Child Engagement Assessment Form
Please complete the Child Engagement Assessment Form to help us understand and improve engagement in child-focused activities. Your feedback is valuable.
Session or Activity Name
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child's Age Group
*
Please Select
Under 5
5-7
8-10
11-13
14+
Overall Engagement Level
*
1
2
3
4
5
Please rate the following aspects of engagement:
*
Rows
Not at all
Rarely
Sometimes
Often
Always
Attention/Focus
1
2
3
4
5
Active Participation
6
7
8
9
10
Enthusiasm
11
12
13
14
15
Interaction with Others
16
17
18
19
20
How likely is the child to recommend this activity to others?
*
Not likely
1
2
3
4
5
6
7
8
9
Very likely
10
1 is Not likely, 10 is Very likely
Select the engagement indicators you observed (select all that apply):
Smiling/Laughing
Asking Questions
Initiating Activities
Helping Others
Other
What did the child enjoy most about the activity?
Suggestions for improving engagement:
Additional Comments
Submit Assessment
Should be Empty: