Daytime Interventions
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- Pages: 7
Daytime Interventions Column 1
Column 2
Column 3
Column 4
Column 5
Medical Condition or Behavior (see Appendix A for examples) Self – stimulating behaviors
Frequency-how often does it occur
Duration-How long does it last
Intensity-what is the injury to self or others-consequence of no intervention
Intervention-See Appendix B, enter code number of intervention here.
X Every 15 minutes Every hour
10 minutes
Inappropriate touching of self in public
50,63,,65
30 minutes
Property damage, aggressiveness ,and escalating violent behavior
50,54,55,57,76,79
20 minutes
Injury to siblings, injury to cat
50,54,55,62,63,64, 79
20 minutes
Self talk and violent talk becomes increasingly louder,
50,63,79
Every two hours Hallucinations x Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours Being rough with siblings and cats
Every 15 minutes x Every hour
Violent talk/ self talk
Every two hours Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours Overflows toiler
Weekly
20 minutes
Becomes hostile and ends up with aggressive behavior Flood bathroom/damage to toilet/bathroom
50,63.79
Puts things in his mouth (dirt, sand, toys, rocks, leaves, weeds, and grass) Pacing, jumping, banging in the walls Refusal to follow directions Picky eatervery limited on what food he will eat Grabbing others inappropriatel y Digs holes in yard/beats/de stroys trees/bushes Paces front yard, battling
Every 15 minutes Every hour
Daily
5 minutes
Choking, spitting, possible death 50,51,63,65,68,75, 76,77
30 minutes
Property damage, exhaustion, memory problems
50,51,52,55,63,65
2 -30 minutes
Becomes hostile and ends up with aggressive behavior
3,4,50,63,64,68
Weekly Monthly
x Every two hours
x Every 15 minutes Every hour Every two hours x Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours 3x day
Daily
40 minutes
Throws food, choking, malnutrition
27,50,51,64,65,68, 79
Every two hours
Daily
10 minutes
Others do not want to work with Harley or be near him, people are afraid of him
50, 65,66,79
Every hour
Daily
10 minutes
Eating dirt,/leaves (PICA), destruction of property
50,63,75,76,79
Every 15 mins
Daily
30 mins
Distresses neighbors and traffic driving by, danger of him being
50,51,52,63,76,79
his hallucinations Destroys mailbox, removes siding from house Hides in van
hit by a car Every hour
Daily
30 mins
Property destruction
50,51,63,79
Every two hours
Daily
60 minutes
50,54,63,75,79
Monthly
10 minutes
Flight risk, suffocation, lack of safety awareness, property damage Cuts, electrocution, property damage
Daily
10 minutes
Overdose, death
Monthly
3 hours
Threatened suspension, injury to self/others
50,51,52,54,57,63, 75,79 4,50,51,53,63,66,6 8,69
Weekly
1 hour
Injury to self/others, property damage, public safety
50,63,64,65
Daily
5 minutes (driver pulls over)
Injry to self others, safety of public, driver distraction
80 parent pulls over, 63,74,51
Cuts phone Every two hours cords/electric al cords (cell phone chargers, small appliances Tries to self Every two hours medicate Throws chairs at school at other students/teac hers Overturns tables in the community Does not Every 15 minutes remain seated in moving
50,51,52,63,79
vehicle Rips and removes screens from windows Overeats until vomits (community) Scratching eczema til bleeding
Every 30 minutes
Daily
Continuing, as replaced.
Property damage, mold, insect / animal infestations, weather
50,51,54,55,79
Every 30 minutes
Monthly
20 minutes
50,63,66,79
Every 15 minutes
Daily
15 minutes
Obesity, malnutrition, public safety/nuisance, health concerns, choking Skin infection, bodily fluids leaking
50,65,80 frequenty applying lotions
3
Nighttime Interventions-on a weekly average how many nights does intervention occur?__Multiple times every hour every night
Column 1
Column 2
Medical Frequency-how often does it occur Condition or Behavior (see Appendix A for
Column 3
Column 4
Column 5
Duration-How long does it last
Intensity-what is the injury to self Intervention-See or others-consequence of no page 5, enter intervention number of intervention here.
