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Community Facilities 0
Student: Student L1
Assessment Date: 11 August 20153
Completed By: Anne May Chua
Frequency Key
0 = once a month or less 0 = 3 times a month or 1 = 2 to 3 times a month 1 = 1 to 2 times a week3 = once a week or more 3 = 3 or more times a
Activity Facility EnvironmentGames/Sports/Fitness Activities Current Future
Swim public pool 0
Cycle playground 0
HobbiesPaint living room 0
Draw living room 0
Passive/Spectator ActivitiesVisit the Zoo 0
Year Around Seasonal
0 Year Around
3 Year Around
0 Year Around3 Year Around
0 Year Around
0 Year Around
1 Year Around
3 Year Around
00 Seasonal
Frequency Key 1 Seasonal
3 Seasonal0 = once a month or less 0 = 3 times a month or 1 = 2 to 3 times a month 1 = 1 to 2 times a week3 = once a week or more 3 = 3 or more times a
Environment Materials and Equipment AvailableSchool
Current: Ring float, tricycle
Future:
School: different types of floats; tricycleNotes:
Materials and Equipment AvailableCurrent: art paper, brushes and watercolours; coloured markers and paper
Future:
School:Notes:
Materials and Equipment AvailableCurrent: Singapore Zoo
Future:
School:Notes:
Year Around Seasonal
3 Year Around
3 Year Around
1 Year Around3 Year Around
0 Year Around
Materials and Equipment Available
Ring float, tricycle
different types of floats; tricycle
Materials and Equipment Availableart paper, brushes and watercolours; coloured markers and paper
Materials and Equipment AvailableSingapore Zoo
3 = once a week or more 3 = 3 or more times a Activity Facility Environment
Social ActivitiesAttend parties 0
Visit relatives 0
0 Year Around3 Year Around
3 = once a week or more 3 = 3 or more times a Environment Materials and Equipment Available
Notes:
Materials and Equipment AvailableCurrent: Birthday celebrations at relatives' homes.
0Future:
School: Birthday celebrations of classmates in school
Notes:
0 Year Around
Materials and Equipment Available
Materials and Equipment AvailableBirthday celebrations at relatives' homes.
Birthday celebrations of classmates in school
LEISURE SKILLS ASSESSMENT Participation Levels Frequency KeyI = Independent Year Around
Student: Student L P = Partial Participation
Assessment Date: 11 August 2015 1 = 2 to 3 times a month
Completed By: Anne May Chua Training Key 3 = once a week or more* = High Priority
Skill Type Name of Leisure Activity Partial Participation and Comments Adaptation
Games/Sports/Fitness Activities
with parent accompaniment P
Roll a ballplays with alone and with parent P
Target Skill →
0 = once a month or less
Eliminated Skills
Particip. Level
Satisfactory Skill →
Indoor playground - Climb, jump, slide and crawl
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Frequency KeyYear Around Seasonal
0 = 3 times per month or less
1 = 2 to 3 times a month 1 = 1 to 2 times a week * I
3 = once a week or more 3 = 3 or more times a week √ 1 P Balance
X Weight/ Balance
Eliminate
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
√2009
* 1 1 1 Balance
1 1 1 Balance
2009
= once a month or less
Home Based
Comm. Based
Weight / Balance
1 Year Around
3 Year Around
3 Year Around
0 Year Around
1
2
3
4
5+
Weight/ Balance
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
0 0
Completed
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Target Skill →Cycling
use a tricycle X P
Target Skill →
Target Skill →Swimmming
use a ring float X P
Target Skill →
Target Skill →
Hobbies
plays with toy carsI
Scribble on doodle boardI
Target Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
* * 1 1 2 2009
2009
* * 1 1 1 2009
2009
2009
√
0 1 1 Balance
1 1 Balance
2009
0 Year Around
3 Year Around
3 Year Around
Weight/ Balance
0 Year Around
3 Year Around
3 Year Around
Weight/ Balance
3 Year Around
3 Year Around
0 Year Around
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
0 0
0 0
0 0
0 0
0 0
0 0
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Target Skill →Colouring
P
Target Skill →
Target Skill →Painting
use thick brushes P
Target Skill →
Target Skill →
use washable markers and pictures with thick black border
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
* 1 1 1 2 2009
2009
* * 1 1 1 1 2009
2009
2009
3 Year Around
3 Year Around
3 Year Around
Weight/ Balance
0 Year Around
3 Year Around
3 Year Around
Weight/ Balance
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
0 0
0 0
0 0
0 0
0 0
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Passive/Spectator Activities
Visit the Zoowith parents X P
Visit the airportwith parents X P
Watch Chinese Newswith grandparents I
Target Skill →Visits to play areas
P
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
adult will prompt child to Initiate play through gesturing
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
1 1 Balance
1 1 Balance
0 1 Balance
* * 1 1 1 2009
2009
2009
2009
2009
2009
0 Year Around
0 Year Around
0 Year Around
0 Year Around
3 Year Around
3 Year Around
3 Year Around
3 Year Around
Weight/ Balance
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
0 0
0 0
0 0
0 0
0 0
0 0
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Social Activities
Visit grandparentswith parents P
Attends partieswith parents P
Target Skill →
Target Skill → I
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Other Activities
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Maintain play near one or two peers.
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
0 1 1 Balance
1 1 Balance
2009
* * 1 1 1 1 2009
2009
2009
2009
2009
1 Year Around
0 Year Around
0 Year Around
3 Year Around
3 Year Around
3 Year Around
Weight/ Balance
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
0 0
0 0
0 0
0 0
0 0
0 0
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Target Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Satisfactory Skill →
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
2009
2009
2009
2009
2009
2009
Total Number of Skills 6
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
0 0
0 0
0 0
0 0
0 0
0 0
Skill Type Name of Leisure Activity Partial Participation and Comments AdaptationEliminated
SkillsParticip.
Level
Balance WeightingEnvironment
Individual Group Year 1 Year 2
Current Future School Rank Date Rank8 7 7 12
133.33 116.67 116.67 200.00
Home Based
Comm. Based
Weight / Balance
14
Weighting TrainingYear 2 Year 3
BegunDate Rank Date
Completed
Rank Ordered List
Games/Sports/Fitness Passive/Spectator Activities
1 Visits to play areas2 Cycling 1 Swimmming
Hobbies Social Activities
2 Colouring 1
1 Painting
Other Activities
Maintain play near one or two peers.
Rank Ordered List
Games/Sports/Fitness Passive/Spectator Activities
Hobbies Social Activities
Other Activities
Rank Ordered List
Games/Sports/Fitness Passive/Spectator Activities
Hobbies Social Activities
Other Activities