Mission Cognition Social Skills Assessment

MISSION COGNITION'S
SI-GFA
SOCIAL INTERACTION
GLOBAL FOCUS AREAS
ASSESSMENT PACKAGE
MY HUMAN CENTERED PLEDGE
I pledge to be present and human in

each step of the assessment process
and all client interactions
thereafter.
I pledge to include the client in the

RELATIONSHIP
goal selection process to the fullest
BASED
extent possible and use client
motivation as a primary guiding
factor in the identification of skill
acquisition and behavior reduction
targets.
I pledge to use the obtained

COMMUNICATION information to target goals which
FOCUSED
are meaningful, relevant, functional
and developmentally appropriate for
each client as an individual.
I pledge to use this tool as a means

of getting to know and understand
another human being with the sole
purpose of providing services to
DATA improve their quality of life.
DRIVEN
The Social Interaction Global Focus Area (SI-GFA) Assessment, consists of
three primary components which include:
Indirect Assessment: Parent/Caregiver Interview

*Participant Questionnaire
Component Skills Rating Scale
Structured Observation: Play

General Social Behaviors
Direct Assessment: Play
General Social Behaviors
This assessment obtains information to develop a comprehensive, whole picture of

an individual’s social behaviors across 15 domains, which are referred to herein as
Global Focus Areas.
This information is used to identify the most relevant, functional and meaningful
goals for the learner under the umbrella of play and social behavior.
Letter Global Focus Area GFA Description

Presence or absence of behaviors demonstrating awareness of
A Early Social Responding
and interest in the social environment and social attention
Social Motivation, Initiation & Presence or absence of behaviors indicating motivation to initiate,
B Reciprocity respond to and maintain back and forth social interactions
Engagement with items, materials and activities classified as toys,

C Toy Play & Leisure
games or leisure activities
Acknowledgment, acceptance and interaction with others during

D Social Play play activities
Presence or absence of skills and behaviors needed to participate safely
E Group Learning and independently as well as acquire new skills in non 1:1 instructional
setting
F Adaptability & Flexibility Ability to accept and safely respond to changes and unexpected outcomes
in day to day life and social situations
Self Regulation & Presence of aberrant behaviors and use of coping skills and self regulation
G Managing Emotions strategies to remain safe while experiencing a wide range of emotions
H Nonverbal Communication
Recognizing, interpreting and responding to non verbal signals including
gestures, body language and facial expressions to make decisions
Mission Cognition Social Skills Development Centers

Presence and absence of skills needed to work and
I Cooperation & Teamwork
communicate effectively as part of a small group or team
Presence and absence of skills needed to participate in, tolerate
J Sportsmanship
and respond to various outcomes in competitive activities
Presence and absence of skills needed to join in, maintain and
K Speaking & Listening
end conversations as motivated and appropriate to do so.
The ability to recognize that others have different thoughts,
L Perspective Taking
beliefs and knowledge based on varied experiences.
Presence and absence of skills required to diffuse, resolve and
M Social Conflict Resolution
move on from a social disagreement.
Distinction between varying levels of familiarity and intimacy
N Friendships & Relationships
along with maintenance of healthy & reciprocal relationships.
Ability to make wants and needs known along with seeking
O Self Advocacy
out and requesting needed accommodations and supports.
Mission Cognition Social Skills Development Centers

INDIRECT
ASSESSMENT
PARENT/CAREGIVER INTERVIEW
SI-GFA INTRODUCTION SCRIPT TEMPLATE
Hello, this is (your name) from (agency). I'm calling to connect with you about (child's name) social skills
assessment. Is now a good time to talk? Great.
The first part of the assessment which we will complete today is what we call the parent (caregiver) interview.
I have a series of questions I will be asking you to learn more about (child's name) social skills in a variety of
areas .You'll notice when we begin that most of the questions are open ended. Please feel free to take time to
think about each one as needed to answer as thoroughly and accurately as possible. Not a problem if you
can't think of specific examples off the top of your head. We can always come back to questions later after
you've had some think time or a chance to actually observe the skill in action. Open ended questions are set
up to give us more insight into some nuanced skills which can be difficult to measure with a checklist or rating
scale.
You may notice that not all questions or social skill areas will be relevant to (child's name) due to age,
interests, or other factors. That's okay, I will learn what's most relevant from many of your responses, but you
can also let me know what's not relevant. Your responses here will help me to focus in more closely on
specific social skills areas to assess in more detail.
The primary objective throughout the assessment process is to gain as much information as possible
through this interview, checklists and observations to get to know (child's name) as an individual and identify
those highly individualized goals and skill targets which are going to have the most significant positive
impact on quality of life and provide (child's name) with the tools to interact more successfully and effectively
with the people in their environment.
Today's interview will take approximately 40 minutes. If at anytime you need to stop, just let me know and
we can reconvene another time or I can follow up with you via email, whichever you prefer.
Do you have any questions before we begin?
Mission Cognition, LLC 2021

SI-GFA
PARENT / CAREGIVER INTERVIEW
Date of Interview: Interviewer: Client:
Respondent: Client's Date of Birth:
Respondent Relationship to Client: Client's Age:
box 1: not developmentally appropriate focus area box 2: not socially significant at this time box 3: Priority global focus area
EARLY SOCIAL RESPONDING COOPERATION & TEAMWORK
SOCIAL MOTIVATION, INITIATION

& RECIPROCITY SPORTSMANSHIP
TOY PLAY & LEISURE

SPEAKING & LISTENING
SOCIAL PLAY
PERSPECTIVE TAKING
GROUP LEARNING
SOCIAL CONFLICT RESOLUTION

ADAPTABILITY & FLEXIBILITY
SELF REGULATION & FRIENDSHIPS & RELATIONSHIPS

MANAGING EMOTIONS
NON VERBAL COMMUNICATION SELF ADVOCACY

EARLY SOCIAL RESPONDING
HOW WOULD YOU DESCRIBE YOUR CHILD'S AWARENESS

OF PEOPLE IN THEIR ENVIRONMENT?
IF YOUR CHILD HEARS AN UNEXPECTED SOUND MADE BY A PERSON IN THEIR ENVIRONMENT SUCH AS,
LOUD SNEEZING, "OUCH! OR "WOW!", HOW WOULD THEY RESPOND?
IF YOU TRY TO DRAW YOUR CHILD'S ATTENTION TO SOMETHING BY POINTING TO IT AND SAYING
"LOOK" "COOL" OR THE NAME OF THE ITEM SUCH AS "AN AIRPLANE!"
HOW DOES YOUR CHILD RESPOND?
HOW DOES YOUR CHILD RESPOND WHEN YOU OR OTHERS CALL THEIR NAME?
IF YOUR CHILD WAS ENGAGING IN A BEHAVIOR YOIU DISAPPROVED OF AND YOU SHOOK YOUR HEAD
"NO" OR MADE A SERIOUS "STOP THAT" TYPE OF FACE, HOW WOULD THEY RESPOND?
HOW DOES YOUR CHILD RESPOND TO SMILING, LAUGHING, OR OTHER POSITIVE EXPRESSION WHILE
YOU ARE INTERACTING WITH THEM?

SOCIAL MOTIVATION, INITITATION &
RECIPROCITY
HOW WOULD YOU DESCRIBE YOUR CHILD'S INTEREST

IN OTHERS IN THEIR ENVIRONMENT?
HOW DOES YOUR CHILD GAIN YOUR ATTENTION WHEN THEY WANT OR NEED SOMETHING?
WHAT ARE THE LAST 3 THINGS YOUR CHILD SOUGHT YOU OUT FOR?
WHAT TYPES OF ACTIVITIES DOES YOUR CHILD MOST ENJOY DOING WITH YOU?
HOW DO YOU KNOW IF YOUR CHILD LIKES SOMETHING YOU ARE DOING AND WANTS YOU TO CONTINUE?
IF YOU WERE TO APPROACH YOUR CHILD TO INITIATE A GAME OF TAG BY TAPPING THEM SAYING,
"YOU'RE IT!" AND RUNNING OFF, OR STARTING A GAME OF PEEK A BOO, HOW WOULD THEY RESPOND?

TOY PLAY & LEISURE

IN TOYS AND LEISURE ACTIVITIES?
WHAT DOES YOUR CHILD DO WHEN THEY HAVE DOWNTIME / FREE TIME?
SOCIAL PLAY

IN PLAYING WITH OTHERS?
HOW DOES YOUR CHILD RESPOND WHEN YOU ARE IN A SITUATION IN WHICH OTHER CHILDREN ARE
PLAYING NEARBY?
HOW DOES YOUR CHILD RESPOND WHEN OTHERS ASK THEM TO PLAY?

GROUP LEARNING
HOW WOULD YOU DESCRIBE YOUR CHILD'S LEVEL OF INDEPENDENCE IN A GROUP LEARNING SITUATION?
Group of 3-5 Proficient Group of 6-10 Proficient Group of 10-20 Proficient
HOW WOULD YOU DESCRIBE YOUR CHILD'S ATTENTION & FOCUS IN A GROUP LEARNING SITUATION?

HOW WOULD YOU DESCRIBE YOUR CHILD'S SKILL LEVEL IN TERMS OF BEING FLEXIBLE AND "GO WITH
THE FLOW" WHEN CHANGES COME UP? Proficient
HOW DOES YOUR CHILD TYPICALLY RESPOND TO GOING NEW PLACES, MEETING NEW PEOPLE OR
TRYING NEW THINGS?
WHEN INTERACTING IN DIFFERENT SETTINGS OR WITH DIFFERENT PEOPLE, HAVE YOU OBSERVED YOUR
CHILD TO CHANGE THE WAY THEY ACT? IF SO, CAN YOU PROVIDE AN EXAMPLE?

SELF REGULATION &
MANAGING EMOTIONS
HOW WOULD YOU DESCRIBE YOUR CHILD'S SKILL LEVEL REGARDING SAFELY & EFFECTIVELY
RESPONDING TO THEIR OWN EMOTIONS SUCH AS, EXTREME ANGER, FRUSTRATION OR EXCITEMENT?
Skill Level
DOES YOUR CHILD EVER NEED ADDITIONAL SUPPORTS FROM YOU OR OTHERS TO EXPRESS EMOTIONS
SAFELY & EFFECTIVELY? IF YES, WHAT DO THOSE SITUATIONS AND THAT ASSISTANCE LOOK LIKE?
NON VERBAL COMMUNICATION

H O W W O U L D Y O U D E S C R I B E Y O U R C H I L D ' S Skill Level

SKILL LEVEL IN TERMS OF INTERPRETING THE EXPRESSIONS & BODY LANGUAGE OF OTHERS?
DO YOU OBSERVE YOUR CHILD TO MAKE FACIAL EXPRESSIONS OR USE GESTURES WHEN
COMMUNICATING WITH OTHERS? IF YES, CAN YOU PROVIDE AN EXAMPLE?

COOPERATION & TEAMWORK
H O W W O U L D Y O U D E S C R I B E Y O U R C H I L D ' S S K I L L L E V E L A S A "T E A M P L A Y E R " ? Skill Level
W O U L D Y O U D E S C R I B E Y O U R C H I L D A S M O R E O F A " L E A D E R " O R A "FOLLOWER"

IN A TEAM ACTIVITY? WHY?
D O E S Y O U R C H I L D A P P E A R T O E N J O Y W O R K I N G O R P L A Y I N G A S PA R T O F A T E A M ? W H Y O R W H Y N O T ?
SPORTSMANSHIP
HOW WOULD YOU DESCRIBE YOUR CHILD'S

AWARENESS OF AND INTEREST IN WINNING & LOSING?
HOW DOES YOUR CHILD RESPOND WHEN THEY LOSE OR FALL BEHIND IN A COMPETITIVE ACTIVITY?
(GAME/SPORT/CHALLENGE)
HOW DOES YOUR CHILD RESPOND WHEN THEY WIN A COMPETITIVE ACTIVITY?
(GAME/SPORT/CHALLENGE)

D E S C R I B E Y O U R C H I L D ' S S K I L L L E V E L I N T E R M S O F M A I N T A I N I NG Skill Level

A MULTI TURN CONVERSATION.
WHAT DOES YOUR CHILD USUALLY DO WITH THEIR EYES AND BODY WHEN THEY ARE TALKING TO YOU
OR OTHERS?
WHAT DOES YOUR CHILD USUALLY DO WITH THEIR EYES AND BODY WHEN YOU OR OTHERS ARE
TALKING TO THEM?
WHAT TYPES OF THINGS DOES YOUR CHILD USUALLY TALK ABOUT?

PERSPECTIVE TAKING
DESCRIBE YOUR CHILD'S SKILL LEVEL WITH REGARD TO UNDERSTANDING THAT OTHERS HAVE
D I F F E R E N T K N O W E L D G E , E X P E R I E N C E S & T H O U G H T S . Intermediate
WHEN PLAYING A GAME THAT REQUIRES SOME LEVEL OF SECRECY SUCH AS HOLDING CARDS OUT OF
VIEW OF OTHER PLAYERS OR PICKING A GOOD HIDING PLACE FOR HIDE & SEEK, HOW DOES YOUR
CHILD DO?
UPON SEEING SOMEONE UPSET OR EXCITED, HOW MIGHT YOUR CHILD DESCRIBE WHAT MAY HAVE
CAUSED THAT FEELING?

DESCRIBE YOUR CHILD'S INVOLVEMENT IN AND AWARENESS OF SOCIAL CONFLICT OR DISAGREEMENT

WITH OTHERS.
DESCRIBE YOUR CHILD'S RESPONSE TO CONFLICT OR DISAGREEMENT WITH OTHERS.

FRIENDSHIP & RELATIONSHIPS
DESCRIBE YOUR CHILD'S AWARENESS & INTEREST IN THE CONCEPT OF FRIENDSHIP.
DESCRIBE YOUR CHILD'S AWARENESS OF DIFFERENT TYPES OF RELATIONSHIPS (STRANGER,

ACQUAINTENANCE, FRIEND, BEST FRIEND, ROMANTIC PARTNER).
SELF ADVOCACY
DESCRIBE YOUR CHILD'S SKILL LEVEL WITH REGARD TO DEFENDING THEIR POSESSIONS AND/OR
P E R S O N A L S P A C E . Skill Level
DESCRIBE YOUR CHILD'S SKILL LEVEL WITH REGARD TO COMMUNICATING PREFERENCES AND NON
PREFERENCES TO OTHERS.
DESCRIBE YOUR CHILD'S SKILL LEVEL WITH REGARD TO ASKING FOR SPECIFIC SUPPORTS,
ASSISTANCE OR ACCOMODATIONS.

SNAPSHOT
Name: Date:
Preferred people, places, things & Non preferred people, places, things
activites: & activites:
Expression of positive feelings Expression of negative feelings
Communication Method & Purpose Request items

Request people
Spontaneously comments
Vocal AAC Request actions on environment
Single Words
Intelligible familiar Sign Request help /
Phrases
Intelligible unfamiliar PECS assistance
Sentences Request attention Respond to comments
SGD made by others
________________ Conversational Request information
Request stop/change
Strategies and tools for positive engagement & interaction

SS-GFA PARTICIPANT QUESTIONNAIRE
How would you rate your skills in the following areas:
1- I don't have this skill

2- I have this skill and use it inconsistently or with reminders
3- I have and use this skill accurately and independently
Find enjoyable things to do with my downtime

1 2 3
Start and end conversations

1 2 3
Have conversations on a variety of topics
1 2 3
Invite others to do things / spend time with me
1 2 3
Keep calm and go with the flow when there are unexpected
1 2 3 changes or things don't go my way
Express big emotions such as anger, frustration, fear and

1 2 3 excitement in a safe way
Interpret what others' tone of voice, facial expressions or body

1 2 3 language mean.
Ask for help, assistance or clarification

1 2 3
Handle disagreements / arguments with others

1 2 3
Stand up for myself if treated unfairly or not getting my needs
1 2 3 met
Take my turn or fulfill my role or job on a team (sport /school/

1 2 3 work project)

PARTICIPANT QUESTIONNAIRE 1
Circle all the words you feel describe you. Put an x on any words you feel do NOT describe you.
Circle True or False at the bottom of the page after reading the three statements.
fun focused thoughtful

talkative
energetic rude
friendly mean
good sport outgoing
generous
kind selfish funny
shy brave
smart positive
stubborn boring
sensitive go with the flow
1. I feel I can be myself when I am with my family. True False
True False
2. I feel I can be myself around my friends.
3. I feel I can be myself when I am alone. True False

SS-GFA PARTICIPANT QUESTIONNAIRE 2
NAME: DATE: Interviewer
Self Completed
Rank methods of communication from least preferred (1) to most

pr e f e r r e d ( 5 )
te x t phone call in person

em a i l video call
depends on :
What 3 words would you use to describe yourself?
Do you have a diagnosis you're comfortable sharing?

yes no diagnosis I'm not comfortable sharing
What kinds of things do you enjoy doing in your free time?
Do you prefer to spend time alone or with others?
What types of social situations do you feel most comfortable in?
What types of social situations do you feel most uncomfortable in?
How would you describe your friendships?

I'm not able to identify friends at this time
One close/ best friend
A couple of close friends
Many close friends
Mostly acquaintances
How would you describe your interest in forming new

friendships/relationships? interestest not interested

PARTICIPANT QUESTIONNAIRE
Put a check mark next to nay goals you might like to set for yourself. You can number your top goals
1-3. Feel free to write in any additional goals you may have for yourself which are not on this list.
Make friends
Learn a new hobby
Be more go with the flow when things change or don't go my way
Learn some ways to help me calm down when upset
Join in more or invite other kids to play with me
Learn how to solve small problems by myself
Learn how to be a good sport
Have less arguments with others
Keep trying when things are hard or frustrating
Be more focused
Stand up for myself if someone is bothering me
Have more conversations

SS-GFA PARTICIPANT QUESTIONNAIRE
What are three skills you'd like to work on or goals you would like to set
for yourself to help you be more comfortable and successful in social
situations with family, friends, at school, work or in the community?
1.
2.
3.

SI -GFA COMPONENT SKILLS RATING SCALE
Participant Name: Completed by: Date Completed:
Participant Date of Birth: Relationship to learner:
Directions for completion: Read the key and each skill description thoroughly.
This form may be completed by anyone with knowledge of the learner. Select the more conservative
response if having difficulty selecting one of two choices. For any questions where the answer is
unknown, leave the response blank. If any responses require additional explanation, clarification, or
example,utilize the space at the bottom of each page.
*"tolerate" & "accept" refer to the absence of challenging behavior
Record X to indicate the skill is currently not developmentally appropriate or relevant for the
learner at this time.
Record N to indicate not yet if the learner does not yet have this skill as part of the repertoire, but is in
situations where the skill would be relevant and helpful for the learner.
Record E to indicate emerging if the learner has started to newly display this skill or is in the early
teaching phase.
Record I to indicate inconsistency or inaccuracy if the learner has the skill as part of their
repertoire and uses it independently in specific situations, but benefits from support to use the skill
consistently and correctly across people, settings & situations as needed.
Record C to indicate correct, competent & consistent use of the skill and variations of the skill at the
independent level across people, places & situations as needed.

X: Skill is currently not developmentally appropriate or relevant for the learner at this time
N: Skill is not yet part of the repertoire, but learner is in situations where the skill would be relevant and helpful for the learner
E: Skill is emerging or in the initial teaching phase
I: Skill is demonstrated inconsistently or inaccurately; prompts needed in certain situations
C: Skill is utilized competently, consistently, independently, and is generalized across people, places & situations as needed
A Description X N E I C
A1 Orients toward people's faces when they are talking
A2 Smiles in response to smiling
A3 Follows a point
A4 Shares attention with a person on an item/activity

(Look & look back)
A5 References parent/caregiver face for comfort or confirmation
SOCIAL MOTIVATION, INITIATION & RECIPROCITY

B Description X N E I C
B1 Approaches an ongoing, preferred activity
B2 Positively responds to social initiations from familiar people
B3 Approaches others to engage socially/playfully
B4 Makes a verbal or nonverbal request to continue a preferred

activity
B5 Participates in multi turn, playful activities/games (non rule

based)
Mission Cognition Social Interaction Global Focus Area Component Skills Rating Scale
TOY PLAY & LEISURE
C Description X N E I C
C1 Spontaneously and independently seeks out play/leisure

activities during downtime/free time
C2 Shows an interest in at least 3 non-electronic

toys/games/activities
C3 Plays with at least 3 toys or engages in at least 3 leisure

activities in a functional way
C4 Engages safely and functionally for at least 5 minutes without

direct instruction/supervision
C5 Has a repertoire of at least 3 play activities in which others may

join in/participate.
SOCIAL PLAY
D Description X N E I C
D1 Joins in with others who are playing with preferred

toy/activity
D2 Tolerates peers playing with preferred items/activities
D3 Tolerate peers playing in close proximity
D4 Takes turns/ trade / share with peers
D5 Talks to peers about actions and includes in a "play plan"
GROUP LEARNING
E Description X N E I C
E1 Refrain from disruptive/distracting behavior during

structured activities
E2 Remain in designated area
E3 Use learning materials safely and as designed
E4 Maintain personal space & boundaries (hands to self)
E5 Maintain attention to task
E6 Transition with the group
E7 Follow group directions
E8 Imitate actions modeled by leader (instructor) as needed
E9 Scan room and imitate others when unsure what to do
E10 Gain instructor/adult attention as needed
F Description X N E I C
F1 Demonstrate a variety of interests
F2 Accept being told "no" and "wait"
F3 Play / explore items in a variety of ways
F4 Tolerate changes to familiar activities
F5 Tolerate additions or cancellations in routine/schedule
F6 Tolerate leaving activities unfinished or accepting "good

enough"
F7 Tolerate own mistakes/ imperfections
F8 Tolerate others' mistakes / imperfections
F9 Accept there may be varied ways to play a game or

complete a known task
F10 Tolerate and move on from situations when problems do

not have an immediate solution
C: Skill is utilized competently, consistently, independently, and is generalized across people, places & situations as needed.
SELF REGULATION & MANAGING EMOTIONS
G Description X N E I C
G1 Refrain from hurting or attempting to hurt self when

upset
G2 Refrain from hurting others or attempting to hurt others

when upset
G3 Refrain from damaging or attempting to damage objects

when upset
G4 Refrain from screaming/yelling when upset and not hurt
G5 Utilize coping tools or strategies when directed or

suggested by others
G6 Use at least 1 effective coping strategy to self soothe

when upset
G7 Use at least 1 effective calming strategy to regulate when

over excited
G8 Request people, items, activities to assist in self

soothing/regulating as needed
G9 Match reaction to the size of the problem/seriousness of

the situation
G10 Let go and move on from unpleasant situations once

addressed
H Description X N E I C
H1 Respond to command gestures such as come here, sit

down & wait
H2 Stop or change behavior in response to a head shake,

“no” or other disapproving expression or gesture
H3 Smile and or continue a behavior in response to a smile,

thumbs up or other approving expression or gesture
H4 Use gestures when communicating to emphasize or to

clarify meaning
Display a range of facial expressions to match the

H5
context of an activity or situation
Reference expressions or body language of others to
H6
make decisions about what to do
Interpret body language of others to identify whether

H7 they are interested or disinterested
Interpret body language of others to identify whether
H8 they are busy or available
Orient toward conversational partner and maintain
H9
personal space when communicating
H10 Maintain good hygiene & tidy appearance
I Description X N E I C
I1 Accept help / assistance
I2 Identify a job or role
I3 Accept an assigned job or role
I4 Make on topic, role aligned vocal contributions
I5 Make on topic, role aligned physical contributions
I6 Add or share ideas
I7 Take balanced role of "leader" or "follower" as needed
I8 Actively listen to ideas shared by others
I9 Provide constructive feedback as needed
I10 Accept constructive feedback as appropriate
SPORTSMANSHIP
J Description X N E I C
J1 Tolerate not being first or another preferred position
J2 Play by the rules and refrain from cheating
J3 Tolerate falling behind in position or points
J4 Tolerate losing or being called "out"
J5 Demonstrate gracious winning without bragging
J6 Request a rematch or to play again if desired and

appropriate
J7 Ask for clarification of rules or perceived unfair calls, as

appropriate
J8 Follow team or group expectations for congratulating

winner
J9 Accept feedback for skill improvement as needed
J10 Encourage teammates
K Description X N E I C
K1 Answer yes /no and other close ended questions
K2 Reciprocate information by sharing similarly what others

have shared
K3 Make comments to demonstrate interest or understanding
K4 Answer open ended questions
K5 Join in an ongoing conversation
K6 Initiate conversation
K7 Talk on a variety of topics
K8 Ask on topic, follow up questions
K9 Appropriately transition the conversation or introduce new

topics
K10 Politely end the conversation as appropriate
PERSPECTIVE TAKING
L Description X N E I C
L1 Identify emotions of others from facial expressions
L2 Orient an object correctly in order to show it to another

person
L3 Infer what others may be thinking based upon expression,

body language and other context clues
L4 Infer how others may feel in hypothetical situations
L5 Identify topics or activities that may be of interest to

others based on prior knowledge
L6 Demonstrate empathy
L7 Know that others have different thoughts, ideas,

knowledge & interests
L8 Determine intent of others by distinguishing between

accidental and purposeful
L9 Identify how words and actions may impact others
L10 Identify multiple different perspectives which may be

present in a given situation
M Description X N E I C
M1 Demonstrate awareness of being involved in a conflict with

others
M2 Ask others to stop when needed
M3 Offer a solution to a simple disagreement
M4 Use at least 1 compromise strategy
M5 Know when to walk away from a problem situation
M6 Refrain from stating thoughts/plans for retaliating as a

solution
M7 Refrain from following through with a retaliatory/sabotaging

act
M8 Refrain from name calling
M9 Accept own responsibility for any ownership in the conflict as

appropriate
M10 Acknowledge/ accept apologies offered from others
FRIENDSHIPS
N Description X N E I C
N1 Recognize the qualities / characteristics of a "good" friend
N2 Seek out friendships / relationships that are positive &

reciprocal in nature
N3 Identify levels of relationships

(stranger/acquaintance/friend/best friend)
N4 Identify friends' likes & dislikes
N5 Differentiate information shared with others based on varying

closeness levels of relationship
N6 Keep in touch with friends via means appropriate for

age/developmental level
N7 Accept that friends may have other friends
N8 Accept that others may act differently/include them

differently based on closeness of relationship
N9 Move on from small disagreements with friends
N10 Know when and how to end an unhealthy friendship or

relationship
C: Skill is utilized competently, consistently, independently; and is generalized across people, places & situations as needed.
SELF ADVOCACY
O Description X N E I C
O1 Request items needed to complete an activity or task
O2 Say no to non preferred offerings
O3 Defend possessions if needed
O4 Ask others to stop/change a non preferred action or activity
O5 Request help or assistance
O6 Request clarification or additional information as needed
O7 Alert others/gain attention when skipped or overlooked (my

turn, what about me, etc)
O8 Correct others' inaccurate responses or information as

needed when pertaining to self (name
mispronounced wrong item given)
O9 Request specific accommodations or modifications to

support learning/participation
O10 Report injustices / mistreatment to a trusted adult
STRUCTURED
OBSERVATION
SS-GFA: OBSERVATIONAL ASSESSMENT SETTING:
Learner: Date: OBSERVER: Duration:
A. Early Social Responding

B. Social Motivation, Initiation &
Reciprocity C. Toy Play & Leisure D. Social Play
Leisure toys or play materials accessible? Potential play partners accessible?
Oriented toward social interaction
partners
Approached play/leisure materials Tolerate peers playing in close proximity
Accepted offered items (preferred/ Tolerate peer playing w/ shared materials
needed) Picked up/selected play/leisure activity Orient toward play partner
Accept offered items from play partner
Showed positive affect in response to Functionally manipulated play materials Respond to requests from play partner
positive affect Initiate bids for attention toward peer
Indicated interest in continuing ongoing Respond to peers' bids for attention
activity List play materials/ activities engaged with: Momentary Time Sampling Play Data
R: _____%
Responded to bids for joint attention
S: _____%
Initiated bids for joint attention
Approached to request tangible item/ O: _____%
activity P: _____%
Approach to join in ongoing play action
A: _____%
Approach to initiate play/social interaction
C: _____%
A-D Skill Summary:

Structured Play Observation
Data Collection: Momentary Time Sampling
Data Collector: Interval Length: Time Start: Total Duration Description of setting: (location, peers & activities
Time End: of Observation: available)
Key
R- Restricted/Repetitive AA-Associative w/adult
S-Solitary Functional AP-Associative w/peer
O-Onlooker / Observer CA- Cooperative w/adult
P-Parallel CP-Cooperative w/ peer
Collect data by marking tallies at the end of the interval to indicate type of play engaged in. Convert to percentages at close of session.
Date R S O P AA AP CA CP Activities
Mission Cognition, LLC Social Skills Development Center www.missioncognition.com

G. Self Regulation &
E. Group Learning F. Adaptability & Flexibility Managing Emotions
Group learning situation observed? Was challenging behavior observed Was learner observed to demonstrate
in response to change, anger, frustration or other "unpleasant "
YES NO
variation or interruption? emotion in an unsafe or disruptive
YES NO manner?
Remained in designated area
YES NO
Remained with designated activity Detailed with ABC Data Sheet
Engaged in safe behaviors Accepted peers joining in play Was learner observed to utilize safe &
Transitioned with group Accepted playing in varied ways
effective calming/coping or self
Responded to whole group directions regulatory strategies?
Accepted change in routine
Did not require consistent 1:1 support Accepted ending prior to completion YES NO
Imitated actions of group as
needed/appropriate Detailed with ABC Data Sheet
H. Non Verbal Communication I. Cooperation & Teamwork J. Sportsmanship

Was learner observed to use gestures Cooperative / Teamwork activity Competitive activity observed?
when communicating? observed?
YES NO
YES NO YES NO
Did learner participate?
Was learner observed to respond to Did learner participate?
YES NO
gestures used by others to communicate YES NO
directions or information? Did learner accept winning/losing
demonstrated via the absence of
Did learner engage in behavior aligned
YES NO unsafe/disruptive behavior?
with reaching the shared goal?
YES NO YES NO

K. Speaking & Listening L. Perspective Taking M. Social Conflict Resolution
Was the intended conversational Was learner observed to demonstrate Conflict / disagreement observed?
partner clear when learner was understanding that others have
YES NO
communicating? different knowledge, thoughts and
beliefs and feelings about a shared If yes, with whom?
YES NO
sitiation? SELF PEER ADULT
Was learner observed to engage YES NO
in reciprocal multi turn
conversation on a shared topic?
Describe: Detailed with ABC Data Sheet
YES NO
See language sample
N. Friendships & Relationships O. Self Advocacy
Did learner appear to have a preference Did learner reliably request preferred or
for a specific peer or peer(s)? needed items ?
YES NO
YES NO
Did learner reliably and safely decline
Was that preference reciprocated? non-preferred items or activities?
YES NO YES NO
Did learner reliably and clearly request
help, clarification or modification
as needed?
YES NO

E-O Skill Summary:

SS-GFA: OBSERVATIONAL ASSESSMENT SETTING:
Learner: Date: OBSERVER: Duration:
A. Early Social Responding

B. Social Motivation, Initiation &
Reciprocity C. Toy Play & Leisure D. Social Play
A-D Skill Summary:

G. Self Regulation &
E. Group Learning F. Adaptability & Flexibility Managing Emotions
H. Non Verbal Communication I. Cooperation & Teamwork J. Sportsmanship

K. Speaking & Listening L. Perspective Taking M. Social Conflict Resolution
N. Friendships & Relationships O. Self Advocacy

E-O Skill Summary:

DIRECT
ASSESSMENT
SS-GFA: PLAY 1 SOCIAL MOTIVATION, INITIATION & RECIPROCITY
TOY PLAY
DIRECT ASSESSMENT SOCIAL PLAY
Child’s Name _________________________ Assessor: _____________________ Date of Assessment: ____________

Location of Assessment: ______________________ Environment: ___Free of distraction Duration of Assessment: _________
___ Partially free of distraction
Global Focus Areas Assessed: Assessment Procedure:

• Social Motivation, Initiation & Reciprocity
• Toy Play  Assess in an environment free of distraction to the extent possible.
• Social Play
• Adaptability & Flexibility
 Model play actions in a functional / developmentally appropriate way
Component Skills (based upon information obtained from indirect assessment)
• Look
• Approach  Model each play action for 1-2 minutes with positive affect & vocalizations in close
• Join
• Continue proximity to learner without placing any direct demands.
• Expand
 Model play action (narrate own play, positive affect, engagement & enjoyment)
 Place no demands (do not ask learner to come or join)
 Observe learner’s interest/motivation (monitor discreetly while keeping attention on play activity)
 Offer item to learner immediately if approaches (hold out object no eye contact or vocalization)
 Offer item to learner after learner looks (hold out object no eye contact or vocal acknowledgement/demand)
 Make item offer attempt to learner after 2 minutes of modeling if learner doesn’t look
 If learner doesn’t look, approach or accept after 2 minutes, move onto modeling next activity
 Do not force item if refused/no interest
 Do not follow child if they walk away from model (unless safety concern)
Item/Activity Did child Did the Did child accept Did the child How did the child engage How did the child Duration of
Modeled Action look? child item when join in activity? with play materials? respond to Interaction
approach? offered? variation
❏ No ❏ Yes ❏ Yes ❏ Yes ❏ Non Functional ❏ Accept _______ sec

❏ Yes ❏ No ❏ No ❏ No ❏ Functional Imitation ❏ Reject
❏ Functional Novel ❏ Retreat _______min





Notes:
SI-GFA: DIRECT ASSESSMENT SETTING:
Learner: Date: Assessor: Duration:
***At anytime, during the assessment, it may be appropriate to terminate the session early due to learner distress. Problem behavior may also need
to be briefly reinforced in the moment in an effort to preserve a positive relationship, pair the environment with reinforcement and build rapport for
future intervention. Presence of challenging behavior provides information pertaining to priority target global focus areas.
___completed assessment absence of challenging bx ___completed assessment in presence of intermittent challenging bx
___terminated early (see attached)
Learner should not be made to separate from parent/guardian if it is not the preference of all parties. Presence of the parent/caregiver provides
additional information about familiar social interactions and parental strategies. It is suggested that the parent refrain from prompting "correct"
responses as there are no right or wrong play or social skills. Having an accurate representation of learner's skill is critical to identification of most
meaningful, relevant and functional targets for the individual. _____parent/caregiver present _____ parent caregiver absent
Describe Initial Transition: Describe Greeting:

from car to building (if applicable) Initiated __vocally __non verbally __did not initiate
__quickly & independently __hesitantly Responded __vocally __non verbally __no response
__vocal resist / refuse __physical resist / refuse Oriented toward greeter __yes __no
Eye contact with greeter __yes __no
*attach description of any aberrant behavior strategies that
were successful or unsuccessful in transitioning used by Describe subsequent transitions:
parent or assessor. Across locations
__quickly & independently __hesitantly
** Direct assessment is not mandatory. Conducting this __vocal resist / refuse __vocal resist / refuse
component of the assessment should not supersede Across activities
respecting client dignity or preserving positive __quickly & independently __hesitantly
relationships. Make decisions accordingly regarding how to __vocal resist / refuse __vocal resist / refuse
proceed.
Learner primarily communicated wants and needs via (check all that apply)
__single words __phrases __complete sentences as needed/appropriate
__AAC (describe): _________________________________
__ Gestures / non verbal communication (describe): _______________________________________
Language Sample: Verbal Operants
Mand Repertoire:
Tact Repertoire:
Intraverbal Repertoire:

SUMMARY &
GOALS
A1 Orients toward people's faces when they are talking
A2 Smiles in response to smiling
A3 Follows a point
A4 Shares attention with a person on an item/activity (Look & look back)
A5 References parent/caregiver face for comfort or confirmation
SOCIAL MOTIVATION, INITIATION & RECIPROCITY
B1 Approaches an ongoing, preferred activity
B2 Positively responds to social initiations from familiar people
B3 Approaches others to engage socially/playfully
B4 Makes a verbal or nonverbal request to continue a preferred activity
B5 Participates in multi turn, playful activities/games (non rule based)
TOY PLAY & LEISURE
C1 Spontaneously and independently seeks out play/leisure activities during downtime/free time
C2 Shows an interest in at least 3 non-electronic toys/games/activities
C3 Plays with at least 3 toys or engages in at least 3 leisure activities in a functional way
C4 Engages safely and functionally for at least 5 minutes without direct instruction/supervision
C5 Has a repertoire of at least 3 play activities in which others may join in/participate.
Mission Cognition Social Interaction Global Focus Area Component Skills

SOCIAL PLAY
D1 Joins in with others who are playing with preferred toy/activity
D2 Tolerates peers playing with preferred items/activities
D3 Tolerate peers playing in close proximity
D4 Takes turns/ trade / share with peers
D5 Talks to peers about actions and includes in a "play plan"
GROUP LEARNING
E1 Refrain from disruptive/distracting behavior during structured activities
E2 Remain in designated area
E3 Use learning materials safely and as designed
E4 Maintain personal space & boundaries (hands to self)
E5 Maintain attention to task
E6 Transition with the group
E7 Follow group directions
E8 Imitate actions modeled by leader (instructor) as needed
E9 Scan room and imitate others when unsure what to do
E10 Gain instructor/adult attention as needed

F1 Demonstrate a variety of interests
F2 Accept being told "no" and "wait"
F3 Play / explore items in a variety of ways
F4 Tolerate changes to familiar activities
F5 Tolerate additions or cancellations in routine/schedule
F6 Tolerate leaving activities unfinished or accepting "good enough"
F7 Tolerate own mistakes/ imperfections
F8 Tolerate others' mistakes / imperfections
F9 Accept there may be varied ways to play a game or complete a known task
F10 Tolerate and move on from situations when problems do not have an immediate solution
SELF REGULATION & MANAGING EMOTIONS
G1 Refrain from hurting or attempting to hurt self when upset
G2 Refrain from hurting others or attempting to hurt others when upset
G3 Refrain from damaging or attempting to damage objects when upset
G4 Refrain from screaming/yelling when upset and not hurt
G5 Utilize coping tools or strategies when directed or suggested by others
G6 Use at least 1 effective coping strategy to self soothe when upset
G7 Use at least 1 effective calming strategy to regulate when over excited
G8 Request people, items, activities to assist in self soothing/regulating as needed
G9 Match reaction to the size of the problem/seriousness of the situation
G10 Let go and move on from unpleasant situations once addressed

H1 Respond to command gestures such as come here, sit down & wait
H2 Stop or change behavior in response to a head shake, “no” or other disapproving expression
or gesture
H3 Smile and or continue a behavior in response to a smile, thumbs up or other approving

expression or gesture
H4 Use gestures when communicating to emphasize or to clarify meaning
H5 Display a range of facial expressions to match the context of an activity or situation
H6 Reference expressions or body language of others to make decisions about what to do
H7 Interpret body language of others to identify whether they are interested or disinterested
H8 Interpret body language of others to identify whether they are busy or available
H9 Orient toward conversational partner and maintain personal space when communicating
H10 Maintain good hygiene & tidy appearance
I1 Accept help / assistance
I2 Identify a job or role
I3 Accept an assigned job or role
I4 Make on topic, role aligned vocal contributions
I5 Make on topic, role aligned physical contributions
I6 Add or share ideas
I7 Take balanced role of "leader" or "follower" as needed
I8 Actively listen to ideas shared by others
I9 Provide constructive feedback as needed
I10 Accept constructive feedback as appropriate

SPORTSMANSHIP
J1 Tolerate not being first or another preferred position
J2 Play by the rules and refrain from cheating
J3 Tolerate falling behind in position or points
J4 Tolerate losing or being called "out"
J5 Demonstrate gracious winning without bragging
J6 Request a rematch or to play again if desired and appropriate
J7 Ask for clarification of rules or perceived unfair calls, as appropriate
J8 Follow team or group expectations for congratulating winner
J9 Accept feedback for skill improvement as needed
J10 Encourage teammates
K1 Answer yes /no and other close ended questions
K2 Reciprocate information by sharing similarly what others have shared
K3 Make comments to demonstrate interest or understanding
K4 Answer open ended questions
K5 Join in an ongoing conversation
K6 Initiate conversation
K7 Talk on a variety of topics
K8 Ask on topic, follow up questions
K9 Appropriately transition the conversation or introduce new topics
K10 Politely end the conversation as appropriate

