINS : Gross Motor ( 13 ), Fine Motor ( 11 ), P O R P O R

Self Help ( 27 ), Receptive Language ( 5 ), Expressive Language ( 8 ), Cognitive SELF HELP DOMAIN BoSY EoSY
1 Points to family members when asked to do so
( 21 ), and Social Emotional ( 24 ). Points to 5 body parts on himself when asked to do
SELF HELP DOMAIN (Feeding sub domain) P O R P O R 2
so
The Philippine Early Childhood Checklist will be administered twice a year Points to 5 names pictured objects when asked to
Feeds self with finger food (e.g. biscuits, bread 3
1) Beginning of School Year - BoSY. 1 do so
using fingers)
2) End of School Year - EoSY. Follows one-step instructions that include simple
Feeds self using fingers to eat rice / viands with 4
BoSY EoSY 2 prepositions (e.g. in, on, etc.)
GROSS MOTOR DOMAIN spillage
P OR P O R Follows 2-step instructions that include simple
3 Feeds self using spoon with spillage 5
Climbs on chair or other elevated piece of furniture like prepositions
1 4 Feeds self using fingers without spillage
a bed without a help Total Score
2 Walks backwards 5 Feeds self using spoon without spillage
3 Runs without tripping or falling Eats without need for spoon feeding during any BoSY EoSY
6 EXPRESSIVE LANGUAGE DOMAIN
meal P O R P O R
Walks downstairs, 2 feet on each step, with one hand
4 7 Helps hold cup for drinking 1 Uses 5-20 recognizable words
held.
8 Drinks from cup with spillage 2 Uses pronoun (e.g. I, me, ako, akin)
5 Walks upstairs holding hand trail, 2 feet on each step
9 Drinks from cup unassisted Uses 2-3 words verb – noun combinations (e.g.
Walks upstairs with alternate feet without holding hand 3
6 10 Gets drink for self unassisted hingi gatas)
trail
Walks downstairs with alternate feet without holding 11 Pour from pitcher without spillage 4 Names objects in picture
7 12 Prepare own food / snack
hand trail Speaks in grammatically correct 2-3 word
Prepares meals for younger siblings / family 5
8 Moves body part as directed 13 sentences
members when no adult is around
9 Jumps up 6 Ask ” what” questions
SELF HELP DOMAIN (Dressing sub - domain) P O R P O R 7 Ask “who and “why” questions
10 Throws ball overhead with direction
Participates when being dressed (e.g. raises Give account of recent experiences (with
11 Hops 1 to 3 steps on preferred foot 14 8
arms or lifts leg) prompting) in order of occurrence using past tense
12 Jumps and turns 15 Pull down gartered shorts pants Total Score
13 Dances patterns / joins group movement activities 16 Remove sando
Dresses without assistance except for buttons
Total Score 17 BoSY EoSY
and tying COGNITIVE DOMAIN
Dresses without assistance including buttons and P O R P O R
18
tying
1 Looks at direction of fallen objects
BoSY EoSY SELF HELP DOMAIN (Toilet Training sub - domain) P O R P O R
FINE MOTOR DOMAIN Looks for partially hidden objects (hide a partially
Informs the adult only after he has already 2
P OR P O R hidden objects)
19 urinated (peed) or moved his bowels (poohed) in 3 Imitates behavior just seen a few minutes earlier
Uses all 5 fingers to get food / toys placed on flat his underpants
1 4 Offers objects but will not release it
surface Informs adult of need to urinate (pee) or move 5 Looks for completely hidden objects
2 Picks up objects with thumb and index finger 20 bowels (pooh-pooh) so he can be brought to a
Exhibits simple pretend play (feed put doll to
designated place (e.g. comfort room) 6
3 Displays a definite hand preference sleep)
Goes to the designated place to urinate or moved
21 7 Matches objects
4 Puts small objects in / out of containers bowels but sometimes still does this in his pants
8 Matches 2-3 colors
Holds crayon with all fingers of all his hand making a Goes to the designated place to urinate or move
5 9 Matches picture
fist (i.e., palmar grasp) 22 bowels and never does this in his underpants
10 Sorts based on objects
anymore
6 Unscrews lid of containers or unwraps food Sorts objects based on 2 attributes (e.g. size and
23 Wipes / cleans self after a bowel movement 11
color)
7 Scribbles spontaneously
SELF HELP DOMAIN (Bathing sub - domain) P 0 R P O R Arranges objects according to size from smallest
12
Scribbles vertical and horizontal lines to biggest
8 Participates when bathing (e.g. rubbing arms with
24 13 Names 4-6 colors
9 Draw circle purposely soap)
14 Copies shapes
25 Washes and dries hand without any help
Draws a human figure (head, eyes, trunk, arms, hands 15 Names 3 animals or vegetables when asked
10 26 Washes face without help
/ fingers) States what common households items are used
27 Bathes without help 16
11 Draws a house using geometric forms for
Total Score 17 Can assemble simple puzzles
Total Score 18 Demonstrates an understanding of opposites by
completing a statements (e.g. “Ang aso ay
RECEPTIVE LANGUAGE DOMAIN BoSY EoSY
 malaki, ang daga ay________”)
21
Can talk about difficult feeling (e.g. anger, Region III
19 Points to left and right side of the body sadness, worry) he experiences
Can state what is silly or wrong with picture (e.g.
