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STUDENT INFORMATION
Student Name
Yuridia ************
Grade
3
Date of Birth
**/**/2006
School
Harbins Elementary School
Date
3/2/2015
POINT OF CONTACT
T. Martin
Vision Impairment
Program Teacher
EQUIPMENT
EQUIPMENT AND SOFTWARE TO BE USED
4x dome magnifier
4x12 telescope
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
Verify that ZoomText application w/desktop monitor is loaded on at least 1 computer per
lab (including Media Center) and on the classroom computer
Order 4x dome magnifier and 4x12 telescope from district assistive technology
department
Set up training session for student and implementation team
C. Rogers
3/9/15
T. Martin
3/9/15
T. Martin
3/16/15
IMPLEMENTATION TEAM
NAME (List all individuals who will implement the AT with the student.)
T Martin
K. Looney
L. Sirmans
C. Rogers
M. Patterson
Maria ****
Students mother
TRAINING
TRAINING NEED
TRAINEES
TRAINER
Student, teachers,
parent, technology
team
3/22
CLASSROOM IMPLEMENTATION
IEP GOAL
CURRICULUM/DOMAIN (e.g.,
math, science, PE, art, etc)
PERSON(S) RESPONSIBLE
Self-advocacy
VI program teacher
Self-advocacy
Classroom teacher
VI / Visual Effeciency
Homeroom teacher
Dome magnifier
Telescope
VI / Assistive Technology
Adaptive Access
HOME IMPLEMENTATION
IEP GOAL
CURRICULUM/DOMAIN (e.g.,
math, science, PE, art, etc)
PERSON(S) RESPONSIBLE
VI / Visual Effeciency
Parent
MONITORING/EVALUATION
GOAL
INSTRUCTIONAL STRATEGY
VI teacher
Homeroom teacher
Homeroom teacher