writing
PreChange
| Days | Minutes of Fill In the Blank | |||
| Sept. 13 | 0 | |||
| Sept. 14 | 10 | |||
| Sept. 15 | 2 | |||
| Sept. 16 | 0 | |||
| Sept. 17 | 3 | |||
| Sept. 18 | 7 | |||
| Sept.19 | 5 | |||
| Your Name: Fill in the Blank | ||||
| Approved SMART Goal: Write the exact goal you submitted and was approved | ||||
| Short Term Goal 1: Fill In the blank | ||||
| Short Term Goal 2: Fill in the blank | ||||
| Short Term Goal 3: Fill in the blank | ||||
| ACTIVITY LOG | ||||
| Date Range: | 9/13/2021 - 9/19/2021 | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | 0 | |||
| Tuesday | 10 | |||
| Wednesday | 2 | |||
| Thursday | 0 | |||
| Friday | 3 | |||
| Saturday | 7 | |||
| Sunday | 5 | |||
| Total: | 27 |
PreChange
Pre Change Week
Week 1
| Week # | Week Dates | Minutes of ______ (type in the name of your approved behavior) | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Your Name: Fill in the Blank | ||||
| Approved SMART Goal: Write Exact Goal | ||||
| Short Term Goal 1: Fill in the Blank | ||||
| Short Term Goal 2: fill in the blank | ||||
| Short Term Goal 3: fill in the blank | ||||
| ACTIVITY LOG | ||||
| Date Range | Sept. 20-26 | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | 4 | |||
| Tuesday | 4 | |||
| Wednesday | 5 | |||
| Thursday | 4 | |||
| Friday | 5 | |||
| Saturday | 4 | |||
| Sunday | 4 | |||
| Total | 30 |
Kerry Kampschroeder:
I got this figure by adding the daily amounts on sheet 1.
Elizabeth Wachira:
Total duration/quantity inputed into graph
Elizabeth Wachira:
TOTAL Minutes
Elizabeth Wachira:
Total from Activity log
Week 1
Minutes of ______ (type in the name of your approved behavior)
PreChange and Week 1 Activity
Week 2
| Week # | Week Dates | Minutes of Fill in the Blank | ||
| Pre-Change | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20 - 26 | 30 | ||
| Week 2 | Type in dates | 3 | ||
| Your Name: Be sure to complete this section | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Type in dates | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | 3 | |||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 3 |
Week 2
Minutes of Fill in the Blank
PreChange through Week 2 Activity
Week 3
| Week # | Week Dates | Minutes of Fill in the Blank | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Week 2 | Sept. 27 - Oct. 3 | 3 | ||
| Week 3 | Type in dates | 3 | ||
| Your Name: Be sure to complete this entire section icluding goals. | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Type in dates | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | 3 | |||
| Wednesday | ||||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 3 |
Week 3
Minutes of Fill in the Blank
PreChange through Week 3 Activity
Week 4
| Week # | Week Dates | Minutes of Fill in the Blank | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Week 2 | Sept. 27 - Oct. 3 | 3 | ||
| Week 3 | Oct. 4-10 | 3 | ||
| Week 4 | Type in dates | 4 | ||
| Your Name: Complete this entire section, including goals. | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Type in dates | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | 4 | |||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 4 |
Week 4
Minutes of Fill in the Blank
PreChange through Week 4
Spring Break
| Week # | Week Dates | Minutes of Fill in the Blank | ||
| PreChange | Feb 4-10 | 27 | ||
| Week 1 | Feb. 11-17 | 30 | ||
| Week 2 | Feb. 18-24 | 3 | ||
| Week 3 | Feb. 25 - Mar. 3 | 3 | ||
| Week 4 | Mar. 4-10 | 4 | ||
| Spring Break | Mar. 11-17 | 0 | ||
