Complete a reflection form after an incident
When to use this goal
For students whose present levels show the same situations repeat because nothing is reviewed afterward. For students on a behavior plan or in a counseling program. Present levels decide the form's reading and writing level.
- Baseline
- Score two or three recent reflections, or complete one after the next incident, before setting the target. Most students start strong on row 1 and weak on rows 2 and 4. Complete reflections only once the student is calm.
- Tips
- Write descriptors for each row. The adult does not supply the content, only the questions. The form is for learning, not for consequences; keep those separate so the student can be honest. Scribing is a support for writing, not for content.
- Limits
- Opportunities depend on incidents, which the team wants to reduce. A good reflection does not prevent the next incident; track the behavior separately.
Original IEP Atlas template based on general measurement principles; not copied from any goal bank. ID ef-sm-016.
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Goal
By the annual IEP review date, after a classroom incident, once calm, with a reflection form, the student will complete a reflection form that meets the reflection rubric independently, earning a score of at least 6 out of 8 on a 4-row incident reflection rubric scored 0 to 2 per row, on 4 of 5 consecutive reflections, as measured by a defined scoring rubric collected each incident and summarized monthly.
Baseline: 2 out of 8 rubric points.
- Condition
- Observable behavior
- Criterion
- Measurement method
Measurability check11 of 11 met
Met: Observable behavior. Stated as an action.
Met: Condition. Stated.
Met: Unit fits the behavior. Rubric score fits this behavior.
Met: Explicit criterion. Number and unit stated.
Met: Mastery rule and schedule. Both stated.
Met: Method produces the metric. Rubric scoring gives rubric score data.
Met: Review timeframe. Stated.
Met: Baseline and target compatible. Same unit, change in the right direction.
Met: Aligned with area of need. Still about Self-Monitoring.
Met: Level of support. Defined.
Met: Blanks filled in. Nothing left to fill in.
Checks structure and wording only. Whether the goal fits the student is the team's call.
Short-term objectives (optional)
When are objectives required?Required for students on alternate assessments (34 CFR §300.320(a)(2)(ii)); some states require them for everyone.
Paste into your IEP system
Most district systems have a separate box for each part of a goal. Copy them one at a time, or all at once as labeled text.
- Area of need
- Executive Function - Self-Monitoring
- Baseline
- 2 out of 8 rubric points.
- Annual goal408 characters
- By the annual IEP review date, after a classroom incident, once calm, with a reflection form, the student will complete a reflection form that meets the reflection rubric independently, earning a score of at least 6 out of 8 on a 4-row incident reflection rubric scored 0 to 2 per row, on 4 of 5 consecutive reflections, as measured by a defined scoring rubric collected each incident and summarized monthly.
- Timeframe
- By the annual IEP review date
- Condition
- After a classroom incident, once calm, with a reflection form
- Behavior
- The student will complete a reflection form that meets the reflection rubric independently
- Criteria
- Earning a score of at least 6 out of 8 on a 4-row incident reflection rubric scored 0 to 2 per row, on 4 of 5 consecutive reflections
- Evaluation method
- A defined scoring rubric
- Schedule
- Each incident and summarized monthly
Copied as plain text, with straight quotes and plain dashes.
Matching data sheet
Rubric tracker. Scores each rubric criterion and totals them.
Rubric tracker
Rubric score- Student label:
- Target:
- earning a score of at least 6 out of 8 on a 4-row incident reflection rubric scored 0 to 2 per row
- Mastery rule:
- on 4 of 5 consecutive reflections
- Collection schedule:
- each incident and summarized monthly
- Method:
- Rubric scoring
- Data collector:
Goal: By the annual IEP review date, after a classroom incident, once calm, with a reflection form, the student will complete a reflection form that meets the reflection rubric independently, earning a score of at least 6 out of 8 on a 4-row incident reflection rubric scored 0 to 2 per row, on 4 of 5 consecutive reflections, as measured by a defined scoring rubric collected each incident and summarized monthly.
| Date | Task / sample | Describes what happened in observable terms | Names what the student did, not only what others did | Identifies the trigger or what came right before | States one specific thing to do differently next time | Total (of 8) | Notes |
|---|---|---|---|---|---|---|---|
Preview shows 4 of 12 rows.
- Score each sample with a 4-row incident reflection rubric scored 0 to 2 per row. Attach or reference the rubric's score descriptors.
- Use the same prompt type and conditions for each scored sample.
- If two people score, check agreement on a few samples before relying on the data.
The CSV opens in Excel or Google Sheets, with formulas. Sheets print blank; no student data is stored.