Classic View: Student Information > Special Ed > General > Documents
Search Terms: Special Ed Documents
Evaluations are used to document the student's educational needs and the student's determination of eligibility for special education. This document describes each editor, the section(s) of the print format that include the entered information, a description of each field on the editor, and any special considerations and instructions for using the editor and fields.
An evaluation must be created whether or not the student is determined to have a disability. A copy of the evaluation summary report, including the documentation of eligibility, is given to the student’s parents by the school district.
The current format of this document is the HI Eval 2022. Evaluation formats are selected in the Eval Types tool.
Editor Home
The Editor Home lists the editors available on the student's Evaluation and the Modification and Completion information.
Header | Description |
---|---|
Name | The name of the editor. |
Status | The state of the editor. Statuses can be:
|
Modified By | The date and the user by whom the editor was last edited. |
Completed By | The date and the user who clicked the Complete button for that editor. |
General Evaluation Information
The following table lists the buttons available for the editors:
Button | Description |
---|---|
Save | Different editors have different save options. Click the arrow next to the Save & Stay button to view all saving options for any given editor.
|
Refresh | Retrieves a new copy of data from the student's record. This includes enrollment, student, parent/guardian, and team member information. This also returns any accidentally deleted people records. Manually entered fields do not change when the refresh button is clicked. The user must Save after clicking Refresh to capture changes. A side panel displays listing all applicable Enrollment records for the student. See the Enrollments article for additional information. |
Cancel | Navigates the user to the Editor Home screen or to the List Screen for List editors. |
Status i.e. Complete, Not Needed, etc. | Changes the status of the editor.
|
Prints the entire evaluation. | |
Editors | Opens a side panel listing all the available editors and their status. Select an editor from this list to navigate to that editor or click Close to collapse the side panel. |
Previous | Navigates the user to the previous editor. |
Next | Navigates the user to the next editor. |
Editor Types
There are two types of editors available: List or Basic editors. When navigating to a Basic editor, the list of fields within the editor display. List editors display a list of all records within that editor. Clicking an existing record or the New button opens the detail view for an individual record. An example list editor is the Individual Conference Announcement editor.
Padlock Icon
Only one user at a time can actively work on an editor. A person with a padlock icondisplays in the Editors side panel, Editor Home, and List Screen of list editors indicating which editors currently have users working on them. Hovering over the icon displays the name of the user who has checked out the editor, including the current user (you).
Editors that are currently being edited are read only for all other users. The name of the person working on the editor displays in the header. Once the editing user navigates away from an editor, that editor becomes available for others to work on.
Template Banks
Certain fields within several editors have a paper icondisplays next to their name. When the icon is clicked, a side panel displays with the available library of predetermined text for that field. Template Banks are managed in System Administration.
Editors
The following section lists each editor and describes each field on the editor.
Evaluation Status
The Evaluation Status editor includes general information about the evaluation, including relevant dates, the type of evaluation, and basic student information.
This editor must be saved before continuing to other parts of the evaluation.
Fields | Description | Ad hoc | Validation |
---|---|---|---|
Date Required | The date this document was created. | Learner Planning > Evaluations > evalDate | When this editor is Completed, the Evaluation Date must match either the Evaluation Meeting Date or the Eligibility Determination Date, with the Eligibility Determination Date taking priority. This date displays on the Documents tool. |
Type of Evaluation Required | The type of eligibility documented; Initial Evaluation, Reevaluation, or Triennial Agreement. | Learner Planning > Evaluations > type | The values available in this dropdown are hard coded. |
Assessment Needed Required | Indicates if an assessment is needed. Options include: Yes or No. | N/A | This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. When this field is No, the Assessment Report and Consent for Assessment editors are marked as Not Needed. When this field is Yes, the Assessment Report and Consent for Assessment editors are Required to complete the Evaluation. |
Evaluation Meeting Date *Required | The date the student is evaluated to determine if they are eligible to receive special education services. | N/A | This field is blank upon entering the editor and read-only. This field auto-populates with the date entered under Conference Actual > Actual Conference Date when the Evaluation Process checkbox is marked. When multiple Conference Actual records exist that meet the criteria, the date updates to the most recent date. *This field is required to Complete the editor when No is selected for the Assessment Needed field OR when Triennial Agreement is selected as the Type of Evaluation. |
Days until Timeline Due Date | The difference between today's date and the Timeline Due Date. | N/A | This is a read-only field. This field auto calculates. Negative values are supported, as needed. This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. Once an Eligibility Meeting Date is entered, this field no longer calculates. |
Consent Sent Date | The date the parent/guardian of the student was sent a request for consent to evaluate the student. | N/A | This field is grayed out when No is selected in the Assessment Needed field. This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. This field is read only and pulls from the Provided to Parent Date field. |
Consent Received Date *Required | The date the parent/guardian of the student returned consent for their student to be evaluated. | Learner Planning > Evaluations > consentDate | *This field is required in order to Complete the editor when available. This field is grayed out when No is selected in the Assessment Needed field. This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. This field is read only and pulls from the School Received Consent Form Date field. |
Timeline Due Date | The date the Evaluation is due. This value is 60 calendar days from the Evaluation Meeting Date when the Assessment Needed field is No OR 60 calendar days from the Consent received Date when the Assessment Needed field is Yes. | N/A | This is a read-only field. This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. When No is selected in the Assessment Needed field, this date automatically calculates to a date 60 calendar days from the Evaluation Meeting Date. When Yes is selected in the Assessment Needed field, this field automatically calculates to a date 60 calendar days from the Consent Received Date. |
Eligibility Determination Date *Required | The date the student was determined to be either eligible or ineligible to receive Special Education services. | N/A | *This is a required field upon completion of the Evaluation. This field is blank upon entering the editor and read only. This field is grayed out when Triennial Agreement is selected as the Type of Evaluation. This field automatically populates with the Actual Conference Date entered on the Conference Actual editor when the IDEA Eligibility checkbox is marked. When multiple Conference Actual records exist that meet the criteria, the date updates to the most recent date. |
Evaluation Delay This section is grayed out when Triennial Agreement is selected as the Type of Evaluation. | |||
Delay Date | The date the Evaluation Meeting takes place after a delay in the process. | N/A | N/A |
Primary Delay Reason *Required | The reason for the delay in timeline. Options available can be found in the Attribute Dictionary and are hard coded. | N/A | This field is required when the Delay Date field is populated. |
Comments | Any additional information related to the delay. | N/A | N/A |
Evaluation Withdrawn This section is grayed out when Triennial Agreement is selected as the Type of Evaluation. | |||
Withdrawn Date | The date the student withdrew from Special Education services. | N/A | N/A |
Withdrawn Reason *Required | The reason the student withdrew from Special Education services. | N/A | *This field is required when the Withdrawn Date field is populated. |
Enrollment Information
The Enrollment Information editor reports Special Education information from the student's Enrollment record. This editor is read only.
The Refresh button retrieves a fresh copy of data from the student's record. See the General Evaluation Information section for additional information.
Field | Description | Ad hoc | Validation |
---|---|---|---|
District | The student's district of residence. | Learner Planning > Learning Plans > subDistrict | This field is pulled from the Enrollment record, then System Administration > Resources > School > State Data Elements > Sub-District. |
Complex Area | The location of the building. | Learner Planning > Learning Plans > complexDistrict | This field is pulled from the Enrollment record, then System Administration > Resources > School > State Data Elements > Complex Area. |
Grade | The student's current grade. | Enrollment > Grade enrollment.grade | This field is pulled from the Enrollment record. |
School Name | The name of the school associated with the student's Enrollment record. | Learner Planning > Learning Plans > Enrollments > residentSchool enrollment.residentSchool | This field is pulled from the Enrollment record. |
School Phone | The phone number of the school associated with the student's Enrollment record. | Learner Planning > Learning Plans > School > Phone v_SchoolCurrent.phone | This field is pulled from the Enrollment record, then System Administration > Resources > School. |
School Year | The school year associated with the student's Enrollment record. | N/A | This field is pulled from the Enrollment record. |
Student Information
The Student Information editor displays basic information about the student such as demographic information. This is a read-only editor.
The Refresh button retrieves a fresh copy of data from the student's record. See the General Evaluation Information section for additional information.
Field Name | Description | Ad Hoc |
---|---|---|
Last Name | The student's last name. | Census > People > Demographics > Last Name identity.lastName |
First Name | The student's first name. | Census > People > Demographics > First Name identity.firstName |
Middle Name | The student's middle name. | Census > People > Demographics > Middle Name identity.middleName |
Suffix | The student's suffix. | Census > People > Demographics > Suffix Name identity.suffix |
Age | The age of the student. | Census > People > Demographics > Age |
Birthdate | The student's birthdate. | Census > People > Demographics > Birth Date identity.birthDate |
Gender | The student's gender. | Census > People > Demographics > Gender identity.gender |
Language at Home | The student's home primary language. | Census > People > Demographics > Language At Home identity.homePrimaryLanguage |
First Language | The student's first spoken language. | Census > People > Demographics > First Language identity.languageAlt |
Most Used Language | The language the student uses the most. | Census > People > Demographics > Language Most Used identity.languageAlt2 |
Address | The student's address. This field becomes a dropdown when more than one address exists for the student. The primary household displays by default. | Census > Households > Address Info address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip |
Student Number | The student's identification number. | Census > People > Demographics > Student Number |
State ID | The student's state identification number. | Census > People > Demographics > State ID |
Case Manager | ||
Name | The name of the student's Case Manager. | Student Information > Special Ed > General > Team Members > Name |
Title | The title of the staff member. | Student Information > Special Ed > General > Team Members > Caseload Role |
Parent/Guardian Information
The Parent/Guardian Information editor populates based on the guardian checkbox on the student's Relationships tool. The editor includes Demographics information for the student's guardian.
The Delete button next to each parent/guardian can be used to remove a parent/guardian from the Evaluation.
The Refresh button retrieves a new copy of parent/guardians' data. This also returns any accidentally deleted people. Manually entered fields do not change when the refresh button is clicked. The user must Save after clicking Refresh to capture changes.
Field Name | Description | Ad Hoc | Validation |
---|---|---|---|
Relationship | The relation of the parent/guardian to the student. | Census > People > Relationships | This field populates from Census. This is part of the header for the parent/guardian. |
Last Name | The last name of the parent/guardian. | Census > People > Demographics > Last Name identity.lastName | This field populates from Census. This is part of the header for the parent/guardian. |
First Name | The first name of the parent/guardian. | Census > People > Demographics > First Name identity.firstName | This field populates from Census. This is part of the header for the parent/guardian. |
Middle Name | The middle name of the parent/guardian. | Census > People > Demographics > Middle Name identity.middleName | This field populates from Census. This is part of the header for the parent/guardian. |
Suffix | The suffix of the parent/guardian. | Census > People > Demographics > Suffix Name identity.suffix | This field populates from Census. This is part of the header for the parent/guardian. |
Print Sequence | The print order of the parent/guardian(s) on the IEP. | N/A | When no Sequence is selected, parent/guardian(s) print in the order displayed in the UI. When any Sequences are selected, only parent/guardian(s) with a sequence number print in the order defined. |
Address | The parent/guardians' address. | Census > Households > Address Info address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip | This field populates from Census. When there are multiple addresses for a person, they is a drop down with an option to select which address. When there is only one address, the drop down only holds one option. The populated address is the one marked "Primary." |
Home Phone | The home phone number of the parent/guardian. | Census > People > Demographics > Household Phone | This field populates from Census. |
Work Phone | The work phone of the parent/guardian. | Census > People > Demographics > Work Phone | This field populates from Census. |
Cell Phone | The cell phone of the parent/guardian. | Census > People > Demographics > Cell Phone | This field populates from Census. |
The primary email address for the parent/guardian. | Census > People > Demographics > Email | This field populates from Census. | |
Interpreter Required | Indicates an interpreter is needed to communicate with the parent/guardian. | N/A | N/A |
Conference Announcement
The Conference Announcement editor is used to document planned meetings of the Evaluation team.
This editor is not optional and must be completed.
Conference Announcement List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Meeting Date | The date of the meeting. |
Meeting Location | The location of the meeting. |
Print in Evaluation | Indicates this meeting information prints on the Evaluation. |
Conference Announcement Detail Screen
Field | Description | Validation |
---|---|---|
Print in Evaluation | Indicates this meeting information prints on the Evaluation. | This defaults to unmarked. |
Scheduled Conference Date Required | The meeting date. | N/A |
Scheduled Conference Time Required | The meeting time. | N/A |
Announcement Date | The date a notification was sent notifying the team members of the meeting. | N/A |
Scheduled Conference Location Required | The location of the meeting. Options include: Virtual, Phone, or In-Person. | N/A |
Conference Location (specify) | The location of the meeting, if clarification or details are needed. | N/A |
Evaluation Process | Indicates the type of evaluation processes needed for the student. Options include:
| When the user selects one of these options, they are not able to select IDEA Eligibility. |
IDEA Eligibility | Indicates the student needs an IDEA Evaluation. Options include:
| When the user selects this value, they are not able to select Evaluation Process. |
Attendance | ||
First Name | The first name of the team member. | This field is required for saving this editor. This field displays information from the Special Education Team Member tool. Any Team Member with an active status displays here as read-only. The user can also enter an additional entry for this field and when they do, an open text field displays and the user is required to enter a value. |
Last Name | The last name of the team member. | This field is required for saving this editor. This field displays information from the Special Education Team Member tool. Any Team Member with an active status displays here as read-only. The user can also enter an additional entry for this field and when they do, an open text field displays and the user is required to enter a value. |
Role Required | The role of the team member. | Values available in this dropdown include locked attributes:
Unlocked Attribute values include:
|
Invited | Indicates this team member has been invited to the meeting. | N/A |
Conference Notification
The Conference Notification editor is used to document when notifications were sent out informing the team of meetings.
Conference Notification List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Scheduled Meeting | The date of the planned meeting. |
Mutually Agreed | Indicates if the parent/guardian consented to the meeting date. |
Conference Notification Detail Screen
Field | Description | Validation |
---|---|---|
Conference Notification | ||
Scheduled Meeting Date | The date of the scheduled meeting. | This field is required for saving the editor. The options in this field are determined from the Conference Announcement entries. |
Mutually Agreed Upon | Indicates if the parent/guardian consents to the meeting date. Options include:
| These options are hard coded. |
Team Member Notification Tracking This table is read only and displays the following columns:
All of these read only values come from the user selecting the Add Notification button and entering information on a side panel recording when notifications were made to certain team members. | ||
Notification Tracking (side panel) This displays when the user clicks Add Notification or on the ">" from a previous entry in the table. | ||
Team Member Name | The name of the team member. | The options in this field are determined from the marked entries from Conference Announcement > Invited checkbox. This displays as First Name Last Name, Role. |
Date | The date the team member was notified. | N/A |
Method | The manner in which the team member was notified. Options include:
| These options are hard coded. Multiple options may be selected. |
Notified By | The person who reached out to the team member. | N/A |
Outcome | The response or end result of the notification. | N/A |
Outside Agency Parent Consent Tracking | ||
Agency | Indicates which outside agency is involved, if applicable. Options include:
| When Other (specify) is marked, the user is able to manually enter their own value. |
Consent to Invite Needed | Indicates that an Outside Agency should be invited and the Consent to Invite document is needed. | N/A |
Consent to Invite Received | Indicates a signed Consent to Invite document was returned to the district. | N/A |
Consent Received Date | The date the signed Consent to Invite document was returned to the district. | This field becomes available and required when the Consent to Invite Received check box is selected. |
Conference Actual
The Conference Actual editor is used to document meetings that took place.
Conference Actual List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Scheduled Meeting | The date of the planned meeting. |
Actual Meeting | The date the meeting took place. |
Actual Location | The location of the meeting. |
Conference Actual Detail Screen
Field | Description | Validation |
---|---|---|
Actual Conference Notification: <date of actual conference> The "<date of actual conference>" populates based on the Actual Conference Date entered. | ||
Scheduled Meeting Date Required | The date of the planned meeting. | The options in this field are determined from the Conference Announcement > Scheduled Conference Date entries. |
Scheduled Conference Time | The time of the planned meeting. | The options in this field are determined from the Conference Announcement entries. This field is read-only. |
Scheduled Conference Location | The planned conference location. | The options in this field are determined from the Conference Announcement entries. This field is read-only. |
Scheduled Conference Location (specify) | The location of the meeting, if clarification or details are needed. | The options in this field are determined from the Conference Announcement entries. This field is read-only. |
Actual Conference Date | The date the meeting took place. | This is required for saving the editor. |
Actual Conference Time | The time the meeting took place. | This is required for saving the editor. |
Actual Conference Location | The location of the meeting. Options include:
| This is a required element for saving the editor. The values available are hard-coded. |
Actual Conference Location (specify) | The location of the meeting, if clarification or details are needed. | N/A |
Evaluation Process: | Indicates the type of evaluation processes needed for the student. Displays two rows of checkboxes, Scheduled and Actual. Options include:
| The Scheduled column is read only and is determined based on the Scheduled Meeting Date selected. The Actual column can be edited. |
IDEA Eligibility | Indicates the student needs an IDEA Evaluation. Displays two rows of checkboxes, Scheduled and Actual. Options include:
| The Scheduled column is read only and is determined based on the Scheduled Meeting Date selected. The Actual column can be edited. |
Attendance | ||
First Name Required | The first name of the team member. | The options available are based on Team Members entered within the Conference Announcement editor who have the Invited checkbox marked. |
Last Name Required | The last name of the team member | The options available are based on Team Members entered within the Conference Announcement editor who have the Invited checkbox marked. |
Role Required | The role of the team member. | Values available in this dropdown include locked attributes:
Unlocked Attribute values are determined by district. |
Attended | Indicates the team member attended the meeting. | Anyone marked as Attended displays on print. |
Admin/Designee | Indicates if the team member is an admin designee for the meeting. | Guardian, Student, Principal, Vice Principal, any District Defined roles, and manually entered team members cannot be marked as Admin/Designee. Those marked as Admin/Designee AND Attended display on print with an asterisk (*) after their name and role. |
Excused | Indicated the team member was excused from the meeting. | Guardian, Student, any District Defined roles, and manually entered team members cannot be marked as Excused. Those marked as Excused display on print with a double asterisk (**) after their name and role. |
Reason for Excusal * Required | The reason the team member was excused from the meeting. | * This field is required when the corresponding Excused checkbox is marked. |
Admin/Designee Statement | ||
Admin Designee Statement * Required | A text field used to describe why a designee being used. | * This field is required when the corresponding Admin/Designee checkbox is marked. |
Consent for Assessment
The Consent for Assessment editor is used to document the consent gathered to assess the student.
