Pre-Assessment Questionnaire for educational professionals

Pre-Assessment Questionnaire – Educational Setting

Step 1 of 5

20%

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This field is for validation purposes and should be left unchanged.

Please note, bibic do not provide a diagnosis, however provide a holistic understanding of the individuals strengths and challenges. Additionally, if standardised tests have been completed within the past year, we may be unable to repeat them. While this does not prevent us from assessing and supporting the individual's needs, alternative methods may be used to address their challenges.(Required)

I understand the above

The following will be shared with the parent/carer's during the assessment process to ensure a holistic approach is taken.(Required)

I understand the above

Your details

Your Name(Required)

Title First Last

Would you like to provide a written pronunciation of your name

Role within education setting

Education setting address(Required)

House Name/Number Street Town County Post Code Country

Education setting Contact number

Your contact email address(Required)

Child/ Young person details

Child/Young person's name(Required)

First Last

Date of birth(Required)

DD slash MM slash YYYY

Does the individual have a suspected diagnosis?(Required)

Yes

If yes please provide more details(Required)

Vision/Auditory

Do you have any observations regarding their vision or hearing?

For example, Skipping lines when reading, getting their words muddled, aversions to bright lights, sight loss, wears glasses. Mishearing things, misunderstanding, hearing loss, hearing aids.

Speech and language – Expression and Understanding

How do they communicate with you and others?

Signs and pictures, Makaton, non-verbal, pre-verbal, verbal, how to they communicate in different settings, are they echolalic do they use texting to communicate

Can they be literal?

Yes

If yes please provide more details

Any additional comments around speech and language?

Such as understanding time concepts, following simple and complex instructions, tone of voice, understanding the subtleties of language or anything along these lines.

Gross motor skills (big movements)

Do you have any observations regarding their mobility?

For example tell us about their balance and coordination, spatial awareness, sitting, crawling, using aids, walking, hypermobile, muscle tone

Fine motor (hand and finger control)

Do you have any observations regarding their fine motor skills?

For example, hand writing, picking up items, dexterity, pen/pencil grip

Sensory Processing

Have you noticed any sensory challenges?

Difficulties with sound, touch, smell, light, movement either seeking or avoiding

Learning

Do you have any observations regarding the individuals ability to manage in the educational setting?

How do they engage with learning?

Concentrating, engagement, change in focus, planning, organising, independence

Do they receive any additional support?

Yes

If yes please tell us what support they receive(Required)

Do you have any observations regarding friendships in the educational setting?

Friendships, play, imagination, interaction with others, safety awareness

What are their strengths?(Required)

Would you like to share any further information?