Assistive Technology Assessment Form - DOC by wqu11468


Assistive Technology Assessment Form document sample

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									                                      Virginia Assistive Technology Assessment Checklist

Date         Process                                                                             Links to Sample Forms*
                    Consideration of AT
                          AT Consideration Guide completed by the IEP team                      Virginia Assistive Technology
                                                                                                 Consideration Guide

                    Referral Process
                           Referral Form completed by IEP team                                  AT referral form (Virginia)
                           Home/School Questionnaire                                            Parent Worksheet AT Planning
                                                                                                 Process (Minnesota)
                              Background Information Form                                       Referral Background Information
                                                                                                 AT Background Information (GPAT);
                                                                                                 Student Profile (Montgomery County

                              Parent Permission for AT assessment obtained (to include          Referral-Parent Permission for AT
                               video/photo)                                                      Assessment (Virginia);
                                                                                                 Referral-Parent Permission to
                                                                                                 Photograph/Video (Virginia)

                    AT Assessment
                          Identify team members and meet
                          Collect and review information (consideration document,
                            referral, IEP)
                          Analyze task(s) that is/are difficult for the student as identified   Student, Environment and Tasks
                            by the referral process                                              Worksheet;
                                                                                                 Student Worksheet;
                                                                                                 Accessible Technology Assessment:
                                                                                                 SETT (Montgomery County MD)

                             Assign AT team members with the expertise to assess the
                              area of need for the task identified in the referral process
     Virginia Department of Education (2008)
                        Complete appropriate assessment tools specific to identified
                         area of need in a timely manner and within natural
                             o Informal observations

                                         Student observation                           Louisiana AT Screening Checklist
                                                                                        for Use in Educational Programming
                                         Environmental observation                     Environmental Observation Guide
                             o Task specific assessment                                 WATI Assessment Package;
                                                                                        Augmentative Communication
                                                                                        Evaluation (GPAT);
                                                                                        Learning Aids Evaluation-Math
                                                                                        Learning Aids Evaluation-Reading
                                                                                         Learning Aids Evaluation-Writing &
                                                                                        Spelling (GPAT);
                                                                                         Computer Access Evaluation
                                                                                         Vision Aids Evaluation (GPAT)
                  Schedule AT team decision making meeting
                  Review completed assessment documents to brainstorm AT               WATI AT Assessment Technology
                   solutions to meet the task needs identified                          Checklist;
                                                                                        AT Checklist (Minnesota);
                                                                                        List of Possible AT

                        Select potential solutions for trial implementation            Methods and Materials to Support
                                                                                        Reading (Montgomery County, MD);
                                                                                        Methods and Materials to Support
                                                                                        Math (Montgomery County, MD);
                                                                                        Methods and Materials to Support
                                                                                        Writing (Montgomery County, MD);
                                                                                        Methods and Materials to Support
                                                                                        Spelling (Montgomery County, MD);

Virginia Department of Education (2008)
                                                                                                        Methods an Materials to Support
                                                                                                        Handwriting and Keyboarding
                                                                                                        (Montgomery County, MD);
                                                                                                        Methods and Materials to Support
                                                                                                        Learning and Studying (Montgomery
                                                                                                        County, MD);
                                                                                                        Academic and Learning Aids
                                                                                                        Assessment Toolkit (GPAT);
                                                                                                        Vision Assessment Toolkit (GPAT);
                                                                                                        Augmentative and Alternative
                                                                                                        Communication Evaluation Toolkit
                                                                                                        Computer Access Assessment
                                                                                                        Toolkit (GPAT)

                            Complete Trial Implementation Plan including implementation                Planning and Implementation
                             schedule, assignment of roles and responsibilities of team                 Summary (Minnesota)
                             members                                                                    Trial Implementation (University of
                                                                                                        Assistive Technology
                                                                                                        Implementation Plan (NATRI)
                                                                                                        AT Trial Use Guide (WATI)
                                                                                                        Accessible Technology Trial Period
                                                                                                        Plan (Montgomery County, MD)
                                                                                                        AT Extended Assessment Form
                                                                                                        (Bowser & Reed)
                                                                                                        Written Productivity Profile
                                                                                                        (Montgomery County, MD)
                            Carry out trial in customary environment

                            AT team reconvenes to review trial data, determine                         Assistive Technology Evaluation
                             recommendations for the IEP team, and write final report                   Report Checklist (Minnesota)
                            Completed report is sent to the IEP team in a timely manner

*These sample forms were developed by other states and assistive technology programs. It is not an exhaustive lis t. These forms are available
for use by your program or can be customized and adapt ed to meet your own needs.

Virginia Department of Education (2008)

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