Observational Child Study 1 (SPED 4)

Republic of the Philippines
UNIVERSITY OF RIZAL SYSTEM

Morong, Rizal
COLLEGE OF EDUCATION
Observational Child Study I
Dr. Rosa F. Portillo Professor, SPED 4
Observational Child Study 1
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University of Rizal System is a premier technology-driven higher education institution by the year 2015.
The University of Rizal System is committed to produce competent and value-laden graduates in agriculture, engineering, science and technology, culture and the arts, teacher and business education through responsive instruction, research, extension and production services in Region IV.
G od Loving A ctive Concern for Environment T eamwork E xcellence and Integrity P roactive A dvocacy for Sustainable Development S ervice-Oriented and Resourceful S ocially Responsible to the global community.
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The College of Education aims to produce professional and competent teachers with knowledge, skills and desirable attitudes and values.
The State, community and family hold a common vision for the Filipino child with special needs. By the 21st century, it is envisioned that he/she could be adequately provided with basic education. This education should fully realize his/her own potentials for development and productivity as well as being capable of self-expression of his/her rights in society. More importantly, he/she is God-loving and proud of being a Filipino. It is also envisioned that the child with special needs will get full parental and community support for his/her education without discrimination of any kind. This special child should also be provided with a healthy environment along with leisure and recreation and social security measures.
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Title Page URS Mission Vision COE Goal Vision for Children with Special Needs
Chapter I - Introduction to Observational Child Study 1

A. Course Description and Objectives 7 B. Strategies for Children with Physical Disabilities .. 11 C. Functional Areas to Consider in Teaching and Managing Children with Physical Disabilities .. 14 D. Observing Children with Physical Disabilities 16 E. Methods of Observing Children with Special Needs in Education .. 17 F. Observing the Childs Present Level of Performance .. 17 G. Observation and Assessment ... 18 H. Assessment Tools . 20
Chapter II - Children with Orthopedically Handicapped and Special Health Problem

A. Observing a Child with Orthopedically Handicapped and Special Health Problem .. B. Child Health History C. Observational Child Study D. Motor Skills Checklists 26 30 39 47
Chapter III - Children with Hearing Impairment

A. B. C. D. E. F. Observing a Child with Hearing Impairment Child Health History .... Observational Child Study . Social Skills Checklists . Motor Skills Checklists . Cognitive Skills Checklists . 58 64 73 81 93 103
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Chapter IV - Children with Visual Impairment

A. B. C. D. Observing a Child with Visual Impairment . Child Health History . Observational Child Study 1 . Social Skills Checklists . 111 114 123 131
Chapter V Developmental Milestones

A. B. C. D. E. F. Infants . 146 Toddlers ............... 147 Preschool . 148 School-age Children .... 149 Early Adolescence . 150 Middle Adolescence . 151
Chapter VI Photo Documentation

A. Children with Orthopedically Handicapped and Special Health Problems 153 B. Children with Hearing Impairment ... 154 C. Children with Visual Impairment ... 155
Chapter VII Daily Time Record
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INTRODUCTION TO OBSERVATIONAL CHILD STUDY 1

Observational Child Study 1 is a course for students taking Bachelor of Elementary Education major in Special Education. This course focuses on studying and observing children with physical disabilities utilizing various observation tools, techniques and methods. Students are exposed in the in schools and residential areas where children with physical disabilities live, in order to understand fully the subject of study. Home environment and the school environment of the subject of study are being explored to gain knowledge and skills in managing and teaching children with physical disabilities. A. COURSE DESCRIPTION The course deals with observation and recording of academic and behavior performance of children with special needs. It is primarily concerned on the
situations, issues and techniques that would employ various methods of observations. It also covers several aspects of social behavior and other functional areas of development among children with physical disabilities.
B. COURSE OBJECTIVES The Special Education students are geared towards the accomplishment of the following objectives: 1. To observe children with physical disabilities in an education setting/home setting. 2. To broaden ones knowledge in observing children with physical disabilities 3. To determine the methods, techniques and approaches used in addressing the physical difficulties and problems of children with special needs. 4. To acquire the appropriate methods, techniques and approaches in dealing with physical disabilities of children with special needs in education 5. To utilize appropriate methods, techniques, and approaches in dealing with physical disabilities of children with special needs. Observational Child Study 1
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To apply principles in the use of unstructured observation forms such as anecdotal record, journal, event recording and interpretation of results
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To utilize other forms of observing children with physical disabilities
Direction: Answer the following questions below. QUESTION # 1 What are some terminologies that are deemed useful and important in observing children with physical disabilities? Enumerate your answer using a tree map below. OBSERVATIONAL CHILD STUDY
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QUESTION #2 What do you think are the goals of observing children with physical disabilities?
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STRATEGIES FOR CHILDREN WITH PHYSICAL DISABILITIES

A. STRATEGIES FOR PHYSICALLY HANDICAPPED CHILDREN Some strategies may become effective in managing children with physical disabilities. The following may be given considerations to achieve success in teaching and managing children with physical disabilities: Focusing on what they can do at all times; Finding out what the child's strengths are and capitalize on them; Keeping expectations high of what the physically handicapped child can do; Regular children need to be taught about physical disabilities to develop respect and acceptance; Compliment appearance from time to time; Making adjustments and accommodations whenever possible to enable this child to participate. Never pity the physically handicapped child; Take time to talk to the child personally to make sure that he/she is aware that you're there to help when needed. Some tips are also helpful in dealing with children in wheel chair. such as providing assistance when needed; Making a child in wheelchair to enjoy conversation by kneeling down to meet him face to face; Assessing the halls, classroom and other areas being used by the child; Making classroom organized in a way that will accommodate the wheelchair user; Treating the child in the wheelchair and the regular children the same; Giving the child freedom to move by his own ; Always plan to accommodate the wheelchair and anticipate the childs needs in advance; and always be aware of the barriers and incorporate strategies around them. B. STRATEGIES FOR HEARING IMPAIRED CHILDREN Hearing losses and or hearing impairments are often caused by genetic factors, illnesses, accidents, problems in a pregnancy, (rubella for instance) complications during birth or a variety of early childhood illnesses such as mumps or measles. Signs of hearing problems include: turning the ear toward the noise, favoring one ear over another, lack of follow through with directions or Observational Child Study 1
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instructions, seeming distracted and or confused. Children with hearing loss often ask for repeated information and will sometimes mispronounce words. Children having frequent earaches or sinus infections are often susceptible. When working with children hearing impairments or hearing loss the following strategies may become effective: Make sure the child can see your lips and facial expressions when you are talking; Never talk with your back turned to the student; Speak naturally and not too loudly if the child wears a hearing aid; Try not to move around too much when you are speaking, if you have to move about, be sure to try and face the child as much as possible; Do not overuse hand gestures. Children do not like to be treated differently; Always ensure that directions, assignments, instructions are understood before the child begins working; Ask the child to repeat instructions and directions back to you, rather than ask if he/she understands; Use visual aids when appropriate. Write lists on the board or paper, ask the child to take notes; If appropriate, teach some sign language to the class; Maintain close contact with the professionals that may be involved; Always speak from a well lit area to enable the child to see your face; Use as many audio/video components as is possible in your program; Reduce extraneous noise whenever possible; and Always ask yourself how you can make the lesson or activity more visual. If the child wears a hearing aid, be aware that the hearing aid amplifies all sounds and doesn't differentiate between wanted and unwanted sounds. Background noise can defeat the purpose of the hearing aid, it's important to eliminate background noise as much as possible to enable the child to receive maximum benefits from the hearing aid. C. STRATEGIES FOR VISUALLY IMPAIRED CHILDREN It is not realistic to expect the working environment to revolve around the needs of one visually impaired child in an integrated setting. Nevertheless it would be prudent for the following points to be considered such as providing him an adjustable desk top where he bring reading materials closer to his eyes . Also, an storage area where he can find his equipment with ease and Observational Child Study 1
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convenience; lighting considerations relative to the needs of the children with visual impairment; ensuring that corridors and stairways are well illuminated; Implementing rules to increasing mobility among visually impaired children; Reducing unnecessary hazards around the school and close supervision for children with limited or no vision is necessary. For the teachers working with the visually impaired children the following must be considered such as making visual displays bold, clear and well contrasted and as near to eye level as possible however, tactual
displays involving Braille should be lower to facilitate comfortable tactual exploration. Moreover, avoid standing with your back to the window, as glare and light may well silhouette your demonstration. Considering the writing materials for children with useful residual vision, a dark felt tip pen on white or yellow paper should provide the necessary level of contrast, moving if possible at a later date to using a dark soft lead pencil. The older child should be able to make his own decision regarding paper preference, but the younger child may be helped by using bold lined or squared paper. In reading, it is important to consider the quality and quantity of print used. The size, color and contrast of print on paper determine quality and should be the primary consideration. Print can be enlarged by some form of magnification using a low vision aid, or by an enlarging photocopier but it can be counterproductive to enlarge poor quality copies as the faults are also magnified. We should also remember that magnification is not always the answer as the greater the magnification, the smaller the field; those children with limited fields of vision should be allowed to use the smallest print possible, so that the remaining field of vision receives the maximum amount of information. Contrast and clarity are essential, it is also important to try and avoid those books which have print across the illustrations, causing unnecessary confusion. Some children may also prefer to place a card or ruler under the Observational Child Study 1
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line they are reading and "reading windows" can be particularly useful to the child who finds it difficult to focus on a word or line of print. Always ensure that the visually impaired child has the sole use of work materials, whether it be books, diagrams, maps etc, avoiding the need to share. He will also need extra time to complete visually demanding tasks and it may even be necessary to reduce the amount of reading/writing you can realistically expect in the same time as the other pupils. As the child with this type of impairment moves up the school, the teacher has to ensure his access to the curriculum. For example, if extensive note taking is required, either from the blackboard, dictated or other means, the teachers aide or assistant has to do one of the following: Ask the teacher to say the notes aloud as he puts them up on the blackboard; they can then be tape recorded if necessary; Ask the teacher to give you the notes in advance so that you can make arrangements for a suitable print or Braille copy to be made and Arrange for one of the child's friends, preferably one who is a neat writer, to make a carbon copy or arrange for his notes to be photocopied. Talking calculator, talking thermometer, Braille ruler, large print typewriter, and other electronic devices can also be very helpful in teaching and managing these children.
FUNCTIONAL AREAS TO CONSIDER IN TEACHING AND MANAGING CHILDREN WITH PHYSICAL DISABILITIES
A. PHYSICALLY HANDICAPPED CHILDREN For students with physical handicaps, self-image is extremely important. Teachers need to ensure that the child's self image is positive. Physically handicapped students are aware of the fact that they are physically different that most others and that there are certain things they cannot do. Peers can be cruel to other children with physical handicaps and become involved in teasing, casting insulting remarks and excluding physically Observational Child Study 1
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handicapped children from games and group type activities. Physically handicapped children want to succeed and participate as much as they can and this needs to be encouraged and fostered by the teacher. The focus needs to be on what the child can do - not can't do. B. CHILDREN WITH HEARING IMPAIRMENT/DEAF Hearing loss or impairment does not affect a child's intelligence. Like most exceptionalities, if caught early, intervention strategies can be implemented and the hearing impaired student will meet with success. C. CHILDREN WITH VISUAL IMPAIRMENT/BLIND Many children with visual impairments need to develop skills not necessarily required by their fully sighted peers. For appropriate remediation to be provided, again the peripatetic support teacher should be consulted at all times. Such specialized skills could include emphasis being placed on listening skills, typing skills, Braille, mobility and orientation skills, visual-motor and visual perceptual skills, (ensuring the child makes the most effective use of the vision he possesses by concentrating on activities such as matching, discriminating, hand-eye coordination, tracking, scanning, copying, fine and gross motor activities etc), and independence and self help skills. Their curriculum includes adaptations of the general curriculum; some additional or specialized content; specialized materials and equipments; tactual experiences and verbal explanations; and ability to listen and relate and remember must be develop to its fullest .Other aspects are considered such as the use of Braille ( developed by Louis Braille), a system of touch reading ; Audio visuals like talking book reproducer, record players, tape recorder, and special phonographs ; Arithmetic aids such as board and
abacus. Calculators are used by brailing the dials. Tape measures, rulers, watches, slide ruler, compasses, protractors have also been used and Embossed and relief maps are utilized in teaching geography and to help orient the blind to their immediate environment and move around freely.
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Teaching principles suited for the blind children include individualization, concreteness, unified instruction, and additional stimulation.
OBSERVING CHILDREN WITH PHYSICAL DISABILITIES

Observation is either an activity of a living being, such as a human, consisting of receiving knowledge of the outside world through the senses, or the recording of data using scientific instruments. The term may also refer to any data collected during this activity. An observation can also be the way you look at things or when you look at something. Special education teachers observe to make decisions about the well-being and education of children with special needs. Observing children gives us information and knowledge about child development, strengths, interests, and needs of each individual child in the group, and knowledge of the social and cultural contexts in which each child lives. Children with special needs have many ways of expressing themselves, and professionals like special education teachers can begin to understand what they are experiencing and the meaning they bring to their experiences by observing them, listening to them, and recording these observations. There are several reasons why we observe children with special needs in education. Observation keeps track of a childs emotional, social, cognitive, and physical development over time; It helps identify a child's strengths and interests; Also, it serves to identify concerns you may have about a child; It also helps special education teacher to decide how best to respond in a certain situation; Figure out how to handle problem situations; Improve your physical environment and materials; Modify your curriculum; and Give specific examples of behavior to share with parents, colleagues, and other specialists.
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METHODS OF OBSERVING CHILDREN WITH SPECIAL NEEDS IN EDUCATION

