Newport News Public Schools rev. 8/2012

Assistive Technology Consideration Form

IEP/504 Committees

Student Name: Student #:

D.O.B./Age: Disability Category/Placement:

Teacher: School:

Step 1. What are the IEP/504 goals and objectives that the student is having difficulty with?

Not a Addressed Not a Addressed

Concern Below Concern Below

Communication (Verbal) / Reading
Composing written material / Learning/Studying/
Organizational
Computer access / Other
Math / Other
Mechanics of Writing / Other

Does the student have IEP goals or accommodations in the area of reading?

·  Does a student with a disability have difficulty reading print based material? Yes No

·  Has the IEP team tested the student to determine if they might benefit from print material in alternate formats (Large Print, Braille, Electronic Text, Audio)? Yes No

If Yes, student can be found eligible for Accessible Instructional Materials – See document on AT webpage: Qualifying Students for Accessible Instructional Materials through NIMAS

Step 2. 2a. Record current strategies or accommodations from Step 1. What are the current technologies used to complete the task (see list of instructional school based).

Task: / A.  How does the student currently complete the task – list special strategies/accommodations. Describe… / B.  What technologies are used to complete the task. Describe…
See list below (pg.2) of available school based technologies. / C.  Why are the current strategies and technologies not working?
E.g. Mechanics of Writing / E.g. Richie refuses to write. His handwriting is illegible. It takes him a long time to write a sentence. Longer time to write; given notes etc. / E.g. Desktop, MSWord; Inspiration – familiarity with the keyboard is noted. Typing is less frustrating.. / They are working. He could benefit from a word processor to start writing at his desk.
E.g. Reading / E.g. Richie is reading below grade level and has trouble decoding words. He concentrates on sounding out the words and loses the meaning of the passage. / E.g. No technologies have been tried.
E.g. {school based technologies like Kurzweil (Elementary) or Read/Write Gold (Middle and High School) need to be tried prior to referral for individual AT devices/services.} / Teacher reads to him – but he needs to be more independent.

Cont.

Task: / D.  How does the student currently complete the task – list special strategies/accommodations. Describe… / E.  What technologies are used to complete the task. Describe…
See list below (pg.2) of available school based technologies. / F.  Why are the current strategies and technologies not working?

List of school based technologies:

Microsoft Word, Powerpoint, Excel and Publisher

Kidpix

Inspiration/Kidspiration

Smartboard/Smart Notebook

Kurzweil/Read & Write (text to speech)

Internet Explorer (websites), Google Earth, Audacity, Skype

School Subscriptions: Tumblebooks, Worldbook, BrainPop

Desktops, laptops, digital cameras, and video cameras

Portable Word Processors

Other

2b. School based technologies are least restrictive and must be tried prior to the referral for assistive technology services. STOP- Trial appropriate instructional/school based technologies.

If the student is successful using school based technologies a referral for Assistive Technology devices and services does not need to be made. Implementation of school based technologies are supported by each school’s ITC. Assistive technology services can be utilized as a resource for the teacher in the implementation for students with special needs. Contact Donna Waldman for assistance. ()

Comments/Concerns of the IEP Team:

Additional Details:

Step 3:

Are the school based/instructional technologies meeting the need of the student?

o  Are the Technologies meeting the student’s needs? YES NO

3a. If YES: – no further consideration is needed. List the technologies under the accommodations section of the IEP/504 Plan and describe the current use in the Present level of Performance. Teachers can call the ATRC for additional support with the integration of technologies into their classroom for students with special needs.

3b. If NO – List the IEP/504 objectives that the assistive technology would address. What is the anticipated outcome of using the assistive technology in relation to the IEP objectives?

List IEP/504 Objectives:

Step 4: Conclusions:

No Assistive Technology/services are needed at this time because:

School based least restrictive accommodations and instructional technologies assistive technologies

need to be implemented.

Student is achieving toward IEP/504 goals.

Student’s academic performance indicates progress.

Student requires access to school based instructional technology as an accommodation.

Current AT devices/services are meeting the student’s needs. [ List AT devices/services under the

accommodations/modifications section of the IEP/504 plan. ]

AT consultation is needed [ send this entire form and the students current IEP to Donna Waldman, ATRC]

School based instructional technology is not meeting the needs of the student;

Consideration of AT indicates the need for technologies for, not available school based, academic

success or to achieve IEP/504 goals.

Staff requires support in implementation of AT solutions;

Student has a degenerative diagnosis or a condition which impacts access to the curriculum or in

attaining IEP/504 goals.

Student has changed: schools, classroom or categorical placement in which AT solutions need to be placed, contact ATRC, no referral is needed.

If an AT consultation is needed, send this complete AT Consideration Form, along with the student’s IEP to Donna Waldman, AT Coordinator, ATRC. Any questions please call 283-7862.

E-mail: .

IEP Team Signatures: Position/Title: Date

Denham, A. P., & Zabala, J. S., (1999). Assistive Technology Consideration Guide for IEP Teams. [Adapted from Georgia AT Project (GPAT), Wisconsin AT Initiative (WATI), Kentucky AT Guidelines, and the SETT Framework.

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