Child Participation Evaluation Form
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1
2TOOLS FOR TEACHERS
PUTTING IT INTO ACTION
EXAMPLE: CHILD PARTICIPATION EVALUATION FORM
This form can be used to consider which children need additional support or enrichment, and when they need it. See the example evaluation form below for
Shawna, a child in Marsha’s class. A blank form is provided on the next page for use in your classroom.
Shawna
Marsha
9/24/14
Child’s name:
Teacher’s name:
Date:
Daily routines/Activities
What do we expect all children to do?
How is this child doing?
What’s the concern?
Transitions
Stay with the group. Move between activities with calm
X
r Good
and safe body, hang/retrieve coat and backpack for
r Needs support
arrival/departure.
r Needs enrichment
Circle time
Sit on a mat. Participate in activities. Use a safe body.
Has a hard time sitting still. Gets
r Good
X
Keep eyes on the teacher. Raise hand before talking.
fidgety and wiggly.
r Needs support
r Needs enrichment
Small group time
Sit at the table. Participate in activity. Ask for and
Draws and colors on others’ work.
r Good
X
share materials with other children.
Peers get frustrated.
r Needs support
r Needs enrichment
Snack/Lunch time
Sit at the table. Have conversations with peers. Pass
X
r Good
food when asked. Clean up when finished.
r Needs support
r Needs enrichment
Center time
Explore the learning centers. Interact safely with toys
Likes to be in dramatic play area,
r Good
X
and peers. Take turns with, and share materials.
but ends up just wandering around.
r Needs support
Doesn’t seem to know what to do.
r Needs enrichment
Toileting/Hand
Ask to use bathroom. Complete all steps of toileting.
Doesn’t wash hands. Turns on the
r Good
X
Wash hands.
water, but then gets distracted
washing
r Needs support
and runs off.
r Needs enrichment
X
Outdoor time
Explore the playground. Take turns with, and share
r Good
equipment/toys. Play safe games.
r Needs support
r Needs enrichment
NCQTL
For more information, contact us at: NCQTL@UW.EDU or 877-731-0764
This document was prepared under Grant #90HC0002 for the U.S. Department of Health and Human Services, Administration for
Children and Families, Office of Head Start, by the National Center on Quality Teaching and Learning.
WINTER 2014
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