1. MY VOICE Copyright 2009-2010, All Rights Reserved

2. Personal Information My name is ________________________ My birthday is ______________________ I go to school _____(where)___________

3. PERSONAL INFO./LIVING ARRANGEMENTS See Section #1 of Binder For: Pre-Admission Screening Procedures and Definitions Description of Types of Residential Options Refer to TPI forms and materials (Student, Home, School) Refer to Flow Chart See CD or flash drive for: “Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file

4. Living Arrangement I live in___________________ with______________________

5. Living Arrangement Eventually, I want to live ________________________ with__________________________________________ I do NOT want to live ___________________________ with _________________________________________

6. Living Arrangement The type of help and supports I may need at home include _________________ _________________ _________________

7. Living Arrangement I have made/or need to contact ___(PAS Agency)____ to assess my eligibility for certain housing options and/or services in my home. A PUNS form was completed with _(agency_____ on ____(date)__ by ___(who)__ to let the state know my needs for supports and services. I must update this information every year.

8. Employment See Section #2 in Binder for: Pocket Resume, Example Resume, Functional Resume Worksheet, High powered action word list, Reference List Outline, Telephone Contact Description, Phone Contacts common questions, Employee handbook description, Employer Contact Table, Cover letter Outline, 28 common cover letter mistakes, Job application tips, Job shadowing activity, My week at work worksheet, Job analysis form, writing a thank you letter or card, Cover letter example Universal Application for DuPage vocational and day program services Military training considerations Work Personality Profile Employability/Life Skills Assessment Job Shadow Expectations, Job Shadow on site activities and materials, “More than Meets the Eye” worksheet, Chamber of Commerce Job Shadow Student Evaluation, Vocational The 411 on Disability Disclosure (workbook) Self-Employment FAQs & Self-Employment Growing Customers article (Griffin-Hammis) See Main Site Binders for: YES software CD’s (compilation of video examples of various careers) found in “Choose and Take Action: Finding the Right Job for You” workbook with interactive CD-ROM (basic career videos and decision making ideas and strategies regarding employment) R-FVII:2 Reading-Free Vocational Interest Inventory: Second Edition See CD or flash drive for: “Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file LPS Vocational Summary Final PDF.

9. Employment For work I ______________________________ with the support of _______________________

10. Employment For work, I do NOT like to _________________ Some things I can not do at work include ______________________________________

11. Employment For work, I would like to ______________________________________ ______________________________________

12. Employment I would like to work ____________ I can work for ____________ I prefer to work _____________

13. Employment To be successful at work, the type of help or supports I need include____________ _________________ _________________ _________________ I have a DHS/DRS counselor named____________

14. Education and Training See Section #3 in Binder for: Postsecondary Course Analysis Guide Adaptations Profile School Modifications and Adaptations Considerations When Preparing for College Questions to Ask About Accommodations for College Student should meet with School Counselor to discuss plans and options See CD or flash drive for: “Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file

15. Education and Training While attending or after leaving the high school/transition program, I would like to attend or be involved in ______________________________________ ______________________________________ ______________________________________

16. Education and Training While attending or after leaving the high school/transition program, I would NOT like to attend or be involved in ______________________________________ ______________________________________ ______________________________________

17. Education and Training To be successful in educational or training programs/classes that meet my needs, the type of help or supports I require include ______________________________________ ______________________________________ ______________________________________

18. Daily Living See Section #4 in the Binder for: Independent Living Assessment Instrument Assessment of Financial Skills and Abilities Independent Living Postsecondary Goal IEP Team Decision Assistance Form (Draft) The Learning Clinic’s Transition & Independent Living Skill Assessment The Transition to Community Living Self-Assessment (from Clearinghouse for Home and Community Based Services) See Main Site Binder for: Life Skills Video Curriculum Series: “Looking Good” Curriculum with data forms “Keeping House” Curriculum with data forms “Home Cooking” Curriculum with illustrated recipes and data forms See CD or flash drive for: “Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file Independent Living Assessment PowerPoint “Independent Living Post-Secondary Goal Decision Assistance Form” Word Document File

19. Daily Living When taking care of my personal grooming, dressing, and hygiene needs, I can ____________________ ____________________ I need some help with help with ____________________ ____________________ I have applied for/must apply for personal care assistance/nursing/ respite services through ____(agency)_________

20. Daily Living I know how to cook ______________________________________________________ When preparing food, I can use ______________________________________________________ I need help with ______________________________________________________

21. Daily Living My favorite foods include _________________________________________________ When eating, I need _________________________________________________ I do not like _________________________________________________

22. Daily Living Around the house, I can ______________________________________ ______________________________________ Around the house, I need help or reminders to ______________________________________ ______________________________________

23. Daily Living When managing money, I can ______________________________________ When managing money, I need some assistance ______________________________________ When I need help with my money, I prefer it when________________ helps me.

24. Daily Living To pay for things, I get my money from _____________________________________________ With the money I have, I pay for _____________________________________________ I would like to spend my money on _____________________________________________

25. Preferences and Interests/Recreation and Leisure See Section #5 in Binder for: Survey of Indoor and Outdoor Recreational Activities Recreation and Leisure Survey WATI Student Information Guide Section 8 Recreation and Leisure Individual Supports Assessment Form Likes and Dislikes Things That Are Difficult for Me Reinforcement Inventory/Reinforcement Inventory with pictures Reinforcement Inventory with pictures 2 Indoor Games and Activities by self or with Others Outdoor Games and Activities by self or with Others Sports-Fitness and School Extra Curricular Activities Music Child Preferences Indicators Personal Preferences Indicators See Main Site Binder for: Life Skills Video Curriculum Series: “Plan Your Day” Curriculum with picture schedules See CD or flash drive for: * “Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file *Reinforcement Inventory with pictures/Reinforcement Inventory with pictures 2 *Sports-Fitness and School Extra Curricular Activities *Indoor Games and Activities by self or with Others/Outdoor Games and Activities by self or with Others *Community Indoor Rec. Activities/Community Outdoor Rec. Activities *Music

26. Preferences and Interests/Recreation and Leisure At home, I like to ____________________ At school, I like to ____________________ At work, I like to ____________________ In the community, I like to ____________________ On vacation, I like to ____________________

27. Preferences and Interests/Recreation and Leisure My favorite music includes _________________ My favorite movies include _________________ My favorite television shows include _________________ My favorite books and/or magazines include ____________________

28. Preferences and Interests/Recreation and Leisure My hobby is ______________________________________ I collect ______________________________________

29. Preferences and Interests/Recreation and Leisure I like to spend time with list people and or pets

30. Preferences and Interests/Recreation and Leisure To make sure my days during the week go smoothly, I do best when I am/have _______________ _______________ _______________

31. Preferences and Interests/Recreation and Leisure To make sure my weekends go smoothly, I do best when I am/have _______________ _______________ _______________

32. Preferences and Interests/Recreation and Leisure For fun, I like to _____________________________________________ I do NOT like to _____________________________________________

33. Preferences and Interests/Recreation and Leisure When I am alone, I like to ____________________ When I am with my family, I like to ____________________ When I am with my friends, I like to ____________________

34. Preferences and Interests/Recreation and Leisure I like to participate in or attend _______________________________________ _______________________________________ To participate in or attend these activities, I need help or assistance that might include _______________________________________ _______________________________________

35. Community See Section #6 for: Community Instruction Ideas Community Indoor Rec. Activities Community Outdoor Rec. Activities Transportation Community Money Ledger See Main Site Binder for: Life Skills Video Curriculum Series: *“Shopping” Curriculum (Grocery and Department store picture task analysis and data sheets) *”Select a Meal” Curriculum (Fast Food, Table Service, and Cafeteria instruction and data sheets) *See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file

36. Community Places I like to access in the community include ____________________ ____________________ The type of help and support I need in these community environments includes ____________________ ____________________ ____________________

37. Community At this time, I get to places in the community by ____________________ Eventually, I would like to get to places in the community by ____________________ I need assistance with and need to learn more about _______________

38. Community As an active member of my community, I participate in _______________ _______________ I know _______________ _______________

39. Community The type of help and support I need to be an active citizen in my community include learning __________________________________ __________________________________

40. Health and Safety See Binder Section #7 for: Health History form Transition Health Care Assessment Sexuality Assessment Getting to Know Your Anger Form Transition to Adult Health Care: A Training Guide in Two Parts (Waisman Center) Transition Health Care Checklist (Pennsylvania Department of Health) See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file

41. Health and Safety When it comes to my health, I have _________________ _________________ as my doctor(s). When it comes to my health needs, I need help and support with _________________ _________________

42. Health and Safety As part of a healthy lifestyle, I _________________ _________________ Sometimes I need reminders, encouragement or support to make healthy choices with _________________ _________________

43. Health and Safety If I am sick or injured, I know how to __________________________________ If I am sick or injured, I need help with __________________________________

44. Health and Safety I understand the reproductive process and know that I must make good choices regarding sexual behaviors such as _______________ _______________

45. Health and Safety In case of an emergency, such as a fire or medical, I know _________________ _________________

46. Self Determination See Binder Section #8 for: Self-Determination/Self-Advocacy Checklist Skills Checklist Questionnaire for Developing Self Advocacy AIR Self-Determination Scale ARC Self-Determination Scale Field-Hoffman-Sawilowsky Self-Determination Scale See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file * WFC Guide Final PDF * Self-Determination Transition Assessment Model

47. Self Determination I like and am good at ______________________________________ ______________________________________ Some challenges I have include ______________________________________ ______________________________________

48. Self Determination Nice things that others say about me include _________________ _________________ I am most proud of _________________ _________________ _________________

49. Self Determination In my life, I make decisions and choices for myself in the areas of ____________________ ____________________ ____________________ I would like to have more control and make more choices about ____________________ ____________________ ____________________

50. Self Determination I let people know what I want in a nice way by ______________________________________ Sometimes I let people know what I want in not so nice ways by ______________________________________

51. Self Determination I let people know what I do not want in a nice way by ________________________________ Sometimes, I let people know what I do not want in not so nice ways by ______________________________________

52. Self Determination Right now ______________________________ help me plan for my future. I would like _____________________________ to help me plan for my future.

53. Communication See Binder Section #9 for: Communication Summary Form WATI Student Information Guide Section 4: Communication “It’s Not Easy Being Me” PowerPoint *See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file **Student Workbook Planning For Student PDF

54. Communication I express myself best through ______________________________________ ______________________________________ When expressing myself, I need to work on ______________________________________ ______________________________________

55. Communication When listening to others, I am good at ______________________________________ ______________________________________ When listening, I need to work on ______________________________________ ______________________________________

56. Communication In reading, I do best with _________________ _________________ In writing, I do best with _________________ _________________

57. Interpersonal Relationships See Binder Section #10 for: Let’s Look at Interpersonal Relationships School and Community Social Skills Rating Checklist Life Centered Career Education Competency Rating Scale Record Form Social Skills Assessment *See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file

58. Interpersonal Relationships My relationship with my family and relatives is ______________________________________ My relationship with my friends is ______________________________________

59. Interpersonal Relationships My relationship with my co-workers and boss on the job is ______________________________ My relationship with my school staff is ______________________________________

60. Interpersonal Relationships When interacting with others, I am good at _________________ _________________ When interacting with others, I need to work on _________________ _________________

61. Interpersonal Relationships I help others by _________________ _________________ I would like to help others by _________________ _________________

62. Interpersonal Relationships I would like to improve my relationship(s) with ______________________________ __________________________________ To accomplish this, I may need assistance with ______________________________ _________________________________

63. Negotiating with Others See Section Binder #11 for: Negotiating with Others form *See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template”Word Document file

64. Negotiating with Others WANTS 1. 2. 3. 4. 5. NEEDS 1. 2. 3. 4. 5. Negotiating means that people are willing to compromise or change. Based on your goals for the future, make some choices about what is important.

65. Negotiating with Others I am willing to consider changing 1. 2. 3. 4. 5. I will not consider changing 1. 2. 3. 4. 5.

66. Making a Plan See Binder Section #12 for: It’s My Life Student Workbook: What I Need to Get What I Want The Self-Directed IEP 10 Step Guide Individual Transition Plan (ITP) for: Martin My Summary of Performance PDF Performance Summary PDF Summary of Performance Understanding PDF *See CD or flash drive for: *“Accompanying Picture Resources for MY VOICE PowerPoint Template” Word Document file *ITP forms *Summary of Performance Folder

67. Making a Plan My dreams for the future are 1. 2. 3. 4. 5.

68. Making a Plan The goals I would like to work on include 1._________________________________________ 2._________________________________________ 3._________________________________________

69. Making a Plan I will need some help and support. The support I will need to achieve my goals include ______________________________________ I would like ____________________to help me. This will cost ____________________________

70. Making a Plan The steps I need to take to make these happen include: 1. 2. 3. 4. 5.

71. Appendices: See Binder Section #13 for: Will Your Special Needs Trust Truly Meet Your Child’s Changing Needs? Sample Student Interview Form Comprehensive Informal Inventory of Knowledge and Skills for Transition Transition Graduation Needs List Transition Planning Inventory Parent Priorities Inventory Service Provider Information/Analysis Form Potential Transition Goals Aligned with IL Standards IEP Planning Form Parent Questionnaire Important Points to Remember for MY VOICE Presentation Word Document Indicator 13 Checklist Vocational Transition Assessment Online Assessments / Resources Word Document and Transition Assessment Websites Word Document Transition Coalition: Assessing Students with Significant Disabilities for Supported Adulthood: Exploring Appropriate Transition Assessments *See CD/Flash drive for: Student Directed IEP Lesson Plans Folder Transition Assessment and Contact Information Folder “Whose Future is It Anyways” Folder Post Secondary Summary PDF Transport Juvenile Justice PDF See Main Site Binder for: TPI (Transition Planning Inventory) Manual TPI Student /Home/School Form TPI Profile and Further Assessment Recommendations Form