Child Observation Assignment

Gross-Motor Skills Development Checklist

Child: Mason Age: 5 Date Observed: 02-14-2020

To Do
Gross-Motor Skills Yes No
Walks on tiptoes
Performs a standing broad jump for 8 ½ inches
Attempts to balance on one foot
Walks to and picks up large ball
30 to 36 months Balances on one foot for five seconds
Catches a large ball with outstretched arms
Walks upstairs with alternating feet
Pedals a tricycle
Performs on to three hops with feet together
Walks toe-to-heel for four steps
Hops and stands on one foot for eight seconds X
37 to 48 months Catches a beanbag while standing X
Performs one to three hops on one foot X
Catches a bounced ball with hands X
Hops on one foot X
Walks down stairs with alternating feet Not observed

Throws a ball overhand X

Carries cup on liquid without spilling X
4 years Not observed
Rides bicycle with training wheels
Balances on one foot for ten seconds X
Skips with alternating feet X
Walks backwards toe-to-heel for four consecutive steps X
As you observe the child, put a check in the column marked yes if you observe the behavior. If
the child is unable to perform the behavior, check no. If the behavior is not observed, do not
check either column. Regardless of the child’s age, start at the first tasks in 30 to 36 months. You
can ask the child to show you these tasks, make it fun and do the checklist together.

Notes:
Mason had a hard time coordinating when asked to skip on one foot to the other. He had to pause
several times in order to complete that specific task. He had a hard time lifting his foot up and
putting it down and alternating both feet.
Mason has a hard time sitting during reading/story time. He will need several reminders to sit, or
stop fiddling with objects that are near him. When observed, he was taking his hat off his head,
tossing it up in the air, un-velcroing it and creating distractions with children next to him. He
also likes to spin and turn his body around. He doesn’t remain focused on the story-time. He isn’t
actively engaged in group discussion, unless the teacher asks him.
Child Observation Assignment
Anecdotal Record

Child: Mason Dale Age: 5 Date observed: 03-03-2020 at 10:30 am

Record an objective account of what the child does as the child is doing it.

What is the child doing? This observation took place outside on the playground.

Child runs to one side of the fence on the playground. Child runs to the tire swing. Child gets
on the tire swing and spins around in a circle. Child is able to slow the swing down by sticking
one of his legs on the ground. Child then puts both feet through the middle of the tire swing.
Child says, “spin me”. Child makes a screeching noise.
Child shakes his head back and forth. Child kicks his feet in the air and say, “aaaaa”. Child
pushes his feet on the swing and leans backwards. Child shakes his head. Child says, “aaaaa”.
Child puts his hands around the chains on the swing.
Child places his hand on a boy’s head. Child gets off the swing and says, “aaaaa”.
Child falls to his knees on the ground. Child gets up and leans on the swing. Child spins the
swing in a circle.
Child laughs and walks away from swing. Child walks back to the swing and pushes it. Child
falls to the ground. Child lands on his knees. Child kicks the swing and child hits the swing.
Child pushes boy off the swing. Child walks up to the swing and lays on it. Child walks away
from swing and then asks teacher, “can you push me”. Child says, “do it super-fast and high”.
Child laughs after being pushed on swing. Child gets off swing and walks to play structure.
Child crosses over play bridge. Child goes down swing. Child goes back upstairs and crosses
bridge. Child goes down slide. Child walks over to fence and picks up pink ball. Child takes
the pink ball and throws it. Child lines up at fence.

Notes: