9/14/2023 EnchantaVaughn Approved (AM) Upon arrival, client was observed settling into class. Client was in a peaceful mood, as evidenced by his laid back demeanor. Client was praised for being on task and avoiding conflict, despite stressful environment. Client was attentive and engaging in class. Client expressed great verbal and nonverbal communication and was supported for his cooperation toward peers and authority. Client was able to complete his work and turn it in on time. Client was observed helping his teacher organize the classroom and clean up the room. Client was seen listening to his teachers and participating in assigned stations without getting frustrated and walking off. Client maintain a positive attitude heading into lunch. (PM) Client was observed in line and being respectful and polite to staff by saying please and thank you. Client sits correctly in his seat and held appropriate conversation with peers. Client was seen cleaning up his trash and asking for permission to see his counselor. Client was full of energy and excitement. Client was happy to see his group members, as evidenced by him laughing and playing safely. Client displayed good social interaction. Client demonstrated good team work skills. Client communicated he was having a good day and will continue making good choices. (EOD) QMHP collaborated with teacher regarding client's performance in class. Teacher is concerned that retaining him back in Kindergarten will cause some issues for him at home since his twin brother will be moving forward without him. Teacher feels client will benefit from repeating the same grade so that he can learn everything he is suppose to know on time and sufficiently. Client has been doing a great job in class and working to achieve his objectives daily. Client understands what is expected of him and he listens to his teacher requests and demands without needed additional TDT support. Client is very easy to deal with and rarely gets into trouble. Client does not show aggressive habits like his twin brother and the benefits of this were reviewed with support system. Client demonstrates excellent social interaction skills and conduct at the table. Client transitions smoothly into dismissal. Client needs improvement with goals and objectives. (AM) QMHP monitored client individualized behavior modifications in collaboration with his classmates and teachers. QMHP expressed gratitude toward positive interaction with his classmates and teachers. QMHP encouraged client to continue displaying positive behaviors. QMHP supported client involvement in selected activities. QMHP processed with client about what he learned from activity after the review from the teacher. QMHP praised client for his cooperation despite of not wanting to go to class or be in school today. (PM) QMHP discussed with student how empathy, communication and awareness of another point of view can prevent or reduce conflicts. QMHP brainstormed with client a list of conflicts that typically occur in his life in school or at home in efforts to identify possible conditions or triggers that preceded the actual conflict. (EOD) QMHP utilized role playing to demonstrate the calming effects of predicting the thoughts, feelings and actions of self and others prior to the outbreak of a conflict. QMHP prompted client to share anticipated thoughts and feelings and to indicate how this process reduces angry reactions. QMHP asked appropriate questions about group activity. QMHP reminded client of school rules and expectations. QMHP supported and monitored client in social and academic setting to ensure goals and objectives are met. (AM) Client modeled different ways to walk away from a conflict when frustrated. Client modeled how to separate himself from negative situations by counting to 10. Client demonstrated how to verbalize his feelings without yelling and being aggressive. Client was able to speak calmly and demonstrate his improved verbalization skills while conversing with other QMHP. (PM) Client participated in brainstorming exercise and was able to identify possible conditions or triggers that precede a conflict in school or at home. Client did not display any outbursts during the role play exercise. Client had difficulty understanding due to minor distractions. Client appeared to be learning from his mistakes and correcting them throughout the day. Client responded well to praise. (EOD) Client was receptive as QMHP demonstrated and defined the meaning of empathy. Client actively participated with QMHP as they discussed and processed empathy. Client demonstrated that he was able to process productive expressions of anger. Client displayed active behaviors in group settings. Client is making progress with expressing himself. Client made insightful comments which contributed to discussion. Client did not run away from group or get frustrated like he normally does during room changes. Client said he likes coloring activities. Client agreed to follow instructions and finish his work. Client was seen interacting well with his classmates and teachers. Client seemed to be enjoying the day and looked excited when transitioning to dismissal setting.