OBSERVATION OF PARENT CHILD INTERACTION

Name of Child:
Date:
Name of Parent(s) observed:
# Observation Session:
Length of Time of Observation:
Name of Observer:
Place of Observation:

Ratings:

0 = Capacity never present
1 = Capacity fleetingly present
2 = Capacity intermittently present
3 = Capacity present most of the time
4 = Capacity present all the time in all circumstances

Parent(s):	Child:
0 1 2 3 4 Emotionally available to child	0 1 2 3 4 Emotionally available to parent(s)
0 1 2 3 4 Comfortable and relaxed with child	0 1 2 3 4 Comfortable and relaxed with parent(s)
0 1 2 3 4 Closes many circles of communication with child	0 1 2 3 4 Closes many circles of communication with parent(s)
0 1 2 3 4 Lets child lead in interaction	0 1 2 3 4 Take lead in interaction with parent(s)
0 1 2 3 4 Warm and accepting of child	0 1 2 3 4 Warm and accepting of parent(s)
0 1 2 3 4 Pleasing tone of voice to child	0 1 2 3 4 Responds well to tone of voice of parent(s)
0 1 2 3 4 Allows child to be assertive	0 1 2 3 4 Assertive with parent(s)
0 1 2 3 4 Encourages child's skills	0 1 2 3 4 Responds well to parent(s)'s encouragement
0 1 2 3 4 Creative interactions with child	0 1 2 3 4 Creative interactions with parent(s)
0 1 2 3 4 Maintain eye level contact with child	0 1 2 3 4 Maintain eye level contact with parent(s)
0 1 2 3 4 Enjoys interaction with child	0 1 2 3 4 Enjoys interaction with parent(s)
0 1 2 3 4 Emotionally stable with child	0 1 2 3 4 Emotionally stable with parent(s)
0 1 2 3 4 Very close in interaction with child	0 1 2 3 4 Very close in interaction with parent(s)
0 1 2 3 4 Very organized with child	0 1 2 3 4 Very organized with parent(s)
0 1 2 3 4 Varies input based on mood of child	0 1 2 3 4 Child responds to changing mood in parent(s)
0 1 2 3 4 Very interested in child	0 1 2 3 4 Very interested in parent(s)'s approach
0 1 2 3 4 Calms child with visual and verbal cues	0 1 2 3 4 Responds to parents verbal and visual cues
0 1 2 3 4 Allows child to play alone	0 1 2 3 4 Child plays alone comfortably
0 1 2 3 4 Maintains purposeful interaction with child	0 1 2 3 4 Maintains purposeful interaction with parents
0 1 2 3 4 Maintains socially meaningful behaviors with child	0 1 2 3 4 Maintains socially meaningful behaviors with parent(s)
0 1 2 3 4 Helps child do symbolic play	0 1 2 3 4 Does symbolic play with parent(s)
0 1 2 3 4 Parent in synch with child	0 1 2 3 4 Child in synch with parent(s)
Parent(s) Score	Child's Score

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