Important Steps



Important Steps, Inc.PREFERENCE ASSESSMENT # 1Student’s Name:_____________________________ EI#:____________________Instructor: ______________________________Possible reinforcerNo reactionRejectsTakes Reaches for/pointsTakes againProtests when taken awayDate &Initialse.g. toy car√√√6/1/15 KMNote: Offer items and check all that applyPlease use these forms for the first 2-3 weeks (pairing period) or longer if approved by the field supervisor. See instruction.ABA Instructor’s Signature: ___________________________________ Date: __________________Important Steps, Inc.PREFERENCE ASSESSMENT # 2Student’s Name:______________________ EI#:_________ Instructor:_______________Edible Reinforcerse.g. cookies, cheerios, potato chipsToy Reinforcerse.g. train, car, dollSocial Reinforcerse.g. verbal praise, high five, tickling 1.1.1.2.2.2.3.3.3.4.4.4.5.5.5.6.6.6.7.7.7.8.8.8.Manipulative Reinforcerse.g. blocks, puzzles, shape sorter Arts & Crafts Reinforcerse.g. play dough, crayons, drawing, paintingActivity Reinforcerse.g. peek-a-boo, hide and seek1.1.1.2.2.2.3.3.3.4.4.4.5.5.5.6.6.6.7. 7.7.8.8.8.Child’s Likes: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Child’s Dislikes: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ABA Instructor’s Signature: ___________________________________ Date: __________________ ................
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