Observational Child Study 1 (SPED 4)

7/31/2019 Observational Child Study 1 (SPED 4)

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Republic of the Philippines

UNIVERSITY OF RIZAL SYSTEM

Morong, Rizal

Professor, SPED 4


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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.

od Loving

ctive Concern for Environment

eamwork

xcellence and Integrity

roactive

dvocacy for Sustainable Development

ervice-Oriented and Resourceful

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/herown 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 educationwithout 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 PageURS Mission

Vision

COE Goal

Vision for Children with Special Needs

Course Description and Objectives 7 Strategies for Children with Physical Disabilities .. 11 Functional Areas to Consider in Teaching

and Managing Children with Physical Disabilities .. 14

Observing Children with Physical Disabilities 16 Methods of Observing Children with Special Needs in Education .. 17 Observingthe Childs Present Level of Performance .. 17 Observation and Assessment ... 18Assessment Tools . 20

Observing a Child with OrthopedicallyHandicapped and Special Health Problem .. 26

Child Health History 30 Observational Child Study 39 Motor Skills Checklists 47

Observing a Child with Hearing Impairment 58

Child Health History .... 64 Observational Child Study . 73 Social Skills Checklists . 81 Motor Skills Checklists . 93 Cognitive Skills Checklists . 103


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Observing a Child with Visual Impairment . 111 Child Health History . 114 Observational Child Study 1 . 123 Social Skills Checklists . 131

Infants . 146 Toddlers ............... 147 Preschool . 148 School-age Children .... 149 Early Adolescence . 150 Middle Adolescence . 151

Children with Orthopedically Handicappedand Special Health Problems 153

Children with Hearing Impairment ... 154 Children with Visual Impairment ... 155


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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.


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6. To apply principles in the use of unstructured observation forms such

as anecdotal record, journal, event recording and interpretation of

results

7. 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.


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QUESTION #2

What do you think are the goals of observing children with physical

disabilities?

1.

2.

3.

4.

5.

6.


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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


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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 yourlips 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 ahearing 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
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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


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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 andit 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.

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
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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/DEAFHearing 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.

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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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.

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, Self-


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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.

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 makingdecisions 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.
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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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(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.

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 anddirect quotes from the childs conversations

Includes responses of other children and/or adults, if anyare involved in the situation.


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(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.


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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.

USING TECHNOLOGY FOR ASSESSMENT

Technology is a very useful tool for recording childrens development. Making

any documentation are excellent ways to preserve information.

(1) Visual Documentation

Visual Documentation refers to collecting or photographing samples of achilds work that portrays learning and development. It provides a record that can be

studied to any purposes.

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Videotaping and Photographing SafetyBe sure to consult parents, families, or caregivers before videotaping or

photographing children. Many centers require written consent to be onfile before staff can videotape or photograph children for educationalpurposes. Some families do not want images taken of their children forprivacy reasons.


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Portfolio ContentsA 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 tellingstories

a list of favorite books, songs and finger plays

(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.


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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 ofthe bones, joints, or muscles.

Born with handicaps (congenital anomalies) such as dislocated hips orjoints, clubfeet, spina bifida (a congenital anomaly affecting the spinal cord).

Children who acquire a crippling condition through accidents orthrough infection such as poliomyelitis (infantile paralysis ,tuberculosis of thebones or joints etc.

Children with special health problems are that whose weakenedphysical rendition renders them relatively inactive or requires special healthprecautions in school that have cardiac anomalies, tuberculosis, anemia,epilepsy, and other abnormal conditions; those who are undernourishedhave 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 inadjusting 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 CHILDChilds 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 problemswith any of these?

Has your child had anyof these diseases?

