June 2003
BILLINGS PUBLIC SCHOOLS
Evaluation Form
SPEECH/LANGUAGE PATHOLOGIST / SCHOOLPRE-CONFERENCE DATE / OBSERVATION DATE(S)
Overall Evaluation
(indicate one): / SATISFACTORY / UNSATISFACTORY
I. SPEECH/LANGUAGE THERAPY
/ SELECT SATISFACTORY OR UNSATISFACTORYA. Planning and Preparation / SatisfactoryUnsatisfactory
B. SLP/Student Relationships / SatisfactoryUnsatisfactory
C. Student Management / SatisfactoryUnsatisfactory
D. Instructional Time/Presentation / SatisfactoryUnsatisfactory
E. Evaluation/Reporting / SatisfactoryUnsatisfactory
F. Monitoring Student Performance / SatisfactoryUnsatisfactory
II. INTERPERSONAL/PROFESSIONAL RESPONSIBILITIES
A. Communicating with Families / SatisfactoryUnsatisfactoryB. Maintaining Accurate Records / SatisfactoryUnsatisfactory
C. Contributing to the School and the District / SatisfactoryUnsatisfactory
D. Showing Professionalism / SatisfactoryUnsatisfactory
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June 2003
III. SUMMARY:The following signatures indicate the data has been read and discussed.
______
LP’s Signature Date Administrator’s Signature Date
Copy: SLP
Administrator
SLP Personnel File
The SLP has the option of presenting a written rebuttal to the administrator within twenty working (20) days.
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June 2003
I. SPEECH/LANGUAGE THERAPY
A. Planning and Preparation
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Demonstrates knowledge of the normal development of communication skills / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Demonstrates knowledge of speech and language disorders/delays / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Individualizes a therapy plan specific to student’s communication needs / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Designs long term goals and short term objectives that are clear and measurable / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Determines clear objectives for each therapy session / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Utilizes or designs appropriate materials, resources, activities and techniques to accomplish objectives and motive students / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
B. SLP/Student Relationships
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Demonstrates the ability to gain respect and cooperation from students / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Demonstrates positive attitude and openness to students / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Personalizes the instructional program to accommodate student’s learning / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
C. Student Management
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Creates a stimulating, organized, and productive environment for learning / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Establishes procedures that elicit appropriate student responses during different types of activities / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Demonstrates the flexibility to adjust and personalize instruction (therapy) as needed for student success / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Maintains a disciplined environment by monitoring student behavior and stopping inappropriate behavior promptly and consistently, while maintaining the dignity of the student / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
D. Instructional Time/Presentation
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Demonstrates awareness of student skills, abilities, and learning styles / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Utilizes direct therapy time efficiently / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Provides activities which develop critical thinking and problem solving abilities / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Implements appropriate activities based on student’s age and needs / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
E. Evaluation/Reporting
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Conducts required screening in compliance with child find procedures / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Uses a variety of assessment tools appropriately / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Completes evaluations within a reasonable amount of time / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Writes reports clearly and concisely / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Develops and maintains appropriate records / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Communicates effectively during CST/IEP meetings, conferences, and other meetings / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
F. Monitoring Student Performance
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· Maintains appropriate data to measure and assess student progress / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· Meets deadlines for required paperwork and reports / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
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June 2003
II. Interpersonal/Professional Responsibilities
A. Communicating with Families
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· SLP participates in school activities and processes for parent communication / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP provides information to parents about the instructional, behavioral, and attendance program and the student’s progress on a regular basis / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP responds to parent concerns in a professional manner / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
B. Maintaining Accurate Records
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· SLP’s system for maintaining information on student completion of assignments, student progress, behavior, and attendance is effective / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
C. Contributing to the School and the District
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· SLP maintains professional working relationships with staff including supervisor / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP cooperates with colleagues to fulfill school required duties / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP participates in school events when assigned (e.g. Open House) / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP actively and constructively participates in and makes a contribution to school or district projects / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
D. Shows Professionalism
/ Select: Satisfactory, Growth Needed, Unsatisfactory, or Not Observed· SLP shows respect for students, parents, peers and administration by being punctual and prepared for class, work and meetings / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP shows respect for students, peers, parents and administration through his/her words and actions / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP participates in activities that will enhance his/her professional skills / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP addresses and/or reports student language, bullying, harassing, hostile, prejudicial or belittling statements and/or behaviors / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
· SLP follows the policies, regulations, and procedures of the school district / SatisfactoryGrowth NeededUnsatisfactoryNot Observed
Strengths:
Recommendations for Improvement and/or Professional Development:
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