Nonverbal Learning Disability Observation Form

Student Name

Date of Observation

Observer Name

1. Social Interaction

Avoids eye contact Difficulty understanding body language or facial expressions Difficulty initiating or maintaining peer interactions Does not understand jokes, sarcasm, or idioms

Notes

2. Spatial & Motor Skills

Difficulty with handwriting or using scissors Awkward or uncoordinated gait Trouble learning new motor tasks or games Drops objects frequently

Notes

3. Academic Skills

Difficulty with math concepts Trouble organizing work or materials Difficulty understanding visual information Needs directions repeated or clarified often

Notes

4. Emotional & Behavioral Observations

Easily frustrated Signs of anxiety Withdrawn or isolated Acts younger than age

Notes

5. Other Comments