Data Collection Form #2 Submitted by: Haley Kebker Date: 2-25-19

Child’s Name: Peter

Prompts and Responses Response % Correct

Goal/Objective /Prompt based on
Ratio IEP
Criteria
Catching a small ball that was Prompt V M M V V V V G V V V 7 66%
bounced to him. (Continued) Response + - - + + + + + - + - 15
Prompt V P V V
Response + - + +
Retell of wordless picture book Prompt M V V V M V V V 7 88%
to work on communication Response + + + - + + + + 8
skills “Flotsam”
Reading Comprehension “The Prompt V V V V V V V V V 7 77%
Best Nest” Response + + + + - + - + + 9
Playing UNO for Engagement Prompt V M V M V V V M V V M 11 100%
Response + + + + + + + + + + + 11
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:

Today we stayed in the living room while doing our intervention session. Peter’s parents are out of town and his grandparents are watching them and he seemed to stay

more engaged in the activities. Peter’s brother was also put down for a nap while we were doing our intervention sessions which helped Peter not get as distracted. While

Peter was not as engaged in the picture walk as we had hoped, but he did want to read the book. Peter also stay engaged while playing UNO for 30 minutes.