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Sample Monthly Program
PLEASE NOTE: The following sample has been provided for illustrative purposes only and may or may not be indicative of the type of program that may be appropriate for your child.
A3. If you hold up a non-reinforcing item, will Max look at it and watch it as you move it to different locations in front of him?
4= will track the movement of the item to 6 different positions in a 10-second period
3= will track the movement of the item to 4 positions in 10 seconds
2= finds it in any position (up/down/left/ right) within 3 seconds
1= will look at item but requires an additional prompt to look or takes more than 3 seconds to respond
Max will look at and track changes in location of non-reinforcing items presented by an instructor.
B2. Can Max put pieces in a form box or shape sorter?
4= 6 pieces by looking at piece then visually locating the corresponding hole
3= 4 pieces by look and locate
2= 4 pieces using trial and error approach
1= 2 pieces by trial and error
When provided a form box or shape sorter and its pieces, Max will be able to put the pieces into the corresponding holes in the form box.
B3. Can Max match objects to an identical object presented in an array of three items?
4= at least 10 objects to objects in a display of 8 items
3= at least 5 objects to objects in a display of 4 items
2= at least two objects to objects in a display of 2 items
1= can match one object to an identical object in a display of 2 items
When given an object, Max will match to an identical object in an array of three items.
C8. When an adult holds out his/her hand and asks for an item, will Max follow instructions to give a named, non-desired item?
2= usually within 3 seconds
1= usually with one additional prompt (not including holding out hand to receive the item)
Max will follow instructions which require him to give a named, non-reinforcing item.
D3. Will Max imitate a gross motor action when asked to "Do this" and provided with verbal prompts?
4= at least 10 actions & readily imitates novel actions
3= imitates any 10 actions
2= imitates any 5 actions
1= imitates any 2 actions
Upon request, Max will imitate a gross motor movement when provided with verbal prompts.
E3. Can Max imitate the initial sounds of words which are modeled to him?
4= readily and accurately imitates at least the first sound of almost any word
3= 15 sounds
2= 5 sounds
1= 2 sounds
When a word is modeled for Max, he will be able to imitate the initial sounds of that word.
L5. Does Max look at others in such a manner as to initiate a social interaction with both peers and adults?
2= Max regularly initiates social interactions with both peers and adults by looking at them
1= Max occasionally initiates social interaction by looking at an individual
Max will look at others (peers and adults) in such a manner as to initiate a social interaction.
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