TEACCH Schedule and Visual Support Assessment

TEACCH Schedule and Visual Support Assessment

Student’s Name:Date of Assessment:

Name of Person(s) Assessing:

Summary of Schedule and Visual Supports:

Section 1 – Matching Visual Support to Ability

Use written schedule and visual supports for this Student. Add pictures if you think it will benefit the Student.

Use Line Drawing icons for this Students schedule and visual supports.

Use generic Pictures for this Students schedule and visual supports.

Use Pictures specific to this Student for this Students schedule and visual supports.

Use Objects for this Students schedule and visual supports.

Section 2 – Distractibility

Use Icons with Velcro schedule where the icon is carried to a receptacle located at the represented person, place or activity (ex: bathroom icon is carried with to bathroom where there is a bathroom icon receptacle).

Use one of the following options: (Check one)

Laminated Schedule with boxes to be checked with a dry erase marker.

Laminated Schedule with boxes next to each scheduled activity to attach a check schedule cue.

Schedule using icons to be removed and placed in a finish pocket on the schedule.

Section 3 – Ability to Discriminate and handle multiple visual Icons

It should be fine to use a full shift schedule with this Student. (This is generally not recommended for students who use icon schedules as it can become visually overwhelming)

Probably best to limit this Student schedule to a half shift in length or no more than 3 – 5 icons.

This student can tolerate completing up to ____ less-preferred activities before receiving a reinforcer of free choice activity.

Use a First/Then type schedule with this Student. Either:

A First/Then schedule with only two activities

A First/Then schedule with multiple activities followed by a reinforcer or free choice activity

Section 4 – Name on Students Schedule

Have their name printed on top of the schedule. Picture of the Student on schedule is optional.

Have their name printed on top of the schedule and a picture of the Student on the schedule.

Section 5 – Special Interests

Special interest can be added to the schedule if you think it will benefit the Student. (Optional)

Incorporate special interest visuals into the schedule to draw the Student to the schedule.

Section 1 – Matching Visual Support to Ability

The Students is a

[ ] Reader[ ] Non-Reader

[ ] YES[ ] NO

[ ] YES[ ] NO

[ ] YES[ ] NO

Section 2 – Distractibility(Check one)

[ ] YES[ ] NO

Section 3 – Ability to Discriminate and handle multiple visual Icons

[ ] YES[ ] NO

[ ] YES[ ] NO

Section 4 –Name on Students Schedule

The Student (Check one)

[ ] Can recognize their name.[ ] Cannot recognize their name.

Section 5 – Special Interests

The Student naturallygoes to their schedule when given a check schedule cue?

[ ] YES[ ] NO

Chileda Institute (Nov, 2011)