The methods of observation that can be utilized to serve children with special needs in education are Checklists, Anecdotal Record, Running Record , Event Sampling, Time Sampling, Journal, Rating Scales, and Media Techniques The discussion below describes the various methods in observing children with special needs in education. A. Using Checklists Checklists are lists of specific traits or behaviors arranged in logical order. These are especially useful for types of behavior or traits than can be easily and clearly specified. 1. Self-Help and Independent Living Skills describe the ability of the child/person to do things necessary for independent functioning 2. Social Skills describe the ability of an individual to participate in social relationships or to reciprocate social interactions. Social Skills checklist is utilized to tolerate and enjoy interactions with other people. Its emphasis is on initiation of social skills and deriving pleasure from social play. Moreover, the individual is geared to survive socially and be accepted socially. B. Anecdotal Record Anecdotal Record is a descriptive narrative recorded after the behavior occurs. It is used to describes fully details of an event or behavior. Anecdotes
describe what happened; how it happened; when; where; and what was said and done.
OBSERVING THE CHILDS PRESENT LEVEL OF PERFORMANCE

A. FUNCTIONAL AREAS OF EDUCATION There are several areas to consider in observing the childs functional development. These include Physical development, Motor skills, Communication Skills, Social and Emotional Development, Recreation, Play or Leisure Skills, SelfObservational Child Study 1
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Care and Independent Living Skills, Community-Living Skills, Academic Skills and others. The childs present level of performance and development observation relative to his/her functional areas of education can be described utilizing observational methods and techniques described above.
OBSERVATION & ASSESSMENT

What is Assessment? Assessment comes from a Latin word meaning to sit beside and get to know. It is the process of observing, recording and documenting childrens growth and behavior. To be an authentic assessment, observations must be done over time in play-based situations. This type of assessment is best because it is the most accurate. It is used to make decisions about the childrens education. Information is obtained on childrens developmental status, growth and learning styles. Sometimes the terms assessment and evaluation are used interchangeably, but they are two different processes. Assessment is the process of collecting information or data. Evaluation is the process of reviewing the information and finding the value in it. When to do Assessments? (1) Initial Assessments this will provide entry data and a baseline to use for each child. Developmental differences will exist. Culture, economic status and home background will impact each childs development. Therefore, the purpose of an initial assessment is to get a snapshot of each child in the group. Observing children and acquiring information from the families are the most common ways to gather this information.
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(2) Ongoing Assessment may take more time, but it will also provide more in-depth information. The information gained will be useful in tracking each childs progress and documenting change over time. It should provide evidence of a childs learning and maturation. This information will also be helpful in making decisions for enriching or modifying the curriculum and classroom environment when necessary. What is Observation? Observation is either an activity of a living being, such as a human, consisting of receiving knowledge of the outside world through the senses, or the recording of data using scientific instruments. The term may refer to any data collected during this activity. An observation can also be the way you look at things or when you look at something. Reference: (http://en.wikipedia.org/wiki/Observation) Two Ways of Doing an Observation (1) Informal Observation also called unstructured or exploratory observation. This is usually done when the research group has little knowledge of a population and its behavior. The main purpose of informal observation is to create hypotheses to be tested later, in a survey or using formal observation. this is the methods that provide important information, they require specialized training for recording data on carefully designed forms. Training is also needed for analyzing and interpreting data. (2) Formal Observation also called structured or systematic observation. This is more like a survey, where every respondent is asked the same set of questions. But in this case, questions are not asked. Instead, particular types of behavior are looked for, and counted. Observational Child Study 1
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Preschool teachers usually use informal observation methods to collect data. These methods are easier to use and more appropriate for program planning. They include observing in the classroom, collecting samples of their work, interviewing parents and talking with children. Three (3) Considerations in Choosing a Method of Assessment (1) The method chosen depends on the type of behavior you want to assess and the amount of detail you need. (2) Whether the information needs to be collected for one child or the entire group. (3) The amount of focused attention required by the observer needs to be considered. Developmental Milestones Developmental Milestones are characteristics and behaviors considered normal for children in specific age groups. Some educators refer to these as emerging competencies. Developmental milestones will assist you in comparing and noting changes in the growth and development of children. They will also help you as you observe young children in preparation for your career working with young children. ASSESSMENT TOOLS There are several types of assessment tools that are used in early childhood programs. (1) Anecdotal Records The simplest form of direct observation and it is a brief narrative account of a specific incident. Often an anecdotal record is used to develop an understanding of a childs behavior. The process of recording the incident requires a careful eye and quick pencil to capture all of the details. You will need to note who was involved, what happened, and where it occurred.
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Contents of Anecdotal Records Identifies the child and gives the childs age Includes the date, time of day and setting Identifies the observer Provides an accurate account of the childs actions and direct quotes from the childs conversations Includes responses of other children and/or adults, if any are involved in the situation.
SUNSHINE CHILD CARE CENTER ANECDOTAL RECORDS Childs Name: Carrie Childs Age: 9 Years Setting: Dramatic Play Time: Observer: Geneva Peterson Incident: Date: 10/9/xx 9 Months to
Interpretation:
(2) Checklists Checklists are designed to record the presence or absence of specific traits or behaviors. They are easy to use and are especially helpful when many different items need to be observed. They often include lists of specific behaviors to look for while observing.
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Name: Program Institution: Date of Observation: Fine Motor Skills Specific Skills Cuts paper Pastes with a finger Pours from a pitcher Copies a circle from a drawing Draws a straight line Uses finger to pick up smaller objects Draws a person with three parts Yes No
(3) Rating Scales Just like checklists, are planned to record something specific. They are used to record the degree to which a quality or trait is present. It requires you to make a judgment about the quality of what is being observed.
Name: Program Institution: Date of Observation:
Age:
Social / Emotional Rating Scales Behavior Shows increased willingness to cooperate Is patient and conscientious Expresses anger verbally rather than physically Has strong desire to please Is eager to make friends and develop strong friendships Respect property rights of others
Never Sometimes Usually Always
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(4) Participation Charts Participation chart can be developed to gain information on specific aspects of childrens behavior. Participation charts have a variety of uses in the classroom. For instance, childrens activity preferences during self-selected play can be determined.
Activity Preferences during Self-selected Play TIME 9:00-9:10 9:10-9:20 9:20-9:30 9:30-9:40 9:40-9:50 9:50-10:00
Mike Ann Kath Ken Gina Marie Perry May Luisa Jen
b b b b b b
dp dp dp st m m
st st m m m a
b b b b b b
a s s s sc sc
a a a s s m
a a a s s s
b b a a s s
st st st st s s
a a a a dp dp
Legend: a- ART m- MANIPULATIVE st- STORYTELLING
b- BLOCKBUILDING s- SENSORY
dp- DRAMATIC PLAY sc- SCIENCE
USING TECHNOLOGY FOR ASSESSMENT Technology is a very useful tool for recording childrens development. Making any documentation are excellent ways to preserve information.
Videotaping and Photographing Safety Be sure to consult parents, families, or caregivers before videotaping or photographing children. Many centers require written consent to be on file before staff can videotape or photograph children for educational purposes. Some families do not want images taken of their children for privacy reasons.
(1) Visual Documentation Visual Documentation refers to collecting or photographing samples of a childs work that portrays learning and development. It provides a record that can be studied to any purposes.
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(2) Portfolios Portfolio is a collection of materials that shows a persons disabilities, accomplishments and progress over time. Portfolios you create for children in your care summarize each childs abilities. A portfolio includes items that show the childs growth and development over time.
Portfolio Contents A portfolio may contain teacher observations and other records gathered through assessment developmental rating scales or checklists parents comments and completed questionnaires a dated series of the childs artwork or writing photographs of the child demonstrating skills or engaged in activities audiotapes or videotapes of the child speaking, singing and telling stories a list of favorite books, songs and finger plays
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CHILDREN WITH PHYSICAL DISABILITIES

ORTHOPEDICALLY HANDICAPPED AND CHILDREN WITH SPECIAL HEALTH PROBLEMS Crippled child has orthopedic impairment with the normal functions of the bones, joints, or muscles. Born with handicaps (congenital anomalies) such as dislocated hips or joints, clubfeet, spina bifida (a congenital anomaly affecting the spinal cord). Children who acquire a crippling condition through accidents or through infection such as poliomyelitis (infantile paralysis ,tuberculosis of the bones or joints etc. Children with special health problems are that whose weakened physical rendition renders them relatively inactive or requires special health precautions in school that have cardiac anomalies, tuberculosis, anemia, epilepsy, and other abnormal conditions; those who are undernourished have been termed delicate children or children with low vitality. Crippled children experience the same needs for recognition, security, and self -esteem as do normal but often have to be guided in adjusting to their handicap and find compensatory satisfaction.
OBSERVING ORTHOPEDICALLY HANDICAPPED

(CHILDREN WITH SPECIAL HEALTH PROBLEM) DIRECTIONS: Interview a source to fill out the form about the subject of your study. GETTING TO KNOW THE CHILD Childs Name: ____________________________ Childs Date of Birth: ______________________________ ____Pre-Mature Birth ____Full-Term Childs Birth Weight: _________ Has child stayed with anyone else besides parents? __________ If so who? _________________________________ Food likes: ________________________________________________ Food Dislikes: ______________________________________________ List amounts of food, types of food and times the child usually eats below: Breakfast ________________________________________________ Lunch ____________________________________________________ Snack ____________________________________________________ Does your child need a special comfort item to sleep with? ________. What is it? _______________________ Has your child had the following common childhood illnesses?
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(Please circle) Does your child have any problems with any of these? Constipation Convulsions Diarrhea Fainting Spells Frequent Colds Frequent Ear Infections Frequent Sore Throats Lice Ringworm Skin Rash Soiling Stomach Upsets Urinary Problem Worms
Has your child had any of these diseases? Asthma Bronchitis Chicken Pox Diabetes Heart Disease Hepatitis Impetigo Measles Mumps German Measles Polio Scarlet Fever Tuberculosis Whooping Cough
Does your child have any speech, hearing or visual problems? __________ Has your child ever been tested for the above? ____________________ Has your child ever had any surgeries or do y have any prosthetic limbs etc.? If yes, Pls. describe____________________________________________ Would there be any restrictions to play or activities? ____________________________________________________________ Age your child began to: Sit __________, Crawl ___________, Walking _______________ Age your child began to: Talk _____________ Any difficulties with speech? If yes to above question, please specify: ___________________________ Have you made any special arrangement for child's care during illness? What is your child's favorite food? ____________________________________ _______________________________________________________________ What food does your child dislike? ____________________________________________________________ Childs favorite color______________________ Childs favorite song______________________ Does your child know the basic shapes _________ ABCs_______ colors________ numbers ___? Does your child eat with a spoon _____ fork_____ hands______ ? (Check all that apply) Does your child have any fears related with toileting? ____________ Does your child have any "accidents"? ________________________ What words does your child use for: Bowel movements __________ Urination ___________ What words does your child use for describing his private parts? ______________________________________________________ What time does your child awaken? _____________________ Observational Child Study 1
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What time does your child go to sleep at night? __________________ Do they sleep through the night? _______________________________ Does your child sleep in a bed or crib, other? _____________________ Does your sleep alone or with someone else? ____________________ Are there any siblings? Please name them and specify ages and gender. Name_____________________________ Age _____________ Name_____________________________ Age _____________ Name_____________________________ Age ____________ Has your child had experience playing with other children? ____________________ Please give a brief description of your child's disposition. Is he friendly by nature, aggressive, shy, withdrawn, imaginative, and demanding? Etc. __________________________________________________________ How does your child show his/her feelings? When afraid: _______________________________________________ When happy: ________________________________________________ When angry: ________________________________________________ When intolerant: ____________________________________________ What forms of discipline are most often used in child's home? __________________________________________________________ __________________________________________________________ Are there any recent traumatic situations the child has been exposed to such as a death in the family, annulment, new sibling etc.? ____________________________________________________________ What language(s) are spoken at home? ___________________ Does your child have any security objects such as a blanket, soother, bottle, toy etc.? _________________________________________________________ How does your child behave when he is sick? ____________________________________________________________ How is your child most easily settled when upset or afraid? ____________________________________________________________ What are your child's favorite activities, toys, books, or games? ____________________________________________________________ Are there any other comments or information you would like to let me know about? ___________________________________________________________________ Any specific concerns? ________________________________________________ ___________________________________________________________________
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AN ORTHOPEDICALLY HANDICAPPED CHILD

(A CHILD WITH A SPECIAL HEALTH PROBLEM) DIRECTION: Describe an orthopedically handicapped child or with special health problems
Physical/Feature Characteristics
Physical Performances
Behavior Performances
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PHOTO CHILD HEALTH HISTORY

General Information 1. Childs Name_____________________ __________________________ _______ (Last Name) (First Name) (MI) 2. Childs address ______________________________________________________________________ (Street) (City, State, Zip) 3. Home Telephone Number __________________________________________________ 4. Childs Gender Female Male 5. Childs Date of Birth __________ __________ _________ Month Date Year 6. Mothers Name: __________________________________________________________ 7. Fathers Name: ___________________________________________________________ Birth History 8. Length of Pregnancy ______ months 9. Childs weight at birth ________ kg 10. Were there any unusual factors or complications during the pregnancy? yes no (Please describe): _______________________________________ 11. Did your child have any medical problems at birth? yes (Please describe): ___________________________________________ no
12. Does your child take any medications or regular basis? yes no If yes, name of medication and dosage: _______________________________________ 13. Has your child had any of the following illness? _______measles ________ rheumatic fever _______mumps ________ chicken pox _______whooping cough ________ pneumonia _______middle ear infection ________ hepatitis (otitis media) ________meningitis 14. Were there any complications with these illnesses, such as high fever, convulsions muscle weaknesses, and so on? yes no (Please Describe): ________________________________________
15. Has your child ever been hospitalized?

Number of times: __________
yes
no
16. Has your child had any other serious illness or injuries that did not involved
hospitalization? yes (Please Describe): ____________________________________ no
17. How many colds has you child had during the past year? Observational Child Study 1
_________ times
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18. Does your child have :

ALLERGIES? (Please specify which allergies): Foods ________ Animals_______ Medicine______ Asthma? Have fever? yes no
yes yes
no no yes no
19. Had your child had any problems with earaches or ear infections?
If yes, how often in the past years? __________ year/s
20. Has your childs hearing been tested?
yes no Date of test: ____________ was there any evidence of hearing loss? If yes, describe: _________________________________
yes
no
21. Does your child currently have tubes in his or her ears?
yes
yes
no
22. Do you have any concerns about your childs speech or language development?
no (if yes, describe):__________________________________________. yes no
23. Has your child vision been tested?

Date of test: ______ ________
(Month) (Year)
24. Was there any evidence of vision loss?
yes no Please describe: ________________________________________________
25. Does your child do some things that you find troublesome?
Please describe: ____________________________________________________
26. Has your child ever participated in out-of-the-same home child care services-for
example, sitter, day care, and preschool? yes no Please describe: ____________________________________________________ Childs Play Activities
27. Where does your child usually play-for example, backyard, kitchen, bedroom?
______________________________________________________________________
28. Does your child usually play:

alone? with brothers/sisters? with younger children? with one to two other children? with older children? with children of the same age? cooperative? shy? aggressive?
29. Is your child usually
30. What are some of your childs favorite toys and activities?
Please describe: _____________________________________________________________
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31. Are there any particular behaviors you would like us to watch?
Please describe: __________________________________________________________ __________________________________________________________ Childs Daily Routine 32. Do you have any concerns about your childs: eating habits? _____________________________ sleeping habits? ___________________________ toilet training? _____________________________
33. Is your child toilet trained?
yes no. If yes, how often does your child have an accident? _______________________________________________________________.
34. What word(s) does your child use or understand for:

Urination ______________________ bowel movement ________________________
35. How many hours does your child sleep? At night? _______
Goes to bed at ___ P.M. Wakes up at: ___A.M. afternoon nap: __________
36. When your child is upset, how do you comfort him or her?
______________________________________________________________________ ______________________________________________________________________
37. The term family has many different meanings. Since the topic of families and family
members is often included in classroom discussions, please list or describe who your child considers to be family at home. ______________________________________________________________________ ______________________________________________________________________
38. How many brothers and (or) sisters does your child have?
Brothers (ages): ________________ Sisters (ages): ________________________
39. What language(s) is/are most commonly spoken in your home?

English Filipino Others __________________
40. Is there any additional information that would help us understand or work more
effectively with your child? _________________________________________________ _______________________________________________________________________
CASE HISTORY RECORD

Childs Name: _______________________________________ Sex: __________ Date: ______________________________________________ Age: _________ Address: _________________________________________________________________ Tel. No.: ________________ Reason for Referral: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
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A. GENERAL Fathers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address: _________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________ Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ Mothers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address__________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________ Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ List of siblings of the child (brothers and sisters) and their dates of birth: Names ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Date of Birth ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________
B. DEVELOPMENTAL HISTORY A. Background Are both parents the childs natural parents? yes no Whom does the child most resemble ______________________________ Parents ages at childs birth: Father: ___________ Mother: __________ B. Pregnancy Number of previous pregnancies: _________ Number of previous live births: ___________ Was pregnancy planned? _______________ Was a boy or a girl expected? ____________ Was the mother under constant pre-natal care? _____ If not, explain in detail, including illness, meditation used, periods of hospitalization, injuries, etc. (use extra space provided at the back of this page if necessary.) ______________________________________________________________________ ______________________________________________________________________ C. Birth Was the baby full term? ________________ Premature _______________________ Was this a difficult labor? __________________________________________________ Was delivery normal? _________________ or by caesarian operation? __________
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When? _____________________________ Were instruments used to assist delivery (what if any?)___________________________ Did baby suffer from lack of oxygen? ________________________________________ Did baby cry right away? __________ Did baby appear normal at birth? ___________ Weight of baby at birth ____________________________________________________ D. Early Feeding Did the child suck readily? _________________________________________________ Feeding: Breast ________ Bottle (please state brand of milk) _________________________ Mixed ________ How often was baby fed? _________________________________________________ Periods of colic, other gastro-intestinal disturbance? ____________________________ Age and method of weaning (please state kind of milk) __________________________ Any allergies to milk? _____________________________________________________ E. Handling Baby was generally fed by ______________________ Changed and handled by _______________________ When baby cried, we usually _______________________ For how long could baby be left alone in his carriage or playpen before showing signs of distress? ________________________ F. Physical Development Age at which baby sat up ________________________ Got first tooth _______________________ Crawled ___________________________ Stood aided ________________________ Stood unaided ______________________ Walked unaided _____________________ Has the child reached puberty? _____________________ G. Toilet Training Was the child toilet-trained? ____________________________ Age training began? _______________________________ Age at which trained? ____________________________________ If a boy, does he stand? ____________________________________ What signs does the child give when he needs to use the bathroom? ___________________________________________________________________ H. Illness During the first 2 years, did the child ever have prolonged high fever? (Please explain)_____________________________________________________ __________________________________________________________________ What preventive measures i.e., immunization, vaccination, etc. had been taken? ___________________________________________________________________ Had the child any serious reactions to immunization? If so, when? ___________________________________________________________________ Operations performed and reasons for these: ___________________________________________________________________
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I. Present Physical Condition Allergies: ______________________________________________________ Preference for right or left hand: ___________________________________ Noticeable problems in coordination: _____________________________________________________________ Does the child fall easily? yes no Does the child drool excessively? yes no Does the child over-perspire? yes no Does the child seem tense? yes no Does the child have normal vision? yes no Does the child have normal breathing pattern? yes no Does the child sniff food or objects frequently? yes no
J. Home Situation Has the child always lived with both parents? _______________________ Have there been any sudden departures or deaths in the immediate family? _________ Has there been any serious illness in the family? _____________________ If the child has a younger sibling, who prepared him for the siblings birth? ___________________________________________________________________ How was the child prepared? ___________________________________________________________________ Who cared for the child while mother was in the hospital? ________________ Was there any noticeably change in the childs behavior after the birth of the baby? _____________________ What was the childs reaction to the new baby? ______________________ Have there been any sudden changes, relocations of family, home, etc. during lifetime of child? ______________________________________________________________ To whom the child is most attached at present? ________________________________ Was it always like this? __________________________________________________ K. Education Age the child entered the school? _________________ Initial reaction to school? _________________________________________________ _____________________________________________________________ Please list schools attended. School Dates ________________________________ _______________________ ________________________________ _______________________ ________________________________ _______________________ Were grades repeated? Which? Why? ___________________________________________________________________ Which subject does he enjoy most? ___________________________________________________________________ In which subject does he excel? ___________________________________________________________________ Which are the subjects he has most difficulty with? ___________________________________________________________________ What are his reactions to his teacher? ___________________________________________________________________ What are his reactions to his classmates? ___________________________________________________________________
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L. Behavior a. Play Describe your childs play activities: __________________________________________________________________ Outdoor physical activities i.e. sports: __________________________________________________________________ Reading: ____________________________________________________________ Imaginary Play: _______________________________________________________ Does he often watch TV? ________________________________________________ What kind of programs does he enjoy watching: ______________________________ Does he often attend movies? ____________________________________________ What kind of movies does he enjoy? _______________________________________ Does he often read comics? ______________________________________________ Name the activities he enjoys most: _______________________________________ Circle any of the following which apply to his play: Repetition Imaginative Cooperation With peer group With older children With a small group b. Sleep Does the child sleep soundly? _______________ Does the child sleep regularly? ______________ Hours of sleep? _________________________ Any naps? How long? ____________________ have nightmare? _________________________ Does he have dreams? ____________________ Is he able to describe his dreams? ___________ Does the child cry when he dreams? _________ Does the child perspire the same dream in a repetitive way? _____________ Does he/she wet the bed? __________________________ How often does this occur? _________________________ How is this handled? _______________________________ How does he read? ________________________________ c. Eating His likes: __________________________________________________________________ His dislikes: ________________________________________________________________ Are there any eating problems? yes no Does the child eat unaided? yes no Are his meals prepared on demand, or does the child eat with the rest of the family? __________________________________________________________________ Fantasy Alone with toys fitting engrossed messy With a large group as a leader as a follower with younger children others: ___________
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Is the child required to eat balanced meal, or snacks or given favorite food? __________________________________________________________________ Does he vomit frequently? yes no How is this handled? ____________________________________________________ d. Habits Is the child attached to any special object? What? __________________________________________________________________ Notable mannerism: __________________________________________________________________ Thumb sucking? yes no Head banging? yes no Does he have any rituals, e.g. before going to bed? yes no If yes, specify: ______________________________________________________________ Check any of the following which describe the child: Negative Quiet Excitable Unresponsive Friendly Happy Sad Suggestible e. Language Did the child cry during the first month? _____________________________________ What was done when he/she cried? ________________________________________ Did he/she make play noise as a baby? ____________________________________ When did he say his first word, and what was the word? ________________________ Was there anything unusual about the childs speech and language development? __________________________________________________________________ Does the child use any inappropriate language? ______________________________ Does the child repeat certain sounds or words many times over with no apparent reason? ___________________________________________________________ What is the primary language spoken in the home? ___________________________ Which other language are spoken? ________________________________________ What language does the child use/understand? _______________________________ M. Problem Description Describe the childs problem. (Please Specify) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Manipulative Passive Lacking Confidence Active Self-Centered Predictable Confident Stubborn Tearful Destructive Aggressive Leadership Fearful Temper Generous Others: ______
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N. Family History Check if any other family member has experienced: Neurological disorder Mental illness Learning Difficulty Reading Difficulty Visual Defects Paralysis Hearing Problems O. Other Professional Help
Emotional Instability Physical Disabilities Retardation Blood Disease Heart Abnormality School Failure (Severe) Speech Problems
Physical Therapist Name Address Phone Speech Therapist Name Address Phone Tutor/Teacher Name Address Phone Others Name Address Phone Name Address Phone : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________ : ______________________________________________________
Assessing for SPED: ______________________ Bachelor of Elementary Education major in Special Education
Date: ______________________
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OBSERVATIONAL CHILD STUDY

I. PERSONAL INFORMATION
PHOTO
Name of the Child Address Age Gender Date of Birth Place of Birth Religion Citizenship Source of Information Citizenship CHILDS DESCRIPTION:
: : : : : : : : : :
_____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________
II.
A. PHYSICAL CHARACTERISTICS
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B. BEHAVIOR PERFORMANCE
C. ACADEMIC PERFORMANCE
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III.
RELEVANT OBSERVATIONS/INFORMATION GATHERED
A.
SELF-HELP SKILLS
B. SOCIAL PLAY AND EMOTIONAL DEVELOPMENT
C. COMMUNICATION SKILLS
D. MOTOR SKILLS
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OBSERVATION OF THE CHILDS FUNCTIONAL AREAS OF EDUCATION Day: _________________ Time: ________________ Date: ____________ ___, 2012 Class/Level: _______________________
Name of the Child: _____________________________________________ Address/School: _______________________________________________ _______________________________________________ FUNCTIONAL AREAS OF EDUCATION FUNCTIONAL AREA/SKILLS Area :
OBSERVATION
Area :
Area:
Area:
DAY 1
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OBSERVATION
Area :
Area:
Area:
DAY 2
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OBSERVATION
Area :
Area:
Area:
DAY 3
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OBSERVATION
Area :
Area:
Area:
DAY 4
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OBSERVATION
Area :
Area:
Area:
DAY 5
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Name: _______________________________ Date of Assessment: ___________
PART 1 Self-Help and Functional Skills Checklist

Please check the box that most appropriately describes your childs ability to perform the following Functional Skills. When selecting skills to teach, start with those your child can already partially do. Can partially Can do Cannot do. do. independently. Dressing Requires full Need some Does not assistance. help require any help Removes pants (does not include unfastening) Puts on pants (does not include fastening) Puts on sock Puts on a pullover shirt Puts on a front opening shirt or jacket Puts on shoes (does not include tying) Threads a belt Buckles a belt Zips up a zipper once it is started Buttons by self Starts a zipper Ties shoes Hangs up clothes Puts dirty clothes in hamper Wears clothes that are clean and wrinkle free Selects clothes that fit Selects clothes that match Selects age-appropriate clothes Selects clothes appropriate to weather Selects clothes appropriate to context Observational Child Study 1
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Eating/Food Preparation Drinks from cup Eats with spoon Eats with fork Spreads with knife Cuts with knife Sets table Clears table Gets own snack Prepares cold breakfast Makes toast Makes sandwich Cooks prepared food (mac n cheese) Uses a can opener Uses measuring cups and spoon Follows written or picture recipe Uses oven (sets temperature and timer) Puts groceries away Identified boxed/canned food by label Stores leftover foods properly Discards spoiled food
Cannot do. Requires full assistance.
Can partially do. Need some help
Can do independently. Does not require any help
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Grooming and Hygiene Uses toilet and toilet paper Washes and dries hands Washes and dries face Takes bath or shower independently Uses deodorant Washes and rinses hair Washes and rinses body in bath or shower Dries self after bathing Brushes teeth Shaves (if appropriate) Applies makeup (if appropriate) Combs and brushes hair Trims fingernails/toenails Uses a tissue to blow nose Uses feminine hygiene products appropriately
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Cleaning and Laundry Puts toys away Make own bed Clears table after eating (puts dishes in sink and garbage in wastebasket) Takes out trash Dusts Vacuums Washes windows or mirrors Cleans sink Cleans toilet Washes and dries dishes Loads dishwasher Separates clean from dirty clothes Sorts light from dark clothes Loads washing machine (knows what setting to use) Measures soap Uses dryer Hangs up clothes neatly Folds clothes neatly Puts clothing away appropriately
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Play and Social (Indoor) Pays attention to someone speaking Grasps or holds large toys or objects Grasps or holds crayons or pencils Pushes, pulls and turns toys Follows 1 step direction about toys or objects Follows 2 step directions about toys or objects Plays simple hide-and-seek games (peek-a-boo, hunts for missing toys) Sits and plays alone for up to 5 minutes Sits and plays alone for up to 10 minutes Imitates movements and gestures Stacks toys such as blocks up to 3 high Stacks toys such as blocks up to 6 high Scoops, sand, water or beans from one container to another Cuts with scissors Pastes with glue stick Scribbles with a crayon staying on paper Colors with crayon, mostly in the lines Does simple non-interlocking puzzles Does simple non-interlocking puzzles of up to 4 pieces Observational Child Study 1
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Does simple non-interlocking puzzles of up to 12 pieces Does complex interlocking puzzles of up to 25 pieces Play simple matching games such as memory matching Play simple board games such as Chutes and Ladders Play complex board games such as Sorry or Life Play complex board games such as monopoly, chess, checkers or backgammon Plays computer or video games once they are set up by adult Can load , turn on and set up a video or computer games Works with other children using same play materials Shares and takes turns in play
Play and Social (Outdoor) Throws and catches a large ball within 2 feet Throws and catches a large ball 3-6 feet Throws and catches a small ball 3-6 feet Hits ball off a tree Hits a ball when pitched Aims basketball at basket at appropriate height for age or size Dribbles basketball standing in place Dribbles basketball while running Kicks a ball at goal or target
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Kicks a ball while running Rides a tricycle Rides a 2 wheel bike Rides a razor scooter Rides a skateboard or in line skates Swims is safe near water
Assessing for SPED:
____________________
Bachelor of Elementary Education major in Special Education
Date: _______________________
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PART 2 Gross and Fine Motor Skills Checklist

Please check the box that most appropriately describes your childs ability to perform the following Functional Skills. When selecting skills to teach, start with those your child can already partially do. I. GROSS MOTOR SKILLS Functional Skills/Areas Adjusts activity level to various demands during class Smoothly transitions between motors skills Demonstrate adequate balance Demonstrate adequate coordination (does not run into or trip over objects) Has adequate stamina to complete physical education services Adequately performs eye-hand coordination tasks (throwing, catching, throwing a ball) Adequately coordinates lower limbs (i.e. running, jumping, kicking, etc.) Is physically fit (consider endurance, strength, flexibility, body weight for height) Has good body awareness (control of body, coordination, directionality, spatial judgment) IMPLICATIONS FOR INSTRUCTION AND PROGRESS MONITORING: Yes No ___ ____ This child demonstrates adequate behavioral/social skills necessary for participation in a regular physical education class (i.e cooperates with teacher/peers, is compliant with class rules, has age-appropriate social skills, interacts positively with teacher/peers, demonstrates appropriate frustration levels). If no, please list suggestions for improvement and/or adaptation. ___________________________________________________________________ ___________________________________________________________________ Strength Typically Need
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II. FINE MOTOR SKILLS Functional Skills/Areas Has fine motor activity which involves coordinated, efficient movement of body parts. Adequately uses classroom supplies (such as scissors, compass, protractor) Adequately draws numbers and geometric shapes (such as cross, circle, square, triangle) Performs eye-hand coordination tasks well (opening doors, sharpening pencils, drawing) Uses one hand consistently for writing and other motor tasks Written work is neat & legible (adequately spaced, orderly, within on the line/s) Completes fine motor tasks without becoming easily frustrated Has difficulty with pencil/pen grasp Strength Typically Need
IMPLICATIONS FOR INSTRUCTION AND PROGRESS MONITORING: Yes No ___ ____ The student generally has the fine motor skills necessary to complete academic work and self-help skills without difficulty in the regular classroom. If no, please list suggestions for improvement and/or adaptation. ___________________________________________________________________ ___________________________________________________________________ Assessing for SPED:
_____________________
Date: _______________________
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CHILDREN WITH HEARING IMPAIRMENT/DEAF

Hearing loss can be manifested in a child who ignores, confuses, or does not comply with directions; who day dreams; educationally retarded; is lazy; has slight speech defect and seems dull.
Over time, the average hearing impaired student shows an ever increasing gap in vocabulary growth, complex sentence comprehension and construction, and in concept formation as compared to students with normal hearing. Hearing impaired students often learn to "feign" comprehension with the end result being that the student does have optimal learning opportunities. Therefore, facilitative strategies for hearing impaired students are primarily concerned with various aspects of communication. Several types of Hearing impairment are described below:
1. Deaf: "A hearing impairment which is so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, which adversely affects educational performance."
2. Hard of Hearing: "A hearing impairment, whether permanent of fluctuating, which adversely affects a child's educational performance but which is not included under the definition of 'deaf'."
3. Deaf-Blind: "Simultaneous hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational problems that a child cannot be accommodated in special education programs solely for deaf children or blind children." (All definitions are from IDEA.)
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OBSERVING A CHILD WITH HEARING IMPAIRMENT/DEAF

DIRECTION: Observe a child with hearing impairment or deaf for five (5) days. Describe his/her, social skills, motor skills, and cognitive/intellectual skills.
Date: _______________________ NAME OF THE CHILD___________________________________________ SCHOOL: ____________________________________________________ TEACHERS NAME: ___________________________________________
DAY 1
Social Skills
Motor Skills
Cognitive Skills
Time: Area:
Time: Area:
Time: Area:
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Date: _______________________ NAME OF THE CHILD___________________________________________ SCHOOL: ____________________________________________________ TEACHERS NAME: ____________________________________________
DAY 2
Social Skills
Motor Skills
Cognitive Skills
Time: Area:
Time: Area:
Time: Area:
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DAY 3
Social Skills
Motor Skills
Cognitive Skills
Time: Area:
Time: Area:
Time: Area:
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DAY 4
Social Skills
Motor Skills
Cognitive Skills
Time: Area:
Time: Area:
Time: Area:
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DAY 5
Social Skills
Motor Skills
Cognitive Skills
Time: Area:
Time: Area:
Time: Area:
Assessing for SPED:
_____________________
Date: _______________________ Observational Child Study 1

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General Information 15. Childs Name_____________________ __________________________ _______ (Last Name) (First Name) (MI) 16. Childs address ______________________________________________________________________ (Street) (City, State, Zip) 17. Home Telephone Number __________________________________________________ 18. Childs Gender Female Male 19. Childs Date of Birth __________ __________ _________ Month Date Year 20. Mothers Name: __________________________________________________________ 21. Fathers Name: ___________________________________________________________ Birth History 22. Length of Pregnancy ______ months 23. Childs weight at birth ________ kg 24. Were there any unusual factors or complications during the pregnancy? yes no (Please describe): _______________________________________ 25. Did your child have any medical problems at birth? yes (Please describe): ___________________________________________ no

yes
no
43. How many colds has you child had during the past year? Observational Child Study 1
_________ times
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44. Does your child have :

ALLERGIES? (Please specify which allergies): Foods ________ Animals_______ Medicine______ Asthma? Have fever? yes no
yes yes
no no yes no
yes
no
yes
yes
no

Date of test: ______ ________
(Month) (Year)
Please describe: ____________________________________________________
______________________________________________________________________

Please describe: _____________________________________________________________
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Please describe: __________________________________________________________ __________________________________________________________ Childs Daily Routine 58. Do you have any concerns about your childs: eating habits? _____________________________ sleeping habits? ___________________________ toilet training? _____________________________

______________________________________________________________________ ______________________________________________________________________

CASE HISTORY RECORD

Childs Name: _______________________________________ Sex: __________ Date: ______________________________________________ Age: _________ Address: _________________________________________________________________ Tel. No.: ________________ Reason for Referral: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
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C. GENERAL Fathers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address: _________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________ Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ Mothers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address__________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________ Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ List of siblings of the child (brothers and sisters) and their dates of birth: Names ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Date of Birth ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________
D. DEVELOPMENTAL HISTORY K. Background Are both parents the childs natural parents? yes no Whom does the child most resemble ______________________________ Parents ages at childs birth: Father: ___________ Mother: __________ L. Pregnancy Number of previous pregnancies: _________ Number of previous live births: ___________ Was pregnancy planned? _______________ Was a boy or a girl expected? ____________ Was the mother under constant pre-natal care? _____ If not, explain in detail, including illness, meditation used, periods of hospitalization, injuries, etc. (use extra space provided at the back of this page if necessary.) ______________________________________________________________________ ______________________________________________________________________ M. Birth Was the baby full term? ________________ Premature _______________________ Was this a difficult labor? __________________________________________________ Was delivery normal? _________________ or by caesarian operation? __________
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When? _____________________________ Were instruments used to assist delivery (what if any?)___________________________ Did baby suffer from lack of oxygen? ________________________________________ Did baby cry right away? __________ Did baby appear normal at birth? ___________ Weight of baby at birth ____________________________________________________ N. Early Feeding Did the child suck readily? _________________________________________________ Feeding: Breast ________ Bottle (please state brand of milk) _________________________ Mixed ________ How often was baby fed? _________________________________________________ Periods of colic, other gastro-intestinal disturbance? ____________________________ Age and method of weaning (please state kind of milk) __________________________ Any allergies to milk? _____________________________________________________ O. Handling Baby was generally fed by ______________________ Changed and handled by _______________________ When baby cried, we usually _______________________ For how long could baby be left alone in his carriage or playpen before showing signs of distress? ________________________ P. Physical Development Age at which baby sat up ________________________ Got first tooth _______________________ Crawled ___________________________ Stood aided ________________________ Stood unaided ______________________ Walked unaided _____________________ Has the child reached puberty? _____________________ Q. Toilet Training Was the child toilet-trained? ____________________________ Age training began? _______________________________ Age at which trained? ____________________________________ If a boy, does he stand? ____________________________________ What signs does the child give when he needs to use the bathroom? ___________________________________________________________________ R. Illness During the first 2 years, did the child ever have prolonged high fever? (Please explain)_____________________________________________________ __________________________________________________________________ What preventive measures i.e., immunization, vaccination, etc. had been taken? ___________________________________________________________________ Had the child any serious reactions to immunization? If so, when? ___________________________________________________________________ Operations performed and reasons for these: ___________________________________________________________________
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S. Present Physical Condition Allergies: ______________________________________________________ Preference for right or left hand: ___________________________________ Noticeable problems in coordination: _____________________________________________________________ Does the child fall easily? yes no Does the child drool excessively? yes no Does the child over-perspire? yes no Does the child seem tense? yes no Does the child have normal vision? yes no Does the child have normal breathing pattern? yes no Does the child sniff food or objects frequently? yes no
T. Home Situation Has the child always lived with both parents? _______________________ Have there been any sudden departures or deaths in the immediate family? _________ Has there been any serious illness in the family? _____________________ If the child has a younger sibling, who prepared him for the siblings birth? ___________________________________________________________________ How was the child prepared? ___________________________________________________________________ Who cared for the child while mother was in the hospital? ________________ Was there any noticeably change in the childs behavior after the birth of the baby? _____________________ What was the childs reaction to the new baby? ______________________ Have there been any sudden changes, relocations of family, home, etc. during lifetime of child? ______________________________________________________________ To whom the child is most attached at present? ________________________________ Was it always like this? __________________________________________________ K. Education Age the child entered the school? _________________ Initial reaction to school? _________________________________________________ _____________________________________________________________ Please list schools attended. School Dates ________________________________ _______________________ ________________________________ _______________________ ________________________________ _______________________ Were grades repeated? Which? Why? ___________________________________________________________________ Which subject does he enjoy most? ___________________________________________________________________ In which subject does he excel? ___________________________________________________________________ Which are the subjects he has most difficulty with? ___________________________________________________________________ What are his reactions to his teacher? ___________________________________________________________________ What are his reactions to his classmates? ___________________________________________________________________
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L. Behavior f. Play Describe your childs play activities: __________________________________________________________________ Outdoor physical activities i.e. sports: __________________________________________________________________ Reading: ____________________________________________________________ Imaginary Play: _______________________________________________________ Does he often watch TV? ________________________________________________ What kind of programs does he enjoy watching: ______________________________ Does he often attend movies? ____________________________________________ What kind of movies does he enjoy? _______________________________________ Does he often read comics? ______________________________________________ Name the activities he enjoys most: _______________________________________ Circle any of the following which apply to his play: Repetition Imaginative Cooperation With peer group With older children With a small group g. Sleep Does the child sleep soundly? _______________ Does the child sleep regularly? ______________ Hours of sleep? _________________________ Any naps? How long? ____________________ have nightmare? _________________________ Does he have dreams? ____________________ Is he able to describe his dreams? ___________ Does the child cry when he dreams? _________ Does the child perspire the same dream in a repetitive way? _____________ Does he/she wet the bed? __________________________ How often does this occur? _________________________ How is this handled? _______________________________ How does he read? ________________________________ h. Eating His likes: __________________________________________________________________ His dislikes: ________________________________________________________________ Are there any eating problems? yes no Does the child eat unaided? yes no Are his meals prepared on demand, or does the child eat with the rest of the family? __________________________________________________________________ Fantasy Alone with toys fitting engrossed messy With a large group as a leader as a follower with younger children others: ___________
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Is the child required to eat balanced meal, or snacks or given favorite food? __________________________________________________________________ Does he vomit frequently? yes no How is this handled? ____________________________________________________ i. Habits Is the child attached to any special object? What? __________________________________________________________________ Notable mannerism: __________________________________________________________________ Thumb sucking? yes no Head banging? yes no Does he have any rituals, e.g. before going to bed? yes no If yes, specify: ______________________________________________________________ Check any of the following which describe the child: Negative Quiet Excitable Unresponsive Friendly Happy Sad Suggestible j. Language Did the child cry during the first month? _____________________________________ What was done when he/she cried? ________________________________________ Did he/she make play noise as a baby? ____________________________________ When did he say his first word, and what was the word? ________________________ Was there anything unusual about the childs speech and language development? __________________________________________________________________ Does the child use any inappropriate language? ______________________________ Does the child repeat certain sounds or words many times over with no apparent reason? ___________________________________________________________ What is the primary language spoken in the home? ___________________________ Which other language are spoken? ________________________________________ What language does the child use/understand? _______________________________ M. Problem Description Describe the childs problem. (Please Specify) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Manipulative Passive Lacking Confidence Active Self-Centered Predictable Confident Stubborn Tearful Destructive Aggressive Leadership Fearful Temper Generous Others: ______
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N. Family History Check if any other family member has experienced: Neurological disorder Mental illness Learning Difficulty Reading Difficulty Visual Defects Paralysis Hearing Problems O. Other Professional Help
Emotional Instability Physical Disabilities Retardation Blood Disease Heart Abnormality School Failure (Severe) Speech Problems
Date: ______________________
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IV. PERSONAL INFORMATION
PHOTO
: : : : : : : : : :
_____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________
V.
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VI.
A.
SELF-HELP SKILLS
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D. MOTOR SKILLS
OBSERVATION
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Area :
Area:
Area:
DAY 1
Name of the Child: _____________________________________________ Address/School: _______________________________________________ _______________________________________________ FUNCTIONAL AREAS OF EDUCATION FUNCTIONAL AREA/SKILLS
OBSERVATION
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Area :
Area :
Area:
Area:
DAY 2
Name of the Child: _____________________________________________ Address/School: _______________________________________________ _______________________________________________ FUNCTIONAL AREAS OF EDUCATION FUNCTIONAL AREA/SKILLS Observational Child Study 1
OBSERVATION
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Area :
Area :
Area:
Area:
DAY 3
Name of the Child: _____________________________________________ Address/School: _______________________________________________ _______________________________________________ FUNCTIONAL AREAS OF EDUCATION FUNCTIONAL AREA/SKILLS Observational Child Study 1 OBSERVATION
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Area :
Area :
Area:
Area:
DAY 4
Name of the Child: _____________________________________________ Address/School: _______________________________________________ _______________________________________________ FUNCTIONAL AREAS OF EDUCATION Observational Child Study 1
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FUNCTIONAL AREA/SKILLS Area :
OBSERVATION
Area :
Area:
Area:
DAY 5
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Social Skills Checklist

Name of Child: ________________________ Date Completed: ______________ Birth Date: ________ Teacher or Family Member Completing Form: _________ Based on your observations, in a variety of situations, rate the childs following skill level. Put a check mark in the box that best represents the childs current level (see rating scale). Write additional information in the comments section. After completing the checklist, place a check in the far right column, next to skills which are a priority to target for instruction.
Observational Child Study 1 82 | P a g e Almost Always: The child consistently displays this skill in many occasions, settings and with variety of people.
Section 1: Social Play and Emotional Development

Almost Always Almost Never
Sometimes
Does the child ...
Comments
1.1 Beginning Play Behaviors a. Maintain proximity to peers within 1 foot. b. Observe peers in play vicinity within 3 feet.
Almost Never Sometimes
Does the child ...
Comments
c. Parallel play near peers using the same or similar materials (e.g., building with blocks next to peer who is also playing with blocks. d. Imitate peer (physical or verbal) Observational Child Study 1
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Priority
Almost Always
Rarely
Often
Priority
Rarely
Often
e. Take turns during simple games (e.g., rolling ball back and forth). 1.2 Intermediate Play Behaviors a. Play associatively with other children (e.g., sharing toys and talking about the play activity, even though the play agenda of the other child/ren may be different). b. Respond to interactions from peers (e.g., physically accept toy from a peer; answer questions). c. Return and initiate greetings with peers (e.g., wave or say hello). d. Know acceptable ways of joining in an activity with others (e.g., offering a toy to a peer or observe play and ask to join in). e. Invite others to play. f. Take turns during structured games/activities (e.g., social or board games) g. Ask peers for toys, food and materials. 1.3 Advanced Play Behavior a. Play cooperatively with peers (e.g., take on pretend role during dramatic play, lead the play, and follow game with rules). b. Make comments about what he/she is playing to peers (e.g., I am making a tall tower.). c. Organize play by suggesting play plan (e.g., Lets make a train track and then drive the trains.).
Does the child ...
Comments
d. Follow another peers play ideas. e. Take turns during unstructured activities (e.g., with toys/materials that are limited, roles during dramatic play). f. Give up toys, food and materials Observational Child Study 1
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Priority
Almost Always
Rarely
Often
to peers. g. Offer toys, food, and materials to peers. Section 2: Emotional Regulation
Sometimes
Does the child ...
Comments
2.1 Understanding Emotions a. Identify likes and dislikes. b. Identify emotions in self. c. Label emotion in self. d. Identify emotions in others. e. Label emotions in others. f. Justify an emotion once identified/labelled (e.g., if a girl is crying the child can say she is crying because she fell down and is hurt). g. Demonstrate affection toward peers (e.g., gives peers hugs). h. Demonstrate empathy toward peers (e.g., if a peers toy breaks, the child may feel sad for them). i. Demonstrate aggressive behavior toward others. j. Demonstrate aggressive behavior toward self.
Sometimes
Does the child ...
Comments
k. Demonstrate intense fears (e.g., the child will not go near dogs and becomes upset when a dog is near.) l. Uses tone of voice to convey a message. (e.g., when the child is sad he/she uses a quiet voice or when saying stop uses a firm Observational Child Study 1
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Priority
Almost Always
Almost Never
Rarely
Often
Priority
Rarely
Often
voice). 2.2 Self Regulation a. Allow others to comfort him/her if upset or agitated (e.g., allows caregiver to give them a hug or peers to pat their back). b. Self regulate when tense or upset (e.g., calms self by counting to 10 or taking a breath). c. Self regulate when energy level is high (e.g., Counts to 10 or runs around the playground to release energy). d. Use acceptable ways to express anger or frustration (e.g., states they are upset or asks to take a break). e. Deal with being teased in acceptable ways (e.g., ignore, walk away, tell adult) f. Deals with being left out of group. g. Request a break or to be all done when upset. h. Accept not being first at a game or activity. i. Say no in an acceptable way to things s/he doesnt want to do. j. Accept losing at a game without becoming upset/angry. k. Deals with winning appropriately (e.g., the child may say, Maybe next time or Congratulate the winner). l. Accept being told no without becoming upset/angry. m. Able to say I dont know. 2.3 Flexibility a. Accept making mistakes without becoming upset/angry. b. Accept consequences of his/her behaviors without becoming upset/angry. c. Ignore others or situations when Observational Child Study 1
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it is desirable to do so. d. Accept unexpected changes. e. Accept changes in routine. f. Continue to try when something is difficult. 2.4 Problem Solving a. Claim and defend possessions. b. Identify/define problems. c. Generate solutions (e.g., if juice spills the child can suggest getting a sponge and cleaning it up). d. Carry out solutions by negotiating or compromising. Section 3: Group Skills
Sometimes
Does the child ...
Comments
3.1 Understanding Emotions a. Seek assistance from adults. b. Seek assistance from peers. c. Give assistance to peers. 3.2 Participate in Group a. Respond/participate when one other child is present. b. Respond/participate when more than one other child is present.
Does the child ...
Comments
c. Use appropriate attention seeking behaviors (e.g., calling name, tapping shoulder) 3.3 Follow Group a. Remain with group. b. Follow the group routine. c. Follow directions. d. Make transition to next activity Observational Child Study 1
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Priority
Almost Always
Rarely
Often
Priority
Rarely
Often
when directed. e. Accept interruptions/unexpected change. Section 4: Communication Skills

Sometimes
Does the child ...
Comments
3.1 Conversational Skills a. Initiate a conversation around specified topics. b. Initiate conversations when it is appropriate to do so (e.g., at recess and not during a time for quiet independent work at school). c. Ask Wh questions for information (e.g., child will ask Where are my shoes? or What is that girl?). d. Respond to Wh question. e. Respond appropriately to changes in topic (e.g., if peer changes the topic from skiing to swimming, the child will talk about the new topic).
Sometimes
Does the child ...
Comments
f. Make a variety of comments, related to the topic, during conversations (e.g., if a friend says, I have blue truck. The child responds, I have a green truck.). g. Ask questions to gain more information. h. Introduce him/herself to someone Observational Child Study 1
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Priority
Almost Always
Almost Never
Rarely
Often
Priority
Rarely
Often
new. i. Introduce people to each other. j. Demonstrate the difference between telling information and asking for more information. 4.2 Nonverbal Conversational Skills a. Maintain appropriate proximity to conversation partner (e.g., does not stand too close or touch other person). b. Orient body to speaker. c. Maintain appropriate eye contact. d. Use an appropriate voice volume. e. Pay attention to a persons nonverbal language and understand what is being communicated (e.g., if someone shakes their head that means no and nodding your head means yes). f. Wait to interject (e.g., waits until there is a pause before they begin talking). g. Appropriately interject (e.g., guess what or do you know what I did). h. End the conversation appropriately (e.g., when the conversation is over says, I have to go now or see you later). 4.3 Questions a. Answer Yes/No questions. b. Answer simple social questions (e.g., name, age, hair color, address). c. Answer subjective questions such as what do you like to eat/drink? or what is your favorite color/video?). d. Respond simple Wh questions (e.g., what color is that ball? where are your shoes?) e. Ask questions to gain more information. Observational Child Study 1
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f. Answer questions about past events (e.g., What did you have for lunch? or Where did you go for vacation?) g. Stay on topic by making comments or asking questions related to the topic. h. Use please and thank you at appropriate times. 4.4 Compliments a. Give compliments to peers. b. Appropriately receive compliments (e.g., thank you, reciprocate). After completing the checklist, place a check in the far right column, next to skills which are a priority to target for instruction.
For Instructor Use: Fill out priority skills for instruction based on check marked skills above. Section 1: Social Play and Emotional Development Skill Area
1.1 Beginning Play Behaviors
Priority Skill(s) for Instruction
1.2 Intermediate Play Behaviors
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1.3 Advanced Play Behavior
Section 2: Emotional Regulation Skill Area

2.1 Understanding Emotions
2.2 Self Regulation
2.3 Flexibility
2.4 Problem Solving
Section 3: Group Skills Skill Area

3.1 Seeking Assistance
3.2 Participate in Group
3.3 Follow Group
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Section 4: Communication Skills Skill Area

4.1 Conversational Skills
4.2 Nonverbal Conversational Skills
4.3 Questions
4.4 Compliments
Assessing for SPED: _________________________ Bachelor of Elementary Education major in Special Education Date: _______________________________
Total % Marked as Almost Always Total % Marked as Often Total % Marked as Sometimes Total % Marked as Rarely Total % Marked as Never AVERAGE
Skill Area
1.1 Beginning Play Behaviors 1.2 Intermediate Play Behaviors 1.3 Advanced Play Behavior 2.1 Understanding Behavior 2.2 Self Regulation Observational Child Study 1
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2.3 Flexibility 2.4 Problem Solving 3.1 Seeking Assistance 3.2 Participate in Group 3.3 Conversational Skills 4.1 Conversational Skills 4.2 Nonverbal Conversational Skills 4.3 Questions 4.4 Complements AVERAGE
SAMPLE CALCULATION FOR RATING SCALES

____ (QUESTION MARKED _____) (TOTAL QUESTIONS) X 100 = ______ %
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PART 1 Self-Help and Functional Skills Checklist

