Due to the identified Visual Impairment, the student needs specially designed instruction. STEP 4. True List and/or describe: False Observation Form Name: School: Student ID: D.O.B.: Age: Grade: The purpose of this evaluation is to provide information regarding this classroom performance and behaviors in the area(s) of difficulty. student’s Observe the student and provide the requested information. Attach additional sheet if necessary. End time of Observation: Date of Observation: Start Time of Observation: Setting of Observation: # of Students in Setting: # of Adults in Setting: Describe the lesson/activities of the class during this observation session (e.g., lecture, discussion, independent seatwork, small group work) and the observed student level of participation and engagement. Include any special supports or conditions during this observation (e.g., student seated away from group, uses interpreter): Identify any instructional strategies and/or behavior supports used during the instruction wait time repetition visual supports graphic organizers rephrasing manipulatives positive reinforcement re-direction teacher proximity other__________________________________________ Describe the reaction to instructional strategy(ies) and/or the behavior supports provided: student’s Describe the behavior during the observation session and how the behavior compares to that of other students in the class at student’s the same time: Describe the academic performance during the observation session and how the performance compares to that of other student’s students in the class at the same time: Summary of additional comments or concerns:
STEP 4. True False Due to the identified Visual Impairment, the student needs specially designed instruction. List and/or describe: Observation Form Name: School: Student ID: D.O.B.: Age: Grade: The purpose of this evaluation is to provide information regarding this student’s classroom performance and behaviors in the area(s) of difficulty. Observe the student and provide the requested information. Attach additional sheet if necessary. Date of Observation: Start Time of Observation: End time of Observation: Setting of Observation: # of Students in Setting: # of Adults in Setting: Describe the lesson/activities of the class during this observation session (e.g., lecture, discussion, independent seatwork, small group work) and the observed student level of participation and engagement. Include any special supports or conditions during this observation (e.g., student seated away from group, uses interpreter): Identify any instructional strategies and/or behavior supports used during the instruction wait time repetition visual supports graphic organizers rephrasing manipulatives positive reinforcement re-direction teacher proximity other__________________________________________ Describe the student’s reaction to instructional strategy(ies) and/or the behavior supports provided: Describe the student’s behavior during the observation session and how the behavior compares to that of other students in the class at the same time: Describe the student’s academic performance during the observation session and how the performance compares to that of other students in the class at the same time: Summary of additional comments or concerns:
guidance_evaluation_eligibility_appendix_a.docx