examples) Stays awake/ Cyclic sleep patterns
Every 15 minutes Every hour Every two hours
Obsessive eating (overnight), overeating certain foods Obsession with sharp objects
X Every 15 minutes Every hour
5- 7 hours
Weekly Monthly Five out of seven nights Daily
40 minutes
Weekly Monthly
Decreased learning ability, decreased attention span, irritability leading to aggressiveness, overnight behavior (see below) disruption of sleep for siblings and parents Choking, constipation, diarrhea, ingestion of harmful substances/ items, death
50,51,53,54,55,57, 60,62,63,75,76,79
50,51,52,54,55,57, 60,62,63,64
Every two hours Every 15 minutes Every hour
(scissors and, Every two hours knifes, etc) pens/pencils Will try to Every 15 escape the minutes house at night Every hour Flooding bathroom, dumping soap, making messes in bathroom
Daily
Every two hours Every 15 minutes Every hour Every two hours
Daily
20 minutes
Cuts, bleeding, cutting off 21,22,50,51,57,62, eyelashes/ eyebrows, 63,79 electrocution hazard( cuts power cords to appliances), injury to self or others
20 minutes
Getting lost, injury to self, unaware of danger, death if hit by a car
52,54,55,57,62,63, 79
20 minutes
Property damage, slip and fall hazard, ingestion of harmful substances
57,63,75,79
Weekly Monthly
Daily Weekly Monthly Daily Weekly Monthly 2 x’sa night
Dismantles vacuum, carpet cleaner, other household appliances Turning off knobs on fridge
Every 15 minutes Every hour
Daily
15 minutes
Property damage
50,51,57,63
10 minutes
Rotten food, property damage
51,52,57,63,79
15 minutes
Skin infection, bodily fluids leaking
50,65,80 frequenty applying lotions
30 minutes
Property damage, aggressiveness ,and escalating violent behavior
50,54,55,57,76,79
30 minutes
Property damage, exhaustion, memory problems
50,51,52,55,63,65
2 -30 minutes
Becomes hostile and ends up with aggressive behavior
3,4,50,63,64,68
10 minutes
Unsanitary conditions, disease,
60,66.79
Weekly Monthly
Every two hours Every 15 minutes Every hour Every two hours
Scratching Every 15 minutes eczema til bleeding Hallucinations Every 15 / constant minutes vocalizations Every hour
Daily Weekly Monthly 1-2 times per night Daily
Daily Weekly Monthly
Every two hours Pacing, Every 15 jumping, minutes banging in the Every hour walls Every two hours Refusal to Every 15 follow minutes directions Every hour Wets bed
Every two hours Every 3 hours
Daily Weekly Monthly Daily Weekly Monthly Weekly
(urine)/spits water on mattress Agitation leads to breaking refrigerator door Breaks faucet from main water valveq Steals and Hides food in his room Rips and removes screens from windows
odor
Every 2 hrs
Weekly
20 minutes
Property damage, injury to self/others, spoiled foods
4,50,52,54,57,63, 79
Monthly
10 minutes
Property damage, mold
4, 50, 52,54,57,63,79
Every hr
Daily
30 minutes
Unsanitary conditions, choking
4, 50, 52,54,57,63,79
Every 30 minutes
Daily
Continuing, as replaced.
Property damage, mold, insect / animal infestations, weather
50,51,54,55,79
Column 2
Column 3
Column 4
Column 5
Medical Condition or Behavior (see Appendix A for examples) Self – stimulating behaviors
Frequency-how often does it occur
Duration-How long does it last
Intensity-what is the injury to self or others-consequence of no intervention
Intervention-See Appendix B, enter code number of intervention here.
X Every 15 minutes Every hour
10 minutes
Inappropriate touching of self in public
50,63,,65
30 minutes
Property damage, aggressiveness ,and escalating violent behavior
50,54,55,57,76,79
20 minutes
Injury to siblings, injury to cat
50,54,55,62,63,64, 79
20 minutes
Self talk and violent talk becomes increasingly louder,
50,63,79
Every two hours Hallucinations x Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours Being rough with siblings and cats
Every 15 minutes x Every hour
Violent talk/ self talk
Every two hours Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours Overflows toiler
Weekly
20 minutes
Becomes hostile and ends up with aggressive behavior Flood bathroom/damage to toilet/bathroom
50,63.79
Puts things in his mouth (dirt, sand, toys, rocks, leaves, weeds, and grass) Pacing, jumping, banging in the walls Refusal to follow directions Picky eatervery limited on what food he will eat Grabbing others inappropriatel y Digs holes in yard/beats/de stroys trees/bushes Paces front yard, battling
Every 15 minutes Every hour
Daily
5 minutes
Choking, spitting, possible death 50,51,63,65,68,75, 76,77
30 minutes
Property damage, exhaustion, memory problems
50,51,52,55,63,65
2 -30 minutes
Becomes hostile and ends up with aggressive behavior
3,4,50,63,64,68
Weekly Monthly
x Every two hours
x Every 15 minutes Every hour Every two hours x Every 15 minutes Every hour
Daily Weekly Monthly Daily Weekly Monthly
Every two hours 3x day
Daily
40 minutes
Throws food, choking, malnutrition
27,50,51,64,65,68, 79
Every two hours
Daily
10 minutes
Others do not want to work with Harley or be near him, people are afraid of him
50, 65,66,79
Every hour
Daily
10 minutes
Eating dirt,/leaves (PICA), destruction of property
50,63,75,76,79
Every 15 mins
Daily
30 mins
Distresses neighbors and traffic driving by, danger of him being
50,51,52,63,76,79
his hallucinations Destroys mailbox, removes siding from house Hides in van
hit by a car Every hour
Daily
30 mins
Property destruction
50,51,63,79
Every two hours
Daily
60 minutes
50,54,63,75,79
Monthly
10 minutes
Flight risk, suffocation, lack of safety awareness, property damage Cuts, electrocution, property damage
Daily
10 minutes
Overdose, death
Monthly
3 hours
Threatened suspension, injury to self/others
50,51,52,54,57,63, 75,79 4,50,51,53,63,66,6 8,69
Weekly
1 hour
Injury to self/others, property damage, public safety
50,63,64,65
Daily
5 minutes (driver pulls over)
Injry to self others, safety of public, driver distraction
80 parent pulls over, 63,74,51
Cuts phone Every two hours cords/electric al cords (cell phone chargers, small appliances Tries to self Every two hours medicate Throws chairs at school at other students/teac hers Overturns tables in the community Does not Every 15 minutes remain seated in moving
50,51,52,63,79
vehicle Rips and removes screens from windows Overeats until vomits (community) Scratching eczema til bleeding
Every 30 minutes
Daily
Continuing, as replaced.
