CHECKLIST FOR NONGRADED

Name: _____________________________________________ Disability: _______________________ Age: ____

PERFORMANCE INDICATORS 1 2 3 4 5
DAILY LIVING SKILLS
SELF –FEEDING
1. Expresses need to eat or drink through non -verbal
and/or verbal means
2. Chews and swallows different kinds of foods
3. Swallows liquid like soup
4. Picks up food with fingers or scoops with spoon
5. Picks up and eats finger food Sips and drinks liquid
6. Eats with spoon and fork Uses the table knife for spreading
7. Cuts food using the table knife
8. Distinguishes edible and non -edible foods and substances
9. Peels/unwrap s food Uses table napkins Exhibits table setting skills
TOILETING
1. Uses comfort room/toilet bowl to urinate or defecate
2. Uses the toilet paper to clean -up self and disposes it properly
3. Uses dipper correctly
4. Cleans self with soap and water after toileting
DRESSING
1. Removes/puts on shoes or slippers
2. Removes/puts on socks
3. Removes/puts on clothes
4. Opens and closes dressing implements (zip/unzip, button/unbutton)
GROOMING and HYGEINE
1. Washes and dries hands properly
2. Cleans own face
3. Brushes Teeth Combs/brushes hair
SOCIO -EMOTIONAL DOMAIN
1. Uses courteous expressions appropriately
2. Asks an apology when necessary
3. Pays attention to someone talking
4. Engages in communication with others
5. Plays with peers Makes friends easy
6. Follows rules and regulations
7. Seeks/accepts help Expresses/shows appropriate emotions
8. Waits for one’s turn
9. Asks permission to use things owned by others
10. Seeks help from older friends Imitates adult activities
11. Displays sense of humor
12. Identifies self as a member of a family/cultural group
13. Identifies personal belongings
14. Displays sensitivity to the feelings of others
15. Shows sportsmanship
16. Shows initiatives to work on task
17. Works independently
18. Shows self-control
LANGUAGE DEVELOPMENT DOMAIN
LISTENING
1. Follows simple direction
2. Distinguishes different types of sounds
3. Comprehends simple and familiar stories
4. Listens attentively to stories, poems/rhymes
SPEAKING
1. Increases vocabulary to describe things
2. Increases vocabulary to express one’s feelings
3. Increases vocabulary to share information
4. Answers and responds to questions accordingly
5. Narrates simple and familiar stories
READING
1. Discriminates similarities and differences
between pictures and objects
2. Classifies objects according to function
3. Notes details in pictures
4. Visualizes objects and pictures from memory
5. Comprehends picture stories
6. Performs relevant study skills
WRITING
1. Holds/grips pencil properly
2. Traces lines and shapes
3. Traces letters, numbers, and one’s name properly
4. Copies lines, shapes, letters, numbers, and one’s name properly
5. Draws basic figures Uses basic strokes correctly
PSYCHOMOTOR DOMAIN
BASIC MOVEMENT
1. Sits, stands and walks with good posture
2. Runs and jogs gradually in increasing distance
3. Jumps and performs other exercise s with or without music
4. Lifts increasing heavy weights
5. Balances in one foot for gradually increasing period of time
6. Imitates motor movements of people and animals
7. Bends and straightens knees properly while feet flat on the floor
8. Goes up and down the stairs
PERCEPTUAL MOTOR SKILLS
1. Uses clay to make simple but increasingly
meaningful shapes and objects
2. Uses crayon to color
GROSS MOTOR COMPETENCIES
1. Walks while carrying objects
2. Jumps toward aim without falling
3. Throws and catches objects
4. Kicks ball without losing balance
5. Hops alternately without falling
FINE MOTOR SKILLS
1. Makes an object out of clay
2. Squeezes soft rubber ball of convenient size
3. Squeezes water from wet rag
3. Folds and divide paper into halves in imitation
4. Cuts out shapes, outline and objects
5. Pastes paper properly Strings and threads beads
6. Turns doorknob with forearm rotation
7. Removes bottle cap
COGNITIVE DOMAIN
1. Identifies colors Identifies shapes
2. Identifies letters of the alphabet
3. Identifies sounds of the letters of the alphabet
4. Identifies sizes (long, short, big, small, tall, short)
5. Sorts objects according to color
6. Sorts objects according to size
7. Sorts objects according to shape
8. Tells the size of an object Identifies numbers up to ___
9. Counts numbers up to ___
10. Follows one to three steps direction
11. Identifies the body parts
12. Identifies the five senses and their functions
13. Develops longer attention span to complete the task
14. Sequences/Arranges picture in the story
15. Identifies/reads simple words with pictures
16. Identifies/reads simple phrases with pictures
16. Identifies/reads simple sentences with pictures
17. Identifies the days of the week
18. Identifies the month of the year
19. Identifies one self
20. Identifies members of the family
21. Identifies different community helpers in school
and/or in the community
22. Identifies objects/pictures being presented
AESTHETIC AND CREATIVE DOMAIN
1. Uses the five senses to observe things in the classroom
2. Enumerates and classifies things in terms of
color, shape, texture and number
3. Points to drawings or paintings that they like or appreciate
4. Identifies basic drawing materials Draws and paints
simple objects based on a visual model
5. Displays his drawings and paintings on display board
6. Listens to musical pieces familiar to the child
7. Sings, with/without prompts, the musical pieces listened to
8. Sees and touches musical instruments found in school
9. Names musical instruments found in school
10. Watches how these musical instruments are used
11. Plays with the musical instruments with teacher’s prompts
12. Expresses appreciation for the dance that they prefer
13. Expresses appreciation for what was heard through
body movements
14. Moves one’s body with the variety of rhythms heard
15. Demonstrates feelings through facial expressions
16. Dances with/without music with the teacher
17. Watches a dramatic play from media
sources (television, internet
BEHAVIORAL DEVELOPMENT

1. Sits for long span period of time 1 2 3 4

2. Uses appropriate verbal communication for social interaction
3. Learns how to speak in a lower tone
4. Familiarizes with and takes rerouted direction
5. Follows “Quieting Down” Instruction
6. Performs simple tasks (e.g. throwing trash in the garbage, etc.)
7. Puts back materials used like pencil in its proper place.
8. Accepts consequences of behavior
9. Follow’s teacher’s command/ instruction
 9. Plays with other children. Takes turn in game activity
10. Participates well in the lesson being executed by the teacher
11. Responds to questions, activities given to him/her
12. Attends to task without getting out from the chair
13. Watch/listen to videos/music for 5 minutes
or more without options.
14. Responds positively to behavior management procedures
15. Reduces/eliminates inappropriate and aggressive
behaviours during the session
16. Reduces/ eliminates tantrums during the session
17. Takes turn in games/knows how to wait when playing time

Legend:

1 – Not Observed – No manifestation at all

2 – Less Prevalent – Rarely manifested

3 – Prevalent – Sometimes manifested

4 – More Prevalent – Often manifested

5 – Most Prevalent - Always manifested