Student Name: Exceptionality: Grade :
Case Manager: Room: Phone :
Present Levels:
Math:
Written Expression:
Reading:
General Information;
Health Information Material Accommodations:
Wears Glasses Taped Texts
Has hearing loss Highlighted Texts
Other medical Study Aids/Manipulatives
Issues Calculator
Interpreter for Deaf
Special Education Services: Large print/Braille
Receives OT/PT/SL Special Instructions
Receives inclusion service for Math/Reading ESL Materials
Written Language/Science/Social Studies Peer/Adult assistance with reading
Qualifies for State /Local assessments with Color Coded materials for reading
accommodations or modifications for Math/Reading Other
Written Language/Science/Social Studies
Methods Accommodations Assignments Accommodations
Pacing Extended Time Assignments
Modified texts/text Shortened Assignments
Taping Lectures Assignment Notebooks
Note Taking Assistance Reduced Written Tasks
Repeated Review Change in Project, report
Check for Understanding requirements
Other Eliminate Spelling Requirements Use Peer Tutoring/Paired Working
Testing Accommodations Arrangement
Oral Tests Reading Assistance Short Answer Test Word bank/reduced options/short
Modified Tests/Text answer
Test to be given and translated by Other
Take test in alternate location Limited choices for multiple choice tests
Other
Grading Accommodations Homework Modifications
Drop the lowest grade during the six weeks period. Reduced homework assignments
Grade only major questions on a test. Opportunity for students to dictate to
Re-teach and allow students to re-take test if a para or their parents
grade is low. Opportunity to write the answer
Provide an alternate assignment to raise a students’ instead of whole sentences
low grade. Taped instruction for homework
Opportunity to create a model/poster/dramatize/ assignment
instead of writing Extended time on homework
Opportunity for typed/dictated responses Other:
Other:
Behavior Accommodations Presentation of Instructions
Preferential Seating – Where Short instructions (1or 2 steps)
Frequent breaks Opportunity to have instruction
Defined Physical Space repeated
Cooling Off Period Opportunity to have instructions
Concrete (Tangible) Reinforcers written
Private discussions regarding behavior Visual Aids (pictures, flash cards, etc.)
Escorted during transition periods by Auditory aids (cues, tapes music, etc.)
Positive Reinforcement Receive a paper copy of lecture notes
Individualized Behavior Management Plan Frequent feedback
Other:
Positive reinforcement for academic
skills
Environmental Modifications Positive reinforcement for
Minimized Auditory Distractions communication skills
Minimized visual distractions Checking for understanding
Organizational Aides Prompts for in class discussion
Other Other:
Grades will be based on:Grades will be determined on: Regular classroom standard Regular Education Teacher
Work completed Special Education Teacher
Effort demonstrated mastery Regular and Special Education
No penalty for spelling/handwriting Teacher collaborating
No penalty for mechanics/grammar
Other
In case of academic/behavior difficulty or failing grades:
Contact case manager
Conference with parents
If you have further questions or need further clarification, please see the case manager.