Oneida School District #351 25 E. 50 S., Suite A Malad, ID 83252 (208) 766-9235 ELIGIBILITY REPORT - SPECIFIC LEARNING DISABILITY Student's Name: Sally Asample District ID:13 State ID: Grade: 04 Sex: Female District:Oneida School District #351 Initial Assessment Reassessment 3-Year Reevaluation Document Date: 12/02/11 Parent/Guardian Name: Super and Great Asample Home Phone: (555)555-7777 Address: 5555 Wonderful Street, Awesome Towne, ID 77777 Native Language: English Daytime Phone: Parent/Guardian Name: Home Phone: Address: Native Language: Daytime Phone: EVALUATION TEAM INFORMATION Directions: Provide a complete list of those in attendance at the eligibility team meeting, be sure to provide name, position or title, and check whether you have agreed with report. Agreement with Report Names of All Evaluation Team Members Invited to Position or Title Yes No Attend Stephanie Dahlke School Psychologist Best Teacher General Education Teacher Nice Teacher Special Education Teacher Great Leader Principal Language Jones Speech/Language Pathologist Mr. and Mrs. Asample Parents Note: Each member must indicate whether the report reflects that member's conclusions. Any evaluation team member who disagrees with the conclusions of this team report must attach a separate written statement of his or her conclusions. Page 1 of 11
Document Date: 12/02/11 Section A: Do Any One of the Following Factors Contribute to the Student's Learning Difficulty? Directions: Please complete this section by carefully reviewing items 1 through 5 prior to considering SLD eligibility. Place a check in the box marked "yes" or "no". If "yes" was checked in items 1 through 5, use the text box provided below to provide additional narrative information. 1. A visual, hearing or motor impairment Yes No 2. Cognitive impairment Yes No 3. Emotional disturbance Yes No 4. Environmental or economic disadvantage Yes No 5. Cultural factors Yes No For any of the above factors marked "yes", describe how the student's performance is impacted and indicate if this factor is a primary factor in the student's learning difficulty. If one or more of the factors listed in this section is found to be primary factor in the student's learning difficulty, the student may not be found eligible for special education services under the category of Specific Learning Disability. Section B: Student does not make sufficient progress in response to effective, evidence-based instruction and intervention for the child's age or to meet state-approved grade level standards in one or more of the following areas: Academic Area(s) of Concern Basic Reading Skills Oral Expression Written Expression Math Calculation Reading Comprehension Reading Fluency Listening Comprehension Math Problem Solving 1. Information shared by the parent(s) Directions: In the text boxes below, describe the student's strengths and weaknesses as related to the area of concern that were shared by the parent(s). Student Strengths: Sally seems to try to listen to my directions and wants to tell me about her day. She can usually communicate to me but she uses short or wrong words. We can usually figure it out. Student Needs: Even though she tries, Sally can`t remember what I ask her to do or sometimes seems like she doesn`t know what I am saying. Sometimes she uses the wrong word to tell me about her day, and she gets angry if we try to correct her or ask her to repeat anything. 2. Educationally relevant developmental, health and medical findings. Directions: Please note any developmental, health and medical findings that are educationally relevant. If none, please provide evidence that records were reviewed (e.g. Vision/hearing screening on August 10, 2010 indicate functioning in the normal range). Sally`s mom reports that she was the product of a normal pregnancy with no complications during gestation or birth. According to an interview with her parents, Sally met all developmental milestones at appropriate ages, except speaking. Sally did not speak in more than one-word utterances until she was 3 or so. Even after she began to speak, her parents and previous teachers report that she often structured sentences incorrectly and was somewhat difficult to understand. Sally does not have a history of any medical issues, and her parents report that she is a generally healthy child. She has her hearing and vision screened regularly and has always passed both screeners. Page 2 of 11
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3. The student's parents were notified about: state and school district policies regarding the amount and nature of student performance data that would be collected and the general education services that would be provided, Yes No strategies for increasing the student's rate of learning, and Yes No their right to request an evaluation. Yes No Parents were provided data-based documentation of repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress during instruction. 4. Data that establishes that the core curriculum is effective for most students. Yes No Directions: For each of the assessments, list the percentage of students within the student's grade level who meet grade-level performance benchmarks. (May include ISAT, IRI, Grade Level Curriculum Based Measures, other measures) Name of Assessment Area Assessed Date Performance Benchmark Percentage of Grade level peers meeting performance benchmark Percentage of Disaggregated Group Level Peers Meeting Performance Benchmark (if applicable) ISAT Reading 4/4/2011 198 86 0 195 ISAT Language Arts 4/5/2011 203 83 0 192 Target Student performance level 5. Document information that the student was provided with appropriate instruction in the general education setting by qualified personnel prior to or as a part of the referral process in the academic area(s) of concern. Core Instruction Provided Academic Area Core Instruction Begin Date (M/D/Y) Duration End Date (M/D/Y) Total (weeks) Frequency (how often per week) Intensity (minutes per session) Language Arts Open Court 08/29/11 12/02/11 13 5 90 Intervention Provided Academic Area of Concern Intervention Begin Date (M/D/Y) Oral Expression Oral Expression Listening Comprehension Lindamood Phoneme Sequencing (LiPS) Program Direct instruction in sentence building targeting subject-verb agreement. Direct instruction in following multiple step directions with a paraprofessional under direction Page 4 of 11 Duration End Date (M/D/Y) Total (weeks) Frequency (how often per week) Intensity (minutes per session) 09/12/11 12/02/11 10 3 30 09/12/11 12/02/11 10 3 30 09/12/11 12/02/11 10 3 30
of SLP The evaluation team determines that the student's learning difficulty is not due to lack of instruction. The student was provided appropriate instruction by qualified personnel in reading, including the essential components of reading, instruction which includes explicit and systematic instruction in (A) phonemic awareness; (B) phonics; (C) vocabulary development; (D) reading fluency, including oral reading skills; and (E) reading comprehension strategies. Yes No The student was provided appropriate instruction by qualified personnel in math Yes No 6. Data-based documentation or repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress during instruction and intervention for each academic area of concern. For students who are culturally diverse and/or English Learners, progress documenting the student's growth should be also compared against their subgroup's progress. Attach to the evaluation report, a copy of the student's progress monitoring graph for each academic area of concern. The graph must include the aimline, trendline, decision points, student's rate of improvement, and national or local norm for grade level peers. For culturally diverse and English Learners, include comparisons to peer group progress. Summary of the data demonstrating the student's progress during instruction and intervention in the academic areas of concern: Oral Expression: Sally was enrolled in the LiPS program in conjunction with direct instruction in subject/verb agreement and other grammatical and syntactical components determined as weaknesses by the SLP through several language samples. The language samples revealed difficulty with subject/verb agreement, switching tenses, incorrect subject/verb/object order. Sally was probed weekly by the SLP and language samples were used to determine her progress toward the goal of correct subject/verb agreement in 8 out of 10 sentences over three consecutive sessions (baseline was 4 out of 10 correct). Despite direction instruction in sentence building targeting subject/verb agreement but also addressing syntax and other grammatical errors, Sally failed to make adequate progress toward meeting language development milestones according to Brown's Stages of Language Development, which is used as a normative scale for these skills. Listening Comprehension: Sally received direct instruction in following multiple directions. At the beginning of the 10 week intervention, Sally could follow one step directions independently 70 percent of the time. The goal was to independently follow two step directions 8 out of 10 times; however, after Sally failed to make adequate gains in following one step directions, the goal was changed to following one step directions independently 10 out of 10 times (see attached graph). Same age peers can independently follow three to four step directions 8 out of 10 trials as evidenced by classroom norms. 7. Observation of academic and behavior functioning in the area(s) of concern: Directions: Include documentation of the results from an observation of the student during routine classroom instruction. (In the case of a student less than school age or out of school, the student must be observed in an environment appropriate for the student's age). The observation should be conducted in a general education environment in which the suspected disability would be manifested. Name and Title of Observer: Date Conducted: Language Jones Speech/Language Pathologist 11/08/11 Location of Observation: Duration of Observation: General Classroom during language arts 30 min Summary of relevant behavior and relationship of behavior to academic functioning in the area(s) of concern during observation: Sally was observed during a group reading and question answering period. When Sally did not know the answer, she would make a comment off the topic to have something to say. Often, her comments contained grammatical errors making it hard for the other Page 5 of 11
students and teacher to understand. She also spoke in a very quiet voice and was often asked to repeat herself, which appeared to aggravate her. Sally was observed using incorrect subject/verb agreement and structuring her sentences inappropriately. When the class was given directions, Sally would watch her peers to see what they did. She was usually the last one to complete tasks. Also, it was evident that she often did not understand what to do. For example, the teacher asked students to turn in their spelling and get our their math books. Sally watched the other students turn in a paper, so she grabbed an already graded paper on her desk, put it in the same pile the other students were handing things into, then sat at her desk and got out a reading book. Page 6 of 11
Section C: Evidence of Low Achievement in One or More Areas Document Date 12/02/11 Basic Reading Skills Oral Expression Written Expression Math Calculation Reading Comprehension Reading Fluency Listening Comprehension Math Problem Solving Area of Concern Date Name of Assessment Composite/Cluster or Listening 11/5/2011 WIAT-III Oral Discourse Comprehension 82 12 Nice Teacher Special Education Teacher Receptive Vocabulary 70 2 The WIAT-III is a norm-referenced, standardized academic achievement test. It was given to Sally in the morning. Sally presented for testing looking clean and attentive. It appears that she gave her full effort to each task. She employed some problem solving skills and did not easily give up. Overall, this is considered an accurate measure of her current level of functioning. Oral discourse required Sally to listen to a CD of spoken sentences and answer questions about what she heard. Receptive vocabulary required Sally to listen to single words and point to a picture of that word. Her skills were in the Borderline (70) to Low Average (82) range. Area of Concern Date Name of Assessment Composite/Cluster or Oral Expression 11/5/2011 WIAT-III Expressive Vocabulary 72 3 Nice Teacher Special Education Teacher Oral Word Fluency 81 10 The WIAT-III is a norm-referenced, standardized academic achievement test. Expressive vocabulary required Sally to look at a picture and listen to a word then tell the word that meets that definition. Oral word fluency required Sally to name nouns belonging to certain categories. Sally struggled greatly with these skills. Her skills are in the Borderline (72) to Low Average (81) range. Section D: Pattern of Strengths and Weaknesses in Psychological Processing Skills That Impact Learning Directions: Provide the specific strengths and weaknesses of the student's psychological processing skills that have a direct impact on learning as demonstrated through the evidence provided throughout this report. Be sure to include specific processing area and use a cross battery approach as needed to demonstrate the areas suspected as strengths and weaknesses. Processing Area Date Name of Assessment Composite/Cluster or Crystalized 11/14/11 Kaufman Ability Expressive Vocabulary Intelligence Battery for Children, second edition Verbal Knowledge 80 76 9 Stephanie Dahlke School Psychologist 5 The KABC-II is a standardized, norm-referenced measure given to assess psychological processing skills. The area of Crystalized Intelligence includes such skills as language development, listening ability, comunication ability, and oral production/fluency. The Expressive Vocabulary subtest required Sally to define a word shown and given to her orally. The Verbal Knowledge subtest included looking at pictures while being read a definition, and pointing at a picture of what was being described. Sally's scores range from Low Average (80) to Borderline (76), placing her significantly below her peers. Sally appeared to give her best effort to each subtest. She was not easily distracted and displayed little peripheral movement. This is Page 7 of 11
felt to be a valid assessment of her current ability. Processing Area Date Name of Assessment Composite/Cluster or Auditory Processing 11/7/11 Woodcock Johnson Sound Blending Psycho-Educational Battery, third edtion Auditory Attention 82 12 Stephanie Dahlke School Psychologist 79 8 The WJIII is a standardized, norm-referenced cognitive assessment. The subtests that measure Auditory Processing include Sound Blending (Borderline Range) and Auditory Attention (Borderline Range). Auditory Processing consists of general sound discrimination, memory for sound patterns, and general response to auditory stimuli. Sally was administered these tests in the morning, when it is reported she does best, and in a quiet location. This is considered to be a valid assessment of her current skills. Processing Area Date Name of Assessment Composite/Cluster or Fluid Intelligence 11/4/11 Kaufman Ability Pattern Reasoning Battery for Children, second edition Story Completion 99 47 Stephanie Dahlke School Psychologist 103 58 Fluid intelligence consists of induction, quantitative reasoning, general sequencing reasoning, and speed of reasoning. This area is a particular ipsative strength for Sally. She scored in the average range on both subtests. Sally noticeably enjoyed these subtests and worked at them diligently. This is considered to be a valid assessment of her current abilities in this area. Section E: Supplemental Assessment Information (when applicable) Directions: Not all students will have assessment information to include in this section. This section is to be used to include additional information gathered through assessments not directly related to academic achievement or psychological processing. This might include assessments conducted to address additional areas of concern such as behavior. Area of Concern Date Name of Assessment Composite/Cluster or Expressive Language 11/10/11 CELF-4 Recalling Sentences Word Classes - Expressive 7 8 16 25 Language Jones Speech/Language Pathologist Formulated Sentences 5 5 EXPRESSIVE COMPOSITE 80 9 The CELF-4 is a standardized language assessment designed to identify students language strengths and weaknesses. The CELF-4 is divided into subtests that provide individual subtest scores as wells as cumulative index scores including: Core Language Score, Receptive Language Index, and Expressive Language Index. Recalling Sentences The Recalling Sentences subtest is used to evaluate the student s ability to recall and reproduce sentences of varying Page 8 of 11
length and syntactic complexity. The student imitates sentences presented by the examiner. Sally's scaled score of 4 places her in the severely impaired range. Word Classes The Word Classes subtest is used to evaluate the student s ability to understand relationships between words that share a variety of functional and conceptual relationships. The student is asked to choose the items that best represent the desired relationship. Sally's score places her in the Borderline range. Formulated Sentences The Formulated Sentences subtest is used to evaluate the ability to formulate compound and complex sentences when given grammatical (semantic and syntactic) constraints. The student is asked to formulate a sentence using target words or phrases while using an illustration as a reference. Sally's scaled score of 8 places her in the low average range. Area of Concern Date Name of Assessment