Data Collection Form #3 Submitted by: Karla Barreno Date: 3/01/17

Childs Name: B.

Response % Correct
Goal/Objective Prompts and Responses
/Prompt based on
Ratio IEP
Criteria

B. will walk with alternating Prompt M P P p V V p p V V V

feet keeping her balance. Response 0 +/> +/> +/> > IN > +/> 0 +/> +/> 6/11 55%
B. will be able to poke the foam Prompt M P p V V V V DI p DI 5/10 50%
block with the pencil correctly Response 0 +/> > > > +/> + > +/> +/>
3-5 times.
Prompt
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
au=Pause DI=direct instruction
Response Key: 0 =No Response IN = Incorrect > = Approximation +/> = Close Approximation + = Target Observed S=
Spontaneous

Notes: Today was a rough day. B. has just woken up from a nap. Mom was home and therefore she wanted to go with her. Her younger brother and the mom participated in

the activities encouraging B. to also do them.

Impression:

Today B. had just woken up from a nap, she was very tired and therefore she did not want to participate in the activities as much. It was great
seeing how her brother and mother were part of the activities and tried engaging B. The mother said B. was during the week ate chicken all by
her self. She said B. was able to poke the chicken with the fork and everyone was very proud of her. I can see the interventions are working.
Also, she was able to more her legs and alternates them with less assistance.

Objective Description of Data and Observations:

In the first goal, B. was engaged and she would lift her leg high and step on the colored square, then she would lift her other leg and aim
towards the other square. We definitely have seen improvement. She responds to various prompts. She still needs to work on her left leg, but
now we have seen that she moves the left leg instead of dragging it towards the right one.

Assessment and Evaluation:

B. needs several verbal prompts in order to complete the objective. Our activity was very engaging but since she was tired she didnt
participate in some activities. We noticed this time she poked the foam blocks with more precision. At times she would try poking it and look
away but the mother would remind her she needed to look at what she was poking. The next time she tried she looked at the block and she was
able to push it in. When we wanted her to poke the white foam, which is harder, she did not want to because it was harder.

Plan: This next week we are hoping to work on stairs, challenging B. to go up the stairs with alternating feet and helping her with her balance
and security. We are also planning on using clothespins to make B. put it around paper so she can work on her little muscles. We are going to
sing songs in between our activities as transitions.