Free Special Education Student Fact Sheet Template
Special Education Student Fact Sheet
I. Student Information
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Student Name: [Your Name]
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Date of Birth: [MM/DD/YYYY]
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Grade Level: 8th Grade
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School: Maplewood Middle School
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Teacher: Ms. Smith
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Case Manager: Ms. Johnson
II. Educational Background
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Primary Disability: Autism Spectrum Disorder
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Other Disabilities (if applicable):
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[Speech-Language Impairment]
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Date of Initial Evaluation: [MM/DD/YYYY]
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Date of Last Evaluation: [MM/DD/YYYY]
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Current Individualized Education Program (IEP) Goals:
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Improve social interaction skills
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Increase reading comprehension level
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Enhance self-regulation skills
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III. Accommodations and Modifications
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Accommodations:
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Extended time on assignments
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Visual schedules
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Use of fidget tools
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Modifications:
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Simplified language in instructions
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Shortened assignments
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Alternative assessment formats
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IV. Behavioral Supports
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Behavioral Strategies:
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Visual behavior charts
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Token economy system
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Break cards for sensory breaks
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Positive Reinforcements:
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Verbal praise
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Preferred activities as rewards
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Privileges earned for meeting goals
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V. Communication Plan
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Preferred Communication Method: [Use of visual aids and gestures]
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Communication Devices/Tools:
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Communication Board
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Augmentative and Alternative Communication (AAC) device
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Picture exchange communication system (PECS)
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VI. Additional Resources and Contacts
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Special Education Department Contact: Ms. Rodriguez, Special Education Coordinator
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Other Support Services Involved:
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Speech and Language Therapy
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Occupational Therapy
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Behavioral Therapy
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