Ceis Documentation Form For Co-Teaching Class
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1
2South Bend Community School Corporation
Special Education Department
CEIS Documentation Form for Co-Teaching Class
Please list ONLY GENERAL EDUCATION students who have been identified as At Risk. (DO NOT INCLUDE THOSE RECEIVING SPEECH THERAPY)
Last Name, First Name
Grade
How was At Risk
Staff providing
Start Date
End Date
Time per Day
Strategies
Gen Ed
# of Spcial Ed students
receiving service in class
Identified?*
service (name)
Used
Teacher
at the same time
*Examples include: M-Class/Acuity Scores, SAT team referral, office referrals, behavior plan (NOT Special Ed BIP)
Signature of Teacher: __________________________________________ School: _______________________________________ Date: __________________
List or check the strategies you are implementing with the above named students:
Academic Strategies
Behavioral Strategies
1.
Flexible groupings
10.
Repeated Readings
1.
Non verbal cues
8.
Student works for specified reward:
2.
Hands-on activities
11.
Reduce copying requirements
2.
Behavior tracking checklist
___________________________
3.
Pre-teach concepts
12.
Allow the use of a textbook or visual chart
3.
Verbal warnings
9.
Review expectations prior to transitions
4.
Extra Examples
13.
Paired/Partner Readings
4.
Visual reminders/cues
10.
____________________________
5.
Read aloud text
14.
Story Mapping
5.
Behavior contract
11. _____________________________
6.
Use of graphic organizers
15.
WilsonLips
6.
Close physical proximity
12. _____________________________
7.
Provide material at
16.
___________________________
7.
Allow choices
13. _____________________________
instructional level
17.
___________________________
14. _____________________________
8.
Assign fewer items
18.
___________________________
9.
Provide writing
supports/prompts\
2/14/14
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