GOAL ATTAINMENT SCALE (GAS) FORM

Building Team: ElementaryDate: 10-18-11

Student (DOB): JL

Level Of
Attainment / Goal 1: / Goal 2: / Goal 3:
-2
Much less
than expected
(Present Level) / Using general education peer supports (as determined by the LINK calendar), JL will elicit an active response to the teacher’s request (e.g. sharing comments, showing “thumbs up”, etc.) 0-1 of 10 opportunities. / Using visual / verbal requests by peers (as determined by the LINK calendar), JL will engage / participate in peer directed activities during non-academic times (e.g. recess, snack, field trips, etc.) 1 of 5 opportunities. / Using a visual schedule, routine checklists, and a check schedule card, JL will follow classroom schedule, classroom routines, and directions with 2-4 visual, verbal and physical prompts.
-1
Somewhat less
than expected
(Progress) / Using general education peer supports (as determined by the LINK calendar), JL will elicit an active response to the teacher’s request (e.g. sharing comments, showing “thumbs up”, etc.) 3 of 10 opportunities. / Using visual / verbal requests by peers (as determined by the LINK calendar), JL will engage / participate in peer directed activities during non-academic times (e.g. recess, snack, field trips, etc.) 2 of 5 opportunities. / Using a visual schedule, routine checklists, and a check schedule card, JL will independently follow classroom schedule, classroom routines, and directions 5 of 10 opportunities.
0
Expected level of outcome
(Annual Goal) / Using general education peer supports (as determined by the LINK calendar), JL will elicit an active response to the teacher’s request (e.g. sharing comments, showing “thumbs up”, etc.) 6 of 10 opportunities. / Using visual / verbal requests by peers (as determined by the LINK calendar), JL will engage / participate in peer directed activities during non-academic times (e.g. recess, snack, field trips, etc.) 3 of 5 opportunities. / Using a visual schedule, routine checklists, and a check schedule card, JL will independently follow classroom schedule, classroom routines, and directions 8 of 10 opportunities on 3 consecutive days.
+1
Somewhat more
than expected
(Exceeds annual goal) / Using general education peer supports (as determined by the LINK calendar), JL will elicit an active response to the teacher’s request (e.g. sharing comments, showing “thumbs up”, etc.) 8 of 10 opportunities. / JL will request / initiate an activity during non-academic times (e.g. recess, snack, field trips, etc.) 1 of 5 opportunities. / Using a visual schedule, routine checklists, and a check schedule card, JL will independently follow classroom schedule, classroom routines, and directions 10 of 20 opportunities on 3 consecutive days.
+2
Much more
than expected
(Far exceeds annual goal) / Using environmental prompts/supports, JL will independently elicit an active response to the teacher’s request (e.g. sharing comments, showing “thumbs up”, etc.) 6 of 10 opportunities. / JL will request / initiate an activity during non-academic times (e.g. recess, snack, field trips, etc.) 1 of 5 opportunities. / Using a visual schedule, routine checklists, and a check schedule card, JL will independently follow classroom schedule, classroom routines, and directions 15 of 20 opportunities on 3 consecutive days.
EBP: Peer Mediated Instruction / Peer to Peer Support / EBP: Peer Mediated Instruction / Peer to Peer Support; Visual Supports / EBP:Visual Supports; Self Management, Video Modeling