THE SCHOOL DISTRICT OF PALM BEACH COUNTY
DEPARTMENT OF EXCEPTIONAL STUDENT EDUCATION
Communication Skills Checklist for Parents/Guardians and Teachers
Student ID First Name Middle Last Name Birth Date
Current Date
Gender Grade School
Describe the Typical Learning Environment
Childcare Center Classroom Home Play Area Structured Activity
Listening Comprehension
1.
Yes No Unknown
2.
4.
3.
5.
6.
7.
8.
9.
Responds to their name
Imitates others (e.g., claps hands)
Shows understanding of simple requests (e.g., get ball)
Shows understanding of inhibitory works (e.g., stop, don't, no)
Confirms understanding of information presented orally
Confirms understanding of question words (e.g., knows who=person,
where=place, when=time)
Demonstrates understanding of common prepositions (e.g., to, from, in,
out, on, off, for, of, by, with)
Identifies meanings of multiple meaning words (e.g., duck=bird, and
duck=bend under)
Sorts common objects into categories (e.g., toys, foods)
Give Examples/Descriptions:
Oral Expression
1.
Yes No Unknown
2.
4.
3.
5.
6.
7.
8.
9.
Observer Title
Uses gestures instead of words to express wants/needs (e.g., points to
or brings adult to desired item)
Uses single words to express wants/needs (e.g., up, no, juice)
Uses 2-3 word phrases (e.g., big truck, want more choice)
Recounts or describes key details from a story
Summarizes information presented orally
Recalls information from experiences to answer a question
Describes familiar people, places, things
Expresses thoughts, feelings, and ideas clearly
Uses frequently occurring nouns and verbs
10.
11.
12.
13.
14.
Uses pronouns (e.g., I, me, my, mine, you, he, him, she, her, they,
them, we)
Forms regular plural nouns orally by adding /s/ or /es/ (e.g., dog/dogs;
wish/wishes)
Uses question words, (e.g., who, what ,where, when, why, how)
Answers question words with correct response type (e.g., when asked
who, answers with a person; when asked where, answers with a location)
Uses the most frequently occuring prepositions (e.g., to, from, in, out,
on, off, for, of, by, with)
Give Examples/Descriptions:
PBSD 0841 (Rev. 10/20/2017) ORIGINAL - Student's ESE Working File Page 1 of 8