4/19/2023 EnchantaVaughn Approved (AM) Upon arrival, client was witnessed in his seat and behaving normally. Client presented himself in a good manner. Client continued his morning by holding conversation with his peers. Client participated in the group activity and was positively encouraged by his peers who were cheering him on and supporting him with sharing his thoughts about the topic. Client is cooperative in class and attentive during lesson. Client was able to successfully complete his assignment and turn it in on time. Client demonstrates excellent team work skills by sharing and taking turns. Client displays appropriate social skills. Client is supported for his contribution and having a good start to his day. Client prepared for middle academic hours with a more optimistic approach. Client seemed to be in a more stable mood. Client worked well with others and participated in team building exercises. Client displayed cooperative manners, staying on task and being attentive to his teacher. Client was observed relaxing and engaging in conversation with his age group without aggressive tone. Client expressed happy thoughts and feelings at this time. (PM) Client was able to transition to lunch in a cooperative manner, as evidenced by him listening and following directions. Client appeared to be focused and content, as evidenced by him paying attention and avoiding distractions. Client was observed listening and following directions. Client displayed appropriate social skills while interacting well with authority and peers. Client displays positive social skills, getting along with others and initiating conversation. The client was supported as he practiced approaching others to increase his involvement in social activities. The client has used positive characteristics, and the benefits of this were reviewed. Client seem to understand the importance of uninterruptive listening by waiting his turn to speak. Client was seen in his seat and exhibiting positive body language. (EOD) Client was in an enthusiastic mood while utilizing the positive reinforcers given by authority figures. Client displays age appropriate social interaction (e.g. good eye contact and listening). Client joined group. Client is monitored in psycho social setting making good choices. Client was observed following directions and maintaining a positive attitude. Client was seen in class on task and displaying appropriate behaviors. Client did not have a problem interacting with his peers. Client demonstrates responsibility by being fair and caring to others in various settings. Client was very productive for the rest of the evening going into his specials and continued his positive behaviors until dismissal. Client showed love and productive behaviors as he exited the classroom, as reported by his teacher. Client successfully met his goals and objectives. (AM) QMHP observed client in the classroom in efforts to determine whether he required assistance. QMHP determined client was on task and did not require assistance. QMHP provided positive gestures to encourage client on his positive classroom behaviors. QMHP reminded client of ISP objectives and what he needs to do in order to achieve them. QMHP reviewed examples of alternative appropriate behaviors he could engage in to stay on task without causing disruption. QMHP encouraged client to resist negative classroom behaviors in efforts to refrain from requiring to be redirected by his teachers so many times throughout the day. QMHP praised client for listening and following directions and interacting well with his peers. (PM) QMHP explored the positive behavior options he was exhibiting with client to support his willingness to continue to make good decisions and have positive behaviors in school. QMHP engaged client in a conversation regarding his recent behaviors, progressions and setbacks. QMHP explored client’s responses and responded accordingly. QMHP talked with client about the importance of adhering to rules and expectations in school, at home and in the community. QMHP provided age appropriate understanding of his mental illness and encouraged him to utilize his coping strategies during social and non-social environments. (EOD) QMHP encouraged client’s teacher to provide frequent positive reinforcement to maintain client's interest and motivation in maintaining positive classroom behaviors and completing his school assignments. QMHP assisted client to behave in more positive ways by addressing the conflict he was facing with his teachers. QMHP informed client of replacement behaviors in efforts to decrease attention seeking behaviors the client often is involved in. QMHP modeled appropriate ways for client to get positive attention from his teacher. QMHP assisted client in exploring other coping strategies that he had previously used to solve other problems. QMHP utilized behavior modification strategies including removing Client from the stimulant environment in efforts for him to reduce impulsive behaviors. QMHP modeled proper positive behavioral expectations for the client to administer additional layers of support and display an understanding of expectations. (AM) Client smiled as he saw QMHP's positive gestures. Client was able to process making good choices with QMHP and his teacher. Client listed 3-4 classroom behaviors that he was going to utilize in efforts to remain positive behaviors. Client appeared to be receptive to receiving positive reinforcement from his teacher as demonstrated by his smiling and inviting body language. The frequency and intensity of the client's defiant affect decreased. Client continued to work on the classroom activity. (PM) Client required additional redirection from QMHP to get him to focus on the classroom assignment. Client was able to settle down and return to classroom activity. Client was responsive to teacher’s lesson. Client reduced impulsive behaviors after 3-4 prompts from his teachers and QMHP. Client began to show greater control of his anger. Client appeared to decrease the intensity of his anger and frustration. Client was pleasant and cooperative and demonstrated a willingness to discuss the factors contributing to his undesirable mood. Client acknowledged that he tends to engage in disruptive behavior when he begins to become frustrated with schoolwork. Client accepted responsibility for his angry outbursts and aggressive behaviors. Client stated he will display anger control and not threaten or intimidate others. (EOD) Client was observed and reported to have been pleasant and cooperative during classroom activities and demonstrated a willingness to adhere to school and classroom rules and expectations. Teacher praised client for being on his best behavior and correcting his mistakes. Client displayed good behaviors, raising his hand when he asked a question, waiting for his turn to speak, using his words instead of hand signals, saying please and thank you, and giving his teacher good eye contact. Client utilized deep breathing techniques to relax and stay calm during stressful moments. Client administered positive behavioral expectations, reducing all symptoms related to ADHD.