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Free printable “Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunities” behavior chart.
Download a free, customizable behavior chart to help students with "Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunities." Instant translation into 28 languages including Spanish and Arabic. Perfect for IEP: Self-Regulation goals.
Print opens a ready-made sheet. Customize opens the editor with this goal in place.
Goal & Progress Chart
Date: ________________
EvidentDaily Check-In
Behavior Goals
- Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunities
- Student will tolerate changes in routine or unexpected events without disruptive behavior in 3 out of 4 instances
- Student will use an agreed support and signal when ready to return to the classroom activity
Weekly Tracking
| Goal | Mon | Tue | Wed | Thu | Fri |
|---|---|---|---|---|---|
| 1. Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunities | |||||
| 2. Student will tolerate changes in routine or unexpected events without disruptive behavior in 3 out of 4 instances | |||||
| 3. Student will use an agreed support and signal when ready to return to the classroom activity |
Reward
Extra recess time
For Parents
Please sign and return daily. Contact the teacher with any questions.
Parent Signature: ___________________
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03 / How it works
Three steps, and the first one is done.
- 01
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- 02
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Add the student's name, pick a template style, set a reward, and translate into any of 28 languages.
- 03
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04 / English and the family language
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Family viewEspañol
- Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunitiesEl estudiante pedirá un descanso de manera independiente usando una tarjeta de descanso o una solicitud verbal antes de alcanzar un nivel de crisis en 4 de 5 oportunidades.
- Reward: Extra recess timePremio: Tiempo extra de recreo
Firmar con el dedo
05 / Why teachers use Evident
Translated, print-ready, and yours to change.
Print-ready
Every chart is optimized for standard US Letter and A4 paper. Customize, preview, and print.
Fully customizable
Add your own goals, set rewards, choose from 14 template styles, and personalize for each student.
06 / Available in 28 languages
This goal, in the languages families speak.
Evident supports the languages most commonly spoken in U.S. schools. Here's this goal, “Student will independently request a break using a break card or verbal request before reaching crisis level in 4 out of 5 opportunities”, translated into six of them. Open any language to see this chart's page in that language.
Spanish · Español
El estudiante pedirá un descanso de manera independiente usando una tarjeta de descanso o una solicitud verbal antes de alcanzar un nivel de crisis en 4 de 5 oportunidades.
Arabic · العربية
سيطلب الطالب استراحة بشكل مستقل باستخدام بطاقة استراحة أو طلب لفظي قبل الوصول إلى مستوى الأزمة في 4 من 5 فرص.
Mandarin Chinese · 中文
学生将在5次中的4次机会中，独立使用休息卡或口头请求请求休息，避免达到危机水平。
Vietnamese · Tiếng Việt
Học sinh sẽ tự yêu cầu nghỉ bằng cách sử dụng thẻ nghỉ hoặc yêu cầu bằng lời nói trước khi đạt đến mức độ khủng hoảng trong 4 trên 5 cơ hội.
French · Français
L'élève demandera de manière autonome une pause en utilisant une carte de pause ou une demande verbale avant d'atteindre un niveau de crise dans 4 sur 5 occasions.
Portuguese · Português
O aluno solicitará de forma independente uma pausa usando um cartão de pausa ou um pedido verbal antes de atingir o nível de crise em 4 de 5 oportunidades.
07 / More IEP: Self-Regulation charts
Other goals in IEP: Self-Regulation.
Student will tolerate changes in routine or unexpected events without disruptive behavior in 3 out of 4 instancesStudent will use an agreed support and signal when ready to return to the classroom activityStudent will delay gratification and wait for a preferred activity for up to 10 minutes without disruptive behavior in 80% of opportunitiesStudent will accept corrective feedback from adults without argument or shutdown in 4 out of 5 opportunitiesStudent will identify triggers that lead to dysregulation and independently implement a coping strategy in 3 out of 5 instancesStudent will demonstrate appropriate responses to losing a game or not being chosen in 4 out of 5 opportunities
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