Philippine Early Childhood

Development Checklist
Form 2
(3.0 – 5.11 years old)

Child’s Name: ______________________________________________

Birthdate: ___________ Age: ________ as of _________ Sex: _____ cleaning/finishing his
room)
23. Watches responsibly
over younger
siblings/family
members
24. Cooperates with
adults and peers in
group situations to
Child’s Name: ______________________________________________________ minimize quarrels
and conflicts
SOCIAL - P O R COMMENTS P O R COMMENTS P O R COMMENTS TOTAL SCORE:
EMOTIONAL Province: ____________Municipality/City: ___________ Barangay:___________
DOMAIN
15. Helps with family Sex: _______ Male Handedness: __________ Right
chores (e.g., wiping
tables, watering _______ Female __________ Left
plants, etc.)
16. Curious about
environment but
To the Parents:
knows when to stop The Philippine Early Childhood Development Checklist (Form 2) contains knowledge,
asking questions of skills and attitudes of children 3 – 5.11 years old. This may be used as a guide in
adults knowing your child and consequently give appropriate care and teaching to guide
17. Waits for turn their growth and development.
18. Asks permission to Content:
play with toy being Every page contains different domains of development with their corresponding total
used by another scores:
19. Defends possessions
with determination
- Gross Motor Domain has 13 items - Expressive Language Domain has 8
20. Plays organized
group games fairly (e.
items
g., does not cheat in - Fine Motor Domain has 11 items - Cognitive Domain has 21 items
order to win)
- Self-help Domain has 27 items - Social-Emotional Domain has 24 items
21. Can talk about
difficult feelings (e.g., - Receptive Language Domain has 5
anger, sadness, items
worry) he
experiences.
22. Honors a simple
bargain with Each item observed are recorded three time within a year: 1) at the start of the
caregiver (e.g., can year, 2) at the middle of the year, and 3) at the end of the year.
play outside only after Columns:
P – Present or the child can do the task
 O – Observed or the child was observed doing the task 10. Imitates adult activities
R – Report given by the parents/caregiver about the skill (e.g., cooking, washing)
11. Identifies feelings in
others
Score: 12. Appropriately uses
cultural gestures of
(√ ) Present or child is able to do the task greetings without much
prompting (e.g., mano,
( - ) Skill is not present or child does not respond bless, kiss, etc.)
( -9) no opportunity to observe the skill
13. Comforts
playmates/siblings in
distress
14. Persists when faced with
a problem or obstacle to
his wants
​SOCIAL-EMOTIONAL DOMAIN
SOCIAL - EMOTIONAL P O R COMMENTS P O R COMMENTS P O R COMMENTS GROSS MOTOR DOMAIN
DOMAIN A. 3.1 – 4.0 Years
1. enjoys watching activities Gross Motor P O R COMMENTS P O R COMMENTS P O R COMMENTS
of nearby people or 1. Climbs on chair or
animals other elevated piece
2. Friendly with strangers of furniture like a
but initially may show bed without help
2.
slight anxiety or shyness Walks backwards
B. 4.1 – 5.0
3. Plays alone but likes to be
near familiar adults or Gross Motor P O R COMMENTS P O R COMMENTS P O R COMMENTS
brothers and sisters 3. Runs without
SOCIAL - EMOTIONAL P O R COMMENTS P O R COMMENTS P O R COMMENTS tripping or falling
DOMAIN 4. Walks down stairs,
4. Laughs or squeals aloud 2 feet on each
in play step, with one
5. Plays peek-a-boo hand held
(bulaga) 5. Walks upstairs
6. Rolls ball interactively holding handrail, 2
with caregiver/examiner feet on each step
7. Hugs or cuddles toys 6. Walks upstairs
with alternate feet
A. 3.1 – 5.0 Years without holding
handrail
B. 5.1 – 5.11 Years 7. Walks downstairs
SOCIAL - EMOTIONAL P O R COMMENTS P O R COMMENTS P O R COMMENTS with alternate feet
DOMAIN without holding
8. Demonstrates respect for handrail
elders using terms like 8. Moves body part
“po” and “opo” as directed
9. Shares toys with others 9. Jumps up
 10. Throws ball 9. Draws circle purposely
overhead with 10. Draws a human figure
direction (head, eyes, trunk, arms,
C. .1 – 5.11 hands/fingers)
Gross Motor P O R COMMENTS P O R COMMENTS P O R COMMENTS 11. Draws a house using
10. Throws ball geometric forms
overhead with TOTAL SCORE:
direction
11. Hops 1 to 3 steps
on preferred foot
12. Jumps and turns
13. Dances
patterns/joins
group movement
activities
TOTAL SCORE:
FINE MOTOR DOMAIN

