PRE-K ASSISTIVE TECHNOLOGY GUIDE

Student: / ID: / DOB: / Date of Entry: / Today’s date:
Teaching Team: / School: / Classroom Program:

CURRICULUM AND LEARNING ENVIRONMENT

1.  To what degree does the child remain engaged with materials presented during Small group?

Not at all / Rarely / Sometimes / Most of the time

2.  To what degree does the child remain engaged with materials presented during Large group?

Not at all / Rarely / Sometimes / Most of the time

3.  How does the student follow the class routine?

Independently / With consistent verbal cues / Class picture schedule
Individual picture schedule / Indiv. Schedule & verbal cues (Rarely) / Physical guidance (Not At All)

4.  To what degree is the child able to visually access classroom materials and activities?

Not at all / Rarely / Sometimes / Most of the time

SOCIAL OR EMOTIONAL BEHAVIOR

Pre-K classroom teachers have access to visual supports for calming/relaxation techniques and problem

solving strategies. They also have a “Safe Place” in their classroom. The Pre-K program utilizes Conscious

Discipline strategies and Positive Behavior Support practices to assist students with implementing successful

adult-child and child-child interactions.

1.  How often does the student remain in the area where activities are occurring?

Not at all / Rarely / Sometimes / Most of the time

2.  To what degree does the student acknowledge the presence of and interactions of others?

Not at all / Rarely / Sometimes / Most of the time

3.  The student is calm and is NOT aggressive or injurious to themselves or others.

Not at all / Rarely / Sometimes / Most of the time

4.  How likely is the student to initiate social interactions with adults and peers?

Not at all / Rarely / Sometimes / Most of the time

INDEPENDENT FUNCTIONING (GROSS MOTOR, FINE MOTOR, SELF HELP)

1.  Does the child have difficulty with safely & independently walking around the school environment?

No / Yes (Please describe):

2.  Does the student evidence any difficulties with using the computer?

No / Yes (Please describe):

3.  Does the student have difficulty with independently sitting at a table, on the floor, and/or in the lunchroom?

No / Yes (Please describe):

4.  Does the child exhibit physical or motor difficulties that impede their ability to use toys, manipulatives,

books and/or writing instruments? (i.e. clothing fasteners, paintbrushes, scissors, spoons, cups, pencils, etc.)

No / Yes (Please describe):

COMMUNICATION

1.  In what ways does the student typically communicate with adults peers? (Select 1 or 2.)

Points/pulls/guides a person / Uses mainly single words / Uses short sentences
Crying and/or shouting / Facial expressions / 2-3 word phrases
Points to pictures / Proximity (moving closer/farther away) / No words/approximations

2.  How well does the student understand and follow through on direction given to them?

Not at all / Rarely / Sometimes / Most of the time

3.  Will the student repeat words and/or phrases provided to them by an adult or peer?

Not at all / Rarely / Sometimes / Most of the time

4.  When the student desires an object (food, toy, etc.) will they use words, point to a picture or activate a speech generating device to indicate their request?

Yes / No (Please describe):

**Note: If the student has been diagnosed with apraxia, a genetic syndrome or any other neurological condition, please inform the Pre-K AT team. Rev. 6/27/16