This editor is not available when Triennial Agreement is selected as the Evaluation Type. This editor is also not available when No is selected in the Assessment Needed field on the Evaluation Status editor.
Field | Description | Validation |
---|---|---|
Consent for Assessment | ||
Consent for Assessment Type | Indicates the type of assessment needing consent. Options include:
| This is a read-only field. This field auto-populates based on the Type of Evaluation selected within the Evaluation Header editor:
|
Provided to Parent Date Required | The date the Consent for Assessment form was provided to the parent. | N/A |
Contact Efforts This table is read-only and displays the following columns:
All of these read-only values come from the user selecting the Add button and entering information on a side panel recording what Contact Efforts were made. | ||
Contacted Efforts (side panel) | ||
Contacted Date | The date the parent/guardian was contacted. | N/A |
Contacted By | The person who attempted to contact the parent/guardian. | N/A |
Contacted Method | The manner in which the parent/guardian was contacted. Options include:
| The values available are hard-coded. |
Contacted Name | The person contacted. | N/A |
Relationship to Student | The manner of relationship the person being contacted has to the student. | N/A |
Outcome | The result of the contact. | N/A |
New | Selecting this New button copies the top 6 fields for another entry of Contact Efforts. | N/A |
Contact Results | ||
Consent Given | Indicates if consent was given by the parent/guardian. | Yes or No. This is a required field on complete of the editor. |
Consent Form Signed Date | The date consent was given. | This is a required field on complete of the editor. |
School Received Consent Form Date | The date consent was received. | This is a required field on complete of the editor. |
Name of Person Signing Consent Form | The name of the person who signed the consent form. | This is a required field on complete of the editor. |
Revocation | Indicates consent has been revoked. | Additional fields become required when marked. |
Revocation Form Signed Date | The date the person signed the revocation form. | Only available when Revocation is marked. This field is required on completion of this editor when available. |
Name of Person Signing Revocation Form | The name of the person who revoked consent. | Only available when Revocation is marked. This field is required on completion of this editor when available. |
School Received Revocation Form Date | The date revocation was received. | Only available when Revocation is marked. This field is required on completion of this editor when available. |
Consent Revocation Reason | The reason for revoking consent. | Only available when Revocation is marked. This field is required on completion of this editor when available. |
Assessment Report
The Assessment Report editor is used to document how data has been gathered concerning the student.
Note: Information from this editor displays at the end of the Evaluation document when printed.
Assessment Report List Screen
Field | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Sequence | The order in which the record prints. |
Assessment | The Assessment type. |
Print in Evaluation | Indicates this record prints on the Evaluation. |
Assessment Report Detail Screen
Field | Description | Validation |
---|---|---|
Assessment Required | The assessment type. Options include:
| The value selected in the Assessment field changes the rest of the editor (documented below). |
Print in Evaluation | Indicates this record prints on the Evaluation. | N/A |
Sequence | The order in which the record prints. | N/A |
Examiner(s)
Required | The person(s) responsible for assessing the student. | Multiple Examiners may be selected. The options available are determined by those listed as active team members who are staff (with a District Employment and District Assignment record) on the student's Team Members tool OR manually entered people. |
Date of Assessment Required | The day the assessment takes place. | N/A |
I verify the information in this report is accurate.
Required | A checkbox indicating the information in the report is accurate. | N/A |
Staff Member Signing Assessment Report | The person who verified the accuracy of the information contained within the report (the person who marked the checkbox above). | This field is read-only and auto-populates with the person's name who is logged in to Camps when the checkbox above was selected. |
Licensed Supervisor Signature Required | A checkbox indication a licensed supervisor signature is required on the report. | This field displays when any Assessment Report other than "Academic" or "Observation" is selected. |
I verify the information in this report is accurate.
Required | A checkbox indicating the information in the report is accurate. | N/A |
Licensed Supervisor Signing Assessment Report | The signature of the licensed supervisor when the above checkbox is marked. | This field is read-only and auto-populates with the person's name who is logged in to Camps when the checkbox above was selected. |
Academic
Field | Description | Validation |
---|---|---|
The student was referred by: Required | The person who referred the student for the academic assessment. | N/A |
Referred due to the following concerns: Required | The reason for referral. Options include:
| N/A |
Background Information | ||
Relevant information regarding:
Required | Any pertinent information regarding the student's background. | N/A |
Parent Information:
Required | Any pertinent information regarding the student's parent/guardian. | N/A |
Pre-referral Interventions: | Any pre-referral interventions. Options include:
| Multiple options may be selected. |
Specify: *Required | Additional information when "Other" is selected above. | *This field is required when "Other" is selected above. |
Outcomes: | The outcome of the interventions. | N/A |
Environmental, Cultural and/or Dialectal Considerations | ||
Language(s) spoken in the home:
Required | The student's spoken language at home. | The values available in this field are pulled from Student Information > Census > Language Spoken in the Home. |
Dialect/Cultural Considerations:
Required | The student's language they primarily speak. Options include:
| N/A |
Specify:
*Required | Additional information when "Other" is selected above. | *This field is required when "Other" is selected above. |
Assessment Procedures and Results | ||
All domains pertaining to the area(s) of concern were assessed and test results are valid. | A checkbox indicating all area(s) of concern were assessed. | N/A |
A variety of assessment procedures were used to gather information. | A checkbox indicating a a variety of assessment methods were used to gather data. | N/A |
Tests Administered: | The tests administered to the student. | N/A |
Informal/Non-Standardized Measures/Methods Used: | Any other assessment methods used. Options include:
| N/A |
Behavioral Observations | ||
Behavior in: | Indicates how the student's behavior was assessed. Options include:
| N/A |
Behavior with: | Indicates who assessed the student's behavior. Options include:
| N/A |
Behavior: | The student's behavior assessment. Options include:
| N/A |
Academic Assessment Findings | ||
Analysis of Findings | A text field used to describe the findings. | N/A |
Implications for Learning and Educational Impact | ||
Student has challenges with skill area(s) that prevent participation in educational activities. | Indicates the student has challenges pertaining to their academic progress. | N/A |
Identify activities and impact on participation: | The activities that impact the student's participation. | This field becomes available when the corresponding check box is selected. |
There is no adverse impact on the student's ability to participate in educational activities. | Indicates the student does not have challenges pertaining to their academic progress. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the evaluation team's recommendations. | N/A |
Cognitive
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
Explain: | The reason for referral. | N/A |
Background Information | ||
Explain: | Any pertinent information regarding the student's background. | N/A |
Environmental, Cultural and or Dialectal Considerations | ||
Explain: | Any pertinent information regarding the student's environment, culture, and dialect. | N/A |
Functional Performance | ||
Explain: | Any pertinent information regarding the student's functional performance. | N/A |
Assessment Procedures and Results | ||
Test(s) Administered: | The tests administered to the student. | N/A |
Date(s) of Assessment(s): | When the tests were administered. | N/A |
All tests administered were validated for the purposes in the assessment. (Cognitive, Social/Emotional, Academic, etc.) | A checkbox indicating all area(s) of concern were assessed. | N/A |
Testing Observation: | Any results observed during testing. | N/A |
Assessment Results: | The results of the test. | N/A |
Interpretation of Assessment Results: | The interpretation of the test results. | N/A |
Implications for Learning and Educational Impact | ||
Explain: | The implications for the student's learning based on the assessments. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the team's recommendations for action. | N/A |
Emotional Behavioral
Field | Description | Validation |
---|---|---|
Why does the student require an EBA: | The reason why the student requires an Emotional Behavioral Assessment. | N/A |
Background Information | ||
Include relevant information regarding the following (format of provided information to be determined by the assessor): | Any pertinent information regarding the student's background. | N/A |
Environmental, Cultural and/or Dialectal Considerations. | ||
Language(s) spoken in the home: Required | The student's spoken language at home. | The values in this field are pulled from Student Information > Census > Language Spoken in the Home. |
Dialect/Cultural Considerations: *Required | The student's language they primarily speak. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Cultural or Transcultural Considerations: | Any cultural considerations. | N/A |
Any other student or environmental characteristics that affects assessment selection or interpretation: | Any other informational that may impact the student's assessment or interpretation of the assessment. | N/A |
Assessment Procedures | ||
Sources of information and assessment tools: | The methods of assessment. | N/A |
Additional Assessment Information Data: | Any other assessment methods used. | N/A |
Results and Functional Performance | ||
Assessment Results: | The results of the functional performance assessment. | N/A |
Implications for Learning and Educational Impact | ||
How the identified characteristics would be expected to impact the student's functioning in the classroom/school setting. Include both positive impact and negative impact. | The implications for the student's learning based on the assessments. | N/A |