A. 3.1 – 4.0 Years

Fine Motor P O R COMMENTS P O R COMMENTS P O R COMM
ENTS A. 3.1 – 4.0 Years
1. Uses all 5 fingers to get COGNITIVE DOMAIN P O R COMMENTS P O R COMMENTS P O R COMMENTS
food/toys placed on flat
surface 6. Exhibits simple pretend
2. Picks up objects with play(feed, put doll to
thumbs and index finger sleep)
3. Displays a definite hand 7. Matches objects
preference
4. Puts small objects in/out B. 4.1 – 5.0 Years
of containers
5. Holds crayon with all COGNITIVE DOMAIN P O R COMMENTS P O R COMMENTS P O R COMMENTS
fingers of his hand 8. Matches 2-3 colors
making a fist (I.e., 9. Matches pictures
palmar grasp) 10. Sorts based on shapes
11. Sorts objects based on
B. 4.1 – 5.0 Year 2 attributes (e.g., size
and color)
Fine Motor P O R COMMENT P O R COMMENTS P O R COMM
12. Arranges objects
S ENTS
according to size from
6. Unscrews lid of smallest to biggest
container or unwraps
13. Names 4-6 colors
food
14. Copies shapes
7. Scribbles spontaneously
15. Names 3 animals or
8. Scribbles vertical and
vegetables when asked
horizontal lines
16. States what common
household items are
C. 5​.1 – 5.11 used for
Fine Motor P O R COMMENTS P O R COMMENTS P O R COMM
ENTS C. 5.1 – 5.11 Years
 COGNITIVE DOMAIN P O R COMMENTS P O R COMMENTS P O R COMMENTS 8. Gives account of
17. Cam assemble simple recent experiences
puzzles (with prompting) in
18. Demonstrates an order of occurrence
understanding of using past tense
opposites by
completing a statement TOTAL SCORE:
(e.g., Ang aso ay COGNITIVE DOMAIN
malaki, ang daga D. 3.1 – 4.0 Years
_____”) COGNITIVE P O R COMMENTS P O R COMMENTS P O R COMMENTS
19. Points to left and right DOMAIN
sides of body
1. Looks at direction of
20. Can state what is silly
or wrong with pictures fallen object
(e.g. Ano ang mali sa 2. Looks for partially
larawang ito? object hidden
21 Matches upper and 3. Imitates behavior just
lower case letters seen a few minutes
TOTAL SCORE: earlier
EXPRESSIVE LANGUAGE DOMAIN 4. Offers object but will
not release it
A. 3.1 – 5.0 Years 5. Looks for completely
EXPRESSIVE P O R COMMENTS P O R COMMENTS P O R COMMENTS hidden object
LANGUAGE DOMAIN SELF-HELP DOMAIN
1 Uses 5-20 recognizable A. 3.1 – 4.0 Years
. words
SELF-HELP P O R COMMENTS P O R COMMENTS P O R COMMENTS
2 Uses pronouns (e.g. I,
1. Feeds self with finger
. me, ako, akin)
food (e.g. biscuits,
3 Uses 2-3 words bread) using fingers
. verb-noun
2. Feeds self using
combinations (e.g. hingi
fingers with spillage
gatas)
3. Feeds self using
4 Names objects in
spoon with spillage
. pictures
4. Feeds self using
B. 5.1 – 5.11 Years fingers without
EXPRESSIVE P O R COMMENTS P O R COMMENTS P O R COMMENTS spillage
LANGUAGE 5. Feeds self using
DOMAIN spoon without
5. Speaks in spillage
grammatically correct
2-3 word sentences ​B. ​4.1 – 5.0 Years
6. Asks “what”questions
SELF-HELP P O R COMMENTS P O R COMMENTS P O R COMMENTS
7. Asks “who” and “why”
6. Eats without need for
questions
spoon feeding during
any meal
7. Helps hold cup for 19. Informs the adult only
drinking after he has already
8. Drinks from cup with urinated (peed) or
spillage moved his bowels
(poohed) in his
C. ​5.1 – 5.11Years underpants
SELF-HELP P O R COMMENTS P O R COMMENTS P O R COMMENTS
9. Drinks from cup 20. Informs adult of need
to urinate (pee) or
unassisted
move bowels
10. Gets drink for self (pooh-pooh) so he can
unassisted be brought to a
11. Pours from pitcher designated place (e.g.
without spillage comfort room)
12. Prepares own
21. Goes to the
food/snack
designated place to
13. Prepares meals for urinate (pee) or move
younger bowels (pooh) and
siblings/family never does this is his
underpants anymore
members when no
adult is around

SELF-HELP P O R COMMENTS P O R COMMENTS P O R COMMENTS

Dressing Sub-Domain
14. Participates when
SELF-HELP P O R COMMENTS P O R COMMENTS P O R COMMENTS
being dressed (e.g.
22. Goes to the
raises arms or lifts leg)
designated place to
15. Pulls down gartered urinate (pee) or move
short pants bowels (pooh) and
never does this is his
16. Removes sando underpants anymore

17. Dresses without 23. Wipes/Cleans self

assistance except for after a bowel
buttons and tying movement (pooh)
18. Dresses without 24. Participates when
assistance including bathing (e.g. rubbing
buttons and tying arms with soap)
25. Washes and dries
Toilet Training sub-domain hands without any
help
26. Washes face without
any help
27. Bathes without any
help
TOTAL SCORE:
RECEPTIVE LANGUAGE DOMAIN
A. 3.1 – 5.11 Years
RECEPTIVE P O R COMMENTS P O R COMMENTS P O R COMMENTS
LANGUAGE DOMAIN
1. Points to family
member when asked
to do so
2. Points to 5 body parts
on himself when
asked to do so
3. Points to 5 named
pictured objects when
asked to do so
4. Follows one-step
instructions that
include simple
prepositions
5. Follows 2-step
instructions that
include simple
prepositions
TOTAL SCORE: