Active Learning Materials and Activities Planning Sheet
An Active Learning Materials and Activities Planning Sheet might be used to gather information for program planning for a student utilizing an Active Learning approach. Gathering information takes a little time, many conversations with caregivers, some trial and error, and a lot of observation.
You may download blank forms to use with your student.
- AL Materials and Activities Planning Sheet (Word Version)
- AL Materials and Activities Planning Sheet (PDF Version)
Sample Planning Sheet
Below is a sample of the Active Learning Materials and Activities Planning Sheet. You may reference this example as you work with your team to complete this form for your student. You shouldn’t expect to complete this form at one meeting or in a few days. This form is meant to help a team get started planning together for their student. As the team continues to learn more about the child, information continues to be added.
These children require close observation and team collaboration if our goal is to build a quality program for them. Don’t rush the team just to fill in all the blanks. Active Learning requires a diagnostic teaching approach: assess, develop and implement instructional strategies, document progress, reassess, revise instructional strategies. In other words, your team is looking for instructional strategies that work for the individual child. It is important to remember, as the child grows and learns, instructional strategies may need to be revised. So it is important to understand the Dynamic Learning Circle and utilize it as you work with a child using an Active Learning approach.
This document can be shared with a variety of people who interact with the child or who will interact with the child in the future. It also can be included (in parts) into a portfolio or other records. This form is based on personal notes from a seminar by van Dijk, J. 1985 and information from Dr. Lilli Nielsen in Functional Scheme and some of her other books.
Program Planning Menu
Child’s Name: David Denton
Date September 16, 2018
Likes and Dislikes
Over a period of time (at least 3-4 weeks) through listening to stories from others and through observation of the child, simply list things the child likes and things he doesn’t like. We all enjoy things that we are good at and that we understand. The child’s “Likes” will be his areas of strength and use sensory channels that are working. His “Dislikes” may include aversive materials or experiences, as well as areas of need and sensory channels that may not be working efficiently. The information gathered on this form will give you underlying themes that you can use for identifying objects and activities to use in Active Learning instruction.
|Appetite or Likes||Aversion or Dislikes|
|Gentle vibration||Other children crying or screaming|
|Music||Icky, sticky stuff on his hands or feet|
|Food/eating – especially sweet tastes||People messing with his feet|
|Water play (prefers warm water)||Soft squishy textures|
|Green and blue things, shiny things||Cold water|
Pathways to Learning Summary Information:How well does the child use each sensory channel? Assign a percentage to each, with 100% being a sensory channel used well to get information, and a lower percentage for a sensory channel that the child is not able to use well. Describe the child’s behaviors that show the reason(s) you recorded that percentage.
|Sensory Channel||%||How do you know?|
|Vision||20%||Nystagmus, exotropia and suspected CVI – responds to light and a few colors (green/blue)|
|Hearing||50%||Responds to music and select people’s voices ….. possible auditory processing since he seems more in tuned to pitch/rhythm and has CP/Seizures|
|Touch||75%||Does not use many exploratory patterns with hands and feet, but does seem very responsive with mouth, lips, tongue|
|Taste||100%||LOVES to eat|
|Smell||30%||Seems to recognize food prep just by smell|
|Movement / Proprioceptive||10%||Unsure – has ONH and may have some issues being aware of own body|
Other ConsiderationsInclude other information that might be important to note in planning, such as seizure activity, special diets, allergies, etc.
- STUDENT has a seizure disorder with many seizures throughout the day. Special consideration should be given to materials, need for breaks, duration of activity and so forth. He is also on a Ketogenic diet so special consideration should be given to any foods used.
- STUDENT is suspected of having CVI and a CVI range might be needed to help pinpoint accommodations to materials and environments.
- Given diagnosis of Optic Nerve Hypoplasia there may be some additional issues related to body awareness.
|1. What are possible attributes of materials that might appeal to his/her top three sensory channels? (Color, shape, texture, size, etc.)|
|2. What do you currently observe the child doing with his/her hands (e.g., grab and release, bat at fisted, transfer hand to hand, throwing, scratching)?|
|3. What do you currently observe the child doing with arms, feet and legs?|
|4. What do you currently observe the child doing with his/her head, mouth, lips and tongue?|
|5. What kinds of vocal play do you observe? (e.g., babbling, squealing, clicking, etc.)|
|6. What sounds does he/she respond to? (e.g., dad’s voice, computer generated sounds, door slamming, etc.)|
|7. What kind of scents does he/she like or dislike? (types of smells or particular things that smell)|
|8. What kinds of foods or flavors does he/she like or dislike?|
|9. What kind of touch does he/she like or dislike? (e.g., light, heavy, deep pressure, etc.)|
Social and Emotional DevelopmentIn order to utilize the best educational approach with your student, what Dr. Nielsen calls the Five Phases of Educational Treatment, we need to look at the child’s behavior. Look at the behaviors described below and place an X in the row(s) where you see behaviors that are demonstrated by your student.
