Learning Disability Eligibility Form Guidance
Specific Learning Disability (SLD) Eligibility Form Guidance
Acknowledgements:
Documents addressing the 2007 Oregon State Department of Education SLD Eligibility Form were developed by the Jefferson County ESD in conjunction with the Special Education teachers of the Jefferson County 509J School District. None of the documents are copyrighted. They may be revised as needed.
Reports:
A report will be needed to address various eligibility components for decisions regarding Specific Learning Disability (SLD). This district will use either a Psycho-Educational Evaluation Report (prepared by the School Psychologist) or an Evaluation Summary Report (prepared by the Case Manager). All original forms (file reviews, reports, progress monitoring worksheets, and eligibility statements, etc.) will be sent to JCESD by the Case Manager.
Psycho-Educational Report:
Completed for:
1. Initial evaluations.
2. Reevaluations where the School Psychologist has completed standardized
assessment(s).
Compiled by: School Psychologist
Evaluation Summary Report:
Completed for:
1. Reevaluations where the team has decided that no additional assessments are
necessary.
2. Reevaluations where the Case Manager (or other trained specialist) has completed
standardized achievement assessment(s) and no other assessments are done by the
School Psychologist.
Compiled by: Case Manager
Team Responsibilities
File Reviews:
On initial evaluations, the School Psychologist or Case Manager will perform and document the Cumulative File review if it has not been done by the SST. The CORE Team will review relevant SST documentation (if available). On reevaluations, the Cumulative File Review will be completed by either the School Psychologist or the Case Manager.
On reevaluations, a Special Education File review document will be completed by the School Psychologist to assist the team in developing the Reevaluation Summary (Plan) and data will be reviewed at the time the Reevaluation Summary (Plan) is completed. For reevaluations where the team has decided that no further evaluation is necessary, this document will be provided to the Case Manager to assist in preparing the Evaluation Summary Report.
Progress towards Oregon grade-level standards:
If data regarding progress towards Oregon grade-level standards is not available in the Cumulative File Review, the Case Manager will be responsible for obtaining the necessary data so that this component is addressed in the eligibility statement.
Observation:
A classroom observation must be conducted by certified school professional. This can include a school psychologist, counselor, administrator, or a regular/special education teacher. The observation must be done by someone other than the instructor in a setting which is relevant to the area(s) of concern. Observation must address relevant behavior noted during observation and its relationship to academic functioning. It may be documented on a separate form or within the Psycho-Educational Report.
Progress Monitoring Data (Worksheet):
The Case Manager will prepare the Progress Monitoring Worksheet. It will be completed on all Initial evaluations and Reevaluations. Attach the worksheet to either the Psycho-Educational Report or the Evaluation Summary Report.
Assessments:
The School Psychologist will perform cognitive (intellectual) and/or behavioral assessments. Either the School Psychologist or Case Manager (or a trained specialist) may conduct standardized achievement assessments. On an initial evaluation, the School Psychologist will have conducted the cognitive, behavioral and/or other types of standardized assessments. On an initial evaluation, if someone other than the School Psychologist performs the achievement assessment, the data should be provided to the School Psychologist in a timely manner so that it may be included in the Psycho-Educational Report.
If a Psycho-Educational Report is to be completed and CBM data is obtained as part of the evaluation, the data should be provided to the School Psychologist in a timely manner so that it may be included within the report.
For reevaluations where the Case Manager (or other trained specialist) has completed the achievement assessment to assist in the determination of continued eligibility (and no standardized assessments are done by the School Psych.) the printout of results from the achievement testing will be attached to the Evaluation Summary Report (prepared by the Case Manager). A narrative summary of this assessment data would be optional.
For reevaluations where the team has decided that no further standardized evaluation is needed to determine eligibility and CBM was done, such data will be summarized and attached to the Evaluation Summary Report (prepared by the Case Manager).
GENERAL GUIDANCE
Computer entry instructions for various data fields on the SLD document may be provided. This district is using the Edvantage Program to assist with documentation. In addition to the document stored on the Edvantage Program, computer entry may be used if some data fields are completed prior to the eligibility meeting and the partially completed form is prepared and presented to assist the team in the eligibility decision. In such cases it will be necessary to complete the SLD document with written entries in certain fields. The copy containing the decisions of the team and signatures of the team members is considered the “official” SLD Eligibility form and a copy will be provided to the parent(s). The official form is submitted to JCESD.
Please note: On the Computer entry form, date fields must be entered in the format xx/xx/xxxx. On the “official” copy, attempt to address empty fields via written input as per instructions in this document.
This document is organized to provide guidance/instructions for both Initial Evaluations and Reevaluations. Each criterion and decision point in the Oregon SLD Eligibility document is addressed separately. The actual criteria are numbered according to how they appear on the Oregon SLD Eligibility form.
General Notes contain information that may be useful for addressing all evaluation situations and the criterion in question. Special Cases contain information that may be useful in addressing infrequently occuring situations or situations which require special consideration. They often contain recommendations that may be applicable to procedural issues.
