Answer these questions to create a “snapshot” of your child.


1.  Who is ___________________ ?  (Describe your child, including information such as place in family, personality, likes and dislikes.)


2.  What are __________________’s strengths?  (Highlight all areas in which your child does well, including educational and social environments.)


3.  What are ____________________’s successes?  (List all successes, no matter how small.)


4.  What are ____________________’s greatest challenges?  (List the areas in which your child has the greatest difficulties.)


5.  What supports are needed for ____________________?  (List supports that will help your child achieve his/her potential.)


6.  What are our dreams for ____________________?  (Describe your vision for your child’s future, including both short-term and long-term goals.)


7.  Other helpful information.  (List any pertinent information, including health care needs, that has not been detailed elsewhere in these quesions.

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