"Sample Progress Monitoring Form - Pmii Activity Observation for Young Children - National Professional Development Center on Asd"

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National Professional Development Center on
Autism Spectrum Disorders
Module:
Peer-Mediated Instruction and Intervention
Sample Progress Monitoring Form: PMII Activity Observation for Young Children
Date: _________________________
Time: ____________________________________
Focal child/children present: ________________________________________________________________________
Peers present: ___________________________________________________________________________________
Activity: _________________________________________________________________________________________
Activity
Yes
No
1. Did the children participate in the activity after your introduction?
2. Did the children seem to enjoy the activity?
3. Did the activity contain materials that promoted social interaction?
4. Did the activity promote positive or negative social interactions? Give examples.
______________________________________________________________________________________________
5. Did the children use the toys constructively or in a repetitive, non-useful manner? Give examples.
______________________________________________________________________________________________
6. What changes should be made in the arrangement of the play setting to improve social interactions (e.g., materials
used, introduction to the activity)?
______________________________________________________________________________________________
______________________________________________________________________________________________
PMII Module 7-23-2008
Page 1 of 2
National Professional Development Center on ASD
FPG Child Development Institute
The University of North Carolina at Chapel Hill
National Professional Development Center on
Autism Spectrum Disorders
Module:
Peer-Mediated Instruction and Intervention
Sample Progress Monitoring Form: PMII Activity Observation for Young Children
Date: _________________________
Time: ____________________________________
Focal child/children present: ________________________________________________________________________
Peers present: ___________________________________________________________________________________
Activity: _________________________________________________________________________________________
Activity
Yes
No
1. Did the children participate in the activity after your introduction?
2. Did the children seem to enjoy the activity?
3. Did the activity contain materials that promoted social interaction?
4. Did the activity promote positive or negative social interactions? Give examples.
______________________________________________________________________________________________
5. Did the children use the toys constructively or in a repetitive, non-useful manner? Give examples.
______________________________________________________________________________________________
6. What changes should be made in the arrangement of the play setting to improve social interactions (e.g., materials
used, introduction to the activity)?
______________________________________________________________________________________________
______________________________________________________________________________________________
PMII Module 7-23-2008
Page 1 of 2
National Professional Development Center on ASD
FPG Child Development Institute
The University of North Carolina at Chapel Hill
National Professional Development Center on
Autism Spectrum Disorders
Module:
Peer-Mediated Instruction and Intervention
7. Do any changes need to be made to the peers included in the activity? Yes ________ No __________ If yes, please
describe. _____________________________________________________________________________________
Social Interaction Behaviors
Time
Activity
Target Behaviors
Looking
Parallel
Taking turns
Exchanging
Requesting items
Asking to play
at peer
play
materials
(Adapted with permission from Odom, S. L., McConnell, S. R., Ostrosky, M., Peterson, C., Skellenger, A., Spicuzza, R.,
Chandler, L. K., McEvoy, C. A., & Favazza, P. C. (1993). Play Time/Social Time: Organizing your classroom to
build interaction skills. Tucson, AZ: Communication Skill Builders.)
PMII Module 7-23-2008
Page 2 of 2
National Professional Development Center on ASD
FPG Child Development Institute
The University of North Carolina at Chapel Hill
Page of 2