Name:

Date:
Good Day! We are Grade 12 students from Mary Immaculate Parish Special School and we are
currently conducting a research paper entitled: Growth Intervention: Perception of Teachers
and Administration on the Effectiveness of the Activities for Daily Living program of the
Special Education Department of Mary Immaculate Parish Special School, in partial
fulfillment of the course requirement for Practical Research 2. We would like to seek your
cooperation in answering the questions provided in this questionnaire. We humbly thank you.
Definition of Terms:
By Growth Intervention, we mean the intervention of teachers, in hopes of achieving a growth
mindset for students.
I. Checklist.
Directions: Please mark your answer.
Questions Extensively Neutral No
Extensively
1. To what extent do teachers track a student’s
success in regards to their Activities for
Daily Living program.

Activities for Daily Implemented to the Implemented to a Implemented to a

Living least extent moderate extent great extent

 Make sign of the

cross (before
starting the
lesson, before
eating, and before
going home)
Before eating time:
 Washes hands
 Prepares
placemat
 Opens food
wrapper/containe
r
 Opens water
container
 Activities for Daily Implemented to the Implemented to a Implemented to a
Living least extent moderate extent great extent

During eating time:

 Eats food
without
spillage
 Drinks water
without
spillage
 Wipes mouth
after eating
 Uses Toilet
without
assistance
Pack-away time:
 Cleans table
without
instruction
and assistance
 Throws trash
in the bin
without
instruction
and assistance
 Returns eating
utensils/food
container
without
instruction
and assistance
 Stays in line
while going
out of the
school
 Taps ID
before going
out of the
school
premises
II. Directions: Please answer on the space provided.

1. What are the strengths and weaknesses of the Activities for Daily Living Program of
Mary Immaculate Parish Special School?
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2. What program modification do Special Education implement to improve Activities for

Daily Living Program of Mary Immaculate Parish Special School?
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3. To what extent do teachers track a student’s success in regards to their Activities for
Daily Living program. Please explain. (Refer to your answer to number 2.)
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4. How often do you evaluate the Activities for Daily Living program of the Special
Education Department?
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5. As a SPED teacher, what factors may affect the learning ability of the students in the
Activities for Daily Living program of Mary Immaculate Parish Special School?
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6. As a SPED teacher, what activities may be proposed in addition to the Activities for
Daily Living program to improve the experience, the learner and the learning
environment of Mary Immaculate Parish Special School Special Education students?
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