OMNIBUS DEVELOPMENT SCALE

Child’s Name: _____________________________________________________________ Sex: __________________________

Date of Birth: ______________________________________________________________ Age: __________________________
Address: _________________________________________________________________________________________________
Height: _____________________________________________________ Weight: ______________________________________
Date of Assessment: _________________________________________ Mobile No.: __________________________________

Direction:
This scale is designed to determine the child’s levels along five (5) developmental areas. Please rate the
child as objectively with the help of the SPED Teacher who will interview you.

LEGEND: HE = HIGHLY EVIDENT

E = EVIDENT
SE = SLIGHTLY EVIDENT
NE = NOT EVIDENT

PHYSICAL HEALTH-GROSS MOTOR

The Child: HE E SE NE
1. Possesses good health. [ ] [ ] [ ] [ ]
2. Has normal height and weight. [ ] [ ] [ ] [ ]
3. Follows good eating and sleeping habits. [ ] [ ] [ ] [ ]
4. Is normally strongly/fast/does not tire easily. [ ] [ ] [ ] [ ]
5. Is normally balance/coordinated. [ ] [ ] [ ] [ ]
6. Moves about with ease ability in Performing gross motor activities like walking, running,
[ ] [ ] [ ] [ ]
jumping, skipping, climbing, and walking upstairs and downstairs.
7. Performs simple chores like making his/her bed, folding, washing his/her clothes, running
[ ] [ ] [ ] [ ]
errands and cleaning the house.
8. Use age-appropriate play facilities. [ ] [ ] [ ] [ ]
9. Performs activities such as rhythmic, dancing, aerobics and exercises with ease. [ ] [ ] [ ] [ ]
10. Participate in games/sport recreation actively. [ ] [ ] [ ] [ ]
11. Discriminates and avoids dangers. [ ] [ ] [ ] [ ]

FINE MOTOR

The Child: HE E SE NE
1. Performs simple visual-motor tasks such as building blocks, sorting beads, putting forms in
form board and peg board. [ ] [ ] [ ] [ ]

2. Performs less easy visual-motor tasks such as assembling lego pieces following patterns,
forming puzzles, forming puzzles, arranging objects in series according to certain rules and
[ ] [ ] [ ] [ ]
replicating block arrangement and bead patterns.

3. Roll/throws/catches balls /objects coordinately and accurately. [ ] [ ] [ ] [ ]

4. Opens and closes water jars/bottles. [ ] [ ] [ ] [ ]
5. Wipes surfaces efficiently. [ ] [ ] [ ] [ ]
6. Unbuttons and buttons clothes. [ ] [ ] [ ] [ ]
7. unwraps and wraps objects/foods. [ ] [ ] [ ] [ ]
8. Pours liquids/sands/beads/seeds into glass container. [ ] [ ] [ ] [ ]
9. Molds clay into different shapes images. [ ] [ ] [ ] [ ]
10. Sharpens pencils using sharpener. [ ] [ ] [ ] [ ]
11. Fixes and ties shoelaces. [ ] [ ] [ ] [ ]
12. Sews simple stitches. [ ] [ ] [ ] [ ]
13. Uses table knife for spreading, slicing/cutting. [ ] [ ] [ ] [ ]
14. Cuts with scissors accurately. [ ] [ ] [ ] [ ]
15. Holds the pencil/crayon correctly. [ ] [ ] [ ] [ ]
16. Color drawings with the lines. [ ] [ ] [ ] [ ]
17. Trace shapes/forms letters/numbers. [ ] [ ] [ ] [ ]
18. Draws objects/persons and others. [ ] [ ] [ ] [ ]
19. Copies shapes/forms/letters/numbers/words accurately. [ ] [ ] [ ] [ ]

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PSYCHOSOCIAL

The child: HE E SE NE
1. Describe himself/herself accurately and adequately. [ ] [ ] [ ] [ ]
2. Identifies/describes family members. [ ] [ ] [ ] [ ]
3. Exhibits appropriate emotional responses. [ ] [ ] [ ] [ ]
4. Expresses his/her personal needs. [ ] [ ] [ ] [ ]
5. Cooperates well with family members/teachers and peers in work play. [ ] [ ] [ ] [ ]
6. Uses polite expressions appropriately. [ ] [ ] [ ] [ ]
7. Follows appropriate social rules expected of his/her age. [ ] [ ] [ ] [ ]
8. Complies with requests and commands. [ ] [ ] [ ] [ ]
9. Respects the members of the family, school and community. [ ] [ ] [ ] [ ]
10. Behaves properly in varied social settings. [ ] [ ] [ ] [ ]
11. Makes appropriate social judgments. [ ] [ ] [ ] [ ]
12. Observes family, school, community rules and ordinances. [ ] [ ] [ ] [ ]
13. Contributes in protecting and maintaining a wholesome and safe environment. [ ] [ ] [ ] [ ]

