UNIVERSAL CHECKLIST July, 2013

Teacher:David Whitney

School/District:NES

Date:11/7/16

Rationale of Use: The purpose of this document is to support teachers and administrators in
developing an enriched and engaging classroom learning environment that meets the needs of all
students.
In Needs
Place Assistance Comments
Environmental Supports

Rules, Routines, Schedules (Visual Supports)

Classroom rules are posted, connected to school-
1 wide expectations, and number 5 or fewer. x
Rules are measurable and observable, are positively
2 stated, and include student voice. x
There is evidence that rules have been taught and
3 practiced. x
Evidence of routines/procedures for each part of the
day in the classroom are available and when
relevant connected to school-wide expectations and
4 routines. x
Adult and student routines exist and include student
5 voice. x
6 There is evidence that routines have been taught x
and practiced.
There is an effective attention signal, both verbal
7 and visual, used in the classroom. x

8 Class schedule is posted and referred to often. x

Schedule includes all student activities, and the
order of highly to lesser preferred activities is
9 considered. x
Individual student schedules are accessible when
1 needed, promote independence, and provide for
0 clear transitions. x
Physical Environment
Classroom has established and defined instructional
1 areas that provide clear, visual boundaries and
1 communicates expectations for achievement. x
The classroom environment is culturally relevant,
1 enriched with materials that are engaging,
2 motivating, and meet the needs of all students. x
1 There are opportunities for movement within the
3 room. x
1 Accommodations are provided to meet individual
4 student needs. x
Teacher/Student Interactions
1 Positive to negative/corrective teacher to student x
5 interaction ratio is at least 4:1.
Students are reinforced for appropriate behavior
following classroom rules both individually and
1 class-wide (using behavior specific praise and
6 incentives). x
 There is evidence the teacher, paraprofessionals, x
1 and other adults use a consistent continuum of
7 consequences for inappropriate behavior.
1 Appropriate behaviors are taught to replace
8 inappropriate behaviors. x
1 Teacher actively supervises students (scan, interact,
9 move). x
Appropriate strategies to prevent, de-escalate
behaviors, and address crisis situations are utilized
2 to promote the care, welfare, safety, and security of
0 all. x
Instructional Strategies
There is evidence of daily, weekly, and yearly lesson
planning in academics, social skills, functional skills,
2 vocational skills, and materials are ready for
1 instruction. x
2 Evidence-based strategies are used to increase
2 student engagement and opportunities to respond. x
2
3 Student choice is embedded into instruction. x
2 Instruction is skillfully differentiated for a variety of
4 learners. x
Evidence of Universal Design for Learning - visual,
2 auditory, and kinesthetic learning styles are used to
5 plan for strengths-based instruction. x
There is evidence that a variety of instructional
2 formats are used, including small group, individual,
6 large-group, student initiated and teacher-directed. x
2 Downtime is minimized or used to improve age-
7 appropriate leisure and social skills. x
2 The pace of instruction is appropriate to promote
8 active student engagement. x
There is evidence that technology is used to
2 promote student engagement, and that digital
9 citizenship has been taught. x
Assistive technology and augmentative
3 communication are utilized based on individual
0 student needs. x
Systems Supports
Communication System
3 There is an effective communication system for
1 students, staff and families. x
3 There is evidence of regularly scheduled team
2 meetings with the use of agendas and minutes. x
If there are paraprofessionals in the classroom, they
3 receive specific and direct instruction regarding
3 their responsibilities to the students. x
Data/Learning Outcomes
3 There is evidence of both formative and summative
4 assessments to guide curriculum planning. x
Behavior and academic data are collected weekly
3 for both individual student and class-wide in order
5 to guide planning and decision-making. x
There is evidence of classroom learning
3 systems/continuous improvement implementation.
6 (PDSA, student data folders, student engagement) x
Treatment integrity and social validity data are
3 regularly used to assess staff effectiveness and
7 implementation of instruction. x

*Online resources (videos, references, documents) will be available to support the researched based practices outlined
*During the year the SSD Behavior Committee will actively seek input from staff. Based on feedback, the Universal Checklist,
will be reviewed and revised annually in the spring.