Mokinio specialiųjų ugdymosi poreikių (išskyrus atsirandančius dėl išskirtinių gabumų) įvertinimo pedagoginiu, psichologiniu, medicininiu ir socialiniu pedagoginiu aspektais ir specialiojo ugdymosi skyrimo tvarkos aprašo

5 priedas

 

(Pažymos forma)

 

 

(mokykla)

 

VAIKO GEROVĖS KOMISIJOS

 

PAŽYMA Dėl SPECIALIŲJŲ UGDYMOSI POREIKIŲ PIRMINIO/PAKARTOTINIO įvertinimo

 

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( data ir registracijos numeris)

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(vieta)

 

                                         

Mokinio vardas ir pavardė ___________________________________________________________

Gimimo data_______________________Adresas, telefono numeris, el. paštas__________________

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Gyvenimo ir ugdymo sąlygos namie___________________________________________________

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Mokinio sveikatos sutrikimai (išrašas iš vaiko sveikatos pažymėjimo (Forma Nr. 027-1/a), naudojimasis techninės pagalbos priemonėmis __________________________________________

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Klasė (grupė)______________________Kurso kartojimas_________________________________

Kalba, kuria kalba namie________________Kalba, kuria mokosi___________________________

Įvertinimas: pirminis, pakartotinis (reikiamą pabraukti).

Jeigu mokinys vertinamas pakartotinai, paskutinio Įvertinimo data___________________________

Mokinio galios___________________________________________________________________

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Ugdymosi sunkumai_______________________________________________________________

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1. Psichologinis vertinimas:

1.1. Vertinimo instrumentai________________________________________________________

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1.2. Galios (nurodomos mokinio (vaiko) pažinimo, veiklos organizacijos, elgesio, asmenybės ir kt. stipriosios sritys, palyginti su teorinės normos standartais ir mokinio (vaiko) individualiais gebėjimais _______________________________________________________________________

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1.3. Sunkumai (nurodomos mokinio (vaiko) pažinimo, veiklos organizavimo, elgesio, asmenybės ir kt. silpnosios sritys, palyginti su teorinės normos standartais ir mokinio (vaiko) individualiais gebėjimais _______________________________________________________________________

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1.4. Psichologinio vertinimo išvada__________________________________________________

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2. Logopedinis vertinimas:

2.1. Galios (nurodomi vaiko kalbėjimo ir kalbos gebėjimai)______________________________

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2.2. Sunkumai (nurodomi vaiko kalbėjimo ir kalbos sutrikimai ir sunkumai)__________________

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2.3. Logopedinio vertinimo išvada___________________________________________________

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3. Pedagoginis vertinimas:

3.1. Mokymosi pasiekimai (nurodomi atskirų  mokymosi dalykų pasiekimai)_________________

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3.2. Mokymosi sunkumai_______________________________________________________

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3.3. Pedagoginio vertinimo išvada___________________________________________________

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4. Kitų specialistų vertinimas________________________________________________________

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Išvada apie mokinio specialiųjų ugdymosi poreikių (išskyrus atsirandančius dėl išskirtinių gabumų) grupę (negalią, sutrikimą, mokymosi sunkumus)_________________________________________

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Išvada apie specialiųjų ugdymosi poreikių (išskyrus atsirandančius dėl išskirtinių gabumų) lygį (nedideli, vidutiniai, dideli, labai dideli)________________________________________________

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Rekomendacijos dėl tolesnio ugdymo (Švietimo pagalbos skyrimo, Įvertinimo tarnyboje, specialiojo ugdymosi skyrimo ir kt.)___________________________________________________

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Mokyklos vaiko gerovės komisijos vadovas               (Parašas)                            (Vardas ir pavardė)

                                

Nariai:                                                                          (Parašas)                            (Vardas ir pavardė)

 

                                                                                     (Parašas)                            (Vardas ir pavardė)

 

 

Susipažinau:

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(vieno iš tėvų (globėjų, rūpintojų) parašas, vardas, pavardė)