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Social Skills Checklist - social skills trivia game

Social Skills Checklist-social skills trivia game

Social Skills Checklist
Name of Child: __________________________ Date Completed: _____________________________
Birth date:_______________ Teacher or Family Member Completing Form: ___________________
Based on your observations, in a variety of situations, rate the child's following skill level. Put a
check mark in the box that best represents the child's current level (scoring below).
Write additional information in the comments section.
After completing the checklist, place a check in the far right column, next to skills which are a
priority to target for instruction.
2 = Consistently/always meets criterion
The child consistently displays this skill in many occasions, settings and with a variety of people.
1 = Inconsistently/sometimes meets criterion
The child displays this skill on a few occasions, settings and with a few people.
0 = Does not/never meet criterion
The child has never or rarely displays this skill. In their daily routine, is uncommon to see the
child demonstrate this skill.
Does the Child... Scoring Comments
1.1 Beginning Play Behaviors
a. Maintain proximity to peers within 1 foot 0 1 2
During play, is proximal to peers (does not need
to be engaged in play).
b. Observe peers in play vicinity within 3 feet. 0 1 2
During play, will watch peers engaged in play.
c. Parallel play near peers using the same or 0 1 2
similar materials
Parallel play such as building with blocks next to
peer who is also playing with blocks.
d. Imitate peer (physical or verbal) 0 1 2
Imitate play actions of peer. For example, in
dramatic play, peer pretends to eat and child
imitates and pretends to eat as well. Imitate verbal
Social Skills Checklist Project DATA-University of Washington 9/2007
action of peer. For example in
e. Take turns during simple games 0 1 2
Rolls ball back and forth with peer. Plays simple
board game.
1.2 Intermediate Play Behaviors Scoring Comments *
a. Play associatively with other children 0 1 2
Shares toys and talks about the play activity even
if the play agenda of the other child may be
b. Respond to interactions from peers 0 1 2
Put out hand to accept toy from a peer. Answer
questions from peers.
c. Return and initiate greetings with peers 0 1 2
Waves hand to greet or says "hello".
d. Know acceptable ways of joining in an activity 0 1 2
with others
Observes peers at playing with blocks and asks to
join in "can I play?" or offers a block to put on
the structure they are building.
e. Invite others to play. 0 1 2
Ask a peer to play or offers toy to peer.
f. Take turns during structured games/activities 0 1 2
For social games will wait for turn and take turn
during musical chairs. For a board game, will
wait turn and take turn when appropriate.
g. Ask peers for toys, food, and materials 0 1 2
Asking (with pictures or speech) in a variety of
ways such as "Can I have ___?"
1.3 Advanced Play Behavior Scoring Comments *
a. Play cooperatively with peers 0 1 2
Take on pretend role during dramatic play, lead
the play by offering play suggestions to peers, and
follow game with rules.
b. Make comments about what he/she is playing 0 1 2
to peers
When drawing will remark, "I am drawing a
train" or when building playing with plastic
Social Skills Checklist Project DATA-University of Washington 9/2007
animals will comment, "the shark is swimming I
the ocean."
c. Organize play by suggesting play plan 0 1 2
Might suggest, "Let's make a train track and then
drive the trains."
d. Follow another peers play ideas 0 1 2
If peer suggests making a train track and drive
trains, the child will join the play to make a track.
e. Take turns during unstructured activities 0 1 2
When playing with art materials that are limited,
the child will wait for a turn for the scissors.
When playing grocery store in dramatic play, the
child will wait for turn to be the cashier.
f. Give up toys, food and materials to peers 0 1 2
If peer asks for a turn, the child will share their
toy with the peer.
g. Offer toys, food, and materials to peers 0 1 2
When playing in the sand, will offer peer shovel to
play with.
2.1 Understanding Emotions Scoring Comments *
a. Identify likes and dislikes 0 1 2
When asked if they like ice cream the child will
say yes or no. The child will be able to talk about
things they like and dislike.
b. Label and identify emotions in self 0 1 2
If their toy breaks, and the child is sad, they can
label that emotion accurately when asked, "how
do you feel?"
c. Label and identify emotions in others 0 1 2
If a peer is angry, the child will be able to say,
"he is mad."
d. Justify an emotion once identified/labeled 0 1 2
If a girl is crying the child can say she is crying
because she fell down and is hurt.
e. Demonstrate affection toward peers 0 1 2
Social Skills Checklist Project DATA-University of Washington 9/2007

What are the skills needed to be a successful social worker? IV. Relationship skills—establishing and maintaining healthy and rewarding relationships based on cooperation; resisting inappropriate social pressure; preventing, managing, and resolving interpersonal conflict; seeking help when needed Activity: Discussion questions and scenarios around healthy relationships