EDUCATIONAL ASSESSMENT REPORT GUIDELINES

Student Name:

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Student ID#

Date of Birth:

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Chronological Age: yrs. mos.

School:

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Date(s) of Assessment:

Grade:

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Date of Report:

County/State:

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Examiner:

Student’s Native Language:

Insert accurate student and assessment information

Purpose:

This assessment is being conducted as a part of the legally mandated process…………

State purpose of evaluation; either an initial evaluation or a re-evaluation – follow guide

Reason for Referral:

This student was referred for………..

For initial identification, the school IEP Team’s hypothesis (i.e., reasons leading to the suspicion of a disability) and the date of the screening IEP Team meeting should be written in this section.

For reevaluation, questions or concerns to be addressed in the reevaluation should be noted.

Background Information:

Insert student background information

Document information that may be affecting the student’s ability to make academic progress. Include dates where applicable. (If the student was born in a country other than the U.S., comment on that history as well.)

Provide Information on the following if pertinent:

  1. School History
  1. Patterns of academic performance
  1. Report card information
  2. Summary of past teacher reports and anecdotal records
  1. Previous program adjustments
  1. Regular education accommodations
  2. EMT and IEP history – e.g., prior referrals or 504 Plan
  3. Additional services received
  4. Other screenings or services – e.g., Reading, G.T.
  1. Record review information
  1. Number of schools attended and reasons for change, if known
  2. Attendance patterns (Absence over twenty days in any one year is significant.)
  3. Retention or advancement – reasons/results
  1. Response to school environment (Provide statements as well as illustrative examples)
  1. Response to authority figures
  2. Peer and adult interactions
  3. Reaction to school routines and rules
  1. Summary of recent previous testing – significant to current referral – e.g., CRTs, past eligibility testing, or patterns of test scores.
  1. Summary of current classroom functioning (synopsis of data gathered for IEP documentation or from current teacher referral reports)
  1. Physical/Environmental, if known to assessor
  1. Social/emotional factors
  1. Significant life experiences/traumas
  2. Therapy or counseling – list source of information and status of intervention
  3. Reactions to everyday situations under normal conditions, under stress, etc.
  1. Health Information
  1. Significant developmental data
  2. Medical issues/significant illnesses/hospitalizations
  3. Activity level
  4. Vision and hearing screening results
  5. Medications, if any
  1. Documentation/Summary of functional behavior assessment and behavior plan (if appropriate). *If functional behavior assessment was conducted as part of current evaluation, place information under informal assessment section.

Observation:

An observation is required when determining a disability to provide information……….

The observation for an initial assessment or reevaluation should be conducted in the classroom by a member of the IEP team other than the classroom teacher. Observations, whenever possible, should document performance in the general education classroom. More than one observation might be necessary, if a variety of settings is important. Additionally, different observers may prove valuable.

Formal Assessment:

Insert results of formal assessments………..

Only the results of tests given for this educational assessment should be reported here. Any test data administered prior to this evaluation should be reported under background information if appropriate. Tests administered by someone other than the person writing this report can be reported in this section if the second examiner is clearly identified and is co-signing the report. Tests designed for individual administration in the areas of suspected need are required for an educational assessment to be valid in the determination/confirmation of an educational disability.

Note: For reevaluations the same areas that were originally investigated must once again be reexamined, but not necessarily with the same tests. * In addition, current areas of concern should be investigated.

Remember that in order to determine/confirm an educational disability, the impact of the disability on education must be clearly indicated. (Therefore, for the student with learning disabilities, patterns of strengths and weaknesses might emerge. Whereas, for the student experiencing behavioral/emotional difficulties, issues around refusal, unwillingness to participate in class assignments, or being unavailable to learn might dominate. For a student with a physical impairment the limitation/inability to perform certain academic tasks might be under investigation. Additionally, differences in performance under test conditions vs. daily routines are noteworthy.)

Please include a general statement about the test setting and the student’s reaction to the assessment process.

Test Description and Scores –

The …….. test is a comprehensive individually administered battery for assessing….

Describe test or attach optional descriptions and list scores

Descriptions of standard scores, i.e. the ‘average range’, are based on guidelines of test publishers and can be found in the test examiner’s manual or within the test protocol.

Test Validity Statement –

The ………… test is judged…………

Statement of test validity for this student – follow guide

Analysis of Performance -

Insert analysis

Analyze each of the significant areas relative to the student’s performance. Include information on: student’s strengths /weaknesses. Include patterns of style, observational data and give examples of each. Take note of approach to task, wait time, method of organization, pattern of responses, processing skills, willingness to risk, subvocalizations, etc.

Other Formal Assessments:

Insert other formal assessment results, if given

Record complete name of test (do not use initials or abbreviations), the date(s) the instrument was administered and state name and position of tester if different from the person writing the report.

Age-based standard scores are to be used to report test results. Please consult the test administration manual for subtest and/or cluster scores which can be documented along with the total score.

Analyze each of the significant areas relative to the student’s performance. Include information on: student’s strengths /weaknesses. Include patterns of style, observational data and give examples of each. Take note of approach to task, wait time, method of organization, pattern of responses, processing skills, willingness to risk, subvocalizations, etc.

Informal Assessment:

List informal assessment results, if appropriate

This section includes criterion-referenced testing, curriculum-based assessments, teacher-made checklists, informal observations, work samples or other techniques employed by the examiner to respond to the committee’s hypothesis for initial identification or to address questions and concerns raised for the periodic review/reevaluation. Provide information relevant to functioning levels, learning styles, learning behaviors, successful learning strategies and appropriate types of instructional materials.

  1. Record briefly the structure of the informal assessment(s) specifically indicating the learning task the student was expected to perform
  1. Record date(s) the instrument was administered
  1. State name and position of tester if different from the person writing the report

Describe the student’s performance. Include information on: student’s approach and response to the task, wait time, method of organization, pattern of responses, processing skills, subvocalizations, etc.

Summary and Recommendations:

Insert summary and recommendations based on assessment(s)

In this section the student’s current functioning as related to the specified purpose of this educational assessment is summarized.

Include specific recommendations regarding instructional approaches, modifications and/or strategies that the assessment data suggest may be effective with this student.

Statements should be made which show the relationship between observed behaviors, student performance, and the overall impact on learning.

The report should not include a definitive statement identifying a disability. That decision is the responsibility of a team of qualified professionals and the parents/guardians of the student.

Under the guidelines of the Individuals with Disabilities Act……….

This section must be included

If the team and the parents confirm the existence of an educational disability, they will then determine whether this student needs special education and related services.

This section must be included

The Report must be signed and dated, with appropriate documentation attached