Student preferences/rejections

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Please complete the following form and add in any information you would like our team to know regarding the preferences and dislikes of your student.

Favorite color

Favorite tv show

Favorite movie *

Favorite character

Favorite animal

Favorite food and/or drink

Click the following options for things you know are preferred by your student... add information to "other" as needed *

drawing

painting

flipping through books

reading books

puzzles (putting together)

puzzles (taking apart)

puzzles (upside-down)

water play

sand play

musical toys

going for a walk

high five

fist bump

thumbs up

applause

verbal praise

positive voice inflection

eye contact

hand shake

squeezes (soft)

squeezes (deep pressure)

swinging

blow bubbles (student)

blow bubbles (adult toward student)

blow bubbles (adult away from student)

jumping (independent)

jumping (while hands are held by adult)

jumping (while steadying self on/next to an item)

spinning

smell

sound

touch/tactile

Other:

Required

Interests- add to other if there is something specific your student is particularly interested in within the categories listed: *

animals

alphabet

numbers

cars

dolls

action figures

dinosaurs

shapes

tools

trains

trucks

weather

sports (participating)

sports (watching)

teams

music

history

movies

gardening

photography

gaming

software

websites

geography

cartoons

characters

tv shows

podcasts

Other:

Required

Any other interests:

Any other preferred activities: *

Please inform of any items/activities/textures/colors/characters/etc. that your student rejects or does not prefer: *

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