Input for IEP

Your Name

First NameLast Name

Student Grade

Courses

Courses - Continued

Course Periods

What are the student's strengths?

What areas of concern do you have in regards to the student's progress in your classroom?

Describe the student's growth in the time you have worked with them.

Functional/ Behavior Competencies

Rows	Seemingly, never	Rarely, with prompts	Sometimes, with prompting	Always, after prompts	Independently, without prompting
follow directions
remain on task
complete work
follow class and school rules
participate with a group
use appropriate language
develop relationships with adults
develop relationships with peers
self-regulate emotions

Functional/ Vocational Competencies

Rows	Seemingly, never	Rarely, with prompts	Sometimes, with prompting	Always, after prompts	Independently, without prompting
be punctual
maintain good attendance
work independently
self-advocate
accept assistance
work as a team player
finish work by the deadline
initiate work
navigate technology in the classroom

Functional/ Motor Competencies

Rows	Seemingly, never	Rarely, with prompts	Sometimes, with prompting	Always, after prompts	Independently, without prompting
navigate the hallways
take notes in a timely manner
write with legible handwriting
type accurately with few errors

Functional/ Communication Competencies

Rows	Seemingly, never	Rarely, with prompts	Sometimes, with prompting	Always, after prompts	Independently, without prompting
communicate wants and needs
address others appropriately
interact with peers at a socially expected level
follow multi-step directions
maintain relevance during conversations

Academic/Reading

Rows	below average	low average	average	high average	Not available
apply phonics to new words
use context clues in reading
monitor their reading, making adjustments when necessary
find the stated main idea
determine the implied message in a text
infer, with supporting evidence
determine fact from opinion and claim
apply strategies for comprehension
summarize a selection

Academic/Writing

Rows	below average	low average	average	high average	Not available
write simple sentences
develop compound sentences
create a composition with a clear topic sentence
include supporting evidence in a composition
complete a composition with a concluding thought
utilize elements of the writing process
write with appropriate punctuation, capitalization, and grammar
write with appropriate spelling
write in a variety of forms, such as literary works, personal narrative, expository and persuasive genres
support a response with evidence from the text

Academic/Math

Rows	below average	low average	average	high average	Not available
determine the value in economic values
tell and calculate time
read, write, and identify place value
recall math facts
estimate the value of a number
solve problems with fractions, decimals, and percentages
simplify using the appropriate order of operations
collect and represent data on a graph to draw conclusions
identify congruent shapes and lines of symmetry

Academic/Science

Rows	below average	low average	average	high average	Not available
practice safety rules in a lab
understand the Scientific Method
read and interpret graphs
collect data and take measurements
work well with peers in a lab situation
apply critical thinking and problem solving skills

Academic/Social Studies

Rows	below average	low average	average	high average	Not available
locate places on a map
understand political issues
understand economic issues
understand social issues
read and interpret charts
read and interpret graphs
read and interpret timelines
read and interpret models
identify the cause and effect of relationships over time

Transition/ Teacher Survey

Rows	Poor	Fair	Average	Above Average	Excelent
1. Is on time for class
2. Turns in assignments on time
3. Completes assigned tasks
4. Completes work in a neat and orderly manner
5. Organizes time and materials
6. Is neat and clean in personal appearance
7. Displays interest and enthusiasm for tasks
8. Attends classes regularly
9. Seems confident of ability to work with others
10. Shows ability to adapt to new situations
11. Shows a positive, overall attitude
12. Is honest in dealing with others
13. Responds well to authority
14. Prefers activities in groups
15. Prefers individual activities
16. Adapts socially to accommodate peers

Transition/ Teacher Survey

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Your information