Form 1: Daily Zone Check-In Log
Purpose: Track ability to identify current emotional zone over time.
How to use:
- Student identifies zone during morning meeting, transitions, or as needed
- Teacher marks correct/incorrect and prompting level
- Calculate weekly accuracy percentage
- Graph monthly progress
Data points:
- Date/Time
- Student Response (Blue/Green/Yellow/Red)
- Accuracy (Correct/Incorrect)
- Prompting Level (Independent/Verbal/Gestural/Physical)
- Notes
Why this works: Takes ~10 seconds per check-in; produces concrete IEP progress data.
Form 2: Breathing Technique Use Tracker
Purpose: Document frequency, independence, and effectiveness of breathing technique use.
How to use:
- Mark each time a technique is used
- Note whether it was prompted or student-initiated
- Rate effectiveness (1–5)
- Review weekly for patterns
Data points:
- Date/Time
- Technique Used (Manta Glide/Bubble Breath/Spiral/Claw Reset)
- Initiation (Adult-Prompted/Student-Initiated)
- Effectiveness Rating (1=Not Helpful to 5=Very Helpful)
- Context (Transition/Conflict/Calm Corner/Other)
Why this works: Demonstrates generalization and growth in independence over time.
Form 3: Calm Corner Use Log
Purpose: Monitor Calm Corner usage patterns and protocol adherence.
How to use:
- Log each Calm Corner visit (student or teacher)
- Track time spent and tools used
- Rate return-to-learning success
- Review weekly to identify patterns
Data points:
- Date/Time In
- Reason for Visit (Zone: Blue/Green/Yellow/Red)
- Tools Used (Breathing/Sensory/Fidget/Other)
- Time Spent (minutes)
- Protocol Followed (Yes/Partial/No)
- Return Success (Calm/Escalated/Needed Support)
Why this works: Shows whether Calm Corner is effective and if protocol skills are improving.
Form 4: Behavior Incident Tracker (Before/After)
Purpose: Measure reduction in behavior incidents after Ocean Zones implementation.
How to use:
- Track behavior incidents for 2 weeks BEFORE implementation (baseline)
- Implement Ocean Zones curriculum
- Continue tracking incidents weekly
- Compare baseline to current averages
Data points:
- Date/Time
- Incident Type (Aggression/Outburst/Destruction/Refusal/Elopement/Other)
- Duration (minutes)
- Intensity (1–5)
- Zone at time of incident
- Intervention used
- Resolution time
Why this works: Gives administrators concrete outcome data and ROI justification.
Form 5: Skills Inventory (Pre/Post Assessment)
Purpose: Measure skill acquisition from Week 1 to Week 12.
How to use:
- Complete in Week 1 (baseline)
- Complete in Week 12 (post-assessment)
- Compare totals and identify growth areas
Skills assessed: Rate each 1–5 (1=no skill, 5=mastered independently).
- Identifies own emotional zone
- Matches zones to scenarios
- Performs breathing techniques
- Selects appropriate regulation tools
- Uses Calm Corner protocol
- Communicates emotional needs
- Recognizes body signals
- Transitions between zones
- Demonstrates empathy for others
- Applies skills across settings
Why this works: Shows measurable growth and aligns easily to IEP goal attainment evidence.
© 2025 Calm Connections Learning Lab LLC • Special Education Toolkit (Version 7.2) • Status: Foundation complete