Student Name *

First Name

Last Name

Date Completed

MM

DD

YYYY

Form completed by:

First Name

Last Name

1. Can play in a group and extend/elaborate games

Working Towards

Mastered

2. Initiates/elaborates on play

Working Towards

Mastered

3. Responds to what others are saying/doing during play

Working Towards

Mastered

4. Has formed good relationships with peers and familiar adults

Working Towards

Mastered

5. Enjoys responsibility of carrying out tasks

Working Towards

Mastered

6. Confidently talks to other children

Working Towards

Mastered

7. Aware of own feelings and that their actions and words can hurt others

Working Towards

Mastered

8. Takes turns, begins to share when appropriate

Working Towards

Mastered

9. Can tolerate a delay in getting what they want

Working Towards

Mastered

10. Can usually adapt behaviour to different events, social situations, and changes in routine

Working Towards

Mastered

1. Listens to stories with increasing attention and recall

Working Towards

Mastered

2. Joins in with repeated refrains and anticipates events and phrases

Working Towards

Mastered

3. Can follow two step directions

Working Towards

Mastered

4. Beginning to understand why and how questions

Working Towards

Mastered

5. Can retell events in correct order

Working Towards

Mastered

6. Uses a range of tenses

Working Towards

Mastered

7. Uses intonation, rhythm and phrasing when talking to make meaning clear to others

Working Towards

Mastered

8. Uses language to connect ideas, explain what is happening, anticipate what will happen next, recall and relive past experiences

Working Towards

Mastered

9. Has an understanding of prepositions

Working Towards

Mastered

1. Moves freely in a variety of ways

Working Towards

Mastered

2. Walks up and down stairs with alternating feet

Working Towards

Mastered

3. Can stand on one foot

Working Towards

Mastered

4. Catches a ball

Working Towards

Mastered

5. Uses scissors to snip paper

Working Towards

Mastered

6. Uses a pincer grip when holding a pencil

Working Towards

Mastered

7. Aware and can communicate when hungry or tired

Working Towards

Mastered

8. Observes the effect of activity on their body

Working Towards

Mastered

9. Dresses self with some help

Working Towards

Mastered