Instrument 1: Fidelity Log
Digital Citizenship: Internet safety lessons for youth with intellectual and developmental disabilities
Online Fidelity Log
Instructions: Please complete one fidelity log per implementation session within 24-hours of facilitating the lesson. The fidelity log should only include activities completed during that session. For example, if it takes two days to deliver the content in Lesson 1: Chatting and Red Flags, you should complete two separate fidelity logs that each describe the activities and engagement for the specific implementation session.
Facilitator ID [pre-populated]:
School or organization name [pre-populated]:
Date:
Period or block when programming was delivered (if applicable):
Did you have a co-facilitator or classroom aide assist with delivering the lesson?
Yes
No, skip to the activity log (table 1)
If yes, what is the role of the co-facilitator in your classroom?
Table 1. Lesson 1: Chatting and Red Flags activity log
Activity  | 
			Time [in minutes spent on this lesson]  | 
			Completion [select one]  | 
			If completed with changes, describe the changes made and why; whether changes were planned or spontaneous; and how students reacted to any changes. Note: Changes might include changing the names in a scenario, adding new content or activities, using other materials, or changing the way you teach something (e.g., making something into a game or using pairs or small groups instead of a large group for an activity).  | 
			
				On
				a scale of 1 to 5, to what extent did students participate during
				this activity?  | 
			On a scale of 1 to 5, to what extent did students understand the content and main messages from this activity? [Select one]  | 
		
Response options  | 
			[open response]  | 
			
				
  | 
			[open response]  | 
			
				1-
				Students did not listen or interact at all  | 
			1- Students did not understand any part of the activity 2- 3- Students understood about half of the content 4- 5- Students understood all the content in the activity  | 
		
Lesson 1: Chatting and red flags  | 
			
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Pre-teach and comprehension check  | 
			
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Consider: Risky online relationships  | 
			
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Reflect: Texting scenario  | 
			
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Explore: Sheyna's situation  | 
			
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Group assessment  | 
			
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Table 2. Lesson 2: Rewarding Relationships activity log
Activity  | 
		Time [in minutes spent on this lesson]  | 
		Completion [select one]  | 
		If completed with changes, describe the changes made and why; whether changes were planned or spontaneous; and how students reacted to any changes. Note: Changes might include changing the names in a scenario, adding new content or activities, using other materials, or changing the way you teach something (e.g., making something into a game or using pairs or small groups instead of a large group for an activity).  | 
		
			On
			a scale of 1 to 5, to what extent did students participate during
			this activity?  | 
		On a scale of 1 to 5, to what extent did students understand the content and main messages from this activity? [Select one]  | 
	
Response options  | 
		[open response]  | 
		
			
  | 
		[open response]  | 
		
			1-
			Students did not listen or interact at all  | 
		1- Students did not understand any part of the activity 2- 3- Students understood about half of the content 4- 5- Students understood all the content in the activity  | 
	
Lesson 2: Rewarding relationships  | 
		
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Consider: Texting and talking  | 
		
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Explore: Friendships and feelings  | 
		
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Analyze: Flag it  | 
		
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Group assessment  | 
		
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Overall, on a scale from 1 to 5 (with 5 being extremely satisfied and 1 being extremely unsatisfied): How satisfied were you with the implementation of today’s lesson(s)? [Select a rating from 1 to 5]
Please use this field to share any notes on how the activities or slides could be adapted and/or improved to make the lesson more engaging and/or accessible for your students? [open ended]
Please use this field to share any notes about the facilitator instructions. For example, how they could be changed to improve instruction clarity. [open ended]
Please use this field to share any additional notes about session overall. For example, elaborating on positive aspects or challenges with student comprehension or engagement. [open ended]
	DRAFT
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| File Title | Mathematica Report Template | 
| Author | Katie Adamek | 
| File Modified | 0000-00-00 | 
| File Created | 2022-05-09 |