Parent Social Monitoring – Inclusive Aquatics

Parent & Session

Child name required

Observer / relationship

Session date required

Aquatics status

Activity type

How did your child communicate today?

Spoken words Gestures/pointing AAC/device Sign language Visuals/pictures

Initiates interaction with…

Coach Peers Family Rarely initiates

Notes or examples (e.g., asked a peer to play kickboard game)

Shares equipment

Waits for turn

Follows group rules

Supports/encourages peers

Accepts feedback

Resolves small conflicts

Scale: 1 = Never · 2 = Sometimes · 3 = Often · 4 = Always

Enjoyment today

Confidence in water

Independence (needs prompts)

Self‑regulation (transitions, waiting)

Notes (what helped, what was hard)

Helpful supports today

Visual schedule First‑Then prompts Peer buddy Short breaks Quieter space Preferred equipment

Notes (moments of inclusion or exclusion)

Max distance with aid (m)

Max distance without aid (m)

Next small goal

How we will support at home

Today’s story (1–3 sentences)

Parent/guardian initials

Share with coach?

Store securely and share only with your child’s coach/authorized staff, in line with local privacy rules.