School Assessment Application

School-Based Assessment

Assistive Technology Technical Assistance (ATTA) Application 

Idaho Assistive Technology Project

Center on Disabilities and Human Development

129 West Third St., Moscow, ID  83843

800-432-8324

Complete the following application, giving as much detailed information about the student as possible.  Submitted applications will go to the IATP office to be reviewed and assigned to an Assistive Technology Practitioner (ATP).  You will then be contacted by the ATP to schedule an assessment time.  If you need help completing the application or have any questions about the application/assessment process, please call Nora at 1-800-432-8324 or email Nora Jehn.

Team Members:  (Should include student, parents, principal, general and special education teachers, and other support staff important to the student)

Classroom Setting

Disability (Check all that apply)

Medical Considerations (Check all that apply)

Assistive Technology Currently Used (Check all that apply)

Please describe the assistive technology that has been previously tried, the length of time you tried each, and the outcome (how did it work, or why it did not work)

Describe the student’s interests and likes

What task (s) does the student need to do that is currently difficult or impossible, and for which assistive technology may be an option?    

Please complete all summaries that apply to your student

Computer/Device Access

Summary of Student’s Abilities and Concerns Related to Computer/Device Access   

 Motor Aspects of Writing

Summary of Student’s Abilities and Concerns Related to Writing

Composing Written Material

Summary of Student’s Abilities and Concerns Related to Composing Written Material

Communication

Summary of Student’s Abilities and Concerns Related to Communication

Reading

Summary of Student’s Abilities and Concerns Related to Reading

Learning and Studying

Summary of Student’s Abilities and Concerns Related to Learning and Studying

 Math

Summary of Student’s Abilities and Concerns Related to Math

Recreation and Leisure

Summary of Student’s Abilities and Concerns Related to Recreation and Leisure

Seating and Positioning

Summary of Student’s Abilities and Concerns Related to Seating and Positioning

Mobility

Summary of Student’s Abilities and Concerns Related to Mobility

Vision

Summary of Student’s Abilities and Concerns Related to Vision

Hearing

Summary of Student’s Abilities and Concerns Related to Hearing

Are there any behaviors (both positive and negative) that significantly impact the student’s performance?

Are there significant factors about the student’s strengths, learning style, coping strategies or interests that the team should consider?

Thank you for completing the Assistive Technology Technical Assistance Application.   If you need any help or have any questions, please contact Nora at the IATP, 800-432-8324 or (208) 885-3630.