Mainstream Checklist for Students with Visual ... - Round Rock ISD
Mainstream Checklist for Students with Visual ... - Round Rock ISD
Mainstream Checklist for Students with Visual ... - Round Rock ISD
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
MAINSTREAM CHECKLIST FOR<br />
STUDENTS WITH VISUAL IMPAIRMENTS<br />
Student:_____________________________<br />
Teacher:________________________________<br />
Date:________________________________ Class:__________________________________<br />
I will be consulting <strong>with</strong> you regarding how________________________’s vision loss affects<br />
his/her educational progress. Would you please take a few minutes to fill out this <strong>for</strong>m as soon as<br />
possible? Please place it in___________________________ box in my office.<br />
__________________________________________<br />
Special Education Teacher <strong>for</strong> <strong>Students</strong> <strong>with</strong> <strong>Visual</strong> Impairments<br />
CLASS PARTICIPATION<br />
Yes Sometimes No<br />
Understands group presentation ________ _________ _________<br />
Volunteers answers or comments _________ _________ _________<br />
Asks <strong>for</strong> instructions to be repeated _________ _________ _________<br />
Contributes pertinent in<strong>for</strong>mation _________ _________ _________<br />
SEAT WORK<br />
Completes seat work <strong>with</strong> minimal instruction ________ _________ _________<br />
Works independently ________ _________ _________<br />
Turns in assignments/homework on time ________ _________ _________<br />
Uses low vision devices ________ _________ _________<br />
Preferential seating ________ _________ _________<br />
INTERPERSONAL SKILLS<br />
Is cooperative <strong>with</strong> teacher ________ _________ _________<br />
Gets along well <strong>with</strong> class members ________ _________ _________<br />
Follows school rules ________ _________ _________<br />
Requests help when necessary ________ _________ _________<br />
Exhibits appropriate school behaviors ________ _________ _________
SPECIAL EQUIPMENT<br />
Yes Sometimes No<br />
Brings equipment daily ________ _________ _________<br />
Equipment is functioning ________ _________ _________<br />
Uses devices <strong>with</strong>out prompting ________ _________ _________<br />
Allowances made <strong>for</strong> this student: (Circle all that are used)<br />
• Reduced drill activities<br />
• Taped materials<br />
• Copies <strong>with</strong> good contrast<br />
• Verbalize materials on the board<br />
• Student dictates answers<br />
• Extra time <strong>for</strong> completion<br />
This student’s level of participation at this time is:<br />
above average _____ average_____ poor_____<br />
Student is passing at this time: yes_____<br />
no_____<br />
Student grade average (if available)_____________________________________________<br />
GENERAL COMMENTS<br />
I need additional in<strong>for</strong>mation on the following
Change language