Exhibit 4.

Management and Discipline Planning

1. For each question, circle the number under the statement that best answers the question. When you are unsure about the answer to a question, circle the middle number. 2. Total the scores for all items. You should have a number between 0 and 120. 3. Use the scale at the end of the form to determine the most appropriate structure level for your classroom management plan. Questions 1 to 6 relate to the population of the entire school: 1. How would you describe Generally quite the overall behavior of irresponsible. I students in your school? frequently have to nag and/or assign consequences. 10 60 percent or more Most students behave responsibly, but about 10 percent put me in the position where I have to nag and/or assign consequences. 5 10 to 60 percent Generally responsible. I rarely nd it necessary to nag and/or assign consequences. 0 Less than 10 percent

2. What percentage of students in your school qualify for free or reduced lunch? 3. What percentage of students in your school typically move in and/or out of the school during the course of the school year?

10 50 percent or more

5 10 to 50 percent

0 Less than 10 percent

10 4. How would you describe A large percentage the overall attitude of hate school and students toward school? ridicule the students who are motivated. 10 5. How would you describe There are frequent the overall nature of the confrontations, which interactions between include sarcasm students and adults in your and/or disrespect. school? 10 6. How would you describe Many parents are the level of interest and openly antagonistic, support provided by the and many show no parents of students in your interest in school. school? 10

5 Its a mix, but most students feel okay about school.

0 The vast majority of students like school and are highly motivated. 5 0 There is a mix, but The vast majority of most interactions are interactions are respectful and positive. respectful and positive.

5 Most parents are at least somewhat supportive of school.

0 The majority are interested, involved, and supportive of what goes on in the school. 0

Taken from Discipline in the Secondary Classroom, Third Edition, by Randall S. Sprick, copyright 2013 by John Wiley & Sons, Inc.

Questions 711 relate to students in your class this year. Use your most difcult class, or if you are doing this before the school year begins, simply give your best guess. 7. What grade level do you Ninth grade teach? 20 8. How many students do 30 or more you have in your class? 10 9. What is the reputation of This class is going to this group of students from be awful. previous years? For example, if you teach tenth grade, what was the reputation of these students as ninth graders? 10 10. How many students in Two or more your class have been identied as severely emotionally disturbed (SED)? Note: This label varies from state to state. 10 11. Not including students Three or more identied as SED, how many students have a reputation for chronic discipline problems? 10 Total: If your total score is: 0 to 30 Your risk factors are: Low, which means your students can probably be successful with a classroom management plan that involves low, medium, or high structure. The level of structure can be dened by your teaching style. Medium, which means that for your students to be successful, your classroom management plan should involve medium or high structure. High, which means that for your students to be successful, your classroom management plan should involve high structure. Regardless of your personal preference or style, your students will probably benet from a detailed, systematic, and organized classroom management plan. Tenth grade 5 23 to 30 5 Its a mix, but most students work hard and cooperate. Eleventh or twelfth grade 0 22 or fewer 0 This group is very hard working and cooperative.

Taken from Discipline in the Secondary Classroom, Third Edition, by Randall S. Sprick, copyright 2013 by John Wiley & Sons, Inc.

5 One Zero

5 One or two

0 Zero

31 to 60

61 to 120