Formulation | ||
Formulations/Conclusions (integrative description) and diagnostic impressions (if any) | Any conclusions, if any. | N/A |
Summary and Recommendations | ||
Summarize: | A summary of the evaluation team's recommendations. | N/A |
Strengths-Based Recommendations: | Any recommendations based on the student's strengths. | N/A |
Multi-Disciplinary
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
Explain: | The reason for referral. | N/A |
Background Information | ||
Explain: | Any pertinent information regarding the student's background. | N/A |
Environmental, Cultural and or Dialectal Considerations | ||
Explain: | Any pertinent information regarding the student's environment, culture, and dialect. | N/A |
Functional Performance | ||
Explain: | Any pertinent information regarding the student's functional performance. | N/A |
Assessment Procedures and Results | ||
Test(s) Administered: | The tests administered to the student. | N/A |
Date(s) of Assessment(s): | When the tests were administered. | N/A |
All tests administered were validated for the purposes in the assessment. (Cognitive, Social/Emotional, Academic, etc.) | A checkbox indicating all area(s) of concern were assessed. | N/A |
Testing Observation: | Any results observed during testing. | N/A |
Assessment Results: | The results of the test. | N/A |
Interpretation of Assessment Results: | The interpretation of the test results. | N/A |
Implications for Learning and Educational Impact | ||
Explain: | The implications for the student's learning based on the assessments. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the team's recommendations for action. | N/A |
Observation
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
The student was referred by:
Required | The person who referred the student for the assessment. | N/A |
Academic: | The academic area. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field becomes available when "Other" is selected from the corresponding field. |
Behavior: | The behavior area. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field becomes available when "Other" is selected from the corresponding field. |
Background Information | ||
Relevant information regarding: | Any pertinent information regarding the student's background. | N/A |
Parent Information: | Any pertinent information regarding the student's parent/guardian. | N/A |
Pre-referral Interventions: | Any pre-referral interventions. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Outcomes: | The outcome of the interventions. | N/A |
Environmental, Cultural and/or Dialectal Considerations | ||
Language(s) spoken in the home:
Required | The student's spoken language at home. | The values in this field are pulled from Student Information > Census > Language Spoken in the Home. |
Dialect/Cultural Considerations:
Required | The student's language they primarily speak. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field becomes available when "Other" is selected from the corresponding field. |
Assessment Procedures and Results | ||
Observation in the domain of: | A checkbox for the domain. | N/A |
Domain:
Required | The domain area. | This field becomes available when the corresponding field is selected. |
A variety of assessment procedures were used to gather information. | A checkbox indicating a a variety of assessment methods were used to gather data. | N/A |
Tests Administered: | The tests administered to the student. | N/A |
Informal/Non-Standardized Measures/Methods Used: | Any other assessment methods used. Options include:
| N/A |
Writing: | The results of the writing assessment. | N/A |
Reading: | The results of the reading assessment. | N/A |
Mathematics: | The results of the mathematics assessment. | N/A |
Behavior: | The results of the behavior assessment. | N/A |
Date of Observation: | When the test was administered. | N/A |
Start Time of Observation: | The start time of the test. | N/A |
End Time of Observation: | The end time of the test. | N/A |
Setting of Observation: | The test setting. | N/A |
#of Students in Setting: | The number of students present during the test. | N/A |
#of Adults in Setting: | The number of adults present during the test. | N/A |
Name and Title of Person Completing Observation: | The person observing. | N/A |
Student was observed during: | When the student was observed. Options include:
| N/A |
Student's level of engagement and participation: | A description of the student's level of participation during the test. | N/A |
Special supports conditions observed: | Any additional observations. | N/A |
Instructional strategies and/or behavior supports used during the instruction: | The supports provided to the student during the test. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field becomes available when "Other" in the corresponding field is selected. |
Student's reaction to instructional strategy(ies) and/or behavior supports provided: | The student's response to the supports provided. | N/A |
Student's behavior during the observation session and how the behavior compares to that of other students in the class at the same time: | A comparison between the student's behavior and their peers during the same session. | N/A |
Student's academic performance during the observation session and how the performance compares to that of other students in the class at the same time: | A comparison between the student's academic performance and their peers during the same session. | N/A |
Implications for Learning and Educational Impact | ||
Student has challenges with skill area(s) that prevent participation in educational activities | Indicates the student has challenges impeding their participation in educational activities. | N/A |
Identify activities and impact on participation: | A description of activities and their impact on the student's education. | This field becomes available when the corresponding value is selected. |
There is no adverse impact on the student's ability to participate in educational activities | Indicates the student does not have challenges impeding their participation in educational activities. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the evaluation team's recommendations. | N/A |
Occupational Therapy
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
The student was referred by:
Required | The person who referred the student for the assessment. | N/A |
Referred due to the following concerns: | The reason for referral. Options include:
| N/A |
Background Information | ||
Relevant information regarding: | Any pertinent information regarding the student's background. | N/A |
Parent Information: | Any pertinent information regarding the student's parent/guardian. | N/A |
Pre-referral Interventions: | Any pre-referral interventions. Options include:
| Multiple options may be selected. |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Outcomes: | The outcome of the interventions. | N/A |
Environmental, Cultural and/or Dialectal Considerations | ||
Language(s) spoken in the home:
Required | The student's spoken language at home. | The values in this field are pulled from Student Information > Census > Language Spoken in the Home. |
Dialect/Cultural Considerations: Required | The student's language they primarily speak. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Assessment Procedures and Results | ||
All domains pertaining to the area(s) of concern were assessed and test results are valid. | A checkbox indicating all area(s) of concern were assessed. | N/A |
A variety of assessment procedures were used to gather information. | A checkbox indicating a a variety of assessment methods were used to gather data. | N/A |
Tests Administered: | The tests administered to the student. | N/A |
Informal/Non-Standardized Measures/Methods Used: | Any other assessment methods used. Options include:
| N/A |
Context/Environment This section has multiple sections describing the different contexts or environments and the level of impact on the student. For each of the sections listed below, the level of impact and a description should be documented:
| ||
Level of Impact: | The level of impact pertaining to the particular environmental condition. Options include:
| N/A |
Description of factor and how it impacts participation and performance in activities: | A description of the environmental condition and specifically how it impacts the student's participation and performance. | N/A |
Functional Performance This section has multiple sections describing the functional areas and the student's strengths and challenges in that area. For each of the sections listed below, the student's performance, strengths, challenges, and additional factors should be documented:
| ||
Student Performance: | The student's performance in the particular area. | N/A |
Strengths: | The student's strengths with these activities. | N/A |
Challenges: | The student's challenges with these activities. | N/A |
Factors Affecting Student Participation: | Additional factors impacting the student's participation in these activities. | N/A |
Standardized Assessment Results | ||
Explain: | A summary of the assessment results. | N/A |
Implications for Learning and Educational Impact | ||
Student has challenges with skill area(s) that prevent participation in educational activities. | Indicates the student has challenges pertaining to their academic progress. | N/A |
Identify activities and impact on participation: | The activities that impact the student's participation | This field becomes available when the corresponding checkbox is marked. |
There is no adverse impact on the student's ability to participate in educational activities. | Indicates the student does not have challenges pertaining to their academic progress. | N/A |
Level of Support Needed | The level of support the student needs in the particular area. Options include:
| The Levels of Support Needed, Responsiveness to Assistance, and Comments fields also applies to the following sections:
|
Responsiveness to Assistance | The student's response to assistance in the particular area. Options include:
| N/A |
Comments: | Any additional information regarding the particular area. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the evaluation team's recommendations. | N/A |
Physical Therapy
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
The student was referred by:
Required | The person who referred the student for the assessment. | N/A |
Referred due to the following Mobility concerns within: | The Mobility concerns of the student that led to the referral. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Background Information | ||
Relevant information regarding medical history: | Any pertinent information regarding the student's background. | N/A |
Pre-referral Interventions: | Any pertinent information regarding the student's parent/guardian. Options include:
| Multiple options may be selected. |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the field prior. |
