Specific Learning Disabilities Classroom Observation Form

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Classroom Observation Form
Student Name:
Observer Name:
Teacher Name:
Observation Date:
Setting:
Check all that apply:
o
Large group
o
Time:
Small group
o
Independent work
Area of academic concern(s): Check ALL that apply based on referral concerns.
[ ] Written Expression
[ ] Basic Reading Skill
[ ] Reading Fluency
[ ] Reading Comprehension
[ ] Math Calculations
[ ] Math Problem Solving
[ ] Oral expression
[ ] Listening Comprehension
Describe the activity/task where student experiences the greatest difficulty. This should be the target of the observation.
What supports are currently in place for the student? (i.e. para support, reading recovery, math tutor)
Observed behaviors in relation to
Yes
No
Not
Example/Explanation
academic tasks
Observ
Student easily locates information and
assignments within texts and
workbooks without prompts.
(acquisition of information;
organization; planning/sequencing;
speed of processing)
Student demonstrates ability to
function within the provided
curriculum without modifications.
(working memory; visual/auditory
processing; verbal/nonverbal
expression)
Student initiates and completes work
at a rate comparable to peers.
(planning/sequencing; transfer of
information; speed of processing;
motor control)
Student follows the routine and
expectations established by the
teacher (organization; planning and
sequencing;
working memory)
Student appears to be listening and
participates orally to demonstrate
understanding of knowledge acquired.
(working memory; transfer of
information; visual/aud processing;
verbal/nonverbal exp;)
Student responds appropriately to any
visuals presented (i.e. map reading,
understanding geometry, using
margins) (acq. of info, visual process,
motor control)
Student demonstrates adequate fine
motor skills necessary to complete
assignments. (motor control for
written tasks)
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