Virginia Assistive Technology Assessment Checklist
Date
Completed
Process
Sample Forms
Consideration of AT

AT Consideration Guide completed by the IEP team
Virginia Assistive Technology
Consideration Guide
Referral Process
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

IEP Team formulates referral question
Referral Form completed by IEP team
Parent Permission for AT assessment obtained
Virginia AT Referral Form
Information Gathering

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


Section 1 of Virginia AT Assessment Student Profile
completed by AT assessment team lead
Inform AT assessment team, assign responsibilities, and set
timeline
o Collect and review information (consideration
document, referral, section 1 of Student Profile, IEP)
o Analyze task(s) that is/are difficult for the student as
identified by the referral process
o Assign AT team members with the expertise to assess
the area of need for the task identified in the referral
process
Complete appropriate assessment tools specific to identified
area of need in a timely manner and within natural
environment(s)
Parent Questionnaire
Student Questionnaire
Environmental observation
Virginia Department of Education (2011)
Virginia AT Assessment Student
Profile
ASNAT manual (5th edition)
Parent Questionnaire
Student Questionnaire
Environmental Observation (WATI)
Decision Making Phase
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

Schedule AT team decision making meeting
Review completed assessment documents to brainstorm AT
solutions
Select potential solutions for trial(s) implementation
Decision Making Guide
Trial(s) Implementation Phase

Develop a trial implementation plan including length of trial(s),
solution to be trialed, data to be documented, training needed,
and responsible parties

Carry out trial(s) in customary environment

AT team reconvenes to review trial data, determine
recommendations for the IEP team, and write final report

Completed report is sent to the IEP team in a timely manner
Virginia Department of Education (2011)
Trial Implementation Guide
Evaluation Report Checklist