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Functional Skills Checklist

This document contains a functional skills checklist that assesses students' motor skills, general knowledge, communication skills, early academics, and other life skills. It evaluates abilities related to personal care, fine motor tasks, self-help skills, vocabulary, literacy, numeracy, and safety. The checklist is adapted from various sources including the Brigance assessments. Teachers use it to identify skills to target and track progress in key developmental areas.

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Laura Carballido
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195 views6 pages

Functional Skills Checklist

This document contains a functional skills checklist that assesses students' motor skills, general knowledge, communication skills, early academics, and other life skills. It evaluates abilities related to personal care, fine motor tasks, self-help skills, vocabulary, literacy, numeracy, and safety. The checklist is adapted from various sources including the Brigance assessments. Teachers use it to identify skills to target and track progress in key developmental areas.

Uploaded by

Laura Carballido
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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FUNCTIONAL SKILLS CHECKLIST

Adapted from various inventories including the Brigance

Student: Grade: Date:

Teacher:

1. Motor Skills *Also see Occupational Therapy Report, if available

Personal Care / Self Help:

Dressing:
⃞ Takes shoes / boots off ⃞ Puts shoes / boots on
⃞ Takes jacket off ⃞ Puts jacket on
⃞ Takes backpack off ⃞ Puts backpack on – with some assistance

Fastening:
⃞ Manages large front buttons ⃞ Attempts to tie shoes
⃞ Velcros shoes closed ⃞ Ties shoes
⃞ Zips up front zipper

Eating:
⃞ Feeds self snacks ⃞ Lifts cup or glass from table
⃞ Spoon feeds without spilling ⃞ Opens containers
⃞ Puts left over food away (garbage or back into containers)

Toileting:
⃞ Knows when he/she needs to go and communicates this in some way
⃞ Needs help with all clothing
⃞ Pulls down pants
⃞ Attempts to wipe self
⃞ Cares for toileting needs other than help for wiping
⃞ Flushes toilet
⃞ Manages clothes adequately on own
⃞ Needs standby help

Fine Motor
⃞ Manipulates small toys / items (large lego, toy figurines...)
⃞ Puts items together (building blocks, interlocking blocks, large puzzles...)
⃞ Scribbles ⃞ Scribbles – seldom going off page
⃞ Traces lines ⃞ Traces some letters
⃞ Traces circles ⃞ Traces name
⃞ Copies some shapes ⃞ Copies some letters
⃞ Copies name ⃞ Colors simple shapes, mostly within the
lines
2. General Knowledge and Comprehension

Personal Data
⃞ First name
⃞ Full name
⃞ Sex
⃞ Age
⃞ Siblings

Vocabulary: Matching

Body Parts: Pointing To (Receptive) / Naming (Expressive)

1. mouth 6. tongue 11. arms 16. chin


2. eyes 7. head 12. fingers 17. tongue
3. nose 8. ears 13. stomach / tummy 18. hair
4. feet 9. hands14. back
5. toes 10. legs 15. teeth

Colours: Pointing To (Receptive) / Naming (Expressive)


1. red 3. green 5. orange 7. brown
2. blue 4. yellow 6. purple 8. black

Shape Concepts: Pointing to (Receptive) / Naming (Expressive):


1. circle
2. square
3. triangle

Quantitative Concepts
1. one / many 2. little / big

Directional / Positional Concepts


1. open / close 3. in / out 4. behind / in front of
2. front / back 4. up / down 6. over / under

Sorting / Classifying
1. Colours
2. Shapes
3. Animals
4. Toys
5. Cars / trucks
Readiness

Recites Alphabet

Recognizes Letters
Receptive:
Upper Case -
Lower Case -
Expressive
Upper Case -
Lower Case -

Word Recognition:
Approximate Grade Level -
Or
Estimated Number of Sight Words that student recognizes -

Reads Colour Words:

Reads Number Words:

Reads Calendar Words (days, months):

Reads Common Signs:

Go Stop In Out Boys Girls Exit Enter Men Women

Walk Wait Caution Danger

Literacy Skills:

⃞ Looks at books – right side up


⃞ Turns pages individually
⃞ Points to specific pictures on request
⃞ Names pictures
⃞ Takes part in read by ‘filling in’ words and phrases
⃞ Tries to read book from memory

Printing:

First Name:

Age:

Last Name:

Phone Number:

Lower Case Letters Dictated:


Upper Case Letters Dictated:

Simple Sentence:

Arithmetic:

Counts Objects to: ___________ Rote Counts to: ___________

Reads Numerals to (estimated):

Numeral Comprehension (matches quantity) to

Writes Numbers in Sequence to

Writes Numerals Dictated

Addition Combinations to

Subtraction Combinations to

Recognition of Money:

Tells Time:
FUNCTIONAL SKILLS SUMMARY FORM

Student: Date:

Personal Care / Self Help Skills to be worked on


1
2
3
4

Fine Motor Skills to work on…. please consult with OT/PT


1
2
3
4

Gross Motor Skills to work on…. please consult with OT/PT


1
2
3
4

Personal Knowledge…. Name, age, family members… to be learned


1
2
3
4

Early Learning - including Vocabulary and Concepts (objects, colours, etc) to be worked on
1
2
3
4
5

Functional Academics…. Early Literacy and Numeracy Skills to be worked on


1
2
3
4

Communication Skills to be worked on (consult SLP)


1
2
3
4

Assistive Technology Skills to be worked on (consult SET-BC)


1
2
3
4

Home and School Safety Skills to be acquired


1
2
3
4

Neighborhood Awareness and Safety to be acquired


1
2
3
4

Leisure Skills to be acquired


1
2
3
4

Community Awareness and Safety to be acquired


1
2
3
4

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