Special Education Observation Form
Use this form to document a structured observation of a student’s learning, participation, behavior, and support needs in a special education setting.
Observation Details
Observer Name
*
First Name
Last Name
Observer Role
*
Date of Observation
*
-
Month
-
Day
Year
Date
Observation Start Time
Hour Minutes
AM
PM
AM/PM Option
Observation End Time
Hour Minutes
AM
PM
AM/PM Option
School/Site
*
Classroom or Setting
*
Please Select
General Education Classroom
Special Education Classroom
Resource Room
Inclusive Classroom
Lunchroom
Playground
Hallway
Other
Grade Level
*
Please Select
Pre-K
K
1
2
3
4
5
6
7
8
9
10
11
12
Postsecondary
Other
Student Name or Identifier
*
Observation Type / Purpose
*
Baseline Assessment
Progress Monitoring
Behavior Observation
Academic Observation
IEP Review
Transition Planning
Other
Student Learning and Behavior Observation
Target Skill/Behavior Observed
*
Reading
Writing
Math
Communication
Social Skills
Attention/Focus
Task Completion
Self-Regulation
Behavior Regulation
Fine Motor
Gross Motor
Other
Frequency of Behavior
*
Rarely
1
2
3
4
Very Often
5
1 is Rarely, 5 is Very Often
Duration of Behavior
Brief
1
2
3
4
Extended
5
1 is Brief, 5 is Extended
Intensity of Behavior
Mild
1
2
3
4
Severe
5
1 is Mild, 5 is Severe
Student Engagement Level
*
1
2
3
4
5
Peer Interaction
1
2
3
4
5
Response to Instruction or Redirection
*
Followed independently
Followed with minimal prompting
Followed with repeated prompting
Resisted or did not respond
Not observed
Accommodations/Modifications Present
Preferential seating
Visual supports
Extended time
Reduced workload
Chunked directions
Assistive technology
Small-group instruction
Frequent breaks
Behavior support plan
Other
Prompts/Supports Used
Verbal prompt
Visual prompt
Gesture prompt
Modeling
Physical assistance
Peer support
Repetition of directions
Positive reinforcement
Choice-making
Other
Observed Strengths
Areas Needing Support
Moment-by-Moment Notes / ABC Observations
Summary and Follow-Up
Overall impression
*
Next steps / recommendations
Classroom accommodations
Behavior support plan
Instructional adjustments
Family communication
Team meeting
Specialist consultation
Other
Need for follow-up observation or referral
*
Follow-up observation needed
Refer for additional support
No further action at this time
Follow-up notes / action items
Additional comments for support planning
Submit Observation
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