Sally J. Rogers and Geraldine Dawsoi Name: EARLY START DENVER MODEL CURRICULUM CHECKLIST FOR YOUNG CHILDREN WITH AUTISM Date: Assessor: Parent(s) interviewed: Others interviewed: Instructions: Use the Checklist to define the child’s most mature skills, those skills that are currently ‘emerging, and those skills that are currently not in the child’s repertoire, in each domain. Consult the Early Start Denver Model for Young Children with ‘Autism manual for item descriptions and administra- tion practices. Use + or P (pass) for consistent per- formance at appropriate times. Use +/- or P/F (pass) fail) for inconsistent performance. Use - or F (fail) when the behavior is difficult to elicit. Use these codes for behavior in each column: direct observa: tion, parent report, and teacher/other report. For the CODE column, use the following: A (acquired)—child clearly demonstrates skill and arent reports skill is used consistently. P (partial ‘or prompted)—child is only able to demonstrate skill inconsistently or with additional prompting and parentlother reports same, or child demonstrates some, but not all, of the steps of the skill. N—child is unable or unwilling to demonstrate the skill and parentlother reports difficulty. X—no opportunity, ‘or not appropriate for this child. ‘Most children’s skills will luster in one of the four levels for each domain. However, for children whose mastered skills fallin the earlier Items in 2 level, review the final items in the previous level to Identify any critical skills where the child is failing in that level. Similarly, if a child has mostly passes in one level and only a few fails, move to the next higher level and assess the first half of the items in that domain to have a good sample of the child’s ‘current repertoire. The range in which passes turn to failures defines the target area for teaching for ‘each domain. ‘©2090 The Guifod Pres, ADision of ufo Publatons Inc, 570 Severth Avenue Site 20, New York, NY 000% wand, Sp GuILrorD 9 8 7 6 5 Allright reserved. No pat of thls checklist may be reproduced, translated stored in a retrieval system, or transmitted, In ‘any form or by any means, electron, mechaniea, photocopying, mitoflming, recording, or otherwise, without writen persion from the publisher. Pintedin the United States of AmericaSkill wo law lau au Level 1 eee Localizes to sounds by turning toward sound source. ‘Looks to playful vocal sounds (raspberry, whistle). Responds to voice by turning toward person. Looks at indicated pictures as adult points to pictures in book. Follows a proximal point to place objects in containers, puzzle pieces, etc. ‘Looks when shown an object and told, “Name, look.” Looks to partner when nameis called. Follows a proximal point to object or location. Follows distal point to retrieve toy. ‘Looks, reaches, or smiles in response to adult gestures and voice in social games. Looks, reaches, smiles, andlor gestures in response to adult languagelgesture in songs. Responds by stopping actions momentarily in response to inhibitory words (eg. “no,” “stop”. Gives object as verbally requested when paired with adult’s outstretched hand. Performs a one-step, routine instruction involving body actions paired with verbal/gesture cue (e.g, ‘Sit dovrn,” “Come here,” “Clean up”). Performs a one-step, routine verbal instruction involving body actions without accompanying gesture (e.g, “‘Sit down,” “Come here,” “Clean up” Uses a goal-directed reach to request. Vocalizes with intent. “Asks” for help by handing object to adult. Takes turns vocalizing with communication partner. Expresses refusal by pushing away object or giving the object back to another person, Points proximally to request desired object. Makes eye contact to obtain a desired object when adult blocks access} }withholds desired object. Points to indicate a choice between two objects. [Combines vocalization and gaze for intentional request. Points distally to request desired object. Points distally to indicate a choice between two objects. Vocalizes with CVCV reduplicative babbling (not necessarily word approximations). Produces five or more consonants in spontaneous vocalizations. Produces CVCV with differing CV sequences (variegated babbling). Rann ‘Accepts brief sensory social activities and touch. Uses motor prompt to initiate or continue a sensory social routine. ‘Attends briefly to another person with eye contact. Maintains engagement in sensory social routines for 2 minutes. Responds to preferred objects/activities via gaze, reach, smiles, and movements. ‘Watches and engages with imitative adult during parallel toy play activities. Other/ Parent Teacher Observed Report Report CODE Erne ESDM Level 1Skill Level 1 Other/ Parent Teacher Observed Report Report CODE Has 2 repertoire of 5-10 sensory social games. Responds to greetings by looking, turning, etc. Responds to greeting by gesture or vocalization. 10 | Shares smiles with partner during coordinated play. Imitates 8-10 one-step actions on objects. Imitates 10 visible motor actions inside song/game routines. Imitates invisible six motor actions on head, face inside songigame routines. Imitates six oral-facial movements. Matchesjsorts identical objects. Matches/sorts identical pictures. Matches/sorts pictures to objects. Matches/sorts objects by color. Fits behavior to the qualities of five different objects. Plays independently and appropriately with 10 one-step toys. Plays independently with toys requiring repetition of the same action on various objects (ring stacker, nesting cups). 4. | Demonstrates appropriate play behaviors on a variety of one-step toddler toys: throws ball, stacks blocks, pegs in holes, rolls ca. 5. | Plays independently with toys requiring two different motor actions (take out, put in). 6 | Plays independently with toys requiring several different motor actions (e.g., put in, open, remove, close). 7. [Demonstrates conventional actions on self with a range of objects. ‘Completes play task and puts away. 1+ [Places one to two shapes in a shape sorter. 2_ | Places rings on a ring stacker. 3. | Completes three-piece wooden handle puzzle. 4. | Puts pegs ina pegboard. 5. |Pushes buttons on five different types of cause-effect toys. 6 | Takes apart pop beads, Duplos. 7 |Uses a pincer grasp and a three-finger grasp as appropriate to toy. 8 | Stacks three big blocks in a tower (or stacking cups). 9 | Makes marks; lines, scribbles, and dots with markerslerayons. 10 | Bangs toy hammer with balls, pegs, etc. 41 | Scoops, rakes, pours with sand, water, rice, etc. tacks big Legos. 1 | Kicks big ball. Walks up and down stairs with support; nonalternating feet. Climbs one to two steps up small ladder to slide, 4 ESDM Level 1Other/ Parent Teacher Level 1 Observed Report Report CODE Creme) Gets on and off pieces of equipment. Protects self when off balance. | Walks around objects on floor rather than stepping on them. Throws ball and beanbags any direction. Rolls ball back and forth with another person. Behavior Exhibits minimal severe behavioral difficulties. Sits ina chair or facing adult during pleasurable activities without difficulty for 2 minutes. willingly engages in simple games in chair and on floor with adult for 5 minutes. Tolerates adult proximity and interaction (minimal demands) without problem behaviors for 20-minute intervals. Interacts appropriately with family members (Le., no aggression or other inappropriate interactions). eno Eats meals and snacks at the table. Eats meal independently. Uses an open cup. [Uses a spoon. Uses a fork. Eats a variety of food textures, types, and food groups. Tolerates new foods on plate. Drinks from straw. Elrond Removes each piece of clothing with assistance. Pulls on each piece of clothing with assistance. oe Puts hands under running water. Dries hands on towel. Rubs washcloth on body, towel on body. Tolerates hair combing, nose wiping, and toothbrushing. Helps with hairbrush/comb. Puts toothbrush in mouth. endo ccaes Puts dirty clothes in hamper. Puts tissues in trash. SOM Level 1Other! Parent Teacher Skil Level 2 Observed Report Report CODE Ee 1 | Follows instructions to “stop” or “wait” without prompts or gestures. 2. | Follows 8-10 one-step verbal instructions involving body actions and actions on objects. 3. | Identifies by pointing or showing several named body parts on self or other person. 4. | Responds to verbal instruction to give/point/show for 8-10 specific objects in natural play, dressing, eating routines (e.g, baby, chair, car, block, Cup, bear). 