PSYCHOEDUCATIONAL ASSESSMENT

REPORT

In Partial Fulfillment for the Requirements in

SPED75- Assessment of Children with Special
Needs Teacher Education Department
College of Education
Cavite State University
Indang, Cavite

JOHN D. CRUZ
II-BEE SPED

March 2016
 CONFIDENTIAL

PSYCHOEDUCATIONAL ASSESSMENT REPORT

I. PERSONAL DATA

Name : John D. Cruz

Age: 6.7 years old
Date of Birth: September 6 , 2010
Address: De Ocampo Trece Martirez City
Name of parents
Mother’s Name
Mrs. Ma. Caridad Cruz
Father’s Name
Mr. Geronimo Cruz
Sibling Order: Only Child
Date of Assessment:
March 7, 2016
March 15, 2016

II. SOURCES OF DATA

A. Medical Assessment Reports
B. Informal Skill Survey
C. Interview
D. Case Study Report
E. Portfolio

III. Report

This assessment was conducted to determine the overall performance of

John D. Cruz. The Psycho-educational Assessment was conducted to determine
the strengths and weaknesses JC along each area of development. It was
conducted on March 7 and March 15 2016.
JC was diagnosed with autism. At the age of 5.2 he was given clinical
intervention in speech or language due to the delay in language development and
psycho-social area because of behavior problems. Developmental and behavioral
assessment was conducted by a developmental pediatrician to approximate the
range of capabilities of JC. in the areas of gross motor , fine motor , language ,
social adaptive , cognitive or problem solving and behavior patterns such as
activity level , mood , and distractibility towards other people.
The medical assessment report shows the overall performance to be fair.
On the other hand, JC excelled in areas of gross motor skill, psycho-social skill.
JC‘s performance interpreted to be adequate for his level of exceptionality. JC
socialized with his peers and tries to adapt to his environment.
Informal skill survey reveals the current performance of JC along the five
areas of development such as cognitive, language, psycho-social, motor (gross
and fine) and self-help.
In Cognitive area , the over all performance of JC was fair. In recognizing
the lower case and upper case letters of the alphabet , it takes time for him to
recognize the letter, he will just repeat the sound of the letter when you are
teaching the letters of the alphabets. With regards to discriminates objects
according to shape , texture , naming primary colors and distinguishing left and
right , recites own address, ask why questions he didn’t accomplish this category.
But it is really surprising that he excelled in discriminating objects according to
height and color. He cannot count numbers from 1 to 30 but if you show him the
visual representation of the numbers from one to ten, he recognized and identifies
it.
The overall performance of JC in psycho-social developmental skill was
very satisfactory. JC shows how he is very sweet and caring towards his family
members. He loves imitating gestures, gestures of his mother, the way she cooked
food and as well as the gestures of other people. He is very approachable and easy
to get along with him. He welcomes their visitors to get inside of their house. It
shows that JC. is not afraid to interact with other people. He is well disciplined ,
but don’t dare to touch his things or rearrange his things because he knows the
arrangement of it JC had a good relationship towards other people, he shares his
toys and food with his playmates. He can easily appreciate things.
The overall performance of JC in language is fair. JC has a language or
speech delay that is why he cannot verbalize other words correctly but he repeats
the sounds what he heard from other people. JC can speak words such as dog, cat,
sponge bob , barney, frog , mama, papa, Lolo , Lola by imitation. He speaks these
words by sounding the letters of each word. He recites the vowels of the alphabet
when you show him the vowels of the alphabet but when there is no visual
representation JC cannot recite the vowels s of the alphabet. He was asked to
look on to my lips and follow the movements of the lips and imitate the sound.
He imitates directly what is asked to him to do. According to his mother he is able
to speak the sounds of the baby , dog and chicken. When JC saw this pictures
asked him what are the sounds , he immediately produces the sound of the
animals and the cry of the baby. JC identifies and recognizes objects if there are
visual representation being shown to him.
The over all performance of JC in fine motor skills was fair. JC holds the
pencil both left and right. He traces numbers from one to ten independently but
when his focus is transferred to another thing he cannot finish tracing the numbers
from one to ten. In building the ten blocks tower, JC is able to finish them
independently. There are times that some blocks fall but he manages to repeat the
procedure in building the tower. But during the cutting activity he cannot cut
straight and curve lines independently because he didn’t know how to use the
scissors independently. His mother’s help him to cut the lines being ask to him to
cut. When JC was asked to copy the picture of a man he didn’t copy it because he
is afraid of those pictures (picture of a person that he didn’t knew). But JC is fun
of writing circles the whole time but he really follows the instruction. JC‘s fine
motor skills is not yet fully developed.
The overall performance of JC in gross motor skill is satisfactory. He
manages to discriminates the simple body movements like walking, running,
 skipping, hopping, jumping , kicking and dancing. He dances gracefully, he
follows your dance step , I seems that he really love to dance. JC imitates
everything that other people would do. He also caches and throw ball
independently. JC moves independently that is really appropriate to his age and
typical of his exceptionality. Still, there are skills that he cannot perform
independently such as scrubbing the floor , crosses the road , sweeps the floor
and washes dishes. If someone will guide him in doing he said activities he can
accomplish this things.
The overall performance of JC in self help skill or practical skill was fair.
He needs support in doing this practical skills such as using knife , prepares his
own meal , removes his shoes, pull off his socks , unzips and zips his pants ,
unbutton and button his clothes and taking a bath. But there are practical skill he
can execute like brushing his teeth, washing his hands, drying his hands, eating
his own meal and choosing his own clothes. Bur if there’s something that catch
his attention he will loose his focus in the activity he is doing. Like in brushing
his teeth according to his mother if he looses his focus he will just play while
brushing his teeth. JC’s attention in accomplishing an activity is really important
most especially in practical skills.

