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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced without the

express written permission of NECC.

1 |

Core Skills Assessment

An Educational Prescription for Individuals with Autism

Testing Booklet

Student Name: _________________ Date of Birth: __________________ Assessment Start Date: __________ Assessment End Date: ___________ Staff: _________________________

(2)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced without the

express written permission of NECC.

2 |

CONTENTS

Considerations

The Core Skills Assessment testing booklet is organized by testing format (i.e., discrete trial sessions, programmed opportunities, task analyses, and teacher report) to help organize implementation of the assessment. If you prefer to view a list of core skills organized by area, use the Index on pages 44 and 45 of this document.

The items may be completed in any order, so skills may be chosen for testing depending on allotted time. Matching tasks and task analyses generally require the most time to assess, while discrete trial sessions with no materials tend to take the least amount of time to assess. Skills with programmed opportunities may be assessed 1-trial at a time, so if properly planned for, each trial can be quickly implemented. The teacher report section does not require the learner to be present, and thus can be completed at any time during the assessment period.

Table of Contents

DISCRETE TRIAL SESSIONS ... 4

ATTENDING ... 5

SESSION BEHAVIOR ... 6

SIMPLE DISCRIMINATION ... 7

MATCH IDENTICAL OBJECTS ... 8

MATCH IDENTICAL PICTURES ... 9

MATCH PICTURE TO OBJECT ... 10

MATCH OBJECT TO PICTURE ... 11

ACCEPT AND REJECT ... 12

FOLLOW 1-STEP DIRECTIONS WITH VISUAL SUPPORT ... 13

FOLLOW 1-STEP DIRECTIONS IN GROUP WITH VISUAL SUPPORT ... 14

INDICATE NAMED BODY PARTS ... 15

INDICATE NAMED OBJECTS ... 16

INDICATE NAMED PICTURES ... 17

NAME OBJECTS ... 18

NAME PICTURES ... 19

FOLLOW A POINT ... 20

IMITATE ACTIONS WITH OBJECTS ... 21

IMITATE GROSS MOTOR ACTIONS ... 22

IMITATE ACTIONS WITH OBJECTS FOLLOWING A DELAY ... 23

WAIT IN THE CONTEXT OF GROUP INSTRUCTION ... 24

EAT WITH UTENSIL ... 25

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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced without the

express written permission of NECC.

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CONTENTS

PROGRAMMED OPPORTUNITIES ... 26

REQUEST NEEDED OR DESIRED ITEMS ... 27

RESPOND TO NAME... 27

RESPOND TO GREETING ... 27

REQUEST ATTENTION ... 27

REQUEST ASSISTANCE ... 27

RESPOND TO STOP ... 27

WAIT FOR PREFERRED ITEM ... 28

MAINTAIN APPROPRIATE SOCIAL DISTANCE ... 28

EAT VARIOUS FOODS ... 29

TAKE MEDICATION ... 30

PRODUCE PERSONAL IDENTIFICATION ... 30

MAINTAIN PRIVACY DURING PERSONAL HYGIENE ... 30

TASK ANALYSES ... 31

USE PICTURE OR WRITTEN SCHEDULE ... 32

SHOWER ... 33 BRUSH TEETH ... 34 WASH HANDS ... 35 DRESS ... 36 UNDRESS ... 37 WASH FACE ... 38 TEACHER REPORT ... 39 DEMONSTRATE PREFERENCES ... 40 REQUEST TERMINATION ... 41 USE CONDITIONED REINFORCERS ... 41 BLADDER TRAINED ... 41 BOWEL TRAINED... 41

TOLERATE MEDICAL PROCEDURES ... 42

EXIT GIVEN A FIRE ALARM ... 42

EXERCISE ... 42

ENGAGE IN INDEPENDENT TASK ... 42

RIDE IN CAR/VAN ... 43

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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced without the

express written permission of NECC.

4 |

Discrete Trial Sessions

The discrete trial format is used to assess isolated skills in a highly structured setting through multiple trials. In the discrete trial format, skills are broken down into smaller units of behavior. Each session contains 5-15 trials and is generally conducted in a single sitting.

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Student Name: ______________________ Date: _________

D

ISCRIMINATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

5 |

A

TTENDING

Attending: Given teacher orientation towards student, student will sit with feet on floor, hands down, oriented towards teacher or materials with no interfering motor or vocal stereotypy in 80% of opportunities.

Attending definition: Within 3-5 seconds of teacher’s orientation towards student, student sits with feet on floor, hands down, oriented towards teacher or materials with no interfering motor or vocal stereotypy. Interval begins with teacher orientation and ends with student response or 5 seconds with no response.

Establishing attending:

1. Student should be seated at the table, with chair pushed in (or body oriented towards teacher) 2. Sit facing student; demonstrate in-seat behavior and eye contact

3. DO NOT USE ANY VOCAL PROMPTS TO GAIN STUDENT’S ATTENTION (do not say student’s name, do not say “get ready”, do not say “look at me”)

4. Wait 3- 5 sec. for student to orient towards teacher or materials

5. If student orients towards teacher or materials, record + and present trial

6. If student does not attend (as defined above) use physical or gestural prompts to gain attention and record -; then present trial.

Indicate named body parts: Follow 1-step directions with visual support Imitate gross motor actions:

State instruction Attending +/-

State instruction and gesture as indicated below

Student Response

Attending +/-

State “do this” and model action

Attending +/-

1. “Touch head” 1. “Stand up” and raise hand Lifts buttocks

off chair

1. Clap hands

2. “Touch legs” 2. “Stomp foot” and point to feet Stomps foot 2. Tap table

3. “Touch arms” 3. “Get ___” (known item on table)

and gesture towards item

Grasps item 3. Arms up

Match identical pictures: Indicate named picture:

Present picture below

Then present 3-picture array

Attending +/-

State item name

Then present 3-picture array

Attending +/-

Left Middle Right Left Middle Right

1. Chips Chips Cracker Candy 1. “Chips” Chips Cracker Candy

2. Cracker Candy Chips Cracker 2. “Cracker” Candy Chips Cracker

3. Candy Cracker Candy Chips 3. “Candy” Cracker Candy Chips

Notes

(6)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

6 |

SESSION BEHAVIOR

Session behavior

: Given a 3-comparison visual array, and an immediate point prompt to the correct

comparison, the student sits, scans, and points in 89% of opportunities. Materials: 2 dimensional stimuli: 1 form, 2 blank stimuli

A = form B = blank

Instructions: Sit across from student. Present form and 2 blanks. Wait 3-5 sec for student to perform each skill in sequence (sit, scan, follow a point prompt to point to the form). If any skill is not demonstrated, use immediate full manual guidance. Record a + for each trial in which the skill sequence is demonstrated independently, or a – if any component is not.

Definitions:

 Sit: Prior to presentation of stimuli, student sits at table with buttocks on chair pushed into table, face oriented toward teacher work area; no interfering stereotypy.

 Scan: Student’s face is oriented toward comparison stimuli; no interfering stereotypy.

 Point: Student points to correct stimulus with isolated finger, then releases contact and does not touch a second stimulus in that trial. L M R Sit Scan Point + = all session

skills independent 1 B B A 2 A B B 3 B A B 4 B A B 5 B B A 6 B A B 7 A B B 8 B B A 9 A B B Score: /9 Notes

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Student Name: ______________________ Date: _________

D

ISCRIMINATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

7 |

SIMPLE DISCRIMINATION

Simple discrimination

:

Student touches the correct comparison when given a simple discrimination task with

a static sample and 2 incorrect comparisons in 89% of opportunities.

Materials:

3 form comparison cards (green square, red circle, yellow triangle) with 1 matching sample card

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Run 3 demonstration trials and provide immediate prompt (by pointing to the correct comparison). DO NOT take data on demonstration trials. For remaining trials, present sample, present comparisons, and wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a - for any other response, and an NR for no response.

A =

Green square,

B =

Red circle,

C

=

Yellow triangle

S

L

M R +/ - /NR

1 A B C A

2 A A C B

3 A C A B

4 A C A B

5 A A B C

6 A B C A

7 A C B A

8 A B A C

9 A A B C

Score: /9

Notes
(8)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

8 |

MATCH IDENTICAL OBJECTS

Match identical objects

: Given an object (sample) and an array of 3 objects (comparisons), the student touches the

correct comparison in 89% of opportunities, for a minimum of 15 objects (5 sets). Materials:

Object set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Object set 2: brush, book, spoon

Object set 3: fork, ball, cup

Object set 4: toothbrush, paper, marker Object set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a – for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9

A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

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Student Name: ______________________ Date: _________

D

ISCRIMINATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

9 |

MATCH IDENTICAL PICTURES

Match identical pictures

: Given a picture (sample) and an array of 3 pictures (comparisons), the student

touches the correct comparison in 89% of opportunities, for a minimum of 15 pictures (5 sets). Materials:

Picture set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Picture set 2: brush, book, spoon

Picture set 3: fork, ball, cup

Picture set 4: toothbrush, paper, marker Picture set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a – for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9

A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

(10)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

10 |

MATCH PICTURE TO OBJECT

Match picture to object

: Given a picture (sample) and an array of 3 objects (comparisons), the student

touches the correct comparison in 89% of opportunities, for a minimum of 5 stimulus sets. Materials: Pictures and objects of the following sets:

Set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Set 2: brush, book, spoon

Set 3: fork, ball, cup

Set 4: toothbrush, paper, marker Set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a – for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9 A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

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Student Name: ______________________ Date: _________

D

ISCRIMINATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

11 |

MATCH OBJECT TO PICTURE

Match object to picture

: Given an object (sample) and an array of 3 pictures (comparisons), the student

touches the correct comparison in 89% of opportunities, for a minimum of 5 stimulus sets. Materials: Objects and pictures of the following sets:

Set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Set 2: brush, book, spoon

Set 3: fork, ball, cup

Set 4: toothbrush, paper, marker Set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a – for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9

A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

(12)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

12 |

ACCEPT AND REJECT

Accept and reject

:

When presented with a preferred and non-preferred item the student will accept or reject

the item (take, push away, nod, shake head, “yes”, “no”) in 4/5 opportunities.

Materials:

2 highly preferred items 3 non-preferred items

Instructions:

Present 1 item at a time. Ask, “Do you want this?” Record a + if student takes the preferred item or pushes away the non-preferred items. Record a - if student takes the non-preferred item or pushes away the preferred item. Record NR for no response.

Date: Setting: Staff: +/- 1. Non-preferred item 2. Preferred item 3. Non-preferred item 4. Preferred item 5. Non-preferred item Score: /5 Notes

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Student Name: ______________________ Date: _________

C

OMMUNICATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

13 |

1-STEP DIRECTIONS

Follow 1-step directions with visual support

: Given a verbal instruction paired with a gestural cue, the

student demonstrates the action in 8/9 opportunities for at least 9 instructions.

Instructions: State the direction, gesture, and wait 3 - 5 seconds for the student to respond. Record + for correct responses, - for incorrect responses and NR for no response.

Spoken Instruction & Gesture Student Response Data +/-

1. “stand up” and raise hand upward

Lifts buttocks off chair

2. “sit down” and gesture towards chair buttocks on chair, feet on floor 3. “get (known item on table)”and gesture

toward item

Grasps item

4. “Walk to (known item)”and gesture towards item

Walks to item

5. “Come here” and curl finger Moves towards

speaker 6. “Throw away (known item)”and gesture

towards trash

Throws item away

7. “Give me 5” (while holding palm up) and hold up hand with palm facing outward

Slaps speaker’s hand

8. “Stomp feet” and point to feet Pounds feet on

floor 9. “Arms up” with palms facing up and raise

slightly

Raises arms in air

Score: /9

(14)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

14 |

1-STEP DIRECTIONS IN GROUP

Follow 1-step directions in group with visual support

: Given a verbal instruction paired with a gestural

cue in a group of two, the student demonstrates the action in 8/9 opportunities for at least 9 instructions. Environmental Arrangement: 2 students sit beside each other across from the teacher (with or without a table). Instructions: While the student is grouped with at least 1 other student, state the direction to both students, gesture, and wait 3 - 5 seconds for the target student to respond. Record + for correct unprompted responses, - for incorrect responses and NR for no response (record data for the target student only).

Spoken Instruction & Gesture Student Response Data +/-

1. “stand up” and raise hand upward

Lifts buttocks off chair

2. “sit down” and gesture towards chair buttocks on chair, feet on floor 3. “get (known item on table)”and gesture

toward item

Grasps item

4. “Walk to (known item)”and gesture towards item

Walks to item

5. “Come here” and curl finger Moves towards

speaker 6. “Throw away (known item)”and gesture

towards trash

Throws item away

7. “Give me 5” (while holding palm up) and hold up hand with palm facing outward

Slaps speaker’s hand

8. “Stomp feet” and point to feet Pounds feet on

floor 9. “Arms up” with palms facing up and raise

slightly

Raises arms in air

Score: /9

(15)

Student Name: ______________________ Date: _________

C

OMMUNICATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

15 |

INDICATE NAMED BODY PARTS

Indicate named body parts

: Given a verbal instruction, the student touches the named body part on self in

80% of opportunities for a minimum of 5 body parts.

Instructions: State, "Touch X", for each body part. Wait 3-5 seconds. Record + for correct responses, - for incorrect responses and NR for no response.

Date

Staff:

+/-

1.

“Touch head”

2.

“Touch legs”

3.

“Touch arms”

4.

“Touch stomach”

5.

“Touch feet”

Score:

/5 Notes
(16)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

16 |

INDICATE NAMED OBJECTS

Indicate named objects

: Given a spoken word (sample) and an array of 3 objects (comparisons), the student

touches the correct comparison in 89% of opportunities, for a minimum of 15 objects (5 sets). Materials:

Object set 1: chips, cracker, candy (set 1 can be changed to student’s preferred edibles) Object set 2: brush, book, spoon

Object set 3: fork, ball, cup

Object set 4: toothbrush, paper, marker Object set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a - for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9

A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

(17)

Student Name: ______________________ Date: _________

C

OMMUNICATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

17 |

INDICATE NAMED PICTURES

Indicate named pictures

: Given a spoken word (sample) and an array of 3 pictures (comparisons), the student

touches the correct comparison in 89% of opportunities, for a minimum of 15 pictures (5 sets). Materials:

Picture set 1: chips, cracker, candy (set 1 can be changed to student’s preferred edibles) Picture set 2: brush, book, spoon

Picture set 3: fork, ball, cup

Picture set 4: toothbrush, paper, marker Picture set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Present sample. Present comparisons. Wait 3-5 sec for student to respond. Record a + if the student points to correct comparison. Record a - for any other response, and an NR for no response.

A = chips, B= cracker C = candy A = brush, B= book C = spoon A = fork, B= ball C = cup

S L M R +/- NR S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 1 C A B C 2 B C A B 2 C C A B 2 A C A B 3 C B C A 3 A B C A 3 B B C A 4 B A B C 4 C A B C 4 A A B C 5 C C A B 5 A C A B 5 B C A B 6 A B C A 6 B B C A 6 C B C A 7 C A B C 7 A A B C 7 B A B C 8 A C A B 8 B C A B 8 C C A B 9 B B C A 9 C B C A 9 A B C A

Score: /9 Score: /9 Score: /9

A = toothbrush, B= paper C = marker A = soap, B= towel C = shoe

S L M R +/- NR S L M R +/- NR 1 A A B C 1 B A B C 2 B C A B 2 C C A B 3 C B C A 3 A B C A 4 B A B C 4 C A B C 5 C C A B 5 A C A B 6 A B C A 6 B B C A 7 C A B C 7 A A B C 8 A C A B 8 B C A B 9 B B C A 9 C B C A Score: /9 Score: /9 Notes DISCONTINUE

testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

(18)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

18 |

NAME OBJECTS

Name objects

:

The student names an object presented individually in 8/9 opportunities for 15 objects (5 sets).

Materials:

Object set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Object set 2: brush, book, spoon

Object set 3: fork, ball, cup

Object set 4: toothbrush, paper, marker Object set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Hold up visual stimulus in front of student and wait 3-5 sec with an expectant look for student to respond. Record a + if student correctly names stimulus. Record a - for any other response, and NR for no response.

A = chips, B = cracker, C = candy A = brush, B = book, C = spoon A = fork, B = ball, C = cup

# S +/- NR # S +/- NR # S +/- NR 1 A 1 A 1 A 2 C 2 C 2 C 3 B 3 B 3 B 4 C 4 C 4 C 5 B 5 B 5 B 6 A 6 A 6 A 7 A 7 A 7 A 8 B 8 B 8 B 9 C 9 C 9 C

Score: /9 Score: /9 Score: /9

A = toothbrush, B = paper, C = marker A = soap, B = towel, C = shoe # S +/- NR # S +/- NR 1 A 1 A 2 C 2 C 3 B 3 B 4 C 4 C 5 B 5 B 6 A 6 A 7 A 7 A 8 B 8 B 9 C 9 C Score: /9 Score: /9 Notes

If the student is non-speaking and does not have all stimuli from the CSA included in their augmentative

communication device – Do not assess this item. Record NA for all sets in the measurement column on the ACE®. Use the comments section to explain why the item was not directly assessed.

DISCONTINUE testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

(19)

Student Name: ______________________ Date: _________

C

OMMUNICATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

19 |

NAME PICTURES

Name pictures

: The student names a picture presented individually in 8/9 opportunities for 15 pictures (5 sets).

Materials:

Picture set 1: chips, cracker, candy (can be changed to student’s preferred edibles) Picture set 2: brush, book, spoon

Picture set 3: fork, ball, cup

Picture set 4: toothbrush, paper, marker Picture set 5: soap, towel, shoe

Instructions: Sit across from student. Establish attending. Hold up visual stimulus in front of student and wait 3-5 sec with an expectant look for student to respond. Record a + if student correctly names stimulus. Record a - for any other response, and NR for no response.

A = chips, B = cracker, C = candy A = brush, B = book, C = spoon A = fork, B = ball, C = cup

# S +/- NR # S +/- NR # S +/- NR 1 A 1 A 1 A 2 C 2 C 2 C 3 B 3 B 3 B 4 C 4 C 4 C 5 B 5 B 5 B 6 A 6 A 6 A 7 A 7 A 7 A 8 B 8 B 8 B 9 C 9 C 9 C

Score: /9 Score: /9 Score: /9

A = toothbrush, B = paper, C = marker A = soap, B= towel, C = shoe # S +/- NR # S +/- NR 1 A 1 A 2 C 2 C 3 B 3 B 4 C 4 C 5 B 5 B 6 A 6 A 7 A 7 A 8 B 8 B 9 C 9 C Score: /9 Score: /9 Notes

If the student is non-speaking and does not have all stimuli from the CSA included in their augmentative

communication device – Do not assess this item. Record NA for all sets in the measurement column on the ACE®. Use the comments section to explain why the item was not directly assessed.

DISCONTINUE testing any set if the first 3 responses are incorrect; score a 0 for the set and continue testing with next set.

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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

20 |

FOLLOW A POINT

Follow a point:

Given a verbal cue "Look" paired with a point, the student will shift gaze from the speaker to

look at the item being indicated in 4 out of 5 opportunities.

Materials: 5 items (pictures/objects) likely to be of interest to the student

Student Teacher 1 3 4 5 Table

Note: item 2 is above the student

Instructions:

a. Arrange all items as described below (see also diagram to right). b. Sit at table diagonal from student.

c. Prompt attending and establish eye contact before beginning each trial. d. Say, “Look!” and then clearly point to one item while also orienting your

head to the item. Then immediately watch for student’s response. e. If the student turns head and eyes towards the item to which you are

pointing, deliver reinforcer and record +.

f. If the student does not turn head and eyes towards the item, or does not respond within 5 seconds, remove eye contact for 2 seconds and record - .

Response Definition:

Student orients head and eyes to item teacher is touching, pointing towards, or looking at within 5 seconds of examiner’s cue “Look.”

Date: Staff: Setting:

For each trial, say, “Look!”, point, and turn your head to: Additional Response Notes Data: +/- 1. Picture (1) on wall to SIDE of student, approximately 3 feet from student

2. Item in the room located ABOVE the student (e.g., light, clock, ceiling fan) Noticeably tilts head and/or eyes upward 3. Object (3) in FRONT of the student, approximately 5 feet from student

4. Picture (4) on wall BEHIND student Turns head sufficient degrees to indicate looking in the general vicinity behind student

5. Object (5) on FLOOR to side of student, approximately 4 feet from student It may help to have a 2nd person observe this trial to determine if the student looks at the object

Score: /5

(21)

Student Name: ______________________ Date: _________

SOCIAL

SKILLS

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

21 |

IMITATE ACTIONS WITH OBJECTS

Imitate actions with objects

: Given a model from the teacher of an action with an object, the student

imitates the model in 8/9 opportunities. Materials:

Fork, plate, box of crayons, cup Instructions:

State, "Do this" and model an action with an object. Present the same object(s) to the student and wait 3 - 5 seconds for student to respond. Record + for correct performance, - for incorrect performance and NR for no response.

Date: Setting: Staff:

+/- NR 1. box (of crayons) on plate

2. fork on top of box 3. cup next to plate 4. cup on top of box 5. fork in cup

6. plate on top of fork 7. cup on plate

8. fork and cup on plate 9. plate upside down and box

on top

Score: /9

(22)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

22 |

IMITATE GROSS MOTOR ACTIONS

Imitate gross motor actions

: Given a model of a physical action, the student imitates the model in 8/9

opportunities.

Materials: None

Instructions:

State, “Do this” and model a gross motor physical action. Wait 3-5 seconds for the student to respond. Record + for correct performance, - for incorrect performance and NR for no response.

Date: Setting: Staff: Data +/- NR 1. clap hands 2. tap table 3. arms up

4. cover ears with hands 5. stand up

6. stomp feet 7. pat stomach 8. arms out to side 9. tap shoulders

Score: /9

(23)

Student Name: ______________________ Date: _________

SOCIAL

SKILLS

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

23 |

IMITATE ACTIONS WITH OBJECTS - DELAYED

Imitate actions with objects following a delay

: Given a model from the teacher of an action with an object,

the student imitates the model following a 3 second delay in 8/9 opportunities.

Materials:

Fork, plate, 2 cups, ball, book, spoon

Instructions:

State, "Do this" and model an action with an object. Remove objects (place out of student’s view). Wait 3 s. Present the

same object(s) to the student and wait 3 - 5 seconds for student to respond. Record + for correct performance, - for incorrect performance and NR for no response. Date: Setting: Staff: +/- NR 1. stack 2 cups

2. put ball in cup 3. put spoon on book 4. turn cup upside down 5. cup on book

6. ball on plate 7. fork on book 8. spoon on plate 9. cup next to book

Score: /9

(24)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

24 |

WAITING IN GROUP

Wait in the context of group instruction:

Student will wait appropriately while teacher attention is directed

toward another student in 4 out of 5 opportunities across 2 consecutive sessions. Response Definition:

While teacher is oriented towards another student, the target student maintains sitting with feet on floor, hands to self, with no interfering behavior (e.g., bids for attention, vocalizations at or above conversational level, distracting motor movements, etc.).

Instructions:

Sit at table across from or between 2 students. There should be no materials on the table other than those required for implementing the maintenance and/or acquisition programs. Both students should be seated with their chairs pushed into the desk or table.

Orient to target student and establish attending (use least-to-most physical assistance for student to attend). Then, present 5 maintenance trials to target student. Turn away from target student and present 5 maintenance trials to the other student. Continue to work with the other student regardless of the target student’s response (unless there is an immediate safety concern).

If target student WAITS appropriately, reinforce waiting, then implement 5 maintenance trials and reinforce according to student-specific guidelines. Begin next trial, turning to again present maintenance trials with the other student.

If target student DID NOT WAIT appropriately, continue to work with the other student until the 5 trials have been implemented, then turn to target student and establish attending using least-to-most intrusive prompting. Do not implement any maintenance trials. Begin next trial, turning to other student to present 5 maintenance trials.

For each trial, record + if target student waits appropriately while teacher attention is directed towards the other student.

Date:

Staff:

Date:

Staff:

Waiting

+/-

Waiting

+/-

1.

1.

2.

2.

3.

3.

4.

4.

5.

5.

Score:

/5

Score:

/5

Scoring: Number of correct

responses/total # of opportunities (10). Total Score: /10

(25)

Student Name: ______________________ Date: _________

S

ELF

H

ELP

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

25 |

MEAL SKILLS

Eat with utensil

: Throughout a meal,

the student eats with a utensil in 80% of opportunities.

Drink from a cup

:

Throughout a

meal, the student drinks from a cup in 80% of opportunities.

Instructions: Present 5 pre-cut (no larger than three quarters of an inch) food items on a plate. Say "eat with a fork." Record a + if student pierces item with the fork. Record a - for any other response.

Instructions: Present 1 oz. of liquid in a plastic cup and say, "Take a drink." Allow student to attempt to drink liquid independently. If student does not drink liquid, or if liquid is released from mouth, record -. Record + if student drinks all or part of the liquid from the cup.

Date: Staff: Date: Staff:

Trial +/- Trial +/- 1 1 2 2 3 3 4 4 5 5 Score: /5 Score: /5 Notes

(26)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

26 |

Programmed Opportunities

The programmed opportunities format uses “naturally occurring” events to assess skills in the context of their actual motivational conditions or

typical circumstances. While these skills require 5 data points, do not collect all data at one time. Set up opportunities to assess these skills across

the entire testing period. Some skills require testing in a specific context or setting. Keep this in mind as you arrange testing sessions.

(27)

Student Name: ______________________ Date: _________

C

OMMUNICATION

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

27 |

PROGRAMMED OPPORTUNITIES

Date: Staff : Date: Staff: Date: Staff:

Request needed or desired items: Across 2 people and 2 settings (at minimum), the student initiates requests for items/actions in 4/5 programmed opportunities with or without a teacher cue (e.g., “What do you want?”).

Respond to name: In response to name, the student turns to look at the speaker in 4/5 programmed opportunities.

Respond to greeting: Given a greeting, the student will orient body, face, and eyes to the speaker and wave or state “hello” in 4/5 programmed opportunities.

Instructions: Place 2-3 high preference items out of reach of student. Direct attention to items. Record + if student points to/asks for item, and – if student grabs/takes item without requesting.

Instructions: Say student’s name. Record + if student looks in the direction of teacher, and – for any other response.

Instructions: Say “Hi, (name)”. Record + if student looks in the direction of teacher and – for any other response.

Trial +/- Trial +/- Trial +/-

1 1. sitting in a chair across from teacher 1. sitting in a chair across from teacher

2 2. working independently on a task 2. working independently on a task

3 3. watching TV 3. watching TV

4 4. during a meal 4. during a meal

5 5. walking in hall 5. walking in hall

Score: /5 Score: /5 Score: /5

Date: Staff: Date: Staff: Date: Staff:

Request attention: The student will obtain attention from another person in 4/5 programmed opportunities.

Request assistance: The student will request assistance when presented with a difficult to complete task in 4/5 programmed opportunities.

Respond to stop: When given the instruction, “Stop,” student demonstrates the action in 4/5 programmed opportunities from a distance of 5 feet or more.

Materials: 2-3 high preference items

Instructions: Sit across from student. Show or play with reinforcing item, then turn so head and body are oriented away from student. Record + if student taps shoulder, states, “excuse me”, or requests item vocally.

Instructions: Present tasks that student is unable to complete. (Opening a jar with a tight lid, tying a shoe, unwrapping a piece of candy). Record NA if student completes task independently, + if student requests help, -if student grabs/takes item without requesting.

Instructions: Walk through environment beside the student. Allow student to move 1’ ahead. Say “Name, stop.” If student stops walking within 5 sec, record +.

Trial +/- Trial +/- Trial +/-

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

28 |

PROGRAMMED OPPORTUNITIES

Wait for preferred item: Given an instruction from a teacher to wait, the student waits appropriately in 4/5 programmed opportunities for at least 2 minutes.

Maintain appropriate social distance: When interacting with another person, student maintains social distance at arm’s length in 5/5 programmed opportunities.

Materials:

Preferred items or activities

Materials: None Instructions:

When a student makes a request for an item, activity or person, say “Wait.” If the student waits appropriately record +. Record – if disruptive behavior occurs.

Instructions:

Prompt student to interact with another person for 3-5 seconds (greet, ask for help, deliver a message). Score + if the student is oriented toward the listener and maintains social distance at arm’s length for duration of interaction. Score – if the student does not orient towards the

listener or does not maintain appropriate distance.

Date: Staff: Date: Staff:

Trial +/- Trial +/- 1 1 2 2 3 3 4 4 5 5 Score: /5 Score: /5 Notes

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Student Name: ______________________ Date: _________

S

ELF

H

ELP

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

29 |

PROGRAMMED OPPORTUNITIES

Eat various foods: Student eats at least 3 foods from each of the 4 food categories.

Instructions:

List 3 foods that the student will eat from each of the following food groups. Score the number of foods eaten out of a possible 12 foods (3 in each food group).

EXAMPLES of foods in each category:

Vegetables: broccoli, spinach, carrots, green beans, zucchini Protein: meat, poultry, fish, tofu, dry beans, eggs, nuts Starch: bread, cereal, rice, pasta, crackers

Fruit: apples, bananas, berries, melon, oranges, grapes

Vegetables Protein Starch Fruit

Notes

Scoring: Number of foods eaten across categories (do not count more than 3 foods from each category)

(30)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

30 |

PROGRAMMED OPPORTUNITIES

Take medication

: Student swallows

medication in any form delivered by a teacher, medical professional or parent in 100% of opportunities with no physical assistance.

Produce personal identification:

Student produces identification when asked by an unfamiliar person in 4/5 opportunities.

Maintain privacy during personal

hygiene

: Across all settings, student

seeks privacy by closing the door when engaging in personal hygiene routines in 100% of opportunities.

Medication can be modified in any way, including disguising liquid medication in juice, or crushing a pill and mixing it in pudding. If student currently takes no medication, use placebo obtained from nursing staff.

Instructions: Using chosen method, present medication. Record + if student ingests medication, - for any other response.

Materials: Identification card (if using) Instructions: Set up 5 opportunities for an unfamiliar person to say, “What’s your name?” to the student. Record + if student hands a personal ID card, or responds vocally.

Note: Do not assess children under 5 (score NA on the ACE®).

Instructions: Record data when student initiates a bathroom request OR moves toward the bathroom. Record a + if student closes the bathroom door after entering the bathroom. Record a - for any other response.

Date: Staff: Date: Staff: Date: Staff:

Trial +/- Trial +/- Trial +/-

1 1 1

2 2 2

3 3 3

4 4 4

5 5 5

Score: /5 Score: /5 Score: /5 Note: This skill is not generally tested in

(31)

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without the express written permission of NECC.

31 |

Task Analysis

The task analysis format is used to teach skills that involve chains of behaviors. In order to assess all behaviors in the chain, prompting is used during

the assessment of task analysis core skills (this is different from all other testing formats). Full physical assistance is provided if the learner does not

respond within 3-5 seconds or begins to complete a step which disrupts the routine, making completion impossible (e.g., putting on shoes before

socks). If a learner completes a step using a different type of response, but functionally accomplishes the same goal, then that step may be scored as

correct (+). For example, with undressing, if the learner does not sit down and place ankle on knee to remove socks and shoes, but is able to remove

socks and shoes while standing, these steps should be considered “correct”.

(32)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

32 |

USE PICTURE OR WRITTEN SCHEDULE

Use picture or written schedule: Student completes the steps of a 3 item (minimum) activity schedule independently for two consecutive sessions.

Materials: Picture or written activity schedule that the student is using currently. If student does not have a Schedule, assess with a schedule that is appropriate to the student’s functioning level.

Instructions: Present student’s current schedule book with the 3 activities and the materials placed where they are usually kept for that student. Teacher stands behind student. Say, "Follow your schedule." If student does not initiate a response, manually guide the response. Record I for any step completed independently.

Activity 1 ________________________ Activity 2 ________________________ Activity 3 ________________________

Activity 1 Activity 2 Activity 3 Open Book/Turn Page

Point to picture Obtain Materials Manipulate Materials

Return Materials (consume if edible)

Score: /15 *Rearrange the order of the pictures before the schedule is presented the second time.

Activity 2 Activity 3 Activity 1 Activity

Open Book/Turn Page Point to picture Obtain Materials Manipulate Materials

Return Materials (consume if edible)

Score: /15

Scoring: Number of independent responses /total # of opportunities (30). Total Score: /30

Notes

List the names of the specific activities used in the comments section on

(33)

Student Name: ______________________ Date: _________

S

ELF

H

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©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

33 |

SHOWER

Shower

: Given an initial instruction to take a shower, the student

completes the routine independently

.

Instructions: Give initial cue to take a shower. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response or if the student begins to complete a step which disrupts the routine, making completion impossible (e.g., putting shampoo on dry hair). Record (+) for correct independent responses, (-) for any other response. If student completes task independently, but in a different order, indicate the order in which the steps were completed.

Step Description +/- Order

1 Get head wet

2 Pick up shampoo and squeeze into hand 3 Put shampoo on head

4 Rub top of head 3x 5 Rub sides of head 3x 6 Rub back of head 3x 7 Rinse hair

8 Pick up face cloth 9 Put soap on face cloth 10 Wash face

11 Pick up body sponge 12 Put soap on sponge

13 Wash one arm and underarm 14 Wash other arm and underarm 15 Wash chest

16 Wash groin 17 Wash one leg 18 Wash other leg 19 Wash back 20 Wash buttocks 21 Rinse soap off body

Score: /21

Notes

This skill is not generally tested in non-residential settings (e.g., public schools).

(34)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

34 |

B

RUSH

T

EETH

Brush teeth

: Given an initial instruction to brush teeth, the student

completes the routine independently.

Instructions: Give initial cue to brush teeth. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response or if the student begins to complete a step which disrupts the routine, making completion impossible (e.g., brushing teeth before putting on toothpaste). Record (+) for correct independent responses, (-) for any other response. If student completes task independently, but in a different order, indicate the order in which the steps were

completed.

Step Description +/- Order

1 Pick up toothbrush with one hand 2 Pick up toothpaste with other hand 3 Open toothpaste cap

4 Squeeze toothpaste onto toothbrush 5 Put down toothpaste

6 Turn on water*

7 Run toothbrush under water 8 Turn off water*

9 Put toothbrush in mouth 10 Brush one side bottom 3x 11 Brush other side bottom 3x 12 Brush one side top 3x 13 Brush other side top 3x 14 Brush top front teeth 3x 15 Brush bottom front teeth 3x

16 Turn water on and spit out toothpaste* 17 Rinse brush

18 Turn water off* 19 Put toothbrush down 20 Pick up towel

21 Wipe mouth 22 Put towel down

Score: /22

Notes

*Note: if using automatic sink, student receives credit for putting toothbrush under faucet to turn on water and removing toothbrush from faucet to turn off water.

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Student Name: ______________________ Date: _________

S

ELF

H

ELP

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

35 |

W

ASH

H

ANDS

Wash hands

: Given an initial instruction to wash hands, the student

completes the routine independently.

Instructions: Give initial cue to wash hands. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response, or if the student begins to make an error. Record (+) for correct independent responses,

(-) for any other response.

Step Description +/- Order

1 Turn water on* 2 Wet both hands 3 Put soap on hands 4 Rub hands together 5 Rub back of one hand 6 Rub back of other hand 7 Rinse hands

8 Turn water off* 9 Get towel 10 Dry hands

11 Throw towel away

Score: /11

Notes

*Note: if using automatic sink, student receives credit for putting hands under faucet to turn on water and removing hands from faucet to turn off water.

(36)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

36 |

DRESS

Dress

: Given an initial instruction to get dressed, the student

completes the routine independently.

Instructions: Give initial cue to get dressed. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response, or if the student begins to complete a step which disrupts the routine, making completion impossible (e.g., putting on shoes before socks). Record (+) for correct independent responses, (-) for any other response. If student completes task independently, but in a different order, indicate the order in which the steps were completed.

Step Description +/- Order

1 Pick up underwear, two hands, backside closest to student 2 Put one leg in hole on same side

3 Put other leg in other hole 4 Pull underwear up to waist

5 Pick up pants, two hands, backside closest to student 6 Put one leg in hole on same side

7 Put other leg in other hole 8 Pull pants up to waist

9 Pick up shirt, two hands, backside closest to student 10 Pull over head

11 Put one arm through hole on same side 12 Put other arm through other hole 13 Pull shirt down

14 Sit down on bed or chair

15 Pick up one sock with two hands 16 Pull sock over 1 foot

17 Pick up other sock with two hands 18 Pull sock on other foot

19 Pick up shoe with two hands 20 Pull onto correct foot

21 Pick up other shoe with two hands 22 Pull onto other foot

Score: /22

Notes

This skill is not generally tested in non-residential settings (e.g., public schools).

(37)

Student Name: ______________________ Date: _________

S

ELF

H

ELP

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

37 |

UNDRESS

Undress

: Given an initial instruction to get undressed, the student

completes the routine independently.

Instructions: Give initial cue to get undressed. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response or if the student begins to complete a step which disrupts the routine, making completion impossible (e.g., taking socks off before shoes). Record (+) for correct independent responses, (-) for any other response. If student completes task independently, but in a different order, indicate the order in which the steps were completed.

Step Description +/- Order

1 Sit on bed with 1 ankle on opposite knee 2 Pull off shoe and place on floor

3 Pull off sock and place on floor 4 Place other ankle on knee 5 Pull off shoe and place on floor 6 Pull off sock and place on floor 7 Stand and cross arms across stomach

8 Grasp shirt bottom and pull up and over head 9 Remove arms from sleeves and put shirt on floor 10 Grasp waistband of pants

11 Pull pants down to ankles 12 Grasp waistband of underwear 13 Pull underwear down to ankles

14 Step out of pants and underwear with one foot 15 Step out with other foot

16 Place clothes in laundry bin*

Score: /16

This skill is not generally tested in non-residential settings (e.g., public schools). *Note: If no laundry bin is present, designate other appropriate location for student to place clothes. Notes

(38)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of

this work is to be reproduced without the express written permission of NECC.

38 |

WASH FACE

Wash face: Given an initial instruction to wash face, the student completes the routine independently.

Instructions: Give initial cue to wash face. Wait 3-5 seconds for the student to begin each step. Use hand-over-hand guidance if there is no response or if the student begins to complete a step which disrupts the routine, making completion impossible (e.g., washing face before wetting facecloth). Record (+) for correct independent responses, (-) for any other response. If student completes task independently, but in a different order, indicate the order in which the steps were completed.

Step Description +/- Order

1 Turn water on* 2 Wet face cloth

3 Wash face in circular motion 2 times 4 Put face cloth down

5 Turn water off* 6 Dry face with towel

Score: /6

Notes

*Note: if using automatic sink, student receives credit for putting face cloth under faucet to turn on water and removing face cloth from faucet to turn off water.

(39)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

39 |

Teacher Report

The teacher report skills are indirectly assessed and do not involve hands-on testing of skills. Because these skills are not directly assessed, they do

not require the learner to be present, and thus can be completed at any time during the assessment period. Skills are assigned a score using data

already recorded for the learner or seeking input from a teacher or clinician who has known the learner for six months or more. Each skill contains

specific instructions regarding what code should be assigned (“always”, “sometimes”, or “never”). A score of “always” indicates that the learner

performs the skill to mastery criteria. A score of “sometimes” indicates that the learner does demonstrate the skill, but the skill is emerging or is

demonstrated inconsistently and not to mastery criteria. A score of “never” indicates that the learner does not perform the skill.

(40)

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

40 |

TEACHER REPORT

Demonstrate preferences

: Student has identified a minimum of 5 high preference stimuli.

Instructions: Conduct a new preference assessment or record the results from an assessment completed within the past 3 months. If you need help selecting which preference assessment to use, see the selection guide in the Preference Assessment module on the ACE®. The ACE also contains instructions and data sheets to help you get started.

Date of most recent preference assessment: _______________________

High Preference Items

Moderate Preference Items

1

1

2

2

3

3

4

4

5

5

Scoring: Record the total number of high preference items.

Total Score: /5

(41)

Student Name: ______________________ Date: _________

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

41 |

TEACHER REPORT

Scoring: Circle the appropriate word (Never, Sometimes, Always) according to the criteria for each of the skills below.

SKILL CRITERIA SCORE

COMMUNICATION -Request termination

The student requests an end to an interaction, environment, event, or other stimuli, through verbalization, sign, picture, or other appropriate mode

Never

Over the past month, the student has never requested an end to an interaction, environment, event, or other stimuli.

Sometimes

Over the past month, the student has requested an end to an interaction,

environment, event, or other stimuli, but not to criteria.

Always

Over the past month, the student has requested an end to an interaction,

environment, event, or other stimuli in 80% of

opportunities. SOCIAL SKILLS - Use

conditioned reinforcers

Student initiates exchange of a conditioned reinforcer to access a tangible item.

Never

Over the past month, the student never initiated an exchange with a conditioned reinforcer. For example, score never if the teacher always prompts the student to exchange tokens, or if the student does not have a token system.

Sometimes

Over the past month, the student initiated an exchange but not to criteria.

Always

Over the past month, the behavior occurred to the specified criteria.

SELF-HELP - Bladder trained

Throughout waking hours, the student voids in the toilet 100% of the time.

Never

Over the past month, during the day, the student has never voided in the toilet.

Sometimes

Over the past month, the student has voided in the toilet but not to criteria.

Always

Over the past month, the student has had no urinary accidents: he or she voids in the toilet 100% of the time. SELF-HELP - Bowel trained Throughout waking hours, the

student voids in the toilet 100% of the time.

Never

Over the past month, during the day, the student has never had a bowel movement in the toilet.

Sometimes

Over the past month, the student has had a bowel movement in the toilet, but not to criteria.

Always

Over the past month, the student has had no bowel accidents: he or she voids in the toilet 100% of the time.

(42)

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without the express written permission of NECC.

42 |

TEACHER REPORT

Scoring: Circle the appropriate word (Never, Sometimes, Always) according to the criteria for each of the skills below.

SKILL CRITERIA SCORE

HEALTH & SAFETY - Tolerate medical procedures

When presented with a routine medical procedure (blood pressure, temperature, ear check, height, weight) student complies with instruction in 100% of opportunities with minimal physical assistance (no more than 1 extra person to assist)

Never

Student never complies with instructions for any of the listed procedures without at least two people assisting.

Sometimes

Student either tolerates some procedures with just one person, or sometimes requires two people to comply with instructions.

Always

Student always complies with instructions for all procedures with no more than one person assisting.

HEALTH & SAFETY - Exit given fire alarm

Given the sound of the fire alarm, student exits building in 100% of opportunities with minimal physical assistance (no more than 1 extra person to assist).

Never

Over the most recent fire drills, student never leaves the building without at least 2 people assisting.

Sometimes

Over the most recent fire drills, student sometimes leave the building with only one person assisting.

Always

Over the most recent fire drills, student always leaves the building with no more than one person assisting. RECREATION & PHYSICAL

ED - Exercise

Note: Total duration does NOT have to be 30

consecutive minutes.

Includes free play and outdoor activities for young children.

Student engages in

cardiovascular exercise for at least 30 minutes per day, 3 times per week.

Never

Over the past month, the student has never engaged in cardiovascular exercise.

Sometimes

Over the past month, the student has engaged in cardiovascular exercise at least once, but not to criteria.

Always

Over the past month, the student has exercised for at least 30 minutes per day, 3 times per week.

RECREATION & PHYSICAL ED – Engage in

independent task

Student engages in an independent play or leisure activity for 15 minutes with teacher or parent in the room

Never

Over the past month, student never engaged in a play or leisure activity for any amount of time.

Sometimes

Over the past month, student engaged in a play or leisure activity, but not to criteria (fewer than fifteen minutes).

Always

Student engaged in a play or leisure activity at least once for 15 minutes.

(43)

Student Name: ______________________ Date: _________

©2012 The New England Center for Children, Inc. (NECC); All Rights Reserved; No portion of this work is to be reproduced

without the express written permission of NECC.

43 |

TEACHER REPORT

Scoring: Circle the appropriate word (Never, Sometimes, Always) according to the criteria for each of the skills below.

SKILL CRITERIA SCORE

COMMUNITY - Ride in car/van

In the context of a van or car ride, student sits with seat belt and hands to self for the duration of the ride in 100% of opportunities.

Never

Over the past month, student never rode in the van with his/her seat belt on and hands to self for any amount of time.

Sometimes

Over the past month, student rode in the van with his/her seat belt on and hands to self, but not to criteria (100%) of the time.

Always

Over the past month, student always rode in the van with his/her seat belt on and hands to self for the duration of the ride.

COMMUNITY - Walk in the community

While in the community, the student walks beside the teacher, keeps hands to self, and maintains appropriate social distance in 100% of opportunities.

Never

Over the past month, the student never walked by the teacher, keeping hands to self and maintaining appropriate social distance.

Sometimes

Over the past mon

References

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