New Student Template

Student Name: Grade: Age:

Special Education Testing and History

Areas of Disability (including data used to determine eligibility)

Effects of Disability on Other Areas of Student’s Life (academic, social, behavior, etc.)

Assistive Technology to Support Learning (Recommend one low tech and one high tech assistive technology and explain how it can be used to support learning based upon diagnoses.)

Low Tech:

High Tech:

Culture, Language, and Family Background Summary (including discussion of how these factors could influence student learning)