Request a workplace accommodation from a supervisor
When to use this goal
For students who have decided to disclose (tn-js-020) or who are in a work-based learning placement and need a change at work, such as written instructions or a different break time. Present levels in communication decide whether the request is spoken, written or both.
- Baseline
- Role-play one request with only the task described. Note whether the student names a specific change or only says the task is hard.
- Tips
- For asking for supports at school, use self-advocacy goals; this template is for the workplace. Job coaches should coach before the conversation and step back during it as skills grow.
- Limits
- Role-play supervisors are friendlier than some real ones. The goal measures the request, not whether it is granted.
Original IEP Atlas template based on general measurement principles; not copied from any goal bank. ID tn-js-021.
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Goal
By the annual IEP review date, during a role-play with a staff member acting as a new supervisor, given a job task that is hard without an accommodation, the student will request the accommodation by naming the task, the change that would help and how it helps, then confirm it in writing, performing at least 5 of 6 steps independently, on 3 consecutive requests, including role-plays, as measured by a task-analysis checklist collected every two weeks.
Baseline: 1 of 6 steps independently.
- Condition
- Observable behavior
- Criterion
- Measurement method
Measurability check11 of 11 met
Met: Observable behavior. Stated as an action.
Met: Condition. Stated.
Met: Unit fits the behavior. Task-analysis steps fits this behavior.
Met: Explicit criterion. Number and unit stated.
Met: Mastery rule and schedule. Both stated.
Met: Method produces the metric. Task-analysis checklist gives task-analysis steps data.
Met: Review timeframe. Stated.
Met: Baseline and target compatible. Same unit, change in the right direction.
Met: Aligned with area of need. Still about Job Seeking & Applications.
Met: Level of support. Defined.
Met: Blanks filled in. Nothing left to fill in.
Checks structure and wording only. Whether the goal fits the student is the team's call.
Short-term objectives (optional)
When are objectives required?Required for students on alternate assessments (34 CFR §300.320(a)(2)(ii)); some states require them for everyone.
Paste into your IEP system
Most district systems have a separate box for each part of a goal. Copy them one at a time, or all at once as labeled text.
- Area of need
- Transition & Postsecondary Skills - Job Seeking & Applications
- Baseline
- 1 of 6 steps independently.
- Annual goal454 characters
- By the annual IEP review date, during a role-play with a staff member acting as a new supervisor, given a job task that is hard without an accommodation, the student will request the accommodation by naming the task, the change that would help and how it helps, then confirm it in writing, performing at least 5 of 6 steps independently, on 3 consecutive requests, including role-plays, as measured by a task-analysis checklist collected every two weeks.
- Timeframe
- By the annual IEP review date
- Condition
- During a role-play with a staff member acting as a new supervisor, given a job task that is hard without an accommodation
- Behavior
- The student will request the accommodation by naming the task, the change that would help and how it helps, then confirm it in writing
- Criteria
- Performing at least 5 of 6 steps independently, on 3 consecutive requests, including role-plays
- Evaluation method
- A task-analysis checklist
- Schedule
- Every two weeks
Copied as plain text, with straight quotes and plain dashes.
Matching data sheet
Task-analysis checklist. Marks each step in each session.
Task-analysis checklist
Task-analysis steps- Student label:
- Target:
- performing at least 5 of 6 steps independently
- Mastery rule:
- on 3 consecutive requests, including role-plays
- Collection schedule:
- every two weeks
- Method:
- Task-analysis checklist
- Data collector:
Goal: By the annual IEP review date, during a role-play with a staff member acting as a new supervisor, given a job task that is hard without an accommodation, the student will request the accommodation by naming the task, the change that would help and how it helps, then confirm it in writing, performing at least 5 of 6 steps independently, on 3 consecutive requests, including role-plays, as measured by a task-analysis checklist collected every two weeks.
Key: I completed independently · S completed with support (note prompt type, e.g., G gesture, V verbal, M model, P physical) · N not completed
| Step | Session 1 Date: | Session 2 Date: | Session 3 Date: | Session 4 Date: | Session 5 Date: | Session 6 Date: | Session 7 Date: | Session 8 Date: |
|---|---|---|---|---|---|---|---|---|
| 1. Asks the supervisor for a few minutes to talk | ||||||||
| 2. Names the task that is hard | ||||||||
| 3. Names the accommodation that would help | ||||||||
| 4. Explains how it would help the work get done | ||||||||
| 5. Listens and answers the supervisor's questions | ||||||||
| 6. Sends a short email that restates what was agreed | ||||||||
| Steps independent (I) | ||||||||
| Initials / notes |
Preview shows 4 of 12 rows.
- Write the date at the top of each session column. Mark each step I, S, or N.
- Total the number of I marks for the session. The goal counts steps completed independently (target: 5 of 6).
- Use the least intrusive prompt first and record the prompt actually needed.
The CSV opens in Excel or Google Sheets, with formulas. Sheets print blank; no student data is stored.