Professional Documents
Culture Documents
A Requirement in
Foundations of Special and Inclusive Education
Instructor : Jessa M. Amon, LPT, MAEd
Submitted by:
Name
Year & Section
Client’s Information
Family:
Parents:
Mother’s Name: Mary Jane M. Guleng
Course: Job: Overseas Filipino Worker (Oman)
Father’s Name: Francisco M. Guleng
Course: Job: Chainsaw Worker
Siblings:
Health:
Religion: Roman Catholic
Income: Ranging Php. 10000 – Php. 15, 000 a month
Source of Income: Padala
Case History
Individual and Background Information
COGNITIVE –
(Communication skills)
(Thinking skills)
(Problem-solving)
(Others)
PHYSICAL –
(Gross-motor skills)
(Fine-motor skills)
(Self-help skills)
(Others)
SOCIAL –
(Interaction with Teachers/Family)
(Interaction with Classmates/Friends)
Interests
Others
EMOTIONAL –
(Moods and temperament, expression of feelings)
Emotional independence
Others