http://www.gvsu.edu/autismcenter/coaching-checklist-231.
htm
This tool is intended to be used by IEP and behavioral planning teams to assist in goal development and identification of necessary supports and strategies.
Student Schedule
In this column, list the
student’s daily schedule
including all primary
activities, courses / classes
and/or transitions.
Schedule Matrix Guide
Expectations &
Instructional Outcomes
In this column, identify the
expectations & instructional
outcomes during this part of
the schedule. Expectations
and instructional outcomes
include:
● Independence Skills
● Social Interaction Skills
● Communication Skills
● Behavioral Skills
● Academic Skills
including task initiation,
engagement, & output
For example, during
“arrival,” the instructional
outcomes may include
independently taking off
outerwear, getting materials
ready, taking a seat, and
completing morning work.
Include in this section any
specific IEP goals targeted
during a particular time in the
schedule.
Current Level of Skills
(Compared to Peers)
In this column, identify the
student’s performance,
compared to peers, in this
part of the schedule.
Include the following:
● Independent Skills
● Social Interaction Skills
● Communication Skills
● Engagement Skills
including task initiation,
participation, and task
completion (output)
● Challenging Behaviors
Deficits in these areas will be
targeted for intervention and
should be included in the last
column.
Current Supports, Potential Goals &
Strategies & EBPs Strategies Needed
List in this column, all the In this column, based on
supports, strategies, and/or information in the previous
supplementary aides and columns, list potential goal
services currently in place to areas (areas of need) and
support the student. These additional strategies needed
include but are not limited to: for the student to
independently make adequate
● Visual / Organizational progress in all areas.
Supports / Strategies
● Peer to Peer Supports
● Functional
Communication System
● Positive Behavioral
Interventions & Supports
● Evidence-Based
Practices
● Accommodations /
Modifications
● Behavioral Response
Plan / Crisis Plan
● Adult (Paraprofessional /
TA Support)
START Sept 2013
http://www.gvsu.edu/autismcenter/coaching-checklist-231.htm

Schedule Matrix

This tool is intended to be used by IEP and behavioral planning teams to assist in goal development and identification of necessary supports and strategies.

Student Name: FaithcvcvNicholas District / Building: Hudson Lincoln Elementary Classroom: Emily Mansfield
1/29/2021 Team: Emily Mansfield, Teacher, Sally Vermilya, Speech Therapist, Katelyn cvcv
VanWyck, SE teacher, Natalie Shalda, student intern, cvcv
cvcv
Susan Wilson, school social worker, Christy Walworth, parapro, Kerri Jent, principal

Expectations & Current Level of Skills Current Supports, Potential Goals &
Student Schedule
Instructional Outcomes (Compared to Peers) Strategies & EBPs Strategies Needed
● Can independently arrive
and get personal items in
her cubby, get her own
● Independence skill-
breakfast and morning
remove outer wear, place
work. She needs ● Peer to Peer
in cubby, take care of
reminders to get her ● Visual organization,
homework folder, make
7:40-8:00-Arrival and folder out and make her checklist, task strips
lunch choice, grab ● Adult Paraprofessional
breakfast lunch choice. ● Social stories
breakfast and open/eat
● She needs reminders to ● Teach how to eat
independently
not get a second particular things
● Independently clean up
breakfast and to clean up
and take care of trash
her table spot when
finished. Ritualistic with
eating.
● Independence and
● Needs adult support to
Academic skill- grab
complete morning work.
morning work paper and
8:00-8:15- Morning Work ● Doesn’t always get to ● Adult Paraprofessional ●
initiate work, remain
morning work because
engaged and complete
she is still eating
independently
● Needs adult support to
● Social Interaction, sit still and stay focused
Behavioral and and on task. No
● Adult Paraprofessional
Communication Skills- participation unless ● Peer to Peer
near but not within
8:15-8:30- Morning Meeting interact in daily asked a question. ● Aide to not sit on the
physical contact (not on
questions and answers, ● Sits on carpet with her carpet
carpet)
share ideas, remain ● Watches other students
seated and engaged not following
expectations
8:30-9:30- Math ● Behavioral, ● Needs adult support to ● Adult Paraprofessional ●

START Sept 2013

http://www.gvsu.edu/autismcenter/coaching-checklist-231.htm
● Academic and
9:30-10:50- Daily
Five/Language Arts
remain engaged and to
complete tasks.
● Plays with supply box,
Independence and picks paper off crayons,
Academic Skill- plays with bracelets, if it
remained seated and gets wet or doesn’t fit
● Accommodations and
engaged, follow along she fusses with things
modifications
with math lesson and frustratedly, shakes, balls
● Visual/Organizational
initiate and engage in fists, may swear under
Supports
work to show breath (demon, etc.)
appropriate level of (remorseful)
output ● mad if pencil dulls,
needs to sharpen to
point, erases lines if not
perfect
● Needs adult to remain on
Behavioral Skills, Social task and complete work
● Adult Paraprofessional
Interaction, and ● Faith wanted a particular
Independence- c
student to help her rather
● Modifications/Accommo
dations
engagement in whole than adult to help her
● teacher modify work that ●
group activity, initiation
both girls could be
and output during work
successful with
time, interaction with
●
peers during instruction
questions and answers

● Independence skill- ● Independently completes

10:50-11:00- Wash for Lunch ● Adult Paraprofessional ●
initiate washing of hands task

● Independently completes
● Independence Skill- task
11:05-11:45- Lunch and
open milk and other ● Needs support/reminders ● None ●
Recess
items for Self care/cleaning up
after lunch
● Behavioral skill-
11:45-12:00- Read Aloud remained seated and ● ● None ●
engaged
12:00-12:25- ● Struggles to complete
● Adult Support
(Speech)Writers Workshop ● Independence skill task without adult ●
● Visual Support
Lesson support

START Sept 2013

http://www.gvsu.edu/autismcenter/coaching-checklist-231.htm
● Independence Skill-
12:25-1:15- Specials
1:15-1:30- Writing
1:30-2:00- Resource Room
1:45-2:35- Science/Social
Studies
2:35-2:45- Clean up and Pack
up/Dismissal
● Struggles to remain
initiate and complete ● None ●
focus and on task
assigned work
Academic and
Independent
Skill-Initiate
writing with
● Independence and
single topic
engagement skill ● Adult Paraprofessional
focus, ●
● Task completion ● Visual Organization
independently
● Challenging behaviors
writing letters
corresponding
to the sounds in
words
Academic Skill ● ● ●
Academic and
Independent skill- ● Engagement and
remain engaged in lesson independence skill ● Adult Paraprofessional ●
and independently ● Task completion
complete assigned work
Independence Skill-
clean table area and
independently pack
● Task completion
folder with papers from
● Struggles to follow the
cubby. Place folder in
necessary steps to get
backpack and make sure
herself ready to go ● Adult Paraprofessional ● Visual Organization
all needed materials are
home. Can get her coat
in backpack to take
and backpack but forgets
home. Put on coat and
her folder
backpack and wait by
chair to be released for
dismissal.
START Sept 2013