Evaluation Team Information

Document Date: / Eligibility Report –Specific Learning Disability / Page 8 of 8
Student’s Name: Victor / District ID: / State ID: / Grade: / Sex:
Native Lang: / Ethnicity: / Birth Date: / Age:
District: / School:

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.

Names of All Evaluation Team Members Invited to Attend / Position or Title / Agreement with Report
Mr. Parent / Parent / Yes No
Mrs. Parent / Parent / Yes No
Mr. G. Teacher / General Education Teacher / Yes No
Mrs. S. Teacher / Special Education Teacher. / Yes No
Mrs. Principal / Principal. / Yes No
Mr. Psychologist / Psychologist. / Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

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.

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.

The team concluded that cultural factors are a consideration but not the primary factor in Victor’s learning difficulties.

If one or more of the factors listed in this section is found to be a 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

Directions: Place an “X” in the space below for each area of academic 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: Victor is very interested in sports and watching movies. He likes going to school.
Student Needs: School can be very difficult for him and he needs help with his reading.

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).

All of Victor’s vision and hearing screenings (conducted September 15, 2012) come back in the normal range.
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. / Yes No

4. Data that establishes that the core curriculum is effective for most students.

Directions: For each of the assessments, list the percentage of students within the student’s grade level who met 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) / Target Student Performance Level
ISAT Reading 4th grade / Reading / May 2011 / 204 / 88% / n/a / 193
AIMSWEB Reading CBM / Reading / September 2011 / 100 / 90% / n/a / 70

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 / Duration / Frequency
(how often per week) / Intensity
(minutes per session)
Begin Date
(M/D/Y) / End Date
(M/D/Y) / Total
(weeks)
Reading / Harcourt Trophies / September 2011 / Ongoing / 20 / 5 days/week / 50 minutes
Intervention Provided
Academic Area of Concern / Intervention / Duration / Frequency
(how often per week) / Intensity
(minutes per session)
Begin Date
(M/D/Y) / End Date
(M/D/Y) / Total
(weeks)
Reading / Read Naturally / October 1, 2011 / Ongoing / 16 / 2 days / 30 minutes

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 of 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(s) 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: Victor has not made progress in math. His performance on ISAT Reading was at the Basic level and even though he is in Read Naturally his last wpm was 70, the goal is 117 for fifth graders.

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 child not attending a typical school setting, the child must be observed in an environment appropriate for the child’s age). The observation must be conducted in a general education environment in which the area(s) of concern would be manifested.

Name and Title of Observer: Mr. Psychologist / Date Conducted: January 14, 2012.
Location of Observation: 5th grade reading class / Duration of Observation: 10 minutes.
Summary of relevant behavior and relationship of behavior to academic functioning in the area(s) of concern during observation: Victor was observed in his class for reading. There were 31 students and 1 teacher, with an assistant. Students engaged in silent reading of a short story. The educational assistant monitored students who appeared to be off task. The assistant periodically helped Victor with a word he didn’t know. Victor appeared to be on task during this activity, although he didn’t finish the story at the same time that his classmates did.

Section C: Evidence of Low Achievement in One or More Areas

Directions: Mark the area(s) of concern with an “X” and provide evidence of low achievement. Complete the table by providing specific assessment information as requested in the table for each are marked with an “X”.

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 / Subtest(s) / SS / %ile / Evaluator/Title
Reading Fluency / Feb 2011 / AIMSWEB / RCBM / 10th / Mrs. Teacher
Feb 2012 / WJ-III / Reading Fluency / 82 / 11 / Mrs. Teacher
Description of assessment measure, validity statement, and interpretive information:
The AIMSWEB RCBM measures a student’s oral reading fluency. Students are given one minute to read a grade level passage aloud and the total number of words read correctly comprises their score. Victor’s performance was 67 words, which puts him below the 10th percentile. The WJIII Reading fluency subtest asks students to read a sentence and then indicate whether it is true/false. Victor’s performance on this test was low, at the 11th percentile.
Area of Concern / Date / Name of Assessment / Subtest(s) / SS / %ile / Evaluator/Title
Description of assessment measure, validity statement, and interpretive information:

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/
Subtest / SS / %ile / Evaluator/Title
IQ / Feb 2012 / Wechsler Intelligence Scale for Children, IV / Verbal Comprehension Index / 88 / 21st / Mr. P/School Psychologist
Description of assessment measure, validity statement, and interpretive information:
The WISC-IV is a norm-referenced, nationally standardized, and individually administered cognitive assessment for students between the ages of 6 and 16. The VCI is a measure of verbal concept formation. It assesses children's ability to listen to a question, draw upon learned information from both formal and informal education, reason through an answer, and express their thoughts aloud. Victor’s performance on the Verbal comprehension index indicates scores in the low average range. Victor was attentive in the one-on-one setting. He willingly attempted all tasks, and appeared to try hard throughout the testing process. Good rapport was established and maintained throughout the entire evaluation, and results are considered valid.
Processing Area / Date / Name of Assessment / Composite/Cluster/
Subtest / SS / %ile / Evaluator/Title
IQ / Feb 2012 / Wechsler Intelligence Scale for Children, IV / Perceptual Reasoning / 82 / 12th / Mr. P/School Psychologist
Description of assessment measure, validity statement, and interpretive information: The WISC-IV is a norm-referenced, nationally standardized, and individually administered cognitive assessment for students between the ages of 6 and 16. The PRI is a measure of non-verbal and fluid reasoning. It assesses children's ability to examine a problem, draw upon visual-motor and visual-spatial skills, organize their thoughts, create solutions, and then test them. Victor’s performance on the perceptual reasoning index indicates scores in the low average range. Victor was attentive in the one-on-one setting. He willingly attempted all tasks, and appeared to try hard throughout the testing process. Good rapport was established and maintained throughout the entire evaluation, and results are considered valid.
Processing Area / Date / Name of Assessment / Composite/Cluster/
Subtest / SS / %ile / Evaluator/Title
IQ / Feb 2012 / Wechsler Intelligence Scale for Children, IV / Working Memory Index / 89 / 24th / Mr. P/School Psychologist.
Description of assessment measure, validity statement, and interpretive information: The WISC-IV is a norm-referenced, nationally standardized, and individually administered cognitive assessment for students between the ages of 6 and 16. The WMI is a measure of working memory. It assesses children's ability to memorize new information, hold it in short-term memory, concentrate, and manipulate that information to produce some result or reasoning processes. Victor’s performance on the Working Memory index indicates scores in the low average range, with a score at the 24th percentile. He willingly attempted all tasks, and appeared to try hard throughout the testing process. Good rapport was established and maintained throughout the entire evaluation, and results are considered valid.
Processing Area / Date / Name of Assessment / Composite/Cluster/
Subtest / SS / %ile / Evaluator/Title
IQ / Feb 2012 / Wechsler Intelligence Scale for Children, IV / Processing Speed Index / 88 / 21st / Mr. P/School Psychologist
Description of assessment measure, validity statement, and interpretive information: The Processing Speed Index of the WISC-IV is a measure of processing speed. It assesses children's abilities to focus attention and quickly scan, discriminate between, and sequentially order visual information. Victor’s performance on this test put him in the low average range. He willingly attempted all tasks, and appeared to try hard throughout the testing process. Good rapport was established and maintained throughout the entire evaluation, and results are considered valid.

Section E: Supplemental Assessment Information (No supplemental assessment conducted)

NOTE: Table removed from training document to reduce copying costs

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):

Directions: Provide supporting evidence using information gathered through formal and informal assessments including: Home Language Surveys, Idaho English Language Assessment (IELA) information, etc.

Date / Assessment/Documentation / Result/Score
11/2011 / Home Language Survey / English
Spring 2011 / Idaho English Language Assessment / Speaking = 115 (Early Fluent +)
Listening = 115 (Early Fluent+)
Reading = 101 (Advanced Beginning+)
Writing = 118 (Early Fluent +)
Comprehension = 109 (Early Fluent+)
Total IELA = 434 Early Fluent (4) 31st Percentile

3. Impact of English Learning on the student’s academic functioning in the area(s) of concern