Property damage, mold, insect / animal infestations, weather
50,51,54,55,79
Every 30 minutes
Monthly
20 minutes
50,63,66,79
Every 15 minutes
Daily
15 minutes
Obesity, malnutrition, public safety/nuisance, health concerns, choking Skin infection, bodily fluids leaking
50,65,80 frequenty applying lotions
3
Nighttime Interventions-on a weekly average how many nights does intervention occur?__Multiple times every hour every night
Column 1
Column 2
Medical Frequency-how often does it occur Condition or Behavior (see Appendix A for
Column 3
Column 4
Column 5
Duration-How long does it last
Intensity-what is the injury to self Intervention-See or others-consequence of no page 5, enter intervention number of intervention here.
examples) Stays awake/ Cyclic sleep patterns
Every 15 minutes Every hour Every two hours
Obsessive eating (overnight), overeating certain foods Obsession with sharp objects
X Every 15 minutes Every hour
5- 7 hours
Weekly Monthly Five out of seven nights Daily
40 minutes
Weekly Monthly
Decreased learning ability, decreased attention span, irritability leading to aggressiveness, overnight behavior (see below) disruption of sleep for siblings and parents Choking, constipation, diarrhea, ingestion of harmful substances/ items, death
50,51,53,54,55,57, 60,62,63,75,76,79
50,51,52,54,55,57, 60,62,63,64
Every two hours Every 15 minutes Every hour
(scissors and, Every two hours knifes, etc) pens/pencils Will try to Every 15 escape the minutes house at night Every hour Flooding bathroom, dumping soap, making messes in bathroom
Daily
Every two hours Every 15 minutes Every hour Every two hours
Daily
20 minutes
Cuts, bleeding, cutting off 21,22,50,51,57,62, eyelashes/ eyebrows, 63,79 electrocution hazard( cuts power cords to appliances), injury to self or others
20 minutes
Getting lost, injury to self, unaware of danger, death if hit by a car
52,54,55,57,62,63, 79
20 minutes
Property damage, slip and fall hazard, ingestion of harmful substances
57,63,75,79
Weekly Monthly
Daily Weekly Monthly Daily Weekly Monthly 2 x’sa night
Dismantles vacuum, carpet cleaner, other household appliances Turning off knobs on fridge
Every 15 minutes Every hour
Daily
15 minutes
Property damage
50,51,57,63
10 minutes
Rotten food, property damage
51,52,57,63,79
15 minutes
Skin infection, bodily fluids leaking
50,65,80 frequenty applying lotions
30 minutes
Property damage, aggressiveness ,and escalating violent behavior
50,54,55,57,76,79
30 minutes
Property damage, exhaustion, memory problems
50,51,52,55,63,65
2 -30 minutes
Becomes hostile and ends up with aggressive behavior
3,4,50,63,64,68
10 minutes
Unsanitary conditions, disease,
60,66.79
Weekly Monthly
Every two hours Every 15 minutes Every hour Every two hours
Scratching Every 15 minutes eczema til bleeding Hallucinations Every 15 / constant minutes vocalizations Every hour
Daily Weekly Monthly 1-2 times per night Daily
Daily Weekly Monthly
Every two hours Pacing, Every 15 jumping, minutes banging in the Every hour walls Every two hours Refusal to Every 15 follow minutes directions Every hour Wets bed
Every two hours Every 3 hours
Daily Weekly Monthly Daily Weekly Monthly Weekly
(urine)/spits water on mattress Agitation leads to breaking refrigerator door Breaks faucet from main water valveq Steals and Hides food in his room Rips and removes screens from windows
odor
Every 2 hrs
Weekly
20 minutes
Property damage, injury to self/others, spoiled foods
4,50,52,54,57,63, 79
Monthly
10 minutes
Property damage, mold
4, 50, 52,54,57,63,79
Every hr
Daily
30 minutes
Unsanitary conditions, choking
4, 50, 52,54,57,63,79
Every 30 minutes
Daily
Continuing, as replaced.
Property damage, mold, insect / animal infestations, weather
50,51,54,55,79
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