Division of Pampanga
20
Ano ang mali sa larawang ito?) Honors a simple bargain with caregiver (e.g. can Macabebe East District
22 play outside only after cleaning / finishing his
21 Matches upper and lower case letters
room) SAN GABRIEL ELEMENTARY SCHOOL
Total Score
Watches responsibly over younger siblings /
S.Y. 2020 – 2021
23
family members
BoSY EoSY PHILIPPINE EARLY CHILDHOOD
Cooperates with adults and peers in group DEVELOPMENT CHECKLIST
SOCIAL EMOTIONAL DOMAIN 24
P O R P O R
situations to minimize quarrels and conflict CHILD’S RECORD FORM 2
3.1 – 5.11 Years Old
Total Score
Enjoys watching activities of nearby people or
1
animals SOCIODEMOGRAPHIC PROFILE
Friendly with strangers but initially may show ECD Summary Report
2
slight anxiety or shyness BoSY EoSY LRN: __________________________
Plays alone but likes to be near familiar adults or
Date Tested
3 Pupil’s Age
brothers or sisters Child’s Name: ___________________________________________________
Raw Scale Raw Scale Last Name First Name M.I.
4 Laughs or squeals aloud in play DOMAINS Score Score Score Score Date of Birth: _____________________ Age: ___________ Sex: ______
5 Plays peek-a-boo Gross Motor month/day/year y/m M/F
6 Rolls ball interactively with caregiver / examiner Fine Motor Address: _______________________________________________________
Self-Help Barangay Municipality Province
7 Hugs or cuddles toys
Receptive Language
Demonstrates respect for elders using terms like
8 Expressive Language Child’s Handedness Righ
“po” and “opo”
(Check Appropriate Box)   t   Left
Cognitive
9 Shares toys with others
Socio-Emotional Both   Not Yet Established
10 Imitates adult activities (e.g. cooking, washing)
Sum of Scaled Scores
11 Identifies feelings in others Is the child presently studying?
Standard Scores
(Check Appropriate Box)   Yes   No
Appropriately uses cultural gestures of greetings
12 without much prompting (e.g. mano, bless, kiss, STANDARD SCORE INTERPRETATION
etc.) Father's Name: ________________________________________________
69 and BELOW SSDOD Suggest Significant Delay in Overall Development
70-79 SSIDOD Suggest Slight Delayed in Overall Development Mother's Name: ________________________________________________
13 Comforts playmates / siblings in distress
80-119 AD Average Development Child's Birth Order: __________
Persist when faced with a problem or obstacle to 120- 129 SSAD Suggest Advanced Development
14
his wants 130 and ABOVE SHAD Suggest Highly Advanced Development
To the Parent:
Helps with family chores (e.g. wiping tables,
15 INTERPRETATION
watering plants, etc.)
Curious about environment but knows when to BoSY: The Philippine Early Childhood Development Checklist
16
stop asking questions of adults
EoSY:
contains knowledge, skills, and attitudes of children 3.2 to 5.1 y/o. This
17 Waits for turn may be used as a guide in knowing your child and consequently give
Asks permission to play with toy being used by PARENT’S SIGNATURE appropriate care and teaching to guide their growth and development.
18
another BoSY:
19 Depends possessions with determination
EoSY: RENATO O. SILVESTRE JANINE C. BACANI
Plays organized group games fairly (e.g. does Teacher Principal I
20
not cheat in order to win) Republic of the Philippines
Department of Education