Speech IEP Input Form
The classroom teacher's input is extremely important when creating a student's IEP. Please have this form completed at least two weeks prior to the student's IEP meeting date. This valuable information will be added to the student's final IEP.
Student's Name and grade level.
Name of person completing this form.
1. What are the student’s academic strengths and other special skills or abilities?
2. What are the areas of weakness that you have noted?
3. Consider the student's speech and language skills. Which is a difficult area of communication for the student? Check all that apply.
Articulation Disorder: speech sounds. *Children 7 years of age>should speak clearly with no errors.
Language: vocab., grammar, difficulty creating questions/statements, retelling stories, figurative language, etc.
Receptive Language: comprehension, understanding others, following directions, spatial concepts, etc.
Fluency: stuttering-repetition of sounds, words, or phrases; cluttering-rapid unclear speech
Pragmatics: How the student uses language socially
Voice: Pitch, loudness, hoarsness, breathiness, etc.
How does the above issue interfere with the student's education. Check all that apply.
Oral Communication *if they have articulation errors, then it at least interferes with oral communication*
Reading (this includes ability and pronunciation of words while reading)
Student becomes frustrated when trying to express himself/herself
Student is reluctant to speak or embarrassed
Asking/Responding to Questions or Creating Satements
Comprehension and Reasoning
Additional Comments concerning speech/language:
4. Are there other concerns, such as hearing, vision, social skills or behavioral issues?
5. Describe any accommodations you may provide the student in class.(e.g., Extended time, small group instruction, visual aids, repeating/rephrasing, reading plan, use of the sound field system, etc.)
6. Please list the student's current grades and current progress in the curriculum. Please include each subject you teach.
8. Additional comments:(e.g., medical conditions, changes in home life, or other topics not addressed on this form).
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