Routine Personal Care and Family Oriented Functions
1. I make my own meals or snacks.
2. I care for my own clothes.
3. I do chores in my home.
4. I keep my own personal items together.
5. I do simple first aid or medical care for myself.
6. I keep good personal care and grooming.
Interaction with the Environment
7. I make friends with other kids my age.
8. I use the post office.
9. I keep my appointments and meetings.
10. I deal with salespeople at stores and restaurants.
Subdomain: Acting on the Basis of Preferences‚ Beliefs‚ Interests and Abilities
Recreational and Leisure Time
11. I do free time activities based on my interests.
12. I plan weekend activities that I like to do.
13. I am involved in school-related activities.
14. My friends and I choose activities that we want to do.
15. I write letters‚ notes or talk on the phone to friends and family.
16. I listen to music that I like.
Community Involvement and Interaction
17. I volunteer in things that I am interested in.
18. I go to restaurants that I like.
19. I go to movies‚ concerts‚ and dances.
20. I go shopping or spend time at shopping centers or shopping malls.
21. I take part in youth groups (like 4-H‚ scouting‚ church groups)
22. I do school and free time activities based on my career interests.
23. I work on school work that will improve my career chances.
24. I make long-range career plans.
25. I work or have worked to earn money.
26. I am in or have been in career or job classes or training.
27. I have looked into job interests by visiting work sites or talking to people in that job.
28. I choose my clothes and the personal items I use every day.
29. I choose my own hair style.
30. I choose gifts to give to family and friends.
31. I decorate my own room.
32. I choose how to spend my personal money.
The Self-Regulation section consists of two subdomains‚ with questions which require students to write (or dictate) answers.
33. Beginning --You are sitting in a planning meeting with your parents and teachers. You want to take a class where you can learn to work as a cashier in a store. Your parents want you to take the Family and Child Care class. You can only take one of the classes.
Ending -- The story ends with you taking a vocational class where you will learn to be a cashier.
34. Beginning -- You hear a friend talking about a new job opening at the local book store. You love books and want a job. You decide you would like to work at the bookstore.
Ending -- The story ends with you working at the bookstore.
35. Beginning -- Your friends are acting like they are mad at you. You are upset about this.
Ending -- The story ends with you and your friends getting along just fine.
36. Beginning -- You go to your English class one morning and discover your English book is not in your backpack. You are upset because you need that book to do your homework.
Ending -- The story ends with you using your English book for homework.
37. Beginning -- You are in a club at school. The club advisor announces that the club members will need to elect new officers at the next meeting. You want to be the president of the club.
Ending -- The story ends with you being elected as the club president.
38. Beginning -- You are at a new school and you don't know anyone. You want to have friends.
Ending -- The story ends with you having many friends at the new school.
Where do you want to live when you graduate?
Where do you want to work after you graduate?
What type of transportation do you plan to use after graduation?
42. I usually do what my friends want.
I tell my friends if they are doing something I don't want to do.
43. I tell others when I have new or different ideas or opinions.
I usually agree with other peoples' opinions or ideas.
44. I usually agree with people when they tell me I can't do something.
I tell people when I think I can do something that they tell me I can't.
45. I tell people when they have hurt my feelings.
I am afraid to tell people when they have hurt my feelings.
46. I can make my own decisions.
Other people make decisions for me.
47. Trying hard at school doesn't do me much good.
Trying hard at school will help me get a good job.
48. I can get what I want by working hard.
I need good luck to get what I want.
49. It is no use to keep trying because that won't change things.
I keep trying even after I get something wrong.
50. I have the ability to do the job I want.
I cannot do what it takes to do the job I want.
51. I don't know how to make friends.
I know how to make friends.
52. I am able to work with others.
I cannot work well with others.
53. I do not make good choices.
I can make good choices.
54. If I have the ability‚ I will be able to get the job I want.
I probably will not get the job I want even if I have the ability.
55. I will have a hard time making new friends.
I will be able to make friends in new situations.
56. I will be able to work with others if I need to.
I will not be able to work with others if I need to.
57. My choices will not be honored.
I will be able to make choices that are important to me.
58. I do not feel ashamed of any of my emotions
59. I feel free to be angry at people I care for.
60. I can show my feelings even
61. I can like people even if I don't agree with them.
62. I am afraid of doing things wrong.
63. It is better to be yourself than to be popular.
64. I am loved because I give love.
65. I know what I do best.
66. I don't accept my own limitations.
67. I feel I cannot do many things.
68. I like myself.
69. I am not an important person.
70. I know how to make up for my limitations.
71. Other people like me.
72. I am confident in my abilities.
Michael L. Wehmeyer‚ Ph.D.
© 1995‚ The Arc of the United States and Michael Wehmeyer (nonexclusive rights). All rights reserved. No part of this book may be reproduced by any means without prior written permission from the publisher.