Outcomes: | The outcome of the interventions. | N/A |
Environmental, Cultural and/or Dialectal Considerations | ||
Language(s) spoken in the home:
Required | The student's spoken language at home. | The values in this field are pulled from Student Information > Census > Language Spoken in the Home. |
Dialect/Cultural Considerations:
Required | The student's language they primarily speak. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above | This field appears when "Other" is selected from the field prior. |
Assessment Procedures and Results | ||
All domains pertaining to the area(s) of concern were assessed and test results are valid. | A checkbox indicating all area(s) of concern were assessed. | N/A |
A variety of assessment procedures were used to gather information. | A checkbox indicating a a variety of assessment methods were used to gather data. | N/A |
Tests Administered: | The tests administered to the student. | N/A |
Informal/Non-Standardized Measures/Methods Used: | Any other assessment methods used. Options include:
| N/A |
Context/Environment This section has multiple sections describing the different contexts or environments and the level of impact on the student. For each of the sections listed below, the level of impact and a description should be documented:
| ||
Level of Impact: | The level of impact pertaining to the particular environmental condition. Options include:
| N/A |
Description of factor and how it impacts participation and performance in activities: | A description of the environmental condition and specifically how it impacts the student's participation and performance. | N/A |
Functional Performance This section has multiple sections describing the functional areas and the student's strengths and challenges in that area. For each of the sections listed below, the student's performance, strengths, challenges, and additional factors should be documented:
| ||
Student Performance: | The student's performance in the particular area. | N/A |
Strengths: | The student's strengths with these activities. | N/A |
Challenges: | The student's challenges with these activities. | N/A |
Factors Affecting Student Participation: | Additional factors impacting the student's participation in these activities. | N/A |
Standardized Assessment Results | ||
Explain: | A summary of the assessment results. | N/A |
Implications for Learning and Educational Impact | ||
Student has challenges with skill area(s) that prevent participation in educational activities. | Indicates the student has challenges pertaining to their academic progress. | N/A |
Identify activities and impact on participation: | The activities that impact the student's participation | This field appears when "Other" is selected from the field prior. |
There is no adverse impact on the student's ability to participate in educational activities. | Indicates the student does not have challenges pertaining to their academic progress. | N/A |
Level of Support Needed: | The level of support the student needs in the particular area. Options include:
| The Levels of Support Needed, Responsiveness to Assistance, and Comments fields also applies to the following sections:
|
Responsiveness to Assistance: | The student's response to assistance in the particular area. Options include:
| N/A |
Comments: | Any additional information regarding the particular area. | N/A |
Summary and Recommendations | ||
Explain: | A summary of the evaluation team's recommendations. | N/A |
Speech and Language
Field | Description | Validation |
---|---|---|
Reason for Referral | ||
The student was referred by: | The person who referred the student for the assessment. Options include:
| N/A |
Speech | Indicates if the student was referred due to speech concerns. | N/A |
Briefly describe concerns: | A description of the speech concern. | This field appears when "Speech" is selected from the corresponding field. |
Language | Indicates if the student was referred due to language concerns. | N/A |
Briefly describe concerns: | A description of the language concern. | This field appears when "Language" is selected from the corresponding field. |
Background Information | ||
Relevant information regarding speech and language development: | Any pertinent information regarding the student's background. | N/A |
Pre-referral Interventions: | Any pertinent information regarding the student's parent/guardian. Options include:
| Multiple options may be selected. |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the corresponding field. |
Outcomes: | The outcome of the interventions. | N/A |
Parent Information: | Any pertinent information regarding the student's parent/guardian. | N/A |
Environmental, Cultural and/or Dialectal Considerations | ||
Language(s) spoken in the home:
Required | The student's spoken language at home. | The options in this field come from Census > Language at Home. |
Dialect/Cultural Considerations:
Required | The student's language they primarily speak. Options include:
| N/A |
Specify: | Additional information when "Other" is selected above. | This field appears when "Other" is selected from the corresponding field. |
Assessment Procedures and Results | ||
Speech and language skills were comprehensively assessed, and results are valid. | Indicates the student's speech and language skills were adequately assessed. | N/A |
A variety of assessment procedures were used to gather information. | A checkbox indicating a a variety of assessment methods were used to gather data. | N/A |
Tests Administered: | The tests administered to the student. | N/A |
Informal/non-standardized measures/methods used: | Any informal methods used for assessment. | N/A |
Behavioral Observations | ||
Behavior In: | Indicates how the student's behavior was assessed. Options include:
| N/A |
Behavior With: | Indicates who assessed the student's behavior. Options include:
| N/A |
Behavior: | The student's behavior assessment. Options include:
| N/A |
Communication In: | Indicates how the student's communication skills was assessed. Options include:
| N/A |
Communication With: | Indicates who assessed the student's communication skills. Options include:
| N/A |
Communication: | The student's communication assessment. Options include:
| N/A |
Comments: | Any additional information. | N/A |
Speech/Language/Communication Findings | ||
Tests Administered: | The tests administered to assess the student's speech/language/communication skills. | N/A |
Informal/non-standardized measures/methods used: | Any informal methods used for assessment. | N/A |
Hearing and Oral Structures | ||
Hearing Screening: | The results of the student's hearing assessment. Options include:
| N/A |
Comments: | Any comments related to the hearing assessment. | N/A |
Oral Structures and Functioning: | The results of the student's oral assessment. Options include:
| N/A |
Comments: | Any comments related to the oral assessment. | N/A |
Speech (Speaking) Skills | ||
Voice: | The results of the student's voice assessment. Options include:
| N/A |
Fluency: | The level of speech fluency for the student. Options include:
| N/A |
Comments: | Any comments related to the student's voice/fluency. | N/A |
Assessment Given: | The assessment given to test the student's speech sound production. | N/A |
Score: | The results of the assessment. | N/A |
Description and Summary of Speech Sound Production: | A description of the speech sound production assessment. | N/A |
Single Words: | A description of the student's use of single words. | N/A |
Connected Speech: | A description of the student's use of connected speech. | N/A |
Understood by a parent or familiar listener | Indicates the student was able to be understood by familiar listeners. | N/A |
Frequency | How often the student was understood by familiar listeners. Options include:
| N/A |
Percentage Rating | The percentage of how often the student was understood by familiar listeners. | N/A |
Understood by unfamiliar listener | Indicates the student was understood by unfamiliar listeners. | N/A |
Frequency | How often the student was understood by unfamiliar listeners. Options include:
| N/A |
Percentage Rating | The percentage of how often the student was understood by unfamiliar listeners. | N/A |
Comments: | Any additional information regarding the student's speech sound production. | N/A |
Language Skills | ||
Management of a Conversation: | An assessment of the student's functional communication skills to manage a conversation. Options include:
| N/A |
Comments: | Any comments related to the student's management of a conversation. | N/A |
Telling a Personal Story (describing an event that happened): | An assessment of the student's skills concerning telling a personal story. Options include:
| N/A |
Comments: | Any comments related to the student's ability to tell a personal story. | N/A |
Interact with others while playing | Indicates the student interacts with others while playing. | N/A |
Use of language while communicating with peers: | An assessment of the student's use of language while communication with peers. Options include:
| N/A |
Activities engaged in while playing | Indicates the student engages in activities while playing. | N/A |
Use of language while communicating with peers: | An assessment of how the student communication with their peers. Options include:
| N/A |
Comments: | Any comments related to the student's use of language. | N/A |
Strength: | The student's speech strengths. | N/A |
Challenge: | The student's speech challenges. | N/A |
Level of support needed to acquire skill: | The amount of assistance the student needs to aid them in gaining speech skills. Options include:
| N/A |
Student's response to support provided: | The student's response to the assistance provided. Options include:
| N/A |
Words and Communication | ||
Assessment(s) Administered and Score(s): | The assessment given to the student to determine their understanding and use of words. | N/A |
Language Sample: | The language sample used in the assessment. Options include:
| N/A |
Mean Length of Utterance | Indicates a mean length of utterance has been calculated. | N/A |
Score: | The student's score for length of utterance. | N/A |
Mean: | The student's mean length of utterance. | N/A |
Standard Deviation: | The student's standard deviation. | N/A |
Total Number of Words | Indicates the total number of words has been calculated. | N/A |
Score: | The student's score for total number of words. | N/A |
Mean: | The student's mean total number of words. | N/A |
Standard Deviation: | The student's standard deviation. | N/A |
Total Number of Different Words | Indicates the total number of different words has been calculated. | N/A |
Score: | The student's score for different words used. | N/A |
Mean: | The student's mean for different words used. | N/A |
Standard Deviation: | The student's standard deviation. | N/A |
Word Knowledge (used the following type of words): | The students word knowledge for the following word types. Options include:
| N/A |
Examples: | An example of the student's word knowledge. | N/A |
Answered the following question words accurately: | Indicates the student the following question words. Options include:
| N/A |
Comments: | Any comments regarding the student's question word proficiency. | N/A |
Followed One Step Directions: | Indicates the student was able to follow a one step direction. Options include:
| N/A |
Followed Two Step Directions: | Indicates the student was able to follow two step directions. Options include:
| N/A |
Comments: | Any comments related to the student's ability to follow directions. | N/A |
Assessment(s) Administered and Score(s): | The assessment administered to examine the student's syntax and grammar skills. | N/A |
Assessment(s) Administered and Score(s): | The results of the assessment. Options include:
| N/A |
Examples: | Examples of the student's syntax and grammar skills. | N/A |
Grammatical Form Used: | The type of grammatical form the student used. Options include:
| N/A |
Examples: | Examples of the student's grammatical form skills. | N/A |
Comments: | Any comments related to the student's grammatical form skills. | N/A |
Phonological Awareness | Indicates the student's language and literacy skills. Options include:
| N/A |
Comments: | Any comments related to the student's language and literacy skills. | N/A |
Print Knowledge Skills | Indicates the student's print knowledge skills. Options include:
| N/A |
Comments: | Any comments related to the student's print knowledge skills. | N/A |
Alphabetic Knowledge: | Indicates the student's alphabet knowledge. Options include:
| N/A |
Comments: | Any comments related to the student's alphabet knowledge. | N/A |
Narratives: Retell of a Familiar Story | An assessment of how the student tells a family story. Options include:
| N/A |
Story Retell Abilities: | The skills demonstrated by the student's retelling of a family story. Options include:
| N/A |
Comments: | Any comments related to the student's retelling of a family story. | N/A |
Implications for Learning | ||
Identify the gap between performance and what is expected. | A description of the gap between the student's performance and the expected results. | N/A |
Recommendations | ||
Recommendations should align with the implications for learning to address what speech and/or language skills is needed to advance in general education. | A description of the team's recommendations for intervention. | N/A |
Summary | ||
A comprehensive speech and language assessment was conducted due to the following speech and language concerns: | An overview of the speech and language concerns that led to this evaluation. | N/A |
The following is a summary of the student's performance. | An overview of the student's performance with the evaluation. | N/A |
Student's Vocabulary and Knowledge of Different Words was: | The overall result of the student's vocabulary and knowledge of different words. Options include:
| N/A |
Language growth is impacted because: | The reasoning for this conclusion. Options include:
| N/A |
Level of support needed to acquire skill: | The level of assistance the student requires to acquire these skills. Options include:
| N/A |
Student's response to support provided: | The student's response to the assistance provided. Options include:
| N/A |
Reason for Referral
The Reason for Referral editor is used to document the reason the student was referred to be evaluated.
Field | Description | Validation |
---|---|---|
Area(s) related to the suspected disabilities: | The area related to the student's suspected disability. Options include:
| N/A |
Specify:
Required when available | A text field used to clarify when Other is selected above. | This field displays when the Other checkbox is marked. |
The following existing information was reviewed: | The existing documentation or information used in the review process. Options include:
| N/A |
Summary of information related to concerns: | A text field used to document any information related to concerns. | N/A |
There are educationally relevant medical and/or physical issues directly related to the student's learning and access to education. | Indicates is there are relevant medical and/or physical issues related to the student's learning and access to education. | Yes or No |
Documentation: | A field used to provide clarity about the above medical issues. | Displays when Yes is selected. |
There are educationally relevant physical issues directly related to the student's learning and access to education. | Indicates is there are relevant physical issues related to the student's learning and access to education. | Yes of No |
Documentation: | A field used to provide clarity about the above physical issues. | Displays when Yes is selected. |
All assessments, materials and/or strategies used, considered racial or cultural bias and linguistic differences. | The assessments used for determination. | N/A |
Interventions Summary This table is read only and displays the following columns:
All of these read only values come from the user selecting the "Add Intervention" button and entering information on a side panel recording what interventions were used. | ||
Intervention Summary (side panel) | ||
Area of Need
Required | The student's area of need. | N/A |
Instructional Strategies Used | The instructional strategies used for the intervention. | N/A |
Length of Time Interventions Provided | The amount of time the intervention is provided. (# of weeks or months) | N/A |
How often and how long interventions were provided | The frequency and length of time the intervention is provided. | N/A |
Student Performance results of interventions | The results of the intervention. | N/A |
Summary and Interpretation of Evaluation Data
Integrate and interpret evaluation data by describing relevant key findings across areas reviewed and assessed related to the area(s) of concern. All data summarized (test results, observations, interviews, etc.) MUST be relevant and related to the referral and suspicion of a disability. Performance must be described. Do NOT just re-state/list every assessment/observation completed. Limit the use of jargon. State findings in language that is understandable to all team members, including the parent.
Field | Description | Validation |
---|---|---|
Findings obtained from a variety of sources were carefully considered and are documented below. This table is read only and displays the following columns:
All of these read only values come from the user selecting the "New" button and entering information on a side panel recording what summary of findings were. | ||
Summary of Findings in area(s) of Concern (side panel) | ||
Area of Concern: Required | The area of concern. | The options available are determined from the values marked under "Areas related to suspected disabilities" on the Reason for Referral editor. |
Strengths: | The student's strengths. | N/A |
Limitations: | The student's limitations. | N/A |
Exclusionary Factors
The Exclusionary Factors editor is used to document any factors excluding the student from regular education.
Field | Description | Validation |
---|---|---|
Lack of appropriate instruction in reading | Indicates a lack of appropriate instruction in reading. | Yes or No This is a required field for saving the editor. |
Lack of appropriate instruction in math | Indicates a lack of appropriate instruction in math. | Yes or No This is a required field for saving the editor. |
Environmental or Economic Factors | Indicates there are environment or economic factors excluding the student from regular education. | Yes or No This is a required field for saving the editor. |
Cultural Factors | Indicates there are cultural factors excluding the student from regular education. | Yes or No This is a required field for saving the editor. |
Limited English Proficiency | Indicates there is a limitation in English proficiency excluding the student from regular education. | Yes or No This is a required field for saving the editor. |
Eligibility Criteria Checklist
The Eligibility Criteria Checklist is used to document if the student meets the criteria for difference disabilities.
Eligibility Criteria List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Sequence | The order in which the record prints. |
Eligibility Category | The area assessed. |
Eligible | Indicates if the student is eligible to receive special education services in that area. |
Print in Evaluation | Indicates this record prints on the Evaluation. |
Eligibility Criteria Detail Screen
Field | Description | Validation |
---|---|---|
Eligibility Category Required | The area assessed. Options include:
| Options available are located in the Attribute Dictionary. |
Sequence | Determines the sort order on the printed evaluation and on the list screen. | N/A |
Print in Evaluation | Indicates this record prints on the evaluation. | N/A |
Eligible | Indicates if the student is eligible to receive special education services in that area. | N/A |
Date of Eligibility Determination *Required | The date the determination was made. | * This field is required when Eligible is marked. |
Criteria for Autism Spectrum Disorder (ASD)
Field | Validation |
---|---|
The student has a developmental disability affecting verbal and nonverbal communication skills (generally evident before the age of three). Required | Yes or No |
Explain or reference data or evidence: | N/A |
The student has a developmental disability significantly affecting social interaction (generally evident before the age of three). Required | Yes or No |
Explain or reference data or evidence: | N/A |
The student exhibits engagement in repetitive activities or stereotyped movements. | Yes or No |
The student exhibits resistance to environmental change or change in daily routines. | Yes or No |
The student exhibits unusual responses to sensory experiences. | Yes or No |
Explain or reference data or evidence: | N/A |
The student’s verbal and non-verbal communication skills and social interaction are adversely affecting the student's educational (academic achievement and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
The student’s educational performance is not adversely affected primarily due to an emotional behavioral disability. | N/A |
ASSURANCES: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of Autism Spectrum Disorder that adversely affects the student's educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting. Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Deaf
Field | Validation |
---|---|
The student has a significant hearing loss, averaging greater than 70dB (decibels) in the speech frequencies (500 Hz to 4,000 Hz)
Required | Yes or No |
A current hearing evaluation was conducted by an audiologist to determine hearing loss.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The hearing loss impairs the student's auditory processing of linguistic information through hearing, with or without amplification. Auditory processing means the ability to listen and understand spoken messages within the school environment.