PERSPECTIVE TAKING
L1 Identify emotions of others from facial expressions
L2 Orient an object correctly in order to show it to another person
L3 Infer what others may be thinking based upon expression, body language and other context
clues
L4 Infer how others may feel in hypothetical situations
L5 Identify topics or activities that may be of interest to others based on prior knowledge
L6 Demonstrate empathy
L7 Know that others have different thoughts, ideas, knowledge & interests
L8 Determine intent of others by distinguishing between accidental and purposeful
L9 Identify how words and actions may impact others
L10 Identify multiple different perspectives which may be present in a given situation
M1 Demonstrate awareness of being involved in a conflict with others
M2 Ask others to stop when needed
M3 Offer a solution to a simple disagreement
M4 Use at least 1 compromise strategy
M5 Know when to walk away from a problem situation
M6 Refrain from stating thoughts/plans for retaliating as a solution
M7 Refrain from following through with a retaliatory/sabotaging act
M8 Refrain from name calling
M9 Accept own responsibility for any ownership in the conflict as appropriate
M10 Acknowledge/ accept apologies offered from others

FRIENDSHIPS & RELATIONSHIPS
N1 Recognize the qualities / characteristics of a "good" friend
N2 Seek out friendships / relationships that are positive & reciprocal in nature
N3 Identify levels of relationships (stranger/acquaintance/friend/best friend)
N4 Identify friends' likes & dislikes
N5 Differentiate information shared with others based on varying closeness levels of

relationship
N6 Keep in touch with friends via means appropriate for age/developmental level
N7 Accept that friends may have other friends
N8 Accept that others may act differently/include them differently based on closeness of
relationship
N9 Move on from small disagreements with friends
N10 Know when and how to end an unhealthy friendship or relationship
SELF ADVOCACY
O1 Request items needed to complete an activity or task
O2 Say no to non preferred offerings
O3 Defend possessions if needed
O4 Ask others to stop/change a non preferred action or activity
O5 Request help or assistance
O6 Request clarification or additional information as needed
O7 Alert others/gain attention when skipped or overlooked (my turn, what about me, etc)
O8 Correct others' inaccurate responses or information as needed when pertaining to self (name
mispronounced wrong item given)
O9 Request specific accommodations or modifications to support learning/participation
O10 Report injustices / mistreatment to a trusted adult

SI-GFA ASSESSMENT
15 Global Focus Areas (GFA)
A B C D E F G H I J K L M N O
1
2
125 component skills (CS)
10
Individual Skill Targets (IST)

Learner Initials: Effective Date: Social Coach:
GOAL 1
Global Focus Area (GFA) Code Component Skill (CS)
Individual Target Skill (ITS) Acquisition / Replacement
GOAL 2
Individual Target Skill (ITS) Acquisition / Replacement
GOAL 3
Individual Target Skill (ITS) Acquisition/Replacement
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MISSION COGNITION'S

I pledge to be present and human in

I pledge to include the client in the

I pledge to use the obtained

I pledge to use this tool as a means

Indirect Assessment: Parent/Caregiver Interview

Structured Observation: Play

This assessment obtains information to develop a comprehensive, whole picture of

Letter Global Focus Area GFA Description

Engagement with items, materials and activities classified as toys,

Acknowledgment, acceptance and interaction with others during

Mission Cognition Social Skills Development Centers

Mission Cognition Social Skills Development Centers

specific social skills areas to assess in more detail.

with the people in their environment.

Do you have any questions before we begin?

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EARLY SOCIAL RESPONDING COOPERATION & TEAMWORK

SOCIAL MOTIVATION, INITIATION

TOY PLAY & LEISURE

SOCIAL CONFLICT RESOLUTION

SELF REGULATION & FRIENDSHIPS & RELATIONSHIPS

NON VERBAL COMMUNICATION SELF ADVOCACY

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HOW WOULD YOU DESCRIBE YOUR CHILD'S AWARENESS

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HOW WOULD YOU DESCRIBE YOUR CHILD'S INTEREST

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HOW WOULD YOU DESCRIBE YOUR CHILD'S INTEREST

HOW WOULD YOU DESCRIBE YOUR CHILD'S INTEREST

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Group of 3-5 Proficient Group of 6-10 Proficient Group of 10-20 Proficient

ADAPTABILITY & FLEXIBILITY

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NON VERBAL COMMUNICATION

H O W W O U L D Y O U D E S C R I B E Y O U R C H I L D ' S Skill Level

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H O W W O U L D Y O U D E S C R I B E Y O U R C H I L D ' S S K I L L L E V E L A S A "T E A M P L A Y E R " ? Skill Level

W O U L D Y O U D E S C R I B E Y O U R C H I L D A S M O R E O F A " L E A D E R " O R A "FOLLOWER"

HOW WOULD YOU DESCRIBE YOUR CHILD'S

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D E S C R I B E Y O U R C H I L D ' S S K I L L L E V E L I N T E R M S O F M A I N T A I N I NG Skill Level

WHAT TYPES OF THINGS DOES YOUR CHILD USUALLY TALK ABOUT?

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SOCIAL CONFLICT RESOLUTION

DESCRIBE YOUR CHILD'S INVOLVEMENT IN AND AWARENESS OF SOCIAL CONFLICT OR DISAGREEMENT

DESCRIBE YOUR CHILD'S RESPONSE TO CONFLICT OR DISAGREEMENT WITH OTHERS.

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DESCRIBE YOUR CHILD'S AWARENESS & INTEREST IN THE CONCEPT OF FRIENDSHIP.

DESCRIBE YOUR CHILD'S AWARENESS OF DIFFERENT TYPES OF RELATIONSHIPS (STRANGER,

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Expression of positive feelings Expression of negative feelings

Communication Method & Purpose Request items

Strategies and tools for positive engagement & interaction

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1- I don't have this skill

Find enjoyable things to do with my downtime

Start and end conversations

Express big emotions such as anger, frustration, fear and