Data Collection Form #3 Submitted by: Michaela Huse Date: November 11, 2017

Childs Name: Juliann Rushforth

Prompts and Responses Response % Correct

Goal/Objective /Prompt based on
Ratio IEP
Criteria
Child will play independently at Prompt V M PP V V M PP M S V PP
a single activity for 3 or more Response + + + 0 0 0 + + + > +
minutes
Prompt M V PP S S 9/16 3/16
Response - - + + +
Ask for help using sign Prompt M P M V V S V V V M S 6/16 3/16
language or words 0 + 0 > + + 0 0 0 > +
Prompt V M P S V
Response 0 0 > + +
Child will put jacket on by Prompt
herself Too cold to go outside Response
Prompt
Response
Prompt
Response
Prompt
Response
Prompt
Response
Prompt
Response
Prompting Key: G= Gesture M= Model I= Visual VI= Verbal Indirect V= Verbal p = Partial Physical P= Full Physical
Response Key: 0 =No Response IN = Incorrect > = Approximation +/> = Close Approximation + = Target Observed S = Spontaneous

Notes: Played for about 5 minutes with ball drop. Played for about 15 minutes with beanbags when interventionists were talking to her and encouraging her. Said ow and
oops during play. Signed please instead of help when prompted to sign help. Played independent for about 6 minutes with almost no interaction from anyone (interventionists
were in the room and only smiled at her, nobody spoke to her during those 6 minutes). Without prompting Juliann began to dump bean bags from one bucket to the other. She was
able to pull the puzzles out of the bag herself the first time. Needed help the second and third time to get one puzzle out of the bag. She put the puzzle away and got it out 3 or 4
different times. Spontaneously said please when she couldnt get the puzzle out of the bag.
Impression: Juliann with initiate play with adults around her and will initiate interaction with adults in the room if they are not playing with her. When adults
are encouraging her to play by saying good job or by handing her objects, Juliann has stayed at a play activity for 15 or more minutes. When no one is
encouraging her, but adults are still in the room, Juliann has stayed at a play activity for about 5 minutes. Juliann likes activities that entail dumping. She was
shown how to toss the bean bags into the buckets but she then took the buckets and filled them with bean bags and dumped them from one to the other. Juliann
can usually be redirected with the addition of a new activity or by adding something else into the play. Sometimes she will come on her own and sometimes we
have to grab her hand and bring her over. When adults encourage her during play she smiles and laughs and claps.

Objective Description of Data and Observations: Juliann played independently for 5 minutes with the beanbags target observed. She did not play with the
puzzles independently. She held out the bag and said please for help. Juliann was prompted to say help and instead said please. The target was for her to ask for
help. Left the beanbag drop activity and was redirected to the activity by the addition of buckets. She had to be led over to the activity with a partial physical
assist because she did not respond to verbal prompts or visual prompts of what she could do with the bean bags (tossing them into buckets). Julianns dad was
not home during the intervention session. Her mom was there but was in and out of the room because they were having a new fridge delivered. When she was
in the room she mostly just watched. Julianns sister and cousin were involved in the intervention. They played with the beanbags and modeled for Juliann what
she could do with the beanbags.

Assessment and Evaluation: The target was observed when Juliann played independently for 5 minutes with the beanbags. She did not receive any adult
prompting or engagement during this time. The adults will still in the room and still acknowledged her with a smile when she initiated interaction but no adults
played with her or prompted her to do anything. Juliann had a close approximation on her goal to say or sign help. The first few times she was prompted to sign
help she did not respond, even with models and a partial physical assist she did not respond. When prompted to say please instead of help, Juliann responded
with the sign for please without any model. Later she said please on her own when she needed to get something out of a bag. She did not sign help or say help
throughout the whole session despite multiple prompts. Alyssa and I worked well together this week. We are each doing our own research and coming with
ideas when we meet which helps us to plan more appropriate activities for Juliann. We are respectful of each others ideas and thoughts.

Plan: The plan is for Juliann to continue to increase her independent play. We have been scaffolding her play and letting her be more independent. Next week
we want to try having most adults leave the room during her play. Juliann will be prompted to stay in the room and play with her toys. If she leaves the room
she will be redirected back. The goal is for Julianns parents to be able to leave the room and have her play independently for at least 5 minutes. We will
continue to work on the sign for help. Julianns mom is going to ask what sign they have been working on for help because she believes it might be different
than what the actual sign is that we have been using. We will provide opportunities for her to ask for help such as putting a toy out of her reach, providing her
with a puzzle that is a little challenging so that she may need to ask for help or asking her if she wants a snack and then encouraging her to ask for help opening
it up. It is starting to get a little cold to be going outside so it is not always practical to have her practice putting on a jacket. We are going to see about
incorporating the self-help skill of getting dressed into a play activity such as dressing a doll. If it is warm enough we will still have her practice getting a jacket
on.