EDEUCATIONAL AND DEVELOPMENTAL SKILLS ASSESSMENT

Independent Living and Functional Academics (ILFA)

School Year:____________

Student Information

Name: Nickname:

Birthdate: Birth Place:

Address:

Mother’s Name: Mother’s Address:

Father’s Name: Father’s Address:

Name of Guardian: Contact Number:

Guardian’s Address:

School:

Adviser:

Pre-natal History:

Health History:

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 I. Social/ Emotional/Psychosocial Skills:

Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Respond when
name is called

Identifies name of
teachers

Self –reliant;
follows classroom
rules and routines
with minimal to no
prompting

Has developed an
attitude of
willingness,
attempting after
an unsuccessful
try

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 Remarks
Skills
st nd
1 2 3rd 4th 5th
DATE:
Respectful of
authority;
obedient and
polite

Fair and honest

when playing
games; practices
sportsmanship

Cooperatively
plays and works
with others

Dependable in
carrying out
simple tasks

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Demonstrates
perseverance,
working until
completion or until
asked to stop

Shows initiative
during play and
work; motivated to
participate in class

Exhibits care and

responsibility for
personal
belongings

Shows empathy
for peers and
adults

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Respects teachers’
and classmates’
property

Works and delayed

rewards; gives way
to others when
requested to do so

Appropriately
deals with own
feelings of anger,
fear, frustration
and sadness

Accepts
limitations,
constructive
criticisms and
consequences of
actions

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 Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Behaves
appropriately in
carried social
situations

Asks for help

when dealing with
difficult situations

Displays a sense
of responsibility
and
accountability;
aware of right and
wrong

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 II. Self – Help and Prevocational Skills

Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Eats
independently
with proper table
manners

Assists in food
preparation, table
setting, and
clearing the table

Independently
carries out
toileting routines

Dresses up
independently
(upper and lower
garments,
including
footwear)

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Performs assigned
responsibilities in
class diligently

Attends to personal
belongings with
care; knows how to
organize things

Able to use hands

for functional
purposes (playing,
eating, feeling
objects, buttoning
shirt)

Skilfully uses both

hands to string
beads holds and
stirs, ties a knot,
laces holes, folds
paper

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Manipulates simple
tools such as a
spoon, hammer,
rolling pin, tongs,
etc

Recognizes
important signs
( fire alarm,
restroom signs, stop
light)

Equipped with
practical problem-
solving skills

Shows initiative in
cultivating hobbies
and interests

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 Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Possesses general
housekeeping skills
according to ability
(cleaning, laundry)

Knows basic
culinary skills
(sanitary practices
and basic food
preparation –
sorting and
organizing
ingredients and
tools; measuring;
and simple
cooking/basic
procedures)
Familiar with
gardening tasks
(preparing pots for
planting, watering;
weeding)

Possesses simple
clerical skills
according to ability
(sorting folders;
punching paper;
answering phone;
listing names)

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 III. HEALTH AND SAFETY SKILLS

Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Knows the
importance of
personal Remarks
cleanliness; Skills st nd
1 2 3rd 4th 5th
practices good body
DATE:
hygiene
Practices preventive
health habits (eg.,
Conscious of washing hands;
maintaining goodtaking vitamins)
body posture

Engages in
appropriate leisure
Recognizes and recreational
appropriate clothing
activities to
for the occasionmaintain
and mental
suited to the health
weather

Aware of potential
dangers inside the
Has good eatinghouse (e.g.,
habits; consumes matches;
well-balanced meals
disinfectants;
at regular intervals
knives; stairs);
practices basic
safety habits
Recognizes potential
dangers in the
community and
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protect self from
harm (e.g., safely
crosses the street;
avoid strangers)
 Remarks
Skills
st nd
1 2 3rd 4th 5th
DATE:
Demonstrates
appropriate
behavior in school
(e.g., stays in line;
no pushing/
shoving; follows
playground rules)

IV. Motor Skills and creativity

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Physically fit,
exhibiting
adequate muscle
control,
coordination,
balance and
fallibility

Knows how to
protect self from
injury/falls,
possessing
adequate motor
planning ability

Strong and agile

enough to
efficiently engage
in work and play

Able to follow
rhythmic patterns
to produce sound
using the body and
simple musical
instruments

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 Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Can dance
rhythmically to
music and follow
basic arm and leg
movements

Drives pleasure
from making
things for others
(greeting cards,
presents, etc.)
using arts and
crafts as an
avenue for self-
expression

Has developed
eye-hand and
finger coordination
to be able to use
manipulative tools
and different art
media for
functional
purposes

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 V. Manipulation Skills

Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Opening and
closing Jars

Stringing Bead
Patterns

Lacing at least 4
holes

Forms simple clay

figures

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 Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Works on a 12
piece puzzle

Builds 5-10 block

figures and 8-
block tower

Folding paper at
least twice

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 VI. Writing Skills and Pre-writing Skills

Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Traces – writes
his/her name on
lines paper

Traces – writes
upper – and lower-
case letters

Traces – copies
numbers (1-20)

Cuts straight lines,

corners, and
simple geometric
shapes

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 Remarks
Skills st nd
1 2 3rd 4th 5th
DATE:
Holds a
pencil/crayon
using age-
appropriate grasp;
palmar grasp a
static tripod
dynamic tripod
Colors medium-
sized figures (2-3”
diameter within
lines

