Child’s Name: ______

Developmental Assessment Grid (DAGR)

Outcome 1: Positive social relationships

relating to adults, relating to other children, following rules related to groups or interacting with others (if older than 18 months old).

S= Score: 0- no, 1- sometimes, 2- consistently
N= Notes: Ob- observed, R- Reported
L= Location: H- Home, D- Daycare, R- Relative, C- Church, O= Outings (shopping, restaurant, park, etc.) / Respondent:
______
Date: ______/ Respondent:
______
Date: ______/ Respondent:
______
Date: ______
Social and Emotional / S / N / L / S / N / L / S / N / L /
·  Visually recognizes caregiver (1 mo) /
·  Smiles back when parent smiles (2 mo) /
·  Enjoys eye contact (0-2) /
· Smiles at self in mirror (4 mo) /
· Laughs (4 mo) /
· Socializes with anyone (3-5) /
· Reacts differently to strangers (e.g., initially studies face of stranger and doesn’t smile) (3-6) /
·  Responds to own name consistently (6-8) /
· Overtly different reaction to family members versus strangers (stranger anxiety) (6-9) /
· Participates in simple interactive games with caregiver (6-9) /
· Repeats actions that get a reaction (6-9) /
· Initiates playing simple games (9-12) /
· Shows strong preference toward primary caregiver to provide needs (9-12) /
· Spontaneously shares toy with adult (12-15) /
· Plays along side other children (parallel play (15-18) /
· Simple cooperative games with other children (e.g., chase each other) (15-18) /
· Expresses variety of behaviors showing affection (e.g. holding hands, patting back, offering a toy) (18-24) /
Social and Emotional / S / N / L / S / N / L / S / N / L /
· Responds appropriately to social contact initiated by adult (e.g., says or waves hello/goodbye, answers simple questions such as “what’s your name?” (21-24) /
· Attempts to comfort others in distress (22-24) /
· Possessive- uses word “mine” more than hitting or taking to express ownership (24-30) /
· Negotiates with peer for toy (“let’s trade”; “you can play with this one”, etc) (24-30) /
· Expresses feelings through language and pretend play (e.g., “the baby is mad!”) (24-30) /
· Plays well for at least 10 minutes with one other child, not sibling (24-36) /
· Shows independence; refuses to have hand held (30-36) /
· Shows independence in wanting to do many things for self (30-36) /
· Expresses preference/affection for certain peers (30-36) /
· Asks permission before doing something (30-36) /

Outcome 2: Acquiring Knowledge and Skills

Thinking, reasoning, remembering, and problem-solving; understanding symbols; understanding physical and social worlds

S= Score: 0- no, 1- sometimes, 2- consistently
N= Notes: Ob- observed, R- Reported
L= Location: H- Home, D- Daycare, R- Relative, C- Church, O= Outings (shopping, restaurant, park, etc.) / Respondent:
______
Date: ______/ Respondent:
______
Date: ______/ Respondent:
______
Date: ______
/ S / N / L / S / N / L / S / N / L /
Communication and Language /
·  Responds to sights and sounds (1 mo) /
·  Vocalizes in ways other than just crying (e.g., coos, gurgles) (0-3) /
·  Vocalizes attitudes- e.g., pleasure, displeasure (not crying), eagerness (2 mo) /
·  Consistently uses predicable sounds for hunger, distress, and pleasure (0-3) /
·  Watches speaker’s eyes and mouth (2-3) /
/ S / N / L / S / N / L / S / N / L /
·  Continues familiar activity/play routine by initiating movements involved in activity (e.g, mom stops bouncing child on knee, child starts bouncing self (4-5) /
·  Uses simple gestures to make wants known (reaching for, pointing) (6 mo) /
·  Responds to simple verbal requests with gesture (6-9) /
·  listens selectively to familiar words (e.g., bottle, daddy, mommy) (7 mo) /
·  Responds to simple verbal direction without gesture (e.g., where’s mommy?”) (9 -10) /
·  Speaks first words (e.g., mama, dada specific to parent) (9-10) /
·  Uses 3 or more words consistently (11-12) /
·  Consistently uses and understands pointing as way to communicate (12-14) /
·  Points to a variety of everyday objects on request (12-15) /
·  Brings familiar objects from another room on verbal request (14-16) /
·  Uses 7-20 words with consistency (14-16) /
·  Points to several large body parts on self, on verbal request (14-16) /
· Obeys 2-part related commands (e.g., “take your napkin and wipe your mouth”) (18-24) /
·  Understands more complex sentences (e.g., “when we get home, we’ll have some ice cream”) (22-24) /
·  Begins combining words into short (2-3 word) sentences (22-24) /
·  Refers to self by own first name (22-24) /
·  Follows directions in daily routine including in, out, and off (24-30) /
·  Frequently uses 2-3 word sentences to express needs (24-27) /
·  Names at least one color (27-30) /
·  Can choose between big and little toys (27-30) /
·  Gives you “one” of something on request (30 mo) /
·  Gives full name on request (30-33) /
· Can tell you in basic terms about things that happened in immediate past (e.g., at preschool today; in Sunday school this morning) (33-36) /
Social and Emotional /
· Expresses feelings through language and pretend play (e.g., “the baby is mad!”) (24-30) /
/ S / N / L / S / N / L / S / N / L /
Cognitive Development /
·  Pays attention to what is happening in the environment (1 mo) /
·  Pays attention to picture in book (6 mo) /
·  Recognizes and grasps toy that’s partially covered up (4-6) /
·  Overcomes obstacle to obtain object (e.g., moves around chair to get toy that’s behind it) (8-11) /
·  Hands toy to adult when unable to get it to work (12-15) /
·  Pretend play with realistic props (e.g., feeds doll with toy bottle) (15-18) /
·  Pretend play with non-realistic props (e.g., feeds block to baby, uses napkin as baby blanket) (18-24) /
·  Finds things at home/daycare by remembering to look where they’re usually kept (18-21) /
·  Figures out how to work simple mechanical toy on own (20-22) /
·  Uses “tools” to accomplish tasks (e.g., chair to reach counter top, basket or wagon to carry all toy cars rather than one at a time, etc) (21-24) /
·  Holds bowl and stirs, pounds pegs with hammer (24-30) /
·  Finds details in favorite picture book (e.g., tail of dog, bird in tree) (24-27) /
·  Talks to self in play routine as is pretending someone else is there (30-36) /
·  Plays “house”-pretend play contains several sequences combined together (e.g. feeds baby, reads to it, puts it to bed) (30-36) /

Outcome 3: Taking Appropriate Action To Meet Needs

Taking care of basic needs (e.g., showing hunger, dressing, feeding, toileting, etc); Contributing town health and safety (e.g. following rules, assists with hand washing, avoids inedible objects) if older than 24 months; Getting from one place to another; using tools

S= Score: 0- no, 1- sometimes, 2- consistently
N= Notes: Ob- observed, R- Reported
L= Location: H- Home, D- Daycare, R- Relative, C- Church, O= Outings (shopping, restaurant, park, etc.) / Respondent:
______
Date: ______/ Respondent:
______
Date: ______/ Respondent:
______
Date: ______
/ S / N / L / S / N / L / S / N / L /
Language/Social and Emotional /
·  Vocalizes attitudes- e.g., pleasure, displeasure (not crying), eagerness (2 mo) /
·  Consistently uses predicable sounds for hunger, distress, and pleasure (0-3) /
·  Can often calm self (e.g., sucks fingers, rocks self) (3-6) /
·  Uses simple gestures to make wants known (reaching for, pointing) (6 mo) /
·  Begins using words to express needs (11-12) /
·  Says “no” or gestures refusal (15-18) /
· Shows independence; sometimes refuses to have hand held (30-36) /
· Shows independence in wanting to do many things for self (30-36) /
Physical Development /
Movement and Coordination /
· Lifts head in prone (0-2) /
· Moves from stomach to back (2-5) /
· Holds head up 90 degrees in prone (3-5) /
· Bears weight on hands in prone (4-6) /
· Moves back to stomach (5-6) /
· Sits independently (5-8) /
· Crawls forward (8-10) /
· Stands alone well (11-13) /
/ S / N / L / S / N / L / S / N / L /
· Walks without support (11-15) /
· Pulls toy behind while walking (15-18) /
· Walks up and down stairs without help (24-27) /
· Runs well (24-30) /
Using Hands /
· Reaches for toys (3 mo) /
· Picks up toy (4 mo) /
· Transfers from hand to hand (5 mo) /
· Purposely releases toy from grasp (5-7) /
· Uses neat pincer grasp to pick up small objects (10-12) /
· Scribbles and imitates strokes (13 mo) /
· Uses hands together to accomplish a task (e.g., child uses one hand to hold container, 2nd hand to put toy in container (16-18) /
· Snips with scissors (23-25) /
Self Help Skills /
Eating /
·  Opens and closes mouth in response to food (1 mo) /
·  Coordinates sucking, swallowing and breathing (0-5) /
·  Munches solid food (5-8) /
·  Finger feeds (9-12) /
·  Brings spoon to mouth (12-15) /
·  Scoops with spoon and feeds self, some spilling (15-18) /
·  Feeds self with spoon, with little spilling (18-21) /
·  Drinks from small open cup held in one hand (24-30) /
·  Begins to use fork (24-30) /
·  Uses fork independently to spear foods (30-36) /
Dressing /
·  Cooperates with dressing by extending arm or leg (10-12) /
/ S / N / L / S / N / L / S / N / L /
·  Removes loose clothing (hat or socks) (12-15) /
·  Puts on shoes with help (21-30) /
·  Pulls down pants with help (24-26) /
·  Puts on simple clothing (slip-on shoes, pants with loose waistbands, etc.) (24-30) /
·  Puts on all major articles of clothing without help (30-36) /
Toileting Skills /
·  Wants to have wet or soiled diaper changed (15-18) /
·  Stays dry for 2-3 hour periods during the day (21-24) /
·  Urinates and has bowel movement when placed on toilet (24-30) /
·  Rarely has bowel accidents (30-36) /
·  Uses toilet by self, except for wiping (30-36) /

Observations/Comments:

______

Compiled by T. Lee Rouse, PhD. New Bern CDSA, Dec 2006. Revised 070501. Sources: HELP, Carolina Curriculum, Ages and Stages Questionnaire, Bayley Scales of Infant and Toddler Development II, OUNCE Scales.

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