FORM GUIDANCE
A. The team has completed the following evaluation components (attach evaluation report):
1. Review of existing information from a variety of sources, including the parents, teacher recommendations
(including Oregon state assessments, if available), the student’s cumulative records, previous IEPs or IFSPs, teacher collected work samples, and information about the child’s physical condition, background, and adaptive behavior. Evaluation report includes relevant information from these sources used in the eligibility determination.
Initial Evaluation:
Enter the date of the current Psycho-Educational Report on Report Date.
Reevaluation:
a). If no further evaluation was done by the School Psychologist, enter the date of
Reevaluation Summary on Report Date.
b). If additional assessment was done by the School Psychologist - Enter the Date of
Psycho-Educational Report on Report Date.
2. An assessment of the child’s academic achievement toward Oregon grade-level standards.
______
Examiner/Title Assessment Date Conducted Date Reviewed
Initial Evaluation & Reevaluation:
Data needed for this component may be found in the Cumulative File review (Oregon Statewide Assessment Test/OSATor OAKS or Oregon Plus). If such data is available, Enter on the eligibility form:
Examiner/Title: School staff
Assessment: OSAT or OAKS (Note: OSAT is now OAKS) or Oregon Plus
Date Conducted: Date in format: xx/xx/xxxx
Note: Attempt to determine the date that the student took the test and enter if available. If this is not available, enter the closest approximation to the date the exam was given. To obtain this date, it may be necessary to contact the school test coordinator to ascertain what date should be used.
Special case:
Students entering the district from another state, private school, homeschool, or in cases where OSAT or Oregon Plus has not been given (such as students in early primary grades). Select Option 1 or 2.
Option 1: For students whose grade placement is such that they can be assessed with a statewide assessment, arrange to have the student take the online assessment. If this is done, Enter on the eligibility form:
Examiner/Title: School Staff
Assessment: OAKS or Oregon Plus
Date Conducted: Date in format: xx/xx/xxxx
The Case Manager should contact the school testing coordinator to discuss this. If this is not feasible or if results can not be forwarded to the Case Manager within referral-eligibility determination timelines, use Option 2.
Option 2: Case Manager should provide the regular teacher(s) with a copy of the Content Standards Teacher Checklist(s). Provide the Math, Reading/Literature, and Writing checklists and either the grade-level standards for the students current grade or the previous grade placement (Case Manager will decide which Content Standards Teacher Checklists should be given). Submit a copy of the checklists with the official eligibility form. Enter on the eligibility form:
Examiner/Title: Person(s) completing teacher checklist/Title(s)
Assessment: Content Standards Teacher Checklist
Date Conducted: Date form(s) completed (in format: xx/xx/xxxx)
General Notes:
a). CBM’s and/or DIBELS may also be listed on the eligibility form as measures of
achievement towards Oregon grade-level standards. However, it is recommended
that CBM and/or DIBELS be used as supplementary measures to statewide
assessments or the Content Standards Checklist. Measures should be linked
to Oregon grade-level standards. Submit data from supplemental measures with
the official eligibility form.
b). The Content Standards Teacher Checklists may assist in completing section B.1. of
the eligibility form.
c). The Case Manager may obtain several Content Standards Teacher Checklists to
examine the pattern of strengths/weaknesses in performance
and/or achievement relative to state approved grade level standards (for more
details on this matter see A.6. General Notes, d).
3. An observation of the child’s academic performance and behavior in a regular classroom setting, or in the case of a child less than school age or out of school, an observation in an age-appropriate environment. (Describe relevant behavior noted during observation, and its relationship to academic functioning in evaluation report.)
______
Observer/Title Date Conducted Report Date Date Reviewed
Initial Evaluation:
Document observer/title, date conducted, and report date. If observation is on a separate form, enter date conducted. Report Date would be either the date of the Evaluation Summary Report (if this report was prepared) or the Psycho-Educational Report (if this document was prepared). If the observation is contained within the Psycho-Educational Report, enter dates from this report for Date Conducted and Report Date.
Reevaluation: (archival data acceptable).
If archival data is used, examine the data to determine if the conditions for the observation are met (see pg 1). If not, an observation must be completed which does meet criteria (see pg. 2).
Enter observer/title, date observation was conducted, and report date (either Psycho-Educational Report date, Evaluation Summary Report date, or date of documentation - if on a separate document)
Special case:
An observation needs to be completed on a student who does not participate in regular classes or the student receives specially designed instruction in a special education classroom in the area(s) of continued concern. It is recommended that an observation be done in a classroom setting that is relevant to the manifestation (occurance) of suspected or previously identified disability(ies).
4. Progress monitoring data: (described in evaluation report)
PART 1.
Data that demonstrate that before or as part of the referral process, the child was provided with appropriate instruction in regular education settings by qualified personnel.
Initial Evaluation:
Compile the Progress Monitoring Data worksheet. Enter the date of the Progress Monitoring Data worksheet on Report Date.
Reevaluation:
Compile the Progress Monitoring Data worksheet. Enter the date of the Progress Monitoring Data worksheet on Report Date.
Special case:
Data regarding this component is unavailable as the student was referred prior to the implementation of this requirement.