5 | Identifies by pointing and visually attends to three named pictures in a book (including cup, car, dog, cat, baby). 6 | Understands early spatial concepts (eg, in, on). 7. | Looks to people and photos of people when named—family, pets, teachers. 8 | Retrieves 8-10 verbally requested objects in room but not directly in front of child, requiring some search. 9. | Upon verbal request (with gesture cues), completes two actions with one object. 10 | Points to named body parts in picture. Expressive Communication 1 |Uses target signs or gestures with vocalizations to express (request, all done, share, help, protest). 2. | Produces 6-10 single words or approximations within the context of famil routines, sensory-social routines, songs. 3. | Spontaneously produces multiple words associated with a play routine (oll, go, stop). 4. | Functional use of 20 or more approximations of nominals (names of objects, ‘animals, people) and nonniominals (words that refer to actions or other relations: all gone, up, etc.) ‘Spontaneously labels objects and pictures. Vocalizes with varied intonation during songs, etc. Requests and refuses using single words with gaze. Labels actions in context (e-g,, during body movements andjor actions on objects). 9. | Approximates names of three important people (includes self). 10 | Shakes head and says “no” to refuse. 11 | Nods head “yes” and says “yes” to affirm. 12_| Asks (approximates) “What's that?” when encountering something unfamiliar. cos) 1. | Responds to “Look” and offered object with gaze shift, body turn, and looks at offered object. 2. | Responds to “Look” and point by orienting to the indicated distal object/ person. Gives or takes object from other person coordinated with eye contact. Responds to “Show me” by extending object to adult. ‘Spontaneously “shows” objects. Spontaneously follows point or gaze (no verbal cue) to look at target. Spontaneously points to interesting objects. Shares smile with adult with alternating gaze during pleasurable object activity. TPs evonsy 6 ESDM Level 2ES xk 10 aD Sas Initiates and maintains eye contact for communication. Verbally requests or physically initiates familiar social games. Returns affection behaviors: hugs, kisses to familiar others. Uses gesture or words to attain adult’s attention. Responds to social greeting with “Hi” or “Bye-bye,” and waves imitatively. ‘Asks for help verbally or gesturally. Consistently coordinates eye contact with vocalization andlor gesture to direct ‘communication. “Dances” with another in circle games to music. Runs with anotherin “chase” game. Gains communication partner’s attention using name of person or game and initiates social game or activity. Gives object to peer when peer requests. Joins in with familiar songs/finger plays in a group setting. Continues with activity when peer joins in parallel play. Responds appropriately to peer’s greetings. ‘Takes turns with peer with simple action toys when peer requests; gives and takes back. Sits in group with peers and attends to adult’s familiar instructions. ‘Takes object from peer when peer offers. Passes objects to peers at table or in group when requested. Imitates peer’s behavior occasionally in play activities. Imitates a variety of vowel and consonant sounds during verbal approximations in meaningful communications. Imitates animal sounds and other sounds. Imitates recognizable single words spontaneously and frequently in interactions. Imitates motions to five songs; imitates at least 10 different actions. Immitatesfepproximates novel actions in songs. Imitates actions on objects—multiple steps (play actions). Imitates pretend play acts to self and partner with miniatures. Imitates two movement sequences in songigame routines. Imitates two-word phrases. ‘Matches/sorts by shapes. Matches/sorts by size. Matchesjsorts designs, line drawings. Sorts similar objects into lke groups. Sorts related common objects into functional groups. Searches|requests for missing object. ‘Matches/sorts in two dimensions. Other/ Parent Teacher Observed Report Report CODE Social Skills with Peers. Plays picture-matching games (Memory, Lotto, etc.) alone and with peer. ‘Matches by quantities one through three. SDM Level 2 7Other/ Parent Teacher Skill Level 2 Observed Report Report CODE mee 1+ [Combines related objects in play (cup on saucer, spoon in dish). 2 | imitatesiproduces sound effects with play (vocalizes on phone, makes car noises, animal sounds with animals). 3. | Carries out single action with a prop on a doll or animal. ‘4, | Combines functionally related actions on a play theme (Feeds and gives drink, puts to bed and covers up). 5 | Demonstrates a trial-and-error approach to problem solving with constructive toys; schemas are flexible, nt repetitive. Pomona ‘6 | Plays appropriately and flexibly for 10 minutes with only occasional adult attention, 7 |can occupy self appropriately with open-ended materials for at least 10 minutes ata time with occasional adult guidance. 8 | Gets materials, brings to table, completes play task, and puts away. Puts three or more shapes in shape sorter accurately. Stacks 8-10 tinch blocks. Copies three or more simple block designs. Puts together five or more Duplos, pop beads, Tinker Toys, bristle blacks in varied ways. 55, | imitates five or more simple actions on play dough (roll, poke, pat, squeeze). 6 |Puts multiple stickers on sheets. 7 opens and closes a variety of containers, 8 9 =. ee - cluding screw-on lids. Zips and unzips large zipper. Strings large objects with rope, thick string, or aquarium tubing. 10 | imitates strokes, scribbles, and dots with marker, crayon. 11 [Snips paper with scissors. 12 | Places checkers and pennies ina slot. 13, | Strings a variety of beads on different types of string. 14 | Completes four- to sixpiece single-inset puzzles. Imitates gross motor actions in a variety of positions (sitting, standing, moving). Jumps off step and over obstacles on ground, Uses some equipment on piayground (climbs, slides). Sits on tricycle and pushes with feet or begins to pedal. Pulls wagon or pushes wheelbarrow. Kicks ball into target. Digs with shovel. Queun- (eine ‘Uses a napkin when cued. Serves self food from bow! with utensil. Passes containers when instructed. Carries plate, cup, and silverware to sink or counter when finished. Stays at table with companion for duration of child’s meal. Eats and behaves appropriately at fast food restaurants. om.8.@ 8 ESDM Level 2Other/ Parent Teacher Skill Level 2 Observed Report Report CODE Personal Independence: Eating (cont) Will touch or taste a new food that has been introduced multiple times. Eats from all food groups. Gets drink of water independently. eee Removes all clothing independently and puts in hamper (no fasteners). Completes some steps of putting on each piece of clothing independently (needs help with fasteners). ‘Takes off jacket, hat (no fasteners), and puts on hook. into oe ‘Wipes face with warm cloth when instructed. Wipes nose when instructed. Participates in all steps of hand washing. Cooperates with hair washing/cutting. Plays with five bath toys appropriately. Puts toys away when requested at end of bath Helps with lotion. Brushes toothbrush over teeth. Goes to sleep independently after bedtime ritual. ‘Shows knowledge of sequence of bedtime routine. Ree ‘Sorts silverware from dishwasher tray to silverware tray. Unloads dryer into basket. Matches socks. Pours water/food into pet dish. Other/ Parent Teacher Skill Level 3 Observed Report Report CODE [irene ‘Attends and joins in with interest for 5-10 minutes as adult reads fa using simple sentences. Follows one-step novel commands involving familiar objectslactions. Identifies many common objects and their pictures: clothing items, objects related to meals, hygiene, play, foods. Responds appropriately to “yes/no” questions regarding preferences. Identifies five or more actions in pictures and books. Follows two or more instructions given in situational routines (bedtime: get a book and get in bed; tooth brushing: get your toothbrush and the toothpaste). Understands spatial relationships involving objects (eg, under, next to) Differentiates early size concepts—bigilttle. Differentiates at least four different colors upon request. Identifies 20 items by sound (e.g,, animals, telephone; “What animal says ‘meow [meow’?”). ESM Level2 9TOR} Skill 2 3 4 5 ‘Comprehends the function of common objects (ride, cut, eat, sleep, put on feet, drink, etc.) Understands pronoun referents “mine” and “yours.” Identifies 10 actions via pictures, choices, acting out. Follows two or more unrelated instructions in novel context. Expressive Communication Produces two- to three-word combinations for a variety of communicative intentions (e-g., requesting, greeting, gaining attention, protesting). Produces two or more word utterances to comment to another person. Labels actions in pictures and books. ‘Comments and requests on location (up, down, in, on top). |Comments and requests using early possessive forms (mine, yours) Gestures oF vocalizes “I don't know” in context. Consistently uses other people's names to get their attention. Delivers a simple message to another person (“Go tell Mommy ‘Hi'”)- Says “Hi” and “Bye-bye” appropriately, both initiating and in response. Uses pronouns for self and other (me and you variants). Uses simple words and gestures to describe personal experiences. Names one to two colors. Responds appropriately to “What?” questions. Responds appropriately to “Where?” questions. Responds appropriately to “Who?” questions. [Asks simple “yesino” questions using rising intonation (can be one-word Utterance with rising intonation). ‘Asks “What2” and “Where?” questions. Answers simple information questions: name, age, color of shirt, ete. Srna era le gross motor games (eg,, ball, “Hide and Seek,” “Ring-around-the- Plays: Rosy”). Shares and shows objects when partner requests. imitates and carries out novel songs/finger plays in group situation. Responds appropriately to simple requests/instructions from peers. Initiates interactions and imitations of peers. Plays in familiar dramatic play routine with peer in parallel play. ‘Takes turns with simple board games. Uses politeness terms: “Please,” "Thank you,” “Excuse me.” Imitates a variety of novel gross motor actions in standing and while moving, ‘such asin “Follow the Leader” or animal walks. Participates in play activities involving verbal scripts. Frequently draws others’ attention to objects verbally and gesturally to /comment, show, share, and request. Responds to others’ bids for joint attention by looking and commenting. Receptively identifies affect (happy, sad, mad, scared) from photos, in others, /andjorin line drawings. Expressively identifies affect from photos, in others, and/or inline drawings. Makes own face reflect affect (happy, sad, mad, scared). Other Parent Teacher Observed Report Report CODE 10 ESDM Level 3Other/ Parent Teacher Level 3 Observed Report Report CODE Matches letters in own name. Matches letters. Matches words, Matches numbers. Receptively and expressively identifies some letters, numbers, shapes, and colors. | Plays games involving memory for hidden objects. Categorizes objects/pictures into eight classes. | Understands relationship between quantities and number symbols through number 5. 9. |Counts correct number of objects to five. 10 | Sequences three or more pictures in correct order and narrates sequence from pictures using “first, then” language. ———E coordinated objects (e.g., trucks on road, blocks make building, beads make a necklace). Performs two or more linked actions on a doll or animal when instructed. Physically places figures on miniature furniture, vehicles, etc., when appropriate. ‘Arranges props for the theme. ‘Completes five- to six-piece interlocking puzzle. Imitates and builds different block structures using a variety of building materials (blocks, Legos, Tinker Toys, etc.) 4 | Lacesa running stitch. 5 | Traces lines and curves with finger and writing tool. 6 | Uses a variety of tools to pick up and release objects: tongs, fork. 7. | Traces a variety of shapes. 8 | Uses scissors with appropriate grasp and uses opposite hand to stabilize and, ‘turn paper. 9. | cuts on a line—straight and curved lines. 