Summary of Performance
NORDONIA HILLS CITY SCHOOLS
Summary of Performance
Student Name Birth Date Date Completed:
Attending School Case Manager/Teacher
Anticipated Exit Date (mm/yy)
Summary of Student’s Academic Achievement
Summary of Student's Functional Performance
Student’s Post-secondary Goals:
Recommendation to Assist Student in Meeting Post-secondary Goals:
District Rep. Special Ed. Teacher
Parent Signature Regular Teacher
Student Signature Other
This form is used to:
1. Comply with the new requirement for a “Summary of Performance” in IDEA 2004, Sec. 614(c)(5)(B)(ii).
a. Provides information to students who are graduating with a regular diploma to assist them in meeting their post-secondary goals; and
b. Provides information to students who are leaving school because they exceed the age of eligibility for a free appropriate public education (end of school year in which they turn 21) to assist them in meeting their post-secondary goals.
2. IDEA 2004 does not explicitly require a Summary of Performance for students who are leaving school before the end of their entitlement period due to graduation with a modified diploma or another diploma or certificate. ODE recommends that school districts provide a Summary of Performance for these students also.
Directions:
1. Enter student’s name and birth date.
2. Enter attending school and name of case manager.
3. Enter anticipated exit date. The exit date should be the same as the exit date information on the student’s IEP.
4. Write a summary of the student’s academic achievement and functional performance. This statement may include:
• How the student’s disability has affected the student’s academic achievement and functional performance;
The student’s academic and functional strengths; what they can do that is measurable. (i.e. Student can tell time to the quarter hour. Student can add 2 digit numbers but not 3 digit numbers. Etc.)
• The results of the student’s most recent state or district assessments;
The results of any college entrance examinations (e.g. SAT, ACT);
• The results of the most recent special education evaluation of the student (testing with accommodating alternate assessment – explanation needed, not just scores.
• A description of any other document (i.e. career passport) or awards the student earned in high school.
Any honors or special awards the student achieved in high school; and
Any career-technical or extracurricular accomplishments of the student.
5. List the student’s post-secondary goals.
6. Write any recommendations for accommodating the student’s disability in the workplace or post-secondary education setting; and
• Recommendations for accommodating the student’s disability in the workplace or post-secondary education setting; and
• Recommendations for assisting the student to achieve the student’s post-secondary goals(s).
7. Enter name and title of teacher or provider completing summary, the name of the school and school district, and a contact phone number for the teacher or provider, and the date of completion of this document.
SUMMARY OF PERFORMANCE: STUDENT PERSPECTIVE
A. How does your disability affect your schoolwork and school activities (such as grades, relationships, assignments, projects, communication, time on tests, mobility, extra-curricular activities)?
( I sometimes take extra time to finish assignments, test and projects.
( I sometimes find regular class texts hard to read.
( I sometimes feel the pace of a regular class moves too quickly.
( I participate in one or more organized school sports.
( I find it easier to earn good grades in smaller, individualized classes.
( My disability does not affect my school relationships/friendships.
B. In the past, what supports have been tried by teachers, parents, or by you to help you succeed in school (aids, adaptive equipment, physical accommodations, other services)?
|Adjusted grade scale 1 |Alpha smart 2 |Alternative materials 3 |
|Assignments/projects shortened |Assistance with class scheduling through special |Big Mac 6 |
|4 |needs/guidance 5 | |
|Braille 7 |Cloze notes 8 |Computer 9 |
|Copy notes/overhead 10 |Extra time 11 |Going to tutors for tests to be read aloud 12 |
|Hearing aid(s) 13 |Individualized instruction 14 |Interpreter 15 |
|Math facts/equations 16 |Modified make-up work 17 |Oral responses 18 |
|Parent tutoring 19 |Recorded books 20 |Scribe 21 |
|Sign language 22 |Smaller/special needs classes 23 |Sound amplification 24 |
|Study guide 25 |Tech Ed Program 26 |Tests or quizzes with fewer concepts 27 |
|Use of calculator 28 |Work Study Program 29 | |
|Other: 30 | | |
|Other: 31 |
C. Which of these accommodations and supports has worked best for you?
Above #s ________________________________________
D. Which of these accommodations and supports has not worked?
( N/A All accommodations/supports worked.
( Numbers _________________were not helpful.
E. What strengths and needs should professionals know about you as you enter the college or work environment?
( I work hard and want to learn new skills. ( I enjoy working with others
( I prefer to work independently. ( I’m a good cook.
( I enjoy working with my hands. ( I am shy.
( I talk easily with others. ( I feel comfortable working on a computer.
( I am creative/artistic ( I enjoy writing activities.
( I enjoy reading activities. ( I’d find it helpful to have textbooks taped.
( I’d like a peer tutor. ( I’d like a mentor on the job.
Student Signature Date
SUMMARY OF PERFORMANCE: TEACHER PERSPECTIVE
A. How does the student's disability affect his/her schoolwork and school activities (such as grades, relationships, assignments, projects, communication, time on tests, mobility, extra-curricular activities)?
( Sometimes take extra time to finish assignments, test and projects.
( Sometimes find regular class texts hard to read.
( Sometimes feel the pace of a regular class moves too quickly.
( Participate in one or more organized school sports.
( Find it easier to earn good grades in smaller, individualized classes.
( Disability does not affect school relationships/friendships.
B. In the past, what supports have been tried by you or other teachers and support staff to help the student succeed in school (aids, adaptive equipment, physical accommodations, other services)?
|Adjusted grade scale 1 |Alpha smart 2 |Alternative materials 3 |
|Assignments/projects shortened |Assistance with class scheduling through special |Big Mac 6 |
|4 |needs/guidance 5 | |
|Braille 7 |Cloze notes 8 |Computer 9 |
|Copy notes/overhead 10 |Extra time 11 |Going to tutors for tests to be read aloud 12 |
|Hearing aid(s) 13 |Individualized instruction 14 |Interpreter 15 |
|Math facts/equations 16 |Modified make-up work 17 |Oral responses 18 |
|Parent tutoring 19 |Recorded books 20 |Scribe 21 |
|Sign language 22 |Smaller/special needs classes 23 |Sound amplification 24 |
|Study guide 25 |Tech Ed Program 26 |Tests or quizzes with fewer concepts 27 |
|Use of calculator 28 |Work Study Program 29 | |
|Other: 30 | | |
|Other: 31 |
C. Which of these accommodations and supports has worked best for the student?
Above #s ________________________________________
D. Which of these accommodations and supports has not worked?
( N/A All accommodations/supports worked.
( Numbers _________________were not helpful.
E. What strengths and needs should professionals know about the student as they enter the
college or work environment?
( Works hard and wants to learn new skills. ( Enjoys working with others
( Prefers to work independently. ( Is a good cook.
( Enjoys working with my hands. ( Is shy.
( Talks easily with others. ( Feels comfortable working on a computer.
( Is creative/artistic ( Enjoys writing activities.
( Enjoys reading activities. ( Finds it helpful to have textbooks taped.
( Likes a peer tutor. ( Like a mentor on the job.
Teacher Signature Date
SUMMARY OF PERFORMANCE: PARENT PERSPECTIVE
A. How does the student's disability affect his/her schoolwork and school activities (such as grades, relationships, assignments, projects, communication, time on tests, mobility, extra-curricular activities)?
( Sometimes take extra time to finish assignments, test and projects.
( Sometimes find regular class texts hard to read.
( Sometimes feel the pace of a regular class moves too quickly.
( Participate in one or more organized school sports.
( Find it easier to earn good grades in smaller, individualized classes.
( Disability does not affect school relationships/friendships.
B. In the past, what supports have been tried by you or other teachers and support staff to help the student succeed in school (aids, adaptive equipment, physical accommodations, other services)?
|Adjusted grade scale 1 |Alpha smart 2 |Alternative materials 3 |
|Assignments/projects shortened |Assistance with class scheduling through special |Big Mac 6 |
|4 |needs/guidance 5 | |
|Braille 7 |Cloze notes 8 |Computer 9 |
|Copy notes/overhead 10 |Extra time 11 |Going to tutors for tests to be read aloud 12 |
|Hearing aid(s) 13 |Individualized instruction 14 |Interpreter 15 |
|Math facts/equations 16 |Modified make-up work 17 |Oral responses 18 |
|Parent tutoring 19 |Recorded books 20 |Scribe 21 |
|Sign language 22 |Smaller/special needs classes 23 |Sound amplification 24 |
|Study guide 25 |Tech Ed Program 26 |Tests or quizzes with fewer concepts 27 |
|Use of calculator 28 |Work Study Program 29 | |
|Other: 30 | | |
|Other: 31 |
C. Which of these accommodations and supports has worked best for the student?
Above #s ________________________________________
D. Which of these accommodations and supports has not worked?
( N/A All accommodations/supports worked.
( Numbers _________________were not helpful.
E. What strengths and needs should professionals know about the student as they enter the
college or work environment?
( Works hard and wants to learn new skills. ( Enjoys working with others
( Prefers to work independently. ( Is a good cook.
( Enjoys working with my hands. ( Is shy.
( Talks easily with others. ( Feels comfortable working on a computer.
( Is creative/artistic ( Enjoys writing activities.
( Enjoys reading activities. ( Finds it helpful to have textbooks taped.
( Likes a peer tutor. ( Like a mentor on the job.
Parent Signature Date
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- cms manual system
- methodology for calculating the national average drug
- calculator policy test act
- us
- provider led arkansas shared savings entity passe
- summary of performance
- individual nongrandfathered health plan pool rate filing
- pdr september 2008 release cisco
- department of energy
- cahps hospital survey hcahps cms
Related searches
- summary of history of philosophy
- summary of starbucks
- summary of 13 reasons why
- summary of max weber theory
- starbucks summary of the company
- brief summary of photosynthesis
- max weber summary of ideas
- summary of books of the bible pdf
- example of summary of an article
- summary of each chapter of huckleberry finn
- summary of life of jesus
- summary of the declaration of independence