SHASTA SELPA
SUMMARY OF THE STUDENT’S ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE
Student Name_____________________
Date of Birth ___/___/________
Summary Date ___/___/________
Note: These accommodations have been documented on the IEP date ___/___/______
Recommendations Of Accommodations, Supports And Resources
Related To Support
Response to Materials & Instruction
Check for understanding
Reduced/shortened tests/assignments/tasks
Instructions/directions repeated/rephrased
_________________________________________________
Present one task at a time
Extended time on in-class assignments/tests
Preferential/assigned seating; explain
_________________________________________________
____________________________________________
Use of notes for tests/assignments
Use of assignment notebook or planner
Open book for tests/assignments
Provided with progress reports
Spelling errors will not impact grade when no opportunity
Supervision during unstructured time
for editing assistance and/or spell-check is available
Cues/prompts/reminders of rules / procedures
Special projects or alternate assignments in lieu of
Offer choices
assignments given to non-disabled peers
Note taking assistance
Use of a calculator
Access to computer on campus
Proof-reader and redo assignment or writing mechanics
Use of a scribe/word processing
not graded
Use of a calculator
Other _________________________________________
Peer tutor/ staff assistance in
______________________________________________
Prior Behavior Support Plan (BSP)
Settings
Home/job/school communication system; explain
Access to study carrel for task/assignments/tests
_____________________________________________
Free from visual distractions
Other _________________________________________
Quiet environment – free from excessive noise
In a small group environment
Other
_________________________________________________
Related to Health Concerns
Reminder to take medication(s)
Timing/Scheduling of Tasks/Assignments/tests
Medication(s) given under supervision
Extended time(s)
Other ______________________________________
___ minutes for every
___ minutes given to non-disabled peers
Tests/assignments given in shortened time segments
Presentation of Materials & Instructions
Extended time on in-class assignments/tests
Books on tape and/or CD
Other__________________________________________
Assignments/tests modified to address identified needs of
learning styles
__________________________________________________
For Additional Information such as however not limited to;
Large print
last cognitive assessment results (psycho-educational report),
Closed caption
academic/functional assessment results, Individual
English language development materials
Educational Program Packet, or other k-12 schooling
Manipulative/study aids for
documentation contact
_________________________________________________
Test questions/assignments- given orally
Name of School District ______________________
Tests/assignments directions- read orally
Tests/assignments- shorten
School District’s Phone number_______________________
Questions on tests/assignments rephrased
Title of Contact Person _______________________
Preview of tests/assignments
Tests/assignments given in smaller parts
Best if contact is made no later than ___/___/______
Visual aids flash cards, maps, posters, clues, etc.
Other; explain __________________________________
Form 27 Transition Summary, Pg 2, Rev. 7-14
Page 2