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1342.12 Companion
July 12, 2017
Page 67
Identify any of the following behavioral concerns and the frequency and intensity with which they are
demonstrated. For each area, describe what it looks like:
Transitions between activities:
Homework/assignment completion:
Ability to accept criticism/correction:
Ability to cope with frustration (e.g. level of task difficulty, wait-time, taking turns):
Social skills/interactions with peers or adults:
Participation in classroom activities:
Does the student demonstrate inconsistencies or problems with regular school attendance and/or
tardiness to class?
☐
Yes |
☐
No
Additional comments that may be helpful in understanding this student's educational performance:
Form Completed By: (Last Name, First Name, Middle Initial)
Date: