Parent Worksheet
Assistive Technology Planning Process
Child’s Name
Meeting Date
Case Manager
Grade
Meeting Location
Phone
Directions: Please answer the following questions regarding your child’s potential need for assistive technology
devices or services. As a parent and a member of the planning team, you have important information that can help in
making the right decisions about what your child needs to be successful in school. If you have any questions about the
Parent Worksheet, please contact the Case Manager indicated above.
Please bring this form with you to the planning meeting.
1. What are your child's strengths, interests, or motivators? Do you have a “success story” you
would like to share?
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2. What task (s) is your child currently unable to do, due to his disability?
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3. Do you have any suggestions for tools or strategies that could help your child be more
successful?
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4. Describe any assistive technology devices (simple or complex) used successfully by your child
in the home or school.
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5. What are your child’s feelings about using these devices?
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6. How successful do you think these devices have been?
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7. What other issues should be discussed at the planning meeting?
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Bismarck Public Schools-Special Education Department
Adapted from MN. Department of Children, Families & Learning (2000). Permission to use is granted if credit is maintained.