FIŞĂ DE EVALUARE COMPLEXĂ A COPILULUI CU DIZABILITĂŢI

A. DATE PERSONALE
1. Numele şi prenumele: _____________________________________________________
2. Data şi locul naşterii: ___.___.______, ________________________________________
3. C.N.P. __________________________
4. Domiciliul _________________________________________________________________

B. MEDIUL FAMILIAL
1. Numele şi prenumele părinţilor:
a. Mama ________________________________
b. Tata _________________________________
2. Atitudinea familiei faţă de copil: _________________________________________________
_____________________________________________________________________________
3. Situaţia în familie: ____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________.

C. DATE MEDICALE:
a. Anamneză: ___________________________________________________________
__________________________________________________________________________
b. Diagnostic: ___________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

D. EVALUARE PSIHOLOGICĂ:
1. Nivelul de inteligenţă: Q.I. = ____
2. Limbajul şi comunicarea: _____________________________________________________
_____________________________________________________________________________
3. Motivaţia: _________________________________________________________________
_____________________________________________________________________________
4. Emotivitate: _________________________________________________________________
_____________________________________________________________________________
5. Temperament: ______________________________________________________________
_____________________________________________________________________________
6. Aptitudini: _________________________________________________________________
_____________________________________________________________________________
7. Atitudini: __________________________________________________________________
_____________________________________________________________________________
8. Nivelul maturizării psihosociale: _________________________________________________

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9. Profilul psihologic: ____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

E. CONDUITA ELEVULUI
1. Conduita la lecţie: ____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
2. Purtarea în general: ___________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
3. Participarea la viaţa de grup: ____________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. Aprecierea grupului vis-a-vis de conduita elevului: _________________________________
_____________________________________________________________________________
_____________________________________________________________________________

F. TRASEU EDUCAŢIONAL
1 Situaţia şcolară actuală (şcoala, clasa): _____________________________________________
______________________________________________________________________________
2. Programe educaţionale la vârsta preşcolară: ________________________________________
_____________________________________________________________________________
3. Pregătirea şcolară (instituţia şi tipul de şcolarizare): __________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. Activităţi de sprijin/educare/recuperare/integrare/normalizare: ________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

G. PROPUNERI PENTRU ORIENTAREA ŞCOLARĂ

1. Unitatea de învăţământ: special/normal ___________________________________________
______________________________________________________________________________
2. Clasă specială/normală în unitatea de învăţământ: __________________________________
3. Meseria (pentru şcoala profesională): ____________________________________________
_____________________________________________________________________________
4. Regim de şcolarizare: _________________________________________________________
______________________________________________________________________________

MEMBRI COMISIEI INTERNE DE EVALUAREA ELEVILOR

SEMENIUC HERMINA – PSIHOPEDAGOG

HONCIUC IONELA - PROFESOR
TOMAZIU ELISABETA – PROFESOR
MOISIUC ANCA - INVATATOR
CIRSTIUC MARIELA - INVATATOR
ANDRONACHI TAMARA - LOGOPED
CLEM CIPRIAN - LOGOPED