If using the IQ/achievement discrepancy model as an eligibility determination procedure, complete this section

Identification of Students with Specific Learning Disabilities

B. If using the IQ/achievement discrepancy model as an eligibility determination procedure, complete this section

B.1. Based on a finding of a severe discrepancy between IQ and achievement, the student exhibits a pattern of strengths and weaknesses in performance, achievement or both, relative to age or ELA or Math Curriculum Framework standards, or intellectual development, in the areas of

Oral Expression Written Expression

Basic Reading Skills Reading Comprehension Reading Fluency Skills Listening Comprehension

Mathematics Problem Solving Mathematics Calculation

B.2. Technically sound instruments have been used that assess cognitive and behavioral factors as well as physical or developmental factors.

Yes No

B.3. More than one measure or assessment has been implemented.

Yes No

B.4. Attach the IQ/achievement assessment report that supports statements B.1-3.

Completed by Date

48 Specific Learning Disability Exclusionary Factors Required documentation for Component 3

Student SASID # Grade

In determining Special Education eligibility with a Specific Learning Disability, the Team must ensure that the identified area of concern is not primarily the result of one of the following. As you work through the flow-chart, keep the student’s area of concern in mind and consider individual characteristics of the student as you answer Yes or No to each of the questions.

YES Is the student’s lack of sufficient progress in the area

of concern due primarily to limited English proficiency?

Is the student’s lack of sufficient progress in the area of concern due primarily to an environmental or economic disadvantage?

Is the student’s lack of sufficient progress in the area of concern due primarily to a visual, hearing, or motor disability?

Is the student’s lack of sufficient progress in the area of concern due primarily to cultural factors?

Is the student’s lack of sufficient progress in the area of concern due primarily to mental retardation?

Is the student’s lack of sufficient progress in the area of concern due primarily to an emotional

disturbance?

If all answers are “No” the Team may consider eligibility for Special Education as a student with a Specific Learning Disability.

If any answers are “Yes” the student cannot be found

eligible for Special Education as a student with a Specific

Learning Disability.

Classroom Observation Checklist Pre-School/Kindergarten

Required documentation for Component 4

Student _____________________________________

Grade ___________________

Class/location observed (include teacher name)

_____________________________________________

Observer name and title ______________________________________

Date of observation _________

This tool is designed for use as a guide during a student observation. You may not see all domains addressed, however, the student should be observed during times when you will be able to monitor behaviors related to the area of concern. If the child is 3-5 years old and not yet in school the observation should be conducted in the child’s natural environment or early intervention program.

In order to obtain a full and accurate picture of the student’s performance, it may be necessary to observe the student more than once, in different settings and at different times of the day. Multiple observation forms may be included in the evaluation documentation.

Directions: First identify the area(s) of concern for the student. Behavior around each identified area is where you will focus your observation. During the observation place a check mark next to the behaviors that are observed within each domain that correlates with the noted areas of concern.

Note, however, these checklists are not exhaustive. In the notes section, write any additional observed behavior, including strengths, which may be relevant to the student’s evaluation.

Check area(s) of concern as identified in SLD 2.

___ Oral Expression ___ Written Expression ___ Basic Reading Skills ___ Reading Comprehension

___ Reading Fluency Skills ___ Listening Comprehension ___ Mathematics Problem Solving ___ Mathematics Calculation

Language (Oral Expression, Basic Reading Skills, Reading Comprehension, Listening Comprehension)

 Age Appropriate

 Has difficulty modulating voice (i.e. too soft, too loud)

 Has trouble naming people or objects

 Has difficulty staying on topic

 Inserts invented words into conversation

 Has difficulty re-telling what has just been said

 Demonstrates slow and halting speech, using lots of fillers (i.e., uh, um, and, you know)

Completed by Date

 Mispronounces words frequently

 Has difficulty rhyming

 Has limited interest in books or stories

 Has difficulty understanding instructions or directions

Notes:___________________________________________________________________________

________________________________________________________________________________

Reading (Basic Reading Skills, Reading Comprehension, Reading Fluency Skills)

