Human Observation Project Procedures AB

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Life-Span Development Observation Form

Use the following information to guide observation reporting:

Name (Your name)

Code Name (Name you assign subject observed in order to provide privacy)

Age of Subject

Date

Location

Supervisor Signature or Contact Information

Physical Development:

  • Height (use actual height if available, frequently need to estimate)

____________________________________________________

  • Weight (may use actual weight if available, frequently need to estimate)

____________________________________________________

  • Body Proportions (Example: The head is 25% of the body length, long arms, thin, frail, muscular, obese)

_______________________________________________________ _____________________________

  • Hearing (state what the subject can hear and from what distance) 

_______________________________________________________ _____________________________

  • Vision (state what the subject saw, distance, and conditions)

_______________________________________________________ _____________________________

  • Tactile Sensitivity (describe what they touched and their response to touching something or being touched)

    • ________________________________________________________________________

    Motor Development:

Fine Motor Skills (small muscle movement such as picking up items, writing, or drawing)

___________________________________________________ ______________________________

  • Gross Motor Skills (large muscle movement such as running, jumping, walking, or climbing)

_________________________________________________________________________________

  • Physical Strength (lifting books, moving a desk, running five miles. Describe the movement and object moved.)

___________________________________________________ ______________________________

  • Eye Hand Coordination (must include eyes and hands as in writing, eating, catching a ball)

_________________________________________________________________________________

Cognitive Development:

  • Attention (be specific. was subject listening, watching, conversing, writing…? How long?)

    • _________________________________________________________________________________

  • Short Term Memory (must be 30 seconds or less)

_________________________________________________________________________________

  • Long Term Memory (may be permanent memory. recall events from the past?)

    • _________________________________________________________________________________

  • Problem Solving (Example - When the paint spilled, the subject grabbed the paper towels and quickly wiped up the spill.)

_________________________________________________________________________________

  • Abstraction (adolescents and adults only) (reflects the use of a representational system. The subject may be observed to solve problems with words rather than having to use trial and error or manipulation of objects. Use of imagination may be displayed.)

_________________________________________________________________________________

  • Imagination (early childhood and elementary) (Example: The subject pretended to be a rabbit and hopped with hands held in front of his chest as if they were paws.)

_________________________________________________________________________________

  • Cognitive Strengths (Example: The subject listened to the coach and carried out the play without error.)

_________________________________________________________________________________

  • Cognitive Weaknesses (Example: Subject picked up the blocks but did not recall the correct shelf on which they were stored.)

_________________________________________________________________________________

Language Development:

  • Receptive Language/Language Comprehension (understanding, comprehension) (Can the subject follow a complex direction? Did he respond to specific terms?)

_________________________________________________________________________________

  • Expressive Language/Spoken or Written Language (verbal, gesture) (specific sentence produced by the subject as examples. Examples: Want drink! Make Joey get off of the tricycle, it’s my turn.)

_________________________________________________________________________________

  • Vocabulary (List of specific words)

________________________________________________________________________________

Grammar/Syntax (Another sentence produced by subject. Try to capture grammatic structure.)

___________________________________________________________ ______________________

  • Articulation (How words are pronounced. Example: My bwofer an my thithter aw wittulu dan me. I have a wittle wed wagon.)

    • _________________________________________________________________________________

    • Voice Quality (Rising and falling of the voice for statements, questions. This is not loudness.)

    _________________________________________________________________________________

    • Rhythm (Hesitate to speak, stutter, pause)

    _________________________________________________________________________________

    • Pragmatics (choice of words, body language, physical distance, loudness of the voice)

    _________________________________________________________________________________

    Soci oe motional Development:

    • Sense of self (specific examples of defense of personal space, ownership, use of “I”, concern for appearance)

    _________________________________________________________________________________

    • Interaction with Authority Figures (Example - "Little Red" lowered his eyes to the floor when spoken to by an adult. The “Teacher” imitated her teacher’s voice and stance.)

    _________________________________________________________________________________

    • Interaction with Peers (Example -The "Terror" shouted directions to his peers on the playground and insisted on leadership in all activities.)

    _________________________________________________________________________________

    • Interaction with Males (Example - "Little Red" avoided males in the classroom and on the playground.)

      • _________________________________________________________________________________

      Interaction with Females (Examples -"Good Grammar" called on more girls than boys when asking questions of her fifth grade class. “Athlete” looked at girls, smiled at girls, but never spoke to girls.)

    _________________________________________________________________________________