Student Observation Form, Inclusion Department

Student's Name *

First

Last

Registration Number *

Date of Birth *

Age *

Section

Observer's Name *

First

Last

Lesson Observed *

Date of the Observation *

Duration of the Observation *

Overt Behavior Traits *

Notes on Behavior

Interactions with Peers *

Interactions with Adults *

Notes on Interactions

Verbal Communication *

Nonverbal Communication *

Notes on Communication

Task Completion & Organizational Skills *

Focus & Attention *

Notes on Academic Performance

Gross Motor Skills *

Fine Motor Skills *

Handedness *

Notes on Motor Skills

Tools & Equipment *

Notes on Tools & Equipment

Additional Observation Notes

Recommendations/Next Steps *

Signature