Daily Goals Tracker Worksheet
Day 1 of 2
Daily Success Tracker
Assignment Check-In & Quiet Break Self-Advocacy
Student:
Date:
1
Goal 1: Review & Turn In Ask teacher what is due, record date, & submit work (Target: 4 of 5).
2
Goal 2: Quiet Area Break Notice stress and use your phrase to request a reset break (Target: 4 of 5).
Part 1: Skill Warm-Up & Self-Advocacy Scripts
Practice before class starts
Scenario A: Reviewing Work Skill 1
Class ends in 5 minutes. You worked on your worksheet but aren't sure if it's due today or tomorrow. What do you say to your teacher?
My Check-In Script:
Scenario B: Asking for a Break Skill 2
The classroom is getting noisy during group work and you feel overwhelmed and unable to concentrate. What words or pass do you use?
My Self-Advocacy Phrase:
Part 2: Day 1 Period-By-Period Checklist
Complete each period across the school day
| Period |
Class / Subject |
Assignment & Due Date Noted |
Reviewed with Teacher? |
Turned In? |
Quiet Break Requested? |
| 1 |
|
|
|
|
|
|
|
|
|
|
|
| | | [ ] Yes [ ] N/A |
| 2 |
|
| | | [ ] Yes [ ] N/A |
| 3 |
|
| | | [ ] Yes [ ] N/A |
| 4 |
|
| | | [ ] Yes [ ] N/A |
| 5 |
|
| | | [ ] Yes [ ] N/A |
Part 3: Teacher Day 1 Opportunity Verification
To be filled by teacher/aide
Goal 1: Review & Turn In Criterion: 4 of 5 (80%)
Opportunities:
[ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5
Day 1 Score: / 5 Target Met? [ ] Yes [ ] No
Goal 2: Quiet Area Break Criterion: 4 of 5 (80%)
Opportunities:
[ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5
Day 1 Score: / 5 Target Met? [ ] Yes [ ] No
Teacher Initials:
Quick Note/Prompt Level:
Day 2 of 2
Daily Success Tracker
Independent Review, Completion & Advocacy Readiness
Student:
Date:
Day 2 Mission: Aim for 4 out of 5 checks in each skill area! Be proactive and take initiative early in each period.
80% Goal
Part 1: Day 2 Problem-Solving Scenarios
Read and write your plan
Scenario A: Due Date Confusion Skill 1
You get a packet with multiple pages. You aren't sure whether you only finish page 1 or the whole packet. What step do you take?
My Action Step & Question:
Scenario B: Warning Signs Skill 2
Before you feel super frustrated, your body gives cues (tense shoulders, tapping pencil, fast heart). Name 1 cue and how you will request a quiet break:
My Warning Cue & Break Signal:
Part 2: Day 2 Period-By-Period Checklist
Track all 5 opportunities today
| Period |
Class / Subject |
Assignment & Due Date Noted |
Reviewed with Teacher? |
Turned In? |
Quiet Break Requested? |
| 1 |
|
|
|
|
|
|
|
|
|
|
|
| | | [ ] Yes [ ] N/A |
| 2 |
|
| | | [ ] Yes [ ] N/A |
| 3 |
|
| | | [ ] Yes [ ] N/A |
| 4 |
|
| | | [ ] Yes [ ] N/A |
| 5 |
|
| | | [ ] Yes [ ] N/A |
Part 3: Teacher Day 2 Verification & 2-Day Milestone
To be filled by teacher/aide
Goal 1: Review & Turn In Criterion: 4 of 5 (80%)
Opportunities:
[ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5
Day 2 Score: / 5 Target Met? [ ] Yes [ ] No
Goal 2: Quiet Area Break Criterion: 4 of 5 (80%)
Opportunities:
[ ] 1 [ ] 2 [ ] 3 [ ] 4 [ ] 5
Day 2 Score: / 5 Target Met? [ ] Yes [ ] No
Teacher Signature:
2-Day Overall: [ ] Mastered [ ] Progressing [ ] Needs Re-teaching
IEP Progress Monitoring
Teacher Goal Tracking Sheet
Formal 2-Day Opportunity & Prompt Hierarchy Observation Log
Student:
Observer/Staff:
Prompt Codes: I = Independent | V = Verbal Reminder | G = Gestural / Visual Cue | M = Model
Criterion: 4 out of 5 Opportunities (80%)
Goal 1: Review Assignments & Turn In (Target: 4/5 Opportunities)
Record each discrete opportunity
| Opp # |
Day / Per |
Assignment Reviewed with Teacher? |
Prompt Level |
Due Date Noted? |
Turned In? |
Goal Met? |
| 1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| I / V / G / M | [ ] Yes [ ] No | [ ] Yes [ ] No | [ ] Y [ ] N |
| 2 |
|
| I / V / G / M | [ ] Yes [ ] No | [ ] Yes [ ] No | [ ] Y [ ] N |
| 3 |
|
| I / V / G / M | [ ] Yes [ ] No | [ ] Yes [ ] No | [ ] Y [ ] N |
| 4 |
|
| I / V / G / M | [ ] Yes [ ] No | [ ] Yes [ ] No | [ ] Y [ ] N |
| 5 |
|
| I / V / G / M | [ ] Yes [ ] No | [ ] Yes [ ] No | [ ] Y [ ] N |
Goal 1 Summary: Opportunities Met: / 5 ( %)
Target Achieved (4/5)? [ ] Yes [ ] No
Goal 2: Self-Advocate for Quiet Area Break (Target: 4/5 Opportunities)
Observe student during stress / sensory overload
| Opp # |
Day / Per |
Observed Antecedent / Trigger |
Self-Advocacy Used? |
Prompt Level |
Quiet Area Used? |
Goal Met? |
| 1 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| [ ] Verbal [ ] Card | I / V / G / M | [ ] Yes [ ] No | [ ] Y [ ] N |
| 2 |
|
| [ ] Verbal [ ] Card | I / V / G / M | [ ] Yes [ ] No | [ ] Y [ ] N |
| 3 |
|
| [ ] Verbal [ ] Card | I / V / G / M | [ ] Yes [ ] No | [ ] Y [ ] N |
| 4 |
|
| [ ] Verbal [ ] Card | I / V / G / M | [ ] Yes [ ] No | [ ] Y [ ] N |
| 5 |
|
| [ ] Verbal [ ] Card | I / V / G / M | [ ] Yes [ ] No | [ ] Y [ ] N |
Goal 2 Summary: Opportunities Met: / 5 ( %)
Target Achieved (4/5)? [ ] Yes [ ] No
Teacher Notes & IEP Progress Summary
Independence & Prompting Notes:
Quiet Area Effectiveness & Reset Time:
Next Steps / Accommodations:
Case Manager / Teacher Signature:
Date Logged: