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Inclusion Guidelines

indicates a required answer

If your child has a diagnosis or a history of an IEP please check off any descriptions below that apply to your child. For any “Yes” answers please provide additional information and accommodation suggestions that your child benefits from.
1. *

Child's Name             Age           Grade level

Please check any challenges that apply to your child:
2. *

Sensory (sensitivities that may come up during LEAP such as light sensitivities, noise levels, etc)
Yes No
3. *

Social (peer interactions, participation in groups, emotional or behavioral dysregulation, etc)
Yes No
4. *

Completing Tasks (ability to maintain focus, follow directions, complete assigned tasks, transition to new classes/teachers, etc)
Yes No
5. *

Learning Style (ability to engage and retain class content at grade level) If yes, please provider further details and accommodation suggestions:
Yes No
6. *

Does your child have an official diagnosis?
Yes No
7. 

If you answered "yes" above, please provider further details and accommodation suggestions for each
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