ALS Diagnostic Assessment - Version 2Additional Learner Support (ALS) ReviewWhere learners have been allocated additional learner support it is mandatory for a review to take place on a monthly basis. The purpose of the review is to ensure that the original plan of reasonable adjustments is effective and continues to be delivered.Learner Firstname:Learner Date of Birth:Learner Department:- Select -Animal CareBusiness SupportChildcare and EducationEnglish, Maths,ICTHair and BeautyHealth and Social CareOtherItem 4Learner Surname:Cohort: Adult Education Budget ApprenticeshipPlease identify whether any of the following learning difficulties / disabilities apply to the learner: Vision impairment Hearing impairment Disability affecting mobility Profound complex disabilities Social and emotional difficulties Mental health difficulty Moderate learning difficulty Severe learning difficulty Dyselxia Dyscalculia Autism spectrum disorder Asperger's syndrome Temporary disability after illness or accident Speech, language and communication needs Other physical disability Other specific learning difficulty Other medical condition Other learning difficulty Other disability None applyPlease provide a brief description of the outcome of the assessment:Has it been determined that the learner requires Additional Learning Support (ALS) for their programme? Yes NoALS PlanPlease note a template ALS Plan can be downloaded here. Please upload a copy of the Action Plan created for the ALS provision for this learner:Choose File Section C - DeclarationsAchievement Training Representative: I confirm that to the best of me knowledge the information recorded on this form is correct, all individuals involved in this plan have been made aware of their roles and responsibilities in order to successfully carry out the plan of delivery. I will review the reasonable adjustment plan on a monthly basis and submit all evidence to the MIS Department.ATL Representative Name:ATL Representative Email Address:ATL Representative Signature: Sign HereLearner declaration: I confirm that to the best of my knowledge the information recorded on this form is correct and I agree to the attached ALS plan being put in place.Learner Signature: Sign HereSubmit Form
