Special Education - Learning Disabilities Teacher Work Sample Scoring Form

Rating Indicators: Indicator Met: 4-5 points; Indicator Partially Met: 2-3 points; Indicator Not Met: 0-1 points

Professor's Last Name:

Professor's Email Address:

Candidate's First Name:

Candidate's Last Name:

Campus Identification:

Semester

I. Contextual Factors:

A. Community Level

B. School Level

C. Classroom Level

D. Student Level

II. Instructional Planning:

A. Alignment w/Curriculum & Learning Goals

B. Sample

C. Design

D. Procedure

E. Data Analysis & Presentation

III. Results-Evidence of Impact on Student Learning:

IV: Reflection & Professional Implications:

Overall Rating

55-50 Exemplary, 49-44 More than Satisfactory, 43-39 Satisfactory, 38 and below Unsatisfactory

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