Please check the box that most appropriately describes your childs ability to perform the following Functional Skills. When selecting skills to teach, start with those your child can already partially do. Can partially Can do Cannot do. do. independently. Dressing Requires full Need some Does not assistance. help require any help Removes pants (does not include unfastening) Observational Child Study 1
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Puts on pants (does not include fastening) Puts on sock Puts on a pullover shirt Puts on a front opening shirt or jacket Puts on shoes (does not include tying) Threads a belt Buckles a belt Zips up a zipper once it is started Buttons by self Starts a zipper Ties shoes Hangs up clothes Puts dirty clothes in hamper Wears clothes that are clean and wrinkle free Selects clothes that fit Selects clothes that match Selects age-appropriate clothes Selects clothes appropriate to weather Selects clothes appropriate to context Cannot do. Requires full assistance. Can partially do. Need some help Can do independently. Does not require any help
Eating/Food Preparation Drinks from cup Eats with spoon Eats with fork Spreads with knife Cuts with knife Observational Child Study 1
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Sets table Clears table Gets own snack Prepares cold breakfast Makes toast Makes sandwich Cooks prepared food (mac n cheese) Uses a can opener Uses measuring cups and spoon Follows written or picture recipe Uses oven (sets temperature and timer) Puts groceries away Identified boxed/canned food by label Stores leftover foods properly Discards spoiled food
Grooming and Hygiene Uses toilet and toilet paper Washes and dries hands Washes and dries face Takes bath or shower independently Uses deodorant Washes and rinses hair Observational Child Study 1
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Washes and rinses body in bath or shower Dries self after bathing Brushes teeth Shaves (if appropriate) Applies makeup (if appropriate) Combs and brushes hair Trims fingernails/toenails Uses a tissue to blow nose Uses feminine hygiene products appropriately
Cleaning and Laundry Puts toys away Make own bed Clears table after eating (puts dishes in sink and garbage in wastebasket) Takes out trash Dusts
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Vacuums Washes windows or mirrors Cleans sink Cleans toilet Washes and dries dishes Loads dishwasher Separates clean from dirty clothes Sorts light from dark clothes Loads washing machine (knows what setting to use) Measures soap Uses dryer Hangs up clothes neatly Folds clothes neatly Puts clothing away appropriately
Play and Social (Indoor) Pays attention to someone speaking Grasps or holds large toys or objects Grasps or holds crayons or pencils Pushes, pulls and turns toys Follows 1 step direction about toys or objects Follows 2 step directions about toys Observational Child Study 1
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or objects Plays simple hide-and-seek games (peek-a-boo, hunts for missing toys) Sits and plays alone for up to 5 minutes Sits and plays alone for up to 10 minutes Imitates movements and gestures Stacks toys such as blocks up to 3 high Stacks toys such as blocks up to 6 high Scoops, sand, water or beans from one container to another Cuts with scissors Pastes with glue stick Scribbles with a crayon staying on paper Colors with crayon, mostly in the lines Does simple non-interlocking puzzles Does simple non-interlocking puzzles of up to 4 pieces Does simple non-interlocking puzzles of up to 12 pieces Does complex interlocking puzzles of up to 25 pieces Play simple matching games such as memory matching Play simple board games such as Chutes and Ladders Play complex board games such as Sorry or Life Play complex board games such as monopoly, chess, checkers or backgammon Plays computer or video games once they are set up by adult Observational Child Study 1
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Can load , turn on and set up a video or computer games Works with other children using same play materials Shares and takes turns in play
Play and Social (Outdoor) Throws and catches a large ball within 2 feet Throws and catches a large ball 3-6 feet Throws and catches a small ball 3-6 feet Hits ball off a tree Hits a ball when pitched Aims basketball at basket at appropriate height for age or size Dribbles basketball standing in place Dribbles basketball while running Kicks a ball at goal or target Kicks a ball while running Rides a tricycle Rides a 2 wheel bike Rides a razor scooter Rides a skateboard or in line skates Swims is safe near water
Assessing for SPED:
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_____________________
Date: _______________________
PART 2 Gross and Fine Motor Skills Checklist

Please check the box that most appropriately describes your childs ability to perform the following Functional Skills. When selecting skills to teach, start with those your child can already partially do. I. GROSS MOTOR SKILLS Functional Skills/Areas Adjusts activity level to various Observational Child Study 1
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Strength
Typically
Need
demands during class Smoothly transitions between motors skills Demonstrate adequate balance Demonstrate adequate coordination (does not run into or trip over objects) Has adequate stamina to complete physical education services Adequately performs eye-hand coordination tasks (throwing, catching, throwing a ball) Adequately coordinates lower limbs (i.e. running, jumping, kicking, etc.) Is physically fit (consider endurance, strength, flexibility, body weight for height) Has good body awareness (control of body, coordination, directionality, spatial judgment) IMPLICATIONS FOR INSTRUCTION AND PROGRESS MONITORING: Yes No ___ ____ This child demonstrates adequate behavioral/social skills necessary for participation in a regular physical education class (i.e cooperates with teacher/peers, is compliant with class rules, has age-appropriate social skills, interacts positively with teacher/peers, demonstrates appropriate frustration levels). If no, please list suggestions for improvement and/or adaptation. ___________________________________________________________________ ___________________________________________________________________ II. FINE MOTOR SKILLS Functional Skills/Areas Has fine motor activity which involves coordinated, efficient movement of body parts. Adequately uses classroom supplies (such as scissors, compass, protractor) Adequately draws numbers and geometric shapes (such as cross, circle, square, triangle) Performs eye-hand coordination tasks well (opening doors, sharpening Observational Child Study 1
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Strength
Typically
Need
pencils, drawing) Uses one hand consistently for writing and other motor tasks Written work is neat & legible (adequately spaced, orderly, within on the line/s) Completes fine motor tasks without becoming easily frustrated Has difficulty with pencil/pen grasp
IMPLICATIONS FOR INSTRUCTION AND PROGRESS MONITORING: Yes No ___ ____ The student generally has the fine motor skills necessary to complete academic work and self-help skills without difficulty in the regular classroom. If no, please list suggestions for improvement and/or adaptation. ___________________________________________________________________ ___________________________________________________________________ Assessing for SPED:
_____________________
Date: _______________________
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Name: _______________________________ Date of Assessment: ___________ Grade/Section: ________________________ Age: ______ Birthdate: _________
PART 1 Mathematical Skills Checklist

Please check the box that most appropriately describes your childs ability to perform the following Cognitive/Intellectual Skills. When selecting skills to teach, start with those your child can already partially do.
Cognitive Skills MATH CALCULATION Observational Child Study 1
Established
Emerging
Area of Need
Not Introduced
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Facts: Addition Subtraction Multiplication Division Addition with regrouping Subtraction with regrouping Multiplication with multi-digits Decimal Operations: Addition Subtraction Multiplication Division Fraction Operations: Addition Subtraction Multiplication Division MATH PROBLEM-SOLVING Grade level arithmetic vocabulary Grade level word problem skills Grade level money skills Grade level time skills Grade level measurement skills Grade level geometry skills Instructional Implications (Please check one): _______ This student generally displays above grade-level math skills _______ This student generally displays grade-level math skills _______ This student generally displays slightly below grade-level math skills _______ This student generally displays significantly below grade-level math skills
Recommendations: Do you feel that the students math needs can be met within the general education setting without special education support? ___ Yes ___ No Because: ___________________________________________________________________ ___________________________________________________________________ What, if any, changes with regards to math skills would you recommend for this student? ___________________________________________________________________ ___________________________________________________________________
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Assessing for SPED:
_____________________
Date: _______________________
PART 2 Reading Skills Checklist

Cognitive Skills BASIC READING Observational Child Study 1
Established
Emerging
Area of Need
Not Introduced
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Phonemic Awareness Letter Recognition Phonics Skills Use of context clues Correctly decodes beginning sounds (blends prefixes) Correctly decodes medial sounds Correctly decodes ending sounds (suffixes, word families) READING COMPREHENSION Retells a story with main idea/ details Factual/Liberal Comprehension Reading for Information Understanding Plot Drawing Conclusions Making Inferences/predications Following Directions READING FLUENCY Oral Reading Silent Reading Instructional Implications (Please check one): _______ This student generally displays above grade-level reading skills _______ This student generally displays grade-level reading skills _______ This student generally displays slightly below grade-level reading skills _______ This student generally displays significantly below grade-level reading skills
Recommendations: Do you feel that the students reading needs can be met within the general education setting without special education support? ___ Yes ___ No Because: ___________________________________________________________________ ___________________________________________________________________ What, if any, changes with regards to reading skills would you recommend for this student? ___________________________________________________________________ ___________________________________________________________________
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Assessing for SPED:
_____________________
Date: _______________________
PART 3 Writing Skills Checklist

Cognitive Skills WRITING CONVENTIONS Observational Child Study 1
Established
Emerging
Area of Need
Not Introduced
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Copies material correctly from board Legibility of handwriting Writes fluently Using correct spelling Using correct capitalization Using correct punctuation Uses Correct Grammar A. Uses plurals correctly B. Uses subj./verb correctly C. Expresses questions correctly WRITING PROCESS Evidences Overall Organizational Skills A. Sequences correctly B. Uses beginning, middle, ending C. Uses topic sentence D. Uses age appropriate vocabulary E. Avoids fragments, run-ons F. Uses details to support ideas Uses Effective Writing Process A. Pre writing activities B. Uses drafting process C. Uses proofing skills D. Uses self-correcting skills E. Shares written report Cognitive Skills WRITING APPLICATIONS A. Produces informal writing B. Writes letters C. Writes stories D. Writes informational essays/ reports Instructional Implications (Please check one): _______ This student generally displays above grade-level writing skills _______ This student generally displays grade-level writing skills _______ This student generally displays slightly below grade-level writing skills Established Emerging Area of Need Not Introduced
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_______
This student generally displays significantly below grade-level writing skills
Recommendations: Do you feel that the students writing needs can be met within the general education setting without special education support? ___ Yes ___ No Because: ___________________________________________________________________ ___________________________________________________________________ What, if any, changes with regards to writing skills would you recommend for this student? ___________________________________________________________________ ___________________________________________________________________
Assessing for SPED:
_____________________
Date: _______________________
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CHILDREN WITH VISUAL IMPAIRMENT/BLIND

Lowenfield categorizes visually handicapped children into six such as: Total blindness, congenital or acquired before the age of 5 years; Total blindness, acquired after 5 years of age and Partial blindness, congenital;Partial blindness,
acquired; Partial sight, congenital and Partial sight, acquired .
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Research conducted by Buell showed the inferiority of the blind to the partially sighted and the inferiority of both to normal when it comes to motor performance. Furthermore, Blindness limits perception and cognition in 3 ways: In the range and variety of experiences; In the ability to get about; and In the control of the environment and the self in relation to it. Blind children often receive significantly lower maturity scores than seeing children. In relation to their speech development , Brieland described these
children for having less vocal variety; lack of modulation; tend to talk louder and loss effective use of gesture and bodily action and can develop language similar to that of seeing children Also, these children learn to read Braille which is a slower process than reading visually, educationally retarded as compared to seeing children in math, spelling and general information. Research found that there was no difference between the blind and seeing subjects in auditory, tactual or kinesthetic sensitivity; It is possible that blind people make better use of their abilities in other sense fields and There is no evidence that blind in general are superior in music ability.
Rating Scales
Rating scales, like checklists, are planned to record something specic. They are used to record the degree to which a quality or trait is present. Rating scales require you to make a judgment about the quality of what is being observed.
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Some scales contain only a numerical range. Others define the behaviors more specifically. In order to choose a rating, the observer should have a good
understanding of the behavior he/ she is rating.
OBSERVING A VISUALLY IMPAIRED/BLIND CHILD
DIRECTION: Devise a rating scale to observe the Social/Emotional Skills of a visually impaired/blind child. Follow the format below.
Behavior
Never Sometimes Usually
Always
Is patient and conscientious
Is eager to make friends
Shows respect to classmates/peers
Accept defeat
OBSERVING A VISUALLY IMPAIRED/BLIND CHILD

DIRECTION: Using the rating scale above, describe the social/emotional skills of a visually impaired/blind child.
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Name of the Child:_____________________________________ Age: _______ Grade Level: ________ School: _______________________________ Teachers Name: ______________________________________
SITUATION:
CHILDS ACTION/BEHAVIOR

General Information 29. Childs Name_____________________ __________________________ _______ (Last Name) (First Name) (MI) 30. Childs address ______________________________________________________________________ (Street) (City, State, Zip)
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31. Home Telephone Number __________________________________________________ 32. Childs Gender Female Male 33. Childs Date of Birth __________ __________ _________ Month Date Year 34. Mothers Name: __________________________________________________________ 35. Fathers Name: ___________________________________________________________ Birth History 36. Length of Pregnancy ______ months 37. Childs weight at birth ________ kg 38. Were there any unusual factors or complications during the pregnancy? yes no (Please describe): _______________________________________ 39. Did your child have any medical problems at birth? yes (Please describe): ___________________________________________ no

yes
no
69. How many colds has you child had during the past year? 70. Does your child have :
ALLERGIES? (Please specify which allergies): Foods ________ Animals_______ Medicine______ Asthma? yes no
_________ times
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Have fever?
yes
no yes no
yes
no
yes
yes
no

Date of test: ______ ________
(Month) (Year)
Please describe: ____________________________________________________
______________________________________________________________________

Please describe: _____________________________________________________________
Please describe: __________________________________________________________ __________________________________________________________ Childs Daily Routine 84. Do you have any concerns about your childs: eating habits? _____________________________
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sleeping habits? ___________________________ toilet training? _____________________________

______________________________________________________________________ ______________________________________________________________________

