UNIVERSITY OF SANTO

TOMAS
COLLEGE OF
EDUCATION
ELEMENTARY EDUCATION DEPARTMENT

DEVELOPMENTAL CHECKLIST

Observer: Eric Matthew M. Esteban Cooperating School: Lourdes Scool QC Child’s

Name (Initials only): MVA Child’s Date of Birth: 02/18/12 Grade Level: Fatina-
(Grade.4) Diagnosis (if known): N/A

MOVEMENT/ PHYSICAL DEVELOPMENT

OBSERVATION OBJECTIVES: Gross and fine motor
MILESTONE 1ST 2ND 3RD
OBSERVATI OBSERVATI OBSERVATI
ON ON ON
MM/DD/YY MM/DD/YY MM/DD/YY

Prefer one hand and foot over NO / A / M

another, which is known as right or
left dominance

how improvement in handwriting and the

ability to use other tools

Complain of growing pains like muscle

cramps

Trouble Coordinate movements, like

dribbling a swinging and serving in volley
ball.

Gain agility, balance, coordination, power,

speed and reaction time
INDICATORS: NO – Not Observed, A- Attempted, M-Mastered

OBSERVATION NOTES
1ST OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

2ND OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

3RD OBSERVATION
• Bullet form the statements that would justify
the indicators for the skills.
UNIVERSITY OF SANTO
TOMAS
COLLEGE OF
EDUCATION
ELEMENTARY EDUCATION DEPARTMENT

COGNITIVE
OBSERVATION OBJECTIVES: *input focus area in this developmental area
MILESTONE 1ST 2ND 3RD
OBSERVATI OBSERVATI OBSERVATI
ON ON ON
MM/DD/YY MM/DD/YY MM/DD/YY

*insert milestones for this area in this NO / A / M

column. Add or remove rows as needed.

Understand that thoughts are private

Understand that people see others

differently than they see themselves

Predict the consequences of an action and

plan accordingly

Rely on friends, the news, and social media

to learn information and form opinions

Develop a better sense of responsibility and

help out around the house
Understand events or things are connected

INDICATORS: NO – Not Observed, A- Attempted, M-Mastered

OBSERVATION NOTES
1ST OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

2ND OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

3RD OBSERVATION
• Bullet form the statements that would justify
the indicators for the skills.
UNIVERSITY OF SANTO
TOMAS
COLLEGE OF
EDUCATION
ELEMENTARY EDUCATION DEPARTMENT

SOCIAL AND EMOTIONAL

OBSERVATION OBJECTIVES: *input focus area in this developmental area
MILESTONE 1ST 2ND 3RD
OBSERVATI OBSERVATI OBSERVATI
ON ON ON
MM/DD/YY MM/DD/YY MM/DD/YY

*insert milestones for this area in this NO / A/ M

column. Add or remove rows as needed.

May be uncertain about puberty and

changes to their bodies
INDICATORS: NO – Not Observed, A- Attempted, M-Mastered

OBSERVATION NOTES
1ST OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

2ND OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

3RD OBSERVATION
• Bullet form the statements that would justify
the indicators for the skills.
UNIVERSITY OF SANTO
TOMAS
COLLEGE OF
EDUCATION
ELEMENTARY EDUCATION DEPARTMENT

LANGUAGE/COMMUNICATION
OBSERVATION OBJECTIVES: *input focus area in this developmental area
MILESTONE 1ST 2ND 3RD
OBSERVATI OBSERVATI OBSERVATI
 ON ON ON
MM/DD/YY MM/DD/YY MM/DD/YY

*insert milestones for this area in this NO / A / M

column. Add or remove rows as needed.

INDICATORS: NO – Not Observed, A- Attempted, M-Mastered

OBSERVATION NOTES
1ST OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

2ND OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

3RD OBSERVATION
• Bullet form the statements that would justify the indicators for the skills.

CONCLUSION
Based on your observations, would you define the child’s development typical or atypical?
Why?
RECOMMENDATION
Are there areas that the child needs more support? What are your recommendations for the
parent/Teacher/ to supplement their child’s
development?
UNIVERSITY OF SANTO
TOMAS
COLLEGE OF
EDUCATION
ELEMENTARY EDUCATION DEPARTMENT

References: