Name: _________________________________
Time:
_______ Day:______________________
Date:
_______________
Therapist name: __________________
Your therapist is going to put you to
work on this task** ______________________.
You will have to watch the clock while
you are doing the task -
because at certain times you will have to stop and do what it
says on the checklist below.
After you finish doing what it says on
your checklist, go back and continue your task.
|
Time |
Task |
|
|
Tell therapist to
close door |
|
|
Change TV channel
to sports show |
|
|
Ask therapist for a
highlighter |
|
|
Write today’s date
on post-it, Give to therapist |
|
|
Pour a drink of
water |
|
|
|
|
|
|
**Primary task suggestions: Puzzle, worksheet, sorting money, coupons, pill sort
Bedside
Interrupt