Using the guiding questions below, prepare a one-pager of skills, challenges, concerns, and interests of your child on the next page.
Hello My Name is (Insert name)
I am (insert age) years old.
| My strengths are… | Some important things you should know about me are… | I respond well to… |
|---|---|---|
| What does your child do well (i.e. feeds self, imitates modeled behaviors)? What skills does your child have (i.e. knows their colors)? What characteristics help them to be successful with difficult tasks or nonpreferred activities? Which personality traits do you appreciate in your child (i.e. very social, a thinker)? | Attach a picture of your child | What behavioral strategies are working at home? What visual or physical supports have been successful in the past? What do you do to ease transitions at home and in other settings (i.e. two minute warning)? What are some methods to make challenges easier (i.e. setting a timer, playing music)? |
| Things that challenge me (but I am still working on) are… | Some Important things you should know about me are… | My likes and interests are… |
| What are some things you are working on at home or in other settings (i.e. making eye contact, responding to my name)? What skills are starting to show, but still need work (i.e. turn-taking, signing/speaking to indicate a need or want)? What are some current problem behaviors and how are you addressing them (i.e. stuffing too much food in mouth – giving a handful at a time)? | What are the most concerning behaviors or needs (i.e. wander risk, no fear of danger or pain)? What should a caretaker know before being left alone with your child (i.e. allergies, health concerns)? What behaviors does your child do that might be misunderstood (i.e. echoes a question when they don’t understand)? | What does your child like that can be used as reinforcement for expected behaviors (i.e. bubbles, tickling, trains)? What might your child find comforting during or following an upset (i.e. preferred character or item)? What causes your child to self-stimulate (stim) (i.e. magnets, stacking blocks, twinkle lights)? |
Sample is below:
