504 STUDENT ACCOMMODATION PLAN

Date Written: April 4, 2016 Reviewed: March 5th,

2018
Student: District: Bettendorf Community School District Grade: 5th Grade
Parent Name(s): Plan Facilitator: Danielle Breier Date of Birth: 3/23/2007

Areas of Strength: is kind, caring, wants to please, loving and friendly

Describe Areas of Concern Based on Eligibility Determination: ADHD and Small Bladder

Date of Eligibility Determination: March 31st, 2016 Team Members:

Parent: Teacher: Hailee Beals School Nurse: Donna Carlson
Administrator: Dave Hlas Expert Reviewer: Ardie Miller Other: Danielle Breier – School Counselor

Areas of Difficulty Accommodations Person Responsible Date of Review

ADHD/Focus Extended time on assessments and assignments including district and state Classroom Teacher
assessments.

Areas of Difficulty Accommodations Person Responsible Date of Review

ADHD/Focus Small group setting for assessments Classroom Teacher

ADHD Focus Preferential seating in the classroom as well as breaks provided when needed Classroom Teacher

ADHD/Focus Shortened assignments when appropriate and needed. Classroom Teacher

ADHD/Focus Non-reading tests to be read out loud to student

Small Bladder Permission to visit the nurse and use the nurse’s bathroom whenever needed. Classroom
Must be told to use the bathroom. Teacher/Nurse