CASE HISTORY RECORD

Childs Name: _______________________________________ Sex: __________ Date: ______________________________________________ Age: _________ Address: _________________________________________________________________ Tel. No.: ________________ Reason for Referral: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ E. GENERAL Fathers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address: _________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________
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Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ Mothers Name: ____________________________________________ Age: __________ Birth Date: ________________ Birthplace: _______________ Citizenship: _________ Address__________________________________________________________________ Education Completed: _______________________________________________________ Occupation: __________________________ Position Held: ____________________ Name of Present Employer: __________________________________________________ Office Address: _________________________________ Tel. No____________________ List of siblings of the child (brothers and sisters) and their dates of birth: Names ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ F. DEVELOPMENTAL HISTORY U. Background Are both parents the childs natural parents? yes no Whom does the child most resemble ______________________________ Parents ages at childs birth: Father: ___________ Mother: __________ V. Pregnancy Number of previous pregnancies: _________ Number of previous live births: ___________ Was pregnancy planned? _______________ Was a boy or a girl expected? ____________ Was the mother under constant pre-natal care? _____ If not, explain in detail, including illness, meditation used, periods of hospitalization, injuries, etc. (use extra space provided at the back of this page if necessary.) ______________________________________________________________________ ______________________________________________________________________ W. Birth Was the baby full term? ________________ Premature _______________________ Was this a difficult labor? __________________________________________________ Was delivery normal? _________________ or by caesarian operation? __________ When? _____________________________ Were instruments used to assist delivery (what if any?)___________________________ Did baby suffer from lack of oxygen? ________________________________________ Did baby cry right away? __________ Did baby appear normal at birth? ___________ Weight of baby at birth ____________________________________________________ X. Early Feeding Date of Birth ____________ ____________ ____________ ____________ ____________ ____________ ____________ ____________
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Did the child suck readily? _________________________________________________ Feeding: Breast ________ Bottle (please state brand of milk) _________________________ Mixed ________ How often was baby fed? _________________________________________________ Periods of colic, other gastro-intestinal disturbance? ____________________________ Age and method of weaning (please state kind of milk) __________________________ Any allergies to milk? _____________________________________________________ Y. Handling Baby was generally fed by ______________________ Changed and handled by _______________________ When baby cried, we usually _______________________ For how long could baby be left alone in his carriage or playpen before showing signs of distress? ________________________ Z. Physical Development Age at which baby sat up ________________________ Got first tooth _______________________ Crawled ___________________________ Stood aided ________________________ Stood unaided ______________________ Walked unaided _____________________ Has the child reached puberty? _____________________ AA. Toilet Training Was the child toilet-trained? ____________________________ Age training began? _______________________________ Age at which trained? ____________________________________ If a boy, does he stand? ____________________________________ What signs does the child give when he needs to use the bathroom? ___________________________________________________________________ BB. Illness During the first 2 years, did the child ever have prolonged high fever? (Please explain)_____________________________________________________ __________________________________________________________________ What preventive measures i.e., immunization, vaccination, etc. had been taken? ___________________________________________________________________ Had the child any serious reactions to immunization? If so, when? ___________________________________________________________________ Operations performed and reasons for these: ___________________________________________________________________
CC. Present Physical Condition Allergies: ______________________________________________________ Preference for right or left hand: ___________________________________ Noticeable problems in coordination: _____________________________________________________________ Does the child fall easily? yes no Does the child drool excessively? yes no
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Does the child over-perspire? yes Does the child seem tense? yes Does the child have normal vision? yes Does the child have normal breathing pattern? Does the child sniff food or objects frequently?
no no no yes yes no no
DD. Home Situation Has the child always lived with both parents? _______________________ Have there been any sudden departures or deaths in the immediate family? _________ Has there been any serious illness in the family? _____________________ If the child has a younger sibling, who prepared him for the siblings birth? ___________________________________________________________________ How was the child prepared? ___________________________________________________________________ Who cared for the child while mother was in the hospital? ________________ Was there any noticeably change in the childs behavior after the birth of the baby? _____________________ What was the childs reaction to the new baby? ______________________ Have there been any sudden changes, relocations of family, home, etc. during lifetime of child? ______________________________________________________________ To whom the child is most attached at present? ________________________________ Was it always like this? __________________________________________________ K. Education Age the child entered the school? _________________ Initial reaction to school? _________________________________________________ _____________________________________________________________ Please list schools attended. School Dates ________________________________ _______________________ ________________________________ _______________________ ________________________________ _______________________ Were grades repeated? Which? Why? ___________________________________________________________________ Which subject does he enjoy most? ___________________________________________________________________ In which subject does he excel? ___________________________________________________________________ Which are the subjects he has most difficulty with? ___________________________________________________________________ What are his reactions to his teacher? ___________________________________________________________________ What are his reactions to his classmates? ___________________________________________________________________ L. Behavior k. Play Describe your childs play activities: __________________________________________________________________
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Outdoor physical activities i.e. sports: __________________________________________________________________ Reading: ____________________________________________________________ Imaginary Play: _______________________________________________________ Does he often watch TV? ________________________________________________ What kind of programs does he enjoy watching: ______________________________ Does he often attend movies? ____________________________________________ What kind of movies does he enjoy? _______________________________________ Does he often read comics? ______________________________________________ Name the activities he enjoys most: _______________________________________ Circle any of the following which apply to his play: Repetition Imaginative Cooperation With peer group With older children With a small group l. Sleep Does the child sleep soundly? _______________ Does the child sleep regularly? ______________ Hours of sleep? _________________________ Any naps? How long? ____________________ have nightmare? _________________________ Does he have dreams? ____________________ Is he able to describe his dreams? ___________ Does the child cry when he dreams? _________ Does the child perspire the same dream in a repetitive way? _____________ Does he/she wet the bed? __________________________ How often does this occur? _________________________ How is this handled? _______________________________ How does he read? ________________________________ m. Eating His likes: __________________________________________________________________ His dislikes: ________________________________________________________________ Are there any eating problems? yes no Does the child eat unaided? yes no Are his meals prepared on demand, or does the child eat with the rest of the family? __________________________________________________________________ Is the child required to eat balanced meal, or snacks or given favorite food? __________________________________________________________________ Does he vomit frequently? yes no How is this handled? ____________________________________________________ n. Habits Fantasy Alone with toys fitting engrossed messy With a large group as a leader as a follower with younger children others: ___________
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Is the child attached to any special object? What? __________________________________________________________________ Notable mannerism: __________________________________________________________________ Thumb sucking? yes no Head banging? yes no Does he have any rituals, e.g. before going to bed? yes no If yes, specify: ______________________________________________________________ Check any of the following which describe the child: Negative Quiet Excitable Unresponsive Friendly Happy Sad Suggestible o. Language Did the child cry during the first month? _____________________________________ What was done when he/she cried? ________________________________________ Did he/she make play noise as a baby? ____________________________________ When did he say his first word, and what was the word? ________________________ Was there anything unusual about the childs speech and language development? __________________________________________________________________ Does the child use any inappropriate language? ______________________________ Does the child repeat certain sounds or words many times over with no apparent reason? ___________________________________________________________ What is the primary language spoken in the home? ___________________________ Which other language are spoken? ________________________________________ What language does the child use/understand? _______________________________ M. Problem Description Describe the childs problem. (Please Specify) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ N. Family History Check if any other family member has experienced: Neurological disorder Mental illness Learning Difficulty Reading Difficulty Visual Defects Manipulative Passive Lacking Confidence Active Self-Centered Predictable Confident Stubborn Tearful Destructive Aggressive Leadership Fearful Temper Generous Others: ______
Emotional Instability Physical Disabilities Retardation Blood Disease Heart Abnormality 122 | P a g e
Paralysis Hearing Problems O. Other Professional Help
School Failure (Severe) Speech Problems
Date: ______________________

VII. PERSONAL INFORMATION
PHOTO
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: : : : : : : : : :
_____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________
VIII.
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IX.

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A.
SELF-HELP SKILLS
D. MOTOR SKILLS
OBSERVATION OF THE CHILDS FUNCTIONAL AREAS OF EDUCATION Observational Child Study 1

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Day: _________________ Time: ________________
Date: ____________ ___, 2012 Class/Level: _______________________
OBSERVATION
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Day: _________________ Time: ________________
Date: ____________ ___, 2012 Class/Level: _______________________
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Social Skills Checklist

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Name of Child: ________________________ Date Completed: ______________ Birth Date: ________ Teacher or Family Member Completing Form: _________ Based on your observations, in a variety of situations, rate the childs following skill level. Put a check mark in the box that best represents the childs current level (see rating scale). Write additional information in the comments section. After completing the checklist, place a check in the far right column, next to skills which are a priority to target for instruction.
Almost Always: The child consistently displays this skill in many occasions, settings and with variety of people. Often: The child displays this skill on a few occasions, settings and with a few people. Sometimes: The child may demonstrate this skill however they seldom display this skill. Rarely: The child has rarely display this skill. Almost Never: The child has never displays this skill. In their daily routine, is uncommon to see the child demonstrate this skill.
Section 1: Social Play and Emotional Development

Sometimes
Does the child ...
Comments
1.1 Beginning Play Behaviors a. Maintain proximity to peers within 1 foot. b. Observe peers in play vicinity within 3 feet.
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Priority
Rarely
Often
Almost Never
Sometimes
Does the child ...
Comments
c. Parallel play near peers using the same or similar materials (e.g., building with blocks next to peer who is also playing with blocks. d. Imitate peer (physical or verbal) e. Take turns during simple games (e.g., rolling ball back and forth). 1.2 Intermediate Play Behaviors a. Play associatively with other children (e.g., sharing toys and talking about the play activity, even though the play agenda of the other child/ren may be different). b. Respond to interactions from peers (e.g., physically accept toy from a peer; answer questions). c. Return and initiate greetings with peers (e.g., wave or say hello). d. Know acceptable ways of joining in an activity with others (e.g., offering a toy to a peer or observe play and ask to join in). e. Invite others to play. f. Take turns during structured games/activities (e.g., social or board games) g. Ask peers for toys, food and materials. 1.3 Advanced Play Behavior a. Play cooperatively with peers (e.g., take on pretend role during dramatic play, lead the play, and follow game with rules). b. Make comments about what he/she is playing to peers (e.g., I am making a tall tower.). c. Organize play by suggesting play plan (e.g., Lets make a train track and then drive the trains.). Observational Child Study 1
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Priority
Almost Always
Rarely
Often
Almost Never
Sometimes
Does the child ...
Comments
d. Follow another peers play ideas. e. Take turns during unstructured activities (e.g., with toys/materials that are limited, roles during dramatic play). f. Give up toys, food and materials to peers. g. Offer toys, food, and materials to peers. Section 2: Emotional Regulation
Sometimes
Does the child ...
Comments
2.1 Understanding Emotions a. Identify likes and dislikes. b. Identify emotions in self. c. Label emotion in self. d. Identify emotions in others. e. Label emotions in others. f. Justify an emotion once identified/labelled (e.g., if a girl is crying the child can say she is crying because she fell down and is hurt). g. Demonstrate affection toward peers (e.g., gives peers hugs). h. Demonstrate empathy toward peers (e.g., if a peers toy breaks, the child may feel sad for them). i. Demonstrate aggressive behavior toward others. j. Demonstrate aggressive behavior toward self.
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Priority
Rarely
Often
Priority
Almost Always
Rarely
Often
Sometimes
Does the child ...
Comments
k. Demonstrate intense fears (e.g., the child will not go near dogs and becomes upset when a dog is near.) l. Uses tone of voice to convey a message. (e.g., when the child is sad he/she uses a quiet voice or when saying stop uses a firm voice). 2.2 Self Regulation a. Allow others to comfort him/her if upset or agitated (e.g., allows caregiver to give them a hug or peers to pat their back). b. Self regulate when tense or upset (e.g., calms self by counting to 10 or taking a breath). c. Self regulate when energy level is high (e.g., Counts to 10 or runs around the playground to release energy). d. Use acceptable ways to express anger or frustration (e.g., states they are upset or asks to take a break). e. Deal with being teased in acceptable ways (e.g., ignore, walk away, tell adult) f. Deals with being left out of group. g. Request a break or to be all done when upset. h. Accept not being first at a game or activity. i. Say no in an acceptable way to things s/he doesnt want to do. j. Accept losing at a game without becoming upset/angry.
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Priority
Almost Always
Almost Never
Rarely
Often
k. Deals with winning appropriately (e.g., the child may say, Maybe next time or Congratulate the winner). l. Accept being told no without becoming upset/angry. m. Able to say I dont know. 2.3 Flexibility a. Accept making mistakes without becoming upset/angry. b. Accept consequences of his/her behaviors without becoming upset/angry. c. Ignore others or situations when it is desirable to do so. d. Accept unexpected changes. e. Accept changes in routine. f. Continue to try when something is difficult. 2.4 Problem Solving a. Claim and defend possessions. b. Identify/define problems. c. Generate solutions (e.g., if juice spills the child can suggest getting a sponge and cleaning it up). d. Carry out solutions by negotiating or compromising. Section 3: Group Skills
Sometimes
Does the child ...
Comments
3.1 Understanding Emotions a. Seek assistance from adults. b. Seek assistance from peers. c. Give assistance to peers. 3.2 Participate in Group a. Respond/participate when one other child is present. b. Respond/participate when more than one other child is present. Observational Child Study 1
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Priority
Rarely
Often
Almost Never
Sometimes
Does the child ...
Comments
c. Use appropriate attention seeking behaviors (e.g., calling name, tapping shoulder) 3.3 Follow Group a. Remain with group. b. Follow the group routine. c. Follow directions. d. Make transition to next activity when directed. e. Accept interruptions/unexpected change. Section 4: Communication Skills
Sometimes
Does the child ...
Comments
3.1 Conversational Skills a. Initiate a conversation around specified topics. b. Initiate conversations when it is appropriate to do so (e.g., at recess and not during a time for quiet independent work at school). c. Ask Wh questions for information (e.g., child will ask Where are my shoes? or What is that girl?). d. Respond to Wh question. e. Respond appropriately to changes in topic (e.g., if peer changes the topic from skiing to swimming, the child will talk about the new topic). Observational Child Study 1
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Priority
Rarely
Often
Priority
Almost Always
Rarely
Often
Sometimes
Does the child ...
Comments
f. Make a variety of comments, related to the topic, during conversations (e.g., if a friend says, I have blue truck. The child responds, I have a green truck.). g. Ask questions to gain more information. h. Introduce him/herself to someone new. i. Introduce people to each other. j. Demonstrate the difference between telling information and asking for more information. 4.2 Nonverbal Conversational Skills a. Maintain appropriate proximity to conversation partner (e.g., does not stand too close or touch other person). b. Orient body to speaker. c. Maintain appropriate eye contact. d. Use an appropriate voice volume. e. Pay attention to a persons nonverbal language and understand what is being communicated (e.g., if someone shakes their head that means no and nodding your head means yes). f. Wait to interject (e.g., waits until there is a pause before they begin talking). g. Appropriately interject (e.g., guess what or do you know what I did). h. End the conversation appropriately (e.g., when the conversation is over says, I have to go now or see you later). Observational Child Study 1
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Priority
Almost Always
Almost Never
Rarely
Often
4.3 Questions a. Answer Yes/No questions. b. Answer simple social questions (e.g., name, age, hair color, address). c. Answer subjective questions such as what do you like to eat/drink? or what is your favorite color/video?). d. Respond simple Wh questions (e.g., what color is that ball? where are your shoes?) e. Ask questions to gain more information. f. Answer questions about past events (e.g., What did you have for lunch? or Where did you go for vacation?) g. Stay on topic by making comments or asking questions related to the topic. h. Use please and thank you at appropriate times. 4.4 Compliments a. Give compliments to peers. b. Appropriately receive compliments (e.g., thank you, reciprocate). After completing the checklist, place a check in the far right column, next to skills which are a priority to target for instruction.
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For Instructor Use: Fill out priority skills for instruction based on check marked skills above. Section 1: Social Play and Emotional Development Skill Area
1.1 Beginning Play Behaviors
1.2 Intermediate Play Behaviors
1.3 Advanced Play Behavior
Section 2: Emotional Regulation Skill Area

2.1 Understanding Emotions
2.2 Self Regulation
2.3 Flexibility
2.4 Problem Solving
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Section 3: Group Skills Skill Area

3.1 Seeking Assistance
3.2 Participate in Group
3.3 Follow Group
Section 4: Communication Skills Skill Area

4.1 Conversational Skills
4.2 Nonverbal Conversational Skills
4.3 Questions
4.4 Compliments
Assessing for SPED: _________________________ Bachelor of Elementary Education major in Special Education Date: _________________________ Observational Child Study 1
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Skill Area
Total % Marked as Almost Always
Total % Marked as Often
Total % Marked as Sometimes
Total % Marked as Rarely
Total % Marked as Never
1.1 Beginning Play Behaviors 1.2 Intermediate Play Behaviors 1.3 Advanced Play Behavior 2.1 Understanding Behavior 2.2 Self Regulation 2.3 Flexibility 2.4 Problem Solving 3.1 Seeking Assistance 3.2 Participate in Group 3.3 Conversational Skills 4.1 Conversational Skills 4.2 Nonverbal Conversational Skills 4.3 Questions 4.4 Complements AVERAGE
SAMPLE CALCULATION FOR RATING SCALES

____ (QUESTION MARKED _____) (TOTAL QUESTIONS) X 100 = ______ %
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AVERAGE
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Infants: (0-18 months)

Developmental Milestones
Physical: 0 -3 months Sucking, grasping reflexes Lifts head when held at shoulder Moves arms actively Is able to follow objects and to focus 3- 6 months Rolls over Holds head up when held in sitting position Lifts up knees, crawling motions Reaches for objects 6-9 months Sits unaided, spends more time in upright position Learns to crawl Climbs stairs Develops eye-hand coordination 9-18 months Achieve mobility, strong urge to climb, crawl Stands and walks Learn to walk on his or her own Learns to grasp with thumb and finger Feeds self Transfers small objects from one hand to another Emotional/Social: Wants to have needs met Develop a sense of security Smiles spontaneously and responsively Likes movement, to be held and rocked Laughs aloud Socializes with anyone, but knows mother or primary caregiver Responds to tickling Prefers primary caregiver May cry when strangers approach Commonly exhibits anxiety Extends attachments for primary caregivers to the world Demonstrate object permanence; knows parents exist and will return (helps child deal with anxiety) Test limits
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Intellectual/Cognitive:
Vocalizes sounds (coos) Smiles and expresses pleasure Recognizes primary caregiver Uses both hands to grasp objects Has extensive visual interests Puts everything in mouth Solves simple problems, e.g., will move obstacles aside to reach objects Transfers objects from hand to hand Begins to respond selectively to words Demonstrates intentional behavior, initiates actions Realizes objects exist when out of sight and will look for them (object permanence) Is interested and understands words Says words like mama, dada
Toddlers: (18-36 months)

Physical Enjoy physical activities such as running, kicking, climbing, jumping, etc. Beginnings of bladder and bowel control towards latter part of this stage Are increasingly able to manipulate small objects with hands Emotional/Social Becoming aware of limits; says no often Establishing a positive, distinct sense of self through continuous exploration of the world Continuing to develop communication skills and experiencing the responsiveness of others Needs to develop a sense of self and to do some things for him/herself Making simple choices such as what to eat, what to wear and what activity to do Intellectual/Cognitive
Limited vocabulary of 500-3,000 words and only able to form three to four word sentences No understanding of pronouns (he, she) and only a basic grasp of prepositions (in, on, off, out, away) Can count, but from memory, without a true understanding of what the numbers represent Cognitively, children in this age are very egocentric and concrete in their thinking, and believe that adults know everything. This means that they look at everything from their own perspective.
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Assumption that everyone else sees, acts, and feels the same way they do, and belief that adults already know everything. This results in their feeling that they dont need to explain an event in detail. Toddlers might have a very clear picture of events as they relate to themselves but may have difficulty expressing thoughts or providing detail. Because of this, most of the questions will need to be asked of their caregivers. Ability to relate their experiences, in detail, when specifically and appropriately questioned Learning to use memory and acquiring the basics of self-control
Pre-School: (3-6 years old)

Physical Is able to dress and undress self Has refined coordination and is learning many new skills Is very active and likes to do things like climb, hop, skip and do stunts "At the start of early childhood, the brain has attained about 50% of its adult weight. By the time children are 6, it has grown to 90% of its full weight (Cole et al, 2005; Huttenlocher, 1994) Emotional/Social Develops capacity to share and take turns Plays cooperatively with peers Is developing some independence and self-reliance Is developing ethnic and gender identities Learning to distinguish between reality and fantasy Learning to make connections and distinctions between feelings, thoughts and actions Intellectual/Cognitive Ability to understand language usually develops ahead of their speech By age 6, vocabulary will have increased to between 8,000 and 14,000 words but it is important to remember that children in this age group often repeat words without fully understanding their meaning They have learned the use of most prepositions (up/down, ahead/behind, beside) and some basic possessive pronouns (mine, his, ours), and have started to master adjectives In the period between 2 and 6 years of age, children's mental and social lives are totally transformed by an explosive growth in the ability to comprehend and use language. [...] 6 year old children are competent language users." (Cole et al, 2005) "Between 2 to 6, children begin to use a great many new constructions that conform to the 'grammatical rules'... ; [...] "language is the medium through which children learn about their roles in the world, acceptable behaviour and their culture's
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assumptions about how the world works. Simultaneously language enables children to ask questions, to explain thoughts and desires, and to make more effective demands on the people around them." (ibid) Pre-school children continue to be egocentric and concrete in their thinking. They are still unable to see things from anothers perspective, and they reason based on specifics that they can visualize and that have importance to them (i.e. Mom and Dad instead of family). When questioned, they can generally express who, what, where, and sometimes how, but not when or how many. They are also able to provide a fair amount of detail about a situation. It is important to keep in mind that children in this age range continue to have trouble with the concepts of sequence and time. As a result, they may seem inconsistent when telling a story simply because they hardly ever follow a beginning-middle-end approach
School-Age Children (7- 9 years old)

Physical Have increased coordination and strength Enjoy using new skills, both gross and fine motor Are increasing in height and weight at steady rates Emotional/Social Increased ability to interact with peers Have more same-sex friends Increased ability to engage in competition Developing and testing values and beliefs that will guide present and future behaviors Has a strong group identity; increasingly defines self through peers Need to develop a sense of mastery and accomplishment based upon physical strength, self-control and school performance Intellectual/Cognitive By early elementary age, children start logical thinking, which means that rather than accepting what they see as true, they begin to apply their personal knowledge and experience to a particular situation to determine whether it makes sense or not Temporal concepts greatly improve in this age range, as early elementary children start to understand the idea of the passage of time, as well as day, date and time as a concept as opposed to a number Most early elementary aged children have acquired the basic cognitive and linguistic concepts necessary to sufficiently communicate an abusive event They can also copy adult speech patterns. As a result, it is easy to forget that children in this age range are still not fully developed cognitively, emotionally, or linguistically
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Early Adolescence (10 12 years old)

Physical Have increased coordination and strength Are developing body proportions similar to those of an adult May begin pubertyevident sexual development, voice changes, and increased body odor are common Emotional/Social Increased ability to interact with peers Increased ability to engage in competition Developing and testing values and beliefs that will guide present and future behaviors Has a strong group identity; increasingly defines self through peers Acquiring a sense of accomplishment based upon the achievement of greater physical strength and self-control Defines self-concept in part by success in school Intellectual/Cognitive Early adolescents have an increased ability to learn and apply skills The early adolescent years mark the beginning of abstract thinking but revert to concrete thought under stress Even though abstract thinking generally starts during this age period, preteens are still developing this method of reasoning and are not able to make all intellectual leaps, such as inferring a motive or reasoning hypothetically Youth in this age range learn to extend their way of thinking beyond their personal experiences and knowledge and start to view the world outside of an absolute blackwhite/right-wrong perspective Interpretative ability develops during the years of early adolescence, as does the ability to recognize cause and affect sequences Early adolescents are able to answer who, what, where, and when questions, but still may have problems with why questions
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Middle Adolescence (13 17 years old)

Physical 95% of adult height reached Less concern about physical changes but increased interest in personal attractiveness Excessive physical activity alternating with lethargy Secondary sexual characteristics Emotional/Social Conflict with family predominates due to ambivalence about emerging independence Strong peer allegiances fad behavior Experimentation sex, drugs, friends, jobs, risk-taking behavior Struggle with sense of identity Moodiness Rejection of adult values and ideas Risk Taking it cant happen to me Experiment with adult roles Testing new values and ideas Importance of relationships may have strongly invested in a single romantic relationship Intellectual/Cognition Growth in abstract thought reverts to concrete thought under stress Cause-effect relationships better understood Very self absorbed
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EVIDENCES FOR CHILDREN WITH ORTHOPEDICALLY AND SPECIAL HEALTH PROBLEM
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EVIDENCES FOR CHILDREN WITH HEARING IMPAIRMENT
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EVIDENCES FOR CHILDREN WITH VISUAL IMPAIRMENT
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Observational Child Study 1 (SPED 4)

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Republic of the Philippines

UNIVERSITY OF RIZAL SYSTEM

Observational Child Study I

Dr. Rosa F. Portillo Professor, SPED 4

Observational Child Study 1

Observational Child Study 1

Chapter I - Introduction to Observational Child Study 1

Chapter II - Children with Orthopedically Handicapped and Special Health Problem

Chapter III - Children with Hearing Impairment

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Chapter IV - Children with Visual Impairment

Chapter V Developmental Milestones

Chapter VI Photo Documentation

Chapter VII Daily Time Record

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INTRODUCTION TO OBSERVATIONAL CHILD STUDY 1

To utilize other forms of observing children with physical disabilities

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STRATEGIES FOR CHILDREN WITH PHYSICAL DISABILITIES

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OBSERVING CHILDREN WITH PHYSICAL DISABILITIES

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METHODS OF OBSERVING CHILDREN WITH SPECIAL NEEDS IN EDUCATION

OBSERVING THE CHILDS PRESENT LEVEL OF PERFORMANCE

OBSERVATION & ASSESSMENT

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Legend: a- ART m- MANIPULATIVE st- STORYTELLING

dp- DRAMATIC PLAY sc- SCIENCE

Observational Child Study 1

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CHILDREN WITH PHYSICAL DISABILITIES

OBSERVING ORTHOPEDICALLY HANDICAPPED

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AN ORTHOPEDICALLY HANDICAPPED CHILD

Observational Child Study 1

PHOTO CHILD HEALTH HISTORY

15. Has your child ever been hospitalized?

18. Does your child have :

20. Has your childs hearing been tested?

23. Has your child vision been tested?

24. Was there any evidence of vision loss?

yes no Please describe: ________________________________________________

28. Does your child usually play:

29. Is your child usually

Observational Child Study 1

33. Is your child toilet trained?

34. What word(s) does your child use or understand for:

39. What language(s) is/are most commonly spoken in your home?

CASE HISTORY RECORD

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Name: _____________________ Date of Assessment: _

Name: _____________________ Date of Assessment: _