To fulfill this component, it is recommended that the team document the date of the earliest SLD Eligibility form available where insufficient teaching / lack of appropriate instruction is addressed (and ruled out). The Special Education File Review will contain the date of this eligibility decision. Reference section on Eligibility Data and note the date of the eligibility form marked (X).
Enter the date of the Eligibility decision marked (X) on Report Date.
PART 2
Data-based documentation of repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress that is directly linked to instruction.
Initial Evaluation:
Compile the Progress Monitoring Data worksheet. Enter Date of Progress Monitoring Data worksheet on Report Date.
Reevaluation:
Compile the Progress Monitoring Data worksheet. IEP Progress Reports may be used to document repeated assessments of student progress (an entire year of IEP Progress Report data may be combined on 1 page). Enter the date of the Progress Monitoring Data worksheet on Report Date.
Special case:
a). Students whose IEP progress data is unavailable or insufficiently documented to meet requirements.
If possible, the team should attempt to obtain progress data prior to the eligibility decision. In some cases where this is not possible, no data may be available for review.
On the official SLD Eligibility form, write “No data available” on Report Date and note reason(s) why. On Computer Entry: leave blank
5. If using a response-to intervention (RTI) model: list scientifically-based interventions attempted (based on the district’s RTI model) and describe the child’s response in the evaluation report.
General Note:
This district is not using the RTI Model at this time.
Write on the Intervention Type line (official form) “This district is not using the RTI Model at this time.”
For Computer Entry: Type “see #6”.
6. If using a model based on student’s strengths and weaknesses: Evaluation of the child’s strengths and weaknesses in performance, achievement, or both, relative to age, state-approved grade level standards, or intellectual development. Results described in evaluation report.
Initial Evaluation:
The Psycho-Educational Report will be used to document this criterion.
Enter: Examiner/Title: Enter name(s)/Title of person(s) completing assessment(s)
Assessment: Enter name(s) of measures used in evaluation
Include measures of performance/achievement
May include measures of intellectual development
Date Conducted: Enter date of Psycho-Educational Report
Reevaluation:
The Psycho-Educational Report or the Evaluation Summary Report will be used
to document this criterion.
Enter: Examiner/Title: Enter name(s)/Title of person(s) completing assessment(s)
Assessment: Enter name(s) of measures used in evaluations
Include measures of performance/achievement
May include measures of intellectual development
Date Conducted: Enter date of Psycho-Educational Report or
date of Evaluation Summary Report.
General Notes:
a) On a Reevaluation, the Special Education File Review may contain data pertaining
to strengths and weaknesses in performance and/or achievement relative to age or
intellectual development. Existing data is acceptable if it appears to be valid.
b). For all evaluations (Initial and Reevaluation), an assessment of achievement is
required. Existing data is acceptable for a Reevaluation if it appears to be
valid. Measures of achievement will include standardized assessments which
generate standard scores (eg. Woodcock-Johnson Tests of Achievement III, \
Wechsler Individual Achievement Test, 2nd. Edition, etc). Other measures may be
used to supplement this data such as CBM.
Data must be obtained which will assist the team in completing sections B.1.
and B.4. of the SLD eligibility form.
When scoring norm referenced achievement assessments, age-based norms will be
used to determine strengths/weaknesses in achievement relative to age and/or
intellectual development.
c). If measures of performance are used to ascertain student strengths and
weaknesses, it is recommended that they be examined in conjunction with results
from measures of achievement. The analysis of strengths/weaknesses in
performance and achievement should result in a more valid and reliable
assessment of factors relevant to learning and assist the team in the decision-
making process.
Measures of performance relative to grade-based standards may include
OSAT/OAKS scores, Content Standards Teacher Checklist(s), grades,
observational data and work samples.
d). Assessment of performance/achievement relative to state approved grade level
standards may be obtained via the Content Standards Teacher Checklists. Data
pertaning to the actual/estimated level of performance/achievement may be
compared with data pertaining to grade level standards (obtained to address
eligibility criterion #2). For example, in the case of a 6th grade student who has
attained a 2nd grade level of skill in reading/written language and a 4th grade level in
math, the checklists for the childs grade level may be compared with a Grade 2
Reading-Literature checklist, a Grade 2 Writing checklist, and a Grade 4
Math checklist.
7. If deemed necessary by the team:
a. A developmental history. Relevant history noted in evaluation report, attached.
General Note:
If this was done, enter dates of documentation on Date Conducted and Report Date.
If it was deemed not necessary – write “Deemed not necessary” on the official SLD Eligibility form. On Computer Entry: leave blank
b. Other assessment(s) related to cognition, fine motor skills, perceptual motor skills, communication,
social/emotional status, perception or memory. Results described in evaluation report, attached.
General Note:
If this was done, enter Examiner/Title, Assessment and Date Conducted.
If it was deemed not necessary – enter “Deemed not necessary” on the Examiner/Title line (for both official document & Computer Entry).
c. A medical statement or health assessment statement indicating whether there are any physical factors that may be affecting the student’s educational performance. Relevant medical findings are described in
evaluation report, attached.
General Note: