PEAK Relational Training System: Pre-Assessment Administration Checklist

Developed by Becky F. Barron, MS, BCBA and Mark R. Dixon, PhD, BCBA-D

Copyright 2018


Examiner: Participant: Observer: Date:

Preparation Checklist
The examiner should complete the following steps prior to administering the assessment Circle One
1. Room is well lit, free of distractions, and other observers are out of view Y N
2. Examiner attempts to build rapport and determine possible reinforcers and motivating
variables for the participant
Y N
3. Examiner states the expectations to the participant (e.g., when the participant will
receive breaks, when reinforcers will be delivered, that they will not be given the correct Y N
answers)
4. Examiner has all necessary materials for the assessment ready and keeps materials not
in use out of view of the participant
Y N
5. Examiner answers any questions the participant has about taking the assessment Y N
6. Examiner positions the Response Scoring Form and assessment script (if applicable) so
Y N
that the child is not able to read questions, answers, or see the recorded responses
7. Examiner begins the assessment promptly when steps 1-6 of preparation are complete Y N

Total Score: /7
Direct Training Pre-Assessment (PEAK-DT-PA) Administration Checklist
The examiner should complete the following steps when administering the PEAK-DT-PA Circle One
1. Examiner positions the participant properly Y N
2. Examiner positions self properly Y N
3. Examiner places the administration book on the table properly Y N
4. Examiner introduces the assessment by reading the script from the assessment verbatim Y N
5. Examiner reads the questions to the participant verbatim Y N
6. Examiner reads the questions to the participant clearly Y N
7. Examiner repeats the questions clearly no more than once per item when needed Y N
8. Examiner allows participant no more than 5-10 seconds to respond Y N
9. Examiner does not prompt, provide feedback, or deliver reinforcement for correct or
Y N
incorrect responses
10. Examiner circles a 1 or 0 immediately following the participant’s response to the
Y N
question
11. Examiner records participant responses correctly Y N
12. Examiner maintains participant attention throughout the assessment by providing
necessary noncontingent reinforcement for task completion unrelated to accuracy based Y N
on the needs of the individual
13. Examiner completes each factor of the assessment prior to providing a break to the
Y N
participant
14. Examiner discontinues the pre-assessment if the participant receives a score of 0 for
Y N
an entire factor
15. Examiner records total factor scores and total raw score correctly Y N

Total Score: /15

Generalization Pre-Assessment (PEAK-G-PA) Administration Checklist
The examiner should complete the following steps when administering the PEAK-G-PA Circle One
1. Examiner positions the participant properly Y N
2. Examiner positions self properly Y N
3. Examiner places the administration book on the table properly Y N
4. Examiner introduces the assessment by reading the script from the assessment verbatim Y N
5. Examiner reads the questions to the participant verbatim Y N
6. Examiner reads the questions to the participant clearly Y N
7. Examiner repeats the questions clearly no more than once per item when needed Y N
8. Examiner allows participant no more than 5-10 seconds to respond Y N

9. Examiner does not prompt, provide feedback, or deliver reinforcement for correct or
Y N
incorrect responses
10. Examiner circles a 1 or 0 immediately following the participant’s response to the
Y N
question
11. Examiner records the participant responses correctly Y N
12. Examiner maintains participant attention throughout the assessment by providing
necessary noncontingent reinforcement for task completion unrelated to accuracy based Y N
on the needs of the individual
13. Examiner provides participant with Learning Response Book and a writing utensil for
Y N
each question that requires such as indicated in the administration book
14. Examiner circles one notable characteristic of each animal (giraffe neck; dog body)
when awarding a score of 1 and fails to do so when awarding a score of 0 for item Y N
CMS-6.
15. Examiner circles 2 notable features on the participant drawing that are different
from the same house when awarding a score of 1 and fails to do so when awarding a Y N
score of 0 for item RPR-12
16. Examiner completes the factor if the participant needs a break or the examiner
needs to resume the assessment at another time Y N
17. Examiner discontinues the pre-assessment if the participant receives a score of 0 for
an entire factor Y N
18. Examiner records total factor scores and total raw score Y N
/ 18
Total:
Equivalence Pre-Assessment Short Form (PEAK-E-PA) Administration Checklist
The examiner should complete the following steps when administering the PEAK-E-PA
Short Form Circle One
1. Examiner positions the participant properly Y N
2. Examiner positions self properly Y N
3. Examiner places the administration book on the table properly Y N
4. Examiner introduces the assessment by reading the script from the assessment verbatim Y N
5. Examiner reads the questions to the participant verbatim Y N
6. Examiner reads the questions to the participant clearly Y N
7. Examiner repeats the questions clearly no more than once per item when needed Y N
8. Examiner allows participant no more than 5-10 seconds to respond Y N
9. Examiner does not prompt, provide feedback, or deliver reinforcement for correct or
Y N
incorrect responses
10. Examiner circles a 2, 1 or 0 immediately following the participant’s response to the
Y N
questions as dictated in the Short Form Script
11. Examiner records the participant responses correctly Y N
12. Examiner maintains participant attention throughout the assessment by providing
necessary noncontingent reinforcement for task completion unrelated to accuracy based Y N
on the needs of the individual
13. Examiner completes the subtest if the participant needs a break or the examiner
Y N
needs to resume the assessment at another time
14. Examiner discontinues the pre-assessment if the participant receives a score of 0 for
Y N
three consecutive questions
15. Examiner records total subtest raw scores and multiplies points by 2 to convert to
Y N
Long Form score
16. Examiner records total raw score and Long Form score Y N
/ 16
Total:
Transformation Pre-Assessment Receptive (PEAK-E-PA) Administration Checklist
The examiner should complete the following steps when administering the PEAK-T-PA
Receptive Test Circle One
1. Examiner positions the participant properly Y N
2. Examiner positions self properly Y N

3. Examiner places administration book on table properly Y N

4. Examiner introduces the assessment by reading the script from the assessment verbatim Y N
5. Examiner reads the questions to the participant verbatim Y N
6. Examiner reads the questions to the participant clearly Y N
7. Examiner repeats the questions clearly no more than once per item when needed Y N
8. Examiner points to stimuli in the book as dictated in the script Y N
9. Examiner allows participant no more than 5-10 seconds to respond Y N
10. Examiner provides prompting and feedback on the Practice Items Y N
11. Examiner does not prompt, provide feedback, or deliver reinforcement for correct or
Y N
incorrect responses
12. Examiner circles a 1 or 0 immediately following the participant’s response to the
Y N
questions on the Response Scoring Form
13. Examiner records the participant responses correctly Y N
14. Examiner maintains participant attention throughout the assessment by providing
necessary noncontingent reinforcement for task completion unrelated to accuracy based Y N
on the needs of the individual
15. Examiner completes the subtest if the participant needs a break or the examiner
Y N
needs to resume the assessment at another time
16. Examiner discontinues the subtest if the participant receives a score of 0 for three
Y N
consecutive questions and proceeds to the next subtest
17. Examiner completes steps 1-16 for all six subtest Y N
18. Examiner records total subtest scores and total raw score Y N
/ 18
Total:
Transformation Pre-Assessment Expressive (PEAK-E-PA) Administration Checklist
The examiner should complete the following steps when administering the PEAK-T-PA
Expressive Test Circle One
1. Examiner introduces the assessment by reading the script from the assessment verbatim Y N
2. Examiner reads questions to the participant verbatim Y N
3. Examiner reads questions to the participant clearly Y N
4. Examiner repeats the questions clearly no more than once per item when needed Y N
5. Examiner allows no more than 5-10 seconds to respond Y N
6. Examiner does not prompt, provide feedback, or deliver reinforcement for correct or
Y N
incorrect responses
7. Examiner circles a 1 or 0 immediately following the participant’s response to the
Y N
questions on the Response Scoring Form
8. Examiner records the participant responses correctly Y N
9. Examiner maintains participant attention throughout the assessment by providing
necessary noncontingent reinforcement for task completion unrelated to accuracy based Y N
on the needs of the individual
10. Examiner completes the subtest if the participant needs a break or the examiner
needs to resume the assessment at another time Y N
11. Examiner discontinues the subtest if the participant receives a score of 0 for three
consecutive questions and proceeds to the next subtest Y N
12. Examiner completes steps 1-10 for all six subtest Y N
13. Examiner records total subtest scores and total raw score Y N
/ 13
Total:
Overall Performance Checklist
The examiner should be assessed on their overall performance conducting all of the
assessments using the following criteria
1. Examiner remains calm throughout administration Y N
2. Examiner handles behavior problems correctly Y N

3. Examiner makes accommodations as necessary for any physical impairments that may
Y N
affect the participant (e.g., hearing or vision loss)
4. Examiner does not take breaks in the middle of factor tests or subtests Y N
5. Examiner maintains participant attention throughout the assessment process by
providing necessary breaks between factors or subtests and noncontingent reinforcement Y N
for task completion unrelated to accuracy of responses
6. Examiner does not provide reinforcement or feedback for any responses during the
assessment
Y N
7. Examiner administers the test professionally and unhurried Y N
8. Examiner speaks clearly throughout the testing process Y N
9. Examiner has all materials ready before beginning administration of each pre-
Y N
assessment
10. Examiner maintains a steady pace Y N
11. Examiner records responses so that the participant cannot see correct or incorrect
Y N
answers
12. Examiner takes short breaks if needed at the end of each factor or subtest Y N
13. Examiner does not give additional items to practice Y N
14. Examiner does not define words for the participant Y N
15. Examiner does not hint at correct responses Y N
16. Examiner makes efforts to administer entire pre-assessment in one session Y N
17. Examiner scores each item directly after the child responds Y N
18. Examiner rechecks scoring after administration Y N
19. Examiner makes note of any accommodations made during the assessment Y N
20. Examiner accurately identifies challenging behavior dimensions observed during the
Y N
assessment on the PEAK Challenging Behavior Index
21. Examiner accurately scores PEAK Challenging Behavior Index
/ 21
Total:

Total Overall Score: / 108