(Helping You Share Your Child’s Strengths, Needs & Support Schedule)
Student Name: ___________________________________________
Date: ________________________
School Year: __________________
1. About My Child
Strengths & Interests:
Subjects/Activities They Enjoy:
2. Areas Where Support Helps
Challenges & Needs:
Successful Strategies That Work Well:
3. Sensory & Emotional Supports
(Examples: noise-canceling headphones, sensory breaks, quiet space access)
4. Communication Preferences
Best Way to Contact Me:
☐ Email: ___________________________________________
☐ Phone: ___________________________________________
☐ Other: ___________________________________________
Preferred Frequency:
☐ Weekly Update
☐ Monthly Update
☐ As Needed
5. ABA Therapy Schedule (If Applicable)
Days & Times of ABA Sessions:
Location of Sessions:
☐ At School
☐ At Clinic
☐ At Home
Transition Support Ideas:
Coordination Notes Between Teacher & ABA Provider:
ABA Provider Name: ___________________________________________
ABA Provider Contact: _________________________________________
6. Additional Notes or Requests
Parent/Guardian Signature: ___________________________
Date: __________________
