Quantity 1
(fill in)
Time 1
(fill in)
Level of Support 1
(fill in)
Input 1
(fill in)
Difficulty 2
(fill in)
Output 1
(fill in)
Participation 1
(fill in)
Alternate Goals 2
(fill in)
Substitute Curriculum 2
(fill in)
Grades based on above Adaptation Plan
Rationale/Evidence for Adaptation Plan
(4/23/04 Adapted from Diana Browning Wright)