Client details & Support Form

- Does the participant take regular medication? (If yes, please specify name and dosage)

- Any diagnosed allergies (including food or environmental)?

- Relevant medical conditions (e.g. epilepsy, asthma, heart condition)

- Is there a Health or Emergency Plan in place?

Yes No

🧠 Behaviour Profile & Support Preferences

- Known Triggers (what might cause distress or dysregulation)?

- Strategies that help regulate?

Movement / space to pace or jump Pressure or deep touch Preferred toy or object Visual support (first/then, countdown, etc.) Quiet space or break Supportive adult staying nearby Breathing exercises / calming prompts

- Additional Notes on Behaviour

- Level of Support Needed When Regulated? (When calm and engaged)

1to1 2to1

- Level of Support Needed When Dysregulated? (distressed or overwhelmed)

Can self-regulate with minimal prompts Needs adult nearby and occasional guidance Needs active adult support throughout episodes Requires continuous supervision from an adult when distressed May require support from two adults to safely regulate

🗣️ Communication & Interaction Profile

- What best describes the participant’s expressive communication? (You may select more than one)

Mainly communicates through behaviour Gestural or non-verbal cues (e.g. pointing, taking adult to item) Verbal – full sentences Verbal – limited words or scripts Uses signs (e.g. Makaton) Uses AAC (e.g. tablet, GoTalk, speech device) Uses PECS or visuals to express needs

- How does the participant best understand instructions?

Verbal instructions only Verbal + gestures Visual support needed (e.g. symbols, schedules, first-then boards)

- Preferred Communication Strategies That Work Well

🧩 Independence & Daily Participation

- Mobility & Physical Independence

Walks independently Uses mobility aids (e.g. wheelchair, walker) Needs adult assistance for transitions or moving between spaces

- Personal Care

Fully independent (e.g. toileting, dressing) Needs physical assistance or supervision

- Task Engagement

Can follow a simple routine independently Needs 1:1 support to complete most activities

- Transitions & Flexibility

Adapts easily to change in activities or environment Struggles with unexpected changes or waiting time

- Risk Awareness & Safety

Understands basic safety rules (e.g. not running off, pool safety) No awareness of danger – needs constant supervision

Client details & Support Form (Registration)