Special Needs:
Learning Style and Behavioral Inventory for Students
Dear Parent,
At Coram Deo, we highly value your role in your child’s life as their first and primary educator and appreciate the expertise that you have in your child’s learning and behavioral style. In an effort to collect information to assist us in determining the best educational experience for your student, please complete the following questions with as much detail as you can provide. We will utilize this information in our meeting between parent, teacher, Special Needs Coordinator and administrator to create your student’s education plan.
The goals I have for my child’s development this coming year include (behavioral, social, academic, etc.):
Mychild has the following area(s) of interest:
My child can do these things independently:
My child needs assistance with:
My child is uncomfortable with or has an aversion to:
A trigger-point for a potential meltdown is when: (Please list all triggers that are common to your child)
When/if my child experiences a melt-down he/she calms when we:
What phrases do you use with your child that are effective in settling him/her when upset or frustrated?
Doing/seeing/experiencing this one thing is an important part of my child’s routine:
My child (circle one) does/does not enjoy music
My child seems most relaxed in settings (circle one) alone, with a few children, among many children
My child really loves:
My child is really picky about:
My child may be trying to communicate their need for(describe) ______when he/she exhibits the following behavior:
When I my child is off-task, I redirect them by:
How does your child respond in competitive situations?
How does your child respond to grading (possible poor grades) or constructive criticism of their work?
What type of school assignment or subject tends to bring the most difficulty or frustration for your child?
What type of school assignment or subject tends to elicit the most excitement and cooperation from your child?
What type of behavioral intervention do you typically use to redirect your child to correct behavior when making poor choices? What type of phrases do you use?
My child learns best through a visual, auditory or tactile-kinesthetic style? (Circle one and explain your observations)
What other information would you like us to know about your child that would help us to know him/her better and meet his/her needs?