This student self-assessment and reflection form has been kicking around my to-do folder for a couple of years now for a couple of reasons. The first is that I could never determine the best way to categorize and tag it (and I post it now because I have decided to take a much more casual attitude toward categories and gags, mostly because I realized this blog has a search function); the second is that this material, I am confident, remains solidly in the authors’ copyright.
Who are, to wit, Jay McTighe and Carol Ann Tomlinson. The book is Integrating Differentiated Instruction & Understanding by Design (Alexandria, VA: ASCD, 2006). If you’re interested in curriculum design in general and in particular, in this case differentiating for struggling or idiosyncratic learners (or both), you probably know the names of these two distinguished experts. The book is excellent: I read it twice, taking extensive notes both times. Then I passed it along to assistant principal under whom I served. Every time I visited his office, I noticed that the book was close at hand.
If you find typos in this document, I would appreciate a notification. And, as always, if you find this material useful in your practice, I would be grateful to hear what you think of it. I seek your peer review.
Mark's Text Terminal 
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