Independence Assessment Rubric Guiding Questions

SAFETY OF SELF AND OTHERS

1. With what frequency is direct service provided?
2. What is the duration of direct support provided?
3. What possible strategies can be put in place in our school to allow the student to develop
independence?
4. What are the interventions that can be put in place in our school to meet the safety needs
of students?
5. What programs and services are available to respond to the needs of the students to allow
them to develop independence (e.g. classroom teacher, School-based EST members, DESS
members, EST- Literacy, EST-Numeracy, ASPEA services, SIW, Educational Assistant, C
& Y, etc.)?
6. What are the determined student goals and outcomes?
Student Name: _________________________ Team Members: _______________________________________________ Date: _____________________

ROUTINE AND ESSENTIAL MEDICAL CARE

1. With what frequency is direct service provided?
2. What is the duration of direct support provided?
3. What possible strategies can be put in place in our school to allow the student to develop
independence?
4. What are the interventions that can be put in place in our school to meet the routine and
essential needs of students?
5. What programs and services are available to respond to the needs of the students to allow
them to develop independence (e.g. classroom teacher, School-based EST members, DESS
members, EST- Literacy, EST-Numeracy, ASPEA services, SIW, Educational Assistant, C
& Y, etc.)?
6. What are the determined student goals and outcomes?
PERSONAL CARE
1. With what frequency is direct service provided?
2. What is the duration of direct support provided?
3. What possible strategies can be put in place in our school to allow the student to develop
independence?
4. What are the interventions that can be put in place in our school to meet the personal care
needs of students?
5. What programs and services are available to respond to the needs of the students to allow
them to develop independence (e.g. classroom teacher, School-based EST members, DESS
members, EST- Literacy, EST-Numeracy, ASPEA services, SIW, Educational Assistant, C
& Y, etc.)?
6. What are the determined student goals and outcomes?

LEARNING SUPPORTS
1. With what frequency is direct service provided?
2. What is the duration of direct support provided?
3. What possible strategies can be put in place in our school to allow the student to develop
independence?
4. What are the interventions that can be put in place in our school to meet the learning
access needs of students?
5. What programs and services are available to respond to the needs of the students to allow
them to develop independence (e.g. classroom teacher, School-based EST members, DESS
members, EST- Literacy, EST-Numeracy, ASPEA services, SIW, Educational Assistant, C
& Y, etc.)?
6. What are the determined student goals and outcomes?

Review Date: _________________________________________________