Interval Sampling Recording Form

 

Student:                                 _______________________                          Date/Time: _____________________

 

Teacher:                                 ______________________                             Observer: ______________________

 

Observation Activity:         ___________________________________________________________________

 

DIRECTIONS:

White Boxes - Momentary time sampling procedures will be used to code on-task (+) or off-task (-) behavior.  Using a stopwatch, observe target student and a same-sex peer and record the observed behavior at the beginning of each 20 second interval. (Record target student observation data first.)  Compute the percentage of time on task by adding the number of +s divided by 30 and multiplying by 100 (+s/30x100).

 

Shaded Boxes Partial or Whole interval recording will be used to code additional specific behaviors of interest.  It is recommended that the observer develop a coding system prior to beginning the observation (e.g., Non-compliance C, Negative Peer Interaction P), and that the number of behaviors (codes) be limited to those of greatest interest.  If using whole interval recording, the code is marked in the interval if the behavior occurs throughout the entire 20 second interval.  If using partial interval recording, the code is entered if that behavior occurs at any point during the interval.  Indicate the behavior codes at the bottom as well as the number of times each occurred for the target and peer.

 

Interval

    1

 

    2

 

    3

 

    4

 

    5

 

    6

 

    7

 

    8

 

Target

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Peer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                     

 

Interval

    9

 

   10

 

  11

 

   12

 

   13

 

  14

 

  15

 

  16

 

Target

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Peer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                     

 

Interval

  17

 

  18

 

  19

 

  20

 

  21

 

  22

 

  23

 

  24

 

Target

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Peer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                     

 

Interval

  25

 

  26

 

  27

 

  28

 

  29

 

  30

 

Target

 

 

 

 

 

 

 

 

 

 

 

 

Peer

 

 

 

 

 

 

 

 

 

 

 

 

                           

 

Summary:____________________________________________________________________________________

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_____________________________________________________________________________________________

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