10 | Carries out simple two-step art projects (cut and paste, stamp with ink pad; folds paper and cuts on line). [Carries out several different schemas with play dough—uses a variety of tools. Rides tricycle well (pedals and steers, follows a route). Kicks with good form and balance. Uses all playground equipment with supports. Plays chase game with adults and peers, running smoothly, changing direction ‘with good balance. Imitates gross motor actions with movement to songs and music. ‘Throws underhand at target. Jumps forward with two feet together. Hops on one foot. 2... ESOMLevel3 1Level 4 Level 3 [omnes Uses spoon, fork, and cup neatly and without spilling. ‘Behaves appropriately at sit-down restaurant. Uses icons or other symbol systems for choices, schedules, etc. independently, if needed at home and at school. carries own materials to and from car, school, and home. ‘Opens and closes backpack independently; puts in and removes objects when requested. Dresses and undresses when appropriate (unfastens clothing fasteners — Zippers and snaps). [inicio ca Uses toilet independently, all steps, when taken or sent. ‘Manages clothing at toilet except for fasteners. ‘Completes all the hand-washing steps independently. Wipes face with warm washcloth when handed to child. Runs brush or comb through hait Covers mouth when coughing and sneezing. Assists actively in bathing and drying self after bath. Brushes teeth with toothbrush, using at least a few strokes. ed Feeds/waters a pet. Parent Observed Report Other! Teacher Report CODE [one ‘Understands a variety of descriptive physical relationship concepts. Retrieves 10-15 items using two to three multiple cues (e.., size, quantity, color, object label). Understands gender pronouns. Understands comparatives: bigger, shorter, smaller, most, least, few, many, etc. ‘Understands spatial relationships involving objects and prepositions: behind, in back of, in front of. Understands negatives (e.g., the box with no balls, the boy who is not sitting). Understands possessives and part-whole relations. Demonstrates attention to short stories and comprehension of parts of the story by responding to simple “wh” questions (what and who). Responds to “yesino” questions for identity. ‘Answers questions about physical states. Responds to personal information questions. Understands “same” and “different.” 16 |Helps clear table. 47. |Helps empty dishwasher. 18 | Puts clean clothes in drawers. 19 | Picks up belongings when asked. Other! Parent Teacher Skill Level 4 Observed Report Report CODE 2 ESDM Level 3Other/ Parent Teacher Skill Level 4 Observed Report Report CODE Receptive Communication ( 13 [Understands quantity concepts. 14 | Identifies features of objects. 15, | Responds to questions regarding category membership of objects/pictures. 16 |Understands past and future tense. 17. |Understands passive voice. 18 | Understands temporal relations. 19 | Follows three-part unrelated verbal instructions. 1. [Responds to complex "wh" questions (“Why?”, “How?"). Describes object functions in response to question (.g., “What do you do with Uses a variety of noun phrases. Uses prepositional phrases (e.g., under, next to, behind, in back of, in front of). Uses a variety of verb phrases (e.g, he cries, she likes him, he fell, he was happy, he is happy, could, should, would). 7. | Demonstrates accurate production of at least 80% of all consonants and consonant blends within connected speech. Describes recent experience using three- to four word sentence. Requests permission to pursue an activity. 10 | Uses plural forms. 1 | Uses later possessives (e.g, his, hers, Mommy's hat). 12 | Uses regular past tense. 13 | Uses articles such aso, an, the. 14 | Uses comparatives/superiatives. 45 | Uses negation with auxiliary verbs. 16 | Uses present progressive verb form. 17_ | Uses words to describe physical states. 18 | Responds to questions about physical states: “What do you do when you are. 19 | Uses category names for familiar objects. 20 | Describes features of objects. 21 | Uses reflexive pronouns. 22 | Answers telephone appropriately, including getting person. 23 | Participates in a conversation that is initiated by an adult for two to three consecutive turns involving a variety of functions (eg. reciprocal commenting, responding to and requesting information). 24 | Initiates and maintains @ conversation on a self-generated topic of conversation ‘with an adult 25 | Describes a two- to three-event sequence of activities (e.g, going to visit Grandma). 26 | Expresses “I don’t know” paired with gesture. 27 | Asks for clarification if doesn't understand what is sald, 28 | Engages in a variety of topics during conversation. 29 | Repairs own communication when listener does not understand. 30 | Answers questions about self and others, ooeu ESDM Level4 13Skill 10 " 2 7 a 9 we evaueuns Level 4 Invites peers to play. Uses polite forms such as “Excuse me,” “Sorry.” Seeks out others for comfort ina group situation. Expresses own feelings appropriately. ‘Takes turns in informal play independently. Describes an event or experience to peer. Identifies what makes self fee! happy, sad, mad, scared. Identifies others’ emotions based on situational factors. Begins to develop coping strategies when feeling upset, mad, or scared. ‘Counts rotely to 20. [counts objects with 11 correspondence to 10. Gives “one,” “some,” “alot,” a litte,” “all of them,” “more,” and “most.” Gives quantities through to. Knows terms for quantity concepts. Knows terms for spatial relations. ‘Matches and understands 5-10 wordjobject associations. ‘Can read some words. [can identify written name out of afield of five. “Reads” signs and symbols. identifies numbers andiletters.. States opposites and analogies. Demonstrates actions of figures in play. Uses placeholder iterns to symbolize props in play. Labels actions and pretend props in play. Spontaneously links three or more related behaviors ina play theme. Directs partner in play. Plays out several life events (e.., birthday party, McDonald's, doctor), including Use of verbal scripts. Plays out several story themes in play. ‘Takes on a character role and plays it out. Follows another's lead in play. Colors ina picture with accuracy using different colors. Imitates triangle, letters using appropriate drawing utensil. Draws lines and shapes and some letters and numbers from memory. Imitates and copies a variety of letters, numbers, and shapes. ‘Writes first name without a model. ‘Traces shapes and letters. Colors in shapes that are outlined. Connects dots with drawing tool. Draws lines to and from corresponding pictures, words, or shapes. Copies a variety of simple representational drawings (@g., face, tree, house, flower). Other! Parent Teacher Observed Report Report CODE 4 ESDM Level 42 Som. a. o ee 10 2 8 4 5 16 7 8 ‘Cuts out angles, straight lines, and curves. Cuts out simple shapes. Completes three-step art projects—cut, color, and paste. Uses paintbrush, stamps, markers, pencils, erasers to complete art activities. Uses a tripod grasp with drawing tool. Builds with a variety of building materials with own design and copies simple models from pictures or 3-D models. Puts together interlocking puzzles, floor puzzles, tray puzzles. ‘Throws tennis ball or baseball to another person with directionality using ‘overhand throw. Uses all playground equipment independently, including swing, merry-go- round. Kicks a moving ball. Plays various games with balls: Throws ball in basket, hts T-ball with bat, bounces bal, goif club, beanbag toss. Rides bicycle confidently with training wheels; able to control speed, maneuver, and brake, Gallops and skips. Walks without falling off balance beam, railroad ties, sidewalk curbs, Plays typical motor games (e.g, ‘“Red Light, Green Light,” “Red Rover; Tag”). nro eoe ‘Manages all steps involved in toileting independently at the level of peers. Takes sef to toilet as needed. Washes hands independently at level of peers. Washes face with washcloth independently. Independently brushes or combs hair. Actively assists with bathing, dries self after bath. Carries out all steps for toothbrushing independently, though adult may also brush teeth for thoroughness. Fastens own clothing—buttons, snaps, and zippers. Blows nose when cued, uses tissue to catch sneezes, covers cough and sneeze. Stops at street; crosses after looking both ways when accompanied. Walks safely beside adult independently in parking lots, stores, etc. Helps with table setting. Uses knife to spread. Cleans up after spills. Pours self drink from small container. Places dishes in sink, counter, or dishwasher. ‘Makes a two-step snack. Assists with cooking activities: stirs, pours, etc. Skill Level 4 ot 11 | Folds paper in half and puts in envelope. 19 |Uses tape, paper clips, keys appropriately. 1_ | Plays catch with playground-sized ball with a peer. Other) Parent Teacher oserved Report Report CODE ESDMLevel4 15= Sp ©2010 The Gullo Press. Allright reserved Foradetiona cecklsts, write to The Culford Press, 370 Seventh Avenue, Sulte 1200, New York, NY 1000 cll tll free at GUILFORD —__visitour website at www.guilford.com.