Child Play Skills Checklist Form
Review and document a child's play skills using this checklist.
Child's Full Name
*
First Name
Last Name
Child's Age
*
Date of Observation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Observer Name
*
Observer Role/Relationship
*
Please Select
Parent/Guardian
Teacher
Therapist
Other
Developmental/Play Skills Observed (Select all that apply)
*
Imaginative play (pretend, role play)
Cooperative play with peers
Turn-taking/sharing
Use of toys/tools appropriately
Problem-solving during play
Other
Briefly describe observed play behaviors
Notable strengths in play
Areas for further support or follow-up
Additional Comments
Submit Checklist
Should be Empty: