Student Information:
Name: [Student Name]
Grade: [Grade Level]
Disability: [Specific Disability, e.g., anxiety disorder, dyslexia]
Areas of Impact:
Difficulty concentrating in noisy environments, Challenges with time management, and Occasional anxiety-related episodes impacting classroom participation.
Accommodations:
Classroom Environment:
Quiet Space: Designated quiet area in the classroom where the student can take breaks when feeling overwhelmed.
Noise Reduction: Use of noise-canceling headphones or earplugs when necessary.
Seating Arrangement: Preferred seating location away from high-traffic areas.
Visual Cues: Use of visual timers to manage time during activities.
Instructional Modifications:
Extended Time: Additional time to complete assignments and tests as needed.
Simplified Instructions: Clear and concise instructions with key points highlighted.
Prior Notice: Advance notice of upcoming tests or high-pressure situations to allow for preparation.
Flexible Due Dates: Ability to submit assignments on alternative deadlines in certain situations.
Alternative Assessment Formats: Options for alternative assessment methods (e.g., oral presentations instead of written essays) when appropriate.
Social and Emotional Support:
Check-Ins: Regular check-ins with the teacher or counselor to discuss any concerns or anxieties.
Positive Reinforcement: Positive feedback and encouragement for effort and progress.
Peer Support: Opportunities to work collaboratively with peers in small groups.
Communication and Collaboration:
Open Communication: Regular communication between teachers, parents, and student to discuss progress and adjustments to the plan.
Parent Conferences: Scheduled parent-teacher conferences to discuss student progress and concerns.
Student Advocacy: Encourage the student to self-advocate for their needs when necessary.
Implementation and Monitoring:
Review Process:
This 504 plan will be reviewed regularly (at least annually) to ensure accommodations remain appropriate and effective.
Teacher Responsibilities:
Teachers will implement accommodations outlined in this plan and document student progress.
Student Responsibilities:
The student will actively participate in their education and communicate any needs or concerns to their teachers.
Signature Page:
Student: [Student Signature]
Parent/Guardian: [Parent/Guardian Signature]
Teacher: [Teacher Signature]
School Administrator: [Administrator Signature]
Note: This is a sample 504 plan and should be tailored to meet the specific needs of each individual student. Always consult with the student, parents, and relevant school professionals to develop an effective plan.