Republic of the Philippines

Department of Education
DIVISION OF DAVAO CITY
SAN JUAN ELEMENTARY SCHOOL
MINTRADE DRIVE, BRGY. CENTRO, AGDAO, DAVAO CITY
Office of the School Principal
SJES SPED FORM 1.5

NAME:__________________________________________________Grade and Section:

______________

TEACHER:_______________________________________________________

PARENTS NAME & SIGNATURE: _____________________________________

Difficulty in Hearing Checklist

CHARACTERISTICS CHECK
IF OBSERVED
Physical Characteristics

• Has no outer ear

• Has closed ear canal
• Has discharging ears
• Has chronic catarrhal condition
Learning Characteristics
• Cups hands behind the ear to catch sound
• Cocks ear/tilts head at an angle
• Shows strained expression when listening
• Pays more attention to vibration and vibrating objects
• Moves closer to the speaker when talked to
• Is less responsive to noise, voice, or music
• Watches face especially the mouth and lips of the speaker when
talked to
• Fails to respond oral questions
• Makes use of more natural gestures, signs and movements to express
himself
• Shows marked imitativeness at work or play
• Often asks for repetition of questions or statements
• Has blank facial expression
• Often unable to follow directions/instructions
• Has difficulty in associating concrete with abstract ideas
• Has poor general learning performance

Address: Mintrade Drive, Brgy. Centro, Agdao, Davao City

Tel. No.: (02) 297-7577
E-mail: sanjuan.es@deped.gov.ph
 Republic of the Philippines
Department of Education
DIVISION OF DAVAO CITY
SAN JUAN ELEMENTARY SCHOOL
MINTRADE DRIVE, BRGY. CENTRO, AGDAO, DAVAO CITY
Office of the School Principal
Speech and Language Characteristics
• Usually has no speech
• If he has speech, he…
> tends to speak in words rather than in sentences
with proper word order

Reference: NTOT/ BLD-SID

Address: Mintrade Drive, Brgy. Centro, Agdao, Davao City

Tel. No.: (02) 297-7577
E-mail: sanjuan.es@deped.gov.ph