Date______[STUDENT SELF-ADVOCACY RUBRIC I Can I need full support to do I need a little coaching I can do this on my own this to do this Clearly describe my 1 2 3 disability Clearly state how it 1 2 3 impacts me at (school/work) Clearly state what 1 2 3 accommodations work for me Total Score

Directions: Students will need initial instruction on using this tool. Remember a rubric does not do the teaching it is just a way of tracking progress. Role play and rehearsal is one way of teaching and reinforcing this skill. The student may role play with you then move on to another familiar person with your support. Practice until the student feels comfortable sharing all or part of this information. A great source for information may be found using “The 411 on Disability Disclosure” on the MontcoTransitionWiki.wikispaces.com.

Sample Measurable Annual Goal:

In general education settings, Sam will advocate for himself (including describing his disability, how it impacts him and accommodations that work for him) as demonstrated by scoring a 7 or higher on the Self Advocacy Rubric on 3 consecutive biweekly trials from a baseline of 3.