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Teacher Form

Section B - Additional Skills

Name of Student*

Name and position of person completing this form:

How would you describe the student's social skills and ability to relate to their peers?

Does the student display any behavioural or emotional issues? If so please explain your concerns and the frequency:

Does the student have any fine motor skill difficulties? (e.g. gripping a pencil, awkward writing, tying shoe laces, etc.):

Does the student have any gross motor skill difficulties? (e.g. running, jumping, catching, uncoordinated, etc):

Does the student have trouble with self-care skills for their age? (e.g. toileting, hygiene, dressing, looking after belongings, etc.):

Do you have any safety concerns regarding the student? (e.g. risk of absconding, hurting self or others, no sense of danger or hazards, impulsivity, etc.):

Does the student have any sensory issues? (e.g. heightened sensitivity to noise, light, foods, or seeks movement, tastes, or the feel of textures, etc):

Are there any supports in place to cater for the student's difficulties or problems with any of the concerns mentioned above? (e.g. therapy, counselling, social programs, etc.):

Please remember to click on 'Submit Information' before moving on to the next Section. 

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