Child Initials:	Date:	
Comfort Zones (CZ)	
Sensory Motor Profile (SMP)

1.	Visual Processing:

2.	Tactile Input:

3.	Oral:

4.	Olfactory:

5.	Auditory:

6.	Vestibular:

7.	Proprioceptive:

8.	Reactivity:

9.	Motor Planning:

Child Initials:	Date:	
Functional Developmental Level (FDL) 
 Level 1: Regulation and shared attention. 
How solid is this level?  Current = 

Level 2: Engaging in relationships. 
How solid is this level?  Current =

Level 3: Purposeful interaction (simple games). 
How solid is this level?  Current =

 Level 4: Organizes chains of interaction and problem solving. 
How solid is this level?  Current =

Level 5: Uses ideas, words and symbols to convey intentions and feelings. 
How solid is this level?  Current =

Level 6: Creates logical bridges between ideas
How solid is this level?  Current =	

Child Initials:	Date:	
Methods
1.	Read the child's cues and intent
2.	Slow the pace of play, observing and waiting for the child’s idea
3.	Follow the child's lead, responding to what the child wants
4.	Open and close circles of communication (back and forth interactions)
5.	Build on the child’s interests	
Techniques	
Activities