application for neuronet tools for learning certification

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To: TEACHER Child’s current grade level in school: _____ Please rate each of the following behaviors as below average ( #1 - #2 ) to average ( #3 - #4 ) to exceptionally above average ( #5 ). Your comments in any area are very appreciated. Feel free to write on the back of the page. LEARNING BEHAVIOR CIRCLE THE NUMBER

1. Reading 1 2 3 4 5

2. Math 1 2 3 4 5

3. Handwriting 1 2 3 4 5

4. Visual memory: sees and remembers details 1 2 3 4 5

5. Visual analysis: sees how to solve problems 1 2 3 4 5

6. Auditory memory: learns days and months 1 2 3 4 5

7. Auditory analysis: repeats new words accurately 1 2 3 4 5

8. Understands and follows directions 1 2 3 4 5

9. Gross motor skills: doesn’t trip or bump things 1 2 3 4 5

10. Fine motor skills: cuts; ties shoes; eats neatly 1 2 3 4 5

11. Completes schoolwork: accurately 1 2 3 4 5

12. Completes schoolwork: neatly 1 2 3 4 5

13. Completes schoolwork: on time 1 2 3 4 5

14. Pays attention 1 2 3 4 5

15. Takes care of own possessions 1 2 3 4 5

16. Self-confidence 1 2 3 4 5

17. Reaction to frustration 1 2 3 4 5

18. Willingness to share 1 2 3 4 5

19. Willingness to be helpful 1 2 3 4 5

20. Kindness 1 2 3 4 5


The NeuroNet Program

Tools for Learning Evaluation

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


The NeuroNet Program Patient Privacy Policy All medical records are privileged and confidential information. Patient records will be released only at the written request of the patient and/or parent. Release of medical records Patient name: ______________________________________________________ (Parent name): ______________________________________________________ I authorize the release of NeuroNet Evaluation and Program records to the following persons: School: _________________________________________ Audiologist: _________________________________________ Optometrist: _________________________________________ Therapist: _________________________________________ Other: _________________________________________ Signature of patient or parent: ______________________________________________________ Date: _________________________________________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


Medical Clearance The NeuroNet Program is a program of integrated physical and academic exercises designed for physically healthy children and adults who have no functional developmental or neurological concerns. NeuroNet Exercises are built around simple, every-day movement and exercise activities. Parents, teachers and therapists must be aware that all physical exercise activities present some level of risk for any participant. Parents, teachers and therapists should never attempt exercises in which they or a their child are uncomfortable or uncertain of their ability to manage the procedure. Always seek assistance from your NeuroNet Provider, or consult with an Occupational Therapist or Physical Therapist for additional help with movement exercises as needed. My child is physically healthy and has no developmental or neurological concerns. Parent’s signature: _________________________________________ Date: _________________________________________ Medical clearance should be obtained for any child who presents with physical challenges or functional developmental or neurological concerns. To: (Doctor’s name) _________________________________ Re: Patient name _________________________________ Date: _________________________________ The NeuroNet Program has been recommended for _____________________________ This program includes integrated physical and cognitive exercises to automate multi-tasking of basic skills essential to perceptual and motor information processing. The NeuroNet program includes, but is not limited to, jumping jacks, jump rope, front somersaults, and stepping up and down. Please note any concerns or medical limitations for this patient in participating in this program. Physician’s signature: _________________________________________ Date: _________________________________________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


Evaluation program notes: General directions: Give these directions before each exercise until you are sure that the child knows to guess or skip and move on. Pictures: If you come to a picture that you don’t know, take a guess or skip it. Then go on to the next one and keep going so that you get more points. Words: If you come to a word that’s too hard, take a guess or skip it. Then go on to the next one and keep going so that you get more points. Numbers: If you come to a number that’s too hard, take a guess or skip it. Then go on to the next one and keep going so that you get more points. Letters: If you come to a letter that’s too hard, take a guess or skip it. Then go on to the next one and keep going so that you get more points.

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


NeuroNet Integrated Rhythms: Summary of Evaluation Scores Expected scores: age 7/gr 2: 8.5-8.9 age 8/gr 3: 9.0-9.4 age 9/gr 4 & up: 9.5-10

Children who meet the expected scores for movement exercises are ready to go ahead to the Tools for Learning program. Children who are close to the expected scores can do a 2-week readiness program with CD Extras to see if they can meet the expected scores within 2 weeks. Children who do not meet the expected scores need to do Integrated Rhythms before Tools for Learning.

1. Jumping jacks & pass the ball: CD Extras, Track 4: “1, pass the ball”

2. One-foot standing balance: 15 seconds: right / left

3. Other foot: One-foot standing balance: 15 seconds: right / left

4. AGE 7: Toe taps + weight bumps + auditory memory for alphabet CD Extras, Track 16: “tick tock a, tick tock b . . . “

4. AGE 8 & up: Toe taps + weight bumps + distractor auditory memory: CD Extras, Track 25: “a 1 b 2 . . . “

5. Toss/catch + head rotation: CD Extras, Track 6: “1, toss-catch”

6. Interhemispheric integration pattern: Red stick: 1 minute

7. Vision blocks Xs Level 1 Professional + facing the computer + say how many Xs

8. Vision blocks fingers Level 1 Beginner + head rotation + say how many fingers

Average NeuroNet Score for movement exercises

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


NeuroNet Tools for Learning: Summary of Evaluation Scores EXPECTED SCORES: AGE 7/GR 2: 8.5-8.9 AGE 8/GR 3: 9.0-9.4 AGE 9/GR 4 & UP: 9.5-10

9. Word retrieval: Fast naming for picture page

10. Lipreading for color phrases

11. Lipreading for number names

12. Decoding spelling and speech patterns for English

13. Force rhyme

14. Create rhyme

15. Syllable analysis for pictures

16. Syllable analysis for number names

17. Syllable analysis for written words

18. Phoneme analysis

19. Auditory closure

20. Navigation alphabet: 1-minute timer

21. Navigation alphabet: CD Extras Track 21

22. Navigation alphabet: CD Extras Track 22

Average NeuroNet Score for Auditory Processing Exercises

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


Movement exercises: #1: Jumping jacks + pass the ball How many without stopping (maximum 60) ________ / 6 = fluency score: ______________ pt How many total (maximum 60) ________ / 6 = total score: ______________ pt Pass the ball: ALL = 10 pt / only misses 1-2 = 8 pt / misses 3-4 = 5 pt / misses 5+ = 2 pt Fluency pt ________ + total pt ________ + ball pt_________ = jumping jacks total __________ Jumping jacks total divided by 3 = jumping jacks score __________________________ #2: One foot & #3: Other foot: One-foot standing balance: Do one foot then other foot Note: which foot does the child choose to use first? Circle one: Right / Left The therapist models and gives verbal instructions: “Cross one arm to the opposite shoulder, then cross the other arm to the other shoulder. Now bend your knee and lift your leg up.” The therapist counts 15 seconds and notes how many times the child loses balance: Hands must be crossed, touching shoulders. The knee must be bent and the foot up. The other foot must remain on the floor, not moving outside of its original foot space. Score: Loses balance 0 times = 10 pt / 1x = 8 pt / 2x = 5 pt / 3x = 2 pt / 4 or more = 0 pt Age 7 years: Evaluate and score with eyes open only. Score: 1st: R / L ________ / 2nd: R / L ________ Age 8 and up: Do with eyes open for practice, then re-do and score with eyes closed. Evaluate and score with eyes closed only. Score: 1st: R / L ________ / 2nd: R / L ________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


4. Age 7: Auditory memory for alphabet: CDX track 16: Score: ______________ Movement pattern: toe taps & swing/bump bump weights Talking pattern: “tick tock, a, tick tock, b” Score: Ending letter: _______________ Errors: _______________ Score = ending number minus one point for each skipped letter or letter out of sequence Ending letter __________ Minus errors __________ = Total score _______________ Total score __________ divided by 2.6 = ____________ Auditory Memory for Alphabet 4. Age 8 & up: Auditory memory for number & alphabet: CDX track 25: Score: ___________ Movement pattern: toe taps & swing/bump bump weights Talking pattern: “a 1 b 2 c 3 . . . “ Score: Ending number: _______________ Errors: _______________ Score = Ending number minus one point for each skipped number or letter NOTES: Ending number __________ Minus errors __________ = Total score _______________ Total score __________ divided by 2.6 = ____________ Auditory Memory for ABC & number Example: a b c d f g h j k l m o p q r x y z 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 18 total letter & number pairs minus 4 sets of skipped letters: (e), (i), (n), (stuvw) = NeuroNet score 14 points

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


5. Toss / catch + head rotation: CDX track 6 Standing on stool, talk along with numbers and then say “toss/catch”. Move head up and down following the movement of the ball. The child MUST talk and MUST move the head up and down in rhythm with the ball in order to get credit for this exercise. Score all = 10 points / most = 8 points / half = 4-6 points / at least 5 = 2 points 6. Red Stick: 1 minute timer: Score: _______________________ Face to face, show the pattern and say the words: up . . . and . . . down . . . sideways . . . sideways Instruct the child: Show me what you remember. Score one point for each completed sequence: Left to right and right to left. Maximum 4 points. It doesn’t matter if the child doesn’t use the exact words. They just have to talk as they move. Face to Face: Score 2 points for each correct sequence: Left-right + right-left If the score for FACE TO FACE is 1 ½ or less, repeat this exercise face to back. Repeat the model, with the child watching the therapist’s back. Face to Back: Score ONE point for each correct sequence: Left-right + right-left The child’s score is the higher of the two scores, face to face OR face to back. 7. Vision blocks Xs Level 1 Professional: Facing the computer: Say how many Xs: NN score ________ Score: ALL = 10 pt / Most = 8 pt / At least half = 5 pt / At least 5 correct = 2 pt 8. Vision blocks Fingers Level 1 Beginner: Head rotation: Say how many fingers: NN score ________ Score: ALL = 10 pt / Most = 8 pt / At least half = 5 pt / At least 5 correct = 2 pt

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


# 9: Word retrieval

#9: Time #1: ________ + time #1: ________ + time #2: ________ + time #3: ________ = __________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#9: Word retrieval: Therapist data page

Do this activity ONLY THREE TIMES but add the first score twice. ADD time #1 _______ + time #1 AGAIN ________ + time #2 _______ + time #3 ________ = _______ Total times ________ divided by 4 = average time ________ (maximum time 50 sec) NN score: ≤25 s = 10 pt / 26 s = 9 pt / 27 s = 8 pt / 28-29 s = 7 pt / 30 = 6 pt / 31-34 = 5 pt / ≥ 36 s = 2 pt example: Time #1: 31 sec time #2: 27 sec time #3: 24 sec ADD time #1: 31 s + time #1 AGAIN 31 s + time #2: 27 s + time #3: 24 s = total time: 113 sec Total time: 113 sec divided by 4 = average time: 28.25 sec (maximum time 50 sec) NN score: ≤25 s = 10 pt / 26 s = 9 pt / 27 s = 8 pt / 28-29 s = 7 pt / 30 = 6 pt / 31-34 = 5 pt / ≥ 36 s = 2 pt

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


# 10: Lipreading: Watch me and look at the words I am saying. Watch my mouth and lipread to understand the words. Then touch and name each picture as you repeat the words I said.

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


# 10: Lipreading for object & color phrases: Therapist data page Say each phrase once and score TWO points for each word correct. Then go back and re-do only the phrases which got zero points. When you repeat the phrase, score 1 point for each word correct. 1st model: _____ x 2 = _____ pt + 2nd model: _____ pt = Total score _____ Total score: _____ divided by 4 = NeuroNet score: _____ BLUE ELEPHANT: _____ _____ GREEN UMBRELLA: _____ _____ ORANGE BUTTERFLY: _____ _____ PURPLE BUTTERFLY: _____ _____ PURPLE FISH: _____ _____ YELLOW TABLE: _____ _____ BROWN BAT: _____ _____ GRAY ELEPHANT: _____ _____ YELLOW FLOWER: _____ _____ RED SHOE: _____ _____ Example: 1st model: 12 √ x 2 = 24 pt + 2nd model: 4 √ = 4 pt. TOTAL = 28 pt. Total: 28 pt divided by 4 = NeuroNet score: 7 points BLUE ELEPHANT: √ √ _____ GREEN UMBRELLA: √ √ _____ ORANGE BUTTERFLY: √ √ _____ PURPLE BUTTERFLY: O √ _____ PURPLE FISH: √ √ _____ YELLOW TABLE: G B √ FL BROWN BAT: G √ _____ GRAY ELEPHANT: √ √ _____ YELLOW FLOWER: ____ R √ RED SHOE: G UM √ √

#11. Lipreading for number names: Therapist data page (there is no student page for this exercise) Now do lipreading for number names. Say each number only once. The child repeats the number. Score one point for each number correct. 35 ________ 24 ________ 29 ________ 47 ________ 74 ________ 79 ________ 93 ________ 55 ________ 52 ________ 99 ________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#12: Decoding: English: 30 years of reading research Underline and say every word. If you’re not sure of the word, take a guess, then go on.

bat car dig fox get

boat call day fire go

hair jump kite loud meat

high jar kick lawn mail

new pay phone quit road

note pole photo quick real

sigh tone thank van we

sir tough third vest way

you zoo shake chirp know

yes zip shop chew knee

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#12: Decoding: Therapist data page: check √ words correct; mark phoneme (\) and word errors Sample: dig/big = incorrect sound; fox/fun = incorrect word

bat √ car √

fox “fun”

get “egg”

bat car dig fox get

boat call day fire go

hair jump kite loud meat

high jar kick lawn mail

new pay phone quit road

note pole photo quick real

sigh tone thank van we

sir tough third vest way

you zoo shake chirp know

yes zip shop chew knee

Decoding: NeuroNet score: __________ How many correct in 1 minute? __________ divided by 5 = 1st minute points __________ And one minute more? __________ divided by 10 = 2nd minute points __________ Add 1st minute points ________ + 2nd minute points _________ = NeuroNet score ________ Example: How many correct in 1 minute? __25___ Divided by 5 = 1st minute points __5___ And one minute more? ___14____ Divided by 10 = 2nd minute points __1.4 __ Add 1st minute points __5__ + 2nd minute points __1.4__ = NeuroNet score __6.4__

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#13: Force Rhyme: One minute and one minute more. Model the first 5 rhyming word pairs.

bat sing bear leg paw

me best soon bag cake

band root win shy stone

deep sock frog boat truck

dirt flat peel rose new First minute _____ x 2 + second minute _____ = total _____ / 5 = NeuroNet score ______

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#14: Create Rhyme: one minute and one minute more. Model the first 5 rhyming word pairs

First minute _____ x 2 + second minute _____ = total _____ / 5 = NeuroNet score ______

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#13: Force rhyme: Therapist data page: Check √√ correct responses; write errors FORCE rhyme: Word list

CAT BAT RING SING CHAIR BEAR EGG LEG SAW PAW

KEY ME NEST BEST MOON SOON FLAG BAG RAKE CAKE

HAND BAND BOOT ROOT PIN WIN PIE SHY BONE STONE

SHEEP DEEP SOCK CLOCK DOG FROG COAT BOAT DUCK TRUCK

SHIRT DIRT BOAT FLAT EEL PEEL NOSE ROSE SHOE NEW

#14: Therapist data page: CREATE rhyme: Check √ correct responses. ASK ABOUT non-words! Example: If the child says coat/moat, you go back after the exercise is complete and you ASK: “Moat, what’s a moat?” If the child knows, he gets credit for the rhyme. If not, no credit. EXAMPLES:

RAKE: M √ ICE: BICE HOUSE: M√ COAT: M ? BIRD: CURD ?

Create rhyme: Word list:

RAKE ________ ICE ________ HOUSE ________ COAT ________ BIRD ________

SUN ________ CHAIR ________ BOOK ________ SHEEP ________ BONE ________

RING ________ FROG ________ PIE ________ BREAD ________ KITE ________

SNAKE ________ BEE ________ DUCK ________ FISH ________ EYE ________

CLOCK ________ NEST ________ FLAG ________ DOG ________ CAT ________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#15: Syllable analysis for pictures: One minute and one minute more. Model the first five words. Draw horizontal lines to show the syllables. Model the First Row with yellow marker.


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#15: Syllable analysis for pictures: Example:


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#16: Syllable analysis for number names. Model the First Row with yellow marker.

1 18 11 9 12

13 2 23 17 4

3 25 14 12 5

19 6 0 15 8

4 19 7 20 11 First minute ____ x 2 + second minute ____ = total ____ / 5 = NeuroNet score ____

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#17: Syllable analysis for words: One minute and one minute more. Draw horizontal lines to show the syllables. Model the First Row with yellow marker.

drive driver driving drove

wash washed washing washes

open opened opener opening

fun funny funnier funniest

lock locker locked unlock

tie untied tying tied

First minute ____ x 2 + second minute ____ = total ____ / 5 = NeuroNet score ____

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#18: Phoneme Analysis: Sounds in Words: Say and show the first row with a YELLOW MARKER.


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#18: Therapist data page: Phoneme analysis: Note any vocabulary differences (ex: cup vs. glass)


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#19: Auditory Closure

One day as I was walking to school, I heard a noise: arf arf! I

looked all around, but I didn’t see anything. Finally I looked inside

an empty garbage can and I saw a little tiny ________ [1] stuck

inside the can. I lifted him out. He was so happy to see me, he

wagged his ________ [2] and licked my ________ [3].

Suddenly I remembered that I had to go to ________ [4]! “Oh,

no!” I said, “I’m going to be ________ [5]! My teacher is going to

be ________[6]!” I tucked the puppy inside my jacket, and ran all

the way to school.

The teacher frowned when she saw me come in late, but then I

told her what had happened and showed everyone the little

_______ [7].

“Wags!” shouted Amy, from the back of the room. We all turned

around to look at __________ [8].

“Wags is my puppy,” explained Amy. “He ran out the door this

morning while my mom was taking out the ________ [9]. I looked

everywhere, but I couldn’t find him. I was so sad because my

puppy was __________[10]. Thank you for rescuing

__________ [11].”

Then the teacher told Amy to go to the office and call her mom to

come to school and get Wags. So Wags went safely back home,

and after that we all wrote a story about The Adventures of

_________ [12].

[1] puppy = 2 pt

dog = 1 pt

[2] tail = 1 pt

[3] face = 2 pt

hands = 1 pt

[4] school = 2 pt

other place = 1

pt

[5] late = 1 pt

[6] ~ mad = 1 pt

[7] ~ puppy = 1 pt

[8] Amy = 3 pt

~ person = 1 pt

[9] ~ trash = 1 pt

[10] ~ lost = 2 pt

[11] him = 2 pt

~ Wags = 1 pt

[12] Wags = 2 pt

~ dog = 1 pt

TOTAL POINTS

______

Total points ________ divided by 2 = NeuroNet score ________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#20: Navigation alphabet a-z: One-minute timer: Talk and write. Always start at the star.

Completed ________ + start star ________ + talk ________ + around/through ________

NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#21: Navigation alphabet a-z: CDX track 21: Listen, then talk and write. Start at the star.


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


#22: Random navigation alphabet: CDX track 22: Listen, then talk and write. Start at the star.


NAME: ________________________ DOB: ___________ AGE: _________ DATE: ___________


Navigation alphabet: Therapist data page #20. Navigation alphabet with one-minute timer How many completed ________ + how many start at the star ________ + How many go around or through the center square ________ + how many talking ________ = Total _______ Total divided by 10.4 = NeuroNet score: ________ #21. Navigation alphabet with CD Extras Track 21 How many completed ________ + how many start at the star ________ + How many wait/listen then talk and write ________ + How many go around or through the center square ________ = Total _______ Total divided by 10.4 = NeuroNet score: ________ #22. Navigation alphabet with CD Extras Track 22: Random letters How many completed ________ + how many start at the star ________ + How many wait/listen then talk and write ________ + How many go around or through the center square ________ = Total _______ Total divided by 10.4 = NeuroNet score: ________

application for neuronet tools for learning certification

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