Required | Yes or No |
The hearing loss is adversely affecting educational (academic achievement and/or functional) performance.
Required | Yes or No |
Areas impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of Deafness, that adversely affects the student’s educational performance. Required | Yes or No |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Deaf-Blindness (D-B)
Field | Validation |
---|---|
Met the criteria for Deaf or Hard of Hearing (attach Deaf or Hard of Hearing worksheet).
Required | Yes or No |
Met the criteria for Visual Disability including Blindness (attach Visual Disability including Blindness worksheet)
Required | Yes or No |
Explain or reference data or evidence: | N/A |
There is an adverse effect on communication.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
There is an adverse effect on developmental performance.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
There is an adverse effect on educational (academic achievement and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of Deaf-Blindness that adversely affects the student's educational performance. The combination of the hearing and visual impairments cause severe communication and other developmental and educational needs such that cannot be accommodated in special education programs solely for children with deafness or blindness. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Developmental Delay 3-5 (DD 3-5)
Field | Validation |
---|---|
Age: The child is between the ages of three (3) through five (5).
Required | Yes or No |
The child was observed in a variety of settings that includes the natural environment such as the child's home, with a parent or caregiver or an early education or care setting that includes peers who are typically developing.
Required | Yes or No |
The child was observed in involved in age appropriate play and learning activities that includes peers who are typically developing. If observation in these settings is not possible, observation in an alternative setting or observing via digital recordings is permitted (include dates and settings of observations):
Required | Yes or No |
List Observations | N/A |
Cognitive development and adaptive behavior are delayed equivalent to 1.5 standard deviations below the mean when compared with the standard score expected for the chronological age.
Required | Yes or No |
ONE of the following areas is delayed equivalent to 1.5 standard deviations below a standard score.
Required | Yes or No |
Check boxes that apply | Options include:
|
Patterns* of learning deviate from age expectations (i.e. developmental milestones) across settings. Required | Yes or No |
At least one must be selected | Options include:
|
Explain or reference data or evidence: | N/A |
The student has a developmental delay that is adversely affecting the student’s ability to participate in age appropriate activities.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of a Developmental Delay that adversely affects the student’s ability to participate in age appropriate activities. | N/A |
The student has educational needs that require specially designed instruction to participate in age appropriate activities.
Required | Yes or No |
List and describe area(s) of educational needs. | N/A |
Criteria for Developmental Delay 6-8 (DD 6-8)
Field | Description |
---|---|
Age: The child is between the ages of six (6) through eight (8).
Required | Yes or No |
The child was observed in the natural environment across multiple settings that includes peers who are typically developing.
Required | Yes or No |
The child was observed in involved in age appropriate play and learning activities that includes peers who are typically developing. If observation in these settings is not possible, observation in an alternative setting or observing via digital recordings is permitted (include dates and settings of observations):
Required | Yes or No |
List Observations | N/A |
Have all other eligibility categories been considered before identifying the category of developmental delay?
Required | N/A |
At least three (3) of the following areas are delayed equivalent to 1.5 standard deviations below a standard score.
Required | Yes or No |
Check boxes that apply | Options include:
|
Patterns* of learning deviate from age expectations (i.e. developmental milestones) across settings. Required | Yes or No |
At least three areas must be selected | Options include:
|
Explain or reference data or evidence: | N/A |
The student has a developmental delay that is adversely affecting the student’s ability to participate in age appropriate activities.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of a Developmental Delay that adversely affects the student’s ability to participate in age appropriate activities. | N/A |
The student has educational needs that require specially designed instruction to participate in age appropriate activities.
Required | Yes or No |
List and describe area(s) of educational needs. | N/A |
Criteria for Emotional Disability (ED)
Field | Validation |
---|---|
One or more of the characteristics exhibited over a long period of time and to a marked degree.
Required | Yes or No |
Check all boxes that apply: | Options include:
|
Explain or reference data or evidence: | N/A |
The disability category of Emotional Disability does not apply if characteristics that the student displays are primarily the result of cultural, or language differences or both. (check to confirm that this is true). | N/A |
The characteristic(s) of an emotional disability are adversely affecting the student's educational (academic achievement and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of an Emotional Disability that adversely affects educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Hard of Hearing (HH)
Field | Validation |
---|---|
The student has a hearing loss (permanent or fluctuating), averaging 26 to 70 decibels(DB) in the speech frequencies (500Hz to 4000Hz).
Required | Yes or No |
A current hearing evaluation was conducted by an audiologist to determine hearing loss.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The hearing loss impairs the student’s auditory processing of linguistic information through hearing, with or without amplification. Auditory processing means the ability to listen and understand spoken messages within the school environment.
Required | Yes or No |
The hearing loss is adversely affecting educational (academic achievement and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of Hard of Hearing that adversely affects the student’s educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | N/A |
List and describe area(s) of educational needs: | N/A |
Criteria for Intellectual Disability
Field | Validation |
---|---|
The student has significantly impaired intellectual functioning: At least 2.0 standard deviations below the mean, on an individually administered, standardized measure of intellectual functioning with consideration given to the standard error of measurement for the assessment.
Required | Yes or No |
Significantly impaired adaptive behavior: At least 2.0 standard deviations below the mean on an individually administered standardized instrument or professionally recognized scales of adaptive behavior.*
Required | Yes or No |
There is a developmental history (birth through 18) that indicates significant impairment in intellectual functioning and a current demonstration of a significant impairment is present.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The student’s intellectual disability and adaptive skill deficits are adversely affecting the student’s educational (academic and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of an Intellectual Disability that adversely affects the student's educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Multiple Disabilities (MD)
Before completing the Multiple Disabilities (MD) Criteria Worksheet, the worksheets for the other eligible criteria need to be completed.
Field | Validation |
---|---|
There is documentation of the below evidence. | Yes or No |
All must be checked: | Options include:
|
Student is eligible under one or more of the following categories and worksheets are included. | Yes or No |
Check all that apply: | Options include:
|
Assessment materials do not conclusively demonstrate eligibility criteria are met, but the team and parent documents the existence of concomitant disability. | Yes or No |
Statement of concomitant disability and method used to determine eligibility: | N/A |
Explain or reference data or evidence: | N/A |
The student’s multiple disabilities adversely affect the student’s educational (academic and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of Multiple Disabilities that adversely affect the student's educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Disability Category Orthopedic Disability (OD)
Field | Validation |
---|---|
There is documentation of an Orthopedic Disability
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The student’s orthopedic disability adversely affects the student’s educational (academic and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of an Orthopedic Disability that adversely affects the student's educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Other Health Disability (OHD)
Field | Validation |
---|---|
The student has a health problem that is listed below: | Yes or No |
Select one or both | Options include:
|
A medically fragile condition such as but not limited to asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, Tourette syndrome | Yes or No |
The student has one or more of the limits listed below: | Yes or No |
Check any that apply: | Options include:
|
Explain or reference data or evidence: | N/A |
The characteristics of the student’s Other Health Disability adversely affect educational (academic and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of an Other Health Disability that adversely affects the student's educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Specific Learning Disability (SLD)
Field | Validation |
---|---|
Section I. Eligibility Considerations | |
The student does not achieve adequately for the student’s age or to meet Hawaii approved grade-level standards in one or more of the following areas, when provided with learning experiences and instruction appropriate for the student’s age or Hawaii approved grade-level standards.
Required | Yes or No |
Check all that apply: | Options include:
|
The student demonstrates a severe discrepancy between actual achievement and intellectual ability by a difference of at least 1.5 standard deviations in one or more of the following areas:
Required | Yes or No |
Check all that apply: | Options include:
|
The student does not make sufficient progress to meet age or Hawaii approved grade-level standards in one or more of the areas, selected using a process based on the student’s response to scientific, research based interventions.
Required | Yes or No |
The student exhibits a pattern* of strengths and weaknesses in performance achievement or both relative to age, Hawaii approved grade level standards, or intellectual development relevant to the identification of a specific learning disability using appropriate assessments.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
Section II. Observation Requirement | |
There is documentation that the student was observed in the student’s learning environment to document the student’s academic performance and behavior in the area of difficulty. Required | Yes or No |
One area must be checked: | Options include:
|
Explain or reference data or evidence: | N/A |
Section III. Educational Performance | |
The specific learning disability is adversely affecting the student's educational (academic and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Section IV. Educationally Relevant Medical Findings | |
There are educationally relevant medical findings.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
Section V. Appropriate Instruction | |
Prior to or as a part of the referral process the team considered data to ensure that underachievement was not due to a lack of instruction in reading or math.
Required | Yes or No |
Each area must be checked: | Options include:
|
Explain or reference data or evidence: | N/A |
Section VI. Exclusionary Statement | |
The student does not have learning problems that are primarily the result of: 1. a visual, hearing, or motor impairment, 2. an intellectual disability, 3. an emotional disability, 4. cultural factors, an environmental or economic disadvantage, or 5. Limited English proficiency.
Required | Yes or No |
Section VII. Disability Category Criteria Determination | |
There is documented evidence of a Specific Learning Disability that adversely affects the student's educational performance. | N/A |
Assurances | Options include:
|
There is documented evidence of a Specific Learning Disability that adversely affects the student's educational performance. | N/A |
Section VIII. Educational Needs | |
The student needs specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Speech or Language Disability (SoLD)
Field | Validation |
---|---|
The student does not demonstrate Limited English Proficiency.
Required | Yes or No |
The student’s age, culture, language background, home language, and dialect were considered when determining a speech or language disability.
Required | Yes or No |
The student was observed in the natural environment using communication skills in interpersonal interactions and learning activities that includes peers who are typically developing and/or familiar adults. If observation in these settings is not possible, observation in an alternative setting or observing via digital recordings is permitted (include dates and settings of observations):
Required | Yes or No |
List Observations: | N/A |
Data was gathered from multiple sources.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
There is documentation of a significant discrepancy from typical communication skills in at least one of the speech areas listed below.
Required | Yes or No |
Check all that apply: | Options include:
|
There is documentation of a significant discrepancy from typical communication skills in the area of language.
Required | Yes or No |
All must be checked: | Options include:
|
At least one area must be checked: | Options include:
|
Explain or reference data or evidence: | N/A |
The speech or language disability is adversely affecting the student's educational (academic achievement or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of a Speech or Language Disability that adversely affects educational performance. | Yes or No |
The student needs specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Traumatic Brain Injury (TBI)
Field | Validation |
---|---|
There is medical evidence of an acquired injury caused by an external physical force resulting in total or partial functional disability or psychosocial impairment, or both.
Required | Yes or No |
There is medical evidence that the injury resulted in total or partial functional disability or psychosocial impairment, or both.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The term Traumatic Brain Injury does not apply if the student's brain injuries are congenital or degenerative, or induced by birth trauma. | N/A |
The traumatic brain injury (either open or closed) results in impairments in one or more areas such as those listed below.
Required | Yes or No |
At least one area must be checked: | Options include:
|
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of a Traumatic Brain Injury that adversely affects educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Criteria for Visual Disability including Blindness (VDB)
Field | Validation |
---|---|
Partially sighted: The student’s visual acuity is 20/70 to 20/200 in the better eye and with the best correction.
Required | Yes or No |
Blind: The student’s visual acuity is 20/200 in the better eye and with the best correction, or less, the subtended visual field of less than 20 degrees, regardless of central visual acuity.
Required | Yes or No |
Progressive visual impairment: The student has a progressive visual impairment, such as retinitis pigmentosa that will lead to eventual visual disability.
Required | Yes or No |
Explain or reference data or evidence: | N/A |
The vision impairment is adversely affecting educational (academic achievement and/or functional) performance.
Required | Yes or No |
Area(s) impacted include: | N/A |
Explain or reference data or evidence: | N/A |
Assurances: The factors in determining if the student is a student with a disability is not based on: | Options include:
|
There is documented evidence of a Visual Disability including Blindness that adversely affects the student’s educational performance. | N/A |
The student has educational needs that require specially designed instruction to participate and perform in the educational setting.
Required | Yes or No |
List and describe area(s) of educational needs: | N/A |
Evaluation Team Information
The Evaluation Team Information editor lists each member of the student's evaluation team and whether they agreed with the result of the evaluation.
The Team Member list is based on the Team Members tool. This editor is only available when Specific Learning Disability is a selected checklist on the Eligibility Checklist editor, as this prints at the end of that specific document.
Evaluation Team List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Team Member | The name of the team member. |
Title/Position | The role of the team member. |
Agreed with Report | Indicates the team member agrees or disagree with the evaluation report. |
Evaluation Team Detail Screen
Field | Description | Validation |
---|---|---|
Team Member | The name of the Team Member. | This pulls from the Team Members tool. Once one record is created for a particular team member, that team member's name is removed from the options available. |
Title/Position | The role of the team member | This field is read-only. This pulls from the Team Members tool. |
Agreed with Report | Indicates the team member agrees or disagree with the evaluation report. Options include Yes or No. | N/A |
Dissenting member(s) statement (specific to only SLD eligibility)
*Required | A text area used to document the dissenting reason. | *This field is required to complete the editor. It also only displays when No is selected above. |
Eligibility Decision
The Eligibility Decision editor indicates if the student is eligible for special education services, the areas of eligibility, and the reasons that led to this conclusion.
Field | Description | Validation |
---|---|---|
The child is eligible for Special Education and Related Services.
Required | Indicates if the student is eligible to receive special education and/or related services. | Required in order to complete the editor.
|
Eligibility Category
Required | The area of eligibility. Options include:
| The values available are those marked as Eligible from the Eligibility Criteria checklists. |
Previous Eligibility Category | If applicable, the previous eligibility of the student. Options include:
| N/A |
Deaf | Indicates this is a secondary disability for the student. | Yes or No |
Hard of Hearing | Indicates this is a secondary disability for the student. | Yes or No |
Deaf-Blind | Indicates this is a secondary disability for the student. | Yes or No |
Visual Impairment including Blindness | Indicates this is a secondary disability for the student. | Yes or No |
Evidence of a Disability | A text field used to document evidence of the student's disability. | N/A |
Prior Written Notice
The Prior Written Notice editor is used to document meeting notices provided to the parent/guardian.
Prior Written Notice List Screen
Column Name | Description |
---|---|
Padlock Icon | The user currently working on the record. |
Meeting Information | The type of meeting. |
Date Provided to Parents | The date the notice was provided to the parent/guardian. |
Print in Evaluation | Indicates this record prints on the Evaluation. |
Prior Written Notice Detail Screen
Field | Description | Validation |
---|---|---|
Print in Evaluation | Indicates this record prints on the Evaluation. | N/A |
Meeting Information | The type of meeting. Options include:
| Options available are pulled from the Conference Actial > Conference Purpose/Actual Conference Date fields. |
Date provided to parents
Required | The date the notice was given to the parent/guardian. | N/A |
Admin / Designee | Indicates who the Admin Designee was for the associated meeting if there was one. | The person listed is whoever is listed on the most associated Conference Actual with a Role of "Principal" OR "Vice Principal" AND listed as Attended. If this does not apply, the person marked as Admin/Designee is pulled into this field. |
Description of proposed or refused action: | A text field used to document the proposed or refused action. | N/A |
Explanation of why the action is proposed or refused: | A text field used to document why the action is proposed or refused. | N/A |
Description of other options considered: | A text field used to describe other options considered. | N/A |
Reasons these options were rejected: | A text field used to describe why these options were rejected. | N/A |
Description of the evaluation procedures, tests, records, or reports used as a basis for the proposed/refused action: | A text field used to document the evidence used as a basis for the action. | N/A |
Other relevant factors: | A text field used to document any other relevant factor. | N/A |
Initial Provision of SPED & Related Services
The Initial Provision of SPED & Related Services editor is used to document an initial provision sent to the parent/guardian.
Field | Description | Validation |
---|---|---|
Provided to Parent Date Required | The date this information was provided to the parent/guardian. | N/A |
Contact Efforts This table is read only and displays the following columns:
All of these read only values come from the user selecting the "New" button and entering information on a side panel recording what Contact Efforts were made. | ||
Contact Date | The date the parent/guardian was contacted. | N/A |
Contacted By | The person who reached out to the parent/guardian. | N/A |
Contact Method | The manner in which the parent/guardian was contacted. Options include:
| Options available are hard coded. |
Contact Name | The name of the parent/guardian. | N/A |
Relationship to Student | The relationship of the person to the student. | N/A |
Outcome | The outcome of the contact attempt. | N/A |
Contact Results | ||
Consent Given | The parent/guardian's consent. | Yes or No |
Consent Form Signed Date | The date the consent form was signed. | N/A |
School Received Consent Form Date | The date the school received the consent form. | N/A |
Name of Person Signing Consent Form | The name of the person who signed the consent form. | N/A |
Revocation | Indicates consent was revoked. | N/A |
Revocation Form Signed Date | The date consent was revoked. | * The field is required and only displays when the Revocation checkbox is marked. |
Name of Person Signing Revocation Form | The name of the person who signed the revocation form. | * The field is required and only displays when the Revocation checkbox is marked. |
School Received Revocation Form Date | The date the school received the revocation form. | * The field is required and only displays when the Revocation checkbox is marked. |
Consent Revocation Reason | The reason for the consent revocation. | * The field is required and only displays when the Revocation checkbox is marked. |