Page 1 Personalised Learning Support Plan

Name: DOB: Teacher:

Parents/ Year:
Caregivers:
NCCD Disability Category: Physical n/a
Primary Disability Category: Physical
Level of Adjustment: Extensive
Disability Confirmation Sheet: No Medication: No Dosage:
Expiry: Type:
OOHC Plan: Personalised Learning Plan:
NDIS: Funding Support:
Risk Management Plan Behaviour Management Plan:
Health Care Plan Mobility & Positioning Plan:

Learning & Social Support Interventions:

Structured Play Uniform/Equipment Breakfast Club
Assistive Technology PBL You can Do It
Rock & Water Seasons for Growth Mind Matters
Behaviour Program Social Skills Program Other:

School Level Support:

LaST Early Intervention ASLO
SLSO School Counsellor Other:

DoE Level Support:

APLAS DGO L & E Officer Other:
APH HSLO APV Other:
Curriculum Advisor OOHC ACLO Other:

External Support:
Speech Pathology Psychologist Other:
OT Paediatrician Other:

PLAT Current Assessment Results Term

Literacy Reading Accuracy/Fluency Comprehension
Tier 3 Intervention Tier 3 Intervention 1
Numeracy All areas
Tier 3 Intervention

Disability Standards Act 2005

Part 3 Reasonable Adjustments: 3.5 Consulting the student or associate of the student 3.6 Deciding on an adjustment to be made 3.7
Adjustments provided in reasonable time
Part 4 Enrolment & Part 5 Participation 4.3 & 5.3 Measures for compliance with standards
Part 6 Curriculum Development, Accreditation & Delivery 6.2 Ensure programs are designed so all students can participate 6.3 Measures for
compliance standards
 Page 2 Personalised Learning Support Plan
Documented Evidence of Adjustments (minimum 10 weeks)
Learning & Support Team Minutes Medical & Paraprofessional reports

Learning & Support Timetables Behaviour/Risk Management Plan

Evidence of collaborative planning with relevant Health Care Plan

staff
Documentation of staff in servicing regarding Transition Plan
adjustments
Teachers Program/Day book School Counsellor Reports
(annotated adjustments)
School Adjustment tick sheet Other

School Goals SMART Goals/PLAT Markers (Specific, Measurable, Achievable, Relevant, Time bound)
Strategies & Adjustments
1.

2.

3.

Resources/Notes:

Disability Standards Act 2005

Part 3 Reasonable Adjustments: 3.5 Consulting the student or associate of the student 3.6 Deciding on an adjustment to be made 3.7
Adjustments provided in reasonable time
Part 4 Enrolment & Part 5 Participation 4.3 & 5.3 Measures for compliance with standards
Part 6 Curriculum Development, Accreditation & Delivery 6.2 Ensure programs are designed so all students can participate 6.3 Measures for
compliance standards
 Page 3 Personalised Learning Support Plan
Parent/Caregiver Goals
1.

2.

Notes/Recommendations:

Student Goals
1.

2.

Notes/Recommendations:

Teacher Name: Signature: Date:

Principal Name: Signature: Date:

Parent/Caregiver Name: Signature: Date:

Student Name: Signature: Date:

Other: Signature Date:

PLSP Review Date:

Disability Standards Act 2005

Part 3 Reasonable Adjustments: 3.5 Consulting the student or associate of the student 3.6 Deciding on an adjustment to be made 3.7
Adjustments provided in reasonable time
Part 4 Enrolment & Part 5 Participation 4.3 & 5.3 Measures for compliance with standards
Part 6 Curriculum Development, Accreditation & Delivery 6.2 Ensure programs are designed so all students can participate 6.3 Measures for
compliance standards