Life Skills Progression Instrument SAMPLE 1.pdf

Notes

by Linda Wollesen and Brad Richardson. Copyright © 2024 Paul H. Brookes Publishing Co., Inc. All rights reserved.

Relationships

Score (NA=0) Area of life skill development Low1 1.5 2 2.5 3 3.5 4 4.5 High5 Notes
RELATIONSHIPS RELATIONSHIPS WITH FAMILY AND FRIENDS
5 1. Family/ExtendedFamily Hostile.Violent.Physically abusive family relationships. Conflicted.Critical or verbal abuse.Frequent arguments.Reluctant support in a crisis. Separated.No contact.Not available for support. Inconsistent or conditional support.Emotionally distant. Supportive.Mutually nurturing family relationships.
3 2. Boyfriend, FOB, or Spouse Hostile.Violent.Physical abuse.Multiple partners.Uncertain paternity. Conflicted.Critical or verbal abuse.Frequent arguments.Reluctant support in crisis. Separated.No contact.Not available for support. Inconsistent or conditional support.Emotionally distant,but available. Supportive.Loving.Committed(unmarried, married, or common law).
4 3. Friends/Peers Hostile, violent, or high-risk friends; friends gang linked. Conflicted.Casual or brief friendships.Some support in a crisis. Very few or no friends.Socially isolated and lonely. A few close friends who can be counted on for support. Many close friends.Extensive support network.
RELATIONSHIPS WITH CHILDREN
0 4. Attitudes to Pregnancy Unplanned and unwanted. Unplanned.Ambivalent.Fearful.Coerced to keep child. Unplanned and accepted. Planned, but unprepared. Planned, Prepared.Welcomed. Baby is 4 months old
5 5. Nurturing Hostile.Unable to nurture,bond or love child.Very limited responsiveness. Indifference.Apathy.Depression or DD impairs nurturing. Lacks information, modeling of love.Marital connectedness.Afraid nurturing “spoils.” Loves, responds inconsistently.Some reciprocal connections. Loving.Responsive.Praises.Regulates child.Reciprocal connections.
4 6. Discipline Has shown reportable levels of physical abuse.Chronic or severe neglect. Uses physical punishment.Frequent criticism.Verbal abuse. Mixture of impatient or critical, and appropriate discipline. Inconsistent limits or ineffective boundaries.At times teaches desired behavior effectively. Uses age-appropriate discipline.Teaches,guides,and directs behavior effectively.
3 7. Support of Child Development Unrealistic expectations.Poor knowledge of child development.Ignores or refuses information. Little knowledge of child development.Limited interest in development.Passive parental role. Open to child development information.Provides some age-appropriate toys, books, and play. Applies child development ideas.Interested in child’s development, skills, interests, and play. Anticipates child development changes.Uses appropriate toys and books.Plays and reads with child daily.
5 8. Safety Child hospitalized for Tx of unintentional injury.Has permanent damage. Outpatient/ER Tx of unintentional injury to child.No permanent damage. No unintentional injury to child.Home or car not safe;not childproofed. No unintentional injury to child.Home partially safe.Uses car seat.Uses information provided. Child protected,no injury.Home and car safe.Teach safety to child.Seeks and uses information age appropriate.

Education & Employment

Score (NA=0) Area of life skill development Low Notes
0 12. Language (non-English speaking only) Low/no literacy in any language. Literate in primary language.Some verbal English skills. Takes ESL classes, Verbal ESL established. Takes ESL classes, Written ESL established. Fully bilingual.Written and verbal ESL established.
0 13. Education <12th Grade Not enrolled. Enrolled, limited attendance in any program.Not at grade level. Enrolled, regularly attends any program.Not at grade level. Regularly attends any adult school or independent study.At grade level with GED goal. Regularly attends HS or alternative HS.At grade level with HSD goal. Graduated
4 14. Education <12th-grade education. Has graduated with GED or HSD. Attends or graduated job or tech training. Attends or graduated community college. Attends or graduated college, or graduate school.
3 15. Employment Unemployed, unskilled or no work experience. Stay-at-home parent. Occasional, seasonal, or multiple entry-level jobs. Stable employment in low-income job. Stable employment with adequate salary and benefits. Career of choice with potential good salary and benefits.

Mental Health & Substance Use

Score (NA=0) Area of life skill development Low1 1.5 2 2.5 3 3.5 4 4.5 High5 Notes
4 24. Substance Use Chronic Hx drug and/or alcohol use with addiction or dependence. Drug/alcohol binge. Intermittent use. No apparent sedation or dependence. Rare or experimental use of drugs, "clean." In recovery group or Tx program. Occasional use of legal substances. Stops if pregnant. No Hx. Minimal or no current use. No use if pregnant.
2.5 25. Tobacco Use Chain smokes, >2 packs/day. Uses smoke leaks. Heavy second-hand exposure. Non-chain use or some second-hand exposure. Decreases amount when pregnant. Controls second-hand exposure. No use. No second-hand exposure in past 6 months or during current pregnancy. None or never.
5 26. Depression/Suicide Recurrent chronic depression with suicidal thoughts or attempts. Severe problem with ADL, parenting, and insight/perception. Recurrent chronic depression without suicidal thoughts or attempts. Moderate problem with ADL, parenting, and insight/perception. Recent postpartum or situational depression. Some problem with ADL, parenting, and insight/perception. Manages or controls depression with Tx and/or medications or has recovered. Adequate ADL parenting, and insight/perception. No depression. Optimistic.

Child Development

Score (NA=0) Area of life skill development Low1 1.5 2 2.5 3 3.5 4 4.5 High5 Notes
5 36. Communication* Below AA/CA and EI criteria, Referred to EI. Not enrolled or attending. Delays; meets EI criteria.Referred; enrolled.Sometimes attends. Delays; meets EI criteria.Referred; enrolled.Attends regularly. No delays.Average development for AA or CA. Above-average development for AA or CA.
4 37. Gross Motor* Below AA/CA and EI criteria, Referred to EI. Not enrolled or attending. Delays; meets EI criteria.Referred; enrolled.Sometimes attends. Delays; meets EI criteria.Referred; enrolled.Attends regularly. No delays.Average development for AA or CA. Above-average development for AA or CA.
5 38. Fine Motor* Below AA/CA and EI criteria, Referred to EI. Not enrolled or attending. Delays; meets EI criteria.Referred; enrolled.Sometimes attends. Delays; meets EI criteria.Referred; enrolled.Attends regularly. No delays.Average development for AA or CA. Above-average development for AA or CA.
5 39. Problem Solving* Below AA/CA and EI criteria, Referred to EI. Not enrolled or attending. Delays; meets EI criteria.Referred; enrolled.Sometimes attends. Delays; meets EI criteria.Referred; enrolled.Attends regularly. No delays.Average development for AA or CA. Above-average development for AA or CA.
3 40. Personal-Social* Below AA/CA and EI criteria, Referred to EI. Not enrolled or attending. Delays; meets EI criteria.Referred; enrolled.Sometimes attends. Delays; meets EI criteria.Referred; enrolled.Attends regularly. No delays.Average development for AA or CA. Above-average development for AA or CA.
4 41. Social-Emotional** Shows signs of neurological or environment-linked concerns.No IMH services. Shows signs of neurological or environment-linked concerns.Referred to or court ordered IMH.Limited participation. Shows signs of neurological or environment-linked concerns.Regular participation in IMH with positive results. No signs of neurological or environment-linked concerns requiring referral to IMH. Responsive,social,alert;communicates needs/feelings.Explores connected to parent.
3.5 42. Regulation Inritable;hard to console or poor self-regulation.Cues unclear.Non-or overly responsive to environment. Passive/flat affect;little exploration.Does not seek comfort or share delight often. Anxious, withdrawn.clingy.Relies on co-regulation.Limited self-regulation, exploration, and play. Quiet or changeable moods;seeks comfort and uses self-regulation, exploration, and play. Happy, content; easily consoled.Well connected to parent.Explores plays, shares delight.
4 43. Breast Feeding Not breast fed or breast fed < 2 weeks. Breast fed/expressed < 1 month. Breast fed/expressed for 1-3 months. Breast fed/expressed 3-6 months, with or without supplement. Breast fed/expressed > 6 months with some supplement.