Constipation AsthmaConvulsions BronchitisDiarrhea Chicken Pox

Fainting Spells DiabetesFrequent Colds Heart DiseaseFrequent Ear Infections HepatitisFrequent Sore Throats ImpetigoLice MeaslesRingworm MumpsSkin Rash German MeaslesSoiling PolioStomach Upsets Scarlet FeverUrinary Problem TuberculosisWorms 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? _____________________


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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 adeath 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, toyetc.? _________________________________________________________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 healthproblems

Physical/FeatureCharacteristics

Physical Performances Behavior Performances


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CHILD HEALTH HISTORY

General Information1. Childs Name_______________________________________________ _______

(Last Name) (First Name) (MI)2. Childs address

______________________________________________________________________(Street) (City, State, Zip)

3. Home Telephone Number__________________________________________________

4. Childs Gender Female Male5. Childs Date of Birth __________ __________ _________

Month Date Year6. Mothers Name:

__________________________________________________________7. Fathers Name:

___________________________________________________________

Birth History8. 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 no(Please describe): ___________________________________________

12. Does your child take any medications or regular basis? yes noIf 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, convulsionsmuscle weaknesses, and so on? yes no

(Please Describe): ________________________________________

15.Has your child ever been hospitalized? yes noNumber of times: __________

16.Has your child had any other serious illness or injuries that did not involvedhospitalization? yes no

(Please Describe): ____________________________________

17.How many colds has you child had during the past year? _________ times

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18.Does your child have :ALLERGIES? yes no(Please specify which allergies):

Foods ________Animals_______Medicine______

Asthma? yes noHave fever? yes no

19.Had your child had any problems with earaches or ear infections? yes noIf yes, how often in the past years? __________ year/s

20.Has your childs hearing been tested? yes noDate of test: ____________ was there any evidence of hearing loss? yes noIf yes, describe: _________________________________

21. Does your child currently have tubes in his or her ears? yes no

22. Do you have any concerns about your childs speech or language development?yes no (if yes, describe):__________________________________________.

23.Has your child vision been tested? yes noDate of test: ______ ________

(Month) (Year)

24.Was there any evidence of vision loss? yes noPlease 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-forexample, 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 one to two other children?

with brothers/sisters? with older children?with younger children? with children of the same age?

29. Is your child usually cooperative? shy? aggressive?

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 anaccident?

_______________________________________________________________.

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 familymembers is often included in classroom discussions, please list or describe who yourchild 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 moreeffectively 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 noWhom does the child most resemble ______________________________Parents ages at childs birth: Father: ___________ Mother: __________

B. PregnancyNumber 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. BirthWas 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 FeedingDid 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. HandlingBaby 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 ofdistress? ________________________

F. Physical DevelopmentAge at which baby sat up ________________________Got first tooth _______________________Crawled ___________________________Stood aided ________________________Stood unaided ______________________Walked unaided _____________________Has the child reached puberty? _____________________

G. Toilet TrainingWas 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. IllnessDuring 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 ConditionAllergies: ______________________________________________________Preference for right or left hand: ___________________________________Noticeable problems in coordination:

_____________________________________________________________Does the child fall easily? yes noDoes the child drool excessively? yes noDoes the child over-perspire? yes noDoes the child seem tense? yes noDoes the child have normal vision? yes noDoes the child have normal breathing pattern? yes noDoes the child sniff food or objects frequently? yes no

J. Home SituationHas 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 Fantasy With a large groupImaginative Alone as a leaderCooperation with toys as a followerWith peer group fitting with younger childrenWith older children engrossed others: ___________With a small group messy

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 noDoes the child eat unaided? yes no

Are his meals prepared on demand, or does the child eat with the rest of the family?__________________________________________________________________


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Is the child required to eat balanced meal, or snacks or given favorite food?__________________________________________________________________

Does he vomit frequently? yes noHow is this handled? ____________________________________________________

d. Habits

Is the child attached to any special object? What?__________________________________________________________________

Notable mannerism:__________________________________________________________________

Thumb sucking? yes noHead banging? yes noDoes he have any rituals, e.g. before going to bed? yes noIf yes, specify:

______________________________________________________________Check any of the following which describe the child:

Negative Manipulative TearfulQuiet Passive Destructive

Excitable Lacking Confidence AggressiveUnresponsive Active LeadershipFriendly Self-Centered FearfulHappy Predictable TemperSad Confident GenerousSuggestible Stubborn Others: ______

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)________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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N. Family HistoryCheck if any other family member has experienced:

Neurological disorder Emotional InstabilityMental illness Physical DisabilitiesLearning Difficulty RetardationReading Difficulty Blood DiseaseVisual Defects Heart AbnormalityParalysis School Failure (Severe)Hearing Problems Speech Problems

O. Other Professional Help

Physical Therapist

Name : ______________________________________________________Address : ______________________________________________________Phone : ______________________________________________________

Speech Therapist


Tutor/Teacher


Others



Assessing for SPED:

______________________Bachelor of Elementary Education major in Special Education

Date:______________________


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OBSERVATIONAL CHILD STUDY

I. PERSONAL INFORMATION

Name of the Child : _____________________________

Address : _____________________________

Age : _____________________________

Gender : _____________________________

Date of Birth : _____________________________

Place of Birth : _____________________________

Religion : _____________________________

Citizenship : _____________________________

Source of Information : _____________________________Citizenship : _____________________________

II. CHILDS DESCRIPTION:

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:_________________ Date: ____________ ___, 2012

Time:________________ Class/Level:_______________________

Name of the Child:_____________________________________________

Address/School:_______________________________________________

_______________________________________________

DAY 1

FUNCTIONAL AREAS OF EDUCATION

FUNCTIONAL

AREA/SKILLSOBSERVATION

Area :

Area :

Area:

Area:


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Day:_________________ Date: ____________ ___, 2012

Time:________________ Class/Level:_______________________

Name of the Child:_____________________________________________

Address/School:_______________________________________________

_______________________________________________

DAY 2


FUNCTIONAL


Area :

Area :

Area:

Area:


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Day:_________________ Date: ____________ ___, 2012

Time:________________ Class/Level:_______________________

Name of the Child:_____________________________________________

Address/School:_______________________________________________

_______________________________________________

DAY 3


FUNCTIONAL


Area :

Area :

Area:

Area:


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Day:_________________ Date: ____________ ___, 2012

Time:________________ Class/Level:_______________________

Name of the Child:_____________________________________________

Address/School:_______________________________________________

_______________________________________________

DAY 4


FUNCTIONAL


Area :

Area :

Area:

Area:


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Day:_________________ Date: ____________ ___, 2012

Time:________________ Class/Level:_______________________

Name of the Child:_____________________________________________

Address/School:_______________________________________________

_______________________________________________

DAY 5


FUNCTIONAL


Area :

Area :

Area:

Area:


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Name: _______________________________ Date of Assessment: ___________

PART 1Self-Help and Functional Skills Checklist

Please check the box that most appropriately describes your childs ability to performthe following

Functional Skills. When selecting skills to teach, start with those your

child can already partially do.

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 freeSelects clothes that fit

Selects clothes that match

Selects age-appropriate clothes

Selects clothes appropriate toweather

Selects clothes appropriate tocontext


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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


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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 orshower

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 productsappropriately


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Puts toys away

Make own bed

Clears table after eating (puts dishesin sink and garbage in wastebasket)

Takes out trash

Dusts

Vacuums

Washes windows or mirrors

Cleans sinkCleans 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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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 orobjects

Follows 2 step directions about toysor objects

Plays simple hide-and-seek games(peek-a-boo, hunts for missing toys)

Sits and plays alone for up to 5minutes

Sits and plays alone for up to 10minutes

Imitates movements and gestures

Stacks toys such as blocks up to 3high

Stacks toys such as blocks up to 6high

Scoops, sand, water or beans fromone container to another

Cuts with scissors

Pastes with glue stick

Scribbles with a crayon staying onpaper

Colors with crayon, mostly in thelines

Does simple non-interlocking puzzles

Does simple non-interlocking puzzlesof up to 4 pieces


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Does simple non-interlocking puzzlesof up to 12 pieces

Does complex interlocking puzzles ofup to 25 pieces

Play simple matching games such asmemory matching

Play simple board games such as

Chutes and LaddersPlay complex board games such asSorry or Life

Play complex board games such asmonopoly, chess, checkers orbackgammon

Plays computer or video games oncethey are set up by adult

Can load , turn on and set up a videoor computer games

Works with other children using sameplay materials

Shares and takes turns in play

Throws and catches a large ballwithin 2 feet

Throws and catches a large ball 3-6feet

Throws and catches a small ball 3-6feet

Hits ball off a tree

Hits a ball when pitched

Aims basketball at basket atappropriate 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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Name: _______________________________ Date of Assessment: ___________

PART 2Gross and Fine Motor Skills Checklist

Please check the box that most appropriately describes your childs ability to performthe following

Functional Skills. When selecting skills to teach, start with those your

child can already partially do.

I. GROSS MOTOR SKILLS

Adjusts activity level to variousdemands during class

Smoothly transitions between motorsskills

Demonstrate adequate balance

Demonstrate adequate coordination(does not run into or trip over objects)

Has adequate stamina to completephysical education services

Adequately performs eye-handcoordination 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 forheight)

Has good body awareness (control ofbody, coordination, directionality,spatial judgment)

IMPLICATIONS FOR INSTRUCTION AND PROGRESS MONITORING:

Yes No___ ____This child demonstrates adequate behavioral/social skills necessary forparticipation in a regular physical education class (i.e cooperates with teacher/peers,is compliant with class rules, has age-appropriate social skills, interacts positivelywith teacher/peers, demonstrates appropriate frustration levels).

If no, please list suggestions for improvement and/or adaptation.______________________________________________________________________________________________________________________________________


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II. FINE MOTOR SKILLS

Has fine motor activity which involvescoordinated, efficient movement ofbody parts.

Adequately uses classroom supplies(such as scissors, compass,protractor)

Adequately draws numbers andgeometric shapes (such as cross,circle, square, triangle)

Performs eye-hand coordination taskswell (opening doors, sharpeningpencils, drawing)

Uses one hand consistently for writingand other motor tasks

Written work is neat & legible(adequately spaced, orderly, within onthe line/s)

Completes fine motor tasks withoutbecoming 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 completeacademic work and self-help skills without difficulty in the regular classroom.

If no, please list suggestions for improvement and/or adaptation.______________________________________________________________________________________________________________________________________

Assessing for SPED:

_____________________Bachelor of Elementary Education major in Special Education

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


Time:

Area:

Time:

Area:

Time:

Area:


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Date: _______________________

NAME OF THE CHILD___________________________________________

SCHOOL: ____________________________________________________

TEACHERS NAME: ___________________________________________

DAY 3


Time:

Area:

Time:

Area:

Time:

Area:


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Date: _______________________

NAME OF THE CHILD___________________________________________

SCHOOL: ____________________________________________________

TEACHERS NAME: ___________________________________________

DAY 4


Time:

Area:

Time:

Area:

Time:

Area:


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Date: _______________________

NAME OF THE CHILD___________________________________________

SCHOOL: ____________________________________________________

TEACHERS NAME: ___________________________________________

Assessing for SPED:

_____________________Bachelor of Elementary Education major in Special Education

Date:_______________________

DAY 5


Time:

Area:

Time:

Area:

Time:

Area:


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CHILD HEALTH HISTORY

General Information15. Childs Name_______________________________________________ _______

(Last Name) (First Name) (MI)16. Childs address

______________________________________________________________________(Street) (City, State, Zip)

17. Home Telephone Number__________________________________________________

18. Childs Gender Female Male19. Childs Date of Birth __________ __________ _________

Month Date Year20. Mothers Name:

__________________________________________________________21. Fathers Name:

___________________________________________________________

Birth History22. 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 no(Please describe): ___________________________________________

26. Does your child take any medications or regular basis? yes noIf yes, name of medication and dosage: _______________________________________

27. 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

28. Were there any complications with these illnesses, such as high fever, convulsionsmuscle weaknesses, and so on? yes no

(Please Describe): ________________________________________

41.Has your child ever been hospitalized? yes noNumber of times: __________

42.Has your child had any other serious illness or injuries that did not involvedhospitalization? yes no

(Please Describe): ____________________________________

43.How many colds has you child had during the past year? _________ times

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44.Does your child have :ALLERGIES? yes no(Please specify which allergies):

Foods ________Animals_______Medicine______

Asthma? yes noHave fever? yes no

45.Had your child had any problems with earaches or ear infections? yes noIf yes, how often in the past years? __________ year/s

46.Has your childs hearing been tested? yes noDate of test: ____________ was there any evidence of hearing loss? yes noIf yes, describe: _________________________________

47. Does your child currently have tubes in his or her ears? yes no

48. Do you have any concerns about your childs speech or language development?yes no (if yes, describe):__________________________________________.

49.Has your child vision been tested? yes noDate of test: ______ ________

(Month) (Year)

50.Was there any evidence of vision loss? yes noPlease describe: ________________________________________________

51. Does your child do some things that you find troublesome?Please describe: ____________________________________________________

52. Has your child ever participated in out-of-the-same home child care services-forexample, sitter, day care, and preschool? yes no

Please describe: ____________________________________________________

Childs Play Activities

53. Where does your child usually play-for example, backyard, kitchen, bedroom?______________________________________________________________________

54. Does your child usually play:alone? with one to two other children?

with brothers/sisters? with older children?with younger children? with children of the same age?

55. Is your child usually cooperative? shy? aggressive?

56.What are some of your childs favorite toys and activities? Please describe:

_____________________________________________________________


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57. Are there any particular behaviors you would like us to watch?Please describe: __________________________________________________________

__________________________________________________________

Childs Daily Routine

58. Do you have any concerns about your childs:eating habits? _____________________________sleeping habits? ___________________________toilet training? _____________________________

59. Is your child toilet trained? yes no. If yes, how often does your child have anaccident?

_______________________________________________________________.

60. What word(s) does your child use or understand for:Urination ______________________ bowel movement ________________________

61. How many hours does your child sleep? At night? _______Goes to bed at ___ P.M. Wakes up at: ___A.M. afternoon nap: __________

62. When your child is upset, how do you comfort him or her?____________________________________________________________________________________________________________________________________________

63. The term family has many different meanings. Since the topic of families and familymembers is often included in classroom discussions, please list or describe who yourchild considers to be family at home.

____________________________________________________________________________________________________________________________________________

64. How many brothers and (or) sisters does your child have?

Brothers (ages): ________________ Sisters (ages): ________________________

65. What language(s) is/are most commonly spoken in your home?English Filipino Others __________________

66. Is there any additional information that would help us understand or work moreeffectively with your child? _________________________________________________

_______________________________________________________________________

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 noWhom does the child most resemble ______________________________Parents ages at childs birth: Father: ___________ Mother: __________

L. PregnancyNumber 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. BirthWas 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 FeedingDid 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. HandlingBaby 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 ofdistress? ________________________

P. Physical DevelopmentAge at which baby sat up ________________________Got first tooth _______________________Crawled ___________________________Stood aided ________________________Stood unaided ______________________Walked unaided _____________________Has the child reached puberty? _____________________

Q. Toilet TrainingWas 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. IllnessDuring 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 ConditionAllergies: ______________________________________________________Preference for right or left hand: ___________________________________Noticeable problems in coordination:

_____________________________________________________________Does the child fall easily? yes noDoes the child drool excessively? yes noDoes the child over-perspire? yes noDoes the child seem tens

Observational Child Study 1 (SPED 4)

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Transcript of Observational Child Study 1 (SPED 4)