The madison social relationship inventory



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Transfer-Practice

Have arrangements been made for the student to transfer and practice what the tutor teaches him/her?


Yes
No

If yes, report those who have agreed to make sure the student performs what is learned in Current Tutor Relationship #1.



If no, report those who should assume transfer-practice responsibilities and the reasons why.


Supervision

Report those responsible for supervising Current Tutor Relationship #1.


Peer tutor advisor
Guidance counselor
Educational assistant
Special education teacher
Coach
Bus Driver



Are those responsible for supervising Current Tutor Relationship #1 acceptable?


Yes
No

If "No," report why those responsible for supervising Current Tutor Relationship #1 are unacceptable.



If "No", report those that should be responsible for supervising Current Tutor Relationship #1.
Coach
Regular education teacher
Peer tutor advisor
Guidance counselor




Evaluation

Report those responsible for evaluating Current Tutor Relationship #1.


Regular Education teacher
Special Education teacher




Are those responsible for evaluating Current Tutor Relationship #1 acceptable?


Yes
No
If "No," report why those responsible for evaluating Current Tutor Relationship #1 are unacceptable.

If "No," report those that should be responsible for evaluating Current Tutor Relationship #1.





Extra Hardships

Record any extraordinary hardships that may be operative because the student participates in Current Tutor Relationship #1.



Are there reasonable courses of action that can be taken to alleviate at least some of the extraordinary hardships that result from the student participating in Current Tutor Relationship #1?
Yes
No

If "Yes," report the actions that may reduce at least some of the hardships and who might take them.






Future Plans

Have plans to accommodate changes in Tutor Relationship 1# been developed?


Yes
No

If "Yes," report where the plans are located.


In the current IEP
In the current Individualized Transition Plan
In the most recent Multidisciplinary Team Report
In the Individualized Family Support Plan (IFSP)

If "No," report why such plans are not available.
Changes in Tutor Relationship #1 are not anticipated.

Other tutor relationships are not high priorities at this time.
No one has considered the future before now.
A plan is currently being developed.


Additional Information

Record additional information that should be considered in the process of determining whether Current Tutor Relationship #1 is in reasonable accordance with the values presented.




Summary Judgment

After considering all the information gathered, is it your judgment that Tutor Relationship #1 is in reasonable accordance with the values or is otherwise acceptable?


Yes
No

Tutor Relationship #2


Adapt the forms, etc. used to compare the realities of Tutor Relationship #2 to the values. After considering all the information gathered, is it your judgment that Tutor Relationship #2 is in reasonable accordance with the values or is otherwise acceptable.
Yes
No


Summary Judgment Across Tutor Relationships

If at least one tutor relationship is not operative, realities are not in accordance with the values.


Is it your judgment that current tutor relationships are in reasonable accordance with the values or are otherwise acceptable?

Record your judgment on the Social Relationship Summary Chart in the Summary and Preferences Section.


Extracurricular Activity Relationships

The significant individuals in the life of a student who is severely disabled are responsible for ensuring that after school hours, weekends, summers, holidays and other nonschool days are spent in enjoyable and constructive environments, activities and social relationships with a reasonable array of knowledgeable, helpful and positive nondisabled persons. Conversely, they are responsible for ensuring that as little time as possible is spent with negative models, in unnatural isolation, engaging in maladaptive actions, etc. Participation in integrated school sponsored extracurricular activities is one of many constructive ways a student with disabilities can enjoy important social relationships with nondisabled peers in safe, supervised and habilitative environments. "School sponsored" means that school space, personnel, dollars or other resources are devoted to the support of an activity that is primarily, and in many instances exclusively, for students who attend a particular school.


The development of extracurricular activity supportive companion relationships is inversely related to financial and other costs. Specifically, the more extracurricular activity supportive companion relationships that are operative, the less economically, emotionally and otherwise demanding it will be for the student, those directly responsible for her/his well being and taxpayers.


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