diocese of columbus academic support plan · academic support plan —statewide achievement and...
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Diocese of Columbus Academic Support Plan
Student: Effective Dates: to
Psychological Evaluation on file School:
Date of Evaluation: Diagnosis:
Educational Support Student Expectations
Educational Accommodations 1.
see page to
Statewide Achievement and Diocesan Testing Accommodations
see page to 2.
Supplemental Goals and Objectives
see page to
Academic/Organizational Support 3.
Total minutes/week
Speech and Language Services*
Total minutes/week 4.
*If checked, student on Service Plan. EMIS #
Other (Please Specify):
5.
Parental Support
1.
6.
2.
7.
3.
PAGE 1A of Adopted 8/2013 Revised
Diocese of Columbus Academic Support Plan
Student: Effective Dates: to
Psychological Evaluation on file School:
Date of Evaluation: Diagnosis:
PAGE 1B of Adopted 8/2013 Revised
Staff responsible for writing /implementing the plan: (Signature required)
Principal’s signature:
I have had the opportunity to participate in the development of my child’s academic support plan.
Parent/Guardian’s signature: Date:
Home/cell: Work:
Parent/Guardian’s signature: Date:
Home/cell: Work:
Student’s signature: Date:
(Cont'd)
Student: Effective Dates: to
Diocese of Columbus Academic Support Plan —Educational Accommodations
PAGE of
Adopted 8/2013
Revised:
Environment
Lesson Presentation
Classroom Testing
Organization
Preferential seating
Seating near a role model/buddy
Consistent classroom routine
Limit distraction stimuli
Student work area free of unnecessary materials
Cueing (verbal, gesture, physical prompt) to stay on task
Other:
Study Guide prior to start of unit
Overview of lesson before presentation
Provide copies of notes or peer note taker
Provide auditor and visual directions and information
Multi-modality and multi-activity based lessons
Presentations broken into shorter segments
Student oral review of key points
Small group instruction when possible
Other:
Open Book/note exams
Essay questions in advance
Extended time for testing in __________________________________________________
Flexible scheduling for exams
Frequent short quizzes vs. long exams
Reading and clarification of test questions
Use of calculator or math charts
Use of spell checker
Provide word banks
Reading guides of filters to cover parts of test
Small group testing when appropriate
Other:
Providing peer assistance with organizational skills
Help student organize binder, notebooks, and /or folders
Daily assignments given orally and/or in writing
Daily teacher check of assignment book
Daily/weekly progress reports
Other:
PAGE of
Adopted 8/2013
Revised:
Student: Effective Dates: to
Diocese of Columbus Academic Support Plan —Educational Accommodations (Cont’d)
Praising specific behaviors
Ignoring minor inappropriate behaviors
Supervise use of self-monitoring strategies
Allowing for short breaks and time out of seat
Concise and clear classroom rules
Behavior modification plan
Other:
Assignments/Classwork Behavior, Motivation, Attention
Extended time for visual procession tasks
Extended time to complete assignments
Reduced workload by __________%
Extra set of textbooks/e-books for home
Allow use of scribe/assistive technology
Long term assignment rubrics and written directions
Provide visual editing checklists
Other:
**Document ALL measurable Goals on Supplemental Goals and Objectives pages.
Student: Effective Dates: to
Diocese of Columbus Academic Support Plan —Statewide Achievement and
Diocesan Testing Accommodations
PAGE of
Adopted 8/2013
Revised:
Testing Accommodations may only be used for students with a documented disability. To be considered current the date of the evaluation must be within the last three years.
Date of Evaluation: Diagnosis:
Name & Credentials of Evaluator(s):
For each subject tested in the child’s grade, choose with or without accommodations. If “with accom-modations” is chosen, provide a description of the accommodations for each subject. Consult the Stu-dent Inclusion Manual (section 6: Accommodations & Modifications or section 8: Regulations & Policies) for allowances.
Area Grade Tested Accommodations
Reading With Accommodations
Without Accommodations
Writing With Accommodations
Without Accommodations
Math With Accommodations
Without Accommodations
Science With Accommodations
Without Accommodations
Social Studies With Accommodations
Without Accommodations
Other With Accommodations
Without Accommodations
Student: Effective Dates: to
Diocese of Columbus Academic Support Plan —Supplemental Goals and Objectives
PAGE of
Adopted 8/2013
Revised:
(One page for each goal) **Include this page only if the student has measurable goals and objectives
Area of Need:
Goal: Staff Responsible:
Objectives:
Interventions:
Methods of Evaluation:
**Progress will be reported quarterly
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