CODF Packet 2 Page 1

Child Observation Data Form Walkthrough

Use this handy walkthrough to familiarize yourself with the Child Observation Data Form, used to record a child’s performance data.

Score Key		10
Mastery performance 2	Emergency performance 1A = Assistance 1I = Incomplete 1AI = Assistance/Incomplete	C= Conduct M= Modification Q= Quality R= Report
A. Reach, Grasp, and Release
		Target	Score	Notes	Score	Notes	Score	Notes
1. Makes directed batting or swiping movements with each hand		13	14	15		C M QR		C M QR
1.1 Brings hands together near midline			C M QR		C M QR
1.2 Makes directed movements with arms				C M QR		C M QR		C M QR
2. Grasps pea-size object				C M QR		C M QR		C M QR
2.1 Grasps hand-size object				C M QR		C M QR		C M QR
2.2 Grasps small cylindrical object				C M QR		C M QR		C M QR
2.3 Grasps pea-size object using fingers in raking or scratching movement				C M QR		C M QR		C M QR
2.4 Grasps hand-size object using whole hand				C M QR		C M QR		C M QR
3. Stacks objects				C M QR		C M QR		C M QR
3.1 Releases object into targeted space				C M QR		C M QR		C M QR
3.2 Releases object into nondefined space				C M QR		C M QR		C M QR
B. Functional Skill Use
1. Activates object with finger				C M QR		C M QR		C M QR
1.1 Uses finger to point or touch				C M QR		C M QR		C M QR
1.2 Uses hand to activate object				C M QR		C M QR		C M QR
1.3 Uses fingers to explore object				C M QR		C M QR		C M QR
2. Rotates wrist to manipulate object				C M QR		C M QR		C M QR
2.1 Turns object using either hand				C M QR		C M QR		C M QR
3. Manipulates object with two hands, each performing different action				C M QR		C M QR		C M QR
3.1 Assembles toy				C M QR		C M QR		C M QR
3.2 Aligns objects				C M QR		C M QR		C M QR

Score Key			Note Key
Mastery performance 2	Emerging performance 1A = Assistance 1I = Incomplete 1AI = Assistance/Incomplete	No performance 0	C = Conduct M = Modification Q = Quality R = Report
Exam(s)
B. Functional Skill Use (continued)				Target	Score	Notes	Score	Notes	Score	Notes
3.3 Fits variety of shapes into corresponding spaces						C MQ R		C MQ R		C MQ R
3.4 Holds object with one hand and manipulates object or produces action with other hand						C MQ R		C MQ R		C MQ R
3.5 Transfers object from hand to hand						C MQ R		C MQ R		C MQ R
C. Mechanics of Writing
1. Holds writing tool using three-finger grasp to write or draw						C MQ R		C MQ R		C MQ R
1.1 Writes or draws using mixed strokes						C MQ R		C MQ R		C MQ R
1.2 Writes or draws using curved lines						C MQ R		C MQ R		C MQ R
1.3 Writes or draws using straight lines						C MQ R		C MQ R		C MQ R
1.4 Scribbles						C MQ R		C MQ R		C MQ R
D. Use of Electronic Devices
1. Uses finger to interact with electronic device						C MQ R		C MQ R		C MQ R
1.1 Uses finger to interact with simple electronic game						C MQ R		C MQ R		C MQ R
1.2 Uses finger to interact with touch screen						C MQ R		C MQ R		C MQ R

To calculate Area Raw Score: Add the 2 and 1 scores in the Score column for the specific test date. To calculate Area Percent Score: Divide the Area Raw Score by the Area Raw Score Possible, then multiply by 100.
Test date
16Area Raw Score
17Area Raw Score Possible	62	62	62
18Area Percent Score

19 Test date and examiner’s name
Space for comments related to the test area. Comments should provide critical information about the circumstances under which a child performed certain skills.

Fine Motor
Total % correct	100
80
60	23
40
20
Test date:

Social-Communication
Total % correct	100
80
60
40
20
Test date:

Literacy
Total % correct	100
80
60
40
20
Test date:

Gross Motor
Total % correct	100
80
60
40
20
Test date:

Social-Emotional
Total % correct	100
80
60
40
20
Test date:

Cognitive
Total % correct	100
80
60
40
20
Test date:

Math
Total % correct	100
80
60
40
20
Test date: