3. What is the likelihood of the (e.g., on-task behavior; cooperation; appropriate behavior student’s successful performance) resulting in acknowledgment or praise from teachers or other school staff? ___ Very likely ___ Sometimes ___ Seldom ___ Never 4. What is the likelihood of the resulting in acknowledgment (e.g., reprimands, (problem behavior) student’s corrections) from teachers or other school staff? ___ Very likely ___ Sometimes ___ Seldom ___ Never 5. What school-related items and activities are to the student? What items or activities could most enjoyable serve as special rewards? ___ Social interaction with adults ___ Listening to ___ Doing art ___ Social interaction with peers music ___ Using the computer ___ Teacher or office assistant ___ Being outside ___ Video/electronic games/apps ___ Going to media center ___ Going for a walk ___ Watching TV/DVD/Movie ___ Sensory activity (specify) ___ Reading ___ Objects (Specify) ___________________ ____________________ ___ Extra PE time __________________________________ ___ Given leadership opportunities ___ Extra free time ___ Food (Specify) _____________________ __________________________________ Other(s):_______________________________________________________________________________ Additional comments not addressed above in the Reinforce Component.
3. What is the likelihood of the student’s appropriate behavior (e.g., on-task behavior; cooperation; successful performance) resulting in acknowledgment or praise from teachers or other school staff? ___ Very likely ___ Sometimes ___ Seldom ___ Never 4. What is the likelihood of the student’s (problem behavior) resulting in acknowledgment (e.g., reprimands, corrections) from teachers or other school staff? ___ Very likely ___ Sometimes ___ Seldom ___ Never 5. What school-related items and activities are most enjoyable to the student? What items or activities could serve as special rewards? ___ Social interaction with adults ___ Social interaction with peers ___ Teacher or office assistant ___ Going to media center ___ Sensory activity (specify) ____________________ ___ Given leadership opportunities ___ Listening to music ___ Being outside ___ Going for a walk ___ Reading ___ Extra PE time ___ Extra free time ___ Doing art ___ Using the computer ___ Video/electronic games/apps ___ Watching TV/DVD/Movie ___ Objects (Specify) ___________________ __________________________________ ___ Food (Specify) _____________________ __________________________________ Other(s):_______________________________________________________________________________ Additional comments not addressed above in the Reinforce Component.
PTRFBASecondaryMultipleTeachersRevised072715.docx