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Re-Evaluation ñ Areas of Concern & Intervention Summary for use ...

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Union County Public Schools<br />

PROGRAMS FOR EXCEPTIONAL CHILDREN<br />

Local Procedures<br />

<strong>Re</strong>­<strong>Evaluation</strong> – <strong>Areas</strong> <strong>of</strong> <strong>Concern</strong> & <strong>Intervention</strong> <strong>Summary</strong><br />

Student:<br />

School:<br />

DOB: Grade: Gender: Ethnicity:<br />

Parent/Guardian:<br />

Student’s Teacher:<br />

SCREENING INFORMATION<br />

Vision Screening Date: Pass Fail<br />

Far R 20/ L 20/ Near R 20/ L 20/<br />

Hearing Screening Date: Pass Fail<br />

dB (Intensity Level)<br />

Hz (Frequencies)<br />

I. DISCUSSION OF STUDENT’S STRENGTHS<br />

a. Describe student’s academic and functional skill strengths (reading, math, written<br />

language, daily living activities, etc.).<br />

b. Describe student’s behavioral/social skill strengths.<br />

c. Describe student’ study/work skill strengths.<br />

d. Describe student’s communication skill strengths.<br />

e. Describe student’s motor skill strengths (gross/fine motor).

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