Early Childhood Education Event Sample Form Child’s initials:

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Early Childhood Education
Event Sample Form
Child’s initials: CM
Observer: LP
Period of Observation: XXXX-XXXX
Age group: 3-5 Years
Course: EARL 112
Center/Room: Head Start/Preschool Room Context: Social-Emotional Development
Purpose: Document your ability to observe and assess the causes of children’s behavior and to
plan responses to promote development (Standard 3)
Date/Time
Antecedent Event
Behavior
Consequent Event
Feb. 2/10:00 CM was watering plants
CM put the watering can
LP came over and put
at the window. His hand
on the table and pushed
her arm on CM’s
moved and water poured
two other cups of plants
shoulder and said, “It’s
out all over the
off the windowsill.
okay, it was just a little
windowsill.
spill. Can you help me
clean up the windowsill?”
Feb. 10/8:30
CM was playing with the
Lincoln Logs. BF joined
him and accidentally
knocked a few pieces off
the building.
CM said to BF, “You
dum-dum!” He then
knocked all the pieces off
and threw himself on the
rug.
LP came over and gently
rubbed CM’s back until
he calmed down, then
she said, “Let’s ask BF if
she wants to help you
make the building
again.”
Assessment: What did you learn about the cause of the child’s behavior?
CM seems to get upset very easily at either himself or others when his play or work gets
disturbed. He seems to react by using socially unacceptable behaviors.
Extension: How would you respond to help the child and adults change their behavior?
LP can remind CM that it is okay to make mistakes and that we can help each other to solve
problems. This would help CM to sustain efforts in spite of failure. This would also build
community.
LP can remind CM to use friendly words rather than hurtful words to express emotions. This
would help CM to gain emotional self-control and learn socially acceptable behaviors.
Instructor feedback on your next learning goals:
__ Specific, accurate, detailed, non-judgmental language
__ Professional literacy/communication
__ Observation linked to child development and learning
__ Assessment linked to planning responses to child
4
4
4
4
3
3
3
3
Key: 4 = Proficient; 3 = Developing; 2 = Emerging; 0 = Not Present
2
2
2
2
0
0
0
0
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