Participation Curriculum

Observational Assessment

Student:______Birth date:______

Instructions:

For each activity the student is working on, mark student’s performance using the key indicating how he/she performs 80% of the time. Do not mark activities that the student does not do.

Explanation of Scoring Key:

K
E
Y /
  1. Passive Cooperation: Student does not initiate activity, but is alert to activity and accepts activity without resistance.
  2. Physical Assistance: Examiner provides supported guidance throughout activity (e.g. “hand over hand”).
  3. Physical Prompts: Examiner provides physical touch to help student start or continue activity.
  4. Verbal/gestural/visual prompts: Examiner provides prompt(s) to cue the student to start or continue on the activity. (If the student has started the task, but makes an error, examiner cueing is considered a “correction” and not a prompt. Correction should not be part of an assessment).
  5. Independently:
  6. Independently with accommodations: Accommodations may include adaptive devices or other supports.
  7. Independently with supervision: Supervision generally means providing observation for safety or behavior concerns.
  8. Independently w/out supports: No supports are given.

*Place an asteriskin box to refer the user to the Progress Notes Page where a specific progress note is recorded for a particular skill/objective.

Interpretation:

Growth is shown in two ways:

  1. The number of activities the individual is able to accomplish in any particular Performance Expectation Area.
  2. The increase towards independence shown by the assistance level needed for each specific activity.

Table of ContentsPage Number

PE 1Leisure and Productivity1

PE 2 Social Interactions13

PE 3Communication15

PE 4Personal Care, Health & Safety19

PE 5Mobility27

Participation CurriculumPE 1: Leisure and Productivity
K
E
Y /
  1. Passive Cooperation
  2. Physical Assistance
  3. Physical Prompts
  4. Verbal/gestural/visual prompts
  5. Independently
  1. Independently with accommodations
  2. Independently with supervision
  3. Independently w/out supports
/ Educational
Setting:
Age: / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
I.DEVELOPS LEISURE/RECREATIONAL SKILLS
A.Interacts with others during leisure activities.
Enjoys physical interaction/play with familiar individual.
Participates in interaction activity.
Attends to play activity of others.
Participates/engages in play with others.
B.Participates in leisure/recreation routines.
Chooses and participates in a variety of activities during “free choice periods”.
Locates equipment/materials/supplies as needed.
Uses equipment correctly and safely and puts away.
C.Participates in auditory activities.Also see PE 3 VIIB
Explores sound making toys.
Maintains attention to musical event/activity.
Interacts with musical activity (sings, claps, plays instruments, marches, dances)
D.Plays/interacts with toys.
Purposefully repeats actions on toys.
Plays/interacts with toys.
Participates in exploratory play through objects other toys.
E.Participates in activities related to reading materials.
Looks at/attends to book/story.
Points to picture in book.
Selects book.
Attends to book/story presented to group.
Visits library and borrows book.
F.Learns arts and crafts skills.
Scribbles with writing utensil.
Imitates simple line drawing.
Paints with fingers.
Paints with utensils.
Manipulates art media through media or technology.
Pastes/glues pieces together.
Duplicates design when given model.
Makes simple art/craft project.
G.Completes puzzle.
Completes form board/insert puzzle.
Completes an interlocking frame puzzle.
Completes jigsaw puzzle.
H.Participates in activities involving computers/equipment.
Uses adaptive device to operate toy/computer/equipment.
Uses standard computer key board/mouse to operate computer/equipment.
Uses appropriate care in operating equipment.
I.Plays table games, electronic/computer games.
Passively participates in simple game/play.
Actively participates in simple game/play.
II.LEARNS MOVEMENT/EXERCISE PATTERNS.
A.Participates in proprioceptive and vestibular movement patterns. See PE 5 XIIIE
B.Participates in movement/equilibrium activities. See PE 5 XIII G
C.Participates in midline body movement activities.
Responds to moving object.
Pulls or maintains grasp on object.
Catches rolled or tossed object.
Rolls or throws object.
Carries object.
D.Participates in exercise to improve/maintain physical fitness.
Participates in exercise routine.
Exercises regularly.
E.Participates in games.
Participates in non-competitive action games.
Participates in simple group active games. (circle, running, relay, interactive)
Participates in individual active games.
F.Improves recreational mobility and endurance.
Walks for ___ minutes.
Uses adapted form of mobility for ____ minutes.
Rides a bike or adaptive riding equipment for ____ minutes.
Maintains active movement patterns while in water for ____ minutes.
G.Participates in water activities.
Follows safety procedures in pool/pool area.
Tolerates simple body movement while in water.
Uses purposeful body movement in water.
Puts head under water and resurfaces.
Propels body (swims) in water using legs and arms.
Swims independently.
H.Uses recreational equipment.
Pulls/pushes wheel toys/equipment.
Lies/sits on wheeled toy/equipment while being pulled.
Propels self on wheel toy without pedals.
Pedals tricycle/bicycle.
Pedals and steers bike.
I.Learns to use playground equipment safely.
Uses playground equipment safely.
J.Learns ball skills.
Pushes ball.
Rolls ball.
Catches balls rolled, thrown or bounced.
Bounces ball to another person.
Uses bat/racquet to swing and hit ball.
Kicks ball to another person.
Tosses and catches ball/beanbag.
Throws ball towards target/person.
K.- N.Learns kickball, softball/T-ball, basketball, and bowling skills.
Runs bases in correct order, stopping when appropriate.
Participates in a kickball game.
Participates in softball/t-ball game.
Participates in a basketball game.
Participates in a bowling game.
O-P.Participates in community outings/activities/leisure/recreation routines.
Exhibits appropriate behavior in public places.
Tolerates social events.
Participates in functional community activities.
Participates in variety of leisure recreational activities in community.
III.LEARNS FUNCTIONAL SKILLS.
A.Matches items according to attribute.
Matches items according to attribute (objects, color, shape, size) given a set of objects.
B.Identifies/names items according to attribute.
Identifies specific attributes of objects (color, shape, size).
Labels attributes of objects (color, shape size).
C.Learns personal information.
Uses response mode to communicate name.
Identifies own name in writing.
Carries personal ID and show it upon request.
D.Learns selected reading skills.
Matches letters.
Matches survival signs/words.
Identifies survival signs/words.
E.Learns to use writing utensils.
Holds writing utensil.
Imitates simple line drawing.
Draws circles/or marks on objects on page.
Traces a line (left to right).
F.Learns selected writing skills.
Traces letters/numbers.
Copies letters/numbers.
Writes letters/numbers.
Writes individually selected words.
G.Learns selected math skills.
Using 1 to 1 correspondence matches 1 set of objects to another or to grid/jig.
Identifies numerals.
Counts by rote.
Counts objects when told to “Count these”.
Counts out specific number of objects when asked to “Give me (number)”.
H.Learns money skills necessary for using community facilities.
Identifies coins and bills as money used for buying goods and paying for services.
Takes items to cashier and pays for purchase.
I.Learns calendar skills.
Identifies weather on given day.
Identifies days/months on calendar.
Identifies activities that regularly occur on each day.
J.Learns time and sequencing skills.
Keeps track of/follows daily schedule
Identifies activities that occur now/before/after a given activity.
IV.LEARNS/IMPROVES OBJECT MANIPULATION AND BILATERAL HAND COORDINATION.
A.Processes tactile stimuli.
Tolerates touching textured surfaces.
Tolerates physical manipulation of hands/arms.
Explores/manipulates objects representing a variety of textures, temperatures and compositions.
B.Exhibits tactile discrimination skills.
Discriminates objects as same or different by touch.
C.Learns/improves/maintains reaching skills.
Turns head in direction of object/or sound before reaching or responding.
Reaches toward object.
Reaches over head or backward.
D.Learns/improves/maintains ability to reach for and grasp objects.
Closes and tightens hand around an object.
Grasps object with thumb, index finger and middle finger.
Retrieves object from container by reaching in with hand.
E.Learns/improves/maintains ability to release objects.
Releases object after grasp.
Releases object into container in controlled manner.
Releases small object into small container.
Releases small object into small container, while holding small container.
F. Learns/improves/maintains ability to adjust hand movements.
Explores objects in environment.
Turns palm up to accept object.
Uses forefinger for functional activities (poke, push, point).
G.Learns/improves/maintains ability to manipulate objects.
Stacks objects.
Opens/closes containers.
Opens/closes doors/drawers.
H.Learns/improves/maintains bilateral hand usage.
Uses both hands to manipulate object.
Picks up, carries and puts down objects.
Pulls apart objects (e.g. snap together type) with hands.
Puts together objects (e.g. snap together type) with hands.
I. Learns functional object use and problem-solving skills.
Removes obstacle in order to obtain object/goal.
Initiates help of another person to obtain object/goal.
Uses tools to help obtain object/goal.
Demonstrates appropriate use of given object.
J.Understands cause and effect relationships.
Repeats action that causes object to move.
Attends to object being activated/manipulated.
Anticipates effect and acts appropriately (e.g. stops pouring when glass is full).
V.PARTICIPATES IN/PERFORMS WORK ACTIVITIES/SKILLS
A.Participates in classroom/building chores.
Puts away personal belongings.
Assists another with specific chores.
Completes specific chores.
B. Learns sorting skills.
Sorts objects into sets.
Sorts items by color.
Sorts items by shape.
Sorts items by size.
E. Learns assembly/packaging/stocking skills.
Disassembles parts of object.
Assembles object parts into whole.
Puts items on shelves in appropriate place.
Follows pattern/grid to package items.
F.Learns clerical skills.
Collates paper into sets.
Puts literature into envelopes.
Prepares mailings (using labels/stamps, stamper).
Uses stapler.
G. Learns food preparation skills.
Demonstrates good food service/health and safety
Locates ingredients/items needed.
Uses standard measures.
Stirs food without spilling.
Uses small kitchen appliances/utensils.
Sets table.
Clears table.
Washes/dries dishes.
Follows pictorial directions for preparing food.
H. Learns food service skills using appliances.
Uses stove/oven/microwave.
Uses small appliances.
Cleans and puts away small appliances.
I. Learns basic cleaning skills.
Wipes off flat surfaces.
Vacuums floor.
Sweeps floor.
Mops floor.
Cleans sink.
Empties baskets/trash can/garbage container.
Follows safety procedures related to cleaning.
J.Learns clothing care skills.
Collects and sorts dirty clothes.
Operates washer/dryer to wash/dry clothes.
Folds towels/clothes.
Returns laundered clothes to designated area.
K. Learns skills related to plant/lawn care.
Picks up litter.
Rakes leaves.
Picks weeds.
Shovels snow.
Cares for plants.
L.Uses tools to contract/repair simple items.
Constructs simple objects using tools.
M.Learns skills related to child care.
Behaves in gentle manner with children.
Follows staff routines/procedures with children.
VI.LEARNS WORK HABITS
A.Improves long term memory skills.
Sequences a familiar story/daily routine.
Demonstrates proper procedure to follow in given instance.
B. Develops attending skills.
Attends to activity.
When interrupted, returns attention to task.
Attends to task with competing background noise/activities.
C.Develops work behaviors and attitudes.
Performs repetitive tasks.
Seeks assistance from familiar adult when needed.
Indicates when work/task is complete.
Works without engaging in behaviors which interfere with work.
D. Maintains work schedule.
Gets ready to begin work within minutes of arrival/request.
Works at a steady, reasonable pace.
Uses "break time" appropriately and returns on schedule.
E. Participates in work routines.
Puts on/wears/takes off vocationally related clothing or equipment.
Maintains proper grooming at work.
Follows check-in or check-out procedures for work routine.
Follows known safety rules for work.

