PROGRESS REVIEW Form 2
PERFORMANCE OBSERVATION FORM for Therapeutic Specialists
Teacher / Subject/GradeBuilding/Administrator / Date
Data Collected Through
- Formal Observation
- Informal Observations
- Input from Others
Observation #1 Observation #2 Observation #3
/ Unsatis-factory / Basic / Proficient / Distin-guished / Not Observed / Goal
DOMAIN 1: Planning and Preparation
1A.Demonstrating Knowledge and Skill in the Specialist Therapy Area; Holding Relevant Certificate or License
- Specialist demonstrates thorough knowledge and skill in therapy area.
- Therapist holds the appropriate certification or license.
1B.Establishing Goals for the Therapy Program Appropriate to the Setting and the Students Served
- Specialist’s goals for the therapy program are clear and appropriate to the situation in the school and to the age of the students.
1C.Demonstrating Knowledge of District, State and Federal regulations and Guidelines
- Specialist demonstrates thorough knowledge of special education laws and procedures.
1D.Demonstrating Knowledge of Resources both within and beyond the School and District
- Specialist displays thorough knowledge of resources for students available through the school and district as well as resources available within the community.
1E.Planning the Therapy Program, integrated with the Regular School Program to Meet the Needs of Individual Students
- Specialist’s plan is coherent and preventive and serves to support students individually within the broader educational program.
1F.Developing a Plan to Evaluate the TherapyProgram
- Specialist has a plan to evaluate the program organized around clear goals and the collection of evidence to determine effectiveness of the program and support continuous improvement.
DOMAIN 2: The Environment
2A.Establishing Rapport with students
- Specialist’s interactions with students are positive and respectful.
- Students appear comfortable in the testing and treatment center.
2B.Organizing Time Effectively
- Specialist exercises good judgment in setting priorities, resulting in clear schedules and work being accomplished in an efficient manner
2C.Establishing and Maintaining Clear Procedures for Referrals
- Procedures for all aspects of referral and testing protocols are clear to everyone involved in the process.
2D.Establishing Standards of Conduct in the Treatment Center
- Standards of conduct have been established in the testing and treatment center.
- Specialist’s monitoring of students is subtle and preventive.
2E.Organizing Physical Spacefor Assessing Students and Providing Therapy
- Testing and treatment center is well organized and inviting to students.
- Materials are available when needed.
Unsatis-
factory / Basic / Proficient / Distin-
guished / Not Observed / Goal
DOMAIN 3: Delivery of Service
3A.Responding to Referrals and Evaluating Student Needs
- Specialist is proactive in responding to referrals and makes thorough assessments of student needs.
3B.Developing and Implementing Treatment Plans to Maximize Students’ Success
- Specialist develops comprehensive plans for students that meet their needs and incorporate many related elements.
3C.Communicating with Families
- Specialist communicates with families and secures necessary permissions for evaluations and does so in a manner sensitive to cultural and linguistic traditions.
3D.Collecting Information; Writing Reports
- Specialist collects are pertinent information on which to base treatment plans
- Reports are accurate, clearly written, and appropriate to the audience.
3E.Demonstrating Flexibility and Responsiveness
- Specialist seeks to continually improve the treatment program based on needs as well as input from students, teachers, and parents.
DOMAIN 4: Professional Responsibilities
4A.Reflecting on Practice
- Specialist reflection is an accurate and objective description of practice citing specific positive and negative characteristics.
- Specialist has specific suggestions as to how the therapy program can be improved.
4B. Collaborating with Teachers and Administrators
- Specialist initiates contact with teachers and administrators to confer regarding individual students
4C.Maintaining an Effective Data Management System
- Specialist has developed an effective data management system for monitoring student progress and uses it to adjust treatment when needed.
4D.Participating in a Professional Community
- Specialist participates actively in school and district events and projects and maintains positive and productive relationships with colleagues.
4E.Engaging in Professional Development
- Specialist seeks out opportunities for professional development based on an individual assessment of need.
4F.Showing Professionalism
- Specialist displays high standards of honesty, integrity, and confidentiality in interactions with colleagues, students, and the community.
- Specialist advocates for students as needed.
Teacher Strengths:
Areas for Improvement:
Other Comments:
Employee signature indicates that they have read and received a copy of this form. Should the employee want to attach a response, they may do so.
Teacher Signature / Date / Administrator Signature / Date
Completion: / Minimum of three observations for probationary staff and one observation for continuing contract staff on high cycle prior to the end of the school year.
Original: / Attach to completed/signed Summative Evaluation Form and submit to Human Resources for inclusion in personnel file.
Copies: /
- Teacher
- Administrator
1 of 5August 2014