3. Yes No 4. Yes No 5. Yes No 6. Yes No REINFORCE Component 1. Yes No 2. Yes No 3. Yes No 4. Yes No 5. Yes No 6. Yes No (# Yes # Total) TOTAL / Percent Score Step 3: PTR Plan Assessment (Fidelity)—Example Teacher: Student: Date: Observation Self-Assessment Interventions Implemented Impact (1 = no impact; 5 = impact) PREVENT Transition Supports—visual checklist 1 2 3 4 5 Visual checklist provided to Isaiah Y / N / NA Choice of reinforcement presented and described on checklist Y / N / NA TEACH Replacement behavior—academic engagement 1 2 3 4 5 Checklist reviewed during study skills class Y / N / NA Goal set Y / N / NA Gave 1 minute at end of class for Isaiah to self-assess Y / N / NA Reviewed Isaiah’s self-assessment and gave feedback Y / N / NA Replacement behavior—escape by asking to be excused 1 2 3 4 5 to non-preferred activity, provided a verbal prompt/cue to remind Isaiah that he Y / N / NA can ask to be excused. REINFORCE Reinforce academic engagement 1 2 3 4 5 Presented choice reinforcement menu to Isaiah when goal met Y / N / NA
3. Yes No 4. Yes No 5. Yes No 6. Yes No REINFORCE Component 1. Yes No 2. Yes No 3. Yes No 4. Yes No 5. Yes No 6. Yes No TOTAL (# Yes / # Total) Percent Score Step 3: PTR Plan Assessment (Fidelity)—Example Teacher: Student: Date: Observation Self-Assessment Interventions PREVENT Implemented Impact (1 = no impact; 5 = impact) Transition Supports—visual checklist Visual checklist provided to Isaiah Choice of reinforcement presented and described on checklist Y / N / NA Y / N / NA 1 2 3 4 5 TEACH Replacement behavior—academic engagement Checklist reviewed during study skills class Goal set Gave 1 minute at end of class for Isaiah to self-assess Reviewed Isaiah’s self-assessment and gave feedback Replacement behavior—escape by asking to be excused to non-preferred activity, provided a verbal prompt/cue to remind Isaiah that he can ask to be excused. Y / N / NA Y / N / NA Y / N / NA Y / N / NA Y / N / NA 1 2 3 4 5 1 2 3 4 5 REINFORCE Reinforce academic engagement Presented choice reinforcement menu to Isaiah when goal met Y / N / NA 1 2 3 4 5