Data Collection Form # 6&7 Submitted by: Jamie VanEvery Date: 7/14/17

Childs Name: Mason Ludlow

Prompts and Responses Response % Correct

Goal/Objective /Prompt based on
Ratio IEP
Criteria

Express emotions verbally Prompt V M V V

Response IN 0 0 +/> 0/4 0%
Write legible sentences Prompt V V I M V
Response IN + IN 0 +/> 1/5 20%
Ask before showing affection Prompt I V I V
Response IN 0 IN + 1/4 25%
Respectful of personal Prompt V V V V None
boundaries. Response IN IN IN IN + 1/5 20%
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:__We did a longer session today to make up for the one we missed. Mason seemed more distracted today than normal so I think that has an impact on his inability

to focus and do well during our session today. ________ ___________ ________________ _______________________ ___________________________________

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Impression:
Like I mentioned above, I think Mason was distracted this visit and it seemed like he was purposely acting out of hand to get more attention.

Objective Description of Data and Observations:

We started out by finishing our game we started the last time I was there. Masons brother kept trying to sit by him and wanted to play with us and
Mason would push him or hit him in the head. I asked him to tell his brother how he felt and he yelled in his brothers face. I then told him that he
should tell him, Im playing with Jamie right now and dont want you to play with us right now. He didnt respond. I asked him how he was
feeling and he didnt answer. When his brother tried to get up by him another time I told him to tell his brother how he felt and he said, Go
away. Mason said that he was done playing the game so we moved on to our second activity for the day. Once Mason heard we would be do
writing, he took my bag of numbers away and told me he would only give them back if I kissed him. I told him he needed to ask but he didnt say
anything, so I told him again that he needed to ask and he said, Can I kiss you? I told him no and he said, Then you dont get the bag I told
him that he cant force someone to kiss him and that he needed to give me the bag back and if I say no to being kissed that means no. He gave me
the bag and didnt kiss me. While writing he pulled out a number and didnt like it so he put it back, I pulled it out and told him that he needed to
write that many sentences about the picture I show him. He wrote the sentence and drew another number. The number was 3 this time and he told
me he wouldnt write 3 sentences. I told him he needed to. He wrote one sentence that wasnt very legible and then wrote two scribble lines.

Assessment and Evaluation:

Mason didnt do as well with his social skills today. He was at 0% for expressing emotions, 20% at showing respect for boundaries, and 25% for
asking before showing affection. I think that this is due to him being distracted today and I think he may have needed more intrusive prompts. His
writing today went okay, but not as good as it has been before. He was responding properly and writing legible sentences 20% of the time. I think
the prompts were okay for writing, he just couldnt stay focused because he was distracted

Plan:
If Im able to see him one more time for the bonus intervention session, I will try and do the activities in an area where there are less distractions
so he can focus better.