Adolescent Autonomy Checklist

Skills at home                                                  Can Do Already     Needs Practice      Plan to Start     Accomplished

Kitchen:

Operate appliances (cook top, oven,            microwave, toaster, dishwasher)

 

 

 

 

Use common kitchen tools (can opener, bottle opener, knife, measuring cups and spoons, grater, timer, egg beater, ice cream scoop)

 

 

 

 

Help plan and prepare meals

 

 

 

 

Follow a recipe

 

 

 

 

Put away the leftovers

 

 

 

 

Set the table

 

 

 

 

Do the dishes

 

 

 

 

Familiarity with contents of packaged foods

 

 

 

 

 

Laundry

 

 

 

 

Put dirty clothes in hamper

 

 

 

 

Sort clothes

 

 

 

 

Use washer and dryer

 

 

 

 

Iron

 

 

 

 

Hand wash

 

 

 

 

Fold clothes

 

 

 

 

Put clothes away

 

 

 

 

 

With the Family

 

 

 

 

Watch TV news and discuss together

 

 

 

 

Help take care of siblings

 

 

 

 

Participate in family decisions

 

 

 

 

Plan family outing

 

 

 

 

Take care of pets

 

 

 

 

 

Housekeeping

 

 

 

 

Clean room

 

 

 

 

Skills at Home                                                 Can Do Already   Needs Practice     Plan to Start       Accomplished

Housekeeping, Cont’d.

 

 

 

 

Make the bed/change the bed

 

 

 

 

Choose decorations for room

 

 

 

 

Minor repairs (change light bulbs, repair or   assemble toys)

 

 

 

 

Take out the trash

 

 

 

 

Basic sewing/mending skills

 

 

 

 

 

Gardening

 

 

 

 

Plant a garden

 

 

 

 

Mow/water the lawn

 

 

 

 

Weed the garden

 

 

 

 

Learn appropriate use of garden tools

 

 

 

 

 

Emergency

 

 

 

 

Plan fire exits and emergency procedures

 

 

 

 

Know where candles and flashlights are

 

 

 

 

Use a fire extinguisher

 

 

 

 

Know how to turn water off

 

 

 

 

Know community emergency telephone numbers

 

 

 

 

Know where extra house key is located

 

 

 

 

Unclog the sink or toilet

 

 

 

 

 

Personal Skills

 

 

 

 

Use the phone

 

 

 

 

Have a house key

 

 

 

 

Budget allowance

 

 

 

 

Go shopping

 

 

 

 

Have privacy in the bathroom

 

 

 

 

Manage personal grooming (shampoo, bath, shower)

 

 

 

 

Skills at Home                                                      Can Do Already    Needs Practice  Plan to Start     Accomplished

Personal Skills, Cont’d.

 

 

 

 

Get a haircut

 

 

 

 

Choose appropriate clothes to wear

 

 

 

 

 

Health Care Skills

 

 

 

 

Understand health status

 

 

 

 

Be aware of existence of medical records, diagnosis information, etc.

 

 

 

 

Prepare questions for doctors, nurses, therapists

 

 

 

 

Respond to questions from doctors, nurses, therapists

 

 

 

 

Know medications and what they’re for

 

 

 

 

Get a prescription refilled

 

 

 

 

Keep a calendar of doctor, dentist appointments

 

 

 

 

Know height, weight, birthdate

 

 

 

 

Learn how to read a thermometer

 

 

 

 

Know health emergency telephone numbers

 

 

 

 

Know medical coverage numbers

 

 

 

 

Obtain sex education materials/birth control if indicated

 

 

 

 

Discuss role in health maintenance

 

 

 

 

Have genetic counseling if appropriate

 

 

 

 

Discuss drugs and alcohol with family

 

 

 

 

Make contact with appropriate community advocacy organization

 

 

 

 

Take care of own menstrual needs and keep a record of monthly periods

 

 

 

 

Skills At Home                                                 Can Do Already   Needs Practice     Plan to Start       Accomplished

Community Skills        

 Get around the city (pedestrian skills, asking directions)

 

 

 

 

Get around the city (pedestrian skills, asking directions)

 

 

 

 

Use public transportation (taxi, bus, etc.)

 

 

 

 

Locate bathroom in unfamiliar building (i.e. know how to ask)

 

 

 

 

Know about neighborhood stores and services

 

 

 

 

Use a pay phone

 

 

 

 

Use a phone book

 

 

 

 

Open a bank account

 

 

 

 

Get a library card

 

 

 

 

Get a picture ID

 

 

 

 

Get  a Social Security Card

 

 

 

 

Use Post Office

 

 

 

 

Volunteer for community services

 

 

 

 

 

 

Leisure Time Skills

 

 

 

 

Help plan a party

 

 

 

 

Invite a friend over

 

 

 

 

Subscribe to a magazine

 

 

 

 

Read a book

 

 

 

 

Plan a TV viewing schedule

 

 

 

 

Go for a walk

 

 

 

 

Join the Scouts, YMCA/YWCA, 4-H Club

 

 

 

 

Go to a recreation center

 

 

 

 

Go to camp

 

 

 

 

Attend school functions (plays, dances, concerts, sports)

 

 

 

 

Go to Church

 

 

 

 

Keep a calendar of events

 

 

 

 

Participate in a sport

 

 

 

 

         

Skills At Home                                                 Can Do Already    Needs Practice     Plan to Start      Accomplished

 

Skills For The Future-

Education

 

 

 

 

Meet with school Guidance Counselor

 

 

 

 

Check future educational options

 

 

 

 

 

Vocational/Technical Options

 

 

 

 

Contact school Guidance or DVR Counselor

 

 

 

 

Check on local workshops/job opportunities

 

 

 

 

Find out about apprentice programs

 

 

 

 

Get information from community colleges

 

 

 

 

Learn how to apply for a job

 

 

 

 

Check on local workshops/job opportunities

 

 

 

 

Find out about apprentice programs

 

 

 

 

Get information from community colleges

 

 

 

 

Learn how to apply for a job

 

 

 

 

 

Living Arrangements

 

 

 

 

Be aware of federal housing regulations for the disabled

 

 

 

 

Explore group homes and tenant support apartment living programs

 

 

 

 

Find out about financial assistance programs

 

 

 

 

Learn how to manage money and budget household expenses

 

 

 

 

Understand leases

 

 

 

 

Know the responsibilities of a tenant & landlord

 

 

 

 

Know how to fill out an application

 

 

 

 

Check for wheelchair accessibility if needed

 

 

 

 

Look into transportation

 

 

 

 

Know about services: electricity, phone, water

 

 

 

 

Developed by the Youth in Transition Project (1984-1987) University of Washington Division of Adolescent Medicine and based on a Model developed by the Children’s Rehabilitation Center at the University of Virginia.

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