Least Restrictive Environment Survey by Eric Sorenson
My child has academic and/or behavioral management needs that interfere with the instructional process.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have academic and/or behavioral management needs that interfere with the instructional process.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has academic and/or behavioral management needs that require additional adult support is needed to engage in learning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have academic and/or behavioral management needs that require additional adult support is needed to engage in learning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has academic and/or behavioral management needs that require specialized/specially designed instruction.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have academic and/or behavioral management needs that require specialized/specially designed instruction.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has academic and/or behavioral management needs which can best be accomplished in a self-contained setting.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have academic and/or behavioral management needs which can best be accomplished in a self-contained setting.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs require intensive constant supervision.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs do not require intensive constant supervision.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs require a significant degree of individualized attention.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs do not require a significant degree of individualized attention.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs require intervention.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs do not require intervention.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs require intensive behavior management.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs do not require intensive behavior management.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs require additional adult support.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child’s severe and chronic management needs do not require additional adult support.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has very high needs in most or all need areas, including academics.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have very high needs in most or all need areas, including academics.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has very high needs in most or all need areas, including social and/or interpersonal development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have very high needs in most or all need areas, including social and/or interpersonal development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has very high needs in most or all need areas, including physical development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have very high needs in most or all need areas, including physical development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has very high needs in most or all need areas, including management.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have very high needs in most or all need areas, including management.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is characterized as aggressive.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is not characterized as aggressive.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is characterized as elf-abusive.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is not characterized as elf-abusive.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is characterized as extremely withdrawn.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child's behavior is not characterized as extremely withdrawn.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has severe difficulties in the acquisition and generalization of language.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have severe difficulties in the acquisition and generalization of language.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has severe difficulties in the acquisition and generalization of social skill development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have severe difficulties in the acquisition and generalization of social skill development.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires very intense individual programming to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require very intense individual programming to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires continual adult supervision, to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require continual adult supervision, to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a specific behavior management program to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a specific behavior management program to engage in all tasks.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program of speech/language therapy (which may include augmentative/alternative communication).
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program of speech/language therapy (which may include augmentative/alternative communication).
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has severe and multiple disabilities with limited language.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have severe and multiple disabilities with limited language.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has severe and multiple disabilities with limited academic functioning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have severe and multiple disabilities with limited academic functioning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child has severe and multiple disabilities with limited independent functioning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not have severe and multiple disabilities with limited independent functioning.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program primarily of habilitation and treatment.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program primarily of habilitation and treatment.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program including training in daily living skills.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program including training in daily living skills.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program that includes the development of communication skills.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program that includes the development of communication skills.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program that includes the development of sensory stimulation.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program that includes the development of sensory stimulation.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child requires a program that includes the development of therapeutic interventions.
Strongly Agree
Agree
Disagree
Strongly Disagree
My child does not require a program that includes the development of therapeutic interventions.
Strongly Agree
Agree
Disagree
Strongly Disagree
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