Request/Advice for Statutory Assessment Education

Request/Advice for Statutory Assessment Education

APPENDIX 2

Request/advice for statutory assessment education.

NAME

Form to be completed by the school/further education provider and returned to the Special Educational Needs and Resources Team

  1. Child or Young Person’s details

Surname
First Name
D.O.B
Gender: / Male/Female
Pupil Premium: / Yes/No / CiC / Yes/No
EAL / Yes/No / Is translator required / Yes/No
Address
Parent/carer name (lead parent for contact) / Address (if different from above)
Parent/carer name / Address (if different from above)
E mail
E mail
Phone Number / Home LA (if not Kent)
Details of any parental requirements to support engagement or communication / e.g. accessibility, intervener
  1. Setting context

Name & address of school/FE provider CYP is currently on roll to.
Type of setting:
e.g primary/secondary/FE
Date CYP joined school/FE provider
If CYP joined in last 18 months give name & address of school/FE previously attended
Number on roll / % SEN on roll
  1. Background

Please note that only factors which relate to the CYP’s educational needs require comment, and any relevant family background information must be factual.
Parental liaison and engagement details
Relevant family/background factors
Is the family currently supported by Early Intervention Team? If ‘Yes’ please provide any relevant information (subject to parental consent)
Family Liaison Officer (FLO) or Parent Support Adviser (PSA) involvement (if any)
Average attendance (comment on any changes over the last 12 months)
Part-time timetable – please record whether there is a current arrangement or has been in the last 12 months
Any diagnosed health conditions that impact on the CYP’s SEN.
  1. Summary of CYP’s Attainment and Progress

For pupils in EYFS /KS1 - Summary of Early Years Foundation Stage Information (from September 2016 include baseline assessment)
End of KS Attainment / Key Stage 1 / Key Stage 2
Reading
Writing
Mathematics
End of KS Attainment / Key Stage 3 / Key Stage 4/5
English
Mathematics
KS4 accreditation gained
KS5 accreditation gained
Comments
List any standardised assessments such as Reading Age etc. not previously recorded
  1. Progress

Please state rates of progress and make comparison where possible to CYP’s previous rate of progress and how this progress compares to peers with similar starting points.
  1. Description of the CYP’s current Special Educational Needs

  1. Cognition and learning (C&L) – e.g. approaches and attitudes to learning, reasoning, organisational skills, problem solving skills and independent learning.

Strengths:
Difficulties:
  1. Communication and Interaction (C&I) – e.g. ASD, articulation, fluency, willingness to communicate, vocabulary, understanding and language structure. Additional language/s spoken. Social skills and interaction – school, home and within the community.

Strengths:
Difficulties
  1. Social ,Emotional and Mental Health needs (SEMH) – e.g. ADHD, ADD, self-image, confidence, anxiety, motivational factors, engagement with learning, classroom/playground behaviour, behaviours outside school (reported or observed)

Strengths:
Difficulties:
  1. Physical and Sensory difficulties – e.g motor skills, coordination, hearing or visual difficulties, daily living skills and self help

Strengths:
Difficulties:
  1. Personalised provision made, impact and evidence of cost

Summary of provision (see guidance notes)
Pastoral care arrangements and Therapy support available (see guidance notes)
Best Practice/Mainstream Core Standards audit tool attached / Yes/No
Supporting evidence: Provision Plan, HNF Statement, attached / Yes/No
External agency involvement
Name of external agency (please indicate if secured through LIFT ) / Details of recommendations and implementation / Evidence of impact
  1. Outcomes that are sought for the CYP (one for each area of need)

  1. Other information

Please provide any additional relevant evidence or advice
Signed:
Designation:
Date:

Version 10 - May 2015

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