Celebrate the Children

School for Children with Alternative Learning Styles

Developmental Individual Relationship-based Intervention
www.celebratethechildren.org
345 South Main Street, Wharton, NJ 07885
Phone: 973-989-4033 Fax: 973-989-7451

Student: Grade: Reports by:

Dates: ___/___/___; ___/___/___; ___/___/___

The following assessment of goals reflect NJ State Core Curriculum Content Standards:

STANDARD 2.1 (WELLNESS) ALL STUDENTS WILL LEARN AND APPLY HEALTH PROMOTION
CONCEPTS AND SKILLS TO SUPPORT A HEALTHY, ACTIVE LIFESTYLE

STANDARD 9.2 (CONSUMER, FAMILY, AND LIFE SKILLS) ALL STUDENTS WILL DEMONSTRATE
CRITICAL LIFE SKILLS IN ORDER TO BE FUNCTIONAL MEMBERS OF SOCIETY

Drs. Stanley Greenspan and Serena Wieder’s Developmental Individual Relationship-based

Intervention (including Sensory Integration), and Howard Gardner’s Theory of Multiple Intelligence
underlie all curriculum areas.
For more information on the DIR approach, please visit www.floortime.org,
WWW.coping.org/earlyin/floortm.htm, and www.icdl.com

Rating Scale TEACHERS MUST RATE EVERY GOAL ONCE PER WEEK
N-Not introduced 3-In progress, needing minimal prompting to reach criteria
1-In progress, needing full prompting to reach criteria 4-Demonstrating skill without prompting/meeting criteria
2-In progress, needing some prompting to reach criteria M-Mastered-Demonstrating consistency in all settings (100% ind.)

Level 1-Shared Attention/Regulation and Interest in the World

The child’s ability to regulate his or her attention and behaviour while being interested in the full range of
sensations (sights, sounds, smells, their own movement patterns, etc.). The child’s ability to enter into a
state of shared attention with another person. This is a child’s ability to process their environment, filter out
distractions, and pay attention in the classroom.
Goal 1 2 3
1.1 Student is comfortable touching textured toys and materials, is comfortable in
own clothing, and in being touched by other people as appropriate 80-100% of the
day.
1.2 Student enjoys moving on equipment or engaging in physical play when
appropriate 80-100% of the time.
1.3 Student is able to tolerate most visuals in the school environment. Student is
not overly visual, looking at toys and books to avoid interactions or participation in
classroom activities 80-100% of the time.
1.4 Student is able to maintain self-regulation (stay calm and organized) and
attention in a non-demanding, non-overstimulating interaction/activity for at least
10 minutes 4 out of 5 opportunities
1.5 Student is able to maintain self-regulation (stay calm and organized) and
attention in a challenging or overstimulating interaction/activity for at least 10
Student name: 1
minutes 4 out of 5 opportunities
Rating Scale TEACHERS MUST RATE EVERY GOAL ONCE PER WEEK
N-Not introduced 3-In progress, needing minimal prompting to reach criteria
1-In progress, needing full prompting to reach criteria 4-Demonstrating skill without prompting/meeting criteria
2-In progress, needing some prompting to reach criteria M-Mastered-Demonstrating consistency in all settings (100% ind.)
Goal 1 2 3
1.6 Student is able to remain calm, with no signs of distress (crying or whining),
showing appropriate frustration, 80-100% of the day.
1.7 Student uses a range of affect including appropriate expressions of
happiness, sadness, anger, frustration, disappointment, fear, etc.. This affect is
displayed using facial expressions and gestures to convey emotions appropriately
4 out of 5 opportunities
NOTE: SCORE ONLY ITEM 1.8 OR 1.9, WHICHEVER APPLIES
1.8 Underreactivity: Appears sluggish or withdrawn in school
Scoring:
0 = withdrawn, difficult to engage
1 = sluggish or slow-paced in actions but can eventually be aroused or
engaged
2 = shows a bright, alert state with focused participation throughout the
day
1.9 Overreactivity: Appears overaroused by toys, materials, peers and
environment.
Scoring:
0 = Very active, moves quickly from one activity to the next or wanders
away from others and materials constantly
1= Moderately active, occasional bursts of changing activity quickly or
wandering away, then settles into one activity for short period
2 = Well-modulated in pace and activity level, focusing on a activities,
teachers or peers for long periods before changing activity.
Additional Comments on Level 1:

Level 2-Engagement/Forming relationships

The child’s ability to engage in relationships, including the depth and range of his pleasure and warmth, the
related feelings, such as assertiveness or sadness, that can be incorporated into the quality of engagement
and the stability of the child’s engagement (does he withdraw of become aimless when under stress).
Goal 1 2 3
2.1 Student shows emotional interest and connection with others by vocalizing,
talking and smiling at them when appropriate 4 out of 5 opportunities.
2.2 Student anticipates with curiosity or excitement when a teacher or a peer
presents an interesting object, activity or game 4 out of 5 opportunities.
2.3 Student uses social references as appropriate during play or work activities
(looks at peer or teacher for feedback to sustain a connection with that person) 4
out of 5 opportunities.
2.4 Student evidences a relaxed sense of security and/or comfort in the
classroom 80-100% of the day.
Reference for inserting number of minutes below (2.5-2.10). Number of minutes inserted in the
Student name: 2
 “non-demanding” goal should be higher than the number of minutes inserted in the
“while being challenged” goal.
With adult:
Pre-K insert 5-15; K-2nd grade insert 10-30; 3rd-5th grade insert 20-30+; 6th grade+ insert 30+
With peer:
Pre-K insert 2-10; K-2nd grade insert 5-15; 3rd-5th grade insert 5-30+; 6th grade+ insert 10-30+
Goal 1 2 3
2.5 Student is able to remain connected (without fragmenting) to an adult in a
non-demanding, non-overstimulating unstructured/play interaction/activity for at
least ___ minutes ____ out of 5 opportunities
2.6 Student is able to remain connected (without fragmenting) to an adult in a
novel, challenging, unpredictable and/or overstimulating (including a range of
emotions and challenges) unstructured/play interaction/activity for at least ___
minutes _____ out of 5 opportunities
2.7 Student is able to remain connected (without fragmenting) to a peer in a non-
demanding, non-overstimulating unstructured/play interaction/activity for at least
___ minutes _____out of 5 opportunities
2.8 Student is able to remain connected (without fragmenting) to a peer in a
challenging, unpredictable and/or overstimulating (including a range of emotions
and challenges) unstructured/play interaction/activity for at least ___ minutes
_____ out of 5 opportunities
2.9 Student is able to remain connected (without fragmenting) in a structured
academic activity or a game with specific steps and rules that is non-challenging
or familiar for at least ___minutes ____ out of 5 opportunities
2.10 Student is able to remain connected (without fragmenting) in a structured
academic activity or a game with specific steps and rules that is novel or
challenging for at least ___minutes _____ out of 5 opportunities
Additional Comments on Level 2:

Level 3-Two-way, purposeful interactions with gestures/Intentional two-way

communication/Language
The child’s ability to enter into two-way purposeful communication. At its most basic level, this involves
helping a child open and close circles of communication. This is a child’s ability to be intentional in
interactions and activities (e.g., a child is able to initiate with another person to keep activities going, for
desired objects or activities, etc.).
3.1 Student opens circles of communication: Initiates intentional actions with
adults using non-verbal cues (eye contact and gestures) when appropriate 4 out
of 5 opportunities
3.2 Student opens circles of communication: Initiates intentional actions with
peers using non-verbal cues (eye contact and gestures) when appropriate 4 out of
5 opportunities
3.4 Student opens circles of communication: Initiates intentional actions with
adults using non-verbal cues (eye contact and gestures) when appropriate 4 out
of 5 opportunities
3.5 Student opens circles of communication: Initiates intentional actions with
peers using non-verbal cues (eye contact and gestures) when appropriate 4 out of
5 opportunities

Rating Scale TEACHERS MUST RATE EVERY GOAL ONCE PER WEEK
N-Not introduced 3-In progress, needing minimal prompting to reach criteria
1-In progress, needing full prompting to reach criteria 4-Demonstrating skill without prompting/meeting criteria

Student name: 3
2-In progress, needing some prompting to reach criteria M-Mastered-Demonstrating consistency in all settings (100% ind.)
Goal 1 2 3
3.6 Student closes circles: Responds to other’s cues in contingent manner (i.e.,
teacher offers toy, child takes it and puts it in a container; teacher gestures for
child to sit down and the child takes his seat) when appropriate 4 out of 5
opportunities.
3.7 Student is able to initiate purposeful and intentional actions in play (Play
shows intentionality and variety, engaging in two or more different behaviors with
a given toy or activity. Gestures are specific and activity is functionally tied to
objects) 80% of the time
Additional Comments on Level 3:

Level 4-Two-way, purposeful problem-solving interactions/Development of

complex sense of self
The ability to string together many circles of communication/Problem solving into a larger pattern (ten or
twenty). This is necessary for negotiating many of the most important emotional needs in life (being close to
others, exploring and being assertive, limiting aggression, negotiation safety, etc.) This is the stage where
the child begins develop a sense of self/Self esteem/Independence (“I did it!” or “Look what I did!” using
affect, gestures and words if verbal)
Number of circles inserted in the “adult” goal (below) should be higher than the number of circles
inserted in the “peer” goal.
4.8 Student engages in complex patterns of communication stringing together ___
circles of communication with teacher (initiated and elaborated on by student)
using gestures, vocalizations, and/or words.
4.9 Student engages in complex patterns of communication stringing together ___
circles of communication with peer (initiated and elaborated on by student) using
gestures, vocalizations, and/or words.
4.10 Student imitates or copies something new that the teacher introduces, and
then incorporates idea into play or work (i.e., teacher feeds doll; child copies this).
4.11 Student is able to use motor planning to execute ideas, problem solve and
join novel activities and interactions 4 out of 5 opportunities (this includes new
lessons, spontaneous interactions, motor planning activities such as dancing,
sports, etc.)
4.12 Student is able to use sequencing and motor planning in long patterns (multi-
step) to be independent 4 out of 5 opportunities
4.13 Student is able to use sequencing and motor planning to share and build off
of other people’s ideas in work and play 4 out of 5 opportunities
4.14 Student will use visual-spatial abilities to solve problems (use a visual in their
mind to work out that if their lunch money isn’t in one pocket, it might be in
another pocket or in their desk) 4 out of 5 opportunities
4.15 Student displays a good sense of self by approaching activities and
interactions with confidence 4 out of 5 opportunities
4.16 Student displays a good self esteem using positive self statements and
taking pride in their accomplishments when appropriate 4 out of 5 opportunities
Additional Comments on Level 4:

Rating Scale TEACHERS MUST RATE EVERY GOAL ONCE PER WEEK
N-Not introduced 3-In progress, needing minimal prompting to reach criteria
1-In progress, needing full prompting to reach criteria 4-Demonstrating skill without prompting/meeting criteria

Student name: 4
2-In progress, needing some prompting to reach criteria M-Mastered-Demonstrating consistency in all settings (100% ind.)
Goal 1 2 3
Level 5-Elaborating Ideas/Representational capacity and elaboration of symbolic
thinking
The child’s ability to create mental representations. The ability to do pretend play or use words, phrases or
sentences to convey some emotional intention (“What is that?,” ”Look at this fish!,” or “I’m angry!” etc.). This
is the ability to share ideas with others and represent ideas and real life through play or activities.
5.1 Student is able to think about the world around him/her and share ideas with
others (“look at the lizard!”) 4 out of 5 opportunities
5.2 Student is able to replicate and understand real life through work and play
(uses dolls to present “Mom and Dad,” etc.) 4 out of 5 opportunities
5.3 Student engages in pretend play patterns of at least one idea, in collaboration
with an adult (e.g., one part of a script or scenario played out), 4 out of 5
opportunities.
5.4 Student engages in pretend play patterns of at least one idea, in collaboration
with a peer (e.g., one part of a script or scenario played out), 4 out of 5
opportunities.
5.5 Student is able to be intentional using non-verbal cues (eye contact and
gestures) to convey ideas 4 out of 5 opportunities
5.6 Student is able to be intentional using original/novel language to convey ideas
4 out of 5 opportunities
5.7 Student is able to be intentional using original ideas/creativity during play and
work 4 out of 5 opportunities
5.8 Student uses language or pretend play (e.g., playing out with doll figures) to
communicate needs, wishes, intentions, or feelings 4 out of 5 opportunities
5.9 Student is able to create a pretend drama with two or more ideas even if they
are not related or logically connected 4 out of 5 opportunities.
5.10 Student is able to take on a role in play and stay in character without
prompting for a short period of time 4 out of 5 opportunities
5.11 Student uses pretend play (or expresses through work or other activities) to
express themes around closeness or dependency (e.g., putting dolls to sleep next
to one another; feeding teacher and dolls) 4 out of 5 opportunities.
5.12 Student is able to express themes of assertiveness in pretend play or work
(i.e., child pretends he's a policeman and puts teacher or peer in jail; child
pretends to go to work and tells peer to stay home; older children role play being
the principal and students) 4 out of 5 opportunities.
5.13 Student uses pretend play or work to express themes around pleasure and
excitement around humorous themes (e.g., imitating humorous behaviors) 4 out
of 5 opportunities.
5.14 Student is able to recognize emotions in others 4 out of 5 opportunities
-using gestures level 4, using words 5 or 6
5.15 Student is able to respond appropriately to other people’s emotions 4 out of
5 opportunities

Rating Scale TEACHERS MUST RATE EVERY GOAL ONCE PER WEEK
N-Not introduced 3-In progress, needing minimal prompting to reach criteria
1-In progress, needing full prompting to reach criteria 4-Demonstrating skill without prompting/meeting criteria
2-In progress, needing some prompting to reach criteria M-Mastered-Demonstrating consistency in all settings (100% ind.)
Goal 1 2 3
5.16 Student is able to recognize own emotions 4 out of 5 opportunities
5.17 Student is able to express own emotions appropriately 4 out of 5
opportunities
Additional Comments on Level 5:
Student name: 5
 Level 6-Building bridges between ideas/Emotional thinking
The child’s ability to make connections between different internal representations or emotional ideas (“I’m
mad because you’re mean.”). This capacity is a foundation for higher level thinking, problem solving and
such capacities as separating fantasy from reality, modulating impulses and mood, and learning to
concentrate and plan.
6.1 Student’s pretend play (or role play or creative work), however unrealistic,
involves 2 or more ideas, which are logically tied to one another. Child may build
on adult's pretend play idea 4 out of 5 opportunities.
6.2 Student elaborates on pretend play (or role play or creative work) sequence of
two or more ideas, which are logically connected and grounded in reality. There is
a planned quality and child can elaborate to "how", "why", or "when" questions,
giving depth to drama 4 out of 5 opportunities.
6.3 Student uses pretend play, language, role play or creative work to
communicate themes containing 2 or more ideas dealing with closeness or
dependency (e.g., doll gets hurt, then gets kiss from daddy, then plays ball
together) 4 out of 5 opportunities.
6.4 Student uses pretend play, language, role play or creative work to
communicate themes containing 2 or more ideas dealing with pleasure and
excitement in humorous game (e.g., imitates funny word heard, watches how
caregiver reacts, then laughs) 4 out of 5 opportunities.
6.5 Student uses pretend play, language, role play or creative work to
communicate themes containing 2 or more ideas dealing with assertiveness (e.g.,
soldiers search for missing person, find her, then battle to save her again) 4 out of
5 opportunities.
6.6 Student is able to answer “why” questions 4 out of 5 opportunities
6.7 Student is able to use reasoning to understand the underlying meaning of
social and academic concepts 4 out of 5 opportunities
6.8 Student is able to build brides between ideas (“I can’t go out now because it is
raining”) 4 out of 5 opportunities
6.9 Student is able to connect ideas logically in play and work (first the boy rides
his bike, then he falls and gets hurt ... during play with figures, sequence ideas
logically in an essay, etc.) 4 out of 5 opportunities

