fomato interes juego niño.docx
Post on 02-Jun-2018
233 Views
Preview:
TRANSCRIPT
-
8/11/2019 fomato interes juego nio.docx
1/28
Alexis D. Henry, ScD, OTR/L
Directions
There are 50 activities in this booklet. For each activity, there are three questions.
1. Do You Do This Activity?
2. Do You Like This Activity?
3. Who Do You Do This Activity With?
If you answer Noto question 1, you do not need to answer questions 2 or 3. Just go on to the next activity.
You can color or circle your answers.At the end, you may add other activities that you do and that you werent asked about.
Name Date
Age Birthday Grade Check Boy Girl
Copyright 2000 by Therapy Skill Builders, a Harcourt Health Sciences Company. All rights reserved. Pediatric Interest Profiles,Alexis D. Henry / 076164010X / This page is reproducible.
-
8/11/2019 fomato interes juego nio.docx
2/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
Sports Activities
1. Play Baseball
2. Play Basketball
3. Play Soccer
Do You Do This Activity? Do You Like This Activity? Who Do You Do This Activity With?
-
8/11/2019 fomato interes juego nio.docx
3/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
4. Play Catch
5. Ride a Bike
6. Play Dodgeball
-
8/11/2019 fomato interes juego nio.docx
4/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
7. Play Frisbeeo
With With a8. Play Hide-and-Seek Yes No A Lot A Little Not at All By Myself Friends Grown-Up
9. Jump Rope
-
8/11/2019 fomato interes juego nio.docx
5/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up10. Play Kickball
With With a11. Play on Playground Yes No A Lot A Little Not at All By Myself Friends Grown-Up
With With a12. Roller-Skate or In-Line Skate Yes No A Lot A Little Not at All By Myself Friends Grown-Up
-
8/11/2019 fomato interes juego nio.docx
6/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up13. Play Tag
-
8/11/2019 fomato interes juego nio.docx
7/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With a14. Play at Beach, Lake, or River Yes No A Lot A Little Not at All By Myself Friends Grown-Up
15. Go on Picnic
16. Swim
-
8/11/2019 fomato interes juego nio.docx
8/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
17. Camp
18. Hike
19. Go Fishing
-
8/11/2019 fomato interes juego nio.docx
9/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up20. Garden
-
8/11/2019 fomato interes juego nio.docx
10/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
21. Go Sledding
22. Play in Snow
23. Ice-Skate
-
8/11/2019 fomato interes juego nio.docx
11/28
With With a24. Ski or Snowboard Yes No A Lot A Little Not at All By Myself Friends Grown-Up
-
8/11/2019 fomato interes juego nio.docx
12/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
25. Play Cards
With With a26. Play Board Games Yes No A Lot A Little Not at All By Myself Friends Grown-Up
27. Read
-
8/11/2019 fomato interes juego nio.docx
13/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
28. Use Computer
29. Watch TV
30. Listen to Music
-
8/11/2019 fomato interes juego nio.docx
14/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
31. Collect Things
32. Take Care of Pet
-
8/11/2019 fomato interes juego nio.docx
15/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
33. Do Puzzles
34. Sing
35. Dance
-
8/11/2019 fomato interes juego nio.docx
16/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
36. Build Things
37. Draw or Paint
38. Cook or Bake
-
8/11/2019 fomato interes juego nio.docx
17/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
39. Music Lessons
With With a40. Swimming Lessons Yes No A Lot A Little Not at All By Myself Friends Grown-Up
41. Dance Lessons
-
8/11/2019 fomato interes juego nio.docx
18/28
42. Gymnastics Lessons Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
43. Arts and Carfts Lessons Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
44. Martial Arts Lessons Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
-
8/11/2019 fomato interes juego nio.docx
19/28
With With aYes No A Lot A Little Not at All By Myself Friends Grown-Up
With With a45. Hang Out With Friends Yes No A Lot A Little Not at All By Myself Friends Grown-Up
46. Go to Scouts
With With a47. Play Superheroes Yes No A Lot A Little Not at All By Myself Friends Grown-Up
-
8/11/2019 fomato interes juego nio.docx
20/28
With With a48. Play School Yes No A Lot A Little Not at All By Myself Friends Grown-Up
With With a49. Play House Yes No A Lot A Little Not at All By Myself Friends Grown-Up
With With a50. Play Dress-Up or Make-Up Yes No A Lot A Little Not at All By Myself Friends Grown-Up
-
8/11/2019 fomato interes juego nio.docx
21/28
51. Fill in YourOwn Yes No ALot ALittle Not at All By Myself WithFriends With aGrown-Up
52. Fill in YourOwn Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
53. Fill in YourOwn Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
-
8/11/2019 fomato interes juego nio.docx
22/28
54. Fill in Your Own Yes No A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
55. Fill in Your Own Yes No ALot ALittle Not at All By MyselfWith
FriendsWith a
Grown-Up
-
8/11/2019 fomato interes juego nio.docx
23/28
Date Tested
Date of Birth
Chronological Age
Kid Play ProfileAlexis D. Henry, ScD, OTR/L
Summary Score Sheet
Childs Name
School
Service Providers Name
Discipline
Gender Male Q Female
Grade
Year Month Day
The child receives the following service(s)
Conditions that may affect the childs play
Category ScoresInstructions
Transfer the following information from the childs KidPlay Profile to each corresponding category table.
Place a checkmark in the Yes column of each activityin which the child has participated.
In the next three columns, circle the score thatindicates how the child likes the activity (3 = a lot; 2 = a little; 1 = not at all).
Place a checkmark in one or more of the last three
columns to indicate with whom the child does theactivity.
Scoring
Add the checkmarks in the Yes column and place thisnumber in the box labeled Number of(Sports, Outside,etc.) Activities Child Participates in.
Divide the number of activities the child participates in by the total number of activities in the category. Then
multiply by 100 to calculate the percent of activities the child participates in. Place the percent in the box
labeled Percent of Activities the Child Participates in.
To calculate how much the child likes the categoryactivities, add the scores of the three columns. Dividethe total by the number of activities the childparticipates in. Place this number in the box labeledHow Much the Child Likes Activities. Scores will rangefrom 1 to 3. The closer the number is to 3, the more thechild likes the activities.
To calculate the percent of activities that the child does
alone, with friends, or with an adult, add thecheckmarks in each column. Divide the total for eachcolumn by the number of activities the child participatesin. Multiply each total by 100 and place the percent inthe appropriate place in the box labeled Percent ofActivities the Child Does By Myself, With Friends, orWith a Grown-Up. Because children may give morethan one answer for this question (for example, childrenmay do an activity both bymyselfand withfriends"),the total for the 3 responses may exceed 100%.
-
8/11/2019 fomato interes juego nio.docx
24/28
Sports Activities Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
1. Play Baseball
2. Play Basketball
3. Play Soccer
TotalNumber of Sports Activities ChildParticipates in
How Much the Child Likes SportsActivities
Percent of Activities the ChildDoes
By Myself
With Friends
With a Grown-UpPercent of Sports Activities ChildParticipates in
Play Interview
Outside Activities Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
4. Play Catch 3 2 1
5. Ride a Bike 3 2 1
6. Play Dodgeball 3 2 1
7. Play Frisbee 3 2 1
8. Play Hide-and-Seek 3 2 1
9. Jump Rope 3 2 1
10. Play Kickball 3 2 1
11. Play on Playground 3 2 1
12. Roller-Skate orIn-Line Skate
3 2 1
13. Play Tag 3 2 1
Total
Number of Outside Activities ChildParticipates in
Percent of Outside Activities ChildParticipates in
How Much the Child Likes OutsideActivities
Percent of Activities the ChildDoes
By Myself
With Friends
With a Grown-Up
Play Interview
-
8/11/2019 fomato interes juego nio.docx
25/28
Summer Activities Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
14. Play at Beach,
Lake, or River
3 2 1
15. Go on Picnic 2 1
16. Swim 2 1
17. Camp 2 1
18. Hike 2 1
19. Go Fishing 2 1
20. Garden 2 1
Total
Number of Summer Activities ChildParticipates in
How Much the Child Likes SummerActivities
Percent of Activities the ChildDoes
By MyselfWith FriendsWith a Grown-Up
Percent of Summer Activities ChildParticipates in
Play Interview
inter Activities Yes A Lot A Little Not at AllWith With a
ByMyself Friends Grown-Up
21. Go Sledding
22. Play in Snow
23. Ice-Skate
24. Ski or Snowboard
Total
Number of Winter Activities ChildParticipates in
Percent of Winter Activities ChildParticipates in
How Much the Child Likes WinterActivities
Percent of Activities the ChildDoes
By Myself
With Friends
With a Grown-Up
Play Interview
-
8/11/2019 fomato interes juego nio.docx
26/28
Indoor Activities Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
25. Play Cards 3 2 1
26. Play Board Games 3 2 1
27. Read 3 2 1
28. Use Computer 3 2 1
29. Watch TV 3 2 1
30. Listen to Music 3 2 1
31. Collect Things 3 2 1
32. Take Care of Pet 3 2 1
Total
Number of Indoor Activities ChildParticipates in
How Much the Child Likes IndoorActivities
Percent of Activities the ChildDoes
By MyselfWith Friends
With a Grown-UpPercent of Indoor Activities ChildParticipates in
Play Interview
Creative Activities Yes A Lot A Little Not at AllWith With a
By Myself Friends Grown-Up
33. Do Puzzles
34. Sing
35. Dance
36. Build Things
37. Draw or Paint
38. Cook or Bake
Total
Number of Creative Activities ChildParticipates in
Percent of Creative Activities ChildParticipates in
How Much the Child Likes CreativeActivities
Percent of Activities the ChildDoes
By MyselfWith FriendsWith a Grown-Up
Play Interview
-
8/11/2019 fomato interes juego nio.docx
27/28
Lessons/Classes Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
39. Music Lessons 3 2 1
0. Swimming Lessons 3 2 1
1. Dance Lessons 3 2 1
2. Gymnastics Lessons 3 2 1
3. Arts and Crafts
Lessons
3 2 1
4. Martial Arts Lessons 3 2 1
Total
Number of Lessons ChildParticipates in
How Much the Child LikesLessons
Percent of Lessons the ChildDoes
By Myself
With FriendsWith a Grown-Up
Percent of Lessons ChildParticipates in
Play Interview
Socializing Activities Yes A Lot A Little Not at All By MyselfWith
FriendsWith a
Grown-Up
5. Hang Out With Friends 3 2 1
6. Go to Scouts 3 2 1
7. Play Superheroes 3 2 1
8. Play School 3 2 1
9. Play House 3 2 1
50. Play Dress-Up or
Make-Up
3 2 1
Total
Number of Socializing Activities ChildParticipates in
Percent of Socializing Activities ChildParticipates in
How Much the Child Likes SocializingActivities
Percent of Activities the ChildDoes
By Myself
With FriendsWith a Grown-Up
Play Interview
-
8/11/2019 fomato interes juego nio.docx
28/28
Other Activities
51.
52.
53.
54.
55.
Total
YesWith With a
A Lot A Little Not at All By Myself Friends Grown-Up
Number of Other Activities ChildParticipates in
Percent of Other Activities ChildParticipates in
Play Interview
How Much the Child Likes Other Percent of Activities the ChildActivities Does
By MyselfWith Friends
With a Grown-Up
TOUR (Exclude other activities when calculating totals)
Number of Activities ChildParticipates in (sum the totals of
the 8 categories)Percent of Activities ChildParticipates in (divide the abovenumber by 50)
Play Interview Summary
Play Observations
How Much the Child Likes All Activities Percent of All Activities the Child DoesHe or She Participates in (sum the By Myself
scores for the 8 categories and divide With Friendsthe number by 8) With a Grown-Up
(add final percentages from eachcolumn and divide by 8)
Interpretations/Recommendations
top related