 Age Appropriate

 Confuses similar-looking letters and numbers

 Demonstrates poor memory for printed words

 Has trouble naming letters

 Has problems associating letters and sounds, understanding the difference between sounds in words or blending sounds into words

 Has poor retention of new vocabulary

 Dislikes and avoids reading or reads reluctantly

Notes:___________________________________________________________________________

 Dislikes and avoids writing and copying

 Has difficulty remembering shapes of letters and numerals

 Frequently reverses letters, numbers and symbols

Notes:___________________________________________________________________________

________________________________________________________________________________

Math (Math Calculation, Math Problem Solving)

 Age Appropriate

 Has difficulty with simple counting and one-to-one correspondence between number symbols and items/objects

 Has difficulty ‘joining in’ and maintaining positive social status in a peer group

 Has difficulty with self-control when frustrated

Notes:___________________________________________________________________________

________________________________________________________________________________

Attention (All Areas)

 Age Appropriate

 Has difficulty sustaining attention in work tasks or play activities

Notes:___________________________________________________________________________

________________________________________________________________________________

Gross and Fine Motor Skills (All Areas)

 Age Appropriate

 Appears awkward and clumsy, dropping, spilling, or knocking things over

 Has trouble with buttons, hooks, snaps, zippers and trouble learning to tie shoes

 Creates art work that is immature for age

 Demonstrates poor ability to color or write ‘within the lines’

 Grasps pencil awkwardly, resulting in poor handwriting

 Experiences difficulty using small objects or items that demand precision (i.e., Legos, puzzle pieces, tweezers, scissors)

Notes:___________________________________________________________________________

________________________________________________________________________________

Other notes or observed behavior

________________________________________________________________________________

Classroom Observation Checklist Grades 1-4

Required documentation for Component 4 Student ____________________________________________________

Grade ___________________

Class/location observed (include teacher name)

_____________________________________________

Observer name and title ______________________________________

Date of observation _________

Note, however, these checklists are not exhaustive. In the notes section, write any additional observed behavior, including strengths, which may be relevant to the student’s evaluation.

Check area(s) of concern as identified in SLD 2.

___ Oral Expression ___ Written Expression ___ Basic Reading Skills ___ Reading Comprehension ___ Reading Fluency Skills ___ Listening Comprehension ___ Mathematics Problem Solving ___ Mathematics Calculation Language (Oral Expression, Basic Reading Skills, Reading Comprehension, Listening Comprehension)

 Age Appropriate

 Has difficulty modulating voice (i.e., too soft, too loud)

 Has trouble naming people or objects

 Has difficulty staying on topic

 Inserts invented words into conversation

 Has difficulty re-telling what has just been said

 Uses vague, imprecise language and has a limited vocabulary

 Demonstrates slow and halting speech, using lots of fillers (i.e., uh, um, and, you know)

 Uses poor grammar or misuses words in conversation

 Mispronounces words frequently

 Confuses words with others that sound similar

 Inserts malapropisms (‘slips of the tongue’) into conversation (i.e., a rolling stone gathers no moths; he was a man of great statue)

 Has difficulty rhyming

 Has limited interest in books or stories

 Has difficulty understanding instructions or directions

 Has difficulty with pragmatic skills (i.e., understands the relationship between speaker and listener, stays on topic, gauges the listener’s degree of knowledge, makes inferences based on a speaker’s verbal and non-verbal cues)

Notes:___________________________________________________________________________

________________________________________________________________________________

Reading (Basic Reading Skills, Reading Comprehension, Reading Fluency Skills)

 Age Appropriate

 Confuses similar-looking letters and numbers or similar-looking words (i.e., beard, bread)

 Has difficulty recognizing and remembering sight words

 Frequently loses place while reading

 Reverses letter order in words (i.e., saw/was)

 Demonstrates poor memory for printed words

 Reads slowly

 Has trouble naming letters

 Has problems associating letters and sounds, understanding the difference between sounds in words or blending sounds into words

 Guesses at unfamiliar words rather than using word analysis skills

 Substitutes or leaves out words while reading

 Has poor retention of new vocabulary

 Dislikes and avoids reading or reads reluctantly

Notes:___________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Written Language (Written Expression)

 Age Appropriate

 Writing is messy and incomplete, with many cross-outs and erasures

 Has difficulty remembering shapes of letters and numerals

 Frequently reverses letters, numbers and symbols

 Uses uneven spacing between letters and words, and has trouble staying ‘on the line’

 Copies inaccurately (i.e., confuses similar-looking letters and numbers)

 Spells poorly and inconsistently (i.e., the same word appears differently other places in the same document)

 Has difficulty proofreading and self-correcting work

Notes:___________________________________________________________________________

________________________________________________________________________________

54 Math (Math Calculation, Math Problem Solving)

 Age Appropriate

 Has difficulty with simple counting and one-to-one correspondence between number symbols and items/objects

 Has difficulty learning strategic counting principles (i.e., by 2, 5, 10, 100)

 Has difficulty estimating quantity (i.e., quantity, value)

 Has difficulty with comparisons (i.e., less than, greater than)

 Has trouble telling time

 Has trouble conceptualizing the passage of time

 Has difficulty counting rapidly or making calculations

Notes:___________________________________________________________________________

________________________________________________________________________________

Social Emotional (All Areas)

 Age Appropriate

 Does not pick up on other people’s mood/feelings (i.e., may say the wrong things at the wrong time)

 May not detect or respond appropriately to teasing

 Has difficulty ‘joining in’ and maintaining positive social status in a peer group

 Has trouble knowing how to share/express feelings

 Has trouble ‘getting to the point’ (i.e., gets bogged down in details in conversation)

 Has difficulty with self-control when frustrated

 Has difficulty dealing with group pressure, embarrassment and unexpected challenges Notes:___________________________________________________________________________

________________________________________________________________________________

Attention (All Areas)

 Age Appropriate

 Has difficulty sustaining attention in work tasks or play activities

 Has difficulty organizing tasks and activities

 Loses things consistently that are necessary for tasks/activities (i.e., toys, school assignments, pencils, books, or tools)

 Is easily distracted by outside influences

 Is forgetful in daily/routine activities

Notes:___________________________________________________________________________

________________________________________________________________________________

Gross and Fine Motor Skills (All Areas)

 Age Appropriate

 Appears awkward and clumsy, dropping, spilling, or knocking things over

 Has limited success with games and activities that demand eye-hand coordination (i.e., piano lessons, basketball, baseball)

 Has trouble with buttons, hooks, snaps, zippers and trouble learning to tie shoes

 Creates art work that is immature for age

 Demonstrates poor ability to color or write ‘within the lines’

 Grasps pencil awkwardly, resulting in poor handwriting

 Experiences difficulty using small objects or items that demand precision (i.e., Legos, puzzle pieces, tweezers, scissors)

Notes:__________________________________________________________________________

________________________________________________________________________________

Other notes or observed behavior

 Confuses left and right

 Often loses things

 Is slow to learn new games and master puzzles

 Has difficulty generalizing (applying) skills from one situation to another

Notes:___________________________________________________________________________

________________________________________________________________________________

Classroom Observation Checklist Grades 5-8

Required documentation for Component 4 Student ____________________________________________________

Grade ___________________

Class/location observed (include teacher name)

_____________________________________________

Observer name and title ______________________________________

Date of observation _________

Note, however, these checklists are not exhaustive. In the notes section, write any additional observed behavior, including strengths, which may be relevant to the student’s evaluation.

Check area(s) of concern as identified in SLD 2.

