The madison social relationship inventory



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Time

Report the typical amounts of time the student spends traveling from home to school and from school to home or examine the Current Travel Charts.



Environments
From - To Time
Home - School min.
School - Home min.

Are the amounts of time the student spends traveling from home to school and from school to home acceptable?


Yes
No

If "Yes," report why the amounts of time the student spends traveling from home to school and from school to home are acceptable.


The student spends the same amount of time he/she would spend if not disabled.
Travel time is excessive but unavoidable because

If "No," report why the amounts of time the student spends traveling from home to school and from school to home are unacceptable.
The student spends much more time in transit than he/she would if not disabled.
The amount of time spent in transit is unhealthy.

Report the amounts of time the student spends traveling to and from nonschool environments during school times or examine the Current Travel Charts.




Environments
From - To Time
- min.
- min.
- min.
- min.
- min.

Are the amounts of time the student spends traveling to and from nonschool environments during school times acceptable?


Yes
No

If "Yes," report why the amounts of time the student spends traveling to and from nonschool environments during school times are acceptable.



If "No," report why the amounts of time the student spends traveling to and from nonschool environments during school times are unacceptable.
The amount of time spent in transit is unhealthy.
Too much time is spent traveling with poor models.

Report the amounts of time the student spends traveling after school and during weekends or examine the Current Travel Charts.
Environments
From - To Time
- min.

- min.

- min.
- min.
- min.

Are the amounts of time the student spends traveling after school and during weekends acceptable?


Yes
No

If "Yes," report why the amounts of time the student spends traveling after school and during weekends are acceptable.



The student spends the same amounts of time traveling he/she would spend if not disabled.
More travel time is unavoidable because




Less time is spent traveling because

If "No," report why the amounts of time the student spends traveling after school and during weekends are unacceptable.






Trips Per Week

The number of trips the student makes off school grounds during school times in a typical week is



Is the number of trips the student makes off school grounds during school times acceptable?


Yes
No

If "Yes," report why the number of trips the student makes off school grounds during school times is acceptable.


The student makes more trips because direct instruction in nonschool environments is necessary and appropriate.

The student makes more trips than he/she would make if not disabled because


The student makes fewer trips than she/he would make if not disabled because



If "No," report why the number of trips the student makes off school grounds during school times is unacceptable.


Important social relationships with nondisabled schoolmates are not being developed because the student makes too many trips off school grounds.
The student should make more trips to nonschool environments during school days for instructional purposes.




The number of trips the student makes per week after school and during weekends is



Is the number of trips the student makes per week after school and during weekends acceptable?


Yes
No

If "Yes," report why the number of trips the student makes per week after school and during weekends is acceptable.


The student makes about the same number of trips he/she would make if not disabled.
The student makes more trips than she/he would make if not disabled. This is acceptable because


The student makes fewer trips than he/she would make if not disabled.

If "No," report why the number of trips the student makes per week after school and during weekends unacceptable.
He/she spends too much time in the house. She/he should visit more places.




Extra Support

Extra support refers to the PERSONNEL, INFORMATION-TRAINING, INDIVIDUALIZED ADAPTATIONS, MONEY and OTHER phenomena a student and those who function with her/him need in order to travel acceptably, THAT WOULD NOT BE NEEDED IF HE/SHE WAS NOT DISABLED. In reality, it is often difficult or impossible to delineate mutually exclusive support categories. However, for organization and communication purposes it seems necessary here.


Report the PERSONS who provide support as the student travels from home to school and from school to home, who would not do so if she/he was not disabled.
Special Education teacher
Regular Education teacher
Instructional assistant
Occupational therapist
Physical therapist
Peer tutor
Adaptation specialist
Mobility therapist
Supportive travel companion



Are the PERSONS who provide extra support while the student travels from home to school and from school to home acceptable?


Yes
No
If "Yes," report why the PERSONS who provide extra support as the student travels from home to school and from school to home are acceptable.