* See Progress Notes Page 1

Participation CurriculumPE 2: Social Interactions
K
E
Y /
  1. Passive Cooperation
  2. Physical Assistance
  3. Physical Prompts
  4. Verbal/gestural/visual prompts
  5. Independently
  1. Independently with accommodations
  2. Independently with supervision
  3. Independently w/out supports
/ Educational
Setting:
Age: / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
VII.DEVELOPS SOCIAL SKILLS.
A. Develops self-awareness.
Responds to mirror image.
Identifies self and others in pictures.
Responds to own name.
Identifies body parts.
Interacts with strangers appropriately.
B.Develops appropriate emotional response patterns.
Gives and receives affection appropriately.
Expresses emotions appropriately.
Acknowledges/identifies own feelings.
Expresses likes and dislikes appropriately.
C. Develops interpersonal skills.
Tolerates physical interaction/play with familiar person.
Initiates social interactions.
Responds appropriately to simple requests/cues.
Uses appropriate behavior or words to get attention of another person.
Accepts guidance/direction from others.
Copes with difficult situations/conflicts.
D. Improves interpersonal/peer relationships.
Plays/interacts appropriately with peers.
Takes turn with peers.
Show concern/compassion for peers.
Invites a peer to join his/her activity.
E. Learns self control.
Maintains self-control.
F. Responds to reinforcement program.
Responds to immediate, positive reinforcement.
Responds to delayed reinforcement.
G. Follows safety procedures.
Follows known safety rules.
Cooperates during emergency drills.
H. Follows directions and routines.
Follows directions given to the class/group.
Follows known rules as part of a routine.
I. Develops positive classroom /work behaviors.
Sits quietly.
Quiets down after being active.
Asks permission to leave room/activity area.
Remains in assigned area/room.
Goes from one location to another within school without unnecessary delays.

* See Progress Notes Page 1

Participation CurriculumPE 3: Communication
K
E
Y /
  1. Passive Cooperation
  2. Physical Assistance
  3. Physical Prompts
  4. Verbal/gestural/visual prompts
  5. Independently
  1. Independently with accommodations
  2. Independently with supervision
  3. Independently w/out supports
/ Educational
Setting:
Age: / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
VIII.DEVELOPS EFFECTIVE COMMUNICATION SKILLS.
A. Processes tactile stimuli.See PE 1 IVA
B. Processes auditory stimuli.
Locates auditory stimuli.
Demonstrates preferences for certain auditory stimuli.
Follows moving auditory source.
C. Processes visual stimuli.
Locates visual stimuli.
Follows movement.
Selects preferred visual stimuli.
D. Processes environmental stimuli.
Locates environmental stimuli.
Recognizes familiar environmental stimuli.
Responds positively to environmental event/activities that involve more than one stimulus.
E. Develops alternate communication skills.
Activates signaling device for assistance as needed.
Communicates using communication board with pictures/photos of objects/activities.
Makes choices using alternate communication system.
Uses voice output system for communication:
F. Develops sign language.
Imitates hand movement for basic signs.
Comprehends/responds to basic (single) signs.
Uses basic signs to communicate wants and needs.
Uses signs regularly.
G. Participates in switch activated activities.
Attends to an object being activated by a switch.
Randomly activates switch.
Purposefully activates switch.
Reactivates switch when activity stops.
H. Responds to interactions.
Shows awareness of speaker.
Maintains eye contact during interaction.
Uses individualized communication mode to interact or obtain object.
Responds differently to tone of voice.
I. Develops early communication patterns.
Demonstrates communicative readiness by reaching out to indicate want/need.
Responds to simple yes/no questions.
Participates in simple communication routines.
Uses conventional gestures with a variety of individuals.
J. Develops responses to words.
Responds to words "no/stop".
Responds appropriately to simple requests/cues.
K. Identifies/makes choices among objects.
Expresses like and dislikes.
When presented with two or more choices, the student will identify an object or picture/symbol of an activity.
Chooses an object/activity using individualized response mode.
L. Follows directions.
Gives object on verbal request.
Responds to directional request like "Go get the .” or “ Where is the ?”
Follows directions which involve two actions.
Follows pictorial directions.
M. Develops early vocalization skills.
Vocalizes to familiar person who is engaging him/her by talking or smiling.
Attempts to get attention by vocalizing.
Imitates familiar sounds/syllables.
N. Develops oral communication.
Imitates some real words.
Uses single words regularly.
Uses two to three word phrases frequently.
Refers to self by name.
Answers question with verbal response.
Controls intensity of vocalizations.
O. Learns/improves/maintains language skills.
Comprehends/expresses noun concepts.
Comprehends/expresses action/verb concepts.
Comprehends/responds to location phrases.
Comprehends/expresses descriptors.
Comprehends/expresses requests.
Comprehends/expresses to "wh" questions.
P. Develops conversational skills.
Expresses one-word greetings.
Engages in simple conversation.
Maintains distance when speaking to someone.
Exhibits appropriate communication routine with unfamiliar person.
Q. Uses language to express feelings and share information. Also see PE 2 VII B
Makes comments about self.
Identifies feelings in stories/pictures.
Recounts previous activities or events.

* See Progress Notes Page 1

Participation CurriculumPE 4: Personal Care, Health and Safety
K
E
Y /
  1. Passive Cooperation
  2. Physical Assistance
  3. Physical Prompts
  4. Verbal/gestural/visual prompts
  5. Independently
  1. Independently with accommodations
  2. Independently with supervision
  3. Independently w/out supports
/ Educational
Setting:
Age: / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12
IX. DEVELOPS POSITIONING AND FITNESS SKILLS.
Entire section is duplicated in PE 5 XIII and PE 1 II F
X. DEVELOPS DRESSING SKILLS.
A. Tolerates body movement/adjusts/manipulates body to assist in dressing.
Actively participates in dressing.
Maintains appropriate position to assist in dressing.
Maintains supported stand to assist in dressing.
Lifts feet alternately to assist in dressing.
Reaches to assist in dressing.
B. Removes outside clothing.
Removes unfastened outside clothing.
Removes all outside wear independently.
C. Removes inside clothing.