| Your Name: Complete this section | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Mar. 11-17 | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | ||||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 0 |
Spring Break
Minutes of Fill in the Blank
PreChange through Spring Break Activity
Week 5
| Week # | Week Dates | Minutes of Fill in the Blank | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Week 2 | Sept. 27 - Oct. 3 | 3 | ||
| Week 3 | Oct. 4 - 10 | 3 | ||
| Week 4 | Oct. 11-17 | 4 | ||
| Week 5 | fill in date | 6 | ||
| Your Name: Complete this ENTIRE section, including goals | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | fill in date | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | ||||
| Thursday | 6 | |||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 6 |
Week 5
Minutes of Fill in the Blank
Pre Change Through Week 5
Week 6
| Week # | Week Dates | Minutes of Fill in Blank | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Week 2 | Sept. 27 - Oct. 3 | 3 | ||
| Week 3 | Oct. 4-10 | 3 | ||
| Week 4 | Oct. 11-17 | 4 | ||
| Week 5 | Oct. 18-24 | 6 | ||
| Week 6 | fill in the date | 4 | ||
| Your Name: Complete this section | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | fill in the date | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | ||||
| Thursday | 4 | |||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 4 |
Week 6
Pre Change Through Week 6
Week 7
| Week # | Week Dates | Minutes of Fill in Blank | ||
| PreChange | Sept. 13-19 | 27 | ||
| Week 1 | Sept. 20-26 | 30 | ||
| Week 2 | Sept. 27 -Oct. 3 | 3 | ||
| Week 3 | Oct. 4-10 | 3 | ||
| Week 4 | Oct. 11-17 | 4 | ||
| Week 5 | Oct. 18-24 | 6 | ||
| Week 6 | Oct. 25-31 | 4 | ||
| Week 7 | Nov. 1-7 | 2 | ||
| Your Name: Complete this section | ||||
| Approved SMART Goal: | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Nov. 1-7 | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | 2 | |||
| Wednesday | ||||
| Thursday | ||||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 2 |
Week 7
Pre Change Through Week 7
PostChange Week
| Days | Minutes of Fill in the Blank | |||
| Nov. 8 | 0 | |||
| Nov. 9 | 0 | |||
| Nov. 10 | 0 | |||
| Nov. 11 | 0 | |||
| Nov. 12 | 0 | |||
| Nov. 13 | 0 | |||
| Nov. 14 | 0 | |||
| Your Name: | ||||
| Approved SMART Goal: Complete this section | ||||
| Short Term Goal 1: | ||||
| Short Term Goal 2: | ||||
| Short Term Goal 3: | ||||
| ACTIVITY LOG | ||||
| Date Range: | Nov. 8-14, 2021 | |||
| Instructions: Please provide specific numbers/times/frequency/amounts in the columns in order to easily convert into graphs for the specific week (date) range | ||||
| Behavior/Activity | Duration/Quantity | Thoughts/Feelings | Notes/Ideas | |
| Monday | ||||
| Tuesday | ||||
| Wednesday | ||||
| Thursday | 1 | |||
| Friday | ||||
| Saturday | ||||
| Sunday | ||||
| Total | 1 |
PostChange Week
Minutes of Fill in the Blank
Post Change Week
9 Week Graph
| Week # | Week Dates | Minutes of Fill in the Blank |
| PreChange | Sept. 13-19 | 27 |
| Week 1 | Sept. 20-26 | 30 |
| Week 2 | Sept. 27-Oct. 3 | 3 |
| Week 3 | Oct. 4-10 | 3 |
| Week 4 | Oct. 11 - 17 | 4 |
| Week 5 | Oct. 18 - Oct. 24 | 6 |
| Week 6 | Oct. 24-31 | 4 |
| Week 7 | Nov. 1-7 | 2 |
| Post Change | Nov. 8-14 | 1 |
| Your Name: Complete this section | ||
| Approved SMART Goal: | ||
| Short Term Goal 1: | ||
| Short Term Goal 2: | ||
| Short Term Goal 3: |
Kerry Kampschroeder:
I got this figure by adding the daily amounts on sheet 1.
9 Week Graph
9 Week Bar Graph
Fall 2020