Student: Krystal
Setting: Hospital
Environment: Central Supply
Activity: Unpacking Supplies

Key:
CUE = what support person does
HELP = the prompt or additional cue given
R+ = the positive Krystal gets for wheeling
Objective = what Krystal is expected to do
Condition to √ = before (number) of seconds elapses

DATA SHEET A (Completed Sample) Dates:

	Instructor CUE HELP or Correction Reinforcement R+	Objective	3/3	3/17	4/7	4/21	5/5	Condition To √
CUE	Face Krystal toward boxes, place hands on her wheels.	With her hands placed on her wheelchair wheels, Krystal initiates wheeling toward boxes after entering supply room.				√	√	Wait 10 secs then HELP.
HELP	Sign “wheel” in her hands, then replace her hands on wheels of wheelchair.
R+	Say, “Good job, Krystal” and rub and/or pat her shoulder.
CUE	Face Krystal toward work table, place hands on wheels	With a box on her tray & her hands placed on her wheelchair wheels, Krystal initiates wheeling toward work table.				√	√	Wait 10 secs then HELP.
HELP	Sign “wheel” in her hands, then replace her hands on wheels of wheelchair.
R+	Say, “Good job, Krystal” and rub and/or pat her
	shoulder.
CUE	Face Krystal toward boxes, place hands on wheels	With her hands placed on her wheelchair wheels, Krystal initiates wheeling toward boxes from work table.			√	√	√	Wait 15 secs then HELP.
HELP	Sign “wheel” in her hands, then replace her hands on wheels of wheelchair.
R+	Say, “Good job, Krystal” and rub and/or pat her shoulder.
CUE	Face Krystal toward work table, place hands on wheels	With a box on her tray & her hands placed on her wheelchair wheels, Krystal initiates wheeling toward work table.			√	√	√	Wait 15 secs then HELP.
HELP	Sign “wheel” in her hands, then replace her hands on wheels of wheelchair.
R+	Say, “Good job, Krystal” and rub and/or pat her
	shoulder.
CUE	Face Krystal toward exit, place hands on wheels	With her spoon & Yogurt card on her tray, & hands placed on her wheelchair wheels, Krystal initiates wheeling toward the exit doors.		√	√	√	√	Wait 15 secs then HELP.
HELP	Sign “wheel” in her hands, then replace her hands on wheels of wheelchair.
R+	Say, “Good job, Krystal” and rub and/or pat her shoulder.

COMMENTS: