Name: Date:

Differentiation Use For: Directions for Use:

Differentiation (Curriculum Based) Observation Collect teacher action and student response in
Observation Tool How are the needs of each level of learner being met? relation to each level of learners.
(It may be helpful to have colored dots to identify
levels of students for the observation).

Below Level Average Above Average

Teacher Action Student Response Teacher Action Student Response Teacher Action Student Response

Objective

Domain I: Instruction and Assessment Domain II: Planning and Preparation

○The educator uses a variety of instructional strategies. ○The educator plans and prepares for the needs of diverse learners.
○The educator involves students in meaningful learning.
○The educator makes reasonable and appropriate individual accommodations. Domain III: Learning Environment
○ The educator advocates, nurtures, and sustains a culture for learning.

©Annette Brinkman/Becky Hatch Tab 6: Data Collection Tools

Great Beginnings, Granite District