Free Special Education Student Fact Sheet Template

Special Education Student Fact Sheet


I. Student Information

  • Student Name: [Your Name]

  • Date of Birth: [MM/DD/YYYY]

  • Grade Level: 8th Grade

  • School: Maplewood Middle School

  • Teacher: Ms. Smith

  • Case Manager: Ms. Johnson

II. Educational Background

  • Primary Disability: Autism Spectrum Disorder

  • Other Disabilities (if applicable):

    • [Speech-Language Impairment]

  • Date of Initial Evaluation: [MM/DD/YYYY]

  • Date of Last Evaluation: [MM/DD/YYYY]

  • Current Individualized Education Program (IEP) Goals:

    1. Improve social interaction skills

    2. Increase reading comprehension level

    3. Enhance self-regulation skills

III. Accommodations and Modifications

  • Accommodations:

    • Extended time on assignments

    • Visual schedules

    • Use of fidget tools

  • Modifications:

    • Simplified language in instructions

    • Shortened assignments

    • Alternative assessment formats

IV. Behavioral Supports

  • Behavioral Strategies:

    • Visual behavior charts

    • Token economy system

    • Break cards for sensory breaks

  • Positive Reinforcements:

    • Verbal praise

    • Preferred activities as rewards

    • Privileges earned for meeting goals

V. Communication Plan

  • Preferred Communication Method: [Use of visual aids and gestures]

  • Communication Devices/Tools:

    • Communication Board

    • Augmentative and Alternative Communication (AAC) device

    • Picture exchange communication system (PECS)

VI. Additional Resources and Contacts

  • Special Education Department Contact: Ms. Rodriguez, Special Education Coordinator

  • Other Support Services Involved:

    • Speech and Language Therapy

    • Occupational Therapy

    • Behavioral Therapy


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