LIVINGSTON COUNTY SCHOOL DISTRICT

SCHOOL:

EMOTIONAL / SOCIAL

BEHAVIORAL OBSERVATION

Student Name: ______ / Grade: _____ / Teacher: ______
Site of Observation: ______ / Date of Observation: ______ / Observer: ______
Observation Time: Beginning ___ Ending ___

I. Physical Environment/Student Location:

At Desk / Group Activity / Cafeteria
At Listening Center / Floor Activity / Gym
At LearningCenter / At Chalkboard / Playground
At Table / Hallway / Other:

II. Task (defined by the teacher) for the student to perform: ______

III. Anecdotal Observation: Record below (and on additional pages if necessary) all pertinent behaviors occurring during the observation period, including comparison to same age, same sex peers without identified disabilities.

Complete the following section in addition to the anecdotal observation.

Please indicate any of the following behaviors observed by placing a mark in the box next to the behavior:

Target Student / Peer Comparison
Behavior Same as Target Peer
Makes inappropriate comments to others
Makes inappropriate or unnecessary noises in the classroom
Fights with other students often
Is physically aggressive with peers or adults
Does not respond appropriately to praise
Is easily angered, annoyed, or upset
Agitates and/or provokes peers
Has little or no interaction with peers
Has few or no friends (Describe:______)
Fails to respect personal space of others
Steals or grabs things from other students
Interrupts the teacher often
Appears sad or lonely
Tattles or tries to create conflicts between others
Fails to participate in group activities or special events
Does not smile, laugh, or demonstrate happiness
Appears tired or listless
Appears unmotivated or uninterested in school
Cries inappropriately or overreacts emotionally to certain situations
Fails to follow directions from authority figures
Is overly critical of self
Demonstrates self-destructive behavior
Avoids social situations
Indicates concern regarding problems in the home or out-of-school
Is not motivated by rewards at school

In the teacher/supervisor/caregiver’s judgment, was the student’s behavior typical? Yes No___ (please explain)______

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