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The University of Iowa
Regional Autism Services Program
Child Health Specialty Clinic

   Picture Print Story Form

Children’s Book Library
Materials Inventory List

Please choose 1 book you would like to view and rank them #1,choice #2 choice, and #3 choice. According to availability, 1 of the 3 books will be delivered/sent UPS. You will be asked to return them within three weeks. After making your selections, please go to the bottom of the page to submit the form.

The Animals That Went to Bed
by Rod Theodorou
   
Set of about 30 pictures (each with a picture and the corresponding word) and the corresponding printed word. Both the picture and large word card have velcro on the back. There is only a black mat enclosed to map out the story in pictures and print along with the actual book  that allows the story to be built one page at a time. No comprehension questions are included.  
Size of Pictures:   1"-2"   Size of Pictures: X <1"  X 1"-2"  X >3"
Language Level Description:
• A Rigby Set D story using a four or five word sentence per page for 8 pages.
Language Level Description:
 
 
Watching the Weather by Marcia Freeman  
Set of approximately 30 pictures (with the word written below) and the corresponding printed word. Both the picture and the large word card have velcro on the back.  The story has 4 short chapters, each with about 30 pictures. Comprehension questions along with the foil answers are available for each chapter of 5 pages of material. The pictures and print are already aligned on black matting, 2-3 mats per chapter.  
Size of Pictures:   2"  Size of Pictures: X <1"  X 1"-2"  X >3"
Language Level Description: Newbridge Discovery Link Early level Set B
• Short sentences of four to five words with two sentences per page.
 
 
   
   
Size of Pictures: X <1"  X 1"-2"  X >3" Size of Pictures:  <1"  X 1"-2"  X >3"
Language Level Description:
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Size of Pictures:  <1"   1"-2"  X >3" Size of Pictures: X <1"  X 1"-2"  X >3"
Language Level Description:
 
Language Level Description:
 
   
   
Size of Pictures:  <1"  X 1"-2"  X >3" Size of Pictures:  <1"  X 1"-2"  X >3"
Language Level Description:
• 
Language Level Description:
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  1
Size of Pictures: X <1"  X 1"-2"  X >3" Size of Pictures:  <1"   1"-2"  X >3"
Language Level Description:
 
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Student:
Age:
Contact Person
Requesting toys:
Role of requester:
Address: 
Phone:
E-mail:
Send available units UPS to contact person.
    Other Person:
I, as a requester, will UPS them back or make other arrangements with you.
    Include inventory list

Choose one from the following:

     I will complete the feedback form for Literature books via the mail.

     I will complete the feedback form for Literature books via the web.

 

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