Transcription of SENSORY-BASED INTERVENTION DATA COLLECTION
1 SENSORY-BASED INTERVENTION data COLLECTION | 1 P a g eThis is an example of a data sheet that can be used in a classroom to help determine the efficacy of the weighted lap pad. Information about the goals for attention, sitting in chair (during circle, in assembly), keeping hands to self, etc. are noted at the top of the page. Baseline of pre-lap pad use will serve as a good comparison to use of the lap pad. Incidents can include out of seat behavior, inattention, inappropriate interactions with peers, etc. Student s Name: _____ Implemented by: _____ Goal of INTERVENTION /targeted outcomes: _____ _____ Recommended frequency (days, times per day etc.): _____ INTERVENTION process/procedure: (Example statements are provided below) 1. Prior to transition out of classroom provide the 2. At the beginning of a class have the 3.
2 Every 30 4. 5. SENSORY-BASED INTERVENTION data COLLECTION | 2 P a g eBASELINE data : Frequency or duration of behavior the sensory strategies will address. Date Target Behavior Activity/Routine Observed Duration of Observation Number of Incidents Duration of Incidents Comments INTERVENTION PHASE: data on implementation of sensory strategies. Date INTERVENTION Desired Outcome Duration of Observation Number of Incidents/ Occurrences Duration of Incidents Comments Yes No
