Name:Age:Grade:
Change Placement: (what grades will student move to a new school)
Future Goals: (what are the student's goals for the future)
Future Placement (where will the student be in 1, 3,and 5 years)
Typing Rate
Brailling Rate on braille writer and any electronic device
Keyboarding skills (obtain typing information on familiar keyboard and migration keyboard)
Reading Rate
Reading distance
Listening
Describe the devices (synthesizer) used, learning style, motor planning, following directions, memory, time involved