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Intermediate School District 917Evaluation Summary Report

Student: Date of Birth: Grade: School: [917 program name], School name]

Example: ISD 917 TESA Program, Lakeville North High SchoolIEP Manager: (Name, Title)

Date of Report:

INITIAL EVALUATION OR RE-EVALUATION [Choose one title & delete the other]

REASON FOR REFERRAL

Example for initial evaluation: Student is being assessed for an initial evaluation due to the recent medical findings of a significant hearing loss and concerns reported by school staff and parents about his academic progress.

Example for re-evaluation: A re-evaluation of Student's current level of performance is being conducted to determine continued eligibility for special education services and to assist her IEP team in planning Student's educational program.

BACKGROUND INFORMATION

Student is currently an eighteen-year-old young woman who attends the Transition Education Service Alternative (TESA) Program located at Dakota County Technical College in Rosemount, Minnesota. The TESA program emphasizes the development of transition skills to assist students in becoming as independent as possible in their future environments of home, community, and work. Student has been eligible for special education services since 1995 due to needs in the areas of behavior, language and parent concerns regarding a possible attention deficit disorder. She met eligibility for early childhood special education services under the category of Developmentally Delayed at that time. She was found to be in need of Occupational Therapy (OT) services in 1996. In 1998, Dr. Scanlon diagnosed Student with Attention Deficit/Hyperactivity Disorder (ADHD). In December of 1998, Student was evaluated and met eligibility for developmental adaptive physical education (DAPE). In March, 1999, Student was reevaluated to determine categorical eligibility, and she met eligibility for Developmental Cognitive Delay, Mild to Moderate (DCD-MM). Student was also found to be in need of Speech/Language services at that time. Student was reevaluated in 2002 and again in 2005, and continued to qualify for DCD-MM and

Evaluation Summary ReportStudent Name, Date

This section should answer the question of why the evaluation is being conducted. This section should be compiled and completed by the IEP manager.

Provide a brief background of relevant information about the student that will assist other readers of the report to better understand the environment and/or conditions that have had an impact on the child to date, such as medical condition(s), age of diagnosis, age of intervention, and previous educational history, including previous educational environments and programming.

This section should be compiled and completed by the IEP manager.

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DAPE services and demonstrate need for Speech/Language and OT services. Student is on medication for ADHD and she attends school regularly.

INFORMATION REPORTED BY THE PARENT

Student’s mother, Mrs. Obama, completed the Developmental History, Family, and Home Questionnaire form as part of the current evaluation. Student has been living at the Shelter Care for Kids program, with the county having custody since December of 2010. Under the area of health and early development, Student’s mother noted the following concerns: history of ear infections, Attention Deficit Hyperactivity Disorder, and depression. There is a positive family history for ADHD and Student’s father has a learning disability. Student’s mother indicated that there were some complications during Student’s birth, noting that she had a c-section and that the cord was wrapped around Student’s neck. Mrs. Obama noted that there was a delay in language development for Student, specifically with speaking.

In terms of school and learning, Student’s mother notes that she does not think Student views school as being important and does not believe Student spends enough time on homework assignments. Student often needs help with homework and can demonstrate difficulty with making and keeping friends. Mrs. Obama indicated that it is “somewhat like my child” to the question of whether her child is someone who is often hurtful to others and can be moody and uncooperative. Student has been receiving special education services since the age of four. Her mother shared that she has been involved with outside clinical therapies, such as occupational and psychological. Student’s mother believes Student’s strengths are that she is very creative and loves affirmation and rewards. Her weaknesses are that she is not able to sit still for longer periods. Mrs. Obama rated Student as having “poor” skills with the following information processing skills: remembering, organizational skills, planning skills, and with understanding what she hears. All other skills were rated to be in the “adequate to good” range.

SPECIAL CONSIDERATIONS

Student’s language, cultural, economic, or environmental background does not indicate that special adaptations in assessment procedures needed to be made. During testing, visual and auditory distractions were minimized. Student’s mother indicated on the Developmental History, Family, and Home Questionnaire form that she does not think that Student’s problems at school are the result of a cultural or racial misunderstanding or are related to a language barrier.

TEST PROCEDURES


This section should be compiled and completed by the IEP manager.

This section should be compiled and completed by the school psychologist or IEP manager. This section heading addresses special testing adaptations, cultural background, sensory

and/or physical considerations, and assistive technology considerations that have an impact on the administration or interpretation of testing.

This section should be compiled and completed by the IEP manager and should match the evaluation plan.

List the domain area, the name of the assessments tools and procedures, and the title of the evaluator

Indicate assessors by position title and area of licensure (e.g. Special Education Teacher, SLD) or certification (e.g. Physical Therapist) only. Do not include assessors’ names, nor include their credentials (e.g. ‘M.Ed., CCC, Ph.D.’).

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Areas Procedures Evaluator’s TitleSensory Vision Screening

Review of Audiological Records

Licensed School Nurse

Educational Audiologist

Health/Physical Record Review, Classroom Observation, Parent Interview

Licensed School Nurse

Communication Review of Records, Clinical Evaluation of Language Fundamentals-Fourth Edition, Observation

Speech Language Pathologist

Intellectual Functioning Review of Records, Wechsler Adult Intelligence Scale-Fourth Edition

School Psychologist

Academic Performance Record Review of Classroom Data, Teacher Interview

Observation, Woodcock-Johnson III Tests of Academic Achievement-Normative Update

Special Education Teacher, DD

School Psychologist

Social/Emotional/Behavior Functional Behavior Assessment, including Review of Records, Observations, Student, Parent, and Teacher Interview

School Psychologist,Special Education Teacher, DD

Motor Skills Staff interview, Observations, Sensory Profile – School Companion, Informal Handwriting Assessment

Record Review, Observation

Review of Records, Functional Motor Scale Checklist

Occupational Therapist

Physical Therapist,

Developmental/Adaptive Physical Education Teacher

Functional Skills Review of Records, Adaptive Behavior Assessment System-Second Edition

School Psychologist

Transition Enderle-Severson Transition Rating Scale-Form J-Revised, Student Interview


Assistive Technology Assistive Technology Checklist



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PRESENT LEVELS OF PERFORMANCE/TEST RESULTS

SENSORY

Evaluators: Julia Roberts, Licensed School Nurse and Laura Stone, Educational AudiologistProcedures: Vision Screening, Review of Audiological Records

Vision ScreeningStudent passed a vision screening by the school nurse on 9/22/10, and no vision concerns were observed.

Review of Audiological RecordsStudent has had a history of middle ear problems. She has been seeing an Ear Nose and Throat physician and audiologist at ENT Specialty Care in Burnsville. Hearing evaluation results obtained 1/21/03 showed normal middle ear function and normal hearing in the right ear with a mild conductive hearing loss in the left ear. She had her tonsils and adenoids removed and PE tubes placed on 4/21/04 and PE tubes re-inserted on 5/12/05. A hearing evaluation done on 1/12/05 indicated normal hearing in both ears, with subsequent periodic hearing screenings conducted all indicating hearing in the normal range. A clinical audiological report dated 8/13/09 indicates normal hearing bilaterally.

Sensory SummaryStudent has normal vision. She has a history of middle ear problems in her early childhood years with a documented mild hearing loss prior to having her tonsils and adenoid removed and PE tubes. Student has normal hearing at this time.

Sensory NeedsExample of a learner with vision needsStudent needs materials with good visual contrast (yellow and lit background), and objects that have lit display to provide greater visual input.

Example of a learner with hearing needsStudent should continue to use her personal hearing aids full-time outside educational situations. De-activating the directional microphone so Student “overhears” more speech should be considered. Student


Describe the child's present levels of performance and the results of testing in the domains in which the child was assessed as indicated on the evaluation plan.

Provide an accurate, concise report of scores, observations and interpretations. Explain what scores mean. Use parent-friendly language. Make sure to provide interpretive statements about observations and test scores.

Interpretative statements of standardized testing results must include the range in which the score fell and a description of how the student scored compared to the normed population.

It is a positive best practice to also describe areas of strength in the above domains.

Note that the Sensory and Health/Physical domains now precede other domains in the ESR template due to the critical nature of how a learner’s functioning in these domains affect all other areas of functioning.

Vision and Hearing Screening and/or clinical findings are reported here. Otoacoustic Emission (OAE) Screening (can be used for the hearing screening for difficult-to-

screen learners) This area can be addressed by a school nurse, or for hearing, an audiologist, depending on

who conducted the screening, testing and/or reviewed clinical findings.

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should continue to use a personal FM system in all educational settings. She should receive preferential seating in the classroom, close to her teacher with a good view of her face. This will allow her to use visual information to help her understand speech. She should be seated away from obvious noise sources such as fans, audio-visual equipment, computers, windows, doorways, or hallways.Students with hearing loss have difficulty following classroom discussions. Stating other students’ names when calling on them or pointing to them when calling on them will help Student know who to look at next during discussions. Student’s auditory skills and middle ear status should be monitored throughout the school year. Her hearing should be evaluated three times per year due to her history of middle ear problems. This should be done more often if there are concerns regarding her hearing.

HEALTH/PHYSICAL

Evaluator: Julia Roberts, Licensed School NurseProcedures: Record Review, Classroom Observation, Parent Interview

Record ReviewHealth Problems and Medical Diagnosis/s: Spastic quadriplegic cerebral palsy with right sided weakness, spasticity particularly involving bilateral lower extremities and right elbow flexor, contractures involving right upper extremity and bilateral lower extremities, progressive neuromuscular scoliosis, right hip dysplasia with increasing right knee pain escalating in severity, right hip subluxation with acetabular dysplasia, windswept appearance, status post right femoral varus osteotomy June 2005, anticipated posterior spinal fusion during 2011, history of medically intractable focal epilepsy in the context of spastic triplegic cerebal palsy, cortical blindness, cerebral hemorrhage following birth complications, global developmental delay, chronic ear infections w/ PE tubes (no longer in place per parent), tonsil and adenoidectomy, surgical repair of right hip, and a history of upper respiratory infections (infancy through approximately age 5).

Immunization (school required): Student’s immunizations are up-to-date. Medication Review: Student receives medication at home for seizure control and for assistance with sleep. She also receives a vitamin supplement at home. Additionally she has available a medication to administer for prolonged seizure events that may occur (available at school and home).

Medication / Food Allergy(s) /Environmental Allergy/s: None

Food Intolerance/s: None

Diet: Student eats a regular diet. If food is dry and “tougher,” i.e. meats, she requires food to be cut up in bite-size pieces. She is able to eat sandwiches (breads) by biting from the whole piece. She needs to be observed that she is completing each bite (swallowing). She does also have a high palate and “starchy or sticky foods” could become adhered to the roof of her mouth. She drinks from a cup with a straw.

Growth: Medical record review indicates Student has had no significant weight gain for 2.5 years. She appears well nourished.


This section addresses a learner’s health, allergy and medication history and needs which impact the learner’s ability to learn and/or function in the school setting

Procedures in this domain can include:o Health History Record Review o Medication Reviewo Informal Interview-Studento Informal Interview- Parent/Guardiano Licensed School Nurse Assessment of Health/Physical Status Worksheet (for learners

with more complex health needs)o Feelings Checklisto Questionnaire: Are you Ready to Manage your Own Health Care?

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Family/Social History: Student lives with her mom and sister. It is noted that her birth was complicated with prolonged labor with fetal distress and that a likely brain hemorrhage occurred resulting in her cerebral palsy and other possible associated health problems. As noted on her medical history and health notes, Student has had increasing problems with comfort due to hip dysplasia, progressive scoliosis and knee concerns. When these problems are under control with positioning, calming strategies, bracing and support and medications, Student typically is able to participate in school activities with minimal difficulty. Student expresses discomfort or possible illness with change in appetite, vocal and crying. She has a cry that is “high pitched” and “loud” when seeking possible drink or hunger satisfaction. Of particular concern the past year has been discomfort associated with her right and left knees joints “popping out” and requiring manipulation to place back and protection with positioning and braces when transferring or turning/rolling. Additional cares has been needed to help prepare Student for transfers to decrease anticipated pain from either hip areas or knees. Some preparations included pre-medicate (home or school), verbal instruction and calming strategies. It is noted that Student has had hip surgery and is also anticipating having spinal fusion done within next year to help alleviate curvature and associated complications-including discomfort.

Classroom ObservationStudent was observed on 2-2-2011 as she was being transferred, positioned on the wedge and on the changing table for toileting and during group activity with music. It was noted that she displayed fearful expression initially but was able to calm herself with redirection of placement of arms and verbal reaffirmation that she would be helped if discomfort persists. It is noted that she did receive an analgesic for discomfort at school on many occasions with some possible benefit, unclear results as transfers persisted to be somewhat difficult and when she may show an increase in discomfort. The parent was informed and a follow up was made with Student’s medical team. It is noted that Student has bilateral visual tracking of light, is able to direct eye gaze to objects of interest i.e. during group activity and locating switch to activate music.

Parent Interview In a phone conversation with Student’s mother on 2-2-2011 her medical plan for hip surgery on 2-14-2011 with anticipation of spinal fusion following recovery from hip surgery was reviewed. It was noted that Student’s medical team believes it is more important to control pain from hip subluxation. Parent states that she thinks that Student uses her vision as best as she is able to. See vision results. She does watch television at home. She enjoys music. The parent has assistance of personal care assistant services.

Health/Physical SummaryStudent has a diagnosis of Spastic Quadriplegic Cerebral Palsy. Student has had increasing problems with comfort due to hip dysplasia, progressive scoliosis and knee concerns. Hip surgery is scheduled for 2-14-2011 with anticipation of spinal fusion following recovery. Student also has a history of medically intractable focal epilepsy in the context of spastic triplegic cerebal palsy as well as cortical blindness.

Health/Physical Needs

Trained staff need to be available for all classroom and community outings. Student requires nursing services for the development of individual health and emergency plans to address her seizure activity, general comfort, and recognition of illness, to address being at risk for choking, hygiene and monitoring. Staff training is also needed to address noted health concerns.

COMMUNICATIONEvaluator: Jack Johnson, Speech Language PathologistProcedures: Review of Records, Clinical Evaluation of Language Fundamentals-Fourth Edition, Observation Review of Records


This is where to put the nursing statement(s) that should be included under the adaptations section in the IEP.

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Student’s last speech language evaluation was completed in February of 2008 by speech language pathologist, Tom Hanks. Assessment tools administered and results are provided below:

Expressive Vocabulary Test (EVT): This test measures vocabulary knowledge with two types of items, labeling and synonym. Standard Scores from 85-115 and Percentiles from 16-84 are within the average range.

Standard Score: 78Percentile: .7%Student’s score on the EVT fell significantly below the average range for her age group.

Comprehensive Assessment of Spoken Language (CASL): The CASL provides an in-depth evaluation of 1) oral language processing systems of auditory comprehension, oral expression and word retrieval, 2) the knowledge and use of words and grammatical structures of language, 3) the ability to use language for special tasks requiring higher level cognitive functions, and 4) the knowledge and use of language in communication contexts. The following results were reported:

Subtest Standard Score PercentileSynonyms 70 2%Grammaticality Judgment 79 8%Nonliteral Language 71 3%Meaning from Context 74 4%Pragmatic Judgment 64 1%TOTAL TEST 70 2%

The overall score is the measure of general language ability that quantifies a student’s overall language performance and is used to make decisions about the presence or absence of a language disorder. Student’s Core Language Score falls in the extremely low range when compared to same age peers (significantly below at 2 Standard Deviations). She demonstrated the greatest difficulty on the Pragmatic Judgment subtest indicating her ability to understand and judge the appropriateness of language used in specific environmental situations and actually use language appropriate to different situations is also significantly impaired. Clinical Evaluation of Language Fundamentals-Fourth EditionThe Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF 4) is a comprehensive receptive and expressive language test designed to measure a student’s functional language ability in a variety of areas. Standardized testing was conducted over three sessions in a quiet room. Student was attentive during the evaluation process, however at times seemed to respond without deliberation (including “I don’t know” responses). When questioned about this, Student reported that she was “trying hard.” Over the last testing session, Student was reluctant to come to the session, however reported that she would do her best during testing. Results are felt to be a fairly adequate reflection of her abilities. Please use the following table when interpreting Student’s language scores:

Range Standard ScoreVery low/Severe 70 and belowLow/Moderate 71-77Borderline/Mild 78-85Average 86-114Above Average 115 and above

Student’s results on the CELF-4 are as follows:

Language Composite Standard Score Percentile RankCore Language 70 2Recalling Sentences 5Formulated Sentences 3Word Classes-Total 7


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Word Definitions 5

Receptive Language Index 67 1Word Classes Receptive 10Understanding Spoken Paragraphs 3Semantic Relations 1

Expressive Language Index 65 1Recalling Sentences 5Formulated Sentences 3Word Classes - Expressive 5

Language Content 58 .3Word Definitions 5Understanding Spoken Paragraphs 1Sentence Assembly 1

Language Memory 50 .1Recalling Sentences 5Formulated Sentences 3Semantic Relationships 1

Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF 4) Test Interpretation Student’s Core Language Score falls significantly below the average range (two standard deviations) indicating an overall language disorder. This score is comparable to her previous testing on the CASL. No significant differences were noted between her Receptive and Expressive Index scores, which also fell significantly below the average range for her age group.

Student received her lowest scores in the area of Language Memory and Language Content. The Language Content Index is derived from a measure of various aspects of semantic development- including vocabulary, concept and category development, understanding of associations and relationships among words, interpretation of factual and inferential information presented orally, and the ability to create meaningful semantically and syntactically correct sentences. Student received her lowest score on the subtest Semantic Relationships which is one of the Language Memory subtests. This subtest measures the ability to interpret sentences that make comparisons, identify location, include time relationships, serial order or use passive voice. Difficulty in this area can also involve problems in retention and recall of word order in sentences.

Student demonstrated a strength on the subtest Word Classes Receptive (scaled score of ten falling in the average range). In this task, Student was given a list of four words and asked to tell the two words that go together best. She had more difficulty on the expressive portion of this subtest (Word Classes Expressive) which required her to explain why the two words went together (had to describe the semantic relationship).

Observation Date: April 14, 2011Class: Speech/Language Therapy session taped peer interviewTime: 1:30 pm

Based on observations throughout the evaluation process and an eight minute observation of a conversation with a classmate, Student demonstrates appropriate social language skills. She successfully initiates, maintains and terminates conversations. During the taped conversation with a peer, she demonstrated good eye contact and active listening skills including smiling, frowning, nodding, use of interjections (e.g. “really”, “funny”, “cool’), and paraphrasing to facilitate the conversation. Intelligibility, voice and fluency are judged to be within normal range and grammatical structure was judged to be adequate (some errors noted but did not interfere with meaning).


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Communication SummaryBased on results of this evaluation and review of records, Student demonstrates strengths in her social language skills, particularly in the area of initiating and maintaining conversations with her peers and being an active listener. Student’s overall receptive and expressive language skills continue to fall significantly below the average range for her age group. She most likely experiences difficulty following age level verbal classroom instruction and discussion in most curriculum areas as well as some conversational speech.

Communication NeedsClassroom staff should use short simple sentence structure during instruction to provide adequate time for her to process the information, and to clarify that she has understood them. Student needs to continue to develop her self-advocacy skills by seeking clarification if she is not clear of the meaning and by informing her teachers what she needs them to do to help her understand more easily (e.g. slow down and use shorter sentences).

INTELLECTUAL FUNCTIONINGEvaluator: Jude Law, School PsychologistProcedures: Review of Records, Wechsler Adult Intelligence Scale-Fourth Edition

Review of RecordsA review of records indicates that Student has had several cognitive test administrations throughout her educational career. Student completed the Kaufman Assessment Battery for Children (K-ABC) in 1999 and obtained a Mental Processing Composite score of 67, which corresponded to the first percentile for children her age.

Student was reassessed in 2002 using the Wechsler Intelligence Scale for Children-Third Edition (WISC-III). She earned a Verbal IQ score of 75, a Performance IQ score of 57, and a Full Scale IQ score of 64. Her ability score corresponded with the first percentile for her age and was indicative of a mild mental impairment.

Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)Administered: 12/13/10Student’s IEP team determined that an adult intelligence test would be given at this time. The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) was administered by Jude Law, School Psychologist for Intermediate School District (ISD) 917.

Observations during testingStudent entered the testing situation willingly. She was cooperative and courteous throughout the assessment. Rapport was easily developed. As test items increased in difficulty, Student appeared to think about the questions for longer periods of time and was willing to provide a guess for answers she did not know. These results are believed to be an accurate measure of Student’s current intellectual functioning.

Test ResultsThe WAIS-IV provides a measure of general intelligence (Full Scale IQ) that is derived from measures of an individual’s verbal comprehension, perceptual reasoning abilities, working memory, and processing speed. An IQ score of 100 is considered to be the average score. Scores between 90-110 are considered to be in the average range. Student’s scores on the WAIS-IV are summarized as follows: [Table of scores placed here] Interpretation of WAIS-IV Test ResultsThe Full Scale IQ (FSIQ) score is said to be a good predictor of learning potential. Student obtained a FSIQ of 65, placing her in the Extremely Low range of cognitive ability. Because test performance can vary and be influenced by a variety of factors, results are most appropriately viewed as falling within a range. The chances that her true score is between 62 and 69 are about 90 out of 100. Student's FSIQ


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score places her at the 1st percentile, which means that out of 100 students her age, she would score the same as or better than 1 student.

The Verbal Comprehension score indicates how well Student did on tasks that required her to listen to questions and give spoken answers to them. Student‘s score on the Verbal Comprehension Index is classified in the Borderline range between Low Average and Extremely Low. This was an area of relative strength for Student.

The Perceptual Reasoning score indicates how well Student did on tasks that required her to examine and think about things such as designs and pictures, and to solve problems without using words. Student’s score on the Perceptual Reasoning Index is classified in the Extremely Low range. This was Student’s weakest area.

The Working Memory score indicates how well Student did on tasks requiring her to learn and retain information in memory. Student’s score on the Working Memory Index is classified in the Borderline range between Low Average and Extremely Low.

The Processing Speed score indicates how well Student did on tasks requiring her to quickly scan symbols and make judgments about them. Student‘s score on the Processing Speed Index is classified in the Borderline range between Low Average and Extremely Low.

Intellectual SummaryOverall, Student’s Full Scale IQ of 65 on this test is similar to her 1999 K-ABC score of 67 and her 2002 WISC-III Full Scale score of 64, indicating that this is a reliable measurement of her intellectual ability. Although the WAIS–IV is a test of thinking and reasoning abilities, a student’s scores on this test can also be influenced by motivation, attention, interests, and opportunities for learning. It is important to note that a few test scores cannot assess all of the skills that a child might be capable of using to assist her in achieving success.

Intellectual NeedsTest results suggest that Student will need help with problem-solving new information, abstract information, and synthesizing (pulling together information). Her relative strength in verbal reasoning skills will benefit her within the school setting, as much of what is taught is through verbal instruction. Given this, hands-on demonstrations should also be utilized to aid in Student’s understanding of what is expected of her when learning new tasks. Due to deficits in working memory skills, repetition and re-teaching of information or expectations is necessary. Student also needs additional time to process information before a response is expected.

ACADEMIC PERFORMANCEEvaluators: Diane Sawyer, Special Education Teacher, DD and Janet Jackson, School PsychologistProcedures: Record Review of Classroom Data, Teacher Interview, Observation, Woodcock-Johnson III Tests of Academic Achievement-Normative Update

Record Review of Classroom Data

Example #1 of a Record Review for a HS StudentA review of the evaluation that was begun at Falcon Ridge Middle School indicated that Dan’s first trimester grades of his 7th grade year ranged from C’s – F’s, with the lowest grades in math and science.

It was also reported that the NWEA Measure of Academic Progress, administered in the fall of his 7 th grade year, indicated below average performance in math (15th percentile) and low average performance in reading (23rd percentile). In the spring of 2010, Dan was administered the Minnesota Comprehensive


A record review of classroom data should include a review of classroom performance data (i.e. Read 180, CBM data), progress toward IEP academic goals, formal standardized testing, report card progress, attendance, and any outside academic testing results.

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Assessment-Second Edition (MCA-II) and partially met state standards in reading (15 th percentile) and did not meet state standards in math (3rd percentile).

Example #2 of Record Review of Classroom Data for an Elementary Student

Review of Classroom data:VocabularyStudent has been monitored for his understanding of vocabulary presented in reading classes this school year. On units since October of 2009, Student was able to identify and state the meaning of an average of 24% of targeted reading words at the start of a unit. By the end of the unit, he was able to identify and state the meaning of 98% of these words. Student’s comprehension of a story may be affected by his inability to recognize and understand all of the words presented in the story.

Reading ComprehensionStudent has also been monitored this school year for his ability to comprehend the stories presented in his reading class. Given comprehension questions about a story he has read for the first time, without any assistance for vocabulary and difficult language concepts, Student was able to answer an average of 56% of the questions correctly on reading units since October. After Student was introduced to the vocabulary and their meanings, and the story was reread and reviewed in class, he was given the same set of questions as a post-test. Student was then able to answer an average of 90% of the questions correctly. In the resource room for deaf/hard of hearing learners, Student has reading instruction in a small group and is currently using materials at a beginning third-grade level. This data indicates that this appears to be an appropriate instructional reading level for Student. When Student has assistance for understanding difficult material, by learning new vocabulary, figurative language, and strategies for comprehension, he is able to be successful at reading the material presented.

Maze ComprehensionMaze passages have been administered to Student on a weekly basis to determine his reading comprehension skills. In a maze passage, every seventh word is deleted, and the student is asked to complete the sentences given three word choices in a one minute time period. The student must find the word that fits best both semantically (with correct meaning) and syntactically (with proper English grammar). In the fall of 2009 (September), Student was administered three maze passages and he scored a median of 6 correct responses. When re-administered these passages in January of 2010, for his winter screening, Student scored a median of 7 correct responses. This shows a slight improvement in Student’s maze comprehension skills. A typical third grader is expected to have a median maze score of 9 by the end of the year, therefore Student appears to be on track for meeting this goal.

Phonetic Spelling Features InventoryStudent was administered an elementary spelling inventory in order to assess what spelling features (patterns) he is able to use when attempting to spell words. The spelling features in the inventory are organized according to their difficulty. Student was administered the Level I Inventory in the fall of 2009 as a baseline for determining his phonetic spelling skills. The Level I Inventory assesses spelling features from the kindergarten to second grade level. The table below shows the results from both his testing in the fall and his winter retest in January.

Level I Inventory

Words spelled correctly

Percentile Spelling Features correctly used

Errors

September 2009

18/25 72% 53/60 nk, ou, oi, ir, pp, ies

January2010

21/25 84% 57/60 nk, ir, ies

Student’s errors were mostly with the more difficult features which are near the far right of the chart. As Student showed improvement since his September testing and was able to spell at least 20 words


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correctly on the Level I Inventory, he was administered the Level II Inventory, which assesses spelling features used at the second- and third-grade levels.

Level II Inventory

Words spelled correctly

Percentile Spelling Features correctly used

Errors

January2010

15/25 60% 48/66 er, ew, ies, tt, le, or, en, ate, ent, ize, op, pp, tion, fortun, fid, civil, pos

Student’s performance indicates that he has appropriate skills for his grade level at this time of year. It is believed he will continue to develop phonetic patterns as he learns additional spelling lists in the classroom. Student has averaged 99% accuracy on unit tests given so far this year in the resource room for deaf/hard of hearing learners. Spelling is seen as strength for him.

Teacher InterviewStudent’s teacher, Diane Sawyer, was interviewed as part of his three year re-evaluation. His teacher reported that Student’s strengths include that he has a strong desire to do well in the classroom. He does struggle significantly with information processing skills related to following two- to three-step directions and with recalling previously learned information. In the classroom, he has difficulty with consistently completing work within the class period and often needs to have directions repeated.

ObservationObserver Name: Diane SawyerDate/Time: April 10, 2011, 9:15 a.m.Class: Geography

The geography class had begun five minutes prior to the start of the observation. There were seven students in the classroom and two classroom staff. Student was sitting in his desk with his materials out waiting for the directions to be given. The assignment for the day was to be reading out of their books and answering questions about the reading. Student was quietly following along with the lesson. One of Student’s peers was engaging in negative and distracting behaviors, Student was able to ignore this peer and refrain from participating in the negative behaviors. While the peer was off task, Student quietly read his assignment. Student asked staff a question about the assignments. He waited patiently for staff to help him with his question. Student received help and moved on with the task. Student continued to work for the next three minutes silently at his desk. He then told staff “I can’t find number three.” The classroom staff instructed Student to continue reading and he would find the answer. He then asked if it was in the second paragraph. Staff informed him it was and to continue reading on. Student was trying to find out what two bodies of water on the planet hold the most water, staff continued to prompt Student to read the first sentence in the paragraph which stated the two types of bodies of water which hold the most water are the oceans and sea’s. Student did not understand the sentence and stated the answer was “seas and the planet.” Staff corrected Student and reminded him to slow down when he was reading and take a bit more time to think about the answer. Student read the sentence again which stated, “The oceans and seas hold most of the water on our planet.” After Student read the sentence aloud, he asked the staff if the answer was oceans and seas. They instructed him it was and he moved on to the next question in his assignment. Student worked quietly again for the next two minutes and then asked staff where he could find the definition for ‘water vapor’. He said he found the definition for ‘water cycle’ but not ‘vapor.’ Staff reminded Student that the definitions are found next to the bold words in the reading. Student spent about 30 seconds looking for it and found it in his reading. Student continued to work quietly until the end of the observation time.

Woodcock-Johnson Tests of Academic Achievement-III, Normative Update Student was given the WJ-III Ach by Janet Jackson, School Psychologist for ISD 917. The WJ-III Ach is an individually administered set of tests used to measure numerous academic areas. Average scores are age standard scores of 100.


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Observations during testingStudent was tested over two sessions. The first was on 12/13/10 and the second was on 12/15/10. He was cooperative throughout both testing sessions. He was attentive to the tasks and was prompt but careful in responding. At times Student seemed disappointed or embarrassed if he did not know an answer, and would say, “I have no idea.” However, he would often provide a guess and several times received credit for his answers because the guess was correct. Towards the end of the testing session on 12/15/10, Student was offered a break. He commented that he’d rather just get the testing done. He did appear a bit fatigued during the Writing Samples subtest, but was willing to persist. The scores are considered valid.

Please use the following tables when interpreting Student’s academic performance scores:

Range Standard Score Percentile RankVery low 69 and below 0.1 to 2Low 70-79 3-8Low Average 80-89 9-24Average 90-110 25-75High Average 111-120 76-91Superior 121-130 92-97Very Superior 131 and above 98-99.9

Broad or Cluster Area Standard Score (SS)(90% Confidence Interval)

Percentile Rank

Classification

Broad Reading(tests 1,2,9)

94 34th Average

Broad Math(tests 5, 6, 10)

97 43rd Average

Math Calculation Skills(tests 5,6)

100 50th Average

Broad Written Language(tests 7,8,11)

95 38th Average

Written Expression(tests 8, 11)

94 35th Average

Test Standard Score (SS)(90% Confidence Interval)

Percentile Rank

Classification

1: Letter Word Identification 99 46th Average2: Reading Fluency 88 21st Low Average5: Calculation 106 66th Average6: Math Fluency 89 23rd Low Average7: Spelling 97 43rd Average8:Writing Fluency 98 44th Average9: Passage Comprehension 92 30th Average10:Applied Problems 95 38th Average11:Writing Samples 93 31st Average

Interpretation of WJ-III Ach ResultsStudent’s strengths on this test were in the areas of letter word identification, calculation, spelling, writing fluency, passage comprehension, applied problems, and writing samples. Student’s weakest academic skills appear to be in the areas of reading fluency and math fluency. Writing was also a weaker area for Student. These test results show an improvement in Student’s skills from his last WJ-III academic assessment in 2008 with the exception of the areas of reading fluency (went down twelve points), applied math problems (went down two points), and writing fluency (went down two points).

Academic Summary


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Standardized test results show Student to be performing within the low end of the average range in reading and written language skills when compared to hearing same-age peers. A strength for Student is his ability to retain and use vocabulary in his spontaneous language that he has previously learned in class. Testing shows that his vocabulary skills are considerably higher than his reading comprehension skills. Student is performing at a level similar to hearing same-age peers in his oral reading fluency and this is seen as a strength for him.

Academic NeedsStudent needs to improve his reading comprehension and written English skills. He needs to improve his ability to write grammatically correct English. Student needs to increase his receptive and expressive vocabulary skills to include basic concepts.

SOCIAL/EMOTIONAL/BEHAVIORAL Evaluators: Janet Jackson, School Psychologist & Diane Sawyer, Special Education Teacher, DDProcedures: Functional Behavior Assessment, including Review of Records, Observations, Student, Parent, and Teacher Interview

Functional Behavior Assessment

Review of RecordsStudent’s last re-evaluation from December of 2009 indicated that there were clinically significant levels of concern across the home and school environments including the following: overall behavioral symptoms index, hyperactivity, aggression, depression, overall internalizing problems, atypicality, and adaptability. Student’s self-ratings at that time indicated clinically significant levels of concern with his attitude towards school and hyperactivity. An FBA conducted during the evaluation, indicated that Student would exhibit oppositional and aggressive behaviors to escape or avoid difficult demands, especially in math. They also observed him to engage in these behaviors as a means to escape or avoid consequences and corrective feedback. ObservationsObserver Name: Diane Sawyer, Special Education TeacherDate: April 10, 2011Class: MathTime: 8:20 am

Student is transported to and from school each day by his mother. While he has had difficulty (including physical behaviors) transitioning from the van into school, today he got out of the van without difficulty and walked upstairs with staff to the classroom area. Once he was in the area, he stood briefly by the counter, and then loudly announced, “I’m staying in my office all day today”. He then walked to his office, slammed the door, and then lay down on his beanbag with his hood over his face. Staff waited a few minutes then entered Student’s office and tried to encourage him to participate. He continued with his eyes closed and did not respond. Staff then stepped out and Student continued with his eyes closed. Staff attempted to engage Student, however, he continued to sleep. At the end of the observation time Student had taken the hood off his face and repositioned himself in the room, but continued with his eyes closed and not responding to staff requests or directions. Staff indicated that this is a typical start of the day for Student. In reviewing his schedule, it is noted that he begins each day 8:00-8:30 with a check in time with staff and does not have academics in his schedule until 8:30.

Observer Name: Tom Brokaw, Special Education TeacherDate: April 11, 2011Class: ReadingTime: 11:45 am

Student was sitting with another student and staff and finishing his lunch. His lunchtime is from 10:50-11:15. He then left the area and went to his office, lying down. After approximately five minutes, he came out of his office and joined staff and another student still in the lunch area of the classroom. The other student initiated conversation with Student, “you should get some of these” (referring to his pair of shoes). They then talked briefly about the students shoes. Staff asked Student if he would like to go for a walk.


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He responded, “In just a little bit” and then sat on the counter. Staff then asked Student if he had any plans for the weekend. Student responded, “I’m going fishing with him”, pointing to the other student. He continued, “If we do go we can’t go to ----- Lake “(named a lake, but speech was unclear). The other student asked Student if he was “banned”. Student responded, “My dad banned me from there, but we might go by Elko. I’ll call you tonight about 8:00. I need to charge my cell phone.”

Staff reminded Student he had about five minutes until the next thing on his schedule (independent activity with staff). Student stated, “hell no, I’m not doing it”, as he pushed the chair back and forth with his feet. He then follows behind another student who leaves the lunch area and walks into the other student’s office. Staff redirects Student back to his area and as Student leaves the space he flicks the other student’s ears. Staff reminds staff that he needs to keep his hands to himself and directs him to his office area to do his work. Student disregards staff direction and walks towards another office space in the area, closes the door and bumps his head once, against the door, then steps to the middle of the room. After approximately one minute, he comes out of the room makes an angry face towards the staff and says “blah, blah, blah”. He then walks into his office area. He closes the door after a few seconds and then begins tapping on the door. Staff did not give attention to the behavior and it quickly stopped. Student then began fanning the door and the slamming it. Staff again ignored the behavior and after only three times of slamming the door.

Another staff then started conversation with Student, asking about his lunch and asking if he wanted her to sit with him. Student responded “yes” and then they began talking about dogs. Student sharing that he was teaching his dog to jump rope. The conversation continued for another minute about dogs and Student’s dog. Suddenly Student changed the conversation. “They want to kill me so I’m going to get a ping pong ball and shoot it at them.” The staff did not respond and began asking questions about Student going fishing and referring to the picture of different kinds of fish by Student’s office. Staff was then able to get Student back to his scheduled reading time. Student and another student listened to staff read “Holes” and completed questions regarding the story together. As he was completing the reading activity, the teacher checked in with Student. He then returned to discussing the “kids” in his neighborhood. He indicated that he was getting threatening notes at home from these kids. When the teacher asked if he had shared these with his parents, Student indicated that he had not because all of these kids have guns. He then continued to focus on the “kids in the neighborhood.” The teacher worked to redirect him to the activity on his schedule.

In talking with staff after the observation, they indicated that Student has been perseverating on a “gang of kids” who are in his neighborhood who want to kill him. His mother also indicated that this is something that Student perseverates on, but there is no truth to the situation

Observer Name: Janet Jackson, School PsychologistDate: April 12, 2011Class: ReadingTime: 11:45 am

Staff approached Student and asked if was ready to work on his math. Student replied, “I guess so.” Student entered the classroom area. He sat at a desk near window and staff desk. Staff gave him a work sheet with ten problems. There were pictures of three-dimensional geometric shapes he needed to label. Staff then asked him if he wanted to open his book to the page that had the names of the shapes so he could look them up. Student stated he did. Student put a book on his desk, staff gave him “Page 218”, and Student repeated “218,” but opened to “178,” then hit the book and said “I can’t find it.” Staff walked over to his desk, turned to the correct page and asked him “Try this”. Student stated, “That wasn’t on the page last time I looked”. Staff said, “You just accidentally turned to the wrong page; that happens.” Student stated “No, I was on this page, but these pictures weren’t here, they had disappeared; now they are back. Student began working; he asked for help when the shapes were in a different direction (i.e. vertical instead of horizontal) but he did well and completed the assignment. After turning in the assignment he told staff that he was going to a ninja tournament over the weekend in Iowa, that he was a black-belt and he would be competing against 18 year olds because they were the only ones that were strong enough to fight him. After about four minutes a second staff asked if Student wanted to attend an activity and Student left.


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Interviews

Student InterviewStudent was interviewed by Diane Sawyer, Special Education Teacher, EBD on 10/30/12. Student indicated that he is close with one of his cousins and that they "hang out a lot." Student explained, "We do things outside, like swimming, and sometimes he has a group of friends that we hang out with.” When asked what qualities Student has to be a good friend, he said he is trustworthy, funny, and nice. When asked what an important rule at his school was, Student said the dress rules were important like no sagging pants, no hats, and dress appropriately. He explained that nobody wants to see someone so exposed. Student said that one thing that makes his teachers mad is if someone is swearing or being aggressive. He said he could tell when they are mad by their faces and they might sigh or take a break. When asked why it is important to look at someone when you are talking to him or her, Student responded, "So they know you’re paying attention." Student stated that he usually gets along with others but sometimes he might tease another person if he is being teased first. Student said three wishes for him would be for him to turn 16, get a license and get a car. He indicated that his favorite class is Math because he is good at it and it’s fun. When asked and prompted to name his least favorite class, Student said Social Studies because it’s hard. Student said he likes school because "It’s learning and I like to learn. Then I can go to college and be successful." When asked to finish the sentence, 'the hardest thing about school is...' Student replied, "Social Studies." Student indicated that someday he would like to become a teacher. He said that he would need to finish school to make that dream come true. Student stated the favorite thing about himself is that he is creative and cares for others. He was unable to identify anything he would like to change about himself.

Parent InterviewStudent’s mother, Michelle, completed a parent interview on 10/26/12. Michelle reported that Student is an overall easy-going young man who has average activity level and is able to adapt well to changes in daily routine. Student is a caring individual. He enjoys spending time rollerblading, swimming and spending time with family. In the interview, Michelle indicated the primary behavior concerns are: noncompliance, tantrums, and quick to anger. She reports the behaviors happen several times per week at home. In addition, Michelle reported Student can become aggressive, is stubborn, and very impulsive. Michelle indicated she observes the behaviors after giving Student a direction or tells him something he does not like. She reported the functions of the behavior as: power/control, attention seeking, and avoidance of undesired activities.

Teacher InterviewStudent’s teacher, Diane Sawyer, was interviewed as part of his three year re-evaluation. His teacher reported that Student’s strengths include that he has a strong desire to do well in the classroom and he is usually polite and on task. He typically gets his assignments completed at a quality level and on time. Following a teaching session, Student often retains the information and is able to complete tasks with independence. When something doesn’t come natural for him, Student may become upset or frustrated. He has not had any major behavior incidents as a result of this frustration during the first several weeks of the 2012-2013 school year, but he did during the 2011-2012 school year. There are times where Student may become verbally challenging to his teachers, swear at others, or refuse to work for a certain amount of time. This usually happens when he feels that something is hard, undesirable, or out of the normal schedule.

FBA SummaryA functional behavior assessment (FBA) is designed to identify problem or 'target' behaviors, suggest hypothesized functions of behavior, and identify alternative behaviors. Record review, observations, and parent, teacher, and student interviews were utilized for the FBA for Student.

Student strengths:-Caring


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-Smart-Sensitive

Behavior(s) of Concern:

Behavior 1:Description of the behavior:

Oppositional behaviors (shut down, refusal)

Frequency (how often per day, hour or week):1-2 times per week – at home and at school.During assignments that seem difficult or undesirable.When his schedule changes or unplanned events occur.

Duration (how long the behavior lasts):School – one-minute to up to an hour

Intensity (high, medium, or low):Low intensity –refusal to complete tasks, laying on floor, walking out of room

Triggers/AntecedentsWhat is most likely to be happening before the behavior occurs.

ConsequencesWhat happens after the behavior occurs. (consider adult/peer/student responses.)

Functions/ReinforcersWhat does the student seem to be getting from the behaviors.

(Example: unstructured time, transition task/ setting, difficult task, demand/request, interruption of routine, negative interaction with adult/peer, crowded setting, independent seat work, etc.)

(Example: behavior ignored, reprimand/ warning, time out, teacher attention, peer attention environmental changes, student emotional state, etc.)

(Example: avoidance of activity/request/ person, escape of classroom/schoolwork, get desired attention from adult/peer, vengeance, intimidation, relief of fear/ boredom, etc.)

Being asked to do a non-preferred taskUnplanned events

Loss of privilegesRedirection

Power/ControlEscape/Avoid difficult or low interest tasksGain attention from others

Hypothesis:Example: When (triggers) happens, (student) does (problem behavior) in order to (function). When asked to do a non-preferred activity, Student may refuse to work, lay on the floor, shutdown, or leave assigned area, in order to avoid/escape the situation, get attention from adults, and/or gain power/control over a situation.

Replacement behaviors (description of desired behaviors):

Student needs to complete all assigned tasks and assignments.

Behavior 2:Description of the behavior:


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Physically aggressive behaviors

Frequency (how often per day, hour or week):1 time per week

Duration (how long the behavior lasts):School – one-minute to up to an hour

Intensity (high, medium, or low):High intensity – Student may strike at others

Triggers/AntecedentsWhat is most likely to be happening before the behavior occurs.

ConsequencesWhat happens after the behavior occurs. (consider adult/peer/student responses.)

Functions/ReinforcersWhat does the student seem to be getting from the behaviors.

(Example: unstructured time, transition task/ setting, difficult task, demand/request, interruption of routine, negative interaction with adult/peer, crowded setting, independent seat work, etc.)

(Example: behavior ignored, reprimand/ warning, time out, teacher attention, peer attention environmental changes, student emotional state, etc.)

(Example: avoidance of activity/request/ person, escape of classroom/schoolwork, get desired attention from adult/peer, vengeance, intimidation, relief of fear/ boredom, etc.)

Being asked to do a non-preferred task or being told “no”

Loss of privilegesRedirection

Power/ControlEscape/Avoid difficult or low interest tasksGain attention from others

Hypothesis:Example: When (triggers) happens, (student) does (problem behavior) in order to (function). When asked to do a nonpreferred activity or when he is told “no”, Student strikes at others with his hands, fist, or feet, in order to avoid/escape the task, gain attention, and/or gain power/control over a situation.

Replacement behaviors (description of desired behaviors):Student needs to accept “no” and complete all tasks without physical aggression.

FBA Team Recommendations:

Possible reinforcers:-Give 2 choices that are equally acceptable whenever possible-Task broken down into steps to reduce anxiety-Praise for asking for help/starting on time-Alternate preferred and nonpreferred activities

Ideas to consider (skills needed, changes to the environment, positive behaviors and supports):Access to a quiet area during work-timePositive ReinforcementAccess to hands-on activities and mechanical activitiesInform him of schedule/routine changes

Social/Emotional/Behavior Summary


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Overall, results of the FBA indicate that the Student has strengths which should be emphasized in the classroom setting. The Student struggles significantly with physically aggressive behaviors and oppositional behaviors (shut down, refusal), which significantly impacts his ability to learn and engage in appropriate social interactions with peers. These behaviors of concern were most commonly observed when it was a non-preferred activity/assignment. It was hypothesized that these behaviors are commonly used as a means of escaping or avoiding work or in order to gain attention or in an effort to control his environment. It is also important to note the significant impact that the student’s medical concerns (Autism, Anxiety, and ADHD) play in terms of his behavior.

