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Student ID #: AJBS-45336
Gender: Male
School: ABC
Phase: Primary
Grade: Grade 4
ASSESSMENT DATA
Test Applied
Psychological Assessment
Date
03/01/xxxx
01/02/xxxx
01/03/xxxx
05/03/xxxx
Summary of Result
Diagnosis of learning disability. Student X has
impairment in motor planning skills that
weakens his ability to write. Also have
auditory/visual processing difficulty that results
in reading deficits.
Functions below the current grade level in
fluency and comprehension. Currently
functioning at grade 1 level in reading fluency
and comprehension.
Functions below the current grade level in
writing. His copying and composing skills are
below his grade level due to motor skills deficit.
Displays deficiency in fine motor skills and
exhibits poor motor planning ability.
Areas of Needs
Additional Skills:
Interest in singing, enjoys computer games and music.
Parental Concerns:
Parents would like him to gain grade level reading and writing skills and also wants him to make
friends and socialize with peers and also want
Present level of Performance
Student X is a grade 4 student having learning disability that hinders his capability to read and
write on his grade level. His reading skills falls on grade 1 level reading and writing skills falls
on grade 2 level. He appears to benefit from taped reading materials, computer programs for
comprehension along with reminders for task completion. Intensive reading and written language
instructions will benefit him along with the services provided by an occupational therapist to
support his motor planning abilities.
Associated Services
SERVICES
Occupational
Therapy
Sp.Ed Resource
Teacher
Remedial
Education
FREQUENCY
Two times per week
DURATION
40 mins each
LOCATION
O.T room
10 times a week/ 2
times a day
2 times a week
50 mins each
Regular classroom
30 mins each
Remedial room
Participants Involved:
NAMES
Mrs. A and Mr. Z
Mr. B
D
E
Natasha Faizan
POSITION
Parents
Asst. Principal
Grade 4 teacher
Special Ed. Resource Teacher
XYZ
_
Annual Goal(s)
Reading Goal 1:
Student X will display reading
fluency of grade level 2 by the
end of year.
Bechmark#1:
Student X will read the grade
level 2 story in 2 minutes with
90 or more correct words.
Benchmark #2:
Student X will read the grade
level 2 story in 2 minutes with
95 or more correct words.
Benchmark #3:
Student X will read the grade
level 2 story in 2 minutes with
100 or more correct words.
Peer/group activities.
Fluency checklists
Norm Referenced Tests for
reading
Oral tests
Reading Goal 2:
Student X will demonstrate
reading comprehension of grade
level 2 by the end of year.
Benchmark #1:
Student X will read the grade
level 2 story independently and
answer 5 questions with 80%
accuracy.
Benchmark #2:
Student X will read the grade
level 2 story independently and
answer 5 questions with 95%
accuracy.
Homework/assignments
Pair with peer for
brainstorming questions and
answers.
Peer/Group activities
Tests/ Quiz
Writing Goal 1:
Student X will demonstrate
writing skills by copying 15
sentences in 20 mins by the end
of the year.
Benchmark #1:
Student X will copy 9 sentences
in 20mins with 90% accuracy.
Benchmark#2:
Student X will copy 12
sentences in 20 mins with 95%
accuracy
Benchmark#3:
Student X will copy 15
sentences in 20mins with 95%
accuracy
Writing Goal 2:
Student X will write three short
10 sentences story on his own
by the end of the year.
Benchmark#1:
Student will write 4 sentences
on her own in 20 minutes with
80% accuracy
Benchmark#2:
Student will write 7 sentences
on her own in 20 minutes with
90% accuracy
Benchmark#3:
Student will write 10 sentences
on her own in 20 minutes with
95% accuracy.
Tests/ Quiz
Norm Referenced test for
writing skills.
Peer/Group activities
Signature: _____________________