Appendix:

Sample Social Skills Survey :

Social Skills
Do the children play games with peers
in a fair manner?

Do the children wait his/her turn when

playing a game with others?

Do the children share most materials

or toys with peers?

Do the children ask others age group

of children to play or extend an
invitation to join in their activity?

Do the some children accept not

being first at a game or activity or
when lining up?
Do the children have problems with
invading another persons space?
(example: getting too close,
interrupting conversations, etc.)

Do the children request what he/she

wants in an appropriate manner?

Do the children persevere when tasks

are difficult?

Do the children respect and accept

others interests and ideas?
Do the children show capacity to care
about peers?

Yes

No

Sometim
es

Comment
s

List the 5 most important social skills for the children to learn.
1._____________________________________________________________
2._____________________________________________________________
3. _____________________________________________________________
4.______________________________________________________________
5. ______________________________________________________________
Source:http://www.harborhaven.com/site/assets/files/1045/social_skills_
survey_2015.pdf
(Social Skill Survey)