Student with Disabilities Form:
Documentation of Allowable Accommodations for Individual Student for Assessment

State ID: / Last Name: / First Name: / Date of Birth: / Grade: / Teacher Name:
District Code: / School Code: / Date:
Soc. Studies / Science / Math / Writing / Reading /

Accommodations for the Presentation or Reception of the Test

01 / Presenting the test in Grade 1 and/or Grade 2 Braille.
02 / Presenting the test in 18 point or larger print. (If print larger than 18 point is needed, please notify the Director, Assessment and Analysis)
03 / Enhancing lighting.
04 / Using visual magnification devices.
05 / Providing verbal or signed assistance for prompts and questions for one or more tests. Examples include reading or signing the prompts or questions. Other examples include oral interpreter, cued speech interpreter, auditory tape, videotape, or text-talk converter*. (For the reading test, this accommodation may not be used for reading texts or passages. See accommodation #46 for reading texts and passages. Note that audiotapes and videotapes will not be available for the off-grade tests in the Spring of 2002.
06 / Using an auditory trainer.
07 / Providing special acoustics, such as buffers.
08 / Using a sign language interpreter, oral interpreter, cued speech interpreter, or transliterator during oral instructions. Students needing a sign language interpreter or transliteator may be tested individually or in small groups.
09 / Presenting instructions, test questions, and individual items in such a way that allows students to stop the test when necessary, such as when student is fatigued. An example includes presenting the test by using an overhead projector and transparencies.
10 / Chunking or highlighting information in passages in a standardized format for students who use American Sign Language.
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Accommodations for Interaction or Processing During the Test

11 / Using preferential seating such as arranging the seat close to the test administrator.
12 / For the writing test, using tape recorder for first draft and as a tool for writing the second and final draft of the paper. Student must be tested individually.
13 / For the writing test, permitting deaf students to videotape their first draft in American Sign Language and use the videotape as a tool for writing the second and final draft of the paper. Student must be tested individually.
14 / Use spell check, grammar options, and word prediction software or a personal scribe who can interpret speech and provide assistance with those functions for constructed response items in all content tests except for the writing test. (The protocol that must be followed is in Appendix A of the DSTP Guidelines for the Inclusion of Students with Disabilities . . . Revised April 14, 2001.)
15 / Administering the test individually.
16 / Administering the test in a small group.
17 / Rereading or resigning directions for each subtest or each test question.
18 / Providing minimal physical assistance, such a manual guidance including intermittent verbal, signed, cued speech, physical prompts or picture communication system prompts to refocus and direct attention to the task.
19 / Using personal assistance from a test administrator to perform steps that cannot be bypassed or adapted such as direct assistance with turning pages or navigating in electronic format.
20 / Providing adaptive or special furniture or equipment to accommodate a physical disability.
21 / For the writing test, using test administrators as a resource for spelling of a word, signed word, or short phrase whenever dictionary use is permitted for other students.
47 / Using a calculator on the two parts of the mathematics test for which calculators are not permitted.**
48 / Using an abacus, cubes, and other like manipulatives. Also, using three-dimensional representations of pictures in the test such as supplying real coins when a picture of coins is presented.
49 / Using arithmetic tables.
50 / Using templates, graph paper, acetate color sheets, (e.g. typo-scope) or other markers, if they are not part of the regular testing conditions.
53 / Extending the maximum allowable time to complete the Stanford-9 reading and mathematics portions of the test.**
54 / Completing the test over several sessions for tests that do not have discrete sections, for example stopping when the student tires.
60 / Using spell check, grammar options, and word prediction software or a personal scribe who assists with those functions for the writing test when dictionary use is permitted.
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Accommodations for Student Responses

26 / Responding using individualized written communication systems. Examples include: Alpha-Smart, eye gaze to letters, Intellikeys, customized keyboard layouts, Braille device, typewriter, speech to text and computer. (Excluding spell check, grammar, and word prediction software for the writing test.) Answers must be transcribed onto the answer sheet.
27 / Responding verbally or via a tape recorder or videotape with answers being transcribed onto an answer sheet using a scribe protocol.
28 / Using a tape recorder or test administrator to record the student’s response to a writing prompt using a scribing protocol. Tape-recorded response must be transcribed onto the appropriate DSTP response form using the scribe protocol found in Appendix A of the DSTP Guidelines for the Inclusion of Students with Disabilities . . . Revised April 14, 2001.
29 / Marking directly on the test booklet with answers being transcribed onto an answer sheet.
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Accommodations for Interaction or Processing During the Test

46 / Reading or signing passages or texts for the reading test (or using cued speech or oral interpreter).
58 / Out-of-level testing. The form to be used for reporting out-of-level testing is found in Appendix A of the DSTP Guidelines for the Inclusion of Students with Disabilities . . . Revised April 14, 2001.
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Unique Accommodations

61 / Unique accommodations specific to the individual student as determined by the IEP team and approved by the DOE/DSTP Review Committee. The status (aggregation/non-aggregation) of the accommodation will be decided by the Committee. The form to be used for requesting unique accommodations is found in Appendix A of the DSTP Guidelines for the Inclusion of Students with Disabilities . . . Revised April 14, 2001.
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Participation in DAPA

64 / This student is in a functional life skills curriculum and is to be included in the Delaware Alternate Portfolio Assessment.
63 / No accommodations.

*Any computer files generated must be deleted immediately after the administration of the test.

**Only the DSTP score will be aggregated; the SAT9 score will be non-aggregated.

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