BEHAVIORAL PSYCHOLOGICAL OBSERVATION SHEET

Student's name:________________________________________________________________

Age_______ Classroom:________________________________ Date___________________________

CONDUCT IN CLASSES

SOMETI
No. CONDUCT ALWAYS MES NEVER
1 Unstable and non-persistent attention
2 Has constant motor agitation
3 Constantly leaves the seat without permission
4 Does not obey what is told to him
5 Persists in inappropriate behaviors, does not analyze situations
6 Responds aggressively to the slightest obstacle
7 He constantly attacks his colleagues for no reason.
8 Excessively capricious
9 Abandon your tasks
10 Disrupt classes for any reason
11 Uses screaming or crying to make yourself heard
12 Injures himself (scratches, digs, picks scabs, etc.)
13 When you talk to him he seems not to listen
14 Tends to leave the classroom frequently
15 Demand immediate satisfaction of your requirements
16 Tends to break and/or throw objects

SCHOOLWORK AND GROUP PARTICIPATION

SOMETI
No. CONDUCT ALWAYS MES NEVER
1 Does not comply with the rules of coexistence
2 Does not adapt to various forms of group work
3 Shows rejection of interpersonal contact
4 Not accepted by the group
5 Inappropriate and/or destructive work habits
6 Your work activity is of very short duration
7 Work habits are outside your interests
8 He throws tantrums
9 Does not tolerate group interaction
10 Executes reckless and risky behavior for their integrity
11 Learning requires work and individual control
12 It is difficult for him to continue a gaming activity
13 Has difficulty waiting his turn
14 Tendency to dominate one's partner or group
Frequently changes activities without completing the previous
15 one
16 Has low tolerance for frustration

OBSERVATIONS______________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________

Psych. From college: Mail: Phone:

_________________________ ____________________________ ________________

CONNERS TEST FOR TEACHERS

Comparing the child(ren) with their classmates, mark with an

0 1 2 3
1. He is restless, too active
2. He is impulsive, he starts doing things without thinking
3. He likes to bother other children
4. You generally DO NOT finish what you start
5. He constantly moves in the chair
6. He is inattentive, easily distracted
7. You have to listen to him immediately, if he doesn't get angry
8. Cry easily and frequently
9. Changes mood suddenly
10. Throws tantrums, has explosive and unpredictable behavior.

What behavioral problem do you have with him

(her)?...................................... ..................................................

………………………………………………………………………………………………………………………………………………………….

Do you consider that your academic performance is in accordance with your

ability?................................... ...

Because?.............................................. .................................................. ................................................

Do you think that by improving your level of attention and concentration your school performance
will be more adequate?

…………………………………………………………………………………………………………………………………………………………..

Suggestions that you would

propose………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………..
REPORT SHEET
DEAR TEACHERS:
I am evaluating the child……………………………………………………………………………………………………........ ......
And for a better diagnosis and treatment, I would greatly appreciate it if you filled out the following:
Grade in which you study:…………………………………… Number of students……… Course……….................
Student performance in relation to their course: Good…………. Regular……………… Low………………..
Is he a sociable child? Does he have friends his age? …………………………………………
Are you very nervous?.......... Are you scared or have exaggerated fears?.........do you cry about
everything?...............
If there was a ranking of grades, what position would you be in? ……………………………………………………………
PLEASE NOTE YOUR EMAIL…………………………………………………………………………………………………………..

ATTITUDES OUTSIDE THE CLASSROOM

At recess: play with others……………….. Prefers to play alone……………….. They isolate it…………………
Has difficulty understanding age-appropriate social norms…………………………
In his social behavior he seems to be a “strange” introvert or different from other children………
When talking to him, he usually looks in the eyes…….. Has obsessions or mania for order………
He gets along better with adults or children older than him……………………………………………………………………..
Do you have tantrums or exaggerated behavior (anger) in relation to your age or the cause that
provoked it?................................... .................................................. .................................................. .........

REGARDING YOUR LEARNING (Comparing it with your peers)

In which course or activity are you most successful? ………………………………………………………………………
In which course or activity do you have the greatest failure? …………………………………………………………………..
What activity do you prefer? ……………………………………………………………………………………………………………
Do you speak coherently and fluently? …………Do you understand what he says? …………………………………….
Do you stutter? …………………………………. Is he clumsy in his movements? …………………………………….
The reading for his age is: Good ……………………. Not very fluid…………………. Syllabeant……………….
When reading: Do you omit letters or words? ……… Do you confuse letters? ………Do you understand
what he says?......
The handwriting for his age is: Good ………………………. Average…………………… Poor…………………………
Do you have difficulty copying what is written on the board in
time?................................................... ................
Do you find it difficult to write dictation?...................Do you make many spelling
mistakes?................. .........
Mathematics performance for his age is: Good …………. Regular………….. Bad………………
Do you write the numbers correctly? ………………. Do you respect the columns?................................
Considering the grade he is in, he has trouble: Counting?............... Add?...............
Subtract?.............. Multiply?................ Divide?............... other details ………………………….......
…………………………………………………………………………………………………………………………………………………..