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APPENDICES

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Republic of the Philippines
Mariano Marcos State University
COLLEGE OF TEACHER EDUCATION
Laoag City
September 11, 2014
MR. PEDRO S. RAMOS
Principal
Lagui-Sail Elementary School
Laoag City
Sir:
Warmest Greetings!
I am Karen Grace M. Alvaro, a third year student of Mariano Marcos State University-
College of Teacher Education, is currently conducting a research titled “ Cases of Learning
Disability/Difficulty Learners in Primary Grade Levels” as a partial fulfilment of the
requirements in SPED 119 (Research in Special Education).
In connection to this, may I respectfully request your permission to observe classes I
primary grade levels (Grade 1 to Grade 3) and to distributed questionnaires and checklists among
primary grade level teachers and advisers. I will guarantee that the needed and gathered
information will be kept confidentially and with the use for research purposes only.
Thank you for your kindness and approval to this request. God bless you!
Very Respectfully Yours,
KAREN GRACE M. ALVARO
Researcher
NOTED BY:
DR. ELIZA T. SAMSON
Professor

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Checklist for Learning Disabilities
Adapted from the book Learning Disabilities A to Z written by Smith An Strick
Name of the Child: ______________________________________________________________
Age: ________________________________________ Sex: _____________________________
Grade: ____________ School: ____________________________________________________
Direction: Put a checkmark (/) on the space corresponding to the characteristics manifested by
the pupils being observed. Please complete every item.
Characteristics Yes No Not Observed
Writing
Dislikes and avoids writing
Delays in learning to write
Papers are messy and incomplete; many cross-
outs and erasures
Difficulty remembering shapes of letters and
numbers
Frequent letter and number reversals
Uneven spacing between letters and words
Omits letters from words and words from
sentences
Inaccurate copying
Poor spelling (spells phonetically)
Cannot spot errors in own work
Difficulty preparing outlines and organizing
written work
Written assignments are short or incomplete;
often characterized by brief sentences, limited
vocabulary
Problems with grammar persists
Bizarre spelling errors (not phonetic); pupils may
unable to decipher own spelling
Ideas in written assignments are poorly
organized, not logically presented
Little theme development; pupils are more likely
to write bare lists of points or events than
provide details or develop ideas, characters, or
plot
On tests, consistently does better with multiple-

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choice questions than essays or filling in banks
Reading
Confuses similar-looking letters (b and d, p and
q)
Difficulty recognizing and remembering “sight
words (but can sounds words out phonetically)
Frequent loses place when reading
Confuses similar-looking words (bread and
beard)
Reverses words (reads was for saw)
Has trouble finding letters in words or words in
sentences
Poor memory for printed words (also number
sequences, diagrams, illustrations, and so on)
Poor comprehension of main ideas and themes
Fine motor
Poor handwriting (sloppy, illegible, poor
spacing, inconsistent letter size, no consistent
font style, strays from lines on paper)
Papers are messy (torn and crumples with many
cross-outs smudges, and incomplete erasures)
Marked slowness, exceptional effort, and
frustration noted writing tasks
Dislike and avoidance of writing or drawing
Content/style of written assignments (poor
primary focus is on aligned numerals)
In severe cases, difficulty learning keyboard
skills
Comprehension for what has been read id
consistently poor, or deteriorates when sentences
become longer and more complex
Poor retention of new vocabulary words
Dislikes and avoids reading

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The Specific Learning Disability Rating Scale
Based from Glynis Hannell Giftedness Checklist
Directions: Each item that applies to the child or adolescent should be checked off using the
following rating scale.
1 Not at all, does not apply
2 Mild, sometimes observed, applies to some extent
3 Moderate, often observed, certainly applies
4 Sever, frequently observed, strongly applies
Please use 0 to indicate that an item has been considered and does not apply. If the 0 is not
checked, it is not clear if the item has been overlooked.
Visual motor difficulties
Was or is slow to learn how to write 1 2 3 4
Does poor bookwork; is untidy, slow, messy 1 2 3 4
Mixes upper and lowercase letters 1 2 3 4
Has difficulties working as fast as other students 1 2 3 4
Has poor coordination; is clumsy 1 2 3 4
Loses place when reading; uses finger to keep track 1 2 3 4
Reverses letters and numbers after the age of 7 1 2 3 4
Disliked puzzles and drawing as a younger child 1 2 3 4
Has difficulties with sustained writing; hand gets tired very quickly 1 2 3 4
Has poor posture; slumps on desk when working; fidgets sitting on the
floor
1 2 3 4
Pupil’s Name: _______________________________________________________________________
Pupil’s Age _________________________________________________________________________
Name of the Person Completing the Rating Scale ___________________________________________
Relationship to the Pupil ______________________________________________________________
Date Accomplished __________________________________________________________________

