Free Special Education Student Fact Sheet

I. Student Information

• Student Name: [Your Name]

• Date of Birth: [MM/DD/YYYY]

• Grade Level: 8th Grade

• School: Maplewood Middle School

• Teacher: Ms. Smith

• Case Manager: Ms. Johnson

II. Educational Background

• Primary Disability: Autism Spectrum Disorder

• Other Disabilities (if applicable):

  • [Speech-Language Impairment]

• Date of Initial Evaluation: [MM/DD/YYYY]

• Date of Last Evaluation: [MM/DD/YYYY]

• Current Individualized Education Program (IEP) Goals:

  1. Improve social interaction skills

  2. Increase reading comprehension level

  3. Enhance self-regulation skills

III. Accommodations and Modifications

• Accommodations:

  • Extended time on assignments

  • Visual schedules

  • Use of fidget tools

• Modifications:

  • Simplified language in instructions

  • Shortened assignments

  • Alternative assessment formats

IV. Behavioral Supports

• Behavioral Strategies:

  • Visual behavior charts

  • Token economy system

  • Break cards for sensory breaks

• Positive Reinforcements:

  • Verbal praise

  • Preferred activities as rewards

  • Privileges earned for meeting goals

V. Communication Plan

• Preferred Communication Method: [Use of visual aids and gestures]

• Communication Devices/Tools:

  • Communication Board

  • Augmentative and Alternative Communication (AAC) device

  • Picture exchange communication system (PECS)

VI. Additional Resources and Contacts

• Special Education Department Contact: Ms. Rodriguez, Special Education Coordinator

• Other Support Services Involved:

  • Speech and Language Therapy

  • Occupational Therapy

  • Behavioral Therapy

Fact Sheet Templates @ Template.net