LANGUAGE COMMUNICATION

The child: HE E SE NE
1. Listen attentively. [ ] [ ] [ ] [ ]
2. Repeats sounds listen to. [ ] [ ] [ ] [ ]
3. Converses with peers fluently. [ ] [ ] [ ] [ ]
4. Describes pictures/things/persons adequately. [ ] [ ] [ ] [ ]
5. Relates own simple stories/incidents. [ ] [ ] [ ] [ ]
6. Relates stories listened to. [ ] [ ] [ ] [ ]
7. Asks answers questions appropriately. [ ] [ ] [ ] [ ]
8. Conceptualizes ideas with ease. [ ] [ ] [ ] [ ]
9. Reasons out intelligently. [ ] [ ] [ ] [ ]

WRITING

The child:
1. Uses lower and upper cases/punctuation marks. [ ] [ ] [ ] [ ]
2. Observes grammatical rules. [ ] [ ] [ ] [ ]
3. Chooses correct sentence conclusion. [ ] [ ] [ ] [ ]
4. Uses references properly including the dictionary. [ ] [ ] [ ] [ ]
5. Observes correct sentence conclusion. [ ] [ ] [ ] [ ]
6. Writes/composes words/phrases and sentences. [ ] [ ] [ ] [ ]

READING

The child:
1. Follows directions. [ ] [ ] [ ] [ ]
2. Discriminates words correctly. [ ] [ ] [ ] [ ]
3. Reads words phrases and sentences. [ ] [ ] [ ] [ ]
4. Notes details, get the main ideas/theme of a selection read. [ ] [ ] [ ] [ ]
5. Sequences/summarizes a selection. [ ] [ ] [ ] [ ]
6. Makes inferences, conceptualize idea with case. [ ] [ ] [ ] [ ]
7. Draws the moral of a selection. [ ] [ ] [ ] [ ]
8. Translates ideas into practical situations. [ ] [ ] [ ] [ ]
9. Solves life-situational problems systematically. [ ] [ ] [ ] [ ]

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SELF-HELP SKILLS

EATING
The child: HE E SE NE
1. Eats with spoon and fork singly. [ ] [ ] [ ] [ ]
2. Eats with spoon and fork simultaneously. [ ] [ ] [ ] [ ]
3. Mixes his/her own drinks getting the right quantities of sugar, milk powder, etc.. [ ] [ ] [ ] [ ]
4. Cleans and clear place at table before/after eating. [ ] [ ] [ ] [ ]
5. Eats independently. [ ] [ ] [ ] [ ]
6. Prepares his/her own simple meals independently. [ ] [ ] [ ] [ ]

DRESSING
The child: HE E SE NE
1. Removes shoes and socks. [ ] [ ] [ ] [ ]
2. Puts on shoes and socks. [ ] [ ] [ ] [ ]
3. Removes clothes including unzipping, unbuttoning, unhooking and unsnapping. [ ] [ ] [ ] [ ]
4. Puts on clothes including zipping, buttoning, hooking and snapping. [ ] [ ] [ ] [ ]
5. Choose and changes his/her clothes whenever needed. [ ] [ ] [ ] [ ]
6. Takes care of his/her clothes by hanging, folding, arranging and washing them properly. [ ] [ ] [ ] [ ]

GROOMING
The child: HE E SE NE
1. Washes his/her hands thoroughly. [ ] [ ] [ ] [ ]
2. Washes his/her face thoroughly. [ ] [ ] [ ] [ ]
3. Combs his/ her hair efficiently. [ ] [ ] [ ] [ ]
4. Brushes his/her teeth properly and regularly. [ ] [ ] [ ] [ ]
5. Trims his/her fingernails/toenails properly and regularly. [ ] [ ] [ ] [ ]
6. Cleans his/her ears thoroughly. [ ] [ ] [ ] [ ]
7. Washing himself/herself after defeating. [ ] [ ] [ ] [ ]
8. Maintains hygiene everyday especially during monthly period (for girls). [ ] [ ] [ ] [ ]
9. Baths himself/herself independently. [ ] [ ] [ ] [ ]

_______________________________ _______________________________
PARENT/GUARDIAN PARENT/GUARDIAN
SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME

DATE ACCOMPLISHED: ______________________________

_______________________________
SPED TEACHER
SIGNATURE OVER PRINTED NAME

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