"Classroom Observation Form"

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Form
QC5
Classroom Observation
Name and Title of Observer: __________________________________________________________
Student: ____________________________________ Grade: _____________ Date: ________________
Classroom Teacher: ____________________________________________________________________
Name of Person Referring Student: ________________________________________________________
Circumstances of Observation: (
)
subject, teacher, time of day, reason for observation, etc.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Comparison of Performance
Compare this student’s performance with that of the majority of other students in the classroom.
• How the student works
❑ more slowly
❑ more quickly
❑ about the same
• Focus and attention span
❑ better
❑ poorer
❑ about average
• Activity level of the student
❑ more active
❑ less active
❑ about the same
• Language skills
❑ better
❑ poorer
❑ about average
• Demonstration of interest
❑ disinterested
❑ very interested
❑ about average
• Diffi culty/frustration with content
❑ high
❑ low
❑ about average
• Emotional/social maturity
❑ less than
❑ greater than
❑ about average
• Other (specify) ____________________________________________________________________________
Teaching Method
(Check all that apply)
• Teaching Methods Observed
❑ visual
❑ auditory
❑ large group
❑ small group
❑ peer tutoring
❑ other (specify) ________________________________________________________________________
• Conceptual Content
❑ concrete
❑ abstract
❑ both
• Behavior Reinforcement
❑ positive
❑ negative
❑ ignored
❑ other (specify) ________________________________________________________________________
Teacher’s Style
(Check all that apply)
• How much movement/activity is allowed?
❑ a great deal
❑ some
❑ minimal
❑ none
• How much talking/noise is tolerated?
❑ a great deal
❑ some
❑ minimal
❑ none
• What type(s) of feedback were given?
❑ praise
❑ criticism
❑ reward
❑ punishment
• What tone/manner was used to communicate?
❑ supportive
❑ matter-of-fact
❑ harsh
• During this observation, how did the teacher spend most of his/her time? (e.g. at the board, with a
small group, at the teacher’s desk, circulating among students at work, etc.)
_________________________________________________________________________________________
• What about the teacher or classroom seemed to have a positive or negative effect on the students
in general or on this student in particular?
_________________________________________________________________________________________
_________________________________________________________________________________________
© MentoringMinds.com
91
Classroom Observation - Form QC5 - (Page 1 of 2)
Form
QC5
Classroom Observation
Name and Title of Observer: __________________________________________________________
Student: ____________________________________ Grade: _____________ Date: ________________
Classroom Teacher: ____________________________________________________________________
Name of Person Referring Student: ________________________________________________________
Circumstances of Observation: (
)
subject, teacher, time of day, reason for observation, etc.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Comparison of Performance
Compare this student’s performance with that of the majority of other students in the classroom.
• How the student works
❑ more slowly
❑ more quickly
❑ about the same
• Focus and attention span
❑ better
❑ poorer
❑ about average
• Activity level of the student
❑ more active
❑ less active
❑ about the same
• Language skills
❑ better
❑ poorer
❑ about average
• Demonstration of interest
❑ disinterested
❑ very interested
❑ about average
• Diffi culty/frustration with content
❑ high
❑ low
❑ about average
• Emotional/social maturity
❑ less than
❑ greater than
❑ about average
• Other (specify) ____________________________________________________________________________
Teaching Method
(Check all that apply)
• Teaching Methods Observed
❑ visual
❑ auditory
❑ large group
❑ small group
❑ peer tutoring
❑ other (specify) ________________________________________________________________________
• Conceptual Content
❑ concrete
❑ abstract
❑ both
• Behavior Reinforcement
❑ positive
❑ negative
❑ ignored
❑ other (specify) ________________________________________________________________________
Teacher’s Style
(Check all that apply)
• How much movement/activity is allowed?
❑ a great deal
❑ some
❑ minimal
❑ none
• How much talking/noise is tolerated?
❑ a great deal
❑ some
❑ minimal
❑ none
• What type(s) of feedback were given?
❑ praise
❑ criticism
❑ reward
❑ punishment
• What tone/manner was used to communicate?
❑ supportive
❑ matter-of-fact
❑ harsh
• During this observation, how did the teacher spend most of his/her time? (e.g. at the board, with a
small group, at the teacher’s desk, circulating among students at work, etc.)
_________________________________________________________________________________________
• What about the teacher or classroom seemed to have a positive or negative effect on the students
in general or on this student in particular?
_________________________________________________________________________________________
_________________________________________________________________________________________
© MentoringMinds.com
91
Classroom Observation - Form QC5 - (Page 1 of 2)
Form
QC5
Classroom Observation
Student Behavior
The student: (
Please answer every question
)
• performs with the group.
❑ Yes
❑ No
❑ Not observed
• voluntarily participates in activities.
❑ Yes
❑ No
❑ Not observed
• is responsive to the teacher.
❑ Yes
❑ No
❑ Not observed
• follows oral instruction.
❑ Yes
❑ No
❑ Not observed
• follows written instruction.
❑ Yes
❑ No
❑ Not observed
• is responsive to other students.
❑ Yes
❑ No
❑ Not observed
• interacts with peers appropriately.
❑ Yes
❑ No
❑ Not observed
• appears prepared and organized.
❑ Yes
❑ No
❑ Not observed
• starts and stays on task.
❑ Yes
❑ No
❑ Not observed
• fi nishes what is started.
❑ Yes
❑ No
❑ Not observed
• answers when called on.
❑ Yes
❑ No
❑ Not observed
• responds appropriately to correction.
❑ Yes
❑ No
❑ Not observed
• shows independence.
❑ Yes
❑ No
❑ Not observed
• seems alert (not sleepy or lethargic).
❑ Yes
❑ No
❑ Not observed
Based on this observation, check area(s) of concern:
❑ English profi ciency
❑ Instructional level
❑ Environment
❑ Developmental concerns
❑ Motor skills
❑ Emotional development
❑ Psychological concerns
❑ Giftedness
❑ Family
❑ Cultural infl uences
❑ Health/Medical issues
❑ Other (
)
describe below
Comments:
____________________________________________________________________________________
____________________________________________________________________________________
Student Strengths
What strengths observed in this student could be used in designing interventions?
____________________________________________________________________________________
____________________________________________________________________________________
Summary
Please provide a narrative summary of the student’s learning/behavior.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
(Use and attach a separate sheet if necessary)
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Classroom Observation - Form QC5 - (Page 2 of 2)
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