Job Application and Personal Information

By: Tori Stanley

Student: Lexie

Date: 11/3/14

Objective
Objective: To fill out a practice job application with
all of her own personal information.

Reinforcement
Type: pictures of Laverne that say "good work
Lexie"

Functional Routine: Will be done every day in life

skills class.

Schedule of delivery: at the completion of task

Program Steps

Error Correction

1. Name
2. Address
3. Name, address
4.Phone number
5. Name, address, phone number
6. Birthday
7. Name, address, phone number, birthday
Select one:
Discrete
Skill
X

Forward
Chain

Backward
Chain

Stop: Lets think about that for a second.

Back-step: Use the previous prompting level that
Lexie needed to complete the action.
Prompt: Give Lexie a verbal prompt for the
information.

Total Task

Location/Setting
In classroom during life skills class with a peer
tutor.
Materials Needed
Folder with personal information
Practice job application asking personal
information targeted
A pencil or pen

Criteria for Moving to Next Step

Lexie will complete each step of the program with
100% accuracy 5 times before she can move to the
next step.
Prompt Strategy

Lexie will utilize only the level of help she needs

for questions.
Select one:
Most-to-least
X

Instruction
Instruction/Cue: "Lexie time to work on job
applications please.

Naturally occurring cue for the behavior: Being

presented with a job application asking personal
information or in class finishing journal and
reading and moving on to job practice.

Time Delay

Generalization
Stimulus Factors: When presented with a form
requesting personal information Lexie will be able
to fill out all of her own information.

Response Factors: Student will be able to fill out

job applications or personal papers at a doctors
offices ect.

Student Response
Lexie will be able to fill out her own personal
information and recite it from memory when
requested.

Special Considerations

Ballroom Dance: Waltz Four Step Program

By: Tori Stanley
Student: Lexie

Date: 11/4/2014

Objective
Objective: Lexie will be able to complete the basic
4 step pattern of the waltz to pass it off in her
ballroom dance class.

Reinforcement
Type: Success at completing ballroom dance steps
to be able to do the steps with all of her peers.

Functional Routine: She will use this skill during

ballroom dance class.

Schedule of delivery: As she becomes more and

more competent at the steps.

Program Steps
3. Lexie will work with a teacher or peer tutor to
complete one full pattern of the basic waltz step
which will be:
Forward step
Side right step
Back step
Side left step
4. Lexie will complete the last step without help.
5. Lexie will complete the second to last step
without help.
6. Lexie will complete the last 3 steps without help.
7. Lexie will do all steps of the pattern without
help.
8. Lexie will do the steps with her peers in the
classroom to music.

Select one:
Discrete
Skill

Forward
Chain

Backward
Chain
X

We will start by working in the hall until she has

mastered the steps enough to be confident doing
them in the ballroom dance classroom with her
peers and music.

Waltz four count music

Dance room with peers
Peer tutor to help walk through steps

Stop: Hold on just a second, lets try that one

again.
Back-step: Start the first step of the pattern again.
Prompt: Okay whats our first step again Then
model the first step with her if she cannot
remember.

Total Task

Location/Setting

Materials Needed

Error Correction

Criteria for Moving to Next Step

Lexie will complete the given step 5 times
successfully.

Prompt Strategy
Most-to-least prompting will be used starting with
peer modeling.

Select one:
Most-To-Least

Time Delay

X
Instruction
Instruction/Cue: Ok Lexie lets try the waltz
steps.

Generalization
Stimulus Factors: Being able to move on to the
next dance that the class begins.

Naturally occurring cue for the behavior: Music

starts to play

Response Factors: No resistance or lag in moving

from the waltz to the next step.

Student Response/Behavior
Lexie will be able to start and complete the four
step waltz pattern.

Special Considerations
To be paired with a teacher or peer tutor not with
or near Alex to avoid conflict
Lexie will take herself downstairs to class and into
her position in line to be ready to begin the dance
when the bell rings without teacher prompting.
Lexie will watch a short video to refresh the basic
four waltz steps.

Carrying Food Trays Upstairs

By Tori Stanley
Student: Lexie

Date: November 4 2014

Objective

Objective: To be able to successfully get her tray of

food up the stairs to the classroom without help.

Functional Routine: This will happen in the morning

when she gets breakfast and in the afternoon when she
gets lunch every day.

Program Steps
1. Lexie will carry her tray and rest her elbow
against the wall while the teacher helps support
one side
2. Lexie will carry her tray while resting her elbow
against the wall
3. Lexie will be able to carry her tray upstairs
successfully alone

Reinforcement
Type: Being able to eat the food that she got
upstairs.

Schedule of delivery: At the completion of the

task.
Error Correction
Stop: Hold on lets make sure our feet are set
before we try to take a step, where do our feet
and arms need to be?
Back-step: Re-check feet and if arm is against
railing for extra support.
Prompt: Lexie check your feet.

Select one:
Discrete
Skill

Forward
Chain

Backward
Chain

Total Task
X

Location/Setting
Moving from the cafeteria to the classroom.

Criteria for Moving to Next Step

After 5 successful trials at each level of assistance
Lexie will be able to move to a lesser level of help.

Materials Needed
Tray full of food

Prompt Strategy
Most to least prompting with the teacher helping Lexie
start up the stairs supporting the weight of her tray and
gradually releasing Lexie to do it by herself.

Select one:
Most-To-Least
X

Time Delay

Instruction
Instruction/Cue: Okay Lexie carry our tray
upstairs.

Generalization
Stimulus Factors: Some restaurants in the
community require the carrying of food on trays as
well.

Naturally occurring cue for the behavior: Breakfast

or lunch time

Response Factors: Being able to carry a tray full of

food to sit down anywhere she wants to sit in any
setting.

Student Response/Behavior
Lexie will be able to carry food upstairs at
breakfast and lunch with different levels of
assistance starting at teacher helping support the
tray.

Special Considerations
If Lexie decides to get the big drink she might need
to use a drink or water bottle carrier so that it
does not weigh the tray down too much.
Lexie will get her tray full of food to the stairs and
prepare to carry it up.