Form 210-4 Student Support Plan Adaptive Dimension/Differentiated Instruction AP 210 Services for Students with Reference Diverse Needs Insert School Name, Revised June 4, , 2013 Address, Town, Sask., Postal Code Phone: (Number) Fax: (Number) Level School email address if applicable Submit to Classroom Teacher (Cumulative File) When As Required

Student Name Male Female Grade School Year School Name Parent(s)/Guardians

What do we know about how this student learns best?

Recommendations from Student Support Services Professionals (SLP, Ed Psych, OT, PT)

Record of Adaptations Date Class/Teacher What’s Been Tried? Is it working? Future plans? (refer to list of adaptations) (provide explanation where possible) (if applicable)

Content / Materials / Instruction Recommended Subject Provide instructions both orally and in written form Use graphic organizers in presenting information Provide classroom and/or individual visual schedules incorporating words and/or pictures Use highlighting (for key words, mathematical signs, due dates, etc.) Provide a visual example (i.e. Mathematical operations) Provide preferential seating Adjust the amount of note-taking and copying required (provide photo copied notes) Provide extended time for oral answers and written work and assignments Provide alternate setting for independent work to limit distractions Assign a peer mentor Provide concrete materials or more visual supports (manipulatives) Pre-teach vocabulary / concepts Provide an overview for an assigned reading Allow use of a tape recorder to record key lectures Provide access to a computer programs for word processing (Dragon Naturally Speaking, Kurzweil), reading (Kurzweil, audio tapes)

D:\Docs\2018-04-11\001e19973bc515d8d66301e4def361a5.doc Page 1 of 3 Allow use of calculator, math tables, formula sheets and/or maps instead of memorizing Adjust assignments (reduce number, spacing, length of the written assignment, etc.) Provide lower level reading materials that deal with similar topics Teach self-advocacy skills. Teach metacognitive (thinking about thinking) skills (i.e.: triggers for behavior, positive self talk, identifying distractions, etc.) Tiered lesson/ assignments (parallel tasks that have varied levels of depth, complexity, and abstractness) Provide instruction, task and product that are sensitive to multiple intelligences Provide multi leveled learning stations based on interest, multiple intelligence, and readiness Learning contracts that stipulate what and how student will learn and how they’re assessed Provide for individual and/or whole class body breaks Colour code materials Direct teaching of organizational strategies with modeling and structured practice Provide sensory tools (i.e.: Sit fit, fidget toys) Use of FM system Reduce the total amount of material to be read or completed (teacher highlights, key passages) Provide information in simpler language or rewrite critical information in simplified language. Chunk long term assignments into several smaller, more manageable with deadlines and teacher review times Allow the student to dictate work to a scribe, provide the report/answers on tape, or access typing support Assignment/homework book or e-mail assignments home Other:

Test Preparation and Test Taking/Assessment Recommended Subject Create visuals and diagrams to develop and remember concepts Create a glossary of terms and develop an understanding of vocabulary Provide and outline/graphic organizer/study guides for materials to be learned Provide test questions in advance Allow students to bring information/fact sheets/formula sheets/models/calculators, etc. into test Alternate ways of demonstrating knowledge (i.e.: graphic organizers, oral answers) Provide additional time/alternate setting for exam Adjust test design (i.e.: fewer questions, core objectives, provide visual examples) Provide a reader and or scribe for test-taking situation

Social skills/specific social situations (i.e.: unstructured time) Recommended Subject

Positive behavioral supports Recommended Subject

Student contribution for success (ask student for input) Recommended Subject

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