MS/HS Organizational & Independent Work Skills/Motor Skills Checklist
This checklist will assist staff in determining if a student meets Other Health Disabilities or Physically Impaired criteria. It may also serve as part of an educational evaluation/re-evaluation and provide classroom teachers information to help identify student needs in organizational independent work skills that may be seen with a variety of disabilities.
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Checklist Guidelines
The following guidelines are suggested when completing the worksheet. Please compare this student to typical peers in your class.

ALWAYS - Performance in skill area meets or exceeds classroom expectations. Student is independent.

OFTEN - Student needs occasional prompting, mostly independent.

SOMETIMES - Student needs prompting approximately half the time.

RARELY - Student needs frequent prompting, mostly dependent.

NEVER - Student is totally dependent.

Comments - Comments can be made whenever an area of concern is noted. Please note strengths when appropriate. Indicate N/O if not observed.

Thank you for your time and assistance.
Date *
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Worksheet completed by: *
Student Name: *
School *
Grade *
Curriculum *
Setting *
ORGANIZATION SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Follows daily class schedule
Uses and follows assignment book or planner
Organizes and studies course materials
Arrives to class/new activity with needed materials and supplies
Shifts from one classroom activity/setting to another within the allowed time
Does work during class time
Completes homework/turns in on time
Comments/Adaptations for Organizational Skills
WORK SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Understands assignment expectations
Listens and works without distractions
Begins and completes work/tests within time allowed
Turns in work on time
Completes multi-step, long-term projects
Obtains and completes makeup assignments when absent
Uses independent time appropriately
Participates actively in class discussions, group activities, projects
Advocates for self to clarify classroom requirements or meet personal needs
Comments/Adaptations for WORK SKILLS
MOTOR SKILLS *
ALWAYS
OFTEN
SOMETIMES
RARELY
NEVER
NOT OBSERVED
Moves through school environment in a safe and timely manner (including emergency evacuations)
Utilizes all school environments (i.e. lunch room, locker room, stage)
Participates in physical education class
Meets personal needs (eating, dressing, toileting) within the daily schedule
Produces written work (notes and assignments) that is legible and completed within time lines, without fatigue
Physically manages school materials and belongings in a timely manner
Organizes school materials, folders, locker
Comments/Adaptations for MOTOR SKILLS
Do you have any concerns regarding this student's behavior? *
Comments
Do you have any concerns regarding this student's attendance? *
Comments
Does this student get along socially with peers? *
Comments
Does this student's disability impact peer acceptance? *
Comments
What strengths does this student have? *
Accommodations/strategies that you routinely make for this student (mark all that apply): *
Required
Other accommodations/strategies you routinely make for this student.
What other issues or concerns do you have for this student?
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