Planning Universally Designed Instruction

(Pre-Planning Guide)
Teacher(s): ___________________
Grades: _______________
Period: ____________________
Subject: ___________________
Collaborators:_______________
Setting: ___________________
# of Students:
_____________________________

Students Needing Extra Supports

Adaptations/Modifications:
(add student initials):
IEPs _______________________
Section 504 _________________
BIPs _______________________
Language ___________________
Other needs/challenges:

Students Needing
Enrichment
Extensions/Challenges (add
student initials:
________________________
____________________
Notes:__________________
______________________

Topic:_______________________________________________________________________________
Standard Course of Study Goals/Objectives:
_____________________________________________________________________________________
_____________________________________________________________________________________
Broad IEP Goals (Where Applicable): ______________________________________________________
Unit Goals and Essential Questions for All Students: __________________________________________
_____________________________________________________________________________________
Lesson Objectives:

Some: _______________________________________________________________
Most: _______________________________________________________________
All:

_______________________________________________________________

Brainstorm Activities
Multiple Means of Representation: __________________________________________________________
______________________________________________________________________________________
Multiple Means of Engagement: ____________________________________________________________
______________________________________________________________________________________
Multiple Means of Expression: _____________________________________________________________
______________________________________________________________________________________
Source(s) for digital/scaffolded text for this unit:
________________________________________________________________________________________
____________________________________________________________________________________
Computer lab needs/schedule________________________________________________________________
Other space requirements: __________________________________________________________________
Other Materials/Resources needed:
___________________________________________________________________
Paraprofessionals:__________________________ Community Resources:__________________________
Grouping Students: Large group: _________________________________
Small group: _________________________________
Individual: _________________________________
Source: Adapted from P. Hubbard, Reducing Barriers to Learning Through a Universally Designed
Classroom, poster session presented at the 2008 CEC Convention and Expo, Boston, MA (2008, April).