PRESENT LEVELS OF ACADEMIC PERFORMANCE FORM

Speech/Language Impairment (SLI) IEPs

Student Name: __A.N.____________________________________________
Hearing Screening Date: _____________

Hearing Screening Results: ________________

Vision Screening Date: ___________________ Vision Screening Results: __________________

Please provide a complete summary of the childs strengths and weaknesses in the following areas.
Please use complete sentences rather than stating them in a list form. This information will go directly
into IEP Pro for the team to discuss during the meeting.
*Reminder: EVERY child has a strength in every area.
COGNITIVE:
Strengths:
__A.N. attends and engages when we have story time every day and will sometimes recall parts of the
story. She sustains interested in playing in centers when an adult is engaged with her. A.N. is able to
make predications when she is asked. A.N. is able to make connections through personal daily routines.
A.C. has demonstrated in sociodramatic play while playing in the kitchen/dramatic center.
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________________________________________
Weaknesses
__It takes A.N. a little longer to recall a part in the story after it has been read. She likes to have a
teacher play with her instead of playing with her peers while inside the classroom. A.N. will be
redirected a lot of the times to play with her peers once the teacher is engaged to get her playing.
_____________________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________________________
Accommodations/Modifications being provided in this subject area
_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________
ADAPTIVE:
Strengths _ A.N. has adapted in the classroom environment. She can function independently in the
classroom environment with little redirection.
_____________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________________________________________

Weaknesses
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Accommodations/Modifications being provided in this subject area
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
SOCIAL/EMOTIONAL:
Strengths __ A.N. has shown that she can regulate her own emotions and behaviors. When she is not
feeling well she does express it and will ask for her mom and to go home. She accepts redirection from
adults. She also manages classroom rules as well as outside rules. A.N. has demonstrated concern for
others. She interacts with her peers when an adult is engaged with the play. She takes turns and shares.
She has a few times seek adult help for social problems that have come up.
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________________________________________
Weaknesses
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Accommodations/Modifications being provided in this subject area
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________________________________________
PHYSICAL: (BOTH GROSS AND FINE MOTOR SKILLS)
Strengths:
__ A.N. shows good gross and fine motor skills . She has been observed outside that she moves
purposefully from place to place running, climbing, jumping, riding a bike, walking on balancing beams,
kicking balls, catching them and throwing them. Observing her inside the classroom she holds writing
tools using a three point finger grip, strings beads, and paints with paint brushes.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________
Weaknesses

_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________
Accommodations/Modifications being provided in this subject area
_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________

WORK HABITS WITHIN THE CLASSROOM:

_____________________________________________________________________________________
_____________________________________________________________________________________

ADDITIONAL INFORMATION YOU WOULD LIKE TO SHARE WITH THE TEAM:

_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
Thank you so much for taking the time to complete this form!
-Mrs. Dyer, Speech Language Pathologist