EDUCACION ESPECIAL

EVALUACION PSICOPEDAGOGICA Y SEGUIMIENTO
1-ANAMNESIS
IDENTIFICACION
Nombres: _____________________________________________________.
Apellidos: _____________________________________________________.
Edad: _____________F.N__________________________________________.
Dirección: _____________________________________________________.
Teléfono: _____________________________Grado:__________________.

Datos Familiares
Nombre del padre: _____________________________Edad:__________.
Ocupacion: ________________________Vive Con el estudiante: _______.
Nombre de la madre: _______________________________Edad: _______.
Ocupacion: ________________________Vive con el estudiante:_______.
Motivo :
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Fecha de valoración:________________________________________________________.
Dx: _________________________________________________________________________.
Remitido por: _______________________________________________________________.
Motivo de consulta remisión:
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_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ III.II. Padre: _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________. autoridad. DINAMICA FAMILIAR (Relaciones familiares. Familiar: _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________. hospitalización. exámenes especializacion). desarrollo social. HISTORIA CLINICA Resumen de la historia personal del estudiante(indagar sobre la historia pre. Madre: _____________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________. juego) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________. peri y post natal. . ANTECEDENTES FAMILIARES Enfermedades padecidas por los padres o por algún (os) familiar (es). enfermedades padecidas. IV.

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________.ASPECTOS ENCONTRADOS U OBSERVADOS EN LA ENTREVISTA.SERVICIOS PEDAGOGICOS (Servicios especializados que recibe el estudiante fuera de la escuela: duración. orientación en el estudio. . VII. repitencia. VI. tiempo) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________. desempeño. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________.HABITO DE ESTUDIO (Actitud. motivo de cambio de colegio). VII. seguimiento. metodología.V. HISTORIA ESCOLAR (Edad de ingreso. tiempo).

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ D. etc.IX. PSICIMOTRICIDAD (Fina y gruesa). semántica.) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ . fonéticos. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ E.VALORACION PEDAGOGIGA FUNCIONES BASICAS DEL APRENDIZAJE A.ATENCION. numerica). visual.PERCEPCION. sintáctico. LENGUAJE (Niveles fonológicos.______________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ C.MEMORIA: (Auditiva.________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ B.

actitud durante el desarrollo de las actividades. aprobación y supervisión al trabajar. integración a diferentes grupos sociales. manejo de situaciones conflictivas.LENGUAJE Y ESCRITURA _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ G. seguridad ante situaciones frustraciones. VOZ Y AUDICION _________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ I.F. cooperación en actividades de grupo. SOCIAFECTIVO (Interés. ritmo de trabajo.CALCULO MATEMATICO _________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ H. empatía con el evaluador. OTROS: HABLA. independencia en actividades escolares) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ .

APOYO PEDAGOGICO (Estrategias) Trabajo en el aula. DIFICULTADES ENCONTRADAS _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ L.NIVEL DE PENSAMIENTO.POTENCIALIDADES. (Tipo de inteligencia. estilo y ritmo de aprendizaje) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ K.J. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Apoyo especializado _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Colaboración con la familia _____________________________________________________________________________ _____________________________________________________________________________ ____________________________________________________________________________ .

ESTRATEGIAS SUGERIDAS AL DOCENTE DE GRADO. .RECOMENDACIONES _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ __________________________________ ORIENTADOR. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ N.M.

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