Bracken ere Record Form Nme AL Gender: MCE) a [en De SchoolAgeney LDEPD PVESACO\ rate Test Date| 2014 pe Ol Binh Dae [2014 Teacher amines GE OLUOKE. Cnalaee| | 4 13, | corn ci en re Grin Ree ad haemo te if i Subtests L6SRC 7 Direction? Position 380) 4380 {8 SafsSocial ‘Awareness 9 Texture! Material mr bt Yu bet 10 Quantity i Time? Sequence Total Test | 5 i ar cm HOSS Se Bi Isms isp] 13) « . SRC Pins ou Bice so 1-68RC* +I8D "7 Direction? Paxton BaSoial G 5 "has |G | i paw = 70 }2sp 10 Quantity Ee t. Very eee) pager | 55 ]38D Sum al Sealed Sees ‘Soma Seed Sere ‘Divided | * Gets sonia epee PAENSNO]NI moor rcive Sree eat Seer ley See Shomgen, SENT BIOGEN wmstorsesmcon DP sychCorp 192021222324 BCoe 2621102 987654 Product Number 0154032131WENT ee ‘The following administration, recording. and scoring directions apply to all subtests, |. Inroduce each test item by saying, "Show me." ‘fer the child fully understands the task, you may delete the "Show me" par of the item and just ead be item (e.g, “which anima is bi). In any case, you should introduce at Jest the first item of each subest by saying, "Show me... to reorient the child to the ask. 2. For items with more than four response choices, write inthe child’ response if tis someting other than the comet. answer. For items with four response choices, mark the number (1, 2,3, or) that coresponds tothe child's response. On these items, the number in blue type is the correct answer. 3, To score each item, circle the 1 if the child chooses the correct answer and circle the 0 ifthe child responds incorrectly. 4, Repeat each item if the child does not respond after about 10 seconds o ifthe child requests it. Do not repeat an item ifthe child responds incomecly after the first presentation unless the child request it 5, Circle the NR (No Response) and score it as 0 if the child does notrespond even after you have repeated the item or ifthe child says something like "I don’t know" or "T can't." coring Directions 6. Asa reminder tothe child, you should begin each subtest by saying, "Look at al of the pictures." If t any point daring testing the child falls into a pattern of pointing to pictures located in only one postion on the stinaulus page, again say, “Look at all ofthe pictures.” I the child continues to perseverate on a certain location, present the nex nem by pointing to each of the four pictures while saying, "Look at ‘his picture, and this picture, and this one, and this one." Watch the child's eyes to make sure he or she is following your rections and is looking a each stimulus option. Then read the item. Continue the cues to look at all the pictures as necessary the child points to more than one picture, say, "You ean only point to one picture. Show me..", and record the child's next response. Ifthe child continues to point to more than one picture for that item, record the multiple responses and score 0. {, Sometimes a child will “se-corec”(comectly revise his or het incorrect response to atest item). Ifthe self-correction occurs before presentation ofthe nex test item erase the child’ frst (incomect) response and score thoroughly before recotding and scoring the self-comected response bye tainty ‘Trial tem 1; Say tothe child, "Lam going to ask you to point to some things. For example, if T asked you to point to ‘your shoe, where would you point?" the child points Tohis orer soe, say, "That's right, you pointed to your she." I the child does not point to his or her shoe, model the behavior by pointing tothe childs shoe end saying, "You ‘would point right here, wouldn't you “Trial Item 2: Say tothe child, "Let's do another one, Show me ‘your hair. That's right, you pointed to your hair." (Or, You would point right here, wouldn't you?) ‘Trial [tem 3; Say to the child, "Now show me the floor. Good, ‘you pointed to the flor." (Or, "You would point right hhere, wouldn't you?") Ask similar questions until you are certain that the child understands the task. Limit your questions to objets inthe room. ‘Do not include actual test materials. Once the child understands the pointing task, administer Trial tem 4. ‘Trial Item 4: Say tothe child, "Now Tam going fo show you some pictures I wil read something to you, and I want you to point to the picture that shows what I say." Tura to the page marked Trial Item 4a the fron ofthe Stimulus ‘Manual and direct the child's attention to the pictures by saying, "Let's lok at each of these pitures, Look at this picture, this picture, this one, and this one." (Point to pictures 1-4 in tum.) "Show me the ball,” Ite child points to the ball, say. "Good, you looked at al of the pictures and pointed to the ball, Now let's do some more. Listen carefully to what I say and then point to the picture that shows what I say 1 can say it again if you need me to." Ifthe child does not point tothe bell or zppears hesitant about the task, use the other thre pictures onthe Trial Item page as practice items before administering the first subtest. aa ioe ‘Administer Subtess 16 beginning with the firs item in each subtest. Some of the stimulus pages are used for more than one item, Administer the ‘items in sequence until the child misses three consecutive items {the ceiling), then continue with the first item ofthe next subtest. Circle the Vif the child responds correctly; circle th 0 ifthe child responds incorrectly. Add the numberof comect responses to subtotal individual subtest. ( conors | SEEWY NUMBERS/COUNTING Say, “Look at al ofthe colors, Show me which colors... | Say, “Look at all of the pictures. how me...” Response Score leer Response Sec NR 10 (Dr34r 1 NR 1 00 NR 0 NRO 100 NR NR 10 ® LO NR 100 NR 0 NRO 100 NR 0 NR 1 0 NR g NR I OO nr 1 a ee) NR 10) nR 1 OO NR 0 orm 1 0 NR 6 NR 0 Subiotal |_| Oo ‘NR o SUI termes x LO NR {1} Q Say, “Look at al ofthe laters. Show me. NR v Q Response. Score nr 1 7 cars NR 1 0 q XR 1 0 Sabtoal | “| NRo1 0 1k 1 0 | ENP ’sizes AR 1 |, Su look ata ofthe pets. Show me.” \ lem sponse Score NRO NR 1 |b Which animals. Q —— xe i o| 2 Mbichtall iste... 0 NR 1 0 3. which dog is small... 0 NR 1 0 4. which candle is tall. a —— xr 1g | & mich water is deep... TQ NR 1 0 6. which rope is long, ~ 1Q Nato | 7 bic abithas short et... 1@ ~ NR 1 OO ‘8. which vase is thin... 10 —_— | 9. which rope is short.. 10 Subtotal | || 10. which rocks large. 19 11. which boat is wide. 10 12, which waters shallow 10Score (BE comparisons | Subtest 6, ASN) Say, “Look a all of the pictures. Show me...” Say, “Look at all ofthe pictures. Show me...” lem ponse Score tem Response L_ which boxes are not the same 134 NRO OL 1. the star NR 2, which fruit ae different 1 2% NR of 2. the heart 2 3(O)NR 3. which puzzle pieces fit exactly 12G/4 NR 1 3. which children are in a lime } 34 RR 1 4, which shoes mateh 34 NR 1 (Oy 4. thecirele NR 5, which boats are alike 34 NR 1 (0) 5. thecone Orsi 6. which balloons are the same T234 NR 1 BD] 6 which one is round 123@)NR 1 7. wihich person is reading something 7. the square veot. ~ NR 1 other than a book 1234 NR | 8 thetriangle Oo 8, which animals ere similar 1234 NR 1 0} 9. whichducks a in a row 1 20 NROO1 9, which cans are of equal size 123 NR 1 0/10. thediamond NR 10, which glasses have unequal TL the oval iycl2 NR 7 amounts of juice 1234 NR 1 6172. therectangle an NRO subtotal | [| 13. the check mark 1 20h NRO 1 14, the cylinder 1274 .R 1 15. the eurve 1234 .R 1 16. the eube 1234 Ro] 17. the pyramid 1234 Ro] 18. the column $234 RR 1 19. the diagonal 1234 Ro 1 20. the angle 1234 Ro] eau tart Point for Step | Subtest Subtotals Add the raw score subtotals from Subtests 1-6 to detemnine the child's 116 School Readiness Composite (SRC) raw soo. a, Step 2 3. Use the SRC raw score to determine the star point (stating items) for 4. Subests 7-L1. Scan across the Start Point Table below to locate the range of numbers that includes the child's SRC raw score, The letter below the SRC raw score represents the pont at which you should begin 10 administer items in Subtests 7-11, Circle the Start Point letter and begin Subtest 7 with the tem that eoesponds to that letter. SRC Raw Score. SRC Raw Seore 0-20 21-30 31-37 Start Point A BC gy ig i (Noe MSL Loot or Subtess 7-11, administer items from the start pont forward. If the cid doesnot ps thre consective tems (a besa), work backward from te start point ntl he chiki does so. After a basal is established (or al ites below te start point are administered), work forward to establish a ceiling (tree consecutive incomect responses) or finish the subst. See Chapter 3 for complete directions. DIRECTION/POSITION Say, “Look at all of the pictures. Show me...” Ike Response Score term Response Score 4. which boy has his hat off. | 36, which als flling 1234 NR 10 2, which child ison the swing 37. the front of the bus. 1234 NR 10 3. which book is open.. 438, which peniisalihe edge oftieble..1 23.4 NR 1 0 B 4, which doo is closed... 239, which hands 2 JOIMEE sane 23-4 NR LO 5. which chilis under the blanket... (2 40. which fence is between the houses... 23 4 NR 1 0 6, which toys are im-the bathtub , 12 3 41, which child is atthe end of the bridge... 2.3 4 NR 1 0 © 7. which clowns upside down... @)3 4 42, the ack ofthe bus. 4 234NR 10 8. which childs behind the chair.....1 2034 43, which ied is below he est 1234NR10 9. whic childs covered with the Bake. 23-4 J 44, which person is holding a eoener of (0. which chickens inside the howse 01-2034 the paper. 1234 NR 10 LU. Which person shih wun l 23 4 45, which bird is ying toward the DE. 12, which person is going UP. LEE QB 4 birdhouse. 1234 NR 10 13, which child is atthe top of the slide. 1{(2)3. 4 46, which box has space in it. 1234NR10 1A, which dog is om ofthe Watt ssn) 209)4 47. which child is leaning forward.....1 23.4 NR 1 0 F 15, which rope is around the €0g.n 1 QQS 4 48, which cats ahead ofthe dog......1 23 4.NR 10 16, which pazaleis pat ewnnvennmn 1 Q)3 4 49, which cis Sil oso 23-4 NR 10 17 which childs closet the book... 1 @)3. 4 50, which acplane is above the clouds... 23.4 NR 1 0 18. which child is moving mo 23 4 ‘G SL, which jacket is inside-OUt..u.oel 2.3 4 NR 1 0 19, which persons mar theca... 30s 4NR I 52. which seesaw is level... 1234NR 10 20. which dog is mext its hose. 23 ENR 1@} 58 which tilde are siting across 21, which birds ere togetNeP.ucsuuuu 1 23 YNR 1D from each oh. onl 234 NR 10 22, which childs stepping into the water..1 23 4 NR 1 0 | K 5% which toy is underlined... 1 2 3 4 NR 10 2 which chilis holding he bottom 55, whith sidewalk goes overite water. 23 4 NR | 0 OF tHE POR ssnsnornnn 123-4 .NR 10] 56 whichtoyisinthecenterofthetable.1 23 4 NR 1 0 G 24, which rope is straight. A234 NR 10 57, which people are separated by 25, which e008 10W onvsnonnsinnnl 23-4 NR IO the et m1 234.NR 10 26, which cais folowing the mouse... 123 4 NR 1 0) $8. whichchldiswalking sideways....1 23.4 NR 1 0 21 which dog isin the middle 1234NR 10| 59. whichcarisgoing down thetil.....I 23.4 NR J 0 28. the side of the car. 1244 NR 10 (60, which child is measuring the height H 29, which toe isin fron of the bouse....1 2.3 4 NR 1 0 EDGER ermeroemenrs | 12 3 FNRI tO} 340. which children are outside 12.34 .NR 10] 61 which plane is rising 1h S4ommi 1 o 51, which child is jumping backwards...1 2.3 4 NR 1 0 (62. which child is measuring the length 32. which il is walking away fom OFTHE DON ncwnnnsnnannnnnenl 23-4 NR LO He WEE annsnnimnnnnnne | 2 3 4-NR 1 Q| 6: Which people are walking in Opposite diteti0RSearenonnnnen! 23 4 NR LO 2 eae “TESA NR TO) shih itis waving her ight had... 2 3-4. NR 1 0 hich rain is going through the i house 124-4 .NR 10] © whid pilus hele fotinthewaur..1. 23 4 NR 1.0 35. which child is going to turn the page 1 23 4 NR 1 0 ‘Subtotal Ib!(ESIIEE SELP-/SOCTAL AWARENESS Say, “Look at all of the pictures. Show me,..”” teem Response ALC 1. which child is erying..... ‘2. which child is laughing . 3, which child is sie 4, which person is sad .... D5, which eid is smiling 6. the ged 7. the boy... 8, which puppy is resting 9. which chil hasbeen BUF oes TOL the MAM serene ELL which person i8 aMgEY nme F 12. the brothers... 13, which persons relaxing... arenes BRRRBBRAZZAB 14, which child sald. NR 15. thesisters... 4 NR 16. whic childs happy 4.NR 17. which person is tired INR 8. which childs excited INR 19. which persons ol NR 20. the woman, INR 21, which chilis wrong. NR | 22 which person is doing something dificult. romsmnimanwaed 23 4 NR 23, which child i SLEEPY... 1234NR 24, which child is worried. 1234.R 25, which people ate Friendly... l 23 4 NR 26, the mother 1234 .NR 27, the father. so ww 1234 ,NR J 28, which person is hedlthy..nssnnnt 23 4 NR 29, which child is dsappointed.......1 23-4 NR 30, which person is young, wl 234 .8R 31, which child is owning soeel 23 4 NR 32, which child is doing the right hing..1 234 NR K-38. which pctore is COFFE .wnsnonne l 2 2 4 NR 34, which peron is exhausted wc l 23 4 NR 35, which one was easy to make, 1234NR 36, the male... 12a4yR 37. which child is curious. 12348 38, the female 1234NR Subtotal i 2. oP HOB. (UID rexruremateriaL Say, “Look at all ofthe pictures. Show me...” em Response which one is HEAVY... 2. which child is making @ loud nois 3. which one is hot... 4. which shoe is wet.. ‘5. which one is cold . 6. 1 8 AD 1 ise Which ons QUI... Which oe is made of Wood. which pain is dark. 9. shih one is sharp. (0. | G10. which one is hard 0 11, hich 0 8 SFE hich ones made of glass hich one is bolting Which one a gas. Which ones shiny. hich rock is smooth TG) 17. which ca sees its reflection oy 18. which ad 8 fat ne 19, which crayon slight coor. 20, whieh one is made of metal 21, which ight is bright, 22, hich on is dry. K_ 23, which one is made of eth... 24, hich 0068 FOU nn 25, which rope i tight. 26, which drinks lear 21 which oe sight 28. which one isa slid 28, wich nie is dull, 30, which rope is loose... 3, which one iss liquid. 1 1, 1 15. 116. ‘A A pizzas redure ERED ovantrry Say, “Look at al ofthe pictures, Show me...” Item ‘which ee has many apple... 1 ‘where there are a lot of ants. 1 ‘the dollar. soc 1 ‘which bow! is full... if whieh Box is EMpLY rrr. 1 6, where both dogs are asleep ..susnsw I 1 1 1 1 1 Response 23 AD F 7, which hid tas nothing to eat 8. sich balloon has enough ar. 9. the teddy bear with a rattle 10. a whole pie. 11, whiet bow has the most fish, NR G 12, Most ofthese children have cookies, Show me which child has none......1/ 2.3 4 NR 13, which persons alone 123 4°NR 14, which puzzle has all ofthe pieces...) 2 3 4 NR 15. which child has & plese of pit.aen 1 23 4 NR 16. which wagon has a wheel missing... 23-4 NR HE 17. which child as mik left 234 NR 18. which child can almost reach the apple weuinnwl 23 4 NR 19. the penny. swum 23 4 NR | 20, where there is apart ofan orange....1 23 4 NR J 21, where each child has an apple. 23 4 NR 22. where every child has aha 1234 .R 23, which farmer has the greatest rumnber of chickeRs..nesnnninnml 23 4 NR 24, which person has tle saMd.ocssl 23 4 NR 25, which vase has several BOWES.eucu.l 23 4 NR 26, the dime... wl 234 .NR 27, which persons without e it...I 23 4 NR 28, which child bas all the toys except the balls 23 4 NR K 9, which child has more eke than the other child. swt 23-4 NR 30. which sandwich is cu in half... l 23 4 NR SL. which person has divided the candy..1 23 4 NR 32. the pal Of $02 ansnen 1234 .NR 33, where there is a single tre 234K 44, which childs taking another candy bar. 234K 35, the MIKE! ease 234 .NR 36, which sign means add... 224 NR Score 0 37. 38. x. 4 a 4B Item Which dog has Jess food than the Ct nnssnnsnmnennnnnenne which child as the least milk. ‘he quarter - 1 which hid has « double serving of smashed potatoes. hese thee ae few AWE none ‘where nelther child has balloon... 1 hich con has triple scoop of| joe cream on it 1 which sign means subtract. .nusoos ‘where there ae a couple Of Pig... 1 ‘which person is measuring weight... 1 ‘whee some ofthe dogshave spots... which chil has as many toys as the other chil 1 where there isa dozen kien 1 BREEZE BRR 2B(ISD tHweszquence Say, “Look at all of the pictures. Show me...” fem Response Score AD. 1, where it is might 1 204 we(Do 2. which child is fas 4 NR 5. which child has finished drinking, © 4, which child has taken the last APF 5. hich shoes are new. (6 which shoe iso... : 7 which children ee through withthe puzzle Hl 8 where iis daytime... 9. which person is leaving the store. 10, which person has quit working... 11, hich chil is waiting forthe cr... 12. where iis winter. al 13. where acupeake has been skipped... 14, which child will pick up the (23 + xeQo oA Os 4 xe 3b 24 NR 1 54 NR 10) pO Oe DB 4 NR 3 ByNR 3CUyr 2 2 3G) Nr 2 Gyr 23@ yr 1 1 T Aol NER nso 1230 i@) || 15. which containers are in order... L234 R10 16. which plants stating to OW! 23 4.NR 10 17, which child is beginning to blow up baton, 1234R | 0 ‘18. which child has fallen twiee .... 123 4NR/0 19. where the first candle has been lit.....1 2.3 4 NR | 0) 20. where itis fall. 1234 R10 21, where itis morning 1234 NR 10 22 whic boy dnc his ik before ettesnssomnnmnninmennnd 234 NR LO 22. which esos have never been used 254NR 10 24. which animal always lives in the WiEfcnnonesinnnmnmel 23-4 NR 10 25, where itis late 12 NR 10 26, wheretis sues wononinenel 23-4 NR-1O 27. which child is in the second window from the door. wmenenenewmwel 23 4 NR 10 28, which child is slow..... wool 23 4 NR 10 20, which boy i picking his third flower ..... ™ 1234 NR 10 30, which person is arriving ........0001 2.3 4 NR 1 0 31. where it is after the rain. 234 R10 32. where the meal is over 234 R10 233, where its spring. 234 R10 eam Response Score 34, which child just jumped. 1234 0R 10 235, which child is eat... 123 4NR 10 236, which chilis standing onthe fourth 829 on 1234NR 10 37. which gas neatly b0KE snd 23 4.NR 10 Subtotal ey Ey