IV. COMMENTS AND RECCOMENDATION

Based on the result on psycho educational assessment, his are he some
comments and recommendation:
1. JC easily understands and follows instructions;
2. JC has a short attention span;
3. JC is very approachable and loving child;
4. A special education teacher is needed in order to help him in developing
his cognitive, language, fine motor skills and self help or practical skills;
5. He needs a language therapy but if the sped teacher is available they can
already perform this to JC;
 6. JC needs to practice writing strokes, simple lines and also trace some letters,
shapes and numbers, for him to be able to develop his fine motor skills
exceptionality. JC really socialized with her peers and tries to adopt the
things that are occurrence to his existent world;
7. Is cognitive, language, fine motor skills and self help or practical skills;
8. He needs a language therapy but if the sped teacher is available they can
already perform this to JC; and
9. JC needs to practice writing strokes, simple lines and also trace some
letters , shapes and numbers , for him to be able to develop his fine motor
skills.
10. Any kind of inclusion practice, including mainstreaming, should be
allowed for JC.
11. Access to a special education classroom--often called a 'Resource Room'
should be made available for JC.

Assessed by:

JEAN V. SANTOS
BEE-SPED Student

Noted:

JASON R. MANIACOP
SPED Specialist
APPENDICES
 APENDICE A
(DIAGNOSTIC REPORT)
 JOEL D. LAZARO, M.D.
Developmental and Behavioral Pediatrics
SUMMARY DF DEVF-LOPMENTAL AND BEHAVIORAL ASSESSMENT

Name
Date of Birth
Chronologic age at time
Date of Assessment

DEVELOPMENTAL PROFILE

Expressive
Receptive
Social-adaptive
Problem Solving /

BEHAVIORAL PATTERNS

Activity level
Adaptability
Nfood
Distractibilit;'
Attention span
R•8ponsiveness
Others

MEDICAL CONCERNS
1.
2.

CURRENT DIAGNOSIS

NTEBC Ct M NDE E V
 JOEL D. LAZARO, M.D.
Fellow, Philippine Society for Developmental and Behavioral Pediatrics

PER No.:
32 No.:

i! ' ‹'';,.. '

 APPENDICE B
(DEVELOPMENTAL RATING SCALE)
 RA TING SCALE FOR DEVELOPMENTAL TASK
(5-7 YEARS OLD)

Legend-
For Cognitive, Psychosocial, Language.
Motor skills (Fine and Gross), and Self-help.

5 - Excellent = E
4 - Very Satisfactory = VS
3 = Satisfactory = S
2 = Fair = F
1 = Poor= P

Developmenta! Task E VS S F P Total

1. Recognizes lower case letters of alphabet
7. Recognizes upper case letter of the alphabet
3. discriminates objects according to size
4. Oiscriminaies objects according to height
5. discriminates objects according to color
6. Discriminates objects according to shape
7. discriminates objects according to texture
8. Idenofies shapes
9. 1&ntifies color
lG. Names shapes
I t. Flames primary colors
ICounts number from i to 30
i3. Counts and tells how many
14. Remember fami!y members
13. Distinguishes up and doHlJ
'6. Distinguishes left and right i directionall}')
i7. Recites ohm address
18. Recites o xzi phone numtx:r
t2. Ask ›vhv questions
 20. 4ShhOn'QUtSh0KS
’ loi

PSYCHOSOt’L4 L

. imitates tenures
2 PTays with othcr child›-cii t X
3. Responds to hislher same when called
4. Shares tovs *Cth others
5. Shares foods with othe
6. Interacts w'ith adults
7. Asks for other’s opinions )
8. Identifies family members
9. Identifies friends
10. Describes family members
11. Describes friend’s personality )
12. Expresses his/her personal needs
13. Waits for his turn
14. Identifies personal belongings
15. Cares for his belongings
1 o. Complies xvith request and command j
17. Says "Thank You "
18. Says "Welcome" I
19. Says *Kxcuse Me”
?0. Sa›'s 'Po and Opo”

LANGUAGE

1. Recites letters from the alphabet

2. Listens anentively
3. Repeals sounds listen to
4. Says name when asked for it
5. Relates oss n simple stories. incidents
f. Names object in picture
7. San‘s \ ords x ith "th" ,Ind “s sc1unds
 10. Recalls parts of a stow
Learns simple songs
12 Sir:gs simple son*s
13 Relates story’ listencd to
!4 Tells time is ith assistance
15 Asks the meaning of new » ords
16 Follows ‹li rectioi i
17 blames dat in a vcc!i
18. Names months in a vear
19. Expresses thouuhts rind ideas
20. Tells tiiiic
Total

MOTOR SK*LLS (FINE)

1. Traces number from I to 10

2. Builds IO block tower
3. Opens bottle jars
4. Clos•.s bottle jars
5. Cuts straight line
b. Cuts curve lines
7. Hold the oencil correctly
8. Conies simple «'ords correctly
9. Draws person ix ith beds,’
10. Print letters
11. Draws different shape
12. Sharpens pencil
13. Pours liquid in'o glass container
14. Assembles Leeo pieces following a pattern
! 5. UnwTaps object
16. W ra9s ot›jeot•›
17.golds clav into diff.rent shapes
18. Uses tab!e knife
i 9. Sews simple stitsches
2G. Ties o«’r. shoes
To‹al
8IO’ftJR SKILLS (GROSS)

1. SL'ps
2. Jumps
s. Stu›tes
4. Main'mining balance xi hile standing
en one foot » ith eyes ciosed
5. Handles bulls with ease
6. Walks back ward
7. Walks neel-to-toe ix ithout losing balance
8. Walks up stairs with alternating fee‹
9. Walks dov.m stair» 'vi*h altemati•b feei
10. Thick bali
11. Catches Call
12. Throws ball
13. Stops
14. Swings
15. Dances
16. Crosses the road
i7. Washes dish
18. Swaps the floor
19. Wa'ers the plants _
20. Scrubs the floor

Total

SELF-HELP.*PRACTIC.4L SKILLS

1..Uses knife and fork

2. Prepares oivn meals
3. Brushes teeth
4. removes shoes
5. All off shocks
6. Unzips pants
7. Zips pants
b Unbutton clothes
9. Buttons clothes
10. 1Inhooks clothes
I ' . Hooks cl.ithes
 10. R emails pan.s of a stow
! 1. Learns simple songs
12. Sings simple sony+
J3. Relates stop' listened to
! 4. Teils time xx ith assistance
15. Asks the meaning of new ii ords
16. Follows ‹lirectioii

T 8. Names i»onths in a near

19. ñxgrcssc» thou his a.nd ideas
20. Tells time
Total

MOTOR SKILLS (FINE)

1. Traces number from 1 to 10

2. Builds IO block tower
3. Opens bottle jars
4. Clos•-s bottle jars
5. Cuts straight line
b. Cuts curve lines
7. Hold the oencil correctly
8. ñooios simple words correctl}
9. Draws person with beds
10. Print letters
1 1. Draws dilTerent shape
12. Sharpens pencil
13. Pours 1iq'aid in*o glass container
14. Assembles Les nieces following a pattern
! 5. Unwraps object
16. Wraps object›
17.golds clay' into diff-.rent shapes
18. Uses tab!e knife
i 9. Sews simple stitschcs
2G. Ties own shoes
12 Chooses o› ’n clnthcs
13. dresses
14. Undresses
15. Washes hands
1 6 Dries hands
7. Unties laces
18. Ties laces
19. Uses toilet
20. Takes a baih
APPENDICE C
(INTERVIEW)
Interview
March 7 , 2016

Pj:Pwede napo ba tayo magsimula?

Mrs. de Guzman:oo
Pj:ano po ang pangalan ny inyong anak po?
Mrs. de Guzman:Luis Antonio pero L.A. tawag namin
Pj:ilan taon nap sya?
Mrs. de Guzman: six , magseseven
Pj:kelan po?
Mrs. de Guzman: sa September 6
Pj:nagundergo nap o ba sya ng mga medication po? If meron po ano poi to?
Mrs. de Guzman: ah.. oo speech theraphy sa school nila dati sa silang,
tapos sa Dela sale kay Dr. Joel Lazaro, speech therapy at occupational
therapy yun
Pj:kelan po nagstart?
Mrs. de Guzman: nung five years old sya
Pj:saan po?
Mrs. de Guzman: ngayon ?
Pj:opo
Mrs. de Guzman: sa school nalang nila
Pj:ah napasok napo pala sya?
Mrs. de Guzman: oo
Pj:saan po?
Mrs. de Guzman:dati sa Dei Gracia , ngayon sa Gods Gift Learning Center
Pj:Saan po yun?
Mrs. de Guzman: sa may Capitol Hills
Pj:Ilan po sila sa room?
Mrs. de Guzman: lima sila
Pj:ano ano po exeptionalities?
Mrs. de Guzman: ah 2 my autism tapos tatlo sila my downsyndrome
Pj:kamusta naman po yung studies nya? Nahihirapan po ba sya o ok lang po?
Mrs. de Guzman:puro academic kasi tinuturo konti lang sa self help, pero
malaki improvement nya , hindi na makulit , hindi kasi sya makatigil ng
ganyan dati.
Pj:maalam nap o ba sya magsulat kahit pangalan nya lang?
Mrs. de Guzman:ah hindi pa sya marunung magsulat ng pangalan nya, pero
par nasa mood nasusulat nya ang letter “A”
Pj:ano pa po ba ang kaya nyang gawin?
Mrs. de Guzman: circles at A , pagtinuturuan ko kasi hindi nasunod pero
pag teacher nagawa naman sya
Pj:ano po yung alam nya na mga words?
Mrs. de Guzman: mama, papa, lola, tsaka yung pinsang kalaro , baby , dog ,
sponge bob , barney , blues clues. Pati yung iyak ng baby ginagaya nya.
Pj:Pag ka panganak palnag po alam nya na special sya?
Mrs. de Guzman:oo naman
Pj:Buti po hindi nyo itango gaya ng ginagawa ng iba
Mrs. de Guzman:Iisang anak nalang tatago, depende din sa magulang yun,
dapat nga iexpose talaga sila e
Pj:alam nya po ba and address nyo pag tinanung sa kanya?
Mrs. de Guzman: naku hindi , pero pag pauwi kami at lumampas kami jan
sa kanto iiyak na iyon ,
Pj:nakakaintindi naman po ba sya?
Mrs. de Guzman:oo , sa teacher nasunod talga yan
Pj:sa mga gamit mya po lam nya kung alin ang kanya?
Mrs. de Guzman:oo , sasabihin nyan kay A, kay mama , kay papa
Pj:buti po nasa mood sya ngayon
Mrs. de Guzman:oo kaya umaga kita pinapunta kais pag hapon naku
mahirapan kana jan
Pj:ah oo nga po
Mrs. de Guzman: sya magsimula kana at baka mawala sa mood iyan,,
Pj:sige po salamat po
Mrs. de Guzman:L.A. dali maycocolor kayo ni ate Pj
 APPENDICE D
(INDIVIDUALIZED EDUCATIONAL PLAN)
 IEP INDIVIDUALIZED
EDUCATIONAL PLAN
Topic / Lesson

Primary shapes
Objective
Draws different shapes

Objectives Activities Duration

Trace the primary shapes 1.Give the child an activity 6 hours
sheets and ask the child to
trace the primary shapes
one by one.

Copy the primary shapes 1.Post a chart or a drawing 6 hours

that contains the primary
shapes and ask the child to:
a. copy square
b. rectangle
c.triangle
d.circle
e. oval

Recognizes and identifies the 1.The teacher will show 6 hours

shape of
primary shapes
a.rectangle.
b. square
c. triangle
d.circle
e. oval
and then the child will tell
what is that shapes.
2.The teacher will ask the
child to group the object
according to shapes.
APPENDICE E
(LESSON PLAN)
 Lesson Plan 1
Topic: Tracing the Primary shapes
Objective:
At the end of the lesson the child will be able to trace the primary shapes.

Materials:
 Activity sheet that include the shapes that would be trace
 Pencil
 Sample visual representation
Procedure
1. The teacher will introduce the different shapes or the primary
shapes to the child one by one.
2. The teacher will give the instruction on tracing the shapes.
3. The teacher will give sample traced shapes to the child.
4. The teacher will now give the child he activity sheet that includes
he shapes to be traced by the child
Evaluatio
n

He will be given another sheet that contains the primary shapes he was
going to trace. The child should trace at least two shapes correctly in able to pass this
activity.
 Lesson Plan 2
Topic
Copying the primary Shapes
Objective
At the end of the lesson the child should be able to copy the primary shapes.
Materials:
 Chart of the Primary shapes
 Activity sheet
 Pencil
Procedures
1. The teacher will post a chart of the primary shapes.
2. She or he will review the primary shapes.
3. She will give an activity.
4. The teacher will give instruction.
5. the teacher will explain the instruction to the child
6. She or he will give he activity sheet to the child
7. The child will be asked to copy the primary shapes.

Evaluation
The child will be given another activity sheet and the teacher will post the
primary shapes individually and the child must copy at least three primary shapes
acceptably.
 Lesson Plan 3
Topic
Recognizes and identifies shapes
Objective:
At the end of he lesson the child should be able to recognizes and
identifies the primary shapes.
Materials:
 Cut outs of the primary shapes.
 Objects with different shapes
Procedures:
1. The teacher will show the primary shape cut outs.
2. The teacher will asked he child what is that shape.
3. the teacher will present different objects and the child will group it
according to shapes.
Evaluation
1. The teacher will show the primary shapes individually and ask the
child what is that shape.
2. The teacher will post all the shapes and ask the child to point the
shape she will be telling.
 APPENDICE E
(PROGRAM OF DEVELOPMENTALLY SEQUENCE PRIORITIES)
 GROSS
COGNITIVE PSYCHOSOCIAL LANGUAGE FINE MOTOR SELFHELP
MOTOR
 Recognizes lower  Ask for others  Recites letters of the  Draws different  Skates  Uses knife and fork
case letters of opinion alphabet. shapes  Walks kneel to  Prepares own meal
alphabet  Says name when ask  Print letters toe with  Removes shoes
First  Recognizes for it.  Copies simple loosing
quarter upper case of the  Relates simple words balance.
alphabet. stories.
 Discriminates
objects according
to size.
 Discriminates  Describes family  Says words with “th” &  Cuts straight lines  Crosses the  Full off socks
objects according members “s” sounds  Cuts straight lines road  Unzips pants
Second to shape.  Use words more  Opens bottle jars  Zips pants
quarter  Discriminates precisely.  Closes bottle jars
objects according  Uses future tense
to texture.
 Names shapes
 Names primary  Describes  Recalls parts of the  Molds clay into  Sweeps the  Unbutton clothes
colors. friend’s personality. story. different shapes floor  Button clothes
 Counts number 1  Learn simple songs  Pours liquid into a  Water the  Unhook clothes
to 30  Relates story listened glass container plants  Hooks clothes
Third  Distinguishes up to.  Assembles lego
quarter & down  Tells he time with pieces following a
assistance. pattern
 Distinguishes left  Says excuse me.  Names day in a week  Wraps objects  Scrubs the  Dresses
Fourth & right  Names the months of  Uses table knife floor  Unties laces
quarter  Recites own the year  Ties own shoes  Ties laces
address  Express thoughts and
 Recites own ideas.
phone number  Tells time
APPENDICE E
(Child’s Outputs)
1