GOAL ATTAINMENT SCALE FORM

Student (DOB): GDDate: 11-14-11

Building Team:

Level Of
Attainment / Goal 1: Social / Goal 2: Self-Regulation / Break / Goal 3: Task Engagement / Completion
-2
Much less
than expected
(Present Level) / During lunch, breaks, and recess, GD insolates himself and when peers attempt to initiate activities with him, he refuses. / When frustrated, GD refuses to do work or yells and throws items 2-3 times daily. / GD requires 5-8 verbal prompts to stay on task and complete classroom work during a 30 minute independent work time.
-1
Somewhat less
than expected
(Progress) / Using peer mediation instruction (peer to peer support), GD will actively participate in recess, break, lunch activities following play initiations from peers 1 of 5 opportunities. / Using a 5 point scale and 2-3 verbal / visual prompts, GD will use the identified strategiesbased on his level of frustration to calm himself 2 of 5 opportunities. / Using a self-management system and 2-3 verbal / visual prompts, GD will stay on task and complete independent work in the allotted time frame 4 of 5 class periods.
0
Expected level of outcome
(Annual Goal) / Using peer mediation instruction (peer to peer support), GD will actively participate in recess, break, lunch activities following play initiations from peers 4 of 5 opportunities. / Using a 5 point scale and 1 visual prompt , GD will use the identified strategies based on his level of frustration to calm himself 4 of 5 opportunities. / Using a self-management system, GD will independently stay on task and complete independent work in the allotted time frame 4 of 5 class periods.
+1
Somewhat more
than expected
(Exceeds annual goal) / Using peer mediation instruction (peer to peer support), GD will actively participate in recess, break, lunch activities following play initiations from peers 8 of 10 opportunities. / Using a 5 point scale, GD will use the identified strategies based on his level of frustration to calm himself 8 of 10 opportunities. / Using a self-management system, GD will independently stay on task and complete independent work in the allotted time frame 6 of 7 class periods.
+2
Much more
than expected
(Far exceeds annual goal) / Using peer mediation instruction (peer to peer support), GD will initiate activities with peers during recess, break, and/or lunch. / Using a 5 point scale, GD will use the identified strategies based on his level of frustration to calm himself. / Using a self-management system, GD will independently stay on task and complete independent work in the allotted time frame.
EBP: Peer Mediated Instruction; Video Modeling / EBP: Visual Supports / EBP: Self-Management

GAS Goal Update

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