CWCS PLT Individual Checklist

Student Name: _________________________ Grade ___ Student Number: ________

Checklist completed by ___________________________ Date ___________

Relationship to student____________________________

Please share your child’s strengths

Please describe your major concerns

Please mark an ‘x’ for each that applies when comparing your child with siblings and/or peer group. Mark an ‘NY’ for each that your child has “Not Yet” attempted.

Language

Delays in learning to speak

Difficulty modulating voice (e.g., too soft, too loud)

Trouble naming people or objects

Difficulty staying on topic

Inserts invented words into conversation

Difficulty re-telling what has just been said

Vague, imprecise language and has a limited vocabulary

Slow and halting speech, using lots of fillers (e.g., uh, um, and, you know, so)

Poor grammar or misuses words in conversation

Mispronounces words frequently

Confuses words with others that sound similar

Inserts malapropisms (‘slips of the tongue’) into conversation (e.g., a rolling stone gathers no moths; he was a man of great statue)

Difficulty rhyming

Limited interest in books or stories

Difficulty understanding instructions or directions

Trouble understanding idioms, proverbs, colloquialisms, humor, and/or puns (note: take into account regional and cultural factors)

Difficulty with pragmatic skills (e.g., understands the relationship between speaker and listener, stays on topic, gauges the listeners degree of knowledge, makes inferences based on a speaker’s verbal and non-verbal cues)

Reading

Confuses similar-looking letters and numbers

Difficulty recognizing and remembering sight words

Frequently loses place while reading

Confuses similar-looking words (e.g., beard/bread)

Reverses letter order in words (e.g., saw/was)

Demonstrates poor memory for printed words

Weak comprehension of ideas and themes

Trouble learning to read

Trouble naming letters

Problems associating letter and sounds

Trouble recognizing the difference between some sounds in words

Difficulty blending sounds into words

Guesses at unfamiliar words rather than using word analysis skills

Reads slowly

Substitutes or leaves out words while reading

Poor retention of new vocabulary

Dislikes and avoids reading or reads reluctantly

Written Language

Dislikes and avoids writing and copying

Demonstrates delays in learning to copy and write

Writing is messy and incomplete, with many cross outs and erasures

Difficulty remembering shapes of letters and numerals

Frequently reverses letters, numbers and symbols

Uses uneven spacing between letters and words, and has trouble staying ‘on the line’

Copies inaccurately (e.g., confuses similar-looking letters and numbers)

Spells poorly and inconsistently (e.g., the same word appears differently other places in the same document)

Difficulty proofreading and self-correcting written work

Difficulty preparing outlines and organizing written assignments

Fails to develop ideas in writing so written work is incomplete and too brief

Expresses written ideas in a disorganized way

Math

Difficulty with simple counting and one-to-one correspondence between number symbols and items/objects

Difficulty mastering number knowledge (e.g. recognition of quantities without counting)

Difficulty learning and memorizing basic addition and subtraction facts

Difficulty learning strategic counting principles (e.g. by 2, 5, 10, 100)

Poorly aligns numbers resulting in computation errors

Difficulty estimating (e.g., quantity, value)

Difficulty with comparisons (e.g., less than, greater than)

Trouble telling time

Trouble conceptualizing the passage of time

Difficulty counting rapidly or making calculations

Trouble learning multiplication tables, formulas and rules

Trouble interpreting graphs and charts

Gross and Fine Motor Skills

Appears awkward and clumsy, dropping, spilling, or knocking things over

Limited success with games and activities that demand and eye-hand coordination (e.g., piano lessons, basketball, baseball)

Trouble with buttons, hooks, snaps, zippers and trouble learning to tie shoes

Art work is immature for age

Demonstrates weak ability to color or write ‘within the lines’

Grasps pencil awkwardly

Demonstrates weak handwriting skills

Experiences difficulty using small objects or items that demand precision (e.g., Legos, puzzle pieces, tweezers, scissors)

Dislikes and avoids writing and drawing tasks