NDS Teacher Observation Questionnaire Step 1 of 9 11% Child's Name First Last Date of Birth Day Month Year Address Street Address Address Line 2 City Postcode SchoolYear GroupHow long have you known this child? Academic Attainment – Which specific age range are they working towards? Please provide us with the child’s latest educational attainments. If the child has been seen by an Educational Therapist, please attach the report below.Upload the report OptionalMax. file size: 1 GB.MathEnglishOther Subjects Optional Please give examples and comments for each question in the space provided.Social Communication SkillsThe tools the child uses to communicate with others including attention, listening, speech, language and non-verbal communication skills such as eye contact, facial expression and gesture.1. Does your child/young person have language difficulties?This includes understanding others, putting their idea ‘s together in an order that’s easy to understand or not talking in certain situations.2. Does your child/young person have unusual use of intonation?This is the sound including pitch / tone of their voice. This includes high or unusual pitch , unusual stress patterns over certain words or letters etc.3. Does your child/young person copy language from their environment?This is called Echolalia. This may include copying language directly from others or from the TV or internet.4. Does your child/young person refer to him/herself as "you", "she" or "he "or have any other difficulties with personal pronouns?This includes referring to themselves by their name.5. Does your child/young person use any unusual words for his/her age or social group that may make his/her speech sound unusual?For example, they sound too formal or speak with an accent not linked to their heritage etc.6. Does your child / young person have any difficulties using language to communicate their needs?This includes when they are frustrated or when you have introduced them to something new.7. Does your child/young person talk mainly about his/her own specific topics of interest?Things they really enjoy e.g., Pokémon, without asking about things others like.Any additional comments regarding communication skills Optional Social InteractionYour child’s relationships with other people to including other family members, siblings and friends.1. Does your child/young person have any difficulties with joining in with play or an activity with other children or do they make inappropriate attempts to join in play with others?This includes aggressive or disruptive behaviour and difficulties with sharing or playing alongside others.2. Does your child/young person have a lack of awareness of social norms?For example, commenting on people’s personal appearance or not picking up on social cues.3. Does your child/young person become over-whelmed in social situations?Possibly withdraw or cling to a parent / carer etc.4. Does your child/young person have any unusual characteristics about their interaction with adults?This includes intense relationships, preferring to spend time with adults over others of the same age or difficulties in forming relationships with adults.5. Does the child/young person get upset by people being in his/her personal space or being rushed to complete something or when a task has to be left unfinished?6. Does the child use any unusual non-verbal communication?For example, poor eye contact and/or lack of a range of facial expressions and use of gestures.Any additional comments regarding social interaction skills Optional Flexible BehaviourTo include repetitive behaviours, need for routines and obsessions and imagination.1. Does your child/young person have difficulties with imagination/ creativity?This may show as difficulty with imaginative play or role play or difficulty with creative writing.2. Does your child/young person have difficulties managing during times which are unstructured?For example, free play in a park, during holiday periods when the day is not structured etc.3. Does your child/young person have any difficulties with managing 'change' or unstructured situations such changes to things which have been planned or going to new places?Additional comments regarding flexible behaviour/obsessive behaviour and imagination: Optional Hyperactive / Impulsive BehaviourThe child’s level of activity and ability to manage in a classroom setting.1. Is your child / young person able to remain in their seat for the duration for an extended period of time e.g. at the dinner table, in the cinema, watching TV etc.?Please consider whether they frequently get up for toilet breaks, make excuses to move, swing their legs excessively under the table.2. Does your child / young person engage in fiddling or fidgeting behaviour when they are expected to remain seated?This may include needing to use blue tac to roll between fingers or frequently picking up things to fiddle or play with.3. Does your child / young person cross the road safely and able to stop and wait for traffic to pass?4. How does your child/ young person manage during quiet activities such as reading, completing homework etc.?5. Is your child / young person able to queue up for example, in the supermarket or shop or when waiting for an activity?If they struggle with queuing, please give details of the behaviour you notice.5. Is your child / young person able to queue up for example, in the supermarket or shop or when waiting for an activity?If they struggle with queuing, please give details of the behaviour you notice. Inattentive BehaviourThe child’s ability to maintain focus. 1. Is your child / young person able to concentrate at home at an age expected level?2. Does your child / young person engage in mind wandering / day dreaming type behaviour?3. Does your child/ young person frequently lose things at home and / or forget instructions they have been given?4. If homework is given, does your child / young person hand it in on time on most occasions?Please also comment if they frequently forget to write it down.Additional comments regarding hyperactive / impulsive / inattentive behaviour: Optional General Behaviour1) Please comment on the general behaviour of your child/young person when they are at home2) Do they ever experience intense emotions?Please give examples. For example, become very upset / angry / worried when asked to do a small job. ADHD RS-IV: Home VersionThe following questionnaire can help us better understand the needs of your child. Please answer to the questions to the best of your ability.Select which best describes your child / young person’s home behaviour over the past 6 months.1. Fails to give close attention to details or makes careless mistakes in schoolworkSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)2. Fidgets with hands or feet or squirms in seatSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)3. Has difficulty sustaining attention in tasks or play activitiesSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)4. Leaves seat in classroom or in other situations in which remaining seated is expectedSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)5. Does not seem to listen when spoken to directlySelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)5. Does not seem to listen when spoken to directlySelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3) Select which best describes the child / young person’s classroom behaviour over the past 6 months.6. Runs about or climbs excessively in situations in which it is inappropriateSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)7. Does not follow through on instructions and fails to finish workSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)8. Has difficulty playing or engaging in leisure activities quietlySelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)9. Has difficulty organising tasks and activitiesSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)10. Is "on the go" or acts as if "driven by a motor"Select an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)11. Avoids tasks (e.g. schoolwork, homework) that require sustained mental effortSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)12. Talks excessivelySelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)13. Loses things necessary for tasks or activitiesSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)14. Blurts out answers before questions have been completedSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)15. Is easily distractedSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)16. Has difficulty awaiting turnSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)17. Is forgetful in daily activitiesSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3)18. Interrupts or intrudes on othersSelect an oprionNever or rarely (0)Sometimes (1)Often (2)Very Often (3) Other Factors1. Please describe the child's recent progress at school. Consider, does the child have an unusual profile of strengths and weaknesses?Please specify.2. Does the child/young person have an unusual response to sensory stimuli?Please give examples. For example, loud noises, smells, light, reflections etc.3. Does your child/young person have any co-ordination difficulties?Please give examples. For example, can be very clumsy or have difficulty handwriting.4. Please describe your view on your child / young person self-esteem?5. Does your child / young person present as having tics?These are movements they may not realise are happening which can occur in their face or throughout the body which your child / young person does not have control of.6. Does your child / young person experience any health-related needs which you feel may impact on classroom learning?Please describe.7. Are there any other factors which you are aware of (e.g. school or home) which you feel may impact on your child / young person's classroom learning and interactions?Any other information you would like to add that would help us understanding your child/young person's needs? OptionalPlease include any additional support the child / young person may receive with the classroom, have the school behaviour support team been involved, is there an IEP in place or statement of EN in place. Other Professional InvolvementDoes the child/young person have any other professional involved with him/her? Educational PsychologistName First Optional Last Optional Contact Details OptionalOccupational TherapistName First Optional Last Optional Contact Details OptionalCAMHSName First Optional Last Optional Contact Details OptionalOtherName First Optional Last Optional Contact Details OptionalName of person completing this form First Last Designation Thank you for completing this checklist which will be used as an integral part of the assessment.Email OptionalThis field is for validation purposes and should be left unchanged.