Case Conference Presentation Guide

Consideration of Emotional Disturbance (ED) and ERMHS

**All components are to be addressed and delivered succinctly (not in narrative format)**

I. Demographic Information

·  Student Name

·  Age

·  Grade

·  Gender

·  School of Attendance

·  Ethnicity & Language Classification

·  Prior/Current Eligibility (if applicable)

·  Prior/Current DIS Services (if applicable)

·  Date Assessment Plan Signed/Received

·  Relevant Family History

II. Pre-referral Intervention

·  Academic and/or Social-Emotional

III. Reason for Referral

·  Initial, Re-evaluation, or Social Emotional only

·  State referral concerns and Suspected Areas of Eligibility

IV. Eligibility Discussion

Emotional Disturbance Eligibility Criteria

·  An inability to learn which cannot be explained by intellectual, sensory or other health factors. Cite supporting data succinctly

·  Exhibits an inability to build or maintain satisfactory interpersonal relationships with peers and teachers. Cite supporting data succinctly

·  Inappropriate types of behavior under normal circumstances. Cite supporting data succinctly

·  A general pervasive mood of unhappiness or depression. Cite supporting data succinctly

·  A tendency to develop physical symptoms or fears associated with personal and school problems. Cite supporting data succinctly

State whether data cited supports the recommendation of the eligibility of Emotional Disturbance.

Consideration of Other Eligibilities

·  If there is a dilemma of eligibility, discuss the additional eligibility or eligibilities considered by succinctly summarizing data related to eligibility criteria (as done for the ED eligibility)

Consideration of ERMHS Indicators

Cite supporting data succinctly for each Indicator

·  Counseling history

·  Psychiatric history

·  Hospitalizations

·  Out-of-home placements due to psychiatric problems

·  Prior diagnoses

·  History of isolation

·  History of significant depression

·  History of social impairment

·  History of self-injurious behavior

·  Suicidal and/or homicidal ideation

·  History of significant aggression towards people or animals

·  Pattern of negative and/or defiant behavior

·  History of Trauma

State whether data cited supports the recommendation of the eligibility of ERMHS service.

V. 60 Day due date and/or IEP Date