Child Observation Assignment (Page 4 of 4) in pdf

Child Observation Assignment Page 4

Consent Form

Child Observation

________________________ is a student in the Childhood and Adolescent Development course

at Hanover College.

All students are being asked to observe a child in his or her home, daycare center/family daycare,

preschool program, or school program. The purpose of the observation is to help students learn

about aspects of children’s development by observing a child in one of his or her naturalistic

settings. The observation should take approximately one hour to complete and does not require

you or the child(ren) to interact with the student. In fact, we hope that the student will remain as

inconspicuous as possible during the observation. Although the student will be taking notes

during the observation, at no time will you or any of the children in your home or program be

identified by name.

If you agree to have the student observe a child in your home or program, please sign your name

and complete the information below.

________________________________________

Signature

_________________________________________

Name (please print name)

_________________________________________

Date

_________________________________________

Name of program or school (if applicable)

If you have any questions about the observation, please contact Ellen Altermatt, the instructor of

the course, at 812-866-7317.

Thank you for your help!

Ellen Altermatt, Ph.D.

Department of Psychology

Hanover College

Hanover, IN 47243

Phone: 812.866.7317

Child Observation Assignment Page 4