Special Class Student / Staff Ration
Determination Tool
Eric Sorenson 75Q009

My child has academic and/or behavioral management needs that interfere with the instructional process.
Agree
Disagree
My child does not have academic and/or behavioral management needs that interfere with the instructional process.
Agree
Disagree
My child has academic and/or behavioral management needs that require additional adult support is needed to engage in learning.
Agree
Disagree
My child does not have academic and/or behavioral management needs that require additional adult support is needed to engage in learning.
Agree
Disagree
My child has academic and/or behavioral management needs that require specialized/specially designed instruction.
Agree
Disagree
My child does not have academic and/or behavioral management needs that require specialized/specially designed instruction.
Agree
Disagree
My child has academic and/or behavioral management needs which can best be accomplished in a self-contained setting.
Agree
Disagree
My child does not have academic and/or behavioral management needs which can best be accomplished in a self-contained setting.
Agree
Disagree
My child’s severe and chronic management needs require intensive constant supervision.
Agree
Disagree
My child’s severe and chronic management needs do not require intensive constant supervision.
Agree
Disagree
My child’s severe and chronic management needs require a significant degree of individualized attention.
Agree
Disagree
My child’s severe and chronic management needs do not require a significant degree of individualized attention.
Agree
Disagree
My child’s severe and chronic management needs require intervention.
Agree
Disagree
My child’s severe and chronic management needs do not require intervention.
Agree
Disagree
My child’s severe and chronic management needs require intensive behavior management.
Agree
Disagree
My child’s severe and chronic management needs do not require intensive behavior management.
Agree
Disagree
My child’s severe and chronic management needs require additional adult support.
Agree
Disagree
My child’s severe and chronic management needs do not require additional adult support.
Agree
Disagree
My child has very high needs in most or all need areas, including academics.
Agree
Disagree
My child does not have very high needs in most or all need areas, including academics.
Agree
Disagree
My child has very high needs in most or all need areas, including social and/or interpersonal development.
Agree
Disagree
My child does not have very high needs in most or all need areas, including social and/or interpersonal development.
Agree
Disagree
My child has very high needs in most or all need areas, including physical development.
Agree
Disagree
My child does not have very high needs in most or all need areas, including physical development.
Agree
Disagree
My child has very high needs in most or all need areas, including management.
Agree
Disagree
My child does not have very high needs in most or all need areas, including management.
Agree
Disagree
My child's behavior is characterized as aggressive.
Agree
Disagree
My child's behavior is not characterized as aggressive.
Agree
Disagree
My child's behavior is characterized as elf-abusive.
Agree
Disagree
My child's behavior is not characterized as elf-abusive.
Agree
Disagree
My child's behavior is characterized as extremely withdrawn.
Agree
Disagree
My child's behavior is not characterized as extremely withdrawn.
Agree
Disagree
My child has severe difficulties in the acquisition and generalization of language.
Agree
Disagree
My child does not have severe difficulties in the acquisition and generalization of language.
Agree
Disagree
My child has severe difficulties in the acquisition and generalization of social skill development.
Agree
Disagree
My child does not have severe difficulties in the acquisition and generalization of social skill development.
Agree
Disagree
My child requires very intense individual programming to engage in all tasks.
Agree
Disagree
My child does not require very intense individual programming to engage in all tasks.
Agree
Disagree
My child requires continual adult supervision, to engage in all tasks.
Agree
Disagree
My child does not require continual adult supervision, to engage in all tasks.
Agree
Disagree
My child requires a specific behavior management program to engage in all tasks.
Agree
Disagree
My child does not require a specific behavior management program to engage in all tasks.
Agree
Disagree
My child requires a program of speech/language therapy (which may include augmentative/alternative communication).
Agree
Disagree
My child does not require a program of speech/language therapy (which may include augmentative/alternative communication).
Agree
Disagree
My child has severe and multiple disabilities with limited language.
Agree
Disagree
My child does not have severe and multiple disabilities with limited language.
Agree
Disagree
My child has severe and multiple disabilities with limited academic functioning.
Agree
Disagree
My child does not have severe and multiple disabilities with limited academic functioning.
Agree
Disagree
My child has severe and multiple disabilities with limited independent functioning.
Agree
Disagree
My child does not have severe and multiple disabilities with limited independent functioning.
Agree
Disagree
My child requires a program primarily of habilitation and treatment.
Agree
Disagree
My child does not require a program primarily of habilitation and treatment.
Agree
Disagree
My child requires a program including training in daily living skills.
Agree
Disagree
My child does not require a program including training in daily living skills.
Agree
Disagree
My child requires a program that includes the development of communication skills.
Agree
Disagree
My child does not require a program that includes the development of communication skills.
Agree
Disagree
My child requires a program that includes the development of sensory stimulation.
Agree
Disagree
My child does not require a program that includes the development of sensory stimulation.
Agree
Disagree
My child requires a program that includes the development of therapeutic interventions.
Agree
Disagree
My child does not require a program that includes the development of therapeutic interventions.
Agree
Disagree
What Ratio is you child in currently?
12:1:1
8:1:1
6:1:1
12:3:1+3-1
Other/Not Sure
What is your relationship to the student under consideration?
Parent
School Psychologist
General Education Teacher
Special Eduction Teacher
Related Service Provider
Special Subject Teacher
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