Pedagogical support plan SCHOOL INFORMATION Pedagogical support plan (PSP) Name and surname of the child, pupil or student (“student”) Name and surname School School, city, street Form Form Reasons for creating the PSP Provide the main reasons that led you to create a PSP for the student. Date of preparation Date of preparation PSP evaluation scheduled for Date of planned evaluation I. Characteristics of the student and their difficulties (strengths, weaknesses; description of difficulties; where applicable, special-pedagogy diagnostics with the aim of determining adjustments in education; current health condition; other factors influencing setting up support) List the student’s difficulties that have led you to create the PSP. See the bracket above for more details. II. Setting the objectives of the PSP (objectives of the student’s development) Based on the information above, state the objectives you want to achieve for the student. III. Support measures at school (Provide specific procedures in the categories of the support measures you use.) (a) Teaching methods (specification of adjustments to the methods of working with the student) State the methods you plan to apply in the context of support for the student to achieve the set objectives. (b) Organization of education (adjustments to the organization of education in the classroom or, where applicable, outside the classroom) State how you plan to use the adjustments to the organization of the student’s education to achieve the set objectives. (c) Evaluation of the student (definition of the adjustments to evaluation; how the evaluation is carried out; what is the aim of the adjustments to the evaluation; criteria) State how you plan to adjust the evaluation of progress to support and help achieve the objectives set by this PSP. (d) Aids (textbooks, worksheets, ICT technology, etc.) State the aids you plan to use to achieve the objectives. (e) Requirements for the organization of the teachers’ work State the requirements you have for the other teachers who teach the student to achieve the set objectives. IV. Support measures for home preparation (description of adjustments to home preparation, form, and frequency of communication with the family) State how the student’s home preparation will be and how communication with the family will take place to ensure the implementation of the support measures synergistically in home preparation. V. Other support measures (to respect the health condition, stress the situation in the family or at school—relationship problems, status in the class; in what activities, in what way) State any other support measures. VI. Evaluation of the effectiveness of the PSP on: (Fulfilment of the objectives of the PSP) State how you succeeded in using the set criteria to achieve the set objectives; provide the date of evaluation. Recommendation for an expert examination^1 ☐Yes ☐ No ☐ PPC ☐ SPC ☐ SEN ☐ Other: Other Title Name and surname Signature and date Class teacher Name and surname of the class teacher Teacher(s) of subject(s) Name and surname of the teacher(s) SCC employee Name and surname of the school counseling center employee Legal representative