Case Manager Survey

IEP Case Manager Survey

Your professional observations help us understand the student's executive functioning profile across the school environment. Rate based on what you've seen this term.

Student

About You

IEP / 504 Context

Executive Functioning Scales

Rate from 1 (significant challenge) to 5 (consistent strength). These ratings set a baseline — not a grade.

Task initiation3

How readily does the student begin academic tasks without prompting or repeated cueing?

1 — Significant challenge5 — Consistent strength
Planning3

How well does the student map out steps and timelines for multi-step assignments?

1 — Significant challenge5 — Consistent strength
Organization3

How organized are the student's materials, workspace, and digital files?

1 — Significant challenge5 — Consistent strength
Time management3

How accurately does the student estimate time needed and meet deadlines?

1 — Significant challenge5 — Consistent strength
Working memory3

How reliably does the student hold multi-step instructions in mind during a task?

1 — Significant challenge5 — Consistent strength
Self-monitoring3

How well does the student check their own work and notice errors before submitting?

1 — Significant challenge5 — Consistent strength
Emotional regulation3

How well does the student manage frustration, stress, and setbacks within the school day?

1 — Significant challenge5 — Consistent strength
Flexibility / shifting3

How well does the student adapt when plans, expectations, or routines change?

1 — Significant challenge5 — Consistent strength
Goal-directed persistence3

How well does the student stick with long-term goals despite distractions or setbacks?

1 — Significant challenge5 — Consistent strength
Self-advocacy3

How effectively does the student ask for help, accommodations, or clarification?

1 — Significant challenge5 — Consistent strength

Context & Goals

Anything Else