___ Oral Expression ___ Written Expression ___ Basic Reading Skills ___ Reading Comprehension

___ Reading Fluency Skills ___ Listening Comprehension ___ Mathematics Problem Solving ___ Mathematics Calculation

Language (Oral Expression, Basic Reading Skills, Reading Comprehension, Listening Comprehension)

 Age Appropriate

 Has difficulty modulating voice (i.e., too soft, too loud)

 Inserts invented words into conversation

 Has difficulty re-telling what has just been said

 Uses vague, imprecise language and has a limited vocabulary

 Demonstrates slow and halting speech, using lots of fillers (i.e., uh, um, and, you know)

 Uses poor grammar or misuses words in conversation

 Mispronounces words frequently

 Confuses words with others that sound similar

 Inserts malapropisms (‘slips of the tongue’) into conversation (i.e., a rolling stone gathers no moths; he was a man of great statue)

 Has limited interest in books or stories

 Has difficulty understanding instructions or directions

Notes:___________________________________________________________________________

________________________________________________________________________________

Reading (Basic Reading Skills, Reading Comprehension, Reading Fluency Skills)

 Age Appropriate

 Frequently loses place while reading

 Confuses similar-looking words (i.e., beard, bread)

 Reverses letter order in words (i.e., saw/was)

 Demonstrates poor memory for printed words

 Has weak comprehension of ideas and themes

 Guesses at unfamiliar words rather than using word analysis skills

 Reads slowly

 Substitutes or leaves out words while reading

 Has poor retention of new vocabulary

 Dislikes and avoids reading or reads reluctantly

Notes:___________________________________________________________________________

 Writing is messy and incomplete, with many cross-outs and erasures

 Uses uneven spacing between letters and words, and has trouble staying ‘on the line’

 Copies inaccurately (i.e., confuses similar-looking letters and numbers)

 Spells poorly and inconsistently (i.e., the same word appears differently other places in the same document)

 Has difficulty proofreading and self-correcting work

 Fails to develop ideas in writing so written work is incomplete and too brief

Notes:___________________________________________________________________________

________________________________________________________________________________

Math (Math Calculation, Math Problem Solving)

 Age Appropriate

 Has difficulty learning strategic counting principles (i.e., by 2, 5, 10, 100)

 Poorly aligns numbers resulting in computation errors

 Has difficulty estimating quantity (i.e., quantity, value)

 Has difficulty with comparisons (i.e., less than, greater than)

 Has trouble telling time

 Has trouble conceptualizing the passage of time

 Has difficulty counting rapidly or making calculations

 Has trouble interpreting graphs and charts

Notes:___________________________________________________________________________

 Does not pick up on other people’s mood/feelings (i.e., may say the wrong things at the wrong time)

 May not detect or respond appropriately to teasing

 Has difficulty ‘joining in’ and maintaining positive social status in a peer group

 Has trouble knowing how to share/express feelings

 Has trouble ‘getting to the point’ (i.e., gets bogged down in details in conversation)

 Has difficulty dealing with group pressure, embarrassment and unexpected challenges Notes:___________________________________________________________________________

 Fails to pay close attention to details or makes careless mistakes in schoolwork or other activities

 Has difficulty sustaining attention in work tasks or play activities

 Has difficulty organizing tasks and activities

 Loses things consistently that are necessary for tasks/activities (i.e., toys, school assignments, pencils, books, or tools)

 Is easily distracted by outside influences

 Is forgetful in daily/routine activities

Notes:___________________________________________________________________________

________________________________________________________________________________

59 Gross and Fine Motor Skills (All Areas)

 Age Appropriate

 Has limited success with games and activities that demand eye-hand coordination (i.e., piano lessons, basketball, baseball)

 Grasps pencil awkwardly, resulting in poor handwriting

 Dislikes and avoids writing and drawing tasks

Notes:___________________________________________________________________________

________________________________________________________________________________

Other notes or observed behavior

 Age Appropriate

 Confuses left and right

 Finds it hard to judge speed and distance (i.e., hard to play certain games, drive a car)

 Trouble reading charts and maps

 Is disorganized and poor at planning

 Often loses things

 Is slow to learn new games and master puzzles

 Has difficulty listening and taking notes at the same time

 Has difficulty generalizing (applying) skills from one situation to another

Notes:___________________________________________________________________________

________________________________________________________________________________

Classroom Observation Checklist Grades 9-12

Required documentation for Component 4 Student ____________________________________________________

Grade ___________________

Class/location observed (include teacher name)

_____________________________________________

Observer name and title ______________________________________

Date of observation _________

Note, however, these checklists are not exhaustive. In the notes section, write any additional observed behavior, including strengths, which may be relevant to the student’s evaluation.

