Pre-K-Kindergarten Organizational & Independent Work Skills/Motor Skills Checklist
This checklist will assist staff in determining if a student meets Other Health Disabilities or Physically Impaired criteria. It may also serve as part of an educational evaluation/re-evaluation and provide classroom teachers information to help identify student needs in organizational independent work skills that may be seen with a variety of disabilities.
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Checklist Guidelines
The following guidelines are suggested when completing the worksheet. Please compare this student to typical peers in your class.

ALWAYS - Performance in skill area meets or exceeds classroom expectations. Student is independent.

OFTEN - Student needs occasional prompting, mostly independent.

SOMETIMES - Student needs prompting approximately half the time.

RARELY - Student needs frequent prompting, mostly dependent.

NEVER - Student is totally dependent.

Comments - Comments can be made whenever an area of concern is noted. Please note strengths when appropriate. Indicate N/O if not observed.

Thank you for your time and assistance.
Date *
MM
/
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/
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Worksheet completed by: *
Student Name *
School *
Grade *
Curriculum *
Setting *
ORGANIZATION SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Follows natural environment of classroom routines
Follows classroom rules
Follows classroom schedules
Comments/Adaptations for Organizational Skills
WORK SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Follows 1-2 step directions
Attends in groups
Begins tasks/activity
Finishes task/activity within the time allotted
Knows when task/activity is complete
Corrects mistakes given verbal feedback
Transitions from one activity/setting to another with needed materials and supplies
Uses free time appropriately (chooses an activity/playmate, plays)
Participates actively in group activities/projects
Seeks adult/peer help appropriately
Comments/Adaptations for WORK SKILLS
MOTOR SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Moves through natural and school environment in a safe and timely manner (including emergency evacuations)
Demonstrates stability at table, on chair, or floor
Participates in learning movement activities similar to peers
Utilizes all natural and school environments
Meets personal needs (eating, dressing, toileting) in natural environment or school
Stabilizes paper while using pencils, crayons, and markers
Picks up, holds, turns pages of books
Manipulates play materials (puzzles, blocks)
Uses school supplies (markers, scissors, eraser, glue, paints)
Manages back pack
Stores and retrieves materials in an orderly, timely manner
Operates standard computer and mouse
Comments/Adaptations for MOTOR SKILLS
Do you have any concerns regarding this student's behavior? *
Comments
Do you have any concerns regarding this student's attendance? *
Comments
Does this student get along socially with peers? *
Comments
Does this student's disability impact peer acceptance? *
Comments
What strengths does this student have? *
Accommodations/strategies that you routinely make for this student (mark all that apply): *
Required
Other accommodations/strategies you routinely make for this student.
What other issues or concerns do you have for this student?
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