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Modified ELM

This document contains an early learning measure data sheet that assesses a child's development over time. It tracks their receptive actions/identification, nonverbal imitation, expressive labels, verbal imitation and matching skills at baseline, 3 months, and 6 months. It also includes sections on manding, play skills, sleeping/eating/toileting patterns, problem behaviors, and notes. The data sheet is used to monitor a child's progress in key developmental areas at different points in time.

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17 views

Modified ELM

This document contains an early learning measure data sheet that assesses a child's development over time. It tracks their receptive actions/identification, nonverbal imitation, expressive labels, verbal imitation and matching skills at baseline, 3 months, and 6 months. It also includes sections on manding, play skills, sleeping/eating/toileting patterns, problem behaviors, and notes. The data sheet is used to monitor a child's progress in key developmental areas at different points in time.

Uploaded by

علم ينتفع به
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EARLY LEARNING MEASURE DATA SHEET

Child: Assessor: Date1:


Date2:
Date 3
I. RECEPTIVE ACTIONS/ identifcation

TIME OF ASSESSMENT TIME OF ASSESSMENT


ITEM ITEM
Baseline 3 months 6 months Baseline 3 months 6 months
Respond to
stand up
name
come here turn around
put block in
jump
bucket
give me hug sit down
cross legs Open the door
Give me
wave
something
raise arms touch ears
Place object
touch head
on the table
Open mouth Turn around
Give me the
clap hands (10 items)
field of 3)
RESULTS RESULTS

II. NONVERBAL IMITATION (Instruct, “Do this,” while performing the action.)

TIME OF ASSESSMENT TIME OF ASSESSMENT


ITEM ITEM
Baseline 3 months 6 months Baseline 3 months 6 months
arms out make fist
clap wave
touch head stomp feet
shake head
touch tummy
(no)
touch
throw kiss
shoulders
arms up turn around
touch knees jump
place object
touch table
on table
touch elbow raise one arm
Like
touch ears sign(thumb
up)
RESULTS RESULTS
III. EXPRESSIVE LABELS (Ask, “What is it?” while presenting the objects. For items 18-20, ask “What color?”)

TIME OF ASSESSMENT TIME OF ASSESSMENT


ITEM ITEM
Baseline 3 months 6 months Baseline 3 months 6 months
ball table
Cup keys
Doll foot (child’s)
Shoe hand (child’s)
nose (child’s) pen
Book head (child’s)
block (natural) watch
Phone door
Car apple
Chair cat
RESULTS RESULTS

IV. VERBAL IMITATION (Instruct, “Say…”)

TIME OF ASSESSMENT TIME OF ASSESSMENT


ITEM ITEM
Baseline 3 months 6 months Baseline 3 months 6 months
Ahh ball
too child’s name
Ka nose
De book
ba shoe
Eee cat
Mama dog
Dada banana
Baby mommy
Cookie daddy
RESULTS RESULTS
MTS instruct “ match” or put with the same in field of 3
TIME OF ASSESSMENT TIME OF ASSESSMENT
ITEM ITEM
Baseline 3 months 6 months Baseline 3 months 6 months
Match identical
object
Match identical
object
Match Picture-
Object
Match non-
identical object
Match non-
identical
pictures
Match shapes
Match colors
RESULTS RESULTS

Manding (specify)

Play skills (describe)

Sleeping patterns: (hours)

Eating:

Toileting:

Problem behavior (describe)

NOTES:_______________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

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