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REVISED PHILIPPINE EARLY CHILDHOOD DEVELOPMENT CHECKLIST

Child Record Form – 2

Child’s Name: Sex: ___male ____female Date of Birth: Age:

Address:
Child’s Handedness: ____ right _____left ____both _______ not yet established

Is the child presently studying? _____yes _____no

Name of School:
Father’s Name : Father’s Age:
Father’s Occupation: Father’s Educational Attainment:
Mother’s Name : Mother’s Age:
Mother’s Occupation: Mother’s Educational Attainment:
Child’s number of siblings: Child’s birth order:
CONTACT NUMBER:

BOSY EOSY INTERPRETATION

INTERVENTIONS/ENHANCEMENTS IN:
Date Conducted:
Sum of Scaled Score:
Standard Score:

GROSS MOTOR DOMAIN

MID-
GROSS MOTOR MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Climbs on chair or
other elevated
Parental report will suffice
piece of furniture
like a bed
without help
2. Walks backwards MATERIALS:
toy
PROCEDURE:
Ask the child to walk backwards by
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demonstrating this. Credit if the child is
able to walk backwards without falling and
holding on to anything.
Parental report will suffice.
3. Runs without tripping MATERIA:
or falling ball
PROCEDURE:
Encourage the child to run by rolling a
ball across te floor. Credit if the child
can run fast and smoothly without tripping
or falling.
4. Walks down stairs, 2 Parental report will suffice.
feet on each step,
with one hand held
5. Walks upstairs MATERIAL:
holding handrail, 2 toy
feet on each step PROCEDURE:
Place a toy in the middle of the step
and ask the child to walk up the stairs
to get the toy. Credit if the child walks up
walks up the stairs using the handrail or
wall for support and places both feet on
each step before stepping on the next one.
Parental report will suffice.
6. Walks upstairs with MATERIAL:
alternate feet without toy
holding handrail PROCEDURE:
Place a toy in the middle of the step
and ask the child to walk upstairs to
get the toy. Credit if the child walks
upstairs, alternating his feet as he steps on
each successive step without holding on to
the handrail or wall for support.
Parenting report will suffice.
7. Walks downstairs MATERIAL:
with alternate feet TOY
without holding PROCEDURE:
handrail Place a toy in the middle of the step
and ask the child to walk downstairs
to eat the toy. Credit if the child walks
downstairs, alternating his feet as he steps
on each successive step without holding on
to the handrail or wall for support. Do not
give credit if the child places both feet on
the step or uses the handrail or wall for
support.
Parental report will suffice.
8. Moves body part as PROCEDURE:
directed Ask the child to raise both arms.

9. Jumps up This must be elicited by the interviews.

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FINE MOTOR DOMAIN

MID-
FINE MOTOR MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Uses all 5 fingers to MATERIALS: small toy/object
get food/toys placed PROCEDURE:
on flat surface Seat the child on the parent's lap
with his elbows at level with the
tabletop and his hands on the table
or flat surface. Drop a small toy in
front of him and attract his attention
by pointing to the toy or tapping the
table/flat surface. Credit if the child
picks up the toy, using all 5 fingers as if
raking.
2. Picks up objects MATERIALS: any small toy or food
with thumb and PROCEDURE:
index finger Place a toy/food in front of the child
and within his reach. Attract his
attention by tapping neat the
toy/food. Credit if the child uses the tips
of his thumb and index or
forefinger to pick up the toy/food.
3. Displays a definite MATERIAL:
hand preference toy
PROCEDURE:
Place the toy directly in front of the
child at midline (not to his left or his
right) and ask him to reach for this.
Credit if he uses the same hand 2 out of 3
times.
Parental report will suffice.
4. Puts small objects MATERIALS: small objects, container
in/out of containers This must be elicited by the interviews
5. Holds crayon with MATERIALS:
all the fingers of his crayon
hand making a fist PROCEDURE:
(I.e., palmar grasp) Present child with a crayon and have
him get this. Credit if he holds it by
wrapping all
5 fingers around as if making a fist.
Automatically credit this item if he uses the
tips of all 5 fingers or his thumb, index and
middle fingers.
This must be elicited by the interviews.
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6. Unscrews lid of MATERIALS: Container with screw-on
container or unwraps top or wrapped candy.
food This must be elicited by the interviews.

7. Scribbles MATERIALS: paper, pencil/crayon

spontaneously PROCEDURE:
Place a paper and pencil/crayon on
the table or flat surface and ask the
child to draw anything he wants
without showing him what to do.
Credit if the child uses the tips of his
thumb and any of his other fingertips to
grasp the pencil/crayon and makes
purposeful marks on the paper (not
accidental marks).
8. Scribbles vertical MATERIALS: paper, pencil/crayon
and horizontal PROCEDURE:
lines Place a paper and pencil/crayon on
the table or flat surface and ask the
child to draw vertical and horizontal
lines after you have demonstrated
these to him. Credit if the child produces
a vertical or horizontal line that is at least 2
inches long and does not divided or vary
from your vertical line by more than 30
degrees. The lines may be
wavy but not broken.
9. Draws circle MATERIALS: paper, pencil/crayon
purposely PROCEDURE:
Place a paper and pencil/crayon on
the table or flat surface and ask the
child to draw a circle or a ball after
you have demonstrate it to him.
Credit if the child produces any curve that
is closed or nearly closed. Continuous
spiral motions are not
credited.
10. Draws a human MATERIALS: paper, pencil
figure (head, eyes, PROCEDURE:
trunk, arms, Give the child a pencil and a paper
hands/fingers) and ask him to draw a picture of a
person. Credit if the child has drawn 3 or
more body parts. A pair is considered one
part (eyes, ears,
arms, hands, legs, and feet)
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11. Draws a house using MATERIALS: paper, pencil
geometric forms PROCEDURE:
Give the child a pencil and paper and
ask him to draw a picture of a house.
Credit if the child has drawn at least the
roof, main frame, and a door or window
TOTAL SCORE
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SELF-HELP DOMAIN

MID-
SELF-HELP MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Feeds self with MATERIALS: bread, biscuits
finger food (e.g. This must be elicited by the
biscuits, bread) interviewer.
using fingers
2. Feeds self using Automatically credit if the child eats without
fingers to eat spillage
rice/viands with
Parental report will suffice
spillage
3. Feeds self using Automatically credit if the child eats without
spoon with spillage spillage
Parental report will suffice
4. Feeds self using
fingers without Parental report will suffice
spillage
5. Feeds self using
spoon without Parental report will suffice
spillage
6. Eats without need
for spoon feeding Parental report will suffice
during any meal
7. Helps hold cup for Note: The cup should not have a lid
drinking or spout.
8. Drinks from cup with Ask the caregiver if the child can
spillage drink from a cup/glass with some
spillage. The cup should not have a
lid or spout.
9. Drinks from cup MATERIALS: drinking cup, water
unassisted This must be elicited by the
interviewer.
10. Gets drink for self
Parental report will suffice
unassisted
11. Pours from pitcher
without spillage Parental report will suffice

12. Prepares Ask the caregiver if the child can

own prepare his own snack without help
except for getting items that are
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food/snack hard to reach (e.g.
bowl spoon).
13. Prepares meals for
younger Parental report will suffice
siblings/family
members when
no adult is
around
14. Participates when
being dressed (e.g. Parental report will suffice
raises arms or lifts
leg)
15. Pulls down gartered
Parental report will suffice
short pants
16. Removes sando Parental report will suffice
17. Dresses without
assistance except for Parental report will suffice
buttons and tying
18. Dresses without Material: small shirt w/button and
assistance shoestring
including buttons PROCEDURE:
and tying Have the child demonstrate how to
button in order to credit this item

TOILET TRAINING SUB-

DOMAIN

19. Informs the adult

only after he has
already urinated
Parental report will suffice
(peed) or moved his
bowels (poohed) in
his underpants
20. Informs adult of
need to urinate (pee)
or move bowels
Parental report will suffice
(poohpooh) so he
can be brought to a
designated place
(e.g.
comfort room)
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21. Goes to the
designated place to
urinate (pee) or Parental report will suffice
move bowels (pooh)
but sometimes still
does this in his
underpants
22. Goes to the
designated place to
urinate (pee) or
Parental report will suffice
move bowels (pooh)
and never does this
is his underpants
anymore

23. Wipes/Cleans self

after a bowel
Parental report will suffice
movement (pooh)

Bathing sub-domain
24. Participates
when bathing
Parental report will suffice
(e.g.
rubbing arms with
soap)
25. Washes and dries Ask the caregiver if the child can
hands without any wash and dry his face without any
help help or supervision except to turn
on/off faucets that are out of reach.
26. Washes face Ask the caregiver if the child can
without any help wash and dry his face without any
help or supervision except to turn
on/off faucets that are out of reach
27. Bathes without any
help
Parental report will suffice

TOTAL SCORE

RECEPTIVE LANGUAGE DOMAIN

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MID-
RECEPTIVE LANGUAGE MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Points to family PROCEDURE:
member when Ask the child to point to his
asked to do so mother/caregiver.
Credit if he does so.
2. Points to 5 body PROCEDURE:
parts on himself Have the child point to his eyes,
when asked to do so nose, mouth, hands and feet.
Credit if he can point to all these.
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pictured objects PROCEDURE:
when asked to do so Show the child a picture book (one
picture per page) and ask him to
point to the picture by saying
“Where's the ?”
Credit if the child can use his finger to point
to at least 5 pictures.
4. Follows one-step MATERIALS:
instructions that block/toy
include simple PROCEDURE
prepositions (e.g., Ask the child to put a block/toy under
in, on, under, etc.) the table; on the table; in the bag.
Do not point or use gestures when
giving the instructions. Credit if the
child is able to
follow at least one of the instructions.
5. Follows 2- MATERIALS:
step instructions block/toy
that include simple PROCEDURE:
prepositions Ask the child to get a block/toy from
under the table and then place it on
the table. Do not point or use
gestures when giving the instruction.
Credit if the child is able to
follow.
TOTAL SCORE

EXPRESSIVE LANGUAGE DOMAIN

MID-
EXPRESSIVE LANGUAGE MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Uses 5-20 PROCEDURE:
recognizable words Ask the caregiver if the child can
clearly say 5-6 words aside from
mama and papa. This will be the
minimum number.
2. Uses pronouns (e.g.
I, me, ako, akin) Parental report will suffice.

3. Uses 2-3 words verb-

noun combinations Parental report will suffice.
(e.g. hingi gatas)
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4. Names objects in MATERIALS: picture book
pictures PROCEDURE:
Show the child a picture book, point
to an object in the book, then ask him
to name this (e.g. “Ano ito?”). Credit if
the child can say the correct name of at
least 4 objects.
5. Speaks in
grammatically Parental report will suffice.
correct 23 word
sentences
6. Asks “what”
questions Parental report will suffice.

7. Asks “who”' and Parental report will suffice.

“why” questions
8. Gives account of PROCEDURE:
recent experiences Ask the caregiver if the child can
(with prompting) in recount recent experiences in correct
order of occurrence sequence and using past tenses
using past tense correctly. The caregiver can prompt
him so he can complete what he is
talking about (e.g., tapos, ano pang
nangyari) Parental report
will suffice.

COGNITIVE DOMAIN

MID-
COGNITIVE MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Looks at direction of MATERIALS: spoon /ball
fallen object PROCEDURE:
With the child seated, get his
attention and drop a spoon/ball in
front of him. Then observe if his eyes
look down as it falls.
Credit if the child can bring his eyes and
head down as the object falls.
2. Looks for partially MATERIALS: ball, small towel/cloth
hidden objects PROCEDURE:
With the child facing you,partially hide
a ball behind a small towel and
observe if he will look for it and find it.
Credit if the child pulls the towel &
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gets the hidden ball.
Automatically Credit if item no. 5 is
passed.
3. Imitates behavior Automatically Credit if item no. 6 is
just seen a few passed.
minutes Parental report will suffice.
earlier
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4. Offers object but will Parental report will suffice.
not release it
5. Looks for MATERIALS: ball, small towel/cloth
completely hidden PROCEDURE:
object With the child facing you, hide a ball
completely under a small towel and
observe if he will look under the
towel. Credit if he looks under the towel
and gets
the hidden ball.
6. Exhibits simple MATERIALS: doll or toy car/block
pretend play (feed, PROCEDURE:
put doll to sleep) If the child is a girl, carry the doll
and try to rock it to sleep. If the
child is a boy, move the toy
car/block back and forth. Credit if
the child can imitate this.
7. Matches objects MATERIALS: pairs of spoons, balls,
blocks PROCEDURE:
Place one spoon, one ball, and one
block on the table. (Live the child the
other set of objects arranged in
random order.
Demonstrate a matching, response
(e.g. spoon to spoon) then return the
objects to the child. Say, “Put each
object on the one that is just like it.”
Credit if the child can
match the objects correctly.
MATERIALS: 3 pairs of crayons (blue,
8. Matches 2 – 3 colors red, yellow)
PROCEDURE:
Place one crayon of each color on the
table or flat surface. Give the child
the other crayons arranged in random
order.
Demonstrate a matching repose (e.g.,
red crayon with another red crayon)
then returns the crayons to the child.
Say, “Put each crayon on the one that
is just like it.”
Credit if the child can match
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9. Matches pictures MATERIALS: 3 pairs of picture cards
(e.g., pictures of an apple, orange,
banana) PROCEDURE:
Place one copy of each picture on the
table or flat surface. Give the child
the other pictures arranged in
random order. Demonstrate a
matching response (e.g., picture of
an apple with another apple) then
returns the pictures to the child. Say,
“Put each picture on the one that is
just like it.” Credit if the child can match
all the pictures
correctly.
10. Sorts based on MATERIALS: 4 pairs of different
shapes shapes that are of the same size and
color.
PROCEDURE:
Show the child the shapes. Tell the
child, “Put together the ones that are
the same.” After the child sorts
and groups, the shapes, point to
the ones with the same shape and
ask. “Why did you put these
together?” Credit if the child can group
the same shapes and say why they are
the same (pareho sila,
pareho sila ng
hugis/shape, puro sila bilog).
11. Sorts objects based MATERIALS: 4 pairs of the same shape
on 2 attributes (e.g., that differ in size and color.
size and color) PROCEDURE:
Show the child the shapes. Tell the
child, “Put together the ones that are
the same”. Credit if the child can sort all
the shapes according to size and color.
12. Arranges objects MATERIALS: 4 pieces of graduated
according to size sized squares and 4 pieces of
from smallest to graduated sized circles
biggest PROCEDURE:
Show the child the first set of squares
spread out at random on a table or
flat surface. Say, “Here are 4
squares. Look, I can begin with the
smallest, then the next big one, until
the biggest one.” Demonstrate how
to arrange the squares. Then
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disarrange these and tell the child,
“Now you start with the smallest, put
the
next one and the next big one until
the last

one.” Repeat this procedure using the

circles without demonstrating.
Credit if the child arranges at least one set
of shapes in correct order from smallest to
biggest. Allow one trial for each set of
shapes.
13. Names 4 to 6 colors MATERIALS; 6 papers of different
colors PROCEDURE: Ask the child,
“What color is this?” Credit if the child
can name 4 – 6 colors correctly.

14. Copies shapes MATERIALS: Paper and pen/crayon

PROCEDURE: Let the child copy a
circle, triangle, and circle after
demonstrating how each of this is
done
15. Names 3 animals or Credit if the child can name 3 animals or
vegetables when vegetables.
asked

16. States what common Credit if he can state the use of function of
household items are at least 2 household items like a bed and a
used for drinking glass.

17. Can assemble simple MATERIAL: simple 4 – 6-piece puzzles

puzzles PROCEDURE:
Allow the child to solve the puzzle in 2
minutes. Proceed to the next item
after 2 minutes
18. Demonstrates an Credit if the child can give the opposite word.
understanding of
opposites by
completing a
statement (e.g., Ang
aso ay malaki, ang
daga ay
”)
19. Points to left and PROCEDURE: Sit across the child and
right sides of body ask “Show me your left hand.” Do the
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same for the following:
Right hand, left foot, right knee, left
shoulder, right eye, right knee, left
leg. Credit if the child can correctly point
out the left and right side on at least 5 body
parts
as requested.

20. Can state what is MATERIALS: A picture

silly or wrong with
pictures (e.g. Ano PROCEDURE:
ang mali sa Show the pictured scenes to the child
larawang ito?) one at a time and ask, “What is
wrong with this picture?” Credit if the
child correctly identifies what made the
picture incorrect.
21. Matches upper- MATERIALS: 2 s e t s o f Alphabet
and lower-case cards with upper- and lower-case
letters letters
PROCEDURE:
Randomly present 4 pairs of upper
case letters. Have the child match
these. Do the same with 4 pairs of
lowercase letters.
Credit if the child can match any 4
pairs, regardless of whether these are
the upper or lower case.
NOTE: The child does not need to
know the names of the letters.

TOTALSCORE

SOCIAL-EMOTIONAL DOMAIN

MID-
SOCIO-EMOTIONAL MATERIALS/PROCEDURE BOSY COMMENTS COMMENTS EOSY COMMENTS
YEAR
1. Enjoys watching
activities of nearby Parental report will suffice
people or animals
2. Friendly with
strangers but initially
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may show slight
Parental report will suffice
anxiety or
shyness
3. Plays alone but likes
to be near familiar Parental report will suffice
adults or brothers
and sisters
4. Laughs or squeals
Parental report will suffice
aloud in play
5. Plays peek-a-boo
Parental report will suffice
(bulaga)
6. Rolls ball
interactively with Parental report will suffice
caregiver/examiner
7. Hugs or cuddles Parental report will suffice
toys
8. Demonstrates
respect for elders Parental report will suffice
using terms like “po”
and “opo”

9. Shares toys with

others Parental report will suffice

10. Imitates adult

activities (e.g., Parental report will suffice
cooking, washing)
11. Identifies feelings in Credit if the child can tell when the
others caregiver is feeling happy, sad, worried,
etc. Parental report will suffice
12. Appropriately uses
cultural gestures of
greeting without Parental report will suffice
much prompting
(e.g., mano,
bless, kiss, etc.)
13. Comforts Parental report will suffice
playmates/sibling
s in distress
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14. Persists when faced Credit if the child tries to solve the problem
with a problem or instead of crying when something stands in
obstacle to his the way of what he wants (e.g.., fastening
wants a box of his treasures with a string if the lid
no longer closes)
15. Helps with family
chores (e.g., wiping Parental report will suffice
tables, watering
plants, etc.)
16. Curious about Credit (if the child asks questions about
environment but things around him but knows when he is
knows when to stop being “makulit” about the topic Parental
asking questions of report will suffice
adults
17. Waits for turn Parental report will suffice
18. Asks permission to
play with toy being Parental report will suffice
used by another
19. Defends Credit if the chid tries to hold on to what is
possessions with his when someone tries to grab this from
determination him. Parental report will suffice

20. Plays organized Parental report will suffice

group games fairly
(e.g., does not cheat
in order to win)

21. Can talk about

difficult feelings
Parental report will suffice
(e.g., anger, sadness,
worry) he
experiences.
22. Honors a simple
bargain with
caregiver (e.g., can Parental report will suffice
play outside only
after cleaning /
finishing his
room)
23. Watches responsibly
over younger Parental report will suffice
siblings/family
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members
24. Cooperates with
adults and peers in
Parental report will suffice
group situations to
minimize quarrels
and conflicts
TOTAL SCORE

Prepared and conducted by: Verified by:

_________________________ _______________________________
Teacher School Head