BEHAVIOUR CHECKLIST FOR PRIMARY SCHOOLS

SCHOOL : NAME OF PUPIL: TEACHER: CLASS: DATE COMPLETED:

.. ..

INSTRUCTIONS
THE BEHAVIOUR OF THE ABOVE PUPIL IS BEING ASSESSED. WHEN COMPLETING THE CHECKLIST PLEASE CONSIDER THE PUPILS RECENT BEHAVIOUR. ADDITIONAL INFORMATION MAY BE RECORDED ON A SEPARATE SHEET.

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ACADEMIC BEHAVIOUR

Please rate each behaviour on the following scale:G-Good 1 -No cause for concern 2 Mild cause for concern 3 Serious cause for concern G 1 2 3 G 1 A1 Following written instructions A2 Following verbal instructions A3 Settling to work A4 Working without direct supervision A5 Classwork:- Written A6 Classwork:- Practical A7 Classwork:- Discussion A8 Classwork:- Groupwork A9 Task Completion A10 Presentation of Work

RULES AND ROUTINES

Please rate each behaviour on the following scale:G-Good 1-No Cause for concern 2-Mild cause for concern 3-Serious cause for concern Rules G 1 2 3 Routines G 1 B1 Follows rules of the classroom B6 Hanging up coat/bag* B2 B7 Entering/leaving* room B3 B8 Starting/finishing* an 1 2 activity B4 B9 distributing materials 1 2 B5 B10 Seeking/waiting* for teacher 1 2 assistance B2 to B5 please insert 4 rules of your classroom and rate pupil compliance on the scale G,1,2 described above . * Delete as appropriate.

3 3 G

G G 1

and 3

VERBAL/NOISY BEHAVIOURS

Please rate each behaviour on the following scale 1 -No cause for concern 2 Mild cause for concern 3 Serious cause for concern 1 2 3 C1 Taps/Bangs*on desk/table* C2 Moves furniture C3 Calls/Shouts* to teacher C4 Inappropriate comments to teacher C5 Talks/shouts*to pupils C6 Talks/mutters*to self C7 Sings inappropriately C8 Whistles inappropriately C9 Makes non verbal noises C10 Giggles/laughs* inappropriately

IN SEAT/OUT OF SEAT BEHAVIOURS

Please rate each behaviour on the following scale:1 No cause for concern 2 Mild cause for concern 3 Serious cause for concern 1 2 3 D1 Turns/rocks in*seat D2 Sits out of position in seat D3 Fidgets/shuffles* in seat D5 Changes seat D7 Runs about classroom D9 Stamps feet *Delete if/as appropriate D4 Stands up out of seat D6 Moves from seat/walks about* D8 Lies/crawls on floor* D10 Climbs on furniture

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E AGGRESSIVE/DESTRUCTIVE BEHAVIOUR
Please rate each behaviour on the following scale:1 -No cause for concern 2 Mild cause for concern 1 2 3 Pupil Orientated Ep1 Strikes other pupil(s) Ep2 Kicks other pupil(s) Ep3 Pushes other pupil(s) Ep4 Trips other pupil(s) Ep5 Ep6 Ep7 Ep8 Ep9 Bites other pupil(s) Scratches other pupil(s) Pinches other pupil(s) Physically/verbally* threatens pupil(s) Damages pupil(s) property

3 Serious cause for concern 1 Teacher Orientated Et1 Argues with teacher Et2 Hits out at teacher Et3 Gives cheek to teacher Et4 Physically/verbally* threatens teacher Et5 Makes inappropriate gestures Et6 Spits/other* antisocial behaviour Et7 Uses offensive language Et8 Throws equipment/books* Et9 Writes/scribbles* others books/property* Et10 Damages others/school property* *Delete as appropriate 2 3

Ep10 Takes pupil(s) property

SOCIAL/EMOTIONAL ADJUSTMENT

Please rate each behaviour on the following scale:1 No cause for concern 2 Mild cause for concern Pupil Orientated F1 Not popular/Disliked by other pupils* F2 Often worried F3 Tends to be solitary F4 Irritable/loses temper easily* F5 Appears Unhappy/Miserable/Tearful/Distressed* F6 Sucks thumb/fingers*. Bites nails/fingers/clothes* F7 Tearful/anxious of new things/situations* F8 Over fussy/particular* F9 Passive/apathetic* F10 Unhappy/Tearful on arrival at school/school refusal*

3 Serious cause for concern 1 2 3

*delete as appropriate List in order of priority the behaviours/work skills that cause you most concern. Example: F4 F1 A3 B1

POSITIVE ATTRIBUTES

Please comment on the pupils positive personal attributes, curriculum strengths, positive peer relationships and the circumstances generally associated with acceptable behaviour. Also report the pupils extra curricular activities and involvement in community activities e.g. cubs, swimming club etc.

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SETTING FACTORS AS TRIGGERS FOR PROBLEM BEHAVIOUR

SETTING FACTORS are circumstances which are associated with certain behaviours; TRIGGERS are circumstances which elicit certain behaviours. Setting factors and triggers which promote undesirable behaviours in schools can be identified. Manipulation of setting factors and removal of triggers are therefore powerful means of preventing the occurrence of undesirable behaviours. Identify the SETTING FACTORS and TRIGGERS from the list below which may contribute to the pupils misbehaviour in the classroom. Transcribe the underlined behaviours into column 1 and then complete columns 2 and 3. 1. classroom entry and exit 6. pupils unsupervised 11. size of classroom 2.availability of 7. activity transitions 12. condition of classroom equip/resources 3. seating arrangements 8. external influences 13. Groupwork activities 4. layout of desks 9.lesson interruptions 14. curriculum 5. pupils unoccupied 10. composition of class 15. others (describe)

Column 1 Transcribe underlined Setting factors/triggers

Column 2 Can be altered or influenced. Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No

Column 3 if Yes, how?

SUMMARY
AREAS OF CONCERN 0 30 total A ACADEMIC B RULES & ROUTINES C VERBAL/NOISY D INSEAT/OUT OF SEAT Ep AGGRESSIVE/DESTRUCTIVE Et AGGRESSIVE/DESTRUCTIVE F SOCIAL & EMOTIONAL INCREASING LEVEL OF CONCERN
No Concern No Concern No concern No concern No concern No concern No concern

DEGREE OF CONCERN 10

20

i priority area of concern ii priority behaviours iii setting factors/triggers

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