Dr. Cook #7
DAY 2
Friday, May 1, 2015
Criteria of Course Completion: All participants must sign-in in the morning and after lunch, attend the course, and participate
in group discussions, question and answer periods and complete this course evaluation form.
Self-Assessment of Learning
Date: May 1, 2015
2015 General & Special Education Conference-San Antonio
Course Title: Addressing Students’ Social, Emotional, And Behavioral Needs To Create The
Foundation For Academic Success: Tier 1 Within A Multi-Tiered System Of Supports By
Clayton R. Cook, PhD, University of Washington
Participant’s Name:_________________________________________________________________________
Check one:
___I am an educator
___ I am a school leader/supervisor
Circle the number that corresponds to the value with which you agree with the following statements.
(1 = strongly disagree, 2 = disagree, 3=neutral, 4 = Agree, 5 =strongly agree)
As a result of this course, I am better able to:
1. Describe the foundational ingredients to promoting students social, emotional, and academic success

1
2
(strongly disagree)
3
5

(strongly agree)
4
(neutral)
2. Describe how to begin to prepare to implement an integrated system of supports to prevent

1
(strongly disagree)
2
3
(neutral)
4
5 
(strongly agree)
3. Describe how to implement Intentional practices to establish, maintain, and restore positive relationships

1
(strongly disagree)
2
3
(neutral)
4
5

(strongly agree)
4. Describe how to develop a plan to implement Proactive Classroom Management Practices

1
(strongly disagree)
2
3
(neutral)
4
5

(strongly agree)
5. Explain how to organize a team to begin implementing or make refinements to School-wide Positive Behavioral
Interventions and Supports

1
(strongly disagree)
2
3
(neutral)
4
5

(strongly agree)
6. Explain the importance of adopting Social Emotional Learning (SEL) and Growth Mindset Curricula to promote
student well-being

1
(strongly disagree)
2
3
(neutral)
4
5

(strongly agree)
1
Dr. Cook #7
DAY 2
Friday, May 1, 2015
7. Describe why a progressive system of responding to problem behavior is a necessary ingredient to effective
schooling

1
(strongly disagree)
2
3
(neutral)
5

(strongly agree)
4
Overall Professional Development Survey Questions:
This course provided examples of how to improve assessment skills and/or how to analyze and use data for
instructional decision-making?

1
2
3
4
5

(poor)
(average)
(Excellent)
Information presented in this course will help me work more effectively with parents and team members/educators.

1
2
3
4
5

(poor)
(average)
(Excellent)
Information presented in this course was based on scientific research and/or evidence-based practices.

1
2
(poor)
3
4
(average)

5
(Excellent)
Overall Conference Rating
Only complete this section on the last day you are attending the conference and rate the overall
conference event.
Overall clarity of session objectives

1
2
(poor)
Effectiveness of presentation method by speakers

1
2
(poor)
Quality of oral presentations

1

1
2

1
2

1
2

1
2

1
(poor)
3
3
3
2
3
3
(average)

5

(Excellent)
4
5

(Excellent)
4

5
(Excellent)
4

5
(Excellent)
4
(average)
2
5
4
(average)
(poor)
Usefulness of subject matter presented
3

(Excellent)
(average)
(poor)
Organization of the event
4
(average)
(poor)
Quality of written/digital materials provided
3
5
(Excellent)
(average)
(poor)
Opportunity for interaction within the sessions
4
(average)
(poor)
Instructors' command of subject matter
3
(average)
5

(Excellent)
4
5

(Excellent)
What did you learn during this conference that will be useful in your practice/classroom/job?
List course topic suggestions and/or speakers recommendations for the 2016 Education Conference and how we
can improve this activity?
2