Data Collection Form # 3 Submitted by: Katelyn & Karin Date: November 15, 2017

Childs Name:

Prompts and Responses Response % Correct

Goal/Objective /Prompt based on
Ratio IEP
Criteria
What would Max Rather do Prompt None 1/1 100%
than Play video games? Response +
Who wanted Max in their Prompt V LB V M 1/5 20%
group? Response - - - - +
What type of science project Prompt LB 1/2 50%
was his class assigned? Response - +
What is Maxs good habit? Prompt V LB M 1/4 25%
Response - - - +
Take card out of the bag, and Prompt VP
turn them all face up. Response
Separate Time Cards and order Prompt V V SV SM SV
the amount of time from least Response - - - - +
too greatest.
Match all Times with Activity Prompt V V SV SM SV SV
Card Response - - - - - -
How long does scriptures take? Prompt V SV RO V 1/4 25%
Response - - - +
How long Does a Movie Take Prompt V V 1/2 50%
Response - +
How long does it take to get Prompt V 1/2 50%
dressed? 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: Said Anna and Josh. I asked if there was anyone else and he said also Liz.

LB=Look Back at Text RO= Removed Options SV=Sister Gave Verbal Prompt. SM= Sister Modeled.