If "No," report why the PERSONS who provide extra support while the student travels from home to school and from school to home are unacceptable.


Classmates without disabilities could easily assist the student, but do not.
He/she receives more supervision from extra PERSONS than is actually needed.
She/he receives less supervision than is actually needed.





Report the PERSONS who should provide extra support as the student travels from home to school and from school to home.
Schoolmates without disabilities
Travel tutor
Adaptation specialist
Mobility specialist
Supportive travel companion

Report the persons who provide extra support as the student travels to and from nonschool environments during school times.


Special Education teacher
Regular Education teacher
Instructional assistant
Occupational therapist
Physical therapist
Peer tutor
Adaptation specialist
Mobility therapist
Supportive travel companion

Are the PERSONS who provide extra support as the student travels to and from nonschool environments during school times acceptable?


Yes
No
If "Yes," report why the PERSONS who provide extra support as the student travels to and from nonschool environments during school times are acceptable.

If "No," report why the PERSONS who provide extra support as the student travels to and from nonschool environments during school times are unacceptable.


She/he receives too much supervision from paid personnel.





Report the persons who should provide extra support as the student travels to and from nonschool environments during school times.
Classmates without disabilities
Travel tutor
Adaptation specialist
Mobility specialist
Supportive travel companion

Report the PERSONS who provide extra support as the student travels after school and during weekends.


Special Education teacher
Regular Education teacher
Instructional assistant
Occupational therapist
Physical therapist
Peer tutor
Adaptation specialist
Mobility therapist
Supportive travel companion




Are the PERSONS who provide extra support as the student travels after school and during weekends acceptable?


Yes
No

If "Yes," report why the PERSONS who provide extra support as the student travels after school and during weekends are acceptable.




If "No," report why the PERSONS who provide extra support as the student travels after school and during weekends are unacceptable.


He/she receives more supervision from extra personnel than is actually needed.
She/he receives less supervision than is actually needed.



Report the PERSONS who should provide extra support as the student travels after school and during weekends.
Classmates without disabilities
Travel tutor
Adaptation specialist
Mobility specialist
Supportive travel companion

In some instances those who interact with the student may be in need of INFORMATION or specific kinds of TRAINING that would not be needed if she/he was not disabled. A carpoolmate may need specific information about behavior management strategies; a school bus driver may need to be trained to use an emergency medical procedure, etc.

Report the extra INFORMATION-TRAINING that has been provided those who are involved with the student as he/she travels from home to school and from school to home.





Is the extra INFORMATION-TRAINING that has been provided those involved with the student as he/she travels from home to school and from school to home acceptable?


Yes
No

If "No," report why the extra INFORMATION-TRAINING provided those involved with the student while he/she travels from home to school and from school to home is unacceptable.




Is there additional INFORMATION-TRAINING that should be provided those involved with the student while he/she travels from home to school and from school to home?


Yes
No

If "Yes," report the additional INFORMATION-TRAINING that should be provided.




Report the INFORMATION-TRAINING provided those involved with the student while he/she travels to and from nonschool environments during school times.




Is the INFORMATION-TRAINING provided those involved with the student while he/she travels to and from nonschool environments during school times acceptable?


Yes
No

If "No," report why the extra INFORMATION-TRAINING provided those involved with the student while she/he travels to and from nonschool environments during school times is unacceptable.





Is there additional INFORMATION-TRAINING that should be provided those involved with the student while he/she travels to and from nonschool environments during school times?
Yes
No

If "Yes," report the additional INFORMATION-TRAINING that should be provided.





Report the INFORMATION-TRAINING that has been provided those involved with the student while he/she travels after school and during weekends.




Is the INFORMATION-TRAINING provided those involved with the student while she/he travels after school and during weekends acceptable?


Yes
No

If "No," report why the INFORMATION-TRAINING provided those involved with the student while he/she travels after school and during weekends is unacceptable.




Is there additional INFORMATION-TRAINING that should be provided those involved with the student while she/he travels after school and during weekends?


Yes
No

If "Yes," report the additional INFORMATION-TRAINING that should be provided.




INDIVIDUALIZED ADAPTATIONS are the materials, equipment, assistive devices, sequences, regulations and other phenomena that may have to be utilized, modified or created so the student can function in reasonable accordance with capacity when traveling.

Report the INDIVIDUALIZED ADAPTATIONS used when the student travels from home to school and from school to home.





Are the INDIVIDUALIZED ADAPTATIONS used when the student travels from home to school and from school to home acceptable?
Yes
No

If "No," report why the INDIVIDUALIZED ADAPTATIONS used when the student travels from home to school and from school to home are unacceptable.


The adaptations being used do not work properly.
The adaptations being used prevent the student from engaging in social interactions with nondisabled schoolmates.
The adaptations being used do not increase her ability to travel more proficiently.
The adaptations being used attract negative attention.
The adaptations being used are demeaning.





Are there INDIVIDUALIZED ADAPTATIONS that can be utilized or created that might help the student travel more proficiently from home to school and from school to home?
Yes
No

If "Yes," report the INDIVIDUALIZED ADAPTATIONS and how they might be used.



Report the INDIVIDUALIZED ADAPTATIONS used when the student travels to and from nonschool environments during school times.




Are the INDIVIDUALIZED ADAPTATIONS used when the student travels to and from nonschool environments during school times acceptable?


Yes
No

If "Yes," report why the INDIVIDUALIZED ADAPTATIONS used when the student travels to and from nonschool environments during school times are acceptable.


The adaptations allow the student to travel more proficiently.

If "No," report why the INDIVIDUALIZED ADAPTATIONS used when the student travels to and from nonschool environments during school times are unacceptable.


The adaptations being used do not work properly.
The adaptations being used prevent the student from engaging in social interactions with nondisabled persons
The adaptations being used do not increase the students ability to travel more proficiently.
The adaptations being used attract negative attention.

The adaptations being used are demeaning.




Are there INDIVIDUALIZED ADAPTATIONS that can be utilized or created that might help the student travel more proficiently to and from nonschool environments during school times?


Yes
No

If "Yes," report the INDIVIDUALIZED ADAPTATIONS and how they might be used.




Report the INDIVIDUALIZED ADAPTATIONS used when the student travels after school and during weekends.




Are the INDIVIDUALIZED ADAPTATIONS used when the student travels after school and during weekends acceptable?


Yes
No
If "No," report why the INDIVIDUALIZED ADAPTATIONS used when the student travels after school and during weekends are unacceptable.
The adaptations being used do not work properly.
The adaptations being used prevent the student from engaging in social interactions with nondisabled peers.
The adaptations being used do not increase the students ability to travel more proficiently.
The adaptations being used attract negative attention.
The adaptations being used are demeaning.



Are there INDIVIDUALIZED ADAPTATIONS that can be utilized or created that might help the student travel more proficiently after school and during weekends?


Yes
No

If "Yes," report them and how each might be used.






Note


Travel cost information specific to Madison, WI during the 1993-94 school year is presented below.


Students with disabilities who used the actual buses they would use if not disabled to get from home to school and from school to home paid for each trip as follows.
Elementary School - Grades K-5 - 0

Middle School - Grades 6-8 - $. per trip

High School - Grades 9-12+ - $. per trip
The cost of transporting a student with severe disabilities from home to school and from school to home on privately contracted specialized vans and buses was $ per round trip.
When taxi cabs were used to transport students from home to school and from school to home, the rates that applied to nondisabled persons were operative.
When students with severe disabilities were provided instruction in nonschool environments during school days and times, the associated travel costs were as follows.
Public buses - $.85 per trip with, and $. per

trip without, a Student ID card.


Privately contracted specialized vans - $ per

trip or $ per round trip.


