Previous Page        Assistive Technology Consideration Checklist

 

Student:  ________________________________________
School:  _________________________________________

 

directions

1.     Complete the student information section below to provide information on the student's needs, abilities, and difficulties as well as environments and barriers to success.

2.     Please check (a) the instructional or access areas in Column A that are appropriate for the student.  Please leave blank any areas that are not relevant to the student.  Specify all relevant tasks (e.g. copying notes from board, responding to teacher questions, etc.) within each area in the space provided.  Check the settings in which the task is required:  GEC:  General Education Classroom  SEC: Special Education Classroom  COM:  Community   HOM: Home.

3.     In Column B, specify the standard classroom tools (low technology to high technology) used by the student to complete relevant tasks identified in Column A.  Place a check (a) in the boxes in Column B if the student is able to independently complete the tasks with standard classroom tools.  For areas in which the student can complete the tasks independently, it will not be necessary to complete Columns C-D.

4.     In Column C, specify the accommodations/modifications and assistive technology solutions that are currently being utilized.  Place a check (a) in the boxes in Column C if the student can adequately complete the tasks specified in Column A using the identified accommodations/modifications and assistive technology solutions.

5.     Complete Column D if the student can not adequately complete the task with accommodations/modifications and assistive technology solutions specified in column C.

 

Student needs, abilities, and difficulties:                                                                                                                                        
                                       
                                                                                                 
                                                                                                                                       
                                                                                                                                      
                                                                                                                                      
                                                                                                                                       
                                                             

 

Student environments:

___General Education Classroom (List all classes):                                                                                                                                        
                                                                                                                                     
                                                                                                                                 

___Special Education Classroom (List all classes):                                                                                                                                           
                                                                                                                                        
                                                                                                                                 

___Community (List all settings):                                                                                                                                
                                                                                                                              
                                                                                                                              
                                                  

___Home:                                                                                                                           
                                                                                            

Barriers to student performance and achievement:                                                                                                                                  
                                                                                                                                  
                                                                                                                                   
                                                                                                                                   
                                                                                                                            

 

 

A.  Instructional or Access Areas

 

B.  Independent with Standard Classroom Tools

C.  Completes Tasks with Accommodations/Modifications and/or Assistive Technology Solutions Currently in Place

D. Additional Solutions/Services Needed Including
Assistive Technology

Accommodations/ Modifications

Assistive Technology Solutions

  Writing

 

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

This document was developed by the Georgia Project for Assistive Technology (528 Forest Parkway   Suite C   Forest Park, GA  30297).  Permission to photocopy is granted for non-commercial purposes if this credit is retained.

 



 

A.  Instructional or Access Areas

 

B.  Independent with Standard Classroom Tools

C.  Completes Tasks with Accommodations/Modifications and/or Assistive Technology Solutions Currently in Place

 

D. Additional Solutions/Services Needed Including
Assistive Technology

 

 

Accommodations/ Modifications

Assistive Technology Solutions

 

  Spelling

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

  Reading

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

  Math

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

  Study/Organizational Skills

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

  Listening

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

This document was developed by the Georgia Project for Assistive Technology (528 Forest Parkway   Suite C   Forest Park, GA  30297).  Permission to photocopy is granted for non-commercial purposes if this credit is retained.
 

 


 

A.  Instructional or Access Areas

 

B.  Independent with Standard Classroom Tools

C.  Completes Tasks with Accommodations/Modifications and/or Assistive Technology Solutions Currently in Place

 

D. Additional Solutions/Services Needed Including
Assistive Technology

 

 

Accommodations/ Modifications

Assistive Technology Solutions

 

 Oral Communication

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

 Aids to Daily Living

 

 

 

 

GEC 

SEC 

COM 

HOM

 

Recreation and Leisure

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

 Pre-vocational/Vocational

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

 Seating, Positioning, and
      Mobility

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

 

 

 

 

This document was developed by the Georgia Project for Assistive Technology (528 Forest Parkway   Suite C   Forest Park, GA  30297).  Permission to photocopy is granted for non-commercial purposes if this credit is retained.

 

 


 

A.  Instructional or Access Areas

 

B.  Independent with Standard Classroom Tools

C.  Completes Tasks with Accommodations/Modifications and/or Assistive Technology Solutions Currently in Place

 

D. Additional Solutions/Services Needed Including
Assistive Technology

 

 

Accommodations/ Modifications

Assistive Technology Solutions

 

 Other   Specify:

 

 

 

 

 

 

 

GEC 

SEC 

COM 

HOM

 

 

Consideration Outcomes:

 

_____ Student independently accomplishes tasks in all instructional areas using standard classroom tools.  No assistive technology is required.

_____ Student accomplishes tasks in all instructional areas with accommodations and modifications.  No assistive technology is required.

_____ Student accomplishes tasks in all instructional areas with currently available assistive technology.  Assistive technology is required.

_____ Student does not accomplish tasks in all instructional access areas.  Additional solutions including assistive technology may be required.

 

Specify any assistive technology services required by this student.

                                                                                                                                                                                    ___                                                                                                                                                                                                                                                           

 

 

 

 

Consideration Checklist Completed by:                                        Position:                                                          Date:
                                                                                                                                                                                                                       
                                                                       
                                                                                                                                               
                                                                                                                                                                                                                       
                                                                       
                                                                                                                                               

 

 

This document was developed by the Georgia Project for Assistive Technology (528 Forest Parkway   Suite C   Forest Park, GA  30297).  Permission to photocopy is granted for non-commercial purposes if this credit is retained.

 

revised 09/27/00