Traces, copies and

draws
lines/form/shapes

Colors pictures
within borders

Creates simple
artworks using
various media;
pastes/glues
appropriately

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 VII. Functional Recognizes

LANGUAGE AND LITERACY

Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Listens to and
follows simple
direction Remarks
Skills
st nd
Appropriately
Acquires
Sorts and 1 2 3rd 4th 5th
DATE: responds
directional
classifies
Knows to simple
thefrom at
questions
concepts
least two skills;
importance choices
of
knows categories)
(broad
personal how print
Uses language work (-right; up-
cleanliness; Remarks
functionallySkills
anddown)
practices good
appropriately; 1 st nd
2 3rd 4th 5th
body hygiene
communicates
DATE: to
optimal level Identifies and
Recognizes
Identifies
understands at least
first and
Conscious
all
lastupper-case
name of
in print;
concepts related to
maintaining
letters
age; the good
ofknowledge
address;
his/her
body posture Remarks
Asks simpleSkillsalphabet
telephone (A-Z)
number
of self, family, st nd
questions and school and 1 2 3rd 4th 5th
makes requests community; able to
DATE:
state basic
information about
Recognizes
Possesses
self a HEALTH AND SAFETY SKILLS
Recognizes
common sight Remarks
functional
Able to listen
Skills sight
to
appropriate
words and 1st 2nd 3rd 4th 5th
vocabulary
story and recall
Communicates clothing for the
associates them
needsDATE: basic story
thru gestures
occasion and details
with picture
main character;
or verbalizationssuited to the
representations
setting)
weather
Remarks
Skills
st nd
Matches
Can
Has good “the
use checklists
eating 1 2 3rd 4th 5th
Sequences
same”
and 2-3 step
objects;
schedule
DATE: habits; consumes
events
notes differences
boards with
well-balanced
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minimal
meals at regular Page 19
supervision
intervals
Practices preventive
health habits (eg.,
washing hands; taking MATHEMATICS
Remarks
vitamins) Skills
1st 2nd 3rd 4th 5th
DATE:
Recognizes and
Engages in appropriate
sorts red, blue and
leisure and recreational
yellow (primary
activities to maintain
mental health colors), associating
them with objects
found in the home,
school, and
Aware of potential
community
dangers inside the house
(e.g., matches; Recognizes and
sorts
disinfectants; knives; circle, square,
triangle
stairs); practices basic and
safety habits rectangle (basic
shapes), associating
Recognizes potential
dangers in the them with objects
community andfoundknowsin the home,
how to protect self fromand
school,
community
harm (e.g., safely crosses
the street; avoidDiscriminates sizes
strangers) according to big-
Demonstrates small, tall/long-
short in
appropriate behavior
school (e.g., stays in line;
no pushing/ shoving;
Discriminates
follows playground rules)
weights according to
heavy-light using
standardized (e.g.,
scale) and non-
standardized Remarks
Skills
measuring tools st nd
(e.g., use of hands) 1 2 3rd 4th 5th
DATE:

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Discriminates
temperature
according to hot- Remarks
cold using Skills st nd
1 2 3rd 4th 5th
standardized (e.g.,
DATE: and
thermometer)
non-standardized Possesses number
measuring toolsawareness,
(e.g., use of hands)
functionally used
Compares to determine age,
capacity: emptyhome number,
vs. full telephone number,
etc.

Rote counts,
recognizes and
sequences 0-10
Measures
according to near-
far

Sorts objects up to
2 attributes at a
time: size, color,
Seriates using 3-5
objects (biggest-shape, texture,
smallest) etc.

Familiar with
positional and
space concept (up-
down, over-under,
in-out, between,
etc.) Remarks
Skills
st nd
1 2 3rd 4th 5th
DATE:

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Recognizes AB
patters made with
real objects SCIENCE Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:
Recites the Focus on science
processes of
months of the year
and associates investigating and
them with exploring,
daily/weekly exploring,
routines observing,
collecting,
Recites the
organizing,
months of the year
measuring and
and associates
comparing, and
them special
cause and effect
occasions
Self-awareness / Body concept
Names/points to
Knows the use and
major body parts
value of money to
and their functions
purchase goods

Knows how to take

care of body and
Recognizes and stay healthy
sorts bills and
coins
Visually
discriminates
familiar objects
according to
color/size/shape,
and recognize
common signs and Remarks
Skills
symbols 1 st
2 nd
3rd 4th 5th
DATE:

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Auditory
discriminates
familiar sounds of Seasons and Weather
Remarks
objects/people
Skills 1st 2nd 3rd 4th 5th
and their source
DATE:
(e.g. bell, horn,
familiar voice, etc)
Recognizes rainy,
cloudy and sunny
Discriminates weather and their
tactile sensationsassociations
as to temperature
texture, moisture

Discriminates Observes daily

different tastes of
weather changes
food as to salty,(cloudy, rainy,
sweet , bitter, sour
sunny)

Discriminates
different odors and
their associations,
Knows the sun as
classifying themour source of light
as pleasant or and warmth
unpleasant

SOCIAL STUDIES
Remarks
Skills
1st 2nd 3rd 4th 5th
DATE:

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 Places That I Got To
My home: different
parts of my home, Remarks
Community Helpers
things found in st nd
Skills 1 2 3rd 4th 5th
each part and
their DATE:
function
Identifies different
community
My school:
helpers and their
different parts of
functions
my school;
identifying people
who make up my
school
My community:
identifying
important Knows places of
landmarks: work and tools of
market, park, different
community
church, hospital,
etc. helpers
Recognizes and
sorts different
modes of
transportation;
has practical
Appreciates
knowledge of using
importance of
transportation to
get from one community
helpers
location to another

1ST 2ND 3RD 4TH

ATTENDACE

TOTAL NUMBER OF DAYS

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 DAYS ATTENDED

DAYS TARDY

Assessed By:

____________________

Date:

___________________

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