ttdatacollectiona_sample

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					Student:       Krystal                             Key:   CUE = what support person does
Setting:       Hospital                                   HELP = the prompt or additional cue given
Environment:   Central Supply                             R+ = the positive Krystal gets for wheeling
Activity:      Unpacking Supplies                         Objective = what Krystal is expected to do
                                                          Condition to  = before (number) of seconds elapses
                                DATA SHEET A (Completed Sample)
                                                              Dates:
          Instructor CUE                                                             Condition
          HELP or Correction           Objective               3/3 3/17 4/7 4/21 5/5 To 
          Reinforcement R+
 CUE      Face Krystal toward          With her hands                                            Wait 10
          boxes, place hands on her    placed on her                                             secs then
          wheels.                                                                                HELP.
          Sign “wheel” in her hands,
                                       wheelchair wheels,
 HELP     then replace her hands on    Krystal initiates                                  
          wheels of wheelchair.        wheeling toward
 R+       Say, “Good job, Krystal”     boxes after entering
          and rub and/or pat her       supply room.
          shoulder.
 CUE      Face Krystal toward work     With a box on her                                         Wait 10
          table, place hands on        tray & her hands                                          secs then
          wheels                                                                                 HELP.
          Sign “wheel” in her hands,
                                       placed on her
 HELP     then replace her hands on    wheelchair wheels,                                 
          wheels of wheelchair.        Krystal initiates
 R+       Say, “Good job, Krystal”     wheeling toward
          and rub and/or pat her       work table.
          shoulder.
 CUE      Face Krystal toward          With her hands                                            Wait 15
          boxes, place hands on        placed on her                                             secs then
          wheels                                                                                 HELP.
          Sign “wheel” in her hands,
                                       wheelchair wheels,
 HELP     then replace her hands on    Krystal initiates                                 
          wheels of wheelchair.        wheeling toward
 R+       Say, “Good job, Krystal”     boxes from work
          and rub and/or pat her       table.
          shoulder.
 CUE      Face Krystal toward work     With a box on her                                         Wait 15
          table, place hands on        tray & her hands                                          secs then
          wheels                                                                                 HELP.
          Sign “wheel” in her hands,
                                       placed on her
 HELP     then replace her hands on    wheelchair wheels,                                
          wheels of wheelchair.        Krystal initiates
 R+       Say, “Good job, Krystal”     wheeling toward
          and rub and/or pat her       work table.
          shoulder.
 CUE      Face Krystal toward exit,    With her spoon &                                          Wait 15
          place hands on wheels        Yogurt card on her                                        secs then
          Sign “wheel” in her hands,   tray, & hands                                             HELP.
 HELP then replace her hands on
          wheels of wheelchair.
                                       placed on her                                    
                                       wheelchair wheels,
          Say, “Good job, Krystal”
 R+       and rub and/or pat her
                                       Krystal initiates
          shoulder.                    wheeling toward
                                       the exit doors.

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posted:6/25/2011
language:English
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