Classroom Observation Form

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Classroom Observation Form
STUDENT NAME
STUDENT ID#
GRADE
DOB
SCHOOL
Date of Observation: ______________________
Time of observation: From: ________ to _________
Observer: ______________________________
Teacher: ____________________________________
Area of Concern:
CLASS/SUBJECT OBSERVED: (Observation should be in the area of difficulty)
Reading
Social Studies
Science
English/Lang Arts
Special Area(s)
Other: _______________________________________
Math
PUPIL/TEACHER RATIO AND CLASSROOM ARRANGEMENT DURING OBSERVATION PERIOD:
Students:
<10
10-15
16-20
>20
Rows of desks
Grouped desks
Tables
Classroom Arrangement:
Centers
Other
Not
Some-
Rarely/
Student’s Behavior
Always
Often
Notes
times
Never
Obs.
Attentive to instruction/instructor
Begins tasks promptly
Follows oral instruction
Follows written instruction
Participates in class discussion
Responded appropriately to Correction
Responded appropriately to Praise
Seems prepared & organized for activity
Small Group
Works Effectively in:
Large Group
Alone
Age appropriate social interaction w/others
Effectively communicates
wants/needs/emotions
Stays on topic/Talks about a variety of
interests
Indep. w/self-help skills (toileting, eating, etc)
Demands Teacher Attention
Out of seat/area without permission
Required firm discipline
Short attention span/Easily distracted
Appears to struggle with reading tasks
Appears to struggle with math concepts
Disturbed Others:
What behavior was observed that relates directly to the student's area of concern? (Must be completed):
Comments:
Signature of Observer
Position (Person other than student's regular classroom teacher)
WMIS CIR2223

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