Name of Client: Tiffany Cheng

Month of Report: Dec, 1999

Behavior: Therapists are continuing to use arm restraints as a consequence for excessive

Choices: The SD is "choose one". Therapists present 3D preferred items and icons of those items in plastic contrtiners. Empty plastic containers are used as distracters. Tiffany is required to touch the container of the one she desires as a response. Tiffany mastered choosing the preferred item over the empty containers when a field of 2 was presented. Currently working on a field of3. With the field of3, two empty containers are presented along with one container holding the highly preferred item approximately 80% of the time.

Compliance: Current SDs are "come here", :"sit down", and "stand up". "Come-here" is being worked on without distracters in Tiffany's environment. Therapists are also using a gesture when saying "come here". Currently Tiffany’s response is between 50-60% with "come here". "Sit down" is not being worked on as a drill, but being done in when calling Tiffgnyy -to work. A gesture of pointing to the chair or tapping the chair is currently being used. Tiffany is currently performing at 80-90% with "sit down". "Stand up" is currently being worked on with therapists using an exaggerated gesture of sweeping both hands up while saying the SD. Currently Tiffany's performance with "Stand Up" is approximately 50%.

Picture Exchange Communication System(PECS): Therapists are working on Tiffany requesting the television program "Barney". When Tiffany touches the 3D "Barney" which is placed directly in front of a television, the therapist turns on a "Barney" video for Tiffany. Currently Tiffany performance with this is approximately -80%.

Play: Currently therapists are using hand over hand prompts to help Tiffany play appropriately with various toys.

Receptive Commands: Current SDs are "Put in", "Hold Cup", "Bau-Bau", and 'Raise Arm". Currently working-on "put in", requiring Tiffany to put various object in a bowl which the therapist is holding. The bowl is being faded out so that eventually Tiffany would be putting the item directly in the therapists hand. A-small Styrofoam bowl is being used. In order to fade the bowl therapists are cutting away the bottom of the bowl. Tiffany is perform at 60-70% accuracy with "put in". ".Hold Cup" has been broken down into the following 3 steps: (1) Tiffany picks up cup with two hands; (2) brings straw to lips; (3) places cup down on table. Currently Tiffanycan perform steps 1 and 2 independently approximately 30% of the time. Therapists need to physically prompt Tiffany to perform step 3 100% of the time. "Bau-Bau": Therapists currently-clap their hands and say " Ting-Ting, Bau-Bau" while Tiffany is in various positions (standing, sitting, lying down). The correct response for "BauBau" is Tiffany stretching her arms up towards the therapist. As a reward for the correct response the therapist picks up Tiffany. Tiffany is performing at approximately 50% accuracy with this. For "raise arm" Tiffany is required to raise her left arm. This is to be a pre-requisite to waving. Currently a gesture is used-with the SD "raise arm". Therapists raise their own arm while saying SD. This is not being considered a prompt. Currently Tiffany's performance is at approximately 80%.

Self-Help: The SD is "eat". Therapists are working on the following 3 steps: (1) Picks up empty fork; (2) Spears food;(3) Brings food to mount. Currently Tiffany can perform step 1 independently 80-90% of the time. Therapists need to prompt Tiffany to spear food 100% of the time. For step2, therapists are prmopting Tiffany by taking only the edge of the fork and spearing food. After food has been speared, therapists release the fork, she can bring food to mouth independently 90% of time

In "self-help" therapists are also working on Tiffany being able to partially pull on a bib which she uses. The SDis "put on". The bib is-placed over Tiffitny's eye and Tiffany is required to reach up and pull the bib down. Currently Tiffany is performing at approximately 70%.