Intern Abilities Profile Form

Intern Abilities Profile

Intern background / history:

Task/Assignment:

Equipment: (Job equipment, protective clothing, chemicals)

Environment: (fumes, odors, dust, temperature, noise, group-work)

Physical Challenges

Accommodations Needed

Options and Resources

Sensory Challenges

Accommodations Needed

Options and Resources

Cognitive Challenges

Accommodations Needed

Options and Resources

Physical, Sensory, & Cognitive Issues and Challenges

Physical Issues

Think of the required physical aspects of the task. What will make the environment accessible, keep the student safe and allow them to be an active participant? What lab equipment must be manipulated?

Physical Challenges

  1. lift / carry
  2. stamina/ endurance
  3. push/pull
  4. Knee/squat
  5. reach
  6. repetitive tasks
  7. fine motor: pinch / grasp
  8. fine motor: manipulate/ maneuver
  9. gross motor
  10. sit in chair
  11. walk / stand
  12. balance
  13. bend / twist
  14. stoop / crouch
  15. other

Sensory Issues

Think of room temperature, noise, fumes, dust, odors, allergies. Also consider the ability to speak and/or communicate, and the visual aspects of task or assignments.

Sensory Challenges

  1. vision
  2. hearing
  3. touch
  4. smell
  5. taste
  6. oral communication
  7. temperature
  8. fumes
  9. external stimuli
  10. lighting
  11. other

Cognitive Issues

Is the assignment done with a group, partner or individually? What memory & communication skills are needed? What is the level of complexity of the task.

Cognitive Challenges

  1. short term memory
  2. long term memory
  3. task complexity
  4. reading
  5. writing
  6. spelling
  7. string of numbers (math)
  8. paying attention
  9. visual, auditory, or kinesthetic learner
  10. self-esteem / advocacy issues
  11. behavior issues / acting out
  12. other