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STUDENT INFORMATION
Student Name
Female Student
Grade
11
Date of Birth
07/30/1999
School
Chestatee High School
Date
1/21/16
POINT OF CONTACT
Adam Rich
EQUIPMENT
EQUIPMENT AND SOFTWARE TO BE USED
Chromebook
Google Documents
EQUIPMENT TASKS
TASK (e.g., order/procure AT, load software, adapt/customize devices/software, set up
at home/school, maintain/repair, etc.)
PERSON RESPONSIBLE
DATE DUE
Administrator
1/22/16
IMPLEMENTATION TEAM
NAME (List all individuals who will implement the AT with the student.)
Sped Teacher
LEA
Math Teacher
Teacher
Science Teacher
Teacher
Administrator
Administrator
English Teacher
Teacher
Parents
Family Member
TRAINING
TRAINING NEED
TRAINEES
TRAINER
Google Classroom
Classroom Teachers
Tech Support
Google Classroom
Student
Teacher
1/25
7am / 4pm
1/28
Class Time
CLASSROOM IMPLEMENTATION
IEP GOAL
CURRICULUM/DOMAIN (e.g.,
math, science, PE, art, etc)
PERSON(S) RESPONSIBLE
Teacher
Chromebook
Teacher
Chromebook
HOME IMPLEMENTATION
IEP GOAL
CURRICULUM/DOMAIN (e.g.,
math, science, PE, art, etc)
PERSON(S) RESPONSIBLE
n/a
Counselor, Parents
Chromebook
n/a
Chromebook
MONITORING/EVALUATION
GOAL
Student will use assistive technology to write
notes in class
student will write a five paragraph essay with
correct grammar, organization
INSTRUCTIONAL STRATEGY
B. If currently
completes task with
assistive technology
tools, describe.
C. D
add
tech
A. If currently completes
task with special
strategies and / or
accommodations,
describe.
n/a
n/a
n/a
Computer Access
n/a
n/a
n/a
n/a
Communication
n/a
n/a
n/a
Reading
n/a
n/a
n/a
Organization
n/a
n/a
n/a
Composing Written
Material
Assessing Students
TaskNeeds for Assistive Technology (2009)
A. If currently completes
task with special
strategies and / or
accommodations,
describe.
Needs assistance with notes
during class
B. If currently
completes task with
assistive technology
tools, describe.
C. D
addi
tech
n/a
n/a
n/a
n/a
n/a
Mobility
n/a
n/a
n/a
n/a
n/a
Vision
n/a
n/a
n/a
Hearing
n/a
n/a
n/a
Math
Recreation and Leisure
Activities of Daily Living
(ADLs)
5. Are there assistive technology services (more specific evaluation of need for assistive tec
modifying the assistive technology, technical assistance on its operation or use, or trainin
family) that this student needs? If yes, describe what will be provided, the initiation and d
This student needs to use a Chromebook in order to assist her with her handwriting and keepin
She has a problem hearing instructions or information and processing it while writing. By allow
Chromebook she can better understand the content and still complete her assignments and no
pace.