Virginia Assistive Technology Assessment Checklist

Date
Completed / Process / Sample Forms
Consideration of AT
·  AT Consideration Guide completed by the IEP team / Virginia Assistive Technology Consideration Guide
Referral Process
·  IEP Team formulates referral question
·  Referral Form completed by IEP team / Virginia AT Referral Form
·  Parent Permission for AT assessment obtained
Information Gathering
·  Section 1 of Virginia AT Assessment Student Profile completed by AT assessment team lead / Virginia AT Assessment Student Profile
·  Inform AT assessment team, assign responsibilities, and set timeline
o  Collect and review information (consideration document, referral, section 1 of Student Profile, IEP)
o  Analyze task(s) that is/are difficult for the student as identified by the referral process
o  Assign AT team members with the expertise to assess the area of need for the task identified in the referral process
·  Complete appropriate assessment tools specific to identified area of need in a timely manner and within natural environment(s) / ASNAT manual (5th edition)
·  Parent Questionnaire / Parent Questionnaire
·  Student Questionnaire / Student Questionnaire
·  Environmental observation / Environmental Observation (WATI)

Virginia Department of Education (2011)

Decision Making Phase
·  Schedule AT team decision making meeting / Decision Making Guide
·  Review completed assessment documents to brainstorm AT solutions
·  Select potential solutions for trial(s) implementation
Trial(s) Implementation Phase
·  Develop a trial implementation plan including length of trial(s), solution to be trialed, data to be documented, training needed, and responsible parties / Trial Implementation Guide
·  Carry out trial(s) in customary environment
·  AT team reconvenes to review trial data, determine recommendations for the IEP team, and write final report
·  Completed report is sent to the IEP team in a timely manner / Evaluation Report Checklist

Virginia Department of Education (2011)