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Articulation Worksheet

Student Name:_____________________________________ Articulation from:_____________________ to:_______________________ Date:___________________________________


Domain
Skill/Activity
Independent Functioning

Universal Interventions
(Currently in Place)

Targeted Interventions
(in Addition to What is
Currently in Place)

Intensive Individual
Interventions
(Specialized)

Comments
Notes

Daily Living/Self Care


Recreation/Leisure
Participation (School)
Participation (Community)
Physical Development (Includes
handwriting, motor planning)
Supervision/Safety
Accommodations to Access
Learning Activities
Other
Curriculum and Learning
Task Related Behavior (Following
Routines, Participation, Task
Completion)
Cognitive Processes (Problem
Solving, Sensory Awareness, Cause
and Effect)
Strategic Learning (Planning,
Seeking Help, Self-Monitoring, Task
Switching)
Higher Thought Processes
(Comparing, Contrasting,
Predicting)
Vocational/Employment
(Workplace Skills, Ethics, Behaviors)
Other
Created: 1/16/2013
Owner: ESE

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2013-012-VCS
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Domain
Skill/Activity
Social/Emotional
Personal Adjustment (Coping with
Frustration, Recognition of
Emotions, Adjustment to
Environmental Changes)
Interpersonal Relationships (Peer
Activities, Initiating Interactions,
Self Control)
Behavior Management Strategies
FBA/BIP
Behavior Regulation (Self/Mutual)
Restricted Repetitive Behaviors
Sensory
Other
Health

Universal Interventions
(Currently in Place)

Targeted Interventions
(in Addition to What is
Currently in Place)

Intensive Individual
Interventions
(Specialized)

Comments
Notes

Medical Diagnoses/Conditions (List)


Emergency Care Plan
Dietary Needs
Other
Communication
Primary Means-List (Verbal, Visuals,
Sign, Braille, Pointing, Eye Gaze)
General Conversation Skills
(initiating, maintaining,
terminating)
Communicating Wants and Needs
(Assistive Technology/AAC)
List/Describe
Joint Attention (Engaging in
Reciprocal Interactions, Sharing
Attention)
Created: 1/16/2013
Owner: ESE

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2013-012-VCS
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Domain
Skill/Activity
Pragmatics (Reciprocity, body
language, hidden message,
nuances)
Other
Action Plan

Created: 1/16/2013
Owner: ESE

Universal Interventions
(Currently in Place)

Targeted Interventions
(in Addition to What is
Currently in Place)

Intensive Individual
Interventions
(Specialized)

Who

Need

When

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Comments
Notes

Where

Intervention

Needed

Developed

Potential Need

2013-012-VCS
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