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Name of Activity:

Time Out Worksheet/Assessment

Purpose of Activity:

To have the student, through writing, identify and think about his/her chosen behavior that resulted in being placed in time out.

Suggested Grade Level:


Materials Needed:

This assessment sheet (which you can print out from here) and writing utensils for the students.

Time Needed to Complete:

To be completed during the length of the time out.

Description of Idea

Use this assessment sheet when you have a child that you have put in a time out.

Submitted by Crystal Coffman Thanks for contributing to PE Central! Posted on PEC: 3/20/2014.
Viewed 100336 times since 8/24/2001.

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Time Out Worksheet/Assessment

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