1/19/2023 EnchantaVaughn Approved (AM) During morning school arrival, client entered the building with impulsive and hyperactive behaviors running and jumping in the hallway and making loud noises. Client continued to be disruptive even after being told to stop several times. Client was off task as he was observed talking to his classmates instead of being attentive to his instructor. Client struggled to refrain from displaying disruptive behaviors, as evidenced by socializing with his peers during instructional period. Client exhibited negative behaviors as he failed to comply with instructor. Client continued talking until his instructor informed him he would be sent to the office if he continued to do so. Client quickly got quiet and was able to redirect his negative behavior. Client seemed to be irritable as he made a side comment in regards to being bored in the class. Client had trouble following directions. Client failed to appropriately express his feelings, as evidenced by failing to verbalize he did not understand the assignment. (PM) Client was observed taking notes as QMHP arrived to his structured setting. Client appeared to be struggling to keep up with the speed of the teacher so he failed to complete all of his notes or ask for help. Client failed to complete his assigned task, as evidenced by client continuing to work on it as the teacher came around to collect it. Client became argumentative, as evidenced by attempting to keep his paper. Client struggled to comply with authority directives during middle academic hours. as evidenced by talking in the hallway on the way to lunch. Client's instructor stopped the class multiple times due to his lack of self-control in the hall. (EOD) Client lacked age appropriate behavior, as evidenced by laughing after being held back. Towards the end of the academic day client struggled to remain in his designated area as he continued to constantly get up from his seat. Client appeared to be nonchalant as his instructor expressed the possible consequences that would follow. As the client prepared for dismissal, he was observed getting up without permission and giving his teacher a hard time about cleaning off his table first. Client did not meet any objectives today. (AM) QMHP welcomed client upon arrival. QMHP inquired about evening and morning. QMHP asked how client was feeling. QMHP asked if client needed help with anything. QMHP encouraged client to have a good day. (PM) QMHP monitored individualized behaviors for acquisition of objectives. QMHP encouraged client to participate in class. QMHP encouraged client to be the example for others. QMHP reminded client of goals and objectives. QMHP praised client for his efforts and encouraged him to remain on task. QMHP commended client for utilizing age appropriate communication skills. (EOD) QMHP reflected with client on his day, reviewing both good and bad experiences. QMHP processed with client, "what could he have done better”. QMHP encouraged client to have a good evening. QMHP encouraged client that tomorrow is a new day. QMHP praised client for utilizing coping strategies and being able to ignore distractions. QMHP encouraged client to continue to use age appropriate skills. QMHP explained the positive outcome associated with doing so. QMHP challenged client to maintain appropriate behaviors through the entire week. (AM) Client had one on one with QMHP. Client expressed he was ready for today’s activities. (PM) Client was able to stay in class and finish his work on time. Client has a clear understanding of goals and objectives and agrees to work on making better decisions. Client smiled and promised to have a good rest of the day. (PM) Client was observed adhering to the rules and regulations and following his expecations for the new school year. Client is acceptive to support and encouragement. Client is happy when he is around his friends in school. Client behaviors are influenced by his peers who are doing wrong and client is observed initiating himself in ways that are unhealthy and inappropriate. Client was able to corrent his behaviors and get back on task. (EOD) Client utilized coping skills to decrease feelings associated with stress and anxiety. Client accepted the challenge by stating that he was going to try to do the right thing at all times and listen to his teacher so that he can have a successful week and share good reports with his family. Client said thank you. Client was confident he would meet his objectives and asked to be rewarded accordingly.