|Developmental Age||Child contacts or responds to contact by:||X|
Ideas for Specific Objects to Include in Instruction:List the items (Lilli says 70 or more) you want to try using and check to see if the properties match the student’s preferences in his/her best sensory channels as identified previously in this form. You should consider using multiples of objects with similar but slightly different features. Remember to have a quantity of everyday objects included in the mix. This can also serve as a shopping list for items you need to find. Our Student’s Pathways to Learning
- Taste: 100%
- Smell: 30%
- Hearing: 50%
- Touch: 75%
- Vision: 20%
- Proprioception/Movement: 10%
|Burlap bag with beans, rice, coffee beans||x||x||x|
|Oil filters (clean with heavy cardboard)||x|
|Metal spoons of all sizes and shapes||x||x||x|
|Metal measuring cups of all sizes and shapes||x||x||x|
|Shiny blue/green ribbons||x||x|
|Wooden wind chimes||x||x|
|Heavy metal or porcelain bells||x||x|
|Shiny Christmas decorations||x||x|
|Netting other scratchy materials||x||x|
|Metal chains of all sizes||x||x|
|Vibrating toothbrush, hand massagers||x||x|
|Things with holes to poke fingers into such as spaghetti strainer, candy tray, large metal nuts for bolts||x|
|Woodpile wood lizard – make of cedar||x||x||x|
|Blue/green mylar pompoms, ribbons||x||x|
|Scrub Daddy sponges||x||x|
|Strands of wooden, metal and plastic buttons||x||x||x|
|Collection of wooden popsicle sticks||x||x|
|Beads (wooden, glass, metal)||x||x|
|Strings of hard candy||x||x||x||x|
|Seed pod rattles||x||x||x|
|Balls with holes in them (wiffle, etc.)||x|
|Tipping boards with wooden dowels||x||x|
|Hair rollers, Velcro, brush, etc. of various sizes||x|
|Strings and laces with knots of various sizes||x|
|Chinese rattles with acute points||x||x|
|Bottle brush, hairbrush and all kinds of stiff brushes||x|
|Strips of paper, especially metallic glazed paper||x||x|
|Lollipops made from round sticks dipped in melted sugar and corn flakes||x||x||x|
|Wire whisks of all sizes and shapes||x||x||x|
|Forks and spoons||x||x||x|
|Greaseproof paper, tissue paper, wrapping paper (folded or crumpled)||x||x||x|
|Key bunches of various shapes and materials||x||x||x|
|Boxes fitted with rubber bands||x||x||x|
|Scented lotions (especially used in Lotion Routines)||x||x|
|Strumming instruments (ukulele, dulcimer, guitar, etc.)||x||x||x|
|Toothpaste (small amounts on toothbrush)||x||x||x|
|Harmonicas, penny whistles, etc.||x||x|
|Aluminum pie pans, trays||x||x||x|
Plan for completing the Functional Scheme:Decide as a team how and by when you will address all sections of the Functional Scheme. It is recommended that team members work in pairs on each section for better verification of the student’s use of skills across multiple domains and with multiple people. Use the chart below to plan who will be responsible for each section. You may choose the official due date or assign an earlier due date to each section to spread work out across time. COMS=Certified Orientation and Mobility Specialist, CT=Classroom teacher, Para=Paraeducator, OT=Occupational Therapist, PT=Physical Therapist, SLP=Speech-Language Pathologist, TDHH= Teacher of the Deaf and Hard of Hearing, TVI=Teacher of Students with Visual Impairments. Completing the entire Functional Scheme on an individual learner may take quite a bit of time, especially if the team is just meeting the student. Setting a timeline helps to keep everyone on track and in communication about skills to focus on during instruction.
|Section||Name and Title of Participants Responsible for Section||Official Due Date||Team Assigned Due Date|
|Gross Movement||Kevin Lauder, PT & Elise Davidson, COMS||10/1/18||May 15, 2017|
|Fine Movement||Cheryl Schultz, OT & Hillary Keyton, TVI||10/1/18||May 30, 2017|
|Mouth Movement||Cheryl Schultz, OT & Kate Kitchens, Parent||10/1/18||May 30, 2017|
|Visual Perception||Hillary Keyton, TVI & Elise Davidson, COMS||10/1/18||June 15, 2017|
|Auditory Perception||Perkins Canton, TDHH & Hillary Keyton, TVI||10/1/18||June 15, 2017|
|Haptic-tactile Perception||Cheryl Schultz, OT & Hillary Keyton, TVI||10/1/18||May 30, 2017|
|Smell & Taste||Cheryl Schultz, OT & Hillary Keyton, TVI||10/1/18||May 30, 2017|
|Spatial Relations||Hillary Keyton, TVI & Elise Davidson, COMS||10/1/18||June 15, 2017|
|Emotional Perception||Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||September 1, 2017|
|Object Perception||TVI/CT Hillary Keyton, TVI & Matt Scott, CT||10/1/18||September 1, 2017|
|Language: Non-verbal||Perkins Canton, TDHH & Hillary Keyton, TVI||10/1/18||June 15, 2017|
|Language: Verbal||Perkins Canton, TDHH & Hillary Keyton, TVI||10/1/18||June 15, 2017|
|Comprehension of Language||Perkins Canton, TDHH & Hillary Keyton, TVI||10/1/18||June 15, 2017|
|Social Perception||Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||September 1, 2017|
|Perception through Play & Activity||Kevin Lauder, PT & Cheryl Schultz, OT||10/1/18||May 30, 2017|
|Developmentally Impeding Functions||Matt Scott, CT & Kate Kitchens, Parent||10/1/18||September 1, 2017|
|Toileting Skills||Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||September 1, 2017|
|Undressing and Dressing||Cheryl Schultz, OT, Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||May 30, 2017|
|Personal Hygiene||Cheryl Schultz, OT, Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||May 30, 2017|
|Eating Skills||Cheryl Schultz, OT, Matt Scott, CT, Susie Walker, Para & Kate Kitchens, Parent||10/1/18||May 30, 2017|
Goals, Objectives, Skills – Data for Child Progress Reporting:You may find it helpful to have a list of goals/objectives and/or skills that will be the focus of data collection for documenting child progress. You can list them for specific environments and activities and post them near each environment so all staff know what behaviors they should take note of during an observation. Or you may have them in a child’s folder so any staff member can select an environment or activity to observe and collect data. This also could serve as the basis for your lesson plan.
|Environments or Activities||Goal/Objective or Skills Child Should Demonstrate||# Observed||
Other Skills to Watch For
|Kicking using Essef Board while in hammock swing||Positioned in a swing, hammock special chair or on the floor in supine during independent and interactive play STUDENT will kick with his legs/feet to produce sounds when provided a variety of materials during independent and interactive play at least 10 times within a 15 minute observation period.||||||||Sitting unsupported Vocalizing Listening and experimenting with sounds Making contact with adult through touch and/or vocalization||| – vocalizing to get adult attention|
|Kicking using an Essef Board and tray of materials when positioned in special chair|||||||Sitting unsupported Vocalizing Listening and experimenting with sounds Making contact with adult through touch and/or vocalization|
|Kicking in water during foot bath in special chair|||||| ||||Sitting unsupported Vocalizing Listening and experimenting with sounds Making contact with adult through touch and/or vocalization|
|Bring objects to mouth to explore with lips and tongue in the Little Room||When given a variety of materials in several different learning environments during independent and interactive play (e.g. Little Room, Snack time) appropriate for mouthing and tasting STUDENT will actively bring things to his mouth and/or explore with lips and tongue at least three times during a 15 minute observation time.||||||||Use of hands to scratch and poke hands/fingers to mouth Vocalizing Making contact with adult through touch and/or vocalization||||| – vocalizing|
|Explore snack and sensory play materials with his mouth during independent play on Resonance Board||||||Use of hands to scratch and poke hands/fingers to mouth Vocalizing Making contact with adult through touch and/or vocalization|||| – vocalizing for contact|
|Position Board Water or sand table||When given visually preferred (green, blue, shiny) objects on a position board or in a tray, water table or sand table, STUDENT will use a visually directed reach to make contact with desired object at least 2 times within a 15 minute observation period.|||||Grasp and release Batting Scratching||||- batting|
|Support Bench during independent play||When placed in a prone position using a Support Bench or Resonance Board STUDENT will extend one arm to reach preferred objects in containers at least 5 times within a 15 minute period.|||||Grasp and release Batting Scratching Vocalizing Making contact with adult through touch and/or vocalization|||| batting ||| – vocalizing|
|Resonance Board during independent play||Grasp and release Scratching Vocalizing Making contact with adult through touch and/or vocalization||II grasp beads, whisk I scratch board|
|Little Room in independent play||In a variety of learning environments in both independent and interactive play when given objects that make a preferred sound STUDENT will reach out towards sound producing objects at least 5 times during a 15 minute observation period.|||||| Wind Chimes||Grasp and release Vocalizing Making contact with adult through touch and/or vocalization|||||| – vocalizing|
|Resonance Board in adult-child interaction||III Seed Pod Rattle (2 x) Beads (1 X)||Grasp and release Vocalizing Making contact with adult through touch and/or vocalization||I – vocalize to make contact|
Team Notes10/12/18 – MS – Had many seizures today and was very lethargic 10/14/18 – MS – Much better today! Very Active in Little Room and vocalized a lot! Actually vocalized throughout the day. Also tolerated being on his stomach on the Support Bench for 15 minutes. Need to check with parents to see if there was a change in his seizure medications that might account for these improvements.