Document assistance across a person’s chosen daily routine with a fixed step list and a fictional step-level planning example.
Define what you are recording
The person and clinician select a meaningful routine and define observable steps. Independent and assisted steps are counted using the same list. Any unavailable or skipped step remains visible under the chosen recording rule.
The fictional routine is organizing a personal activity bag. It is a record example, not a recommended routine, developmental norm or assessment.
Collect the data consistently
Write the step list with the person and version it.
Record which supports are usual and which are additional assistance.
Keep the total steps and note unavailable materials or changed steps.
How to complete each data sheet column
Use the stated units and distinguish an observed zero from a missing observation.
Date: Date of this observation. Use YYYY-MM-DD, for example 2026-10-09. Rows are ordered by date; equal spacing on the graph does not represent elapsed calendar time.
Target: Short fictional or de-identified label for the one activity being observed. Use the same target throughout this report; keep its agreed definition in your approved record.
Phase: Optional label for the observation conditions, such as Observation A. A change creates a chart marker; it does not demonstrate a treatment effect.
Independent steps: Whole-number count of scored steps completed independently using the agreed scoring rule. For example, 4 independent out of 6 total scored steps gives 66.7%.
Prompted steps: Optional whole-number count of steps completed with the defined assistance. Keep these separate from independent steps; the two counts cannot exceed total scored steps.
Total steps: Total scored steps in the same defined step list, including unsuccessful scored steps. Use a positive whole number; exclude steps with no observation under your agreed rule.
Notes: Optional observation context or recording limitation. Exclude names, contact details and other identifiable clinical information.
Fictional worked example
These are original fictional observations, not patient records or a treatment recommendation.
Daily routine step recording sheet
Date
Target
Phase
Independent steps
Prompted steps
Total steps
Notes
2026-01-05
Fictional self-help-sequence
Observation A
3
2
6
Fictional bag routine A
2026-01-07
Fictional self-help-sequence
Observation A
4
1
6
Routine A
2026-01-09
Fictional self-help-sequence
Observation A
3
2
6
One unavailable step noted
2026-01-12
Fictional self-help-sequence
Observation B
4
2
7
Routine B adds a step
2026-01-14
Fictional self-help-sequence
Observation B
5
1
7
Routine B
2026-01-16
Fictional self-help-sequence
Observation B
4
2
7
Fictional observation
Review and interpretation
Aggregate steps offer a summary only. The source step list shows what was accomplished and where chosen support was used.
A physically inaccessible step is not automatically a skill deficit.
Percentages can hide the one step that matters most to the person.