Teacher Rating Scale
(Created by Pamela Russell, May 2002)
Name: ______________________________________ Date: ______________________
I. Directions: Use the following scale to rate the students behavior in your class.
NEVER 0 MOST OF THE TIME 2 NOT APPLICABLE N/A
SOMETIMES 1 ALWAYS 3
_____1. Makes appropriate use of free time (e.g., performs homework & other assignments)
_____2. Remains on task for required length of time
_____3. Follows directions
_____4. Makes responsible decisions
_____5. Is organized
_____6. Is dependable
_____7. Demonstrates initiative in absence of directions
_____8. Demonstrates problem-solving skills
_____9. Pays attention
_____10. Responds appropriately to authority figures/is respectful
_____11. Demonstrates respect to peers
_____12. Follows rules
II. Directions: Please list strengths and weaknesses concerning the student in your class.
STRENGTHS: ________________________________________________________________________
________________________________________________________________________
WEAKNESSES: ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
III. Directions: Please list accommodations or modifications you feel were beneficial to this student in your class.
ACCOMMODATIONS: ________________________________________________________________________
(curriculum is NOT changed)
________________________________________________________________________
MODIFICATIONS: ________________________________________________________________________
(works on different curriculum)
________________________________________________________________________
IV. Utilize the space provided below to list other concerns you may have that were not addressed in sections I, II, and III.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
IEP Data
Students Name: __________________________________ Date: ____________________
Teachers Name: __________________________________ Subject: _________________
Areas of Strengths &/or Weaknesses: __________________________________________
__________________________________________
__________________________________________
__________________________________________
Beneficial Accommodations/Modifications: _________________________________________
__________________________________________
__________________________________________
__________________________________________
Other: __________________________________________
__________________________________________
__________________________________________
__________________________________________
Personal Qualities Checklist
(Pamela Russell, December, 1999)
Name: _____________________________________________________ Date: ___________________
Directions: Rate the student based on his /her current level of competence for each behavior listed. A
score of one would be the lowest score and five would be the highest score.
BEHAVIORS 1 2 3 4 5
Poor Fair Average Good Excellent
1. Demonstrate self-advocacy skills.
A. Expressing feelings of self-worth
B. Describing others perception of self
C. Accepting and giving criticism
D. Developing a positive view of self
E. Practicing personal safety
2. Develop the ability to recognize responsible
behavior in self & others.
A. Respecting the rights and properties of
others
B. Respecting authority and following
Instructions
C. Exerting a high level of effort
D. Setting and achieving goals
3. Demonstrate an awareness of appropriate
communication & social skills.
A. Personal relationships
B. Group and individual work activities
C. Group and individual leisure activities
D. Utilization of available community
resources
4. Recognize diversity among multicultural
populations.
A. Gender
B. Race
C. Ability/Interest
D. Language
E. Tolerance/acceptance
5. Develop awareness of independent behaviors.
A. Self-advocacy
B. Self-organization
C. Affects of ones behavior
6. Develop appropriate decision-making/goal-setting skills.
A. Locate and select sources of assistance
B. Anticipate consequences
C. Develop and evaluate alternatives
D. Recognize the nature of the problem
E. Develop goal-setting behavior
COMMENTS:
SIGNATURE: _______________________________________________________ DATE: ______________________________
CIRCLE THE APPROPRIATE PERSON DOING THE RATING: (1) Parent (2) Student (3) Employer (4) Teacher
Parent/Teacher Rating Scale
(Created by Pamela Russell, May 2002)
Name: ______________________________________ Date: ______________________
Directions: Use the following scale to rate the students work related behaviors, interpersonal relations, and social/community
expectations.
NEVER 0 MOST OF THE TIME 2 NOT APPLICABLE N/A
SOMETIMES 1 ALWAYS 3
Work Related
_____1. Makes appropriate use of free time (e.g., performs homework assignments, studies,
etc.)
_____2. Remains on task for required length of time
_____3. Follows directions
_____4. Makes responsible decisions
_____5. Is organized
_____6. Is dependable
_____7. Demonstrates initiative in absence of directions
_____8. Demonstrates problem-solving skills
_____9. Pays attention
_____10. Is persistent in seeking success (e.g., will stay on task)
_____11. Takes responsibility for his/her own actions
_____12. Learns from mistakes
_____13. Recognizes consequences of inappropriate behavior and responds appropriately
Interpersonal Relations
_____1. Responds appropriately to peers
_____2. Cares for personal appearance (e.g., grooming, clothing, etc.)
_____3. Demonstrates the ability to resolve conflict situations appropriately
_____4. Responds appropriately to authority figures
_____5. Adjusts easily to new situations (e.g., works with individuals he/she does not know,
adjusts to new surroundings, etc.)
_____6. Maintains consistent patterns of acceptable behavior and emotions
_____7. Is loyal to friends, family, and work associates
Social/Community Expectations
_____1. Is responsible for appropriate care of personal property
_____2. Follows rules
_____3. Obeys laws
_____4. Behaves appropriately in the absence of supervision
_____5. Demonstrates appropriate care and handling of others property
_____6. Is honest
_____7. Follows safety guidelines
_____8. Demonstrates ability to control temper
Other areas of parent &/or student concerns or needs:
