SST SUMMARY FORM
STUDENT: ______Lorena Lopez______SCHOOL: _____ Clearwater ______TEAM: ___ “SST3” ____ DATE OF INITIAL SST: __ March 31, 2003 ___
PRIMARY LANGUAGE: ___ English ______GRADE: __ 7 ___ BIRTHDATE: ___ 1/25/85______PARENTS: ___ Navidad & Jorge Lopez ______
STRENGTHS / KNOWN / CONCERNS / QUESTIONS / STRATEGIES / ACTIONSInformation / Interventions / Prioritize / Brainstorm / (Prioritize) / Who / When
self directed
bold
perceptive
likes to help
social
charismatic
speaks his mind
Risk taker
Organized in oral presentation
Negotiator
Forgiving spirit
Likes animals
Career goals:
-fireman
-engineer
/
Family-
Lives with mom & two teenage siblingsSchool-
Attended OUSD (k-5th)SAUSD (6th)
Grades-
Soc. Studies-DEnglish-F
Math-D
PE-C
Health-
No chronic healthNormal birth
Physical 3 years ago / + math tutoring after school
+ counseling 1x per week
- Sat. school
- Detention
- Suspension 2x
- checking agenda with mom
_Change in schedule
-Moved seat in classroom.
-Tested MDA in 5th DNQ
?Has a 504 plan from OUSD for ADHD / 2
Academics: failing grades, risk for retention, unprepared for class 1
Verbal conflicts with staff and & disruptive behavior in/out of classroom
3
Conflicts at home with mother and siblings / Are problems at home affecting school performance?
Does current 504 plan need to be updated/changed?
Is he acting out because of academic frustration?
Is tutoring after school appropriate for this student?
Has the student ever been on medication for ADHD? / 1&2-Review 504 plan strategies and recommendations
1&3-Pull out for counseling during non-academic classes
1-Teach problem-solving skills
1-Be mobile in order to be frequently near student.
1-Redirect focus when off task, Send to “recovery” area in 8th gr. class
3- Parenting strategies for Mom / - Call OUSD, review 504 plan w/previous teacher
-Provide list of necessary class materials
-Teach problem solving skills
-Pull out for counseling/nonacid.
-Close proximity to student
-Redirection when off task
-volunteer as class helper/leader
-Parenting strategies
-Good communication btw home/school / Teacher/Counsel
Teacher
Teacher
TeacherCounsel
Teacher
Teacher
Teacher
Student
Counsel Parent
Teacher
Parent
Student /
By 4/15
By 4/30By 4/12
By 4/12
By 4/12
By 4/30
By 4/12
By 4/12
1. / Parent _____ Navidad Lopez______/ 5. / ______ Guilda Lowenstein ______/ / / ______ Teacher ______
2. / Student ______ Lorena Lopez ______/ 6. / ______ Mel Jurisch__ ______/ / / ______ ORC ______
3. / Administrator ______ Michelle Allen______/ 7. / ______ Belinda Guterrez ______/ / / ______
4. / Referring Teacher ______ Barney Scnorr ______/ 8. / ______ Nurse__ ______/ / / ______
OUSD SST_IdealExample