Student Social Skills Assessment Form
Assess and document a student's social skills across key behavioral areas.
Student Name
*
First Name
Last Name
Student Grade/Year
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
High School (9-12)
Other
Observer Name (Teacher/Staff)
*
First Name
Last Name
Observer Role
*
Please Select
Classroom Teacher
Special Education Teacher
Counselor
Administrator
Other
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please rate the student's social skills in the following areas:
*
Rows
Never
Rarely
Sometimes
Often
Always
Initiates conversations appropriately
1
2
3
4
5
Listens when others are speaking
6
7
8
9
10
Works cooperatively in groups
11
12
13
14
15
Shares materials and ideas
16
17
18
19
20
Shows empathy toward peers
21
22
23
24
25
Resolves conflicts peacefully
26
27
28
29
30
Accepts feedback and correction
31
32
33
34
35
Controls impulses
36
37
38
39
40
Follows classroom rules
41
42
43
44
45
Expresses feelings appropriately
46
47
48
49
50
Overall, how would you rate the student's social skills development for their age group?
*
Very Poor
1
2
3
4
Excellent
5
1 is Very Poor, 5 is Excellent
Does the student require additional support or intervention for social skills?
*
Yes
No
Not Sure
Please provide specific examples or comments regarding the student's social interactions (optional):
Additional comments or recommendations (optional):
Submit Assessment
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