The personal cars of teachers - $. per mile paid

by the school district.


Taxi cabs - standard rates.

For each trip made from home to school and from school to home report: the travel mode typically used, the approximate cost and the source of funds.


Day From - To Mode Cost Source
M Home - School
School - Home
T Home - School
School - Home

W Home - School


School - Home

Th Home - School


School - Home

F Home - School


School - Home

The average daily cost of travel from home to school and from school to home is




Is the cost of travel from home to school and from school to home acceptable?


Yes
No

If "No," report why the cost of travel from home to school and from school to home is unacceptable.


Money is being unnecessarily spent on specialized transportation.
Parents are unnecessarily burdened with travel costs.
The school district is wasting valuable tax dollars.
Money would be saved if the student traveled from home to school and from school to home via the less costly modes she/he would use if not disabled.
If the student attended his/her home school, he/she could ride with nondisabled students on less costly regular school buses.
If the student attended his/her home school, she/he could walk or wheel with nondisabled schoolmates at no cost.



Can the student use less costly, yet appropriate, modes to travel from home to school and from school to home?


Yes
No

If "Yes," record the costly, yet appropriate, modes that could be used to travel from home to school and from school to home.




For each trip made to and from nonschool environments during school times report: the nonschool environment visited, the travel mode typically used, the approximate cost of each round trip and the source of funds.


Day Environment Mode Cost Source
M


T



W




Th




F




Is the cost of travel to and from nonschool environments during school times acceptable?


Yes
No

If "Yes," report why the cost of travel to and from nonschool environments during school times is acceptable.


The costs are the same as they would be if the student was not disabled.
It costs more to travel to and from nonschool instructional environments. This is necessary to minimize serious health risks.
It costs more to travel to and from nonschool instructional environments, but higher costs are unavoidable because



If "No," report why the costs of travel to and from nonschool environments during school times are unacceptable.
Money is being unnecessarily spent on specialized transportation.
Money would be saved if the student learned to travel to and from nonschool instructional environments via the modes she/he would use if not disabled.
If the student attended his/her home school, she/he could walk or wheel to nonschool instructional environments near his/her home.
If the student attended his/her home school she/he could travel to and from instructional environments near his/her home on less costly public buses.

Are there less costly, yet appropriate, modes the student should used to travel to and from nonschool environments during school times?


Yes
No

If "Yes," record the less costly, yet appropriate, modes that should be used.





For each trip made during a typical week that is not associated with traveling from home to school and from school to home or to and from nonschool environments for instructional purposes during school times, report: the environments visited, the travel modes typically used, the approximate costs of each round trip and the sources of funds.


Day Environment Mode Cost Source
M


T



W




Th




F



S



S




The average weekly cost of after school and weekend travel is



Are the costs of after school and weekend travel acceptable?


Yes
No
If "No," report why the costs of after school and weekend travel are unacceptable.
Money is being unnecessarily spent on specialized transportation.
Parents are unnecessarily burdened with travel costs.
Money would be saved if the student was taught to ride the public buses.
Money would be saved if the student rode in a carpool with nondisabled peers.

Are there less costly, yet appropriate, modes the student can use to travel after school and during weekends?


Yes
No

If "Yes," record the less costly, yet appropriate, modes that could be used to travel after school and during weekends.



The weekly cost of travel to the family is approximately

Is the weekly cost of travel to the family acceptable?


Yes
No

If "No," report why the weekly cost of travel to the family is unacceptable.


Are there instances in which the family uses more costly when less costly modes could be used?


Yes
No

If "Yes," report the more costly modes that are used by the family and why.


A family car is used on a long vacation because commercial buses are not accessible or because of prior negative experiences on less costly public buses.

Record the cost of any travel that was not reported above. Specifically, record the relevant environments, the modes used, the number of such trips per week, the approximate cost per trip, and the sources of money.

Environments # of

From - To Modes Trips Cost Source

-
-

-

-
-

-


-



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