Form 210-17
Assistive Technology Team Meeting Template
Box 700, Rosetown, Sask., S0L 2V0
Phone: (306) 882-2677 Fax: (306) 882-3366
Toll Free: 1(866) 375-2677, www.sunwestsd.ca
Reference
AP 210 Services for Students with
Diverse Needs
Revised
August 1, 2013
Level
Division
Submit to
Superintendent of Education
(Student Support Services)
When
As Required
Student Name
Date
Birth Date (dd/mm/yyyy)
Age
Grade Placement
School Name
Parent/Guardian Names
Address
Phone Number
Cell Number
Team/Teachers
Determining the Need
(Review each area below, indicate any areas in which there are concerns and order from most to least need with the ability to function as
independently as possible in that area because of disabilities.)
Communication
Sensory
Speech sound production and use, receptive and expressive
language, voice, fluency, augmentative and alternative
communication
(Vision, hearing, sensitivity to/of touch)
Social Competence
Physical
Adaptive behaviors and social skills, which enable a child or
youth to meet environmental demands and to assume
responsibility for their own and other’s welfare.
(Health, motor abilities, seating, positioning)
Environmental Control
Recreation/Leisure
Ability to control events within the environment; Ability to
interact with others to influence actions of others.
Free time, maintenance of physical fitness, use of generic
community recreation facilities and resources and degree of
social involvement.
Academic Performance
Vocational Performance
Basic and content reading; Reading comprehension;
Mathematics calculation, reasoning and application; Written
expression; Oral expression; Listening comprehension;
Learning preference; learning style, strategies; Effect of the
disability on acquisition, development, mastery and
applications of academic skills.
General work behaviors; Following directions; Working
independently or with job supports; Job preferences or interests;
Dexterity; Abilities; Interpersonal relationships and socialization;
Related work skills.
Cognitive
Other
An appraisal of aptitude and mental processes by which an
individual applies knowledge, thinks and solves problems.
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Decision
Needs are currently being met, and goals are being addressed, without assistive technology. Assistive
Technology is not required at this time.
It is anticipated that adequate progress cannot be made without the support of Assistive Technology.
Assistive Technology is recommended by the team, and the team will explore the various options
available to meet the needs of the student.
Determining the Technology Device
Guiding questions to consider when choosing a device.
Has the student and the family been included in the AT process?
Have the attitudes of towards technology for student, family and school personnel been considered?
Does the student understand general concepts about computers?
Can the student access the device and the recommended applications?
Has the student’s motivation to use the device been considered?
(ie. Reinforcers and a plan to reduce the reinforcers will be developed)
Have the physical, cognitive, linguistic and time needed to use the device been considered?
What are the focus, goals and objectives of the program (please see needs on page 1)?
Will the device increase curriculum access or skills in the student’s next environment?
(ie. Next grade, work program, post-secondary, etc.)
Have environmental factors such as portability across settings, space and electrical outlets been
addressed?
Does the student have access to internet if the device is to be taken home?
What activities does the student enjoy?
What performance strengths and limitations should be considered and will be directly related to the use
of device?
What attempts will be made to reduce the stigma of the device, if necessary?
New or additional assistive Technology to address continuing barriers
Laptop
Android
iPad
Other
Responsible Parties
Potential software to accompany the hardware
Accessories required
(such as a protective case, stylus, carry case)
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Training with the Technology
All school personnel who will interact with the student’s device will receive training on device operation
and ways to incorporate the device into the student’s daily activities.
Student will be trained to use the device including rationale for use and basic device maintenance.
Student’s family members will be orientated to the device.
Who will be responsible for the training?
Notes and Timelines (after device arrives):
Evaluation of the Technology
On-going data will be collected to ensure that the device is meeting the needs of the student:
Type of data and responsibility________________________________________________
Follow up meeting with the group:
 Is the device meeting the needs that it was originally intended for?
 Is the device being used consistently? If not, what strategies can be used to increase the use?
 Can the device be used for additional purposes?
 Is further training required for the device for students, school personnel, parents?
Proposed Meeting Date: __________________________________
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