Student: ____________________________

MEASUREMENT TOOL
DATES ADMINISTERED

Knowledge and Ideas

SL.6 Speak audibly and express thoughts,
feelings, and ideas clearly

Work Samples

K.W.1 Draw, say, and write an opinion

piece that tells a reader the topic or
the name of the book they are writing
about.
K.W.3 Draw, say and write to tell a
single part or several parts, tell about
the events in the order in which they
occurred,
and
reaction
to
CC.1
Count
byprovide
ones upato
25.
CC.3 Write numbers from 0-5 and
represent a number of objects with a
written numeral.
CC.4a When counting objects, say the
number names in order and matching
the number to the objects.

MATH

Performance Task

Observation

FUNCTIONAL
BEHAVIOR

SKILLS MEASURED

Formative (September to
current)
Performance Task
Observation
Dialogues

WRITING

READING

CONTENT

Date: November 12, 2014

STRENGTHS & WEAKNESSES

Able to do . . .
SL.6 Use finger to point and tries
to verbalize one-to-two word
utterances (pee, mine, yes, no).
Having difficulty with . . .
RF.2 Counting number of
environment sounds heard.
RF.1
Able Pointing
to do . . . to and identifying
K.W.1 and 3 Form scribble
on paper with assistance.
Having difficulty with . . .
K.W.1 and 3 Forming age
appropriate lines, shapes
and texts.
Able to do . . .
Imitate student and teacher
responses.
Having difficulty with . . .
Performing all tasks
independently
Able to do . . .
Sit comfortably with peers for
about 2 to 3 minutes.
Sit in time-out for 2 minutes after
about an attempt of an average of
20 minutes trying to get her sit in
the time-out area.
Run
Walk

Recommended Intervention(s)

Tier I
Reduce amount of items
Allow frequent breaks

Tier III
One-to-one assistance for
activities
Engaging Manipulatives
Playdoh
linking cubes
bears
beans
number mats
white board mats
white board markers