Smart Inclusion Tracking and Evaluation (Year End Version – Classroom Teacher)
Your evaluation of various “inclusion targets” is required so that we can assess the impact of Smart Inclusion on student engagement, participation,
communication and learning this year, 2008-2009. You will be asked to complete ONE form for the ONE student in your class for whom the SEA
equipment was purchased. If you have other special needs students you would like to report on, please do so by completing forms for them as well.
You should have consents for all students for whom a form is completed. Information from all evaluations will be collated for reporting
purposes. Students, schools, and teachers will not be identified by name in any reporting. Thank you.
Complete the student information box below
Please attach (or forward when finalized) all IEPs and Report Cards for the 2008-2009 school year.
Return all by FAX (613) 925-3244 or Courier to: Alison Inglis at the Frankville office.
Student:
Year End Evaluation - Date completed___________________________
School:
Teacher:
Grade:
Education Assistant:
DOB:
Please proceed to the next set of questions
If you have ANY questions about, or need ANY clarification of, questions asked please contact
alison.inglis@ucdsb.on.ca or alexandra.dunn@ucdsb.on.ca
Please read each question carefully and provide a response using CURRENT Evaluation date as your response-point unless otherwise
indicated by question. A space for additional comments is provided.
Question
Percentage of time the
student is in the
classroom during the
school day (instructional
time only; 310 minutes –
excludes
nutrition/recess breaks).
Circle One –>
Response
1. No time spent in class (0%)
2. A small part of the day
(1-10% = up to 30 minutes, total for day)
3. Some parts of the day
(11-39% = between 31 and 120 minutes, total for day)
4. Several parts of the day
(40-60% = between 121 and 190 minutes, total for day)
5. Many parts of the day
(61-75% = between 191 and 232 minutes, total for day)
6. Most of the day
(76-95% = between 233 and 295 minutes.
7. Almost all day
(more than 295 minutes, total for day).
Percentage of time
student is engaged in
activities -social,
academic, etc. (e.g.
looking, listening,
responding).
1. 0% of the time (never engaged)
2. up to 10% of the time (limited engagement)
3. 11 to 50% of the time (some engagement)
4. 51 to 79% of the time (engaged a lot of the time)
Circle One – >
5. 80 to 100% of the time (engaged most or all of the time)
Comments
Question
Response
Has there been a decrease
in significant disruptive
incidents over the course
of this school year?
_____Behaviour has not ever been seriously
disruptive (Go to next question).
Disruptive incidents are
defined as those that
require removal of student
from classroom and/or
removal of other students
from the class and/or
significant interruptions to
learning of others.
If disruptive incidents have been/are an issue
with respect to the student, please rate (circle one)
1. No decrease in disruptive incidents over the
course of the school year.
2. Disruptive incidents have decreased by
about 25% but continue to be a concern.
3. Disruptive incidents have decreased by
about 50% and are less of a concern.
4. Disruptive incidents have decreased by
about 75% and are only seen occasionally.
5. Disruptive incidents have decreased by
almost 100% - very rare now.
Comments
The student’s level of participation in the classroom, with peers, and with programming, is being evaluated. Levels of participation may include:
“Competitive”: Student participates in the same educational activities with, and at the same time as, peers. Adaptations/accommodations to access
curriculum may be used as needed. Academic expectations are the same as those of peers. Progress is evaluated similarly to peers.
“Active”: Student participates in the same educational activities with, and at the same time as, peers (i.e., literacy activities during literacy block). Some
adaptations to access curriculum are used as needed, and some modifications are made to the curriculum - academic expectations are different from those of
peers. Progress is evaluated according to individualized standards.
“Involved”: Student pursues individualized goals through activities that are woven into educational activities of peers, and involves interaction with peers
during those activities (i.e., student hands out math manipulatives to peers to meet social, communication, and fine motor goals) = modified goals and
objectives to meet individual needs in cross-curricular domains. Progress is evaluated according to individualized standards.
“None”: Student participates in different educational activities than those that the rest of the class is involved in. Peer interaction is limited to very little or
none. Academic expectations may range from the same as those of peers (though the student is not involved with peers or pursuing the expectation at the
same time as peers), to highly individualized and very different from those of peers.
Subject areas, and
participation level for each
subject area.
Continued next page…
Subject: ______________________________
Subject: ______________________________
Participation Level(circle one):
Participation Level(circle one):
A – Competitive
B – Active
C – Involved
D - None
A – Competitive
B – Active
C – Involved
D - None
Subject: ______________________________
Subject: ______________________________
Participation Level(circle one):
Participation Level(circle one):
A – Competitive
B – Active
C – Involved
D - None
A – Competitive
B – Active
C – Involved
D – None
Continued next page…
Continued…….
Subject areas, and
participation level for each
subject area.
Subject: ______________________________
Participation Level(circle one):
A – Competitive
B – Active
C – Involved
D - None
Subject: ______________________________
Participation Level(circle one):
A – Competitive
B – Active
C – Involved
D - None
Other areas? Comments?
Question
Amount of additional direct
assistance required during
the day to
interpret/understand
lesson/task (over and
above usual assistance that
is often provided to all
students)
Check One –>
Response
____Direct assistance required almost all of the time to
interpret/understand lesson/task (almost all hours of
the day)
____A lot of assistance - direct assistance required up
to 75% of the time to interpret/understand
lesson/task
____Some assistance - direct assistance required up
to 50% of the time to interpret/understand
lesson/task
____A bit of assistance - direct assistance required up
to 25% of the time to interpret/understand
lesson/task
____No (or very minimal) direct assistance required.
Amount of additional direct
assistance required during
the day to complete work
or task (over and above
usual assistance that is
often provided to all
students)
____Direct assistance required almost all of the time to
complete work/task (almost all hours of the day)
Check One –>
____A bit of assistance - direct assistance required up
to 25% of the time to complete work/task
____A lot of assistance - direct assistance required up
to 75% of the time to complete work/task
____Some assistance - direct assistance required up
to 50% of the time to complete work/task
____No (or very minimal) direct assistance required.
Comments
Question
Percentage of time
communication
opportunities are present
for the student during
academic activities (i.e.,
chance to take a turn,
engage with peers, provide
an answer, etc.)
Circle One –>
Response
1. 0% of the time - no communication opportunities
present.
2. up to 10% of the time - limited communication
opportunities present.
3. 11 to 50% of the time - some communication
opportunities present.
4. 51 to 79% of the time - frequent communication
opportunities present.
5. 80 to 100% of the time - communication
opportunities present much or all of the time.
Percentage of time that the
student’s communication
responses are successful
during academic activities
(i.e., student engages in the
communication
opportunities – see
previous - when they are
presented)
Circle One –>
1. 0% of the time – no successful communication
responses.
2. up to 10% of the time - limited successful
communication responses.
3. 11 to 50% of the time - some successful
communication responses.
4. 51 to 79% of the time - frequent successful
communication responses.
5. 80 to 100% of the time – most or all communication
responses are successful.
Comments
Question
Percentage of successful
social communication
attempts during the school
day (e.g. greeting,
manners)
Circle One –>
Response
1. 0% – no social communication attempts.
2. up to 10% of the time - limited social communication
attempts.
3. 11 to 50% of the time - some social communication
attempts.
4. 51 to 79% of the time - frequent social
communication attempts.
5. 80 to 100% of the time – social communication
attempted most or all of the time.
Quality of work/tasks
undertaken e.g. marks,
meeting expectations…..
Comments/Describe (use extra sheets if necessary):
Most significant
achievements for the
student this year…..
Comments/Describe (use extra sheets if necessary):
Hopes for future
achievements for
student…..
Comments/Describe (use extra sheets if necessary):
Comments
How would you describe
this student’s social
experiences at school this
year?
___ Socialized with many peers.
___ Socialized with one or two peers.
___ Rarely socialized with peers.
i.e., social experiences
would include playing with
peers, talking with peers
about things other than
school work, eating lunch
as part of a peer group, etc.
Additional comments/observations:
Additional comments (use extra sheets if necessary):
Person(s) who completed this form:__________________________________________________________________________________
Thank you for taking the time to provide this information!
Please attach, or forward when finalized, copies of ALL IEPs and Report Cards
for the 2008-2009 school year
Return all by FAX (613) 925-3244 or Courier to: Alison Inglis at the Frankville office