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Concentration Difficulties
Is attentive, in a daydream 1 2 3 4
Is easily distracted 1 2 3 4
Has been diagnosed as having Attention-Deficit Disorder 1 2 3 4
Is often restless and fidgety 1 2 3 4
Is often impulsive; does not stop and think; calls out in class 1 2 3 4
Makes many careless errors 1 2 3 4
Cannot rad for more than a short period of time 1 2 3 4
Is poorly organized; often forgets books, equipment 1 2 3 4
Additional Comments and Observations:

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Checklist for Specific Learning Disabilities
Adapted from Winand H. Dittrich and Rona Tutt, 2008
Name of the Child: ______________________________________________________________
Age: ________________________________________ Sex: _____________________________
Grade: ____________ School: ____________________________________________________
Directions: Each item that applies to the child or pupil should be checked off using the
following rating scale.
5 Always
4 Often
3 Sometimes
2 Rarely
1 Never
Symptoms 1 2 3 4 5
Dyslexia
Slow to learn sounds
Muddles vowel sounds
Slow to blend words
Sequences letters incorrectly
Copies down incorrectly
Disorganized
Needs time to process spoken language
Weak speller
Dysgraphia
Letters poorly formed
Handwriting untidy
Often writes very little
Difficulty organizing ideas to put them on to paper
Body posture abnormal: lying on desk or moving
across desk as writing moves across page

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Lagui-Sail Elementary School
Brgy. 54-A Lagui-Sail, Laoag City
List of Pupils
Grade I
Mrs. Cezanne A. Bernardino
Teacher I
Boy
1. Agudong, Christian Danielle D.
2. Asuncion, Neal Boy A.
3. Barroga, Gian Jay M.
4. Dagan, Jeremy Dave B.
5. Eric, John Ashley R.
6. Guerrero, Hilarion Jr. J.
7. Guillermo, Jiro Erosh G.
8. Jacinto, Raja Ransen John A.
9. Jose, Alexus Bryan D.
10. Ramos, Zane Thirdee Blu
11. Ringpis, Mc John M.
12. Rollon, Mark Cedie G.
13. San Juan, John Reign
Girls
1. Badua, Khaizen Karyl S.
2. Camit, Sunshine Mae L.
3. Curameng, Aliza Cloiu S.
4. Curameng, Jennea Leirish D.
5. Espana, Liza
6. Jacinto, Princess Thalian A.
7. Marcos, Irene Tricia B.
8. Racsa, Cristine Joy
9. Ventura, Trisha Mae R.
Total: 22 Pupils

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Lagui-Sail Elementary School
Brgy. 54-A Lagui-Sail, Laoag City
List of Pupils
Grade II
Mrs. Primrose R. Pastor
Teacher III
Boys
1. Andres, AJ Matthew
2. Andres, Marley Anderson R.
3. Asuncion, Danny M.
4. Bacani, Gayland R.
5. Bumanglag, Jaybee L.
6. Geurerro, Elmhar Jade B.
7. Manibog, James Vincent D.
8. Pascual, Karl Daye I.
9. Saducas, Ryan Jake R.
Girls
1. Acosta, Kaye Irish R.
2. Agullana, Bhea N.
3. Bautista, Jemima E.
4. Bumanglag, Juliana Aleina R.
5. Cleope, Mary Jane R.
6. Domingo, Jillian Khate R.
7. Duran, Abigail T.
8. Erica, Frace Jamaica R.
9. Ignacio, Rogelyn D.
10. Maros, Kristine Joy
11. Medina, Marianne Angel U.
12. Medina, Rochelle Joy G.
13. Rafael, Ma. Jennelle P
14. Ramos, Angeline A.
15. Ramos, Kreizelle Weign
Total: 24 Pupils

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Lagui-Sail Elementary School
Brgy. 54-A Lagui-Sail, Laoag City
List of Pupils
Grade III
Mrs. Leticia S. Daguro
Teacher II
Boys
1. Acosta, Kier Cynell R.
2. Agnir, Richard R.
3. Asuncion, Jasper Gian Y.
4. Bumanglag, Justin Mark R.
5. Calumag, Gian Ashley A.
6. Duldulao, Bench Ezekiel M.
7. Florague, Aron Josh M.
8. Gonzales Jr., Artemio M.
9. Guererro, Calvin James P.
10. Guererro, Jhay Mark B.
11. Lingan, Raphael Jay C.
12. Medina, Christian Mark C.
13. Medina, Jhon Lester C.
14. Medina, Marvin D.
15. Nolasco, Jan Hersen L.
16. Ragadi, Christian R.
17. Ragadi, Vhon Jayvee L.
18. Ramos Mark Harris T.
19. Rivera, Franzen Thomas
20. Valdez, Mark Daniel R.
Total: 37 Pupils
Girls
1. Andres, Marsha Nicole R.
2. Asuncion, Alexandra Nicole
3. Buatista, Mae T.
4. Baysa, Aira Lei C.
5. Camit, Francisca Q.
6. Geurerro, Sharina Jane J.
7. Jose, Nicole Jane D.
8. Manapat, Casper Irra M.
9. Medina, Chrizel Joy A.
10. Medina, Chryzzamel Riz A.
11. Medina, Leah Marie B.
12. Passion, Rica Jasmin Mae B.
13. Raboy, Zhil Anne Akina R.
14. Ragadi, Claudine Jane A.
15. Ramos, Gheryl Anne T.
16. Rivera, Jessamine Keith A.
17. Salvador, Abigail A.

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Tables
Table 1.1 Profile of the Observed Primary Grade Level Pupils
Primary Grade Levels Boys Girls Total
Grade I 13 9 22
Grade II 9 15 24
Grade III 20 17 38
Total 42 39 83
n= 83
Primary Grade Levels Boys (%) Girls (%) Total (%)
Grade I 16 11 27
Grade II 11 18 29
Grade III 24 20 44
Total 51 49 100
n= 83
Table 1.2 Cases of Learning Disability/Difficulty
Primary Grade Levels Number of cases
Grade I 1
Grade II 2
Grade III 3
Total 6
n= 83

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Primary Grade Levels Total (%)
Grade I 1
Grade II 2
Grade III 4
Total 7
n= 83
Table 2.1 Prevalence Type of Learning Disability/Difficulty
Types of Learning
Disability/Difficulty
Number of Pupils Total
Dyslexia 4 4
Dyscalculia 0 0
Dysgraphia 2 2
Dyspraxia 0 0
Dysarthria 0 0
Visual Agnosia 0 0
Auditory Agnosia 0 0
Olfactory Agnosia 0 0
Motor Aphasia 0 0
Total 6 6
n= 84

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Table 2.1 Prevalence Type of Learning Disability/Difficulty
Types of Learning
Disability/Difficulty
Number of Pupils
(%)
Total
(%)
Dyslexia 5 5
Dyscalculia 0 0
Dysgraphia 2 2
Dyspraxia 0 0
Dysarthria 0 0
Visual Agnosia 0 0
Auditory Agnosia 0 0
Olfactory Agnosia 0 0
Motor Aphasia 0 0
Total 7 7
n= 84

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Table 2.2 The Occurrence of Type of Learning Disability/Difficulty Among
Learning Disabled Pupils
Types of Learning
Disability/Difficulty
Number of Pupils Total
Dyslexia 4 4
Dyscalculia 0 0
Dysgraphia 2 2
Dyspraxia 0 0
Dysarthria 0 0
Visual Agnosia 0 0
Auditory Agnosia 0 0
Olfactory Agnosia 0 0
Motor Aphasia 0 0
Total 7 7
n= 6

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Table 2.2 The Occurrence of Type of Learning Disability/Difficulty Among
Learning Disabled Pupils
Types of Learning
Disability/Difficulty
Number of Pupils
(%)
Total
(%)
Dyslexia 67 67
Dyscalculia 0 0
Dysgraphia 33 33
Dyspraxia 0 0
Dysarthria 0 0
Visual Agnosia 0 0
Auditory Agnosia 0 0
Olfactory Agnosia 0 0
Motor Aphasia 0 0
Total 100 100
n= 6
Table 3.1 Characteristics of Dyslexic Learner in Primary Grade Level
Item # 1 2 3 4 5 T 𝒙 R I
1 0 2 1 0 3 22 3.67 5 Often
2 0 2 1 0 3 22 3.67 5 Often
3 0 2 1 0 3 22 3.67 5 Often
4 0 0 0 3 3 27 4.5 2.5 Often
5 0 0 0 3 3 27 4.5 2.5 Often
6 0 0 0 1 5 29 4.83 1 Always
7 0 2 1 3 0 19 3.17 7 Sometimes
8 0 2 1 2 1 20 3.33 8 Sometimes

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Table 3.2 Characteristics of Learner with Dysgraphia in Primary Grade Level
Item # 1 2 3 4 5
1 0 0 0 0 0
2 0 0 0 2 22
3 2 3 3 2 1
4 2 1 1 1 1
5 2 2 2 1 2
T 24 23 23 19 21
𝒙 4 3.83 3.83 3.17 3.5
R 1 2.5 2.5 5 4
I Often Often Often Sometimes Sometimes
Table 3.3 Writing Characteristics of Learning Disabled in Primary Grade Levels
Item # Yes No Not Observed Total
1 2 4 0 6
2 0 4 2 6
3 6 0 0 6
4 2 4 0 6
5 3 3 0 6
6 6 0 0 6
7 3 3 0 6
8 6 0 0 6
9 4 0 3 6
10 3 0 4 6
11 0 0 6 6
12 1 0 5 6
13 1 0 5 6
14 1 0 5 6
15 1 0 5 6
16 0 0 6 6
17 0 0 6 6

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Item # Yes (%) No (%) Not Observed
(%)
Total
1 33 67 0 100
2 0 67 33 100
3 100 0 0 100
4 33 67 0 100
5 50 50 0 100
6 100 0 0 100
7 50 50 0 100
8 100 0 0 100
9 67 0 33 100
10 33 0 67 100
11 0 0 100 100
12 17 0 83 100
13 17 0 83 100
14 17 0 83 100
15 17 0 83 100
16 0 0 100 100
17 0 0 100 100
Table 3.4 Reading Characteristics of Learning Disabled in Primary Grade Levels
Item # Yes No Not Observed Total
1 5 1 0 6
2 5 1 0 6
3 5 1 0 6
4 5 0 1 6
5 5 1 0 6
6 3 1 2 6
7 2 2 2 6
8 5 0 1 6

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Item # Yes (%) No (%) Not Observed
(%)
Total
1 83 17 0 100
2 83 17 0 100
3 83 17 0 100
4 83 0 17 100
5 83 17 0 100
6 50 17 33 100
7 33 33 33 100
8 83 0 17 100
Table 3.5 Fine Motor Characteristics of Learning Disabled in Primary Grade Levels
Item # Yes No Not Observed Total
1 4 1 1 6
2 5 0 1 6
3 5 0 1 6
4 4 2 0 6
5 1 0 5 6
6 0 0 6 6
7 1 0 5 6
8 4 0 2 6
9 4 1 1 6
Item # Yes (%) No (%) Not Observed
(%)
Total
1 67 17 16 100
2 83 0 17 100
3 83 0 17 100
4 67 33 0 100
5 17 0 83 100
6 0 0 100 100
7 17 0 83 100
8 67 0 33 100
9 67 16 17 100

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Table 3.6 Visual Motor Characteristics of Learning Disabled in Primary Grade Levels
Item # 1 2 3 4 T 𝒙 R I
1 0 4 0 2 16 2.67 4 Often
2 0 1 0 5 22 3.67 4 Often
3 1 3 2 1 17 2.83 1.5 Often
4 0 0 3 3 21 3.5 6 Frequent
5 0 0 4 2 20 3.33 7 Frequent
6 0 2 1 3 19 3.17 8 Frequent
7 5 1 0 0 7 1.17 9 Mild
8 6 0 0 0 6 1 10 Not at all
9 1 2 1 2 16 2.67 4 Often
10 0 3 1 2 17 3.83 1.5 Mild
Table 3.7 Concentration Characteristics of Learning Disabled in Primary Grade Levels
Item # 1 2 3 4 T 𝒙 R I
1 0 0 0 6 24 4 1.5 Frequent
2 0 0 0 6 24 4 1.5 Frequent
3 6 0 0 0 6 1 8 Not at all
4 0 2 3 1 17 2.83 3.5 Often
5 0 5 0 1 14 2.33 7 Often
6 0 1 4 1 18 3 6 Often
7 1 0 0 2 17 2.83 3.5 Often
8 0 0 3 3 21 3.5 5 Frequent

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