Summary Of The Student’s Academic
Achievement And Functional Performance (B)
Name
Date of Birth
NOTE: These accommodations have been documented on student's most recent IEP
Related to Support:
Response to Materials & Instruction
Check for understanding
Reduced/shortened tests/assignments/tasks:
Instructions/directions repeated/rephrased
Extended time on in-class assignments/tests:
Present one task at a time
Use of notes for tests/assignments
Preferential/assigned seating; explain:
Open book for tests/assignments
Use of assignment notebook or planner
Spelling errors will not impact grade when no opportunity for editing assistance and/or spell-check is available
Provided with progress reports
Special projects or alternate assignments in lieu of assignments given to non-disabled peers
Supervision during unstructured time
Use of a calculator
Cues/prompts/reminders of rules/procedures
Proof-reader and redo assignment or writing mechanics not graded
Offer choices
Other:
Note taking assistance
Access to computer on campus
Use of a scribe/word processing
Settings:
Use of a calculator
Access to study carrel for task/assignments/tests
Peer tutor/staff assistance in:
Free from visual distractions
Prior Behavior Support Plan (BSP)
Quiet environment - free from excessive noise
Home/job/school communication system; explain:
In a small group environment
Other:
Other:
Presentation of Materials & Instructions
Related to Health Concerns:
Books on tape and/or CD
Reminder to take medication(s)
Assignments/tests modified to address identified needs of learning styles:
Medication(s) given under supervision
Large print
Other:
Closed caption
English language development materials
Manipulative/study aids for:
Test questions/assignments - given orally
Tests/assignments directions - read orally
Tests/assignments - shorten
Questions on tests/assignments rephrased
Preview of tests/assignments
Tests/assignments given in smaller parts
Visual aids: flash cards, maps, posters, clues, etc.
Other:
Exit Summary Completed
Exit Summary Completed
by:
For additional information, please contact:
Name
Position
District
School
Telephone
Department
School District Phone Number
Student Signature
Date