Present Levels of Academic Achievement and Functional Performance
Name
IEP Date
CST
ELA
Math
Science
History
Writing
CMA
ELA
Math
Science
Writing
CAPA
English/Language Arts
Mathematics
Science
CELDT
Listening
Speaking
Reading
Writing
Hearing Date
Hearing Date
Pass
Fail
Pass
Fail
Vision Date
Vision Date
Pass
Fail
Pass
Fail
Other Assessment Data
Other Assessment Data
(e.g., data from last triennal such as WJ, WIAT)
Preacademic/Academic/Functional Skills
Preacademic/Academic/Functional Skills
Communication Development
Communication Development
Gross Motor Development
Gross Motor Development
Fine Motor Development
Fine Motor Development
Social-Emotional/Behavioral
Social-Emotional/Behavioral
Health
Health
Health Care Plan
Yes
No
Yes
No
Pre-vocational/Vocational
Pre-vocational/Vocational
Adaptive/Daily Living Skills
Adaptive/Daily Living Skills
Areas of need to be addresed in goals for student to receive educational benefit
Areas of need to be addresed in goals for student to receive educational benefit