HEAD OF YEAR WEEKLY CONCERN REPORT CARD: NAME……………………………………… FORM………………… WEEK BEGINNING: MONDAY……………………… Please rate the students on a scale 0 – 5. Progress towards achieving target 0 = Not achieved at any time 5 = achieved throughout lessons DAY TARGET 1 TARGET 2 TARGET 3 Signature Agreed Targets M O N P1 1. P2 P3 P4 P5 2. P6 T U E P1 P2 P3 3. P4 P5 P6 W E D P1 Initial: HEAD OF YEAR HOME P2 MON P3 P4 P5 P6 TUE T H U R P1 P2 P3 WED P4 P5 P6 F R I P1 THUR P2 P3 P4 FRI P5 P6
SEN Handbook see section 3.3.2 and Audit Attainment and Arrangements Guidance. The Multi Professional Team can also provide information on available resources. Students with Emotional and Behavioural Difficulties School Action Plus Triggers and Action Behaviour/Trigger School based intervention by External input from School refuser SENCO/HoY EWO/CAMHS Truant HoY/HoS EWO Erratic attendance HoY/HoS EWO Neglected / dirty / smells HoY /Matron / Tutor/Child Protection Officer Social Care teams Bruises /Indications of abuse HoY/Matron/ Child Protection Officer Social Care teams CAMHS Weight Loss / eating disorder HoY/Matron/ SENCO/Child Protection Officer Social Care teams GP Self harm / suicide attempt/ depressed HoY/Matron/ SENCO/Child Protection Officer Social Care teams CAMHS GP ADD / ADHD HoY/Matron/ SENCO/Child Protection Officer Social Care teams CAMHS GP Continued Referral Forms / Serious offences HoY/HoS/LG Behaviour Support CAMHS bullied / is the bully HoY/HoS/LG Behaviour Support CAMHS Physical violence to others HoY/HoS/LG Behaviour Support CAMHS Behaviour masking low academic achievement SENCO/ Matron Ed Psych GP CAMHS Medical condition impacts on learning and behaviour SENCO/ HOY/Tutor Matron Ed GP CAMHS Curriculum / timetable issues HoY/ Tutor HoS/LG Ed Psych Serious offences action required HoS/LG Ed Psych Poor behaviour / vandalism on public transport HoS/LG Ed Psych
ASSISTED SELF ASSESSMENT FOR: ____________________ WEEK BEGINNING: ___________ To be completed by pupil and teacher. Mark on a scale of 1 – 5 1 = 5 = - thank you P MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 1 2 3 4 5
Name of Parent/Carer: Address: Tel: Alternative/Change of Address: Tel: IEP record Form IEP co-ordinate by: COP Stage Year 7 Year 8 Year 9 Year 10 Year 11 General Information Hearing Vision Co-ordination Special language General health Details of any medication Nature of Concern From previous school Concern 7 8 9 10 11 Poor literacy skills Speech/language difficulty Listening/following instructions Poor numeracy skills Written recording Grasping/retaining new concepts Difficulty with maps/graphs/charts Short concentration span keeping on task Distracts others/ is distracted Working independently Keeping classroom code of conduct Relating to pupils Working in co-operation with others Relating positively to adults Poor motor co-ordination Slow pace of working Handwriting/presentation difficulties Low self-esteem/lack of confidence Organisational skills Homework Becoming upset at difficulties Poor attendance affects progress concerns Summary of Assessment Screening and national assessment Year 3 screening PIPS Reading Attitude ______
How parents/guardians can help IEP School Action PLUS EMOTIONAL/BEHAVIOURAL DIFFICULTIES COP PUPIL TUTOR GROUP DOB OUTSIDE AGENCY INVOLVED NAMED CONTACT SENCO: Head of House: TUTUTOR Start date: Reviewed: Summary of concerns: Summary of Provision:- Areas where pupil will experience most difficulty Keeping on task Not shouting out Working independently Working in groups Telling the truth Easily distracted by peers Being safe using equipment Long term targets: Making friends Coming to school Poor social skills Showing feelings Getting into the class room Lack of confidence & self esteem Being depressed Exit criteria – targets achieved.