Stimulus Response Data Sheet

Stimulus Response Data Sheet

Learner: ______Skill: Independent WorkCriteria: ______Chaining Procedure: ______

Instructions: Create a stimulus response chain with the SD and consequence listed for each response. Record the prompt level for each response (total task), or current target step (backward chain or forward chain).

Step # / SD / Consequence / Response / Baseline
1 / SD___”Go do your work”______
C ____In front of work area_____ / Walks to work area / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
2 / SD___In front of work area______
C ____Chair is out______/ Pulls out chair / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
3 / SD_____Chair is out______
C _____Sitting in chair______/ Sit Down / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
4 / SD_____Sitting in chair______
C _____Facing drawers______/ Turn to face drawers / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
5 / SD_____Facing Drawers______
C ______Drawer # 1 pulled out____ / Pull out Drawer # 1 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
6 / SD_____Drawer # 1 pulled out___
C ______Contents in hand_____ / Take contents out of drawer # 1 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
7 / SD_____Contents in Hand______
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
8 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
9 / SD_____Task complete______
C______Task contents in drawer___ / Return task to drawer # 1 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
10 / SD____Task contents in drawer_
C ______Drawer # 1 closed______/ Close Drawer # 1 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
11 / SD_____Drawer # 1 closed______
C ______Drawer # 2 pulled out__ / Pull out Drawer # 2 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
12 / SD_____Drawer # 2 pulled out_____
C ______Contents in hand______/ Take contents out of drawer # 2 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
13 / SD_____Contents in Hand______
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND

Date

Step # / SD / Consequence / Response / Baseline
14 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
15 / SD_____Task complete______
C______Task contents in drawer_ / Return task to drawer # 2 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
16 / SD ____Task contents in drawer_
C ______Drawer # 2 closed______/ Close Drawer # 2 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
17 / SD_____Drawer # 2 closed______
C ______Drawer # 3 pulled out__ / Pull out Drawer # 3 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
18 / SD_____Drawer # 3 pulled out____
C ______Contents in hand______/ Take contents out of drawer # 3 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
19 / SD_____Contents in Hand______
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
20 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
21 / SD_____Task complete______
C______Task contents in drawer___ / Return task to drawer # 3 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
22 / SD ____Task contents in drawer__
C ______Drawer # 3 closed______/ Close Drawer # 3 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
23 / SD_____Drawer # 3 closed______
C _____Drawer # 4 pulled out____ / Pull out Drawer # 4 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
24 / SD_____Drawer # 4 pulled out____
C ______Contents in hand______/ Take contents out of drawer # 4 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
25 / SD_____Contents in Hand______
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
26 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
27 / SD_____Task complete______
C ____Task contents in drawer_____ / Return task to drawer # 4 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
28 / SD____Task contents in drawer__
C ______Drawer # 4 closed______/ Close Drawer # 4 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND

Date

Step # / SD / Consequence / Response / Baseline
29 / SD_____Drawer # 4 closed_____
C _____Drawer # 5 pulled out___ / Pull out Drawer # 5 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
30 / SD_____Drawer # 5 pulled out_____
C ______Contents in hand______/ Take contents out of drawer # 5 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
31 / SD_____Contents in Hand______
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
32 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
33 / SD_____Task complete______
C ______Task contents in drawer___ / Return task to drawer # 5 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
34 / SD____Task contents in drawer__
C ______Drawer # 5 closed______/ Close Drawer # 5 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
35 / SD_____Drawer # 5 closed______
C _____Drawer # 6 pulled out______/ Pull out Drawer # 6 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
36 / SD_____Drawer # 6 pulled out_____
C ______Contents in hand_____ / Take contents out of drawer # 6 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
37 / SD_____Contents in Hand_____
C ______Contents set up______/ Set up contents to complete task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
38 / SD_____Contents set up______
C ______Task complete______/ Complete Task / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
39 / SD_____Task complete______
C ______Task contents in drawer___ / Return task to drawer # 6 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
40 / SD____Task contents in drawer__
C ______Drawer # 6 closed_____ / Close Drawer # 6 / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
41 / SD_____ Drawer # 6 closed_____
C ____ Facing Table______/ Turn to face table / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
42 / SD_____Facing Table______
C _____”Yes ______” ______/ Raise Hand / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND
43 / SD_____ “Yes _____”______
C _____Independent work is complete / “All Done” / NR
FP PP
IND / NR
FP PP
IND / NR
FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND / FP PP
IND

Date