Name: __________________________

_________________________

Date:

Monitoring Checklist: Organization/Study Skills - Student/Teacher Feedback

Use this checklist to evaluate organization and study skills habits. Have students self-evaluate
and re-evaluate at pre-determined intervals. Assist students in analyzing results as they pertain
to their thoughts and behaviors. This can be used to measure Social/Emotional ALP goals.
Student
Teacher
Comments
Yes
No
Yes
No
In class, I start work independently
with only occasional reminders.
At home, I start my homework
independently with only occasional
reminders.
I routinely complete classwork on time.
I routinely complete homework and
turn it in on time.
I am consistently on task.
I regularly review my work for
completeness and correctness.
I bring to school all the materials I
need to be successful (examples: read
aloud book, teacher/parent notes,
Friday Folder, planner.)
I bring home all the materials I need to
be successful (examples: read aloud
book, teacher/parent notes, Friday
Folder, planner.)
I bring to each class the materials I
need to learn.
I regularly prepare for assessments
using appropriate study materials.
At school, I keep my work space mostly
organized and free of distractions.
I have a regular space at home to do
homework that is free from
distractions.
I am able to select what I need to do
first based on importance.
I take care of my needs to block out
noise so that I can focus.
My student planner is completely and
clearly filled out. Homework due dates
are clear.
I clean out my desk/backpack weekly
(or sooner) if I get frustrated with the
disorganization.
If I have a long-term project, I have a
plan to complete the task in
appropriate time.
I have a study method to help me
remember information and prepare for
assessments.
Social & Emotional: Affective Needs All levels

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Name: __________________________
_________________________
I have an efficient and effective way to
take notes.
My commitments outside of school do
not interfere with my ability to study or
complete work.

Date:

Analysis of Monitoring Checklist

Total
Number of
Student
Yes
Responses:

Total
Number of
Teacher
Yes
Responses:

Total
Number of
Parent Yes
Responses
(when
applicable):

Total
Number of
Yes
Responses:

____/20

____/18_

____/14_

____/_52__

Interventions Used:
___ Backpack/Folder Organization
___ Develop plan for organization (planner)
___ Weekly/Monthly Check-in with counselor
___ Enrollment into support class
___ Direct instruction (see Organization Study Skills_Teacher Information)
___ Class discussion (see Organization Study Skills_Teacher Information)
___School Counselor/Psychologist meetings
___ Other (please explain):

Comments:

Social & Emotional: Affective Needs All levels

Page 2 of 3

Name: __________________________
Date:
_________________________
Monitoring Checklist: Organization & Study Skills - Parent Feedback (Optional)
Please use this checklist to evaluate your childs use of organization & study skills at home.
Yes

No

Comments

At home, my child starts their

homework independently with only
occasional reminders.
My child routinely completes
homework and turns it in on time.
My child is consistently on task.
My child regularly reviews their work
for completeness and correctness.
My child takes to school all the
materials they need to be successful
(examples: read aloud book,
teacher/parent notes, Friday Folder,
planner.)
My child brings home all the materials
they need to be successful (examples:
read aloud book, teacher/parent notes,
Friday Folder, planner.)
My child regularly prepares for
assessments using appropriate study
materials.
My child has a regular space at home
to do homework that is free from
distractions.
My child is able to select what they
need to do first based on importance.
My child takes care of their needs to
block out noise so that they can focus.
My childs planner is completely and
clearly filled out. Homework due dates
are clear.
My child cleans out their
desk/backpack weekly (or sooner) if
they get frustrated with the
disorganization.
If my child has a long-term project,
they have a plan to complete the task
in appropriate time.
My childs commitments outside of
school do not interfere with their ability
to study or complete work.

Social & Emotional: Affective Needs All levels

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