NAME:

DOB:

SEIS ID:

Goal: By November 21, 2015, STUDENT will be able to jump forward with both feet over a stationary rope with no assistance, 4 out of 5 attempts (80%), on 2 out of 3
trials, as measured by the APE teacher.
Obj 1: By February 21, 2015, STUDENT will be able to jump forward with both feet over a stationary rope with no assistance, 1 out of 5 attempts (20%), on 2 out of 3
trials, as measured by the APE teacher.
Obj 2: By May 21, 2015, STUDENT will be able to jump forward with both feet over a stationary rope with no assistance, 2 out of 5 attempts (40%), on 2 out of 3 trials, as
measured by the APE teacher.
Obj 3: By August, STUDENT will be able to jump forward with both feet over a stationary rope with no assistance, 3 out of 5 attempts (60%), on 2 out of 3 trials, as
measured by the APE teacher.

10 min +

5-10 min.

3-5 min.

None

Goal

Participation

Met Obj.

1-3 min.

Met Goal

Gestural

NonCompliant

Full Physical

Attmepts Act

NonResponsive

Gestural

Visual

Full Physical

Partial Physical

Verbal

Independent

Behavior

Objective 1

Prompting

Objective 3 Objective 2

Date

Trials

Attempts (%
Accuracy)

attempts (80%), on 2 out of 3

attempts (20%), on 2 out of 3

mpts (40%), on 2 out of 3 trials, as

60%), on 2 out of 3 trials, as

Notes/Criterion