Check area(s) of concern as identified in SLD 2.

Language (Oral Expression, Basic Reading Skills, Reading Comprehension, Listening Comprehension)

 Age Appropriate

 Has difficulty modulating voice (i.e., too soft, too loud)

 Uses vague, imprecise language and has a limited vocabulary

 Demonstrates slow and halting speech, using lots of fillers (i.e., uh, um, and, you know)

 Uses poor grammar or misuses words in conversation

 Confuses words with others that sound similar

 Inserts malapropisms (‘slips of the tongue’) into conversation (i.e., a rolling stone gathers no moths; he was a man of great statue)

 Has difficulty understanding instructions or directions

Notes:___________________________________________________________________________

________________________________________________________________________________

Reading (Basic Reading Skills, Reading Comprehension, Reading Fluency Skills)

 Age Appropriate

 Frequently loses place while reading

 Confuses similar-looking words (i.e., beard, bread)

 Demonstrates poor memory for printed words

 Has weak comprehension of ideas and themes

 Reads slowly

 Guesses at unfamiliar words rather than using word analysis skills

 Substitutes or leaves out words while reading

 Dislikes and avoids reading or reads reluctantly

Notes:___________________________________________________________________________

 Writing is messy and incomplete, with many cross-outs and erasures

 Uses uneven spacing between letters and words, and has trouble staying ‘on the line’

 Copies inaccurately (i.e., confuses similar-looking letters and numbers)

 Spells poorly and inconsistently (i.e., the same word appears differently other places in the same document)

 Has difficulty proofreading and self-correcting work

 Fails to develop ideas in writing so written work is incomplete and too brief

Notes:___________________________________________________________________________

________________________________________________________________________________

Math (Math Calculation, Math Problem Solving)

 Age Appropriate

 Has difficulty learning strategic counting principles (i.e., by 2, 5, 10, 100)

 Poorly aligns numbers resulting in computation errors

 Has difficulty estimating quantity (i.e., quantity, value)

 Has difficulty with comparisons (i.e., less than, greater than)

 Has trouble telling time

 Has trouble conceptualizing the passage of time

 Has difficulty counting rapidly or making calculations

 Has trouble interpreting graphs and charts

Notes:___________________________________________________________________________

 Does not pick up on other people’s mood/feelings (i.e., may say the wrong things at the wrong time)

 May not detect or respond appropriately to teasing

 Has difficulty ‘joining in’ and maintaining positive social status in a peer group

 Has trouble ‘getting to the point’ (i.e., gets bogged down in details in conversation)

 Has difficulty dealing with group pressure, embarrassment and unexpected challenges Notes:___________________________________________________________________________

 Fails to pay close attention to details or makes careless mistakes in schoolwork or other activities

 Has difficulty sustaining attention in work tasks or play activities

 Has difficulty organizing tasks and activities

 Loses things consistently that are necessary for tasks/activities (i.e., toys, school assignments, pencils, books, or tools)

 Is easily distracted by outside influences

 Is forgetful in daily/routine activities

Notes:___________________________________________________________________________

________________________________________________________________________________

Gross and Fine Motor Skills (All Areas)

 Age Appropriate

 Has limited success with games and activities that demand eye-hand coordination (i.e., piano lessons, basketball, baseball)

 Grasps pencil awkwardly, resulting in poor handwriting

Notes:___________________________________________________________________________

________________________________________________________________________________

63 Other notes or observed behavior

 Age Appropriate

 Confuses left and right

 Finds it hard to judge speed and distance (i.e., hard to play certain games, drive a car)

 Trouble reading charts and maps

 Is disorganized and poor at planning

 Often loses things

 Is slow to learn new games and master puzzles

In document SCITUATE PUBLIC SCHOOLS SPECIAL EDUCATION PROCEDURES MANUAL (Page 47-64)