Division of Special Education Student Interview

Division of Special Education

Student Interview

Student Name: Referring Teacher:

Interviewer: Date:

What are the behaviors that get you in trouble for at school? 1. 2. 3.

During what classes, or at what times of the day, are you more likely to get in trouble for each of these behaviors? 1.

2.

3.

Are there classes or activities in which you do not have these problems?

What makes these classes/activities different?

What seems to set off the problem behaviors?

Class demands that are: 1. too hard 2. boring 3. unclear/confusing 4. long

Teacher reprimands Peer teasing Peer encouragement Other:

What usually happens after you engage in the problem behaviors?

Escape or avoid: Get attention

1. from peers 2. from teachers/adults Get activity or item:

Student Interview (Page 1 of 2)

FM-6665 Rev. (01-20)

What could be different so that you could be more successful in school?

Do you find your work to be either too hard or too easy for you? If so in which classes or activities do you find it to be too hard/easy for you?

What classes do you enjoy/not enjoy in school? Enjoy

Not Enjoy

What do you do when you need help in your classes? Do you feel like you get help when you need it?

Do you enjoy completing seatwork alone or in groups? Are you generally recognized for your good work in school? In what subjects/activities do you find your work to be interesting?

Are you easily distracted when completing class work?

What are your favorite activities, hobbies, or interests at school/during free time?

What activities would you like to participate in at school/during free time?

Student Interview (Page 2 of 2)

FM-6665 Rev. (01-20)

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