Caregiver-Child Interaction Worksheet
Child’s Name: _______________________
Caregiver’s Name: ________________________
Date: ________ Description of Routine/Routines: ______________________________________
Location: __________________________ Length of Interaction sample: _______________________
Child Observation: While watching the interaction complete the table below by recording all words/
utterances and non-symbolic communicative behaviors* (NsCBs) made by the child. Also indicate the
purpose of the communication act** (behavior regulation, joint attention, or social interaction).
✔ Type of
Child’s word/utterance or non-symbolic communicative behavior
Communication Act
(NsCB). Put NsCB descriptions in parentheses.
BR
JA
SI
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Analysis:
Rate of Communication __________ = ______ utterances and NsCBs / _______ minutes
# of different words = _________ # Nouns = ____
#Adjectives = _____ # Verbs = _____
# Pronouns = ________
MLU = _________
# of NsCBs = ________
# BR = _______
# SI = _______ #JA= _______
Created by Heather Moore, Ph.D. for use at the Young Child Assessment and Treatment Clinic at
the University of Oregon. hbmoore@uoregon.edu
Caregiver Observation: Complete the table below rating the frequency of use of the following caregiver strategies.
How Often?
n/a = the child
Questions about Specific Questions about the Interaction
doesn’t do the
Caregiver’s
behavior that
Skills
Examples/ Comments
would encourage
Did the caregiver…?
How responsive
is the caregiver?
How engaged is
the caregiver?
Can the caregiver
create
opportunities for
the child to
communicate?
Did the caregiver
use strategies
known to
encourage
communication
growth?
the parent to do it
0 = Never
1 = Rarely
2 = Occasionally
3 = Consistently
4 = Always
Respond verbally to the child’s verbal and nonverbal communication
attempts? (e.g., saying “thank you” when the child handed her something)
Respond nonverbally to the child’s verbal and nonverbal communication
attempts? (e.g., handed the child something they asked for)
Match their communication turns to the child? (i.e., was most of the
caregiver’s communication in response to something the child did or said?)
Appear to be interested in the child and what they were doing?
Appear to be encouraging their child to participate in the activity?
Put items desired by the child in-view but out-of-reach so the child had
to ask for them? Or create opportunities for the child to request
assistance?
Give the child pieces of desired items (e.g., small pieces of food, one
puzzle piece) one at a time to encourage the child to request more often?
Give the child choices between 2 or more objects to encourage the child
to verbally request?
Did the caregiver create opportunities for the child to talk in any other
way? (e.g., doing something silly)
Put words to the child’s NsCBs (verbal mapping)? (e.g., child points to
a ball and the caregiver says “ball” or the child reaches to be picked up and
the caregiver says “up”)
Expand the child’s utterances? Expansion is when the caregiver adds
just 1-2 words to what the child just said (e.g., child says “go” and the
parent responds “go outside”)
Imitate the child’s vocalizations, words, or actions?
Model a gesture, word/sign, and/or sentence with the expectation
that the child will imitate them?
Created by Heather Moore, Ph.D. for use at the Young Child Assessment and Treatment Clinic at the University of Oregon.
hbmoore@uoregon.edu
Definitions
* Non-symbolic Communicative Behaviors (NsCB). When a child communicates with the adult in a non-symbolic fashion, usually gesturing (i.e.,
without words or signs, such as “giving” a toy or “protesting” by pushing away, making a funny face to make someone laugh). The communication must be
intentional and purposeful (i.e. it must be clear the child is trying to communicate directly to another person.). Usually if there is purposeful communication
there is eye contact (may be brief) with the communication partner. Credit is not typically given if the child is just following a direction (e.g. giving something
when asked to give it or taking something that is handed to him) unless the child adds something very communicative to it (e.g. looking right at the person and
laughing as they give the object). A good question to ask yourself is, “what is the child trying to communicate?” If you can’t answer the question then it’s not a
communicative behavior.
** Communication Acts
 Joint attention (JA) – includes the following child behaviors: showing, commenting, requesting information, answering questions.
 Behavior regulation (BR) – includes the following child behaviors: protesting, requesting objects or actions
 Social interaction (SI)- includes the following child behaviors: attention seeking, showing off, participation in social games, greetings,
conventions (such as “thank you” and “please”)
Created by Heather Moore, Ph.D. for use at the Young Child Assessment and Treatment Clinic at the University of Oregon.
hbmoore@uoregon.edu