Test Note Gross Motor Development 1 2 3 4 5 6 7 8 9 10 11 Throwing ball with motive Catch the ball with both hands Throw, catch and lob the big ball catch and lob the small ball Hoping and enable to play ‘hob-scotch’ Running with ropes Running without fall Climb up the climber Ride three wheel bicycle Ride three wheel bicycle skillfully and fast Ride two wheel bicycle skillfully and fast ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( )
6. / 6 Left / Right 7. / 12 Left / Right Total of Score / 26 Conclusion: Test Note Sense of touch 1 2 3 Differentiate between Hot/ cold Smooth/ rough Soft/ hard Identify object by touching object) Recognize and identify people by touching (state how, e.g.: hair, height) ( ) ( ) ( ) ( ) ( ) Sense of scent 4 5 6 Comparing two type of Nice scent Bad scent Identify and tell the differences of scent Onion Powder Soap Nescafe Name of scent Nice scent ( ) ( ) ( ) ( ) ( ) ( ) ( )
7 Bad scent Recognize type of scent Belacan Fragrance/ perfume ( ) ( ) ( ) Sense of taste 8 9 10 11 Bring the object/ toys to mouth (state if other object) Differentiate between Sour Sweet Grouping the type of taste (sweet, sour, salty) Grouping the type of food vegetable, meat). State. ( ) ( ) ( ) ( ) ( ) Sense of hearing 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Respond to the sound of ringing bell Turn face towards the ringing sound Respond to the rattler Turn face towards the rattler Respond to obvious sound (e.g.: Lamp switch) Respond to the voice (behind the child) (e.g.: head moving, speak aloud, changing the activity, facial expression) Baby smiles when examiner speaks and smiles to him/ her. Selectively listen to the usually words heard. Copying the word (note down the pronounced words) Look for the source with eyes (ascertain the sound of bell or rattle) Interested with the sound making Differentiate between two type of sound: Loud Soft Knowing and declare the sound (e.g.: animal sound) Knowing the source of From left From right From front From back ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Sense of visual 26 27 28 29 30 31 Look for a while at the red coil Spend longer time looking at red coil Eyes movement to the left and right (horizontal eye movement) following the red ring Eyes movement up and down (vertical eye movement) following the red ring. Eyes movement following the red ring developing a circle (circular eye movement). Eyes turning towards the red ring. ( ) ( ) ( ) ( ) ( ) ( )
32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 Grasped a hanging red ring in front of them (state if other object) Head movement towards light (state if using other object) Approach the hanging red ring (check the hand used and from left, right, and not any) Carefully pull the rope to get the coil Looking at the tester/ examiner for a while Eyes movement following people movement Eyes movement to the left and right following the light movement Eyes movement up and down Eyes movement following the light to form circle Eyes turning towards the light Looking around freely Eyes winking toward hand image Baby’s reaction when tissue paper or cloth put on his/ her face Turn from one object to another Eyes movement following a ball crossing a table (state if using the other object) Head movement follows a falling spoon (state if using the other object) Looking for a falling spoon Observing the bell, with great detail Taking 2/3 of offered cubes Trying to hold three cubes together (state success or fail) Constructing a tower using ten cubes Putting ten into a bowl Constructing a tower using three cubes Constructing the tower using six cubes Eyes following a pencil movement Show an interest on scribble Trying to copy the scribbles Spontaneously scribbling Copying the crayon model Differentiate scribbling and modeling Copying horizontal and vertical model Looking at picture in a book Closing a round box Putting a round block at pink board Completing pink board Putting in an opposite condition for pink board Constructing a tower using eight cubes Purring one puzzle block at a blue board Putting two round block at a blue board ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( )
72 73 74 75 76 77 78 79 80 81 82 83 84 Putting two round block and two square at a blue board Putting six block at a blue board Complete the blue board puzzle in 150 second Identify basic shapes Circle Square Triangle Grouping the shape Circle/ oval Square/ triangle (pentagon) Differentiate between shapes (size and concrete shapes) Big Small Short Long Square Circle Recognize the primer colours White Red Blue Recognize the secondary colours Brown Orange Purple Recognize the soft colours Pink Grey Buff/ Identify the differences between the intensity colours Dark/ light Darker/ lighter Realize the two prepositions (e.g. above, below, inside, outside) Realize the three prepositions Identify the spatial relation Far/ near Inside/ outside Above/ below First/ last Front/ back Left/ right Identify and make differences the letter and number a/ o s/ z ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( )
Category ()/( X ) Note Intimate 1 2 3 4 5 6 Cry when teacher/ guardian leave them to teacher/ guardian when there is visitor Kick or hit teacher/ guardian Like to be hug Hug and kiss a familiar person Able to kiss stranger ( ) ( ) ( ) ( ) ( ) ( ) Happy Emotion 1 2 3 4 Smile a lot when playing with someone familiar a lot when playing with someone familiar Show happiness when happy Happy when play ( ) ( ) ( ) ( ) Stability/ Calm Emotion 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Seldom yell Seldom whine Not easy tantrum Not jealous when guardian or mother give attention to other children Cry only when in pain/ hungry/ tired Did not suck finger Did not bite on blankets, cloths or toys Did not bite finger nails Easy to coax (when cry) Obedient Able to control self when Did not revenge other children Deep sleep Able to face frustration well (like to laugh/ talk about things that make him/ her frustrated) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Bravery
Category ()/( X ) Note Self-concept 1 2 3 4 Know his/ her sex (Female/ Male) Tell about his/ her family Know about his/ her race Show skill and ability ( ) ( ) ( ) ( ) Proud with Success 1 2 3 4 Show happiness yield) when successful doing something Show attention at what he/ she has done (drawing, block, puzzle) Stand the justice Defend themselves when have challenged ( ) ( ) ( ) ( ) Trust Adult 1 2 3 Ask to help in new thing Ask guardian opinion in solving problems Willing to involve in daily activities ( ) ( ) ( ) Act accordingly 1 2 3 4 5 6 7 8 Sit properly when eating Listen when people talk Obey rules Understand and respect other people Help friends when playing or doing activities Help other people Console a friend when they are unhappy Invite friends to play together ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Co-operation with friends in completing the task 1 2 Construct building with Play beside friends without disturbing or snatching his/ her toys ( ) ( ) Friendship 1 2 3 4 5 6 7 Like children Ready to be near other friends Able to receive criticism from other children to someone he/ she newly met Easy to approach someone he/ she newly met Look when talking to strangers Like to share toys with friends ( ) ( ) ( ) ( ) ( ) ( ) ( )