Self-Advocacy Checklist

Penncrest High School    Progress Monitoring Worksheet  –  Student Version

Directions: Please answer the following questions about your progress over the past week:

SELF-ADVOCACY

Recently…              A little…                          A lot….                                  All the time…

?  I am completing my work in school

? I am not completing some work at school.

? I am not completing most of my work at school.

? I am not completing any of my work at school.

Strategy: ? Talk to a friend   ? Talk to my parent    ? Talk to my teacher  ? Talk to my therapist  ? Prioritize  

  ? Identify the cause  ? improve time management    ?  Clarify assignments    ? Stay after school  ? Go to tutoring  ?Socialize at more appropriate times  ? No strategy

? : Teacher(s): _____________   ?: Course(s) : _________________ 

 

? I feel caught up with school work.     

 

? I am a little behind with school work.    

 

? I am a lot behind but managing.     

 

? I very behind and am having trouble managing

Strategy: ? Spoke to the teacher outside of class.  ? Spoke to my parent  ? Spoke to my case manager

? Spoke to my therapist  ? Made a list of things I need to do     ?worked on it during AC     ? No strategy

? : Teacher (s):_____________   ?: Course (s): _________________ 

 

? I am succeeding with a teacher

 

? I am having a little difficulty with a  teacher.

 

? I am having a lot of difficulty with a teacher.

 

 

 

? I am having difficulty with my teacher all the time

Strategy:? Conflict resolution support is needed for this situation ? I have a plan to talk to the teacher after class/school  ? I plan to talk to therapist about this ? I plan to talk to my parent about this  ? I plan to talk to my case manager about this. ? : Teacher (s): _____________ ?: Course(s): _________________ ?No Strategy  

 

 

 

EXECUTIVE FUNCTIONING                

 

 

 

Recently…

?  I feel organized  (all classes)   

A little…

?  I feel a little unorganized (one class)

A lot….

? I feel a lot unorganized (multiple classes)

All the time…

?I feel unorganized

 (all my classes)

Strategy: ? Spend Achievement center time getting organized ? Write deadlines and to do list in a calendar ? Talk to my case manager about my organization  ? Talk to my teacher about an assignment   ? No strategy

   ? : Teacher (s):_____________   ?: Course (s): _________________ 

 

? I have prioritized my assignments.

 

?  I feel a little unprepared.

 

? I feel a lot unprepared.

 

? I feel completely unprepared.

Strategy:  ? Talk to my parent   ? Talk to my case manager. ? Talk to my teacher  ? Talk to my therapist   ? Talk to a friend  ? Change my self talk.  ? Use AC time to prioritize

? : Teacher (s):_____________   ?: Course (s): _________________     ? No strategy

 

? I have studied and am ready for assessments

 

? I need a little more time to study.

 

? I need a lot more time to study.

 

? I feel I like I have not studied at all.

Strategy: ? Talk to my case manager/teacher  ? Talk to a friend   ? Change my self-talk ? Study in AC

? : Teacher (s):_____________   ?: Course (s): _________________  ? No strategy

 

? I can concentrate.

 

? I have difficulty concentrating at times.

 

?  It is hard to concentrate on anything for very long.

 

?  I cannot concentrate on anything.

Strategy: ? Ask to change my seat   ? Get more sleep  ? Exercise   ?Use focus techniques  ?Talk to therapist

    ? Walk/Water break    ? Write in Journal    ? Listen to music   ? Draw    ? No strategy