Clark Wroldsen's IEP Survey - 11/2014
Name: 


  1. Clark is attentive during classtime.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark asks teacher question/s or seeks help for clarification or information.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark will state or indicate when he is not able to complete a curricular task or activity.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark demonstrates appropriate social and communication skills by initiating and responding to peers and adults.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark actively participates in class by taking notes, etc.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark completes homework assignments on time:
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Clark asks for progress updates from the teacher.
    1 - 0-20% of the time
    2 - 20-40% of the time
    3 - 40-60% of the time
    4 - 60-80% of the time
    5 - 80-100% of the time


  1. Comments:





Christie Mead
Harmony Middle School
KS