Team Member Needs Assessment Please take a moment to let us know what information is most helpful to you and how you would like to receive this information from the Florida and Virgin Islands (FAVI) Deaf-Blind Collaborative. Team Member Training Needs Assessment Please let us know which training and information topics are of greatest value / interest to you. If you would like to be contacted by FOP, please provide OPTIONAL contact information at the bottom of this form. Families, please also see the FAMILY NEEDS ASSESSMENT (left side menu)! Please tell us about your role: Parent of a child with deaf-blindness (PLEASE ALSO SEE THE FAMILY NEEDS ASSESSMENT in menu at left!) Parent of a child with other disabilities Other Disabilities affecting my child:Please tell us about your role: Special Education Teacher Teacher of students with vision loss (TVI) or hearing loss (DHH) General Education Teacher Physical Therapist / Occupational Therapist / Speech Language Pathologist Other Other Role / Title not listed above:Section Break1. Is "Understanding Sensory Loss" an important training topic for you? Yes No Which specific Sensory Loss topics are most important to you? (Select up to three) Understanding / accommodating vision loss Understanding / accommodating hearing loss Understanding / accommodating deaf-blindness Role of the Intervener Other Other specific topic not listed above:2. Is "Accommodations/ Modifications" (IEP/504) an important training topic for you? Yes No Which specific Accommodations / Modifications topics are most important to you? (Select up to three) Access Curriculum Inclusion Deaf-Blindness Other Other specific topic not listed above:3. Is "Curriculum" an important training topic for you? Yes No Which specific Curriculum topics are most important to you? (Select up to three) Accessible Instructional Materials Expanded Core Curriculum Alternative Curricula Curricular Modifications Other Other specific topic not listed above:4. Is "Access" an important training topic for you? Yes No Which specific Access topics are most important to you? (Select up to three) Accessible Instructional Materials Accessible Instructional Environments Recreation & Community Access Training Paraprofessionals as Interveners Other Other specific topic not listed above:5. Is "Assessment" an important training topic for you? Yes No Which specific Assessment topics are most important to you? (Select up to three) Alternate Assessment (grade-level standards) Accommodations for Assessment Alternate Assessment (modified standards) Portfolio Assessment Other Other specific topic not listed above:6. Is "Assistive Technology" an important training topic for you? Yes No Which specific Assistive Technology topics are important to you? (Select up to three) Computer / Software iPad Low tech solutions Deaf-Blindness Other Other specific topic not listed above:7. Is "Communication & Language Development" an important training topic for you? Yes No Which specific Communication & Language Development topics are most important to you? (Select up to three) How do people who are deaf-blind communicate? (includes sign languages, coactive and tactile signing) Communication Symbols (includes Tangible/Tactile symbols) Technologies that support communication Recognizing Behavior as Communication Other Other specific topic not listed above:8. Is "Augmentative & Alternative Communication" (AAC) an important training topic for you? Yes No Which specific AAC topics are most important to you? (Select up to three) AAC Options / Choices Using / Implementing / Integrating AAC Communication Partners Role of the Intervener Other Other specific topic not listed above:9. Is "Daily Living Skills" an important training topic for you? Yes No Which specific Daily Living Skills topics are most important to you? (Select up to three) Self-Care / Health Home Skills Community Skills Orientation & Mobility Other Other specific topic not listed above:10. Is "Literacy" an important training topic for you? Yes No Which specific Literacy topics are most important to you? (Select up to three) Developing literacy in students with blindness / low vision (includes Braille) Developing literacy in students with hearing loss Alternative / Accessible texts Paths To Literacy website (www.pathstoliteracy.org) Other Other specific topic not listed above:11. Is "Recreation & Community Inclusion" an important training topic for you? Yes No Which specific Recreation & Community Inclusion topics are most important to you? (Select up to three) Recreation Options Developing Leisure Skills Existing Programs Community Inclusion Other Other specific topic not listed above:12. Is "Social Skills" an important training topic for you? Yes No Which specific Social Skills topics are most important to you? (Select up to three) Development of Social Skills Interactions Managing challenging behaviors Circle of Friends Other Other specific topic not listed above:13. Is "Tactile Strategies" an important training topic for you? Yes No Which specific Tactile Strategies topics are most important to you? (Select up to three) Touch cues Tactile symbols Tactile signing Tactile graphics Other Other specific topic not listed above:14. Is "Transitioning to Adulthood" an important training topic for you? Yes No Which specific Transitioning to Adulthood topics are most important to you? (Select up to three) Post-secondary education & training Employment services (Supported & Customized Employment) Deaf-Blind Transition Initiatives (https://nationaldb.org/groups/page/13/transition) Adult services Other Other specific topic not listed above:Please add other topics of interest:Specific Questions:Comments:Section BreakPlease tell us about yourself (optional). Name:Organization:Phone:Email:Address:City & Zip Code:Section BreakPlease tell us about your preferences: A. How would you like to receive info or training from the FAVI Deaf-Blind Collaborative? I would like to consult with the D-B Collaborative by phone I would like to consult with the D-B Collaborative by email I would like to consult with the D-B Collaborative in person I would like to borrow materials from the D-B Collaborative lending library I would like to attend training through distance learning I need training in (name of city or School District):B. How do you like to receive notification about disability-related trainings, events, and opportunities?C. Where would you like to receive training from the D-B Collaborative? In my home In my workplace At another location Could you travel to Central Florida for training? Yes No Please choose preferred Central Florida location(s): Orlando Ocala Could you travel to North Central Florida for training? Yes No Please choose preferred North Central Florida location(s): Gainesville Lake City Could you travel to Northeast Florida for training? Yes No Please choose preferred Northeast Florida location(s): Jacksonville St Augustine Daytona Beach Could you travel to South / Southwest Florida for training? Yes No Please choose preferred South / Southwest Florida location(s): Ft Lauderdale Miami Palm Beach Sarasota Tampa Could you travel to West Florida for training? Yes No Please choose preferred West Florida location(s): Tallahassee Panama City Pensacola Other preferred locations:
