Data Collection Form # 2 Submitted by: Veronica Madden Date: 2/23/17

Childs Name: Jane Doe

Prompts and Responses Response % Correct

Goal/Objective /Prompt based on
Ratio IEP
Criteria

Jane will choose between two Prompt P V IN IN p V IN IN V V IN 10/10 100%

activities by pressing a button. Response + + + + + + + + + + +
Jane will show her desire for an Prompt V V V V V V IN IN IN IN IN 10/10 100%
activity to continue by Response + + + + + + + + + + +
vocalizing.
Jane will turn an object on and Prompt P V V IN p V p IN V p V 7/10 100%
off by pushing a joystick Response + + - + + - + + + + -
Prompt
Response
Prompt
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:

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Impression: When we first got to the visit Janes mom explained that she had botox injections earlier that day, and had a full day. She looked very
tired. Her muscles were not moving as much as she normally seems to. Her mom explained that she normally gets really tired from such a full day
and that she does not move as easily. Overall we noticed that this time she did not meet her goals the way she did last time. She was very tired and
we had to stop some of the activities early. She did do the choice activity and was making choices, and she was vocalizing with the singing
activity. We were able to see that there is still room for practicing and improvement. Jane was doing really well with the activities she did, but was
not responding as readily and as much as usual.

Objective Description of Data and Observations: We started by singing the song the itsy bitsy spider. Janes head moved from left to right, and her
eyes opened and closed. We then brought out the buttons. We showed Jane the red button and showed her the squeaky toy. We pushed the button,
and then squeaked the toy. After the toy squeaked, Jane smiled. We moved the button down her arm and put it below her hand. We used hand over
hand and pushed down the button using Janes hand, then squeaked the toy. After that, Jane smiled. Janes hand moved around from left to right.
We introduced the blue button next. We hit it and then shook the tambourine. Janes head and eyes moved towards the tambourine. We then moved
the button down Janes arm and put it under her hand. We moved her hand onto the button and pushed down. We then shook the tambourine, and
then Jane smiled. Her hand moved around from left to right. We held the buttons below Janes hands. We used a verbal prompt by saying, Jane,
hit one of the buttons for the squeaky toy or the tambourine. Jane hit the tambourine button. We shook the tambourine, Jane then smiled. Jane
pushed the squeaky toy button, we squeaked the toy, and then Jane smiled. Jane then hit the tambourine button, we shook the tambourine, and then
Jane smiled. Janes eyes started to close. She sat for a little bit. We then moved her hand and hit the squeaky toy button using hand over hand. We
then squeaked the toy, and then Jane smiled. Jane continued to hit the buttons back and forth, sometimes with verbal cues. We then sang the song
Old McDonald had a farm. We sang 7 verses. Between each verse we stopped. Each time after stopping we would say, Jane tell us if you want us
to sing more. Each time, Jane would vocalize and we would begin to sing again. We then sang The Wheels on the Bus. During this song the
whole time we were singing, Jane was making vocalizations. We then moved Janes arms together and said we were all done. The last activity was
the joystick. We brought out the joystick and showed it to Jane. We used hand over hand multiple times to show her the on and off of the light. We
used verbal cues to invite hand to hit the joystick. A few times, Jane hit the joystick with her hand on her own. We ended this activity early
because Jane began to close her eyes.
Assessment and Evaluation: Jane was able to do some of the activities visibly today. We were not able to know if she intentionally met all of her
goals. She did not move as much today and was not able to meet every goal on her own. She required prompting multiple times and a variety of
prompts. She did not always react quickly, and sometimes did not respond to the promptings.

Plan: Our plan is to continue helping Jane with the goals we have set with her. She can still use some practice and more of an introduction to the
activities. We are still working on making sure she knows and understands to vocalize and complete different tasks throughout the session. We
will be continuing to use the same activities to keep things familiar, and we will add in more activities if we feel that she is ready.