Child Observation Data Form Walkthrough

Use this handy walkthrough to familiarize yourself with the Child Observation Data Form, used to record a child’s performance data.

2 Demographic information for the child and family

6 Name of developmental area

7 Child’s name

9 Note Key lists options to describe child’s performance: C, M, Q, and R

8 Score Key lists scoring options: 2, 1A, 1I, 1AI, and 0

12 Goals and objectives appear below each strand

11 Shading highlights the strands for each area

13 Column for marking AEPS-3 items that are IFSP/IEPs or other learning goals

Child’s numerical performance data

14 Child’s numerical performance data

15 Notes to describe performance, if applicable

16 Area Raw Score line is the sum of the child’s item scores in the area.

| To calculate Area Raw Score: Add the 2 and 1 scores in the Score column for the specific test date.

To calculate Area Percent Score: Divide the Area Raw Score by the Area Raw Score Possible, then multiply by 100. | | --- | --- | --- | | Test date | | | | 16Area Raw Score | | | | 17Area Raw Score Possible | 62 | 62 | 62 | | 18Area Percent Score | | |

17 Area Raw Score Possible is the number of points possible in the area. In the Fine Motor area, the Area Raw Score Possible is 62, as shown on the form (31 items x 2 points per item).

18 Area Percent Score line is the total percent the child scored in relation to the possible score in the area.

19 Test date and examiner’s name

Space for comments related to the test area. Comments should provide critical information about the circumstances under which a child performed certain skills.