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Sample Outcome Report

Every participant gets a report like this within 5 working days of the last session. Jay is an invented participant; the scores and words are an example only.

Impact6
Example · invented participant
Outcome ReportFunctional capacity program
ParticipantJay
ProgramFOUNDATIONS
Program dates11 March to 22 April 2027
Sessions attended12 of 12

01What changed

4areas moved
1did not

Functional capacity was measured across the 5 areas this program develops, before the program began and again at the end, by the same practitioner using the same instrument. Every area is reported below, whether it moved or not.

02Area by area

Start of programEnd of programType of Support, 0 to 5. Lower means less help needed.
1

General Tasks and DemandsRoutines and organisation

Moved 1 level

From 3 Moderate to 2 Minor

Completes the morning routine using a sequence he made. Requires one prompt to begin.

2

Interpersonal InteractionsGetting along with others

Moved 1 level

From 3 Moderate to 2 Minor

Initiates a greeting with familiar adults and with peers in a known setting. Requires a cue before unfamiliar people.

3

Community, Social and Civic LifeGetting out and about

Moved 2 levels

From 4 Extensive to 2 Minor

Walks a known route to the shop on his own and completes a purchase, checking the change. Requires the trip to be agreed with a parent beforehand and a text on arrival.

4

Self CareLooking after himself

Moved 1 level

From 2 Minor to 1 Managed Independence

Selects and lays out his own clothing the evening before, using a checklist he wrote. No other person involved.

5

Learning and Applying KnowledgeLearning how to learn

No change

At 3 Moderate at the start and the end

Follows written instructions for a four-step task. Continues to require a parent to direct the sequence for homework.

This is the area to work on next.

0 Independent · 1 Managed Independence · 2 Minor · 3 Moderate · 4 Extensive · 5 Pervasive

Capacity Builders Skilling & Training Pty Ltd · ABN 21 639 524 495 · Registered NDIS provider 4053448890Page 1 of 2

03The goal

Goal, in Community, Social and Civic LifeGo to the shop by myself.
AchievedRated 0, the expected outcome, on the goal scale set in week 1

At the last session Jay walked a known route to the local shop on his own, selected an item, queued, paid and checked his change. The practitioner observed from across the street and gave no prompting. Jay texted his mother on arrival, as they had agreed. At the start an adult made every purchase on his behalf.

Asked what was different: "I can get my own stuff now."

Goal levels, written in week 1
  1. +2Walks on his own, makes the purchase, and manages an unexpected problem, such as the item being out of stock
  2. +1Walks on his own to the local shop and to a second shop he has not practised, and makes each purchase himself
  3. 0Walks a known route to the shop on his own and makes the purchase himselfEnd of program
  4. −1Walks to the shop with an adult beside him and makes the purchase himself
  5. −2No change: an adult still makes the purchase on his behalfStart of program

04Supports delivered

Program
FOUNDATIONS, ages 9 to 14
Delivery approach
A, Neurodevelopmental
Sessions attended
12 of 12
Start and end scoring
Same practitioner both times

05What Jay keeps

Everything made during the program stays with Jay: his morning sequence, his checklist, his route map, and the tracking sheet he kept.

06Recommendation

Complete

Jay moved in 4 of 5 areas and achieved the goal he set. Learning and Applying Knowledge is where further work would have most effect, and would be the focus of a further program.

07Assessment approach

Functional capacity was measured at entry and exit using a domain-level rating of support type, scored 0 to 5, applied by an allied health practitioner. Its wording, rules and examples are Impact6’s own. This is not a functional capacity assessment.

Shared only with the people named in the participant's consent.Page 2 of 2