INTELLECTUAL OUTPUT 2 English version | Page 13

CHAPTER I part 1. Initial diagnosis sheet (School’s full name) Student’s name: Date: Class: School year: The diagnosis based on: ● ● ● Disability degree certificate no. …………………….., Issued by……………………… An opinion no. PPP4-4331-338/12 issued by Psychological and Pedagogical Counselling Centre no. 4 in Łódź. Conversations with parents concerning child’s needs, abilities and interests. The observations of the level of functioning of a student carried by the class teacher, other teachers and specialists. (The diagnosis) Explanation ● ● The planned range of a psychological- pedagogical aid: ● psycho-corrective: ● psycho-didactic: ● didactic: ● psycho-therapeutic: Recommended forms, means and the time to give psychological-pedagogical aid, suggested number of hours. No. 1. 2. Classes Day Time Number of hours