Additional Comments on Level 6:

Level 7-Multi-cause, Comparative, and Triangular thinking-Pre-Adolescents

The child is able to explore multiple reasons for a feeling, comparing feelings, and understanding triadic
interactions among feeling states (“I feel left out when Susie likes Janet better than me.”) Finding an indirect
road to problem solve. Example: John wants to be Sarah’s friend. He sees that Tom is Sarah’s friend, so
John becomes Tom’s friend. This type of thinking is more expansive and even a little manipulative. He
learns to “work the crowd” to satisfy his social needs. During this stage the child becomes more interested in
his body and sexual relations. These feelings may cause the child to be fearful. Nurture him through his
fears and help him to understand his feelings. It is a good sign when a child becomes manipulative in a
Student name: 6
triangular way. Understanding the three person system the child becomes interested in all facets of their
world: sex, death, where did I come from?, etc.. Some children experience fear and anxiety dealing with this.
This is common in all pre-adolescents. Work on the fears and nurture them giving them structure while they
are going through this.
7.1 Student is able to understand another person’s motives and respond
appropriately 4 out of 5 opportunities
7.2 Student is able to think about and reflect on multiple reasons for feelings for
age expected experiences 4 out of 5 opportunities
Additional Comments on Level 7:

Level 8-Emotionally differentiated gray-area thinking

Shades and gradations among differentiated feeling states (Ability to describe degrees of feelings about
anger, love, excitement, disappointment-“I feel a little annoyed”) The child begins to know where they fall on
the social ladder. He begins to define himself by how accepted he is by his peer group. He begins to see the
“shades of gray” and become better problem solvers. He can also see consequences of their behavior. The
child is able to give you a range of emotions. For example, “I’m a little mad, very mad, etc.” or “I’m the best,
Jo is the second best, and John is the worst.”
8.1 Student is able to understand that everything is not always black and white
(displays the use of gray area thinking) to stay regulated, problem solve and be
independent 4 out of 5 opportunities
Additional Comments on Level 8:

Level 9-Intermittent Reflective Thinking, a Stable Sense of self, and an internal

standard
Reflecting on feelings in a relationship to an internalized sense of self (“It’s not like me to feel so angry” or “I
shouldn’t feel this jealous”) The child begins to internalize values and develops a greater sense of self that
can’t be broken down by lack of acceptance by peer group. Example: Sally was mean to me because she
was having a bad day, but I’m still a good person.
9.1 Student is able to look at indirect influences in social situations (e.g., she is
mad at her parents, not me”) 4 out of 5 opportunities
Additional Comments on Level 9:

Level 10-The individual has an increasing interest is community. He begins to consider the future and
where he fits in. Hormones are changing, as well as their bodies. Greater interest in sexuality and
exploration of their bodies. There are conflicts within the child, which can cause aggressiveness. Identities
are forming; “Who am I?” There is also a feeling of humiliation caused by changing body.
Comments on Level 10:

Student name: 7
Additional Developmental Comments
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Social Skills (please comment on the students social skills in the classroom and their
participation in social skills lessons)
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Peer Interactions (please comment on the students peer interactions and

relationships in the classroom)
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Student name: 8
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Self help (please comment on the student’s self help skills, organization of self and
belongings, and independence in the classroom)
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Self help (please comment on the student’s self help skills and independence in the
classroom) Continued
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Class Participation (please comment on the student’s ability to follow the classroom
routine, follow teacher’s directions, and overall attitude in the classroom)
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Student name: 9
Comprehensive Health and Physical Education
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Mathematics
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Social Studies
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Student name: 1
Student name: 11
Language Arts
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Science
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Additional Comments:

Student name: 1
Work Place Readiness
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Technology
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Additional Comments:

Student name: 1