manual wheelchair power wheelchair self propels crutches/cane non propellor other (eg. crawls.) Hand Use Comment:: right hand left hand both (dominance & age appropriate impaired/delayed not functional function): Please rate student use with the following B = beginner SP = some proficiency P = proficient NA = not applicable B SP P NA B SP P NA B SP P NA regular keyboard regular pencil head pointer regular mouse adapted pencil grip hand switch joystick alternate keyboard head switch trackball (specify type) switches alternate Physical needs: writing samples attached scribing extended time reduced workload 2.3. Vision No Concerns Acuity low vision cortical visual impairment right eye Visual totally blind colour vision deficit left eye Impairment: visual field restrictions progressive both eyes Braille large print (preferred font size) Reading large print (lp) Medium: lp with speech support Braille: uncontracted contracted auditory only typing speed Optical Aids Used Student preferred magnification Ability: low vision clinic (include report) 2.4. Communication No Concerns Speech/Language: speaking articulation difficulties language difficulties non-speaking: communicates by (explain briefly below) sign language gesturing/pointing communication Picture Exchange Communication System simple speech output device (Big Mac) dedicated output communication device other (specify) What is the student’s primary mode of communication? 2.5. Social / Behavioural No Concerns Please Describe: peer interaction time on task / attention span work productivity impulsivity safety issues no concerns 2.6. Access to Curriculum (student snapshot) What barriers prevent this student from meeting reasonable educational goals? What non-technical and / or technical strategies have been investigated or put in place to overcome the barrier(s)? Please indicate and comment on the student’s willingness to use technology and on his / her technology preference.
manual wheelchair self propels non propellor power wheelchair crutches/cane other (eg. crawls.) Hand Use (dominance & function): right hand age appropriate left hand impaired/delayed both not functional Comment:: Please rate student use with the following B = beginner SP = some proficiency P = proficient NA = not applicable B SP P NA B SP P NA B SP P NA regular keyboard regular mouse joystick trackball regular pencil adapted pencil grip alternate keyboard (specify type) head pointer hand switch head switch switches alternate Physical needs: scribing extended time reduced workload writing samples attached 2.3. Vision No Concerns Visual Impairment: low vision totally blind visual field restrictions cortical visual impairment colour vision deficit progressive Acuity right eye left eye both eyes Reading Medium: Braille large print (lp) lp with speech support auditory only large print (preferred font size) Braille: uncontracted contracted Student Ability: typing speed Optical Aids Used low vision clinic (include report) preferred magnification 2.4. Communication No Concerns Speech/Language: speaking articulation difficulties language difficulties non-speaking: communicates by (explain briefly below) sign language gesturing/pointing communication Picture Exchange Communication System simple speech output device (Big Mac) dedicated output communication device other (specify) What is the student’s primary mode of communication? 2.5. Social / Behavioural No Concerns Please Describe: peer interaction time on task / attention span work productivity impulsivity safety issues no concerns 2.6. Access to Curriculum (student snapshot) What barriers prevent this student from meeting reasonable educational goals? What non-technical and / or technical strategies have been investigated or put in place to overcome the barrier(s)? Please indicate and comment on the student’s willingness to use technology and on his / her technology preference.
SEP-2nd-Level-Service-Package-Final-May15.docx