Name: School Year:

DOMAIN 1: PLANNING AND PREPARATION /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 1a
Demonstrates knowledge of content and skill in the area of specialization;
Holds the Professional Educator License endorsed for Speech-Language / Therapist demonstrates little or no knowledge and skills in their discipline nor trends in professional development; does not maintain appropriate license
☐ / Therapist demonstrates beginning level knowledge of clinical areas and trends in professional development; maintains appropriate license
☐ / Therapist demonstrates thorough knowledge in most clinical areas and their impact on student performance; maintains appropriate license
☐ / Therapist demonstrates thorough knowledge in all clinical areas and their impact on student performance; therapist is considered a resource in their discipline; maintains appropriate license

Component 1b
Demonstrates knowledge of child and adolescent development and therapy approaches / Therapist demonstrates little or no knowledge of the developmental characteristics of the age group and the impact of the disability on student performance; Therapist displays little or no knowledge of specific interventions appropriate to meet individual student’s needs
☐ / Therapist demonstrates some knowledge of the developmental characteristics of the age group and the impact of the disability on student performance; Therapist understands the importance of selecting specific interventions to meet individual student’s needs and matches specific interventions in some clinical areas
☐ / Therapist demonstrates good knowledge of child and adolescent development and many specific interventions, selects interventions that are specific to all individual student’s learning needs and goals
☐ / Therapist demonstrates thorough knowledge of specific interventions for all clinical areas that are appropriate to meet the individual leaning needs of each student; Therapist has gained expertise in one or more clinical area

Notes:

MAIN 1: PLANNING AND PREPARATION /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 1c
Establishes goals for the therapy program appropriate to the setting and the students served / Therapist demonstrates little or no ability to plan cohesive services that can be incorporated into school or community based educational programs; Therapist does not confer with educational teams as part of establishing the therapy program; Program does not reflect a variety of therapy models and service minutes to meet student needs, including individual therapy, group therapy, push in or pull out therapy, and consultation level services to foster the development and generalization of skills across environments; Therapist does not recognize the need to revise service delivery model based on students’ needs and enrollment
☐ / Therapist inconsistently confers with the educational teams as part of establishing the therapy program; Therapist demonstrates the ability to plan services that include some variety of therapy models and service minutes including individual, group, classroom, and consultation services; Therapist recognizes the need to make revisions to the service delivery model when necessary but needs assistance in designing changes
☐ / Therapist purposefully seeks knowledge and input from educational teams as a part of establishing the therapy program; Therapist designs a therapy program that incorporates appropriate therapy models including individual, group, classroom, and consultation services based on individual student needs, various situations and settings; Therapist recognizes the need for revisions to the service delivery model and implements changes when necessary
☐ / Therapist collaborates with the educational teams as part of establishing the therapy program; Therapist designs a full continuum of therapy models and service minutes matched to individual student needs, evaluates the service delivery model on an ongoing basis and makes revisions based on evidence with a clear path for improving service delivery in a manner consistent with LADSE’s mission

Component 1d
Demonstrates knowledge of LADSE, districts, state, and federal regulations and of resources both within and beyond the school and cooperative / Therapist demonstrates little or no knowledge of LADSE, districts, state, and federal regulations and procedures; Does not seek out additional resources to enhance one’s skills or assist in the assessment or interventions with students
☐ / Therapist demonstrates basic knowledge of special education regulations and procedures and sometimes fails to seek guidance; Therapist is aware of some specific resources available for themselves or for students
☐ / Therapist demonstrates thorough knowledge of special education regulations and consistently implements procedures; Therapist seeks out new additional resources through professional organizations, community, or personnel to support self and students
☐ / Therapist demonstrates thorough knowledge of special education regulations and consistently implements procedures with fidelity; Therapist suggests resources to families and teams to support student programming; Therapist takes a leadership role in reviewing and revising LADSE policies, procedures, or forms and in investigating resources

Notes:

DOMAIN 1: PLANNING AND PREPARATION /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 1e
Develops student goals and interventions that are appropriate to the setting and individual needs of students / Therapist does not plan activities with specific students’ individual goals in mind; Students’ goals are not individualized, do not align with common core state standards (CCSS). Present levels of performance (PLOP) and goals are either not specific or measureable; Goals may be inappropriate to the setting or age of the student
☐ / Therapist addresses some students’ individual goals in activities; Students’ goals are moderately individualized and minimally aligned with CCSS. PLOPs may be based on specific standardized assessments but don’t necessarily incorporate data from performance on current goals; Goals are appropriate to the setting and age of students
☐ / Therapist incorporates all students’ goals in activities; Goals are individualized, specific and measureable; CCSS are embedded in the goals; PLOPs are documented based on performance on current measureable goals; Goals include viable measures of assessment
☐ / Therapist plans activities that address individual student’s goals; Goals are clear, measureable and include viable measures of assessment; Data collection systems are developed prior to implementation; PLOPs are based on data from current measureable goals and reflect how these levels impact student’s overall performance

Component 1f
Designs coherent instruction / Planned learning activities are not appropriate to chronological and developmental age levels and do not incorporate individual student goals; Activities do not engage students; Communication, behavior, and technology supports are not provided; Materials and resources are not suitable; The lesson has no clearly defined structure or the structure is chaotic; Activities do not follow an organized progression, pacing is not appropriate and time allocations are unrealistic
☐ / Some planned learning activities are appropriate to chronological and developmental age levels; Activities incorporate only some of the students’ individual goals; Some students are engaged in the activities for only a portion of the activity; Communication, behavior and technology and supports are used inconsistently; The lesson has a recognizable structure but progression of activities and pacing is uneven with most time allocation reasonable
☐ / Planned learning activities are appropriate to chronological and developmental age levels and incorporate students’ individual goals; Students are actively engaged in appropriate instructional groups with consistent communication, behavior, and technological supports; Materials and resources are suitable and adapted when necessary; The lesson has a clearly defined structure and progression of activities and pacing is even with reasonable time allocation
☐ / Planned learning activities are appropriate to chronological and developmental age levels and incorporate individual students’ goals; Students are actively engaged in appropriate instructional groups with individualized communication, behavioral, and technological supports to optimize independence and generalization of skills; Materials and resources are highly motivating with adaptations of lesson and pacing easily made based on students’ performance

DOMAIN 1: PLANNING AND PREPARATION
OVERALL RATING – DOMAIN 1 / q UNSATISFACTORY / q BASIC / q PROFICIENT / q DISTINGUISHED
Notes:
Name: School Year: Evaluator: Date:
DOMAIN 2: ENVIRONMENT /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 2a
Creates an environment of respect and rapport with students / Therapist’s interactions with at least some of the students are negative, demeaning, sarcastic, or inappropriate to the age or culture of the students. Students appear uncomfortable or disrespectful of the therapist; Student-student interactions are characterized by sarcasm, conflict, or put-downs
☐ / Therapist-student interactions are generally appropriate but reflect occasional displays of inconsistencies and disregard for students’ ages, developmental level, and culture; Students exhibit minimal respect for the therapist; Students do not demonstrate disrespect towards each other
☐ / Therapist-student interactions are positive, respectful, and show genuine caring. Interactions are appropriate to the age and culture of the students. Students appear comfortable and respectful of the therapist; Student-student interactions are generally polite and respectful.
☐ / Therapist interactions with students reflect genuine respect, trust, and caring for individuals as well as groups of students; Students demonstrate caring for one another, monitor one another’s treatment of peers, correcting classmates respectfully when needed

Component 2b
Establishing a culture for learning / Therapist or students convey a negative attitude toward the content, suggesting that it is not important or has been mandated by others; Instructional outcomes, activities, and assignments, and interactions convey low expectations for at least some students; Students demonstrate little or no pride in their work
☐ / Therapist communicates the importance of the work but with little conviction and only minimal apparent buy-in by the students; Instructional outcomes, activities and assignments, and interactions convey only modest expectations for learning and achievement; Students minimally accept responsibility to do good work
☐ / Therapist conveys genuine enthusiasm for the content, and students demonstrate consistent commitment to its value; Instructional outcomes activities and assignments and interactions convey high expectations for most students; Students accept responsibility and demonstrate pride in high quality work
☐ / Students demonstrate active participation, curiosity, and taking initiative; Instructional outcomes, activities and assignments, and interactions convey high expectations for all students; Students take obvious pride in their work and make improvements in their work or assist peers

Notes:

DOMAIN 2: ENVIRONMENT /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 2c
Organizes the environment for therapy and evaluation / The therapy and evaluation is disorganized, and poorly suited for working with students; Materials are difficult to find when needed;
The therapist makes no attempt to modify space or find alternative space; Considerable instructional time is lost due to disorganization, chaotic transitions, and attention to non-instructional duties;
Therapist does not organize time and schedule efficiently, is often late for meetings/therapy sessions or paperwork deadlines; does not communicate schedule changes;
Paraprofessionals have no clearly defined duties and are idle or inappropriately engaged most of the time
☐ / The therapy and evaluation area is moderately organized; Therapist attempts to modify space or find alternative space; Materials are usually available;
Some instructional time is lost due to transitions, looking for materials, and attention to non-instructional duties; Therapist inconsistently uses effective strategies for time management, co-planning, and/or organization;
Not always effective at communicating schedule changes; Meets paperwork deadlines;
Paraprofessionals are productively engaged during portions of the day but require frequent supervision and direction
☐ / The therapy and evaluation area is well organized and materials are easily accessible;
Efficient routines for transitions and non-instructional duties result in minimal loss of instructional time;
Therapist consistently uses effective strategies for time management, organization of schedule, and co-planning;
Communicates schedule changes. Completes paperwork in a timely manner;
Paraprofessionals are productively and independently engaged
☐ / The therapy and evaluation area is highly organized; Materials are easily accessible;
Students demonstrate independence or assume some responsibility when following routines and transitions;
Therapist organizes time and schedule, effectively negotiates schedule changes, and proactively communicates schedule changes;
Paper work is completed ahead of recommended dates;
Paraprofessionals make a substantive contribution to the classroom environment

Component 2d
Manages student behavior / No standards of conduct have been established and/or students are unaware of the expectations;
Student behavior is not monitored and therapist does not know what students are doing; Therapist fails to address misbehavior or does so without respect to student dignity
☐ / Standards of conduct appear to have been established and most students seem to understand them;
Therapist is generally aware of student behavior but may miss the misbehavior of some of the students in the group;
Therapist’s attempts to respond to student misbehavior are inconsistent
☐ / Standards of conduct are made clear to all students; Therapist monitors student behavior and implements proactive interventions, such as, praise, visual cues, reinforcement of positive behavior, shaping, and proximity control, to prevent behavior;
Therapist provides insight to the team regarding the possible correlation between behavior and communication needs;
Therapist’s response to misbehavior is appropriate and respectful of the student’s dignity
☐ / Standards of conduct are made clear to all students;
Consistent, proactive interventions are implemented;
Therapist’s monitoring of students’ behavior is subtle and preventative;
Therapist assists in the development of behavior plans and implements behavior plans with integrity

Notes:

DOMAIN 2: ENVIRONMENT /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 2e
Establishes and follows clear procedures for referrals and evaluations / Procedures for referral, intervention, reporting, and collaboration are either not established or are unclear to others; There is little to no evidence that applicable forms are used and maintained by the Therapist; Procedures are not regularly followed and timelines are not regularly met
☐ / Procedures are established and available, but may be inconsistently followed and unclear to others; applicable forms and timelines are inconsistently used and/or met
☐ / Procedures are established, available and consistently followed by other team members; applicable forms and timelines are consistently used and/or met
☐ / Procedures and forms are clear, readily accessed, and used by other team members; implementation occurs consistently and aligns with both the LADSE mission and with the practices and missions found in partner organizations; there is evidence of ongoing review of forms and procedures

DOMAIN 2: ENVIRONMENT
OVERALL RATING – DOMAIN 2 / q UNSATISFACTORY / q BASIC / q PROFICIENT / q DISTINGUISHED
Notes:
Name: School Year: Evaluator: Date:
DOMAIN 3: INSTRUCTION /
/ Level of Performance /
/ UNSATISFACTORY / BASIC / PROFICIENT / DISTINGUISHED /
Component 3a
Communicates with students / Therapist’s purpose, expectations, steps, and directions involved in a lesson or therapy session are unclear and confusing to students;
Therapist’s explanation of the content is unclear, confusing, or is at a level that is inappropriate for students;
Spoken or written language is unclear, contains errors or inappropriate use of vocabulary;
Therapist does not model use of augmentative communication when appropriate;
Feedback to students is not provided in a timely manner or is vague
☐ / Therapist attempts to explain the instructional purpose, expectation, steps, and directions involved in a lesson or therapy session with limited success and so clarification is required after initial student confusion; Explanation of content is uneven/ some is done skillfully, but other portions are difficult to follow;
Therapist’s language is clear; vocabulary is correct but limited or is not appropriate to the student’s age or instructional level;
Therapist models use of augmentative communication inconsistently;
Feedback to students is inconsistent in quality and timeliness
☐ / Therapist provides clear purpose, directions, and expectations for the lesson or therapy session;
Therapist’s language is clear, correct and concise; Vocabulary is appropriate for the student’s instructional level;
Therapist models use of augmentative communication during most activities and interactions;
Feedback is consistently provided in a timely manner and specific to the situation and student’s instructional level
☐ / Therapist provides clear purpose, directions and expectations for the lesson or therapy session;
Therapist’s language is clear, correct, and includes vocabulary chosen to enrich the therapy;
Use of augmentative communication is modeled and integrated throughout the day in multiple settings;
Feedback to students is consistently provided in a timely manner and is specific to the situation and student’s instructional level

Component 3b
Uses a variety of speech and language techniques and strategies / Therapist uses minimal speech language techniques or strategies to facilitate student comprehension or expressive language skills
☐ / Therapist inconsistently uses some speech-language techniques and strategies to facilitate student comprehension or expressive language skills
☐ / Therapist uses most speech language techniques; models the use of techniques for team members; individualizes strategies based on student’s needs; utilizes techniques and strategies of other team members
☐ / Therapist uses a wide variety of speech language techniques; models the use of techniques for team members and incorporates team members’ techniques and strategies during interventions; designs supports to optimize student independence and generalization across environments

Notes: