IEP Teacher Input Form (Model)
Thank you for providing your input about this student.
EXECUTIVE FUNCTIONING SKILLS
The student arrives to class on time.
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The student brings required materials to class (i.e., pencil, binders, textbooks, etc.).
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The student submits assignments on time.
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The student organizes materials effectively (binders/folders include only necessary papers, and are arranged so that the student can quickly locate what is needed).
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The student speaks appropriately in class (no blurting out or disrupting).
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The student works hard and stays focused in class.
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The student demonstrates the ability to access grades online (PowerSchool) and identify missing assignments.
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The student effectively self-advocates and asks for help if needed (email or in person)?
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The student demonstrates the ability to track reminders, assignments, and goals with their IASD planner (or online app).
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The student completes all work currently due without complaining before engaging in other “free time” activities (YouTube, music, visiting, etc.)?
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STRENGTHS & NEEDS
Please describe the student's content-specific STRENGTHS in your class (i.e., Eric has demonstrated mastery in solving one-step equations by scoring 95% on a recent assessment.)
Please describe the student's content-specific NEEDS in your class (i.e., Eric needs additional instruction in finding main idea. When asked questions pertaining to main idea, Eric answered with 40% accuracy).
What adaptations or strategies have you found most effective in supporting this student in your class?
BEHAVIORS
List any behaviors of concern with specific, observable descriptions.   See tiny.cc/inputexamples
Emotional Intelligence
OPTIONAL: If you have observed the student demonstrating one of these qualities, please give a brief description: 1) showing kindness to others; 2) expressing gratitude; 3) talking about emotions in a healthy way; 4) showing perseverance or shifting strategies when facing a difficult task.
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