Student ADHD Classroom Observation Form

Student ADHD Classroom Observation Form
Use this form to record classroom observations, attention patterns, behavior, supports used, and follow-up recommendations for a student.
Student and Observation Details
Student Name or Identifier
Observer Name and Role/Position
Classroom / Subject
Grade Level
Date of Observation
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Start Time
Hour Minutes
AM/PM Option
End Time
Hour Minutes
AM/PM Option
Observation Duration
Attention and Behavior Observation
Sustained Attention

1
2
3
4
5
6
7
8
9
10
1 is Very Limited, 10 is Highly Consistent
Task Initiation

1
2
3
4
5
6
7
8
9
10
1 is Very Difficult, 10 is Very Easy
Task Completion

1
2
3
4
5
6
7
8
9
10
1 is Rarely Completed, 10 is Fully Completed
Impulsivity

1
2
3
4
5
6
7
8
9
10
1 is Very Low, 10 is Very High
Restlessness / Fidgeting

1
2
3
4
5
6
7
8
9
10
1 is Very Low, 10 is Very High
Ability to Follow Instructions

1
2
3
4
5
6
7
8
9
10
1 is Rarely Followed, 10 is Consistently Followed
Required Prompts
Behavior by Time Period
Rows Attention Issues Impulsivity Restlessness Task Off-Track
Beginning of session
Middle of session
End of session
Triggers, Supports, and Outcomes
Known triggers or situations noticed
Other
Other trigger details
Instructional strategies and supports used
Other
Student response to supports
Peer interaction and social participation
Work environment factors observed
Other
Recommended follow-up actions or accommodations
Should be Empty:

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