Composite/Cluster or Receptive Language 11/10/11 CELF-4 Concepts and Following Directions Word Classes - receptive RECEPTIVE LANGUAGE COMPOSITE The CELF-4 is a standardized language assessment designed to identify students language strengths and weaknesses. The CELF-4 is divided into subtests that provide individual subtest scores as wells as cumulative index scores including: Core Language Score, Receptive Language Index, and Expressive Language Index. Concepts & Following Directions The Concepts & Following Directions is used to evaluate the student s ability to interpret, recall, and execute oral commands of increasing length and complexity that contain concepts of functional language. The student identifies objects in response to oral directions. Sally received a scaled score of 5, placing her in the Borderline range. It was noted that Sally had difficulty with following directions that used sequencing terms (first, last, before, after, etc.). 5 8 81 5 25 10 Language Jones Speech/Language Pathologist Word Classes - Receptive The Word Classes subtest is used to evaluate the student s ability to understand relationships between words that share a variety of functional and conceptual relationships. The student is asked to choose the items that best represent the desired relationship. Sally scored a scaled score of 8, placing her in the average range. Page 9 of 11
Section F: English Learner (EL) Directions: Include information detailing how the student's language acquisition impacts his/her ability to learn. 1. Is the student's first language English? Yes No 2. Documentation of English Language Proficiency when the Student is an English Learner (EL): Document Date: 12/02/11 Directions: Provide supporting evidence using information gathered through formal and informal assessments including: Home Language Surveys, Idaho English Language Assessments (IELA) information, etc. Date Assessments/Documentation Result/Score 3. Impact of English Learning on the student's academic functioning in the area(s) of concern Directions: Describe how the student's English Learning impacts his/her ability to learn and their achievement level. Sally is not an English Learner Section G: Summary of Evidence and Eligibility Determination Summarize evidence as documented in sections A through F of this report. The impact on achievement of the following factors: visual, hearing or motor impairment, Cognitive impairment, Emotional disturbance, Environmental or economic disadvantage, Culture, or English Language Learning. Sally is in good health, has adequate hearing and vision. No emotional or cultural factors have been identified. Response to evidence based instruction and interventions in areas of concern Sally was in an intervention with the speech and language pathologist for 10 weeks. During this time, Sally made negligible gains toward meeting developmental milestones for language. She made little progress despite direct instruction. This progress is significantly lower than what is expected for 9 year 11 month old children. Summarize the evidence regarding whether the student demonstrates low achievement in the suspected area(s) of difficulty indicated above as evidenced by a norm-referenced, standardized achievement assessment. For culturally and linguistically diverse students, provide evidence indicating low achievement: Sally achieved scores in the severely impaired to Borderline range in Oral Expression and Listening Comprehension. These areas are significant ipsative weaknesses for Sally. Summarize the evidence regarding whether the student demonstrates a pattern of strengths and weaknesses in psychological processing and the impact on academic achievement. For English Learners, provide the preponderance of evidence that supports the psychological processing deficits are not related to the student's level of English acquisition. Sally shows normative weaknesses in her Crystalized Intelligence and Auditory Processing skills. These skill deficits tie to processing auditory stimuli and developing language as a whole. Sally showed a particular ipsative strength in her Fluid Intelligence skills. Her reasoning abilities are a strength when she does not have to express answers verbally. Her other areas of processing fall in the normal range and consist of an otherwise normal profile. The evidence in sections A through F of this report demonstrates that the student meets of the state criteria for Specific Learning Disabilities. Yes No Describe the adverse effect that the student's Specific Learning Disability has on their educational performance in the general education curriculum and ability to meet grade level achievement standards. Sally's low skills in grammar, syntax, and sentence construction make the academic work in the general education classroom difficult. The ability to speak with clarity of thought, understand and use appropriate grammar, follow directions, and listen effectively are skills needed to perform and participate successfully in the classroom. Without these, Sally will have a difficult time succeeding in the regular classroom. Describe the specially designed instruction necessary for the student to be able to access and progress in the general Page 10 of 11
education curriculum and grade level achievement standards: In order to benefit from her education, Sally will need direct instruction in expression, correct grammar and syntax, and thought organization. She will also need instruction in following directions and receptive vocabulary. This may happen in pull-out therapy or in the classroom (gen ed or resource) and in small groups. In consideration of the reported information, the evaluation team finds the student: meets the criteria requirements and is eligible to receive special education services does not meet the criteria requirements and is not eligible to receive special education services under the category of Specific Learning Disability. Page 11 of 11