Inclusion For All™

Dedicated to including ALL people with special needs™

The Camp-For-All™ Information Center

The complete resource to help parents and professionals include ALL kids in summer camp

Provided by Jewish Community Center of Cleveland, 26001 S. Woodland Road, Beachwood, Ohio, 44122

Special Needs Classroom Observation-Teacher Interview

Camper Name _____________________________ Date _______________

School ___________________________________ Phone ______________

Teacher Name _________________________________________________

Activity Observed ______________________________________________

Observation

Physical Description

________________________________________________________________________________________________________________________

Interaction with Peers/ Interaction in Classroom Setting

________________________________________________________________________________________________________________________

Communication with others (teachers, aids, adults in the room)

________________________________________________________________________________________________________________________

Transition skills (is it easy for the child to move from activity to activity?)

________________________________________________________________________________________________________________________

Behavior

________________________________________________________________________________________________________________________

Teacher Interview:

Activities

What are the child’s most favorite activities?

________________________________________________________________________________________________________________________

What are the child’s least favorite activities?

________________________________________________________________________________________________________________________

Communication and Behavior

Describe the child’s communication skills and tendencies. – verbal skills, initiation of conversation with peers, with adults, devices, pictures, sign language.

________________________________________________________________________________________________________________________

Does the child ever become aggressive? (Temper tantrums, stubbornness, self-injurious behaviors, towards others.) What are some things that may upset the child?

________________________________________________________________________________________________________________________

What do you do to manage/prevent these behaviors?

________________________________________________________________________________________________________________________

Are their key words and phrases used in school to help child calm and relax? Are there key phrases that the child uses to regain focus or help with transitions?

________________________________________________________________________________________________________________________

Transitions and Change

What motivates the student? (activities, food, drink)

________________________________________________________________________________________________________________________

How do you let them know they are doing a good job?

________________________________________________________________________________________________________________________

How does the child transition between activities?

________________________________________________________________________________________________________________________

How does the child deal with change? How did they transition/adjust into the school year?

________________________________________________________________________________________________________________________

Would the child benefit from a picture schedule? A written schedule?

________________________________________________________________________________________________________________________

Are there any classroom/school goals that we can continue to work on throughout the summer?

________________________________________________________________________________________________________________________

Does the child have people or personalities that they work well with? (i.e. an enthusiastic energetic person vs. a laid back relaxed person? Man

vs. Woman?)

________________________________________________________________________________________________________________________

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