Anexa 4

ANTETUL UNITII DE NVMNT

Nr. inregistrare: _____/______________

Aprobat,
Directorul unitii de nvmnt

FIA PSIHOPEDAGOGIC
pentru elevul cu dizabiliti i/sau cerine educaionale speciale

I. DATE PERSONALE:
Numele i prenumele: _______________________________________
Data naterii: ______________________
Domiciliul: ___________________________________________
________________________________________________

Unitatea de nvmnt: ___________________________________

Grupa/Clasa: ______________________

II. DATE FAMILIALE:

Date despre prini/reprezentant legal:
Tatl - numele i prenumele: ________________________
- ocupaia: ________________ locul de munc: _________________
Mama - numele i prenumele: ________________________
- ocupaia: ________________ locul de munc: _________________
Reprezentant legal - numele i prenumele: ________________________
- ocupaia: ________________ locul de munc: _________________
Structura i componena familiei:
Tipul familiei:
monoparental prin: statut iniial, deces, divort, separatie
legal constituit
alte situaii _________________________________
Frai/surori (numr frai/surori, vrst, statut/ocupaie):
________________________________________________
________________________________________________
Alte situaii relevante pentru evoluia copilului:
prini plecai n strintate: ______________________
crescut de rude de gradul II, III: ____________________
n protecie special: ________________
alte situaii: ___________________________________
 Atmosfera i climatul familial:
raporturi armonioase, de nelegere ntre prini/ ntre prini i copii
raporturi punctate de conflicte mici i trectoare
dezacorduri puternice n familie, conflicte frecvente
familie destrmat sau pe cale de destrmare
alte situaii: _______________________________
Atitudinea prinilor/reprezentantului legal fa de coal i fa de problemele de
educaie ale copilului: _____________________________
________________________________________________________

III. STAREA DE SANATATE:

a) Starea generala de sanatate ___________________________
b) Mentiuni medicale importante pentru procesul de invatamant: __________________
_________________________________________________________________________________________________________________________
___________________________________________________________
IV. EVALUARE PSIHOPEDAGOGIC:

Dezvoltare psihomotorie (coordonare motorie, schema corporal, lateralitate, structuri perceptiv-

motrice, orientare spaio-temporal/Repere fundamentale in invatarea si dezvoltarea timpurie a
copilului de la nastere pana la 7 ani): ______________________________
____________________________________________________________
____________________________________________________________
Alte particulariti(deficiene i conduite specifice): ___________________________
____________________________________________________________

Procesele cognitive i stilul de munc:

Gndirea:
nelegenoiuni: simple complexe
Definetenoiuni: simple complexe
Opereaz cu noiuni: simple complexe
nelegerelaiilecauz-efect: da nu
Alteparticulariti ale gndirii:________________________________________________
______________________________________________________________________
Memoria:
Formele memoriei:
de scurtdurat delung durat
vizual auditiv mixt

Alteparticulariti ale memoriei:______________________________________________

_________________________________________________________________
Limbaj i comunicare:
Vocabular:
redus mediu dezvoltat bogat
Exprimare oral:
nu comunic oral greoaie incorect gramatical clar, corect
 Tulburri de limbaj: _______________________________________________

Alteparticulariti ale limbajului:______________________________________________

_________________________________________________________________

Atenia:
tulburri deatenie nu prezint tulburride atenie
Alteparticulariti (concentrare, stabilitate, volum, etc.):______________________________
_________________________________________________________________

Motivaia de nvare:
extrinsec intrinsec

Alteparticulariti:____________________________________________________

Receptivitatea,participarea i implicarea:
participactiv,cuinteres interesinegal,fluctuant pasiv
greu de antrenat inegal, absent

Alteparticulariti:____________________________________________________
__________________________________________________________________
Relaii sociale:
sociabil,comunicativ retras, izolat, puin comunicativ
turbulent agresivitate verbal agresivitate fizic

Alteparticulariti:____________________________________________________
_____________________________________________________________

Nivelul achiziiilor colare (deprinderi, interese):

Deprinderi de citit:
total absente slabe bune foarte bune
Deprinderi de scris:
total absente slabe bune foarte bune
Deprinderi de calcul:
total absente slabe bune foarte bune
Abiliti sau interese speciale: ____________________________________________________

Alteparticulariti: ___________________________________________________
_____________________________________________________________

V. REZULTATE SCOLARE SI EXTRASCOLARE ALE ELEVULUI

a) Discipline la care a obinut rezultate deosebite_________________________________________
b) Rezultate deosebite obinute n activiti extracolare: _________________________________
c) Factori explicativi ai reuitei colare/dificultilor ntmpinate pe parcursul programului scolar:
_______________________________________________________________________________
_____________________________________________________________________________________
VI. TRASEUL EDUCAIONAL:
Programe educaionale la vrst anteprecolar (cre, grdini, centre de zi cu component
educaional):
Denumirea instituiei: _____________________________________________
Perioada: ______________________________________________________
Observaii: _____________________________________________________

Programe educaionale la vrst precolar ( grdini, centre de zi cu component educaional):

Denumirea instituiei: _____________________________________________
Perioada: ______________________________________________________
Observaii: _____________________________________________________

Pregtirea colar (uniti de nvmnt de mas, uniti de nvmnt special/special integrat):

Denumirea instituiei: _____________________________________________
Perioada: ______________________________________________________
Observaii: _____________________________________________________
Denumirea instituiei: _____________________________________________
Perioada: ______________________________________________________ Observaii:
_____________________________________________________
Denumirea instituiei: _____________________________________________
Perioada: ______________________________________________________ Observaii:
_____________________________________________________

Promovat n anul anterior: DA NU

Activiti desprijin anterioare i prezente, inclusivextracolare (terapii n centre/clinici, n grdini

sau coal): ____________________________________
_____________________________________________________________________________________________________________________

Comportamentul n timpulactivitilorcolare anterioare i prezente: _______________

____________________________________________________________
____________________________________________________________

Observaii i recomandri, inclusiv privind forma de colarizare: _________________

_________________________________________________________________
_________________________________________________________________

ntocmit,
Numele i prenumele: Data ntocmirii:
Funcia:
Semntura: