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Early Childhood Development Assessment

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SCORE SHEET

Fine Motor Domain

Receptive Language Domain

Cognitive Domain

Total

NOTES

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FINE MOTOR DOMAIN

Fine Motor Skill no. 7

I can draw independently.

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FINE MOTOR DOMAIN

Fine Motor Skill no. 8

I can draw vertical and horizontal lines.

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FINE MOTOR DOMAIN

Fine Motor Skill no. 10

I can draw a circle independently.

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FINE MOTOR DOMAIN

Fine Motor Skill no. 11

I can draw a human figure (head, eyes,

body, arms, hands, fingers, legs, etc.).

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RECEPTIVE LANGUAGE DOMAIN

Receptive Language Skill no.1

I can point to family members when asked.

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RECEPTIVE LANGUAGE DOMAIN

Receptive Language Skill no. 2

I can point out my parts of the body when asked.

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COGNITIVE DOMAIN

Cognitive Skill no. 7

I can match pair objects.

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COGNITIVE DOMAIN

Cognitive Skill no. 8

I can match two to three colors.

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COGNITIVE DOMAIN

Cognitive Skill no. 9

I can match similar objects.

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COGNITIVE DOMAIN

Cognitive Skill no. 10

I can distinguish similar and different shapes.

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COGNITIVE DOMAIN

Cognitive Skill no. 11

I can arrange objects according to two criteria. (ex; size and color)

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COGNITIVE DOMAIN

Cognitive Skill no. 12

I can arrange objects from smallest to biggest.

maliit

malaki

pinakamalaki

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COGNITIVE DOMAIN

Cognitive Skill no. 13

I can name four to six colors.

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COGNITIVE DOMAIN

Cognitive Skill no. 14

I can copy and draw a design.

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COGNITIVE DOMAIN

Cognitive Skill no. 15

I can name three animals and vegetables when asked.

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COGNITIVE DOMAIN

Cognitive Skill no. 16

I can say the name and functions of objects used at home.

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COGNITIVE DOMAIN

Cognitive Skill no. 18

I understand opposite words by completing a sentence.

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COGNITIVE DOMAIN

Cognitive Skill no. 20

I can tell what's wrong in the picture.

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Cognitive Skill no. 7

Cognitive Skill no. 8

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Cognitive Skill no. 9

Cognitive Skill no. 10

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Cognitive Skill no.12

Cognitive Skill no.11