Social/Emotional/Behavior Needs Student needs to improve his ability to display appropriate behaviors across settings. Student needs to improve his ability to remain alert and participate in classroom activities.

MOTOR

Fine Motor and Sensory IntegrationEvaluator: Sandra Bullock, Occupational Therapist Procedures: Staff Interview, Observations, Sensory Profile – School Companion, Informal Handwriting Assessment

Staff Interview In an interview with Mrs. Bradshaw, Student’s IEP manager, she reported that Student can be caring and helpful to peers/staff, loves to read, has a great imagination, a good sense of humor, loves sharks/playing games, and does well turn-taking and accepting losing. She noted that when regulated and calm, he is able to anticipate the needs of other students, shows concern and assists when needed (i.e., especially a lower-functioning physically-challenged student). Mrs. Bradshaw reported primary concerns in the areas of work refusal, resistance to tasks (especially academic), and low frustration tolerance. She shared that when Student becomes frustrated he quickly loses his ability to think and processing time becomes much slower. In these situations Student’s interactions with peers can become quite impaired (i.e. name calls, makes derogatory comments, may become verbally and physically aggressive). Mrs. Bradshaw indicated that Student generally requires a lot of staff support to sustain attention. She reported that he may at one time have difficulty attending, while at another time (especially during a preferred activity) become “hyper-focused” and have difficulty transitioning from the task at hand. Mrs. Bradshaw shared that Student often has difficulty accepting novel activities or changes in routine, and seems to have anxiety in general, but especially around such situations. She indicated that Student is working toward moving independently to the calming center when he is frustrated. He responds best to sensory objects (i.e., fidgets) and distraction (i.e., talking about preferred objects) when he is attempting to calm himself. Mrs. Bradshaw reports that Student responds well to visuals and structured assistance to problem-solve more appropriate responses to task demands.

Observations General Testing Observations: Student appeared to become quite anxious at onset of testing with occupational therapist(s). When the word, “testing” was used his affect and demeanor changed significantly. His willingness to engage in tasks changed to requiring maximal prompting to initiate. However, once started he worked for one 50 minute session with a break in the middle; testing was ended when he demonstrated increased agitation and non-compliant comments. Two more sessions (25 minute sessions each) were needed in order to complete motor and visual-perceptual testing. At the beginning Student stopped after one task, saying “It’s your turn”, seeming to be most comfortable with alternating tasks with staff. When corrected or redirected to perform a task as instructed he responded well to firm limits and consistent expectations. During a 10 minute tracking period during initial test items (fine-motor Bruininks-Oseretsky subtests) he complied with 9/12 simple commands (such as “Push in chair”, “Put this away,” “set down pencil”). Student frequently asked what was next, and made statements suggesting concern over his performance, such as, “I don’t want to be wrong”, “I hate timings”, and “How


OT, PT and DAPE assessments and test results are all addressed under the motor domain. Sensory integration abilities and status are addressed in this section, and not the Sensory

domain. The Sensory domain addresses a learner’s vision and hearing status.

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did I do?” after every subtest. He often made off-task comments, some of which were inappropriate (“this looks like my brother’s butt”) disparaging (“You’re the one that forgot”, “You said ‘go’ not ‘start’” ), attempts to alter the task (“ Real guys do it this way”, “That doesn’t make any sense”, “I know a trick”) or non-compliant (“That one can’t count”). He often impulsively grabbed materials and had difficulty starting and stopping when verbally directed to do so. Occasionally he argued over how many points he earned on a given subtest, due to such early starts. He made several negative comments about his skills/performance (“I am not good at drawing…mine are sloppy just like my handwriting”) although tempered them with some positive self-statements (“I am good at tracing,” “I was good at that”). He often was overly harsh in his self-assessment, given his overall test results in this area.

Sensory-Motor Observations: Student was observed over several opportunities during formal testing (12/16, 12/20/10, 1/7/11), during free play opportunities and circle time (12/13/10), during mainstream gym (12/23/10), and in lunchroom with mainstream peers (1/21/11). Student demonstrates mildly decreased muscle tone observed in posture and gait pattern. He sat with a rounded back with jaw occasionally slack and/or forward and head tilted back. He often shuffled his legs when walking and showed excessive arm swing. Many of his movements were oversized and apparently intended to increase his sensory input. He occasionally held sleeves over his hands, in possible attempt to control touch input. Eye gaze was atypical; he often looked out of the “corner of his eye” or over his eyeglasses, or stared off in space. At times it appeared that he was not responding to any input. He often was distracted by the sensory properties of objects (i.e., fidgeted with materials) and sought out movement (i.e., tipping back in chair, bearing weight through his shoulders, sitting on hands, inverting head). He indicated clear preferences about the type of input that he needed/wanted and actively advocated for himself in this area (i.e., often used office chair at circle, rotating ½ turns back and forth). He often appeared distracted by noise in particular, complaining when peers were noisy. At other times (i.e., in the mainstream gym) he was able to filter out extreme noise in order to focus in on the instructor. Student exhibited positive affect and appropriate behavioral responses in the later instance (i.e., engaged in back-and-forth interchange with peers around a bean bag). In this context, his motor responses were quick and adept; i.e., he was able to transfer a bean bag from his forearm to his hand 5/5 opportunities, and was able to cease his activity when the music stopped 4/4 times. This appeared to be an extremely preferred activity.

The Sensory Profile – School CompanionThe Sensory Profile – School Companion is a questionnaire designed to measure a student’s sensory processing abilities and their effect on the student’s functional performance in the classroom and school environment. The questionnaire was completed by Mrs. Bradshaw, IEP manager and interpreted by Sandra Bullock, Occupational Therapist.

Scores are reported as: Typical Performance – scores above 1 Standard Deviation (SD) below the mean to 1 SD above the meanProbable Difference – scores that are more than 1 SD to 2 SDs from the meanDefinite Difference – scores that are more than 2 SDs from the mean

Much Less Than Most People

Less Than Most People

Similar To Most People

More Than Most People

Much More Than Most People

Raw Score Definite Difference

Probable Difference

Typical Performance

Probable Difference

Definite Difference

Auditory 25/50 xVisual 27/55 xMovement 42/70 xTouch 35/60 xBehavior 39/75 x

Sensory processing patterns are divided into:Registration – the students awareness of all types of sensationSeeking – the student’s interest in and pleasure with all types of sensationEvaluation Summary ReportStudent Name, Date

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Sensitivity – the student’s ability to notice all types of sensationAvoiding – the student’s need for controlling the amount and type of sensations







Probable Difference

Typical Performance

Probable Difference

Definite Difference

Registration 49/85 xSeeking 27/60 xSensitivity 38/80 xAvoiding 54/85 x

Items are also categorized into School Factors:Factor 1 – the student’s need for external support to participate in learningFactor 2 – the student’s awareness and attention within the learning environmentFactor 3 – the student’s tolerance within the learning environmentFactor 4 – the student’s ability to learn within the learning environment







Probable Difference

Typical Performance

Probable Difference

Definite Difference

Factor 1 53/105 xFactor 2 29/65 xFactor 3 46/85 xFactor 4 40/55 x

Results from this school inventory indicate severe difficulties processing information from all senses, similar to findings on the home inventory. In the area of auditory processing, Mrs. Bradshaw reported that Student “almost always” doesn’t appear to hear what you say. She indicated that he “frequently” misses oral directions more than other students, seems oblivious in an active environment (especially mainstream), is distracted or has trouble functioning when there is a lot of noise in the area, tells others to be quiet, is overly bothered by loud or unexpected noises, and has difficulty participating in group activities when there is a lot of talking. In the visual area, Mrs. Bradshaw reported that Student “almost always” has trouble keeping materials and supplies organized, leaves items blank on a busy worksheet even when he know the answers, and looks away to notice other activity in the room. He “frequently” misses written or demonstrated directions more than other students, watches other students when they move about the room, and comments on small details in objects that others haven’t noticed. In the movement area, Mrs. Bradshaw reported that Student “almost always” plays with objects or school supplies, and is easily upset by minor injuries, and the he “frequently” touches people/objects to the point of irritating them, is fidgety or disruptive in lines, displays an unusual need to touch certain objects, and wants to wipe hands quickly or often during messy tasks. Classroom behaviors possibly related to sensory processing that were observed by Mrs. Bradshaw include: “almost always” can be described an inflexible when compared to peers, and “frequently” is inefficient in doing things, is bothered by rules being broken, is bossy with peers, has difficulty tolerating changes in routines, plans, expectations, is stubborn/uncooperative, withdraws when there are changes in environment or routine, and is frustrated easily.

Informal Handwriting Assessment Student was assessed informally on 1/7/11 when he was completing a handwriting assignment task in his classroom with his teacher, Mrs. Bradshaw sitting across from him. Student sat in an armless chair that was properly sized for him at an appropriately sized table. Student was hunched over the table with both of his arms resting on the tabletop. Student is right hand dominant and held the white board marker with a modified tripod grasp with his thumb wrapped tightly around the marker while adding significant pressure while writing on the laminated surface with the marker. Student completed about five minutes of writing task and began to chatter with this OT about the planet Mars for about two minutes. After this brief Evaluation Summary ReportStudent Name, Date

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conversation, Student appeared to “check out” for awhile. He laid his body back onto the chair with his feet up on top of the table. When asked by his teacher how many times he will trace his name, it took him two minutes to respond. There was no eye contact during that entire time. Teacher mentioned to this OT that handwriting tasks are very challenging for Student and has produced a meltdown in the past with Student having to be removed from the room to calm down. After two minutes, Student agreed respectively to continue with his handwriting task. He agreed to trace his name three times and followed through with this task. Teacher assisted Student with stabilizing his paper. Student held his face close to his paper and appeared to be holding his breath during all of handwriting tasks. His strokes were jerky and imprecise. When he printed his name beneath the sample, his letters were oversized, stretching beyond the 1 ¾ inch lines.

Gross Motor – Physical Therapy AssessmentEvaluator: Elizabeth Taylor, Physical Therapist Procedures: Record Review, Observation

Record ReviewStudent has a diagnosis of cerebral palsy, developmental delays and medically intractable focal epilepsy. In June 2005, Student underwent right hip surgery due to subluxation. In October 2010, Student developed pain through her right lower extremity. She cries when the hip and knee are put through simple range of motion and when she is transferred from her wheelchair to the large wedge or to the changing table. She appears more comfortable when a two person lift is used rather than using a lift and sling for this lift. At the end of the October, she received Botox and Phenol but this has not seemed to lessen her extremity pain. Student has upcoming surgeries to correct her scoliosis and also hip surgery. Because of her pain, Student's positioning and mobility program has been altered. Her past level of function and current level were assessed.

Student displays limited functional mobility at school. She is transported via a manual wheelchair to and from school, as well as, moving through her environment. Her wheelchair was recently adjusted for her growth. The chair is an Invacare Spree tilt in space model. It has shoulder straps, head support, trunk laterals and a pelvic strap for increased support and positioning. It also has footrests with ankle straps. It has Student is dependent on staff for all transfers and transitions. Staff typically uses a full body sling and lift for transfers. Two individuals assist for safety. Student comes to school sitting on the sling. Student is unable to stand or sit without support. Parent has reported that Student has not been able to actively weight bear through her lower extremities since having hip surgery in the summer of 2005. Previous to her right lower extremity pain, Student tolerated supported standing in a supine stander. She wears bilateral knee immobilizer splints for increased support and alignment of the lower extremities. Because of knee instability, a knee splint is worn on the left knee at all times. Knee instability has also appeared on the right. Student wears bilateral solid ankle foot orthoses (AFOs) during the daytime to provide improved alignment and support to the ankles and feet. ObservationObserver Name: Elizabeth Taylor, Physical TherapistDate: January 18, 2011Location: Special Education ClassroomTime: 1:45 am

Student was mobile when lying on the floor. She was able to move from her back to her side and push to her stomach or back. Student was placed on her stomach over a large wedge. She tolerated this position well and was able to prop on her elbows and displays good head control. Student did not crawl and was unable to hold and maintain a long-sit position on the floor without moderate assistance. When in sitting, Student pushed back into extension. Protective reactions are limited. Student demonstrated increased muscle tone throughout her lower extremities and right upper extremity. Currently, an Ultraflex brace is being used on the right elbow to increase elbow extension. This is worn periodically throughout her day. Muscle tightness was noted in the hamstrings and calf muscles. Student has a leg length discrepancy of left greater than right by about one inch. This is accommodated with the use of a wedge when standing in the stander.

Gross Motor – Developmental Adaptive Physical Education (DAPE) Assessment


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Evaluator: Jerry Seinfeld, Developmental/Adaptive Physical Education TeacherProcedures: Review of Records, Functional Motor Scale Checklist

Review of RecordsStudent's special education evaluation dated 10/2009 indicated that a review of records and informal observation were completed to assess Student's abilities and needs within the physical education setting. At that time, Student demonstrated that she was interested in the activity or object by moving her arms towards those objects on command on most attempts. The report indicated that she had preferred activities and skills within the physical education environment including swift movements and sensory objects. It was noted in these assessments that Student required hand-over-hand assistance to complete most physical activity tasks. Student had some success with focus on lights, sounds, or people in her last assessment. The evaluation indicated that Student did enjoy working with sensory toys or objects including scents, bubbles, lights, and music. Student’s previous testing indicated that she required longer processing time for communication (switch use) during DAPE activities.Student’s IEP and progress reports show that she is participating in DAPE class three days a week for 50 minutes each, and is involved in various recreation and leisure activities everyday in her regular classroom. Student's DAPE program includes community activities and games. Student needs to continue her work on activities that work on independent participation (arm movements), communication within the activity, sensory stimulation, and activity enjoyment with the goal of finding activities that Student enjoys so that she can participate in those activities as she transitions out of the school setting. These community activities include bowling, Ring Toss, Toss Across, Curling, Shuffleboard, parachute, AirFlow, modified basketball, and Tee Ball. Student enjoys activities such bowling and AirFlow. Student seems to enjoy participating in activities with her classmates. Student has participated in DAPE this year by executing arm movements as well as communication within activities such as sticky board baseball, tee ball, and flying kites. Jen has activated her switch twice and moved her arms towards the tennis ball on two attempts which gave her a score of 66%. This is very exciting considering she has not participated in DAPE since the fall due to her modified/homebound schedule. Jen has moved her arms towards the tennis ball in sticky ball baseball on 66% of her attempts on the one day she has been at DAPE. Student activated her switch on two out of three opportunities for her turns in DAPE. As a result of Student's disability, she has difficulties in the areas of motor development, communication, and attending to tasks or activities. Her involvement and progress in the general education curriculum is affected by her disability. Student is unable to participate in the general physical education setting based on her needs in these areas.

Functional Motor Scale ChecklistStudent was informally assessed on 3-28-12 by Jason Nickleby, DAPE teacher. Student was assessed using the Functional Motor Scale Checklist. The checklist addresses gross motor abilities and the results are as follows:

Skills Score Percentile ClassificationHead Control 24 out of 50 48% Below Average

Vision/Tracking 73.5 out of 125 58.8% Below AverageArm Control 26 out of 65 40% Below Average

Hand Use 60 out of 150 40% Below AverageManipulatives 29.5 out of 70 42.1% Below Average

Devel. of running/walk 4 out of 140 2.9% Below Average

Head Control: Student could utilize her head movements to complete activities and participate during adapted physical education with assistance. Jen did require assistance to pick her head up from the ground while lying down, but she did allow assistance to perform the task. Student also required some assistance to move her head to look at the examiner or at objects if they were placed out of her direct visual field. Student could turn her head towards equipment being used and also towards classmates that were participating in the activity, but she required assistance to do so. Student could complete many tasks in physical education; however she needed moderate to maximal assistance to complete the required elements. Student had an easier time moving her head to the left versus the right.


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Vision/Tracking: Student could track objects such as a pen, textured (colored) tennis balls, and an open hand with moderate assistance. Student did not have consistency when it came to looking at or tracking objects for any period of time. Student tracked each object from a distance of two feet to her left and right with moderate assistance on 33% of attempts. The same assistance was required for objects across her midline. Student needed moderate physical prompting when it came to tracking objects that were farther away and when the object moved out of her visual field such as behind a table or behind her. Student needed moderate assistance to track lit objects at a variety of distances. Student was able to follow the lit objects across the midline, in a circular motion, and at far distances on some attempts with independence. Student tracks staff or other students at a higher rate than other objects.

Arm Control: Student could move her arms in a solo fashion and concurrently to complete physical activities with maximum assistance for both arms. Student required maximal assistance to complete the commands on the day of assessment. Student did move her arms towards bean bags and a small basketball to touch, but she needed assistance on most attempts. Student could bring her arms together to hold objects or to clap with maximum assistance. Student completed arm stretches with maximum assistance; however she was unable to secure a large basketball using her arms for any period of time without assistance.

Hand Use: Student could move her wrists and fingers on both hands when holding or manipulating objects for physical activities, but she required maximal hand-over-hand assistance to complete the skill. Student could grip and drop items with maximal assistance with both hands during the assessment. During the assessment, Student was able to pincer grip a pen and release it with maximum assistance on most attempts. Student allows maximum assistance to complete physical activity movements including passing objects from one hand to the other. Student needed maximal assistance to lift large items and to manipulate objects during physical activity participation.Manipulatives: Student would move her arms to touch objects like a basketball on 33% of her attempts. Student required assistance when holding a hockey stick, bat, or racquet. Student could manipulate or move other items such as pucks or balls with maximum assist. She was able to complete manipulations of pucks or balls while on the move using the adapted hockey stick with maximum assistance. Student was successful at gripping and transferring manipulatives like bean bags or light equipment with maximum assistance.

Running and Walking Development: Student is unable to perform walking, jumping, hopping, or other basic motor movement skills with her legs at this time. She is able to move her legs towards equipment with maximum assistance.

Motor Summary

Fine Motor and Sensory Integration (OT): Test scores indicate that Student demonstrates significant underlying sensory processing difficulties which affect his ability to function in both school and home environments. Student has difficulty interpreting all types of input (including auditory, visual, movement and touch) meaning that he often receives incomplete or inaccurate information from his environment, and may at times be distracted or troubled by input that others can ignore. These deficits likely impact his ability to stay alert, sit with upright posture, meet motor requirements of tasks, and respond adaptively to events/demands in the classroom. His system appears to require more sensory input that typical to register a response (“low registration”) which results in a tendency to miss important environmental/social cues (i.e., reading other’s faces, noticing others coming into the room) and appear “bored”, disinterested or self-absorbed. In addition to inattentiveness there were short periods of time (i.e., 5-20 seconds) where he stared off in space, after which he was able to re-engage without apparent loss of retention. Staff and parents concur that work avoidance is the primary concern and that Student seems to experience a great deal of stress and anxiety when anticipating un-preferred tasks. It is possible that sensory deficits are magnified by underlying anxiety. The Motivation Assessment Scale indicates that pursuit of a preferred task/object or escape from a perceived unpleasant activity appears to be the primary motivation behind task refusals. Fine-motor testing (Bruininks-Oseretsky Test of Motor Proficiency- 2) indicates that Student’s fine-motor/visual-motor skills rank in the average to below-average range. Student demonstrates adequate fine-motor skills to use all classroom tools with basic skill. His


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performance on informal handwriting tasks was labored, imprecise and anxiety-producing. Visual-perceptual skills rated relatively high meaning that Student’s ability to interpret visual information for reading/writing is essentially intact. Student shows decreased flexibility/resiliency which limits his participation in classroom activities and ability to cope with frustration. He demonstrates relative strength in his awareness of his sensory needs and willingness to advocate on his own behalf. Overall Student appears to perform better and processing time is lessened when information is presented in a visual and/or kinesthetic format vs. auditory directions alone.

Gross Motor (PT): The physical therapy assessment conducted indicates the Student's physical impairments greatly affects her ability to perform age-appropriate motor skills and participate fully in educational activities.

Gross Motor (DAPE): Student is participating in adapted physical education (DAPE) class three days a week for 50 minutes each, and is involved in various recreation and leisure activities everyday in her regular classroom. Student's DAPE program includes community activities and games. Student enjoys activities such bowling and AirFlow. Student has participated in DAPE this year by executing arm movements as well as communication within activities such as sticky board baseball, tee ball, and flying kites. As a result of Student's disability, she has difficulties in the areas of motor development, communication, and attending to tasks or activities. Her involvement and progress in the general education curriculum is affected by her disability. Student is unable to participate in the general physical education setting based on her needs in these areas.

Motor Needs

Fine Motor and Sensory Integration Needs (OT): Student needs to improve his ability to regulate his levels of alertness and positive engagement in all presented classroom activities. He needs to increase his resiliency in order to cope with frustration and disappointment. He needs to increase his handwritten production and expand use of handwriting alternatives. Student requires access to interventions/activities which will provide the sensory input that he needs in order to participate more effectively and calmly in his education. Increasing the sensory features of tasks (i.e., adding weights to objects/materials, using textured materials such as sand/shaving cream or Wikki sticks for letters, placing instructional cards in a bin of beans or rice, carrying a weighted backpack, or pushing a weighted cart) will help give him the input that he needs to remain engaged and alert. Specifically providing opportunities for “hands-on” learning activities/ fidgeters will assist alertness and retention of information. Reducing visual and auditory distractions and highlighting important information will be helpful in compensating for Student’s difficulty filtering information. Activities that will improve his muscle tone/posture, and alertness are especially important. Input through the proprioceptive (including deep pressure, compression/traction through the joints, weightbearing activities) and vestibular system (rotating, swinging) are especially important sources of controlled input to assist in regulation. It is recommended to include familiar rituals within novel activities in order to expand his resiliency. He would benefit from structured problem-solving routines, visuals, and role-play to assist him in developing these skills. Occupational therapy can continue to assist in this sensory/self-regulation area, should the team deem necessary.

Gross Motor Needs (PT): The physical therapy assessment indicates Student needs assistance in the areas of weight-bearing, range of motion, transfers, adaptive equipment, and alternative positioning in order to maximize her potential to fully participate and benefit from her educational activities. Student needs to improve on-task time during motor activities.

Gross Motor Needs (DAPE): Student needs to increase her appropriate communication (switch use) within the physical education setting. Student needs to increase her purposeful arm movement skills in structured group games. Student needs to increase her attention and focus on activity cues as well as peer and staff interactions during DAPE. Student needs to continue to find activities that she enjoys so that she can participate in those activities as she transitions out of the school setting.

FUNCTIONAL SKILLSEvaluator: Janet Jackson, School PsychologistProcedures: Review of Records, Adaptive Behavior Assessment System-Second Edition


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Review of RecordsStudent’s parents and teacher completed an Adaptive Behavior Assessment System-II (ABAS-II) rating scale as part of his 2008 special education reevaluation. The examiner noted that “both parent and teacher rate Student as having social skills (e.g. leisure skills, social interaction) and practical skills (e.g. community use, home/school living, self-care,) that are in the low average to below average range for his age. Whereas Mrs. Hanson rates Student’s conceptual skills as low average, Ms. Jones’s ratings place Student in the very low range for his age in terms of conceptual skills (e.g. communication, functional academics, self-direction). In the school setting, his teacher’s ratings place Student in the 2nd percentile in terms of overall adaptive skills. His mother’s ratings place Student at the 13 th percentile in terms of overall adaptive skills. Student’s most difficult areas appear to be communication, functional academics, self-care, and self-direction.”

Adaptive Behavior Assessment System-Second EditionRaters: Mrs. Hanson-Parent Form

Diane Sawyer-Teacher Form

In order to assess Student’s functional skills for the current evaluation, the Adaptive Behavior Assessment System-Second Edition (ABAS-II) was again utilized. The ABAS-II is a standardized, nationally normed measure of adaptive skills (i.e. those skills that indicate age-appropriate independent functioning). The ABAS-II addresses functional skills in nine different areas that produce composite scores in Conceptual, Social, and Practical Areas. An overall General Adaptive Composite score is also calculated. Composite standard scores of 100 are considered average.

Parent ratings resulted in the following scores: [table of scores placed here]

Teacher ratings resulted in the following scores: [table of scores placed here]

Functional Skills SummaryThere are marked differences in scores between parent and teacher ratings, with parent ratings being higher in all areas, especially the Social and Practical areas in comparison to teacher ratings. The area of Conceptual Skills was more similar between raters. The lower teacher ratings in the Social area may have to do with the greater opportunity that Student has to socialize at school versus at home and the expectations that are placed on Student at the more formalized setting of school versus in his home setting where interaction takes place mainly between Student and his mother. The difference in ratings for the Practical area may have to do with the broader range of skills that are expected at home versus at school. It could also be related to the fact that Student actually functions and acts differently in the two environments. Despite some variation in scores, the overall results of both raters are consistent in the finding that Student is currently functioning below the expectations of those in his age group.

Functional Skills NeedsBased on his levels of functional independence reported by his mother and teacher on the Adaptive Behavior Assessment System-II, Student will continue to need specialized instruction, more than others his age, because of limited adaptive behaviors. Student will continue to need assistance with daily tasks such as managing money and health maintenance. Student will need help with navigating throughout the community, maintaining peer relationships, and improving his functional academic skills. Student should work towards increased independence in all of these areas. Student will continue to require adult assistance and supervision in his environment to assure his safety. Staff should continue to plan and assist with vocational skills and provide opportunities for Student to attend and participate in familiar and new events. Instruction should focus on helping Student to problem-solve various life situations through role-playing, group work, and/or exposure to real-life situations.

TRANSITION


This needs to be included for learners entering 9th grade or above during the duration of the three-year term of the evaluation

There must be at least two measures used within this domain, at least one of which must provide scores.

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Evaluator: Diane Sawyer, Special Education Teacher, DDProcedures: Enderle-Severson Transition Rating Scale-Form J-Revised, Student Interview

Enderle-Severson Transition Rating Scale – Form J-RevisedThe Enderle-Severson Transition Rating Scale – Form J-Revised (ESTR-J) is a formal assessment that measures if a student is consistently and independently able to demonstrate knowledge in the areas of employment, recreation and leisure, home living, community participation, and post secondary education. The ESTR-J is composed of a series of yes or no questions regarding the student’s abilities in each area of transition. If a student is able to perform a task independently and consistently, a score of 1 is earned. If the student is unable to perform a task, a score of 0 is earned. If the student is able to perform a task with adaptations, a score of 1 is earned. The scores in each section are tallied and a percentage score is given for each of the five areas. This score represents the percentage of tasks mastered in each area. The goal of this assessment is to gather information that accurately and comprehensively states the learner’s present level of performance in each of the transition areas.

Student’s overall ESTR-J scores are in the left hand column; Student’s foster mothers’ ESTR-J scores are in the right hand column.

Student Foster Mother

Employment 100% 26%Recreation and Leisure 100% 50%Home Living 87% 2%Community Participation 100% 0%Post-Secondary Education & Training 50% 0%TOTAL Performance Scale 87% 3%

Employment: Student rated himself at 100% in the ESTR-J area of Employment while his foster mother rated him at 26%. Foster mother and Student both stated he has good attendance and is punctual. Attendance records indicate he has been present 99% of days enrolled since beginning at Options on 1/4/12; he has only missed once. Both agreed he demonstrates an understanding that different jobs require varying levels of training (e.g., college, technical colleges, high school, other), demonstrates an understanding of factors that influence job retention, dismissal, and promotion, and both agree that he has had some successful community-based work experience (i.e., apprenticeships, summer jobs, and part-time jobs). Only Student believed he could do everything else: demonstrate appropriate hygiene and grooming, recognize the need to eventually support himself, respond appropriately to authority figures, access various resources for assistance in job searching, demonstrate the necessary interpersonal skills to work with others, demonstrate the skills necessary to perform successfully in a job interview, demonstrate the skills necessary to accurately complete a job application, has a realistic expectation of his or her vocational potential.

Recreation and Leisure: Student scored 100% in the area of Recreation and Leisure; his foster mother’s score was 50%. He and his foster mother said he chooses a variety of recreation/leisure activities which he would like to continue as an adult. They include “listening to music, Internet, playing videogames, rollerskating, skateboarding, visiting friends, walking, games, and movies.” He and his foster mother believe he initiates and participates in a variety of recreation/leisure activities with friends outside of the home and that he effectively communicates with others. Student believes he is able to act appropriately in public and effectively communicate with others but his foster mother does not agree.

Home Living: Student scored 87% in the area of Home Living; his foster mother’s score was 2%. He and his foster mother agreed he knows how to use the telephone, is able to perform household cleaning and laundry along with light household maintenance, has an acceptable understanding of concepts related to sexual awareness, is able to treat minor medical problems, perform basic first aid, knows how and when to seek medical assistance, has the skills necessary to perform written correspondence, knows how to respond to household emergency situations, and is able to prepare and serve foods that require a variety Evaluation Summary ReportStudent Name, Date

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of cooking procedures. Student alone indicated he dresses appropriately for specific situations, demonstrates the qualities of a good citizen, practices preventive health care, understands nutrition and is able to plan balanced meals, manages his money responsibly, and demonstrates an understanding of basic parenting skills.

Community Participation: Student scored 100% in the transition area of Community Participation; his foster mother rated him at 0%. Only Student believes he is able to use relevant community resources, demonstrates appropriate social behaviors in the community, he understands cost saving techniques such as comparison shopping, sale prices, and using discount stores rather than department stores, can get around in the community, has a realistic plan for addressing post secondary housing needs and the ability to secure housing, an understanding of basic insurance needs and where to purchase coverage, or an understanding of purchasing options and how to pay for large purchases in the community.

Post Secondary Education and Training: Student scored 50% in the area of Post Secondary Education; his foster mother’s rating was 0%. Student alone indicated some relevant supports have been identified and included in his transition plan, believed he could identify a variety of post secondary options, and that he demonstrates self-awareness and self-confidence. He is currently an 11th grader and his needs in this area will likely evolve as he continues to mature. His education should include continued relevant supports for his transition plan, continued fine-tuning of a variety of post-secondary options, and he should continue to demonstrate self-awareness and increase self-confidence. He would benefit from completing more vocational assessments, researching plans for post secondary housing, and learning how to apply for post secondary training and potential sources of financial assistance.

Student InterviewStudent said he would like to have a part time job in retail or sales, and that to do so, he needs to graduate from high school. He added that he might like to continue to go to school but has not decided on what at this time. Currently, he would like to study science. He believes science and history are his best subjects, while math is most difficult. Student indicated he will do the following in his free time after graduation: listening to music, partying, going to the movies, and driving around. He said that to reach this goal, “I will need to have money.” Student said he would like to live in the city and that he will clean, cook, take medications, grocery shop, do laundry, have a checking account, pay bills, and shop for clothes. To live independently, he said he would continue to work and save money. Student said he intends to have a driver’s license and a car, will work and get an apartment in his neighborhood, would use parks, stores, and sometimes the library, and will stay in the neighborhood and not move out. Student plans to use or go to the following community resources: banks, video rental stores, grocery stores, restaurants, work, movie theaters, friends’ houses, and shopping malls. When he lives on his own, he plans to get around by driving his own car. He said that to reach this goal, he will need a driver’s license.

Transition SummaryOverall, Student and his foster mother had different perceptions of his abilities in each area of transition, with Student rating himself significantly higher than his foster mother. His greatest strength is in the area of Recreation and Leisure, while he has needs in the areas of Employment, Home Living, Community Participation, and Post-Secondary Education.

Transition NeedsStudent needs to improve his understanding of skills that influence job retention and dismissal. He needs to improve his interpersonal communication skills, including responding appropriately to authority figures and respecting others’ personal boundaries. Additionally, Student needs to improve his classroom performance skills of focusing, following directions, and completing assignments. He needs to explore post-secondary options, requirements, financial aid and supports that are available at different schools.

ASSISTIVE TECHNOLOGY

Evaluator: Diane Sawyer, Special Education Teacher, DDProcedure: Assistive Technology Checklist


Assistive technology must be assessed for every learner, making sure the IEP manager has ensured it has been considered for each domain.

If assessment involving assistive technology for a learner is not to be addressed as a separate domain, but is addressed under another domain(s), include the sentence in the AT domain, “Assessment for assistive technology has been addressed in the [name] domain(s).”

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Assistive Technology ChecklistThe Assistive Technology Checklist was completed by Diane Sawyer, Special Education Teacher, to determine assistive devices available that may support Student’s needs that were identified in this evaluation. The following assistive technology tools were identified:

Area of Need ToolsSeating, Positioning and Mobility Adapted/alternate chair

Stander (Easy Stand)Walking devices (walker)Manual wheelchair

Communication Concrete representationSpeech generating device with levelsPhotographsSymbolsAAC devices (Big Mac, Step-By-Step)

Computer Access Positioning of studentStandard keyboard/mouse with accessibilityadaptationsAlternate keyboard/mouseSwitch accessSwitch interfaceComputer software

Motor Aspects of Writing Environmental and seating adaptationsAdapted pen/pencilComputer with accessibility featuresAlternative keyboardsComputer with scanner

Composition of Written Material Pictures with wordsPicture Exchange Communication System

Reading Book adapted for access (switch, computer)Use of pictures/symbols with textHead phonesCD/cassette playerAudio media

Mathematics Math manipulativesAlternative keyboards/portable math processorsMath software and web simulations

Organization Sensory regulation tools, includingmovement and deep pressure tools, fidgetsMinimal auditory distractionsVisualsOnline manipulatives, interactive programsChecklistsVisual schedulesPortable timekeeper

Vision Slant boardLarge printAudio textComputer-based reading softwareLarge print measuring toolsLarge key calculatorTactile measuring devicesTalking calculatorEnlarged format


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Models or objectsTactile-audio graphicsComputer-based recording software

Hearing 1:1 communicationVisual or vibrating alerting devices

Independent Living Adapted utensils/platesArm supportVelcro fastenersScheduling aidsCommunication aid

Recreation and Leisure Adapted sporting equipmentElectronic aids (timers, AAC device, remotes)Computer-facilitated and computer based activitiesOnline and virtual recreational experiencesBattery interrupters and switchesUniversal cuff to hold crayons, markers, paint brushModified utensilsAdapted toys and gamesVehicle ramp or lift

Assistive Technology SummaryThe results from the Assistive Technology Checklist indicate that Student needs a wide variety of supports to be successful in his educational environments including seating, positioning, and mobility, communication, computer access, motor aspects of writing, composition of written material, reading, mathematics, organization, vision, hearing, independent living, and recreation and leisure. The types of assistive technology Student requires vary from access tools, classroom materials, hardware items, and specialty devices. Incorporating these assistive technology items into Student's educational programming will help him become more successful and interactive with his individualized educational program.

Assistive Technology Needs Student needs to be given opportunities to incorporate assistive technology into all his academic activities and school environments. He needs to use assistive technology to gain more independence in academic lessons and social interactions. Student needs to continue to have a variety of assistive technology items provided to him to assist with his educational programming.

INTERPRETATION OF EVALUATION RESULTS

Summary

A reevaluation of Student’s current level of performance has been conducted to determine continued eligibility for special education services and to assist his IEP team in planning his educational program. In addition to a record review, a health history review, and parent and teacher input, updated testing was also completed in the areas of academics, communication, functional, and transition skills. A hearing and vision screening as well as an assistive technology checklist were also completed. Student is currently a 12th grader at the SUN program receiving special education services under the primary category of Developmental Cognitive Disability-Mild to Moderate with a secondary disability of Speech/Language Impairment. Student has consistently demonstrated very significant impairment in the area of cognitive skills and remains very significantly delayed in this area when compared to his same-age peers. Student shows strengths in communicating by using sign language. He follows routines well and has improved his skill in indicating he needs a break rather than becoming physically aggressive. Student needs to Evaluation Summary ReportStudent Name, Date

There should be a conclusive summary here of all the test results and findings in the report. This is the section where readers often go to without reading the rest of the report to get the overall "abstract" or "summary" of the evaluation. This section answers the question of why the evaluation was conducted in the first place, and needs to tie together all the findings in a clear, concise, and comprehensive manner.

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increase his expressive language skills. Results of adaptive functioning assessments indicate that Student continues to display extremely low adaptive behavior skills both at home and at school. Results of sensory integration assessments suggest significant difficulties processing sensory input across systems (i.e., touch, movement, sound, joint/limb position). These sensory deficits significantly affect Student’s ability to make sense of his environment, and to participate fully in classroom activities and self-cares.

Eligibility Statement

Developmental Cognitive Disability: Mild to Moderate1. Adaptive Behavior Student demonstrates below-average adaptive behavior in school by a composite score at or below the 15th percentile on a nationally normed, technically adequate measure of adaptive behavior. The Teacher Rating Scale of the current Vineland Adaptive Behavior Scales-Second Edition shows a composite score percentile of <1. Student also demonstrates below-average adaptive behavior at home by a composite score at or below the 15th percentile on a nationally normed, technically adequate measure of adaptive behavior. The Parent Rating Scale of the current Vineland Adaptive Behavior Scales-Second Edition completed by Student’s foster mother shows composite score percentiles of <1 percentile.

There is also documentation of needs in six of the seven (work skills were not evaluated) adaptive behavior domains across multiple environments including daily living and independent living skills, social and interpersonal skills, communication skills, academic skills, recreation and leisure skills, and community participation skills. Student requires pervasive adult support in the settings of home, school, and community, and demonstrates the following needs as evidenced at the end of this report. These results are supported by a systematic observation and parent input.

2. General Intellectual Functioning Student was given a Comprehensive Test of Non-Verbal Intelligence (CTONI) on 5/12/06 with a standard score of 68, indicating that Student demonstrates significantly below-average general intellectual functioning in the mild to moderate range, 2 standard deviations below the mean (+ or – 1 standard error of measurement). Student’s significantly below-average general intellectual functioning is verified through a written summary of results from at least two systematic observations with consideration for culturally relevant information, medical and education, history and alternative methods of intellectual assessment.


Identify the disability criteria Address each component of the criteria the learner has met Indicate how the learner’s performance, including data, meets each criteria area. Do not cut and paste in the entire MN state criteria wording, and check off those

components which the learner has met. Rather, summarize how the learner met criteria in a briefer, paragraph format.

There must be a statement in this section that addresses exclusionary factors, if there are any. There must be an eligibility statement in this section. There must be an eligibility statement for each disability area determined by a team as being

primary and secondary disabilities. There must be an eligibility statement for each applicable disability area for a learner identified as

Severely Multiply Impaired (SMI). There must be an eligibility statement for DAPE for learners who qualify, addressing the criteria

components met, and how a learner has met them. It is not appropriate to indicate Speech/Language Impairment as a ‘secondary disability,’ even if a

learner meets Sp/L criteria, if the communication, language and/or speech delays stem from the learner’s primary disability. If the needs stem from the primary disability, identify the needs in the Communication domain and summary of the ESR. These needs will then most appropriately be met on the learner’s IEP under the auspices of the provision of Speech/Language services as a ‘related service’ vs. under a stand-alone disability eligibility status of Speech/Language.

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Review of Eligibility Determination: The documentation supports the team decision that Student continues to be eligible under the area of Developmental Cognitive Disability: Mild to Moderate.

Developmental Adapted Physical EducationStudent qualifies for Developmental Adapted Physical Education services due to his primary disability of Developmental Cognitive Disability: Mild to Moderate in addition to his challenges with motor development, communication, transitions, and attending to tasks or activities as documented via a record review and the Functional Motor Scale Checklist.

General Education Impact Statement

A Developmental Cognitive Disability as well as a Speech Language Impairment adversely impacts Student’s ability to progress at a rate commensurate to his peers in the general education setting. Deficits in verbal and nonverbal reasoning, working memory, processing speed, and adaptive behavior result in the Student is not able to comprehend assignments nor keep up with the tasks and pace of the general education curriculum. Deficits in expressive and receptive language adversely impact Student’s ability to follow age-level verbal classroom instruction and discussion in most curriculum areas, as well as some conversational speech.

TEAM RECOMMENDATIONS

Based on results of the current evaluation, Student’s IEP team should consider how best to meet her educational needs in the areas of vision, hearing, health, communication, fine/sensory motor, and gross motor skills.


Include statements in this section indicating how the learner’s disability and performance impacts his/her learning and development of skills in comparison to same-age learners without disabilities in the general education setting.

These statements will be required to include in the learner’s IEP should eligibility for special education services be the outcome of the evaluation.

Other notes related to SLD eligibility and team override: For SLD reports a statement must be included addressing the effects of environmental, cultural, economic disadvantage or history of inconsistent education program, and a statement ruling out

vision, hearing or motor impairment, mental impairment of emotional or behavioral disorders as the primary cause of the disability.

IF the IEP team is considering an override, documentation needs to be included to support the decision. This should include: Information explaining why procedures used with the majority of Students resulted in invalid or

inconclusive findings for this Student; A summary of the data used to determine that the Student has a disability and is in need of

special instruction and related services. Examples of acceptable data include test scores, work products, medical data and previous testing. Additionally, the summary should describe any modifications made during the administration of standardized procedures including the use of interpreters.

An indication of which data sources had the greatest relative importance in the eligibility decision.

Signatures of each team member indicating their agreement. If team members disagree, a statement of why they disagree and their signature must be included.

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Educational Instructional Needs

Student needs to develop vocabulary, word-attack, reading comprehension and written language skills.Student needs to develop basic computation skills including multiplication and beginning division, functional skills related to time and money, and problem-solving skills.Student needs to develop articulation and spoken language skills appropriate for his age.Student needs to increase his independent skills in being responsible for the location and care of his FM unit.Student needs to decrease his use of inappropriate language with peers and adults in the school setting.Student needs to increase his range of motion in the upper extremities.Student needs to develop employment skills including a working knowledge of his skills, interests, and abilities, how to look for job opportunities; how to get and keep a job, resume, cover letter, and thank you letter writing skills, and interviewing skills. Exposure to more work experience and job seeking strategies will be of benefit to Student.

Educational Adaptations Needs

Student will need help with problem-solving verbal and non-verbal information and synthesizing information through the support of visual schedules and graphic organizers. Multi-modal presentation of information should be utilized when instructing Student. For example, pictorial or hands-on demonstrations paired with verbal instruction will benefit Student’s understanding of what is expected of his in new learning situations. Explanations should take place only a short time before Student participates in an expected activity. Directions should be clear and concise and repetition and re-teaching may be necessary. Student will need additional time to process information before a response is expected. Student should be allowed access to the use of a calculator on assignments and tests to compensate for very low math calculation skills.Student needs to have access to word processing programs that will allow his to spell check and edit his work.Classroom staff need to use short simple sentence structure during instruction, provide adequate time for Student to process the information, and clarify that she has understood them. Student continues to need assistance with interpreting social events and consistently communicating many of his needs and desires. Instruction should focus on helping Student to problem-solve various life situations through role-playing, group work, and/or exposure to real-life situations. School staff and parents should continue to communicate about how to best address additional problem behaviors as noted by Student’s mother.


When transferring need statements from the previous testing domains, take care to differentiate what need statements belong in this section, and those which belong in the Educational Adaptations Need section heading below.

Include learner-based instructional need statements in this section, which indicate what skills or behaviors need to be learned or developed “by” the learner. These statements will become the needs statements in the subsequent IEP from which goals and objectives will be written.

Do not make recommendations for type (i.e. direct or indirect) and amount of services in this section. Service and placement for the Student are to be addressed in the IEP process.

Include learner-based adaptations need statements in this section, which indicate the instructional or environmental accommodations and supplementary aids and services which need to be done “for” the learner by staff in order to support the learner’s special education program. These statements will subsequently appear in the Adaptations section of the learner’s IEP.

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Student needs nursing services due to health diagnoses that require assistance with identifying health conditions and risky behaviors, implementation of asthma action plan, managing health symptoms including headache/discomforts, use of medication and health counseling.

Based on the information included in this report, the team has made the judgment that the Student:

___ Does not meet eligibility criteria for special education for the following reason(s):

___ does not have a disability.___ does not demonstrate a need for special education services at this time.___ learning difficulty is primarily due to lack of instruction in reading or math or to

limited English proficiency.___ no longer qualifies for special education services.___ is no longer eligible under the developmental delay criteria and does not meet

other eligibility criteria.

_X_ Does meet eligibility criteria for special education:

___ For initial evaluation, the Student meets the entrance criteria for the disability(ies) indicated below.

_X_ For reevaluation, the Student continues to have a disability(ies) indicated below and demonstrates a need for special education service.

___ The Student qualifies through a team override decision in accordance with 3525.1354 for the disability(ies) indicated below.

(P) indicates primary disability and (S) indicates secondary disability(ies):

____Autism Spectrum Disorder P Developmental Cognitive Disability____Specific Learning Disability ____Emotional or Behavioral Disorder____Deaf and Hard of Hearing ____Speech and Language Impairment____Deaf-Blind ____Other Health Disabilities____Developmental Delay ____Physically Impaired____Visually Impaired ____Severely Multiply Impaired____Traumatic Brain Injury

If an evaluation team member disagrees with the decision in A or B above, attach a statement as to the reason.

Signatures Title Agreement with conclusions Yes No

_______________________ Parent _____ _____

_______________________ Parent _____ _____

_______________________ Student _____ _____

_______________________ District Representative _____ _____

_______________________ Special Ed. Teacher _____ _____

_______________________ ________________ _____ _____

_______________________ ________________ _____ _____

_______________________ ________________ _____ _____


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Signatures and indication of agreement with the conclusions are required only for SLD evaluations and for an override of any criteria.


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