IEP PROGRESS REPORT – TEACHER INPUT REQUEST
PLEASE MAKE A COPY, UNDER “FILE,” USE THAT COPY FOR INPUT.
PRINT AND RETURN TO U12 OR “SHARE” INPUT AT
MOLLIQUEY@ESUHSD.ORG
STUDENT:
TEACHER:
GRADE:
1. How is the student performing in your classroom?
Classroom Observations
Academic Concerns
PLEASE CHECK ALL THAT APPLY.
____Contributes to class
_____Well organized
____Easily grasps ideas
____Has original ideas
____Completes assignments on time
____Puts forth good effort
____Cooperative
_____Shows leadership in group work
_____Does more work than required
_____Shows initiative
_____Uses time effectively
_____Does not ask for help
_____Poor organizational skills
____Difficulty communicating ideas/needs
_____Difficulty seeing board
_____Other______________________
COURSE:
Social Development
(Mark “S” for greatest strength and “W” for greatest weakness.)
____Lack of Participation in Class
_____Difficulty following directions
____Difficulty paying attention
_____Frequently forgets directions
_____Difficulty reading (vocabulary)
_____Difficulty writing (penmanship)
_____Difficulty writing (spelling/structure)
____Habitually unprepared for class
_____Careless work
____ Poor use of time
_____Late/missing assignments
_____Poor attendance
____Low/failing tests and/or quizzes
_____Excessive tardies
_____Tired/Drowsy in class
____Other:______________________
_____Self-confident
____Considerate
_____Shows leadership potential
___Cooperative
____Good sense of humor
____Well-liked by peers
____Works well in a group
____Prefers to work alone
_____Shy/introverted
_____Disrespectful
_____Uses foul language
_____Needs attention
____Very talkative
_____Disrupts class
_____Low self image
_____Other________________________
2. Which factors influence this student’s grade most? (Check all that apply)
____ homework performance
___ use of class time
___ class participation
___ test performance
___ peer interaction
___ respect for others
___ attendance/tardiness
_ other (specify):
_missing work he needs to
make up
3. I have used the following modifications with this student:
Classroom Testing
Accommodations/Modifications
Assignment
Accommodations/Modifications
Classroom Accommodations/Modifications
PLEASE CHECK ALL THAT APPLY
____Extended Time
_____Oral Testing (Read Aloud Test Items)
____Repeating Directions Verbatim
_____Use of Calculator
_____Modify grading scale
_____Use of dictionary/thesaurus
_____Modify Format
(multiple choice, short answer)
_____Abbreviated Concepts
_____Other______________________
_____Assignment Notebook
_____Abbreviated Assignments
_____Additional Time
____Study Guide
____Extra Grade Opportunities
(extra credit, re-do missed items)
_____Compacting/Acceleration
_____ Enrichment projects
Describe: _____________________
_____Other: _____________________
____Preferential Seating
____Provide Copies of Notes
____Peer Tutoring
_____Behavior/Performance Contracting
_____Highlighted Textbook
_____Readings on CD/tape
_____Quiet area in which to work
_____Other________________________
4. Do you have any specific concerns regarding the student? ___ Yes ___ No