1
General
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
Unique Learning System materials are evident in mulple instruconal
areas of the classroom.
Standards-based instrucon reects the chronological grade band
of the students with age and ability respecul materials.
All team members show consistent responses and interacons with
individual students (e.g., wait me before prompts, responding to
communicaon forms, natural cues to encouraging independence).
Communicaon/Behavior
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
All students are presented with communicaon opportunies, including
verbal and nonverbal modes of expression.
Level of prompng is appropriate to meet the individual student’s
parcipaon levels, while maintaining the greatest level of independence
and addressing appropriate wait me.
Students are oered communicaon supports (e.g. objects, pictures, text)
and technology as needed to increase responses.
ADMINISTRATIVE TOOLS
Observaon Checklist
SCHOOL TEACHER DATE
NUMBER OF STUDENTS NUMBER OF
OBSERVATION CHECKLIST
2
Literacy/Reading
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
There is evidence of shared reading experiences, including visual supports
or voice output opons to build on student parcipaon.
There is evidence of dierenated reading instrucon to build on word
recognion and “learning-to-read” skills (e.g. word wall, phonics acvies).
Age-respecul / leveled reading materials are available and accessible
to all students.
Comprehension acvies are scaolded using a variety of formats
appropriate to the dierent levels of students (e.g. symbol support, text).
Wring Acvies
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
There is evidence of varied wring acvies for all levels of learners
including errorless wring, response to literature, book reports, topic
paragraphs and journaling acvies.
Math Acvies
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
There is evidence of math instrucon for all level of learners ranging from
errorless engagement to full independence.
Reects applicaon to real life skills (e.g., scenarios, money, measurement
and me).
Social Studies/Science Acvies
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
Lessons align with the current topic for the month and presented
in age/grade appropriate materials.
Proles/Assessments
ROUTINELY
EVIDENT
SOMEWHAT
EVIDENT
NOT
EVIDENT N/A
Student proles and assessments are completed and up to date.
Evidence of data from assessments is being ulized to drive
instruconal strategies.
OBSERVATION CHECKLIST
3
Life Skills Acvies
The following life skills instrucon was demonstrated during observaon:
Assisve Technology
The following technology was ulized during the observaon: (e.g. interacve whiteboard, voice output,
communicaon devices, alternave keyboards, switch-acvated soware, iPod
®
, iPad
®
)
1.
2.
3.
Observaon/Notes
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