WRITTEN INPUT
Teacher:
Grade/Team: 6th
Student: Johnny Cruz
DOB:
Current Grade in Class: 90% Citizenship: Excellent / Satisfactory
Attendance: Never absent.
Strengths: Math is easily Johnny's best subject. He excels in math computation skills. He is able to add, subtract, multiply,
and divide whole numbers, decimals, and fractions with ease. He helps others in math. He is eager to learn and help others
with their assigned work.
Present Levels of Academic Achievement and Functional Performance (PLAAFP):
Content area: Math
Name of Test / Text (s) if applicable, e.g., WRAT, QRI, Nelson, RFU, Brigance, Teacher Made Test, Chapter test: Wide Range
Achievement Test
Date Given: 12/15/14
How is the student doing in your class? List the skills addressed this quarter and describe how the student is doing for each
skill:

Johnny scored at the 5th grade level on the WRAT. He had issues with the words problems on the assessment.

He is able to add, subtract, multiply, and divide whole numbers, decimals, and fractions

He excels in math computation skills with ease.

His issues with reading comprehension affect his ability to solve word problems. He is able to solve word problems with
the aid of an operation clue word reference sheet. He is typically given fewer word problems to solve and the word
problems are read to him.

CCSS.MATH.CONTENT.6.NS.A.1Interpret and compute quotients of fractions, and solve word problems involving division
of fractions by fractions, e.g., by using visual fraction models and equations to represent the problem. For example,
Susie's mom packed her an apple sliced in half. At lunch, Susie and three of her friends shared the apple. If they
shared equally, what fractional part did each child get? Johnny scored 60% on this CCSS skill test with
accommodations. Johnny understands parts of a whole and how to group (divide) using a simplified fraction word
problem, manipulatives, and visual aids. After using manipulatives to solve the story problem, Johhny is able to transfer
the information into a numerical equation and solve.
How is the student in the following areas?

Social/Emotional: He gets along with peers in class. No concerns

Fine Motor Skills: He is able to write and cut materials.

Gross Motor Skills: He is able to walk and run
Unique Needs:

Johnny does not have unique needs in math.
Modifications & Accommodations:

Allow him to use operation clue word reference sheet

Fewer word problems to solve

Word problems are read to him

Simplify and explain questions
Manipulatives
Visual Aids
Simplified word problems



District Assessment Recommendation: Yes/ No With Accommodations: Yes/No
List Accommodations: Test read to him, simplified instructions
One to One aide determination: None needed/ needed 50% 80%
Placement Recommendation:
90%
100%
General Education / Resource Room
Does your student have a goal and objective for your subject? Yes / No (If yes, attach form 16B)
How the student’s disability affects his/her involvement and progress in the general education curriculum: Johnny's has a
learning disability that affects his decoding, comprehension, and fluency for reading. He excels in math computational
skills. However, because of his disability in reading comprehension, Johnny's math reasoning skills are affected. He scored
at the 5th grade level on the WRAT because he struggled with the word problems on the assessment. He is able to solve
word problems with accommodations. He is able to participate in the general education math classes when
accommodations are in place. He does not require resource room services in math.