Title
Student Needs - Evaluation for Additional Services and/or Resources
Content
Copy into an e-mail, complete, and submit to office.
Student:
Teacher:
Date:
Does the student
| tic | struggle with… | grade level (where appropriate) |
| reading | ||
| writing | ||
| numeracy | ||
| motor skills | ||
| behaviour | ||
| other |
due to a physical or processing dysfunction
| tic | relating to... |
| brain processing difficulties | |
| visual/motor difficulties | |
| auditory processing and/or speech difficulties | |
| behaviour and attending difficulties | |
| sensory processing difficulties | |
| giftedness with a glitch | |
| modality dominance/weakness |
Does the adaptation or individualization of the student's plan for optimal learning and retention require
| tic | support in the form of... | specify |
| technology | ||
| software | ||
| hardware and/or equipment | ||
| alternate delivery formats | ||
| alternate documenting strategies | ||
| tutoring / therapy | ||
| assessment |
Documentation Attached
required:
- completed Student Needs Evaluation form
- annecdotal observations from parent and teacher
Send completed form to office.