Appendix A
Transition To Kindergarten for Children with Special Needs: Meeting Guide
*Appoint a recorder to complete this form and forward to team members involved if the family has given permission to do so.*
Date: Click here to enter a date.
Child’s Name: Click here to enter text. Child’s DOB: Click here to enter a date.
Parent(s) Name: / Click here to enter text. / Address: / Click here to enter text.Parent(s) Phone #: Click here to enter text.
Transitioning to School/Grade: Click here to enter text.
Diagnosis &/or Learning Needs: Click here to enter text.
Agency Involvement: ☐ Good Spirit School Division ☐ Christ the Teacher Catholic School Division
☐ Yorkton Nursery School ☐ Daycare Home/ Daycare Centre
☐ Sunrise Children’s Therapy (PT/OT/SLP/ECP/ASD)
☐ Parkland ECIP ☐ SPARC
☐ CNIB ☐ Alvin Buckwold Child Development Program
☐ Wascana Children’s Program ☐ Ministry of Social Services
☐ Family Support Program ☐ Yorkton KidsFirst Program
OTHER Click here to enter text.
Documentation/Reports Available: Click here to enter text.
Welcome & Introductions (Team Members in Attendance/Regrets)
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Background Information
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Strengths and Interests of Child
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Transportation
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Safety Concerns
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Adaptations/Specialized Equipment/Assistive Technology Needs
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Child Development Profile
Independence/Self Help Skills
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Complete tasks and follows instructions in a manner similar to same-age peers / Completes tasks and follows instructions with periodic assistance and supervision / Completes tasks and follows instructions with frequent assistance and supervision / Completes tasks with continuous assistance and supervision
Current level of performance:
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Possible Goals or Next Steps:
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Personal/Social wellbeing
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Generally demonstrates positive age-expected emotional health and social skills / Periodically benefits from support in developing age-expected emotional health and social skills / Frequently benefits from support in developing age-expected emotional health and social skills / Requires intensive support in developing age-expected emotional health and social skills
Current level of performance:
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Possible Goals or Next Steps:
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Communication
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Effectively expresses ideas, thoughts and needs at a level commensurate with peers / Periodically has difficulty understanding and/or expressing ideas, thoughts and needs; requires prompts and supports / Frequently has difficulty understanding and/or expressing ideas, thoughts and needs; requires prompts and supports / Benefits from intensive support to communicate basic needs and wants.
Current level of performance:
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Possible Goals or Next Steps:
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Health/Medical Needs/Personal Care
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐No health needs or medical condition is currently well-managed / Requires periodic monitoring and/or assistance with health and/or personal care needs / Requires frequent monitoring and/or assistance with health and/or personal care needs / Requires intensive monitoring and/or assistance with health and/or personal care needs
Current level of performance (include allergies & toileting):
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Possible Goals or Next Steps:
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Safety
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐No threat or harm to self or others / Requires periodic supervision to ensure no harm to self or others / Requires frequent supervision and prompting to ensure no harm to self or others / Requires intensive supervision and behavioral intervention to ensure no harm to self or others
Current level of performance:
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Possible Goals or Next Steps:
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Sensory
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Readily regulates sensory information presented in the environment / Periodically experiences difficulty regulating sensory information; Requires classroom based sensory intervention / Frequently experiences difficulty regulating sensory information; Requires individual programming and occasional monitoring / To regulate sensory information, student requires intensive, individual sensory programming with frequent monitoring
Current level of performance:
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Possible Goals or Next Steps:
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Motor Skills
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Does not require assistance for age-expected activities / Periodically requires assistance with certain motor activities / Frequently requires assistance with motor activities / Continuously requires assistance to complete tasks
Current level of performance:
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Possible Goals:
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Transition
Level 4 / ☐ / Level 3 / ☐ / Level 2 / ☐ / Level 1 / ☐Does not requiredassistance in transitioning / May require assistance with some activities during transitioning / Requires assistance frequently during transitioning / Requires continuous assistance during transitioning
Current level of performance:
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Possible Goals:
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Other Needs of Child (that have not already been addressed)
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Preferred Communication Between Home and School
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Parent Questions or Concerns
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Date of Next meeting (if required): Click here to enter a date.
Parent Signature ______
Team Leader Signature ______
Team Members Signatures ______
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