Professional Documents
Culture Documents
Quick Reference 092413 2
Quick Reference 092413 2
: Mathematics Subtest 15 21
ACT
: Mathematics Subtest 18 23
AP
Calculus 2 3
CLEP
College Algebra 30 40
IB
: Mathematics Subtest 42 52
SAT
: Applied Mathematics 5 6
ACE Algebra II ACT
: Mathematics Subtest 20 25
AP
Calculus 2 3
CLEP
College Algebra 40 50
COMPASS
Algebra 46 NA
IB
: Mathematics Subtest 46 55
SAT
: Applied Mathematics 5 6
ACE Geometry ACT
: Mathematics Subtest 18 23
AP
Calculus 2 3
IB
: Mathematics Subtest 42 52
SAT
: Applied Mathematics 5 6
Science Alternate Tests
EOI Exam Alternate Proficient Advanced
ACE Biology I ACT PLAN
: Science Subtest 16 23
ACT
: Science Subtest 19 25
AP
Biology 2 3
CLEP
General Biology 30 40
IB
US History 2 3
CLEP
: Reading Subtest
ACT
: English Subtest
and
ACT
: Writing
Combined 30
(with neither
below 14)
and
8
Combined 46
(with neither
below 22)
and
10
AP
: Critical Reading
Subtest
34 51
SAT
: Business Writing
4
and
4
5
and
5
ACE English III
ACT
: Reading Subtest
ACT
: English Subtest
and
ACT
: Writing
Combined 32
(with neither
below 15)
and
8
Combined 48
(with neither
below 23)
and
10
AP
: Critical Reading
Subtest
37 53
SAT
: Business Writing
4
and
4
5
and
5
Definitions Notes
AP
Advanced Placement
ACT
, COMPASS
, PLAN
, and WorkKeys
College-Level
Examination Program
AP
, Advanced Placement
, CLEP
,
PSAT/NMSQT
,
and SAT
International Baccalaureate
IB
_____ __________________________
_____ __________________________
_____ __________________________
_____ __________________________
_____ __________________________
_____ __________________________
Testing Requirements*
Beginning with students entering 9th grade in the
2008-09 school year, every student shall demonstrate
mastery of the state academic content standards in the
following subject areas in order to graduate from a
public high school with a standard diploma.
_____ English II, and
_____ Algebra I, and two of the following:
_____ English III
_____ Algebra II
_____ Geometry
_____ Biology I
_____ U.S. History
23 UNITS are required in order to meet state graduation requirements.
*Students with disabilities may participate in the Oklahoma Alternate Assessment Program (OAAP) or Oklahoma
Modied Alternate Assessment Program (OMAAP), as determined by their Individual Education Program (IEP) teams.
The local school boards graduation requirements may exceed the state graduation requirement of 23 units.
See the school counselor for local coursework requirements or for information regarding profciency-based promotion.
Personal Financial Literacy Requirement (Title 70 O.S. 11-103.6h )
Beginning with students entering the 7th grade in the 2008-2009 school year, in order to graduate from a
public high school, students must complete and demonstrate satisfactory knowledge in 14 areas of instruction
related to fnancial literacy, including such topics as credit card debt, saving money, interest, balancing a
checkbook, understanding loans, identity theft, and earning an income. School districts have the option of
determining when the areas of instruction are taught and whether these are integrated into existing courses or
taught as a separate course (which may count as an elective credit). Contact your local school district offcials
for specifc details.
GRADUATION PROCEDURES
The IEP team must identify and document the projected date of graduation when
completing the IEP transition plan for a student in the 9
th
grade or 16 years of age,
whichever comes first.
All special education students fall under the ACE four of seven EOI requirements. Credit
checks should be completed annually, prior to the IEP subsequent. Please note that the
Opt-out letter denies students access to two free years of education through
Oklahoma Promise.
If the student is not going to graduate as indicated on the previous IEP, you must hold
an IEP Not Subsequent to extend the graduation date. The graduation date is on the
transition section. FAPE can be provided through age 21 if necessary.
The SOP is a form designed to meet the IDEA 2004 law related to addressing the
students post-secondary goals. The IEP team should provide the student with a copy of
the Graduation event, SOP, reevaluation assessments, and the sample Post
Secondary Service Provider letter.
Graduation requirements are listed annually in the Student Handbook. Refer to the ACE
section of the Quick Reference.
Half Day Placement
The instructional team has noticed an increased number of students placed
on days at the secondary level. Remember, you must work the LRE
continuum prior to reducing a students school day. According to the Office
of Special Education Programs (OSEP) a students placement in the
general education classroom is the first option the placement group should
consider. IEP teams must consider each students individual needs when
determining LRE and cannot be made as a matter of general policy by
administration, teachers, or others apart from the IEP team process.
Additionally, there must be a plan of action in place to return a student to a
full day program, if a student is currently on day. A reduced school day is
not a permanent solution and should be utilized for 60 days or less.
The LRE continuum consists of :
Regular education full-timeInside the regular class more than
80% of school day or 5 out of 7 class periods
Special class part-timeInside the regular class 40% to 80% of the
day
Special class full-timeInside the regular class less than 40% of the
day
Separate day school
Separate residential facility
Home Instruction/Hospital Environment
Correctional Facility
The IEP team needs to initiate an FBA prior to reducing a students day.
Transportation can be arranged at this time with your Instructional
Supervisor.
Refer student to Special Service Social Worker, if needed.
Remember a decrease in seat time (6.5 hours a day according to State
law) extends the time it will take a student to graduate.
For alternative ways to meet a students educational needs in the LRE
please contact your instructional supervisor.
Refer to p. 114 117 of the Special
Education Handbook.
HIGHLY QUALIFIED
FREQUENTLY ASKED QUESTIONS
1. What is the definition of highly qualified teacher?
The requirement that teachers be highly qualified applies to all special education
teachers who teach a core academic subject.
A. Holds a minimum of a bachelors degree; and
B. Has obtained full Oklahoma certification or holds an Oklahoma teaching
license and does not have certification or licensure requirements waived
on an emergency, temporary, or provisional basis;
C. Has demonstrated subject-matter competency in each of the academic
subjects in which the teacher delivers the content knowledge.
2. Do special education teachers need to meet the highly qualified requirement
if they are not teaching a core academic subject?
No, only teachers who teach core academic courses are required to meet the definition
of a highly qualified teacher. If you are collaborating or co-teaching you do not need to
meet the requirements of highly qualified.
3. If a special education teacher was highly qualified using the 2005-2006
HOUSSE documentation is the teacher highly qualified for the 2006-2007
school year?
No. The HOUSSE has been revised and you will need to use the 2006-2007 HOUSSE
documentation.
4. If a special education teacher teaches core academic subjects exclusively to
students who are being assessed against alternate academic achievement
standards, at what subject matter level must the special education teacher
be highly qualified?
The 2004 IDEA amendments provide that if a special education teacher teaches core
academic subjects exclusively to students who are being assessed against alternate
achievement standards, the teacher must meet the highly qualified requirements for
elementary school teachers and for instruction above the elementary level have subject-
matter knowledge appropriate to the level of instruction being provided.
5. Must a special education teacher who teaches core academic subjects
exclusively to students with disabilities be highly qualified in all subjects
they teach?
Refer to pp. 232, 242 - 245 of the
Special Education Handbook.
Yes. Special education teachers in this category, whether new to the profession or not,
must be highly qualified. Special education teachers who are not new to the profession
must demonstrate competence in all core subjects they teach. You will use the revised
2006 single subject special education HOUSSE to demonstrate subject-matter
competency in each of the core academic subjects that you teach.
The 2004 IDEA amendments provide that special education teachers new to the
profession who teach multiple core academic subjects and are highly qualified in early
childhood, elementary, mathematics, language arts, or science at the time they are
hired, have two additional years after the date of hire to become highly qualified in all
other academic subjects they teach, including through use of a core academic
HOUSSE.
6. What activities may special education teachers carry out if they are not
highly qualified in the core academic content area being taught?
There are many activities that special education teachers may carry out that would not,
by themselves, require those teachers to be highly qualified in a particular subject
matter. Special educators who do not directly instruct students in any core academic
subjects or who provide only consultation to highly qualified teachers of core academic
subjects in adapting curricula, using behavioral supports and interventions, or selecting
appropriate accommodations do not need to demonstrate subject-matter competency in
those subjects. These special educators could also assist students with study skills or
organizational skills and reinforce instruction that the child has already received from a
highly qualified teacher in that core academic subject.
7. Do all areas of advanced certification by the National Board of Professional
Teaching Standards make a teacher automatically highly qualified?
A teacher is automatically highly qualified at the middle/secondary level if the national
board certification is in the specific core academic subject area the teacher teaches.
Example: English Language Arts/Early Adolescence.
A teacher holding national board certification in a non-core academic subject may
become highly qualified by counting the national board certification within their
HOUSSE.
Example: Exceptional Needs Specialist/Early Childhood.
8. Will college course work at the college of education count when building a
HOUSSE?
No. An EDUC, CIED, or any other education prefix is not acceptable except for reading.
Examples of acceptable core academic prefixes are: POLSCI, ENG, MATH, etc.
9. Can psychology or sociology count when building a HOUSSE in social
studies?
No. NCLB specifically identified the social studies core academic areas as civics and
government, economics, history, and geography. This is in contrast to the other core
academic areas of science, mathematics, language arts, etc. Therefore, when counting
coursework for social studies only these specific core academic social studies areas
may be counted.
10. Can college course work in Humanities count for any core academic
subjects when building a HOUSSE?
Yes. When a teacher is teaching a course for art or music credit, they may count
Humanities when building a HOUSSE.
11. Can college course work in speech, drama, journalism, or communication
count when building a HOUSSE in language arts?
No. These courses are not considered core academic subjects.
12. Can you count out-of-state years of teaching experience when building a
HOUSSE?
No. Each state must develop their HOUSSE based on their state standards.
13. When building a HOUSSE, can service in the content area (Column 3) count
if they are accrued out of state?
No. Each state must develop their HOUSSE based on their state standards.
14. What is meant by High Objective Uniforms State Standard of Evaluation
(HOUSSE) procedures?
As of July 1, 2006 you will be required to use the revised HOUSSE for all special
education teachers who teach a core academic subject.
15. May Districts offer HOUSSE procedures as a way for experienced teachers to
demonstrate subject-matter competency in the subjects they teach after the
2005-2006 school year?
Yes. Districts will need to use the revised HOUSSE for special education teachers, as a
way of determining that individual teachers have the subject-matter competence they
need to be highly qualified in each subject they teach.
16. Do you build a HOUSSE (High Objective Uniform State Standard of
Evaluation) for each academic area you are teaching?
Yes. Due to requirements by USDE we have revised the HOUSSE document and you
will need to use the revised form for the school year 2006-2007.
17. If you have a masters degree in special education are you automatically
highly qualified?
No, you would still need to build your HOUSSE using the revised document.
18. If you have elementary certification plus special education certification are
you highly qualified?
For veteran teachers teaching the subject of elementary, you are qualified only when
content competency is demonstrated by also passing the elementary test or by building
a HOUSSE in the subject of elementary education. Teacher testing began in 1982.
19. In column 1 of the HOUSSE do I only count one academic area for credits?
Yes, you add up all your credit hours of a C or better, for the academic area and then
multiply by 4. Remember education courses do not count except for Reading.
20. I have taken my national board certification in special education; will that
automatically make me highly qualified?
No, you may use National Board certification in special education under column 6 of the
HOUSSE document.
21. What if I cannot reach 100 points to build a HOUSSE will I lose my job?
You cannot be the teacher of record for any core academic area. You have until June
30, 2007 to use the revised HOUSSE. Your school district may need to look at
reconfiguring your teaching assignments where you are in a consultative, collaborative
or co-teaching role.
HOMEBASED
If there is medical documentation from a licensed physician indicating a need for
Homebased instruction, a special education student could receive instruction in the
home setting.
For information and procedures please call the Special Services Office, Karen Petree,
587-0411 or kspetree@okcps.org.
Homebased and homeschool are two different educational setting.
INITIAL EVALUATION
KEY POINTS
Review of Existing Data(REDs) is required for all initial evaluations. Pages 1 & 5 are
required in all circumstances. Pages 2, 3, & 4 are also required if existing, or outside,
information is available. Page 6 is required for all students suspected of having a
Learning Disability or Other Health Impairment.
Interventions must be documented on the REDs for a minimum of 6 weeks prior to
determining need for an evaluation. (See RTI for students suspected as having a
Learning Disability or Other Health Impairment.) The Qualified Diagnostician/Examiner
must sign the REDs.
(Qualified Diagnostic Examiner Psychologist, Psychomotrist or Speech Language
Pathologist)
Due Diligence must always be performed when attempting to meet with parents. Due
Diligence is performed when two attempts, using two different methods of contact, are
made. For example; personal phone call and mailed notification
Parent Consent must be obtained prior to an initial evaluation. Parent consent is also
required before an outside transition specialist can attend the IEP meeting.
Eligibility Team Qualified Diagnostic Examiner, parent, special education teacher(s)
certified in areas of suspected disability, regular education teacher, and student (age 14
and above).
MEETS/MEEGS are completed by the Qualified Diagnostic Examiner.
MEETS/MEEGS - Special education teacher(s) certified in all areas of suspected
disabilities must be present at the eligibility meeting. Page 5 is required for all students
suspected of having a Learning Disability or Other Health Impairment.
Parents are to be given copies of the IEP, eligibility, evaluation and Parent
Rights/FERPA.
Timelines:
Evaluations within 45 school days
Eligibility within 15 days from report
IEP within 30 days from eligibility
Refer to pp. 64-65 of the
Special Education Handbook.
Melissa Eldridge, Bilingual Specialist
(405)587-0426*mgeldridge@okcps.org
Fax # (405) 297-6594
PROCEDURES FOR REQUESTING LANGUAGE DOMINANCE
The following information must be mailed or faxed to the Bilingual
Specialist:
Special Services Request for language Dominance Testing form
Communication/Language Background for ELL Students (For teachers only)
Bilingual Language Proficiency Questionnaire (For parents of Pre-K students and also Kindergarten
students that have had no previous schooling.)
Health Information (Vision and Hearing Screening Results)
WIDA Teacher Report (If the WIDA score is a 4.0 or higher the student is English Dominant and does
not need a Language Dominance Evaluation. Check with parents and look at the Home Language
Survey information that was filled out by the parent at the beginning of the year before the referral is
send to the Bilingual Specialist.)
When an English Language Learner is referred for a Re-evaluation, the
following procedure should be followed.
A copy of the Review of Existing Data attached to a Request for Language Dominance form should be
faxed or mailed to Special Services, Melissa Eldridge. Language dominance is not needed if student was
English dominant in the initial evaluation or if the student has scored a 4.0 or above on the WIDA test. If
student was bilingual or Spanish dominant, language dominance must be done again.
The teacher does not need to fill out the Communication /Language Background Form unless the student is
new to the district.
When requesting a Waiver for a Language dominance evaluation, the
following should be followed.
Fill out Waiver form and fax or mail to Melissa Eldridge
Explain clearly why the student does not need a language dominance evaluation
Example: The Student has been diagnosed Intellectually Disabled- and is non-verbal. (Waivers are
usually considered for more severe disabilities affecting communication) or has only been in our
schools district for 1 year or less and is apparent that the student does not speak English.
When requesting a Language Dominance Evaluation for Speech and
Language students.
If a student is referred for articulation only, a Language Dominance Evaluation is not needed. If
the student is Spanish dominant or Bilingual, refer student to Laura Clark, SLP.
When can an English Language Learner be referred?
Students Pre-K 12 can be referred when the classroom teacher and other school professional
belief the student is exhibiting academic difficulties that may not be related to learning a second
language.
[When requesting for Language dominance testing please keep the original forms in the students file
and send a copy (not the original) to Special Services.]
OKLAHOMA CITY PUBLIC SCHOOLS
Educating Students for Life-Long Learning and Responsible Living
Special Services
900 N. Kline, Oklahoma City, OK 73106
SPECIAL SERVICES REQUEST FOR LANGUAGE DOMINANCE TESTING
Initial Evaluation Re-Evaluation
STUDENT REFERRED FOR TESTING:
Date of Request: ____________________________
Name: ________________________________ Birth date: ______________ Age: ________
School: ____________________________ Grade: ____________ ID#: _________________________
Classroom Teacher /Case Manager: ________________________________________________________________
*Request sent by: ______________________________________________________________________________
*Primary Language Spoken at Home: ______________________________________________________________
Are there signs of a language disorder in the students native language that may impede English language
learning? Yes No
Explain:___________________________________________________________________________________
__________________________________________________________________________________________
Are the students English skills within the expected level, given his or her years of formal schooling and literacy
in native language? (Explanation below) Yes No
Explain: __________________________________________________________________________________
_____________________________________________________________________________________________
[Students learn basic interpersonal communication skills (BICS) in about 2 years upon entering a new language
environment. However, learning deeper, more abstract, and complex language as involved in classroom
instruction(Cognitive Academic Language Proficiency, CALP) takes 4-7 years of formal schooling in order to
acquire an average level of academic language if they have had the support of native language instruction
(Cummins 1984). If they have had only English instruction, the typical ELL student will need 7-10 years to attain
average achievement, if they ever do (Thomas & Collier, 2002). ]
Has the Student ever been taught in a Bilingual setting, Dual language program, or in his/her Native language.
Yes No
If yes, for how long has the student been taught in these types of settings? _________________________________
Has the Student repeated grades: Yes No
Note circumstances involving retention of student: ____________________________________________________
_____________________________________________________________________________________________
Reason(s) for Request:
Speech or Articulation Only-Language Dominance is not needed
Speech and Language
Academic Difficulties
Parent Request
Other _____________________________________________________________________
[Please attach a copy of the*Communication/Language Background for ELL or for Pre-K students attach only the *Bilingual
Language Proficiency Questionnaire. Also, attach a copy of the*WIDA Teacher Report. Mail or fax to Melissa Eldridge,
Bilingual Specialist at Special Services. Keep all original forms in their confidential file at school.]
OKLAHOMA CITY PUBLIC SCHOOLS
Educating Students for Life-Long Learning and Responsible Living
1
BILINGUAL
LANGUAGE DOMINANCE TESTING
PRE-REFERRAL INTERVENTION
Questions and Answers
What is pre-referral intervention?
A safeguard against inappropriate referrals to special education
A process for problem solving student difficulties which are not the result of a
disability
A process which supports the classroom teacher and assists in the development of
alternative strategies for students experiencing difficulty
A process which assists in distinguishing true learning disorders from
characteristics of second language acquisition, culture, and other linguistic
differences
A process which helps to rule out linguistic, cultural, social-economic and/or
other environmental differences as the primary source of a students academic
failure
What are the benefits of pre-referral intervention?
Referrals to special education are more valid. Students are more likely to have a
true disorder
Students who do not have a disability, but need instructional support will receive
it in the regular program
Teachers in the regular program develop a network of peer support
Problem solving as a team facilitates professional growth in needed areas; staff
development is formative and directly in response to teacher needs
Why must a language dominance test be conducted?
Public Law 105-17 (IDEA), formerly, P.L. 94-142, mandates that a student be evaluated
in his or her native language to provide the most descriptive and fair assessment results.
Also, the regulation implementing Section 504, at 34 C.F.R. sec.104.35 mandates that a
school district conduct an evaluation of any person who, because of disability needs or is
believed to need special education or related services in a regular or special education
program. Since the students tested are not part of normative populations for standardized
instruments, many factors must be considered when interpreting assessment results. The
regulation at 34 C.F.R. sec. 104.36 mandates that school district must establish a system
Refer to p. 65 of the Special
Education Handbook
2
of procedural safeguards for students who need or are believed to need special education
or related services.
Language dominance testing provide expertise regarding expected second language
learning and helps determine whether or not concerns are due to normal second language
acquisition processes or if they may signal other areas of concern that warrant
consideration for further assessment. Also, language dominance testing serves as a
safeguard against inappropriate referrals to special education. However, language
dominance testing is one source for determining further consideration for Special
Education. The decision for further evaluations should be drawn from a variety of
sources, including aptitude and achievement tests, teacher recommendations, physical
condition, social or cultural background, and adaptive behavior, including persons
knowledgeable about the child. Decisions made should be in conformity with section
104.34. [34 C.F.R. sec. 104.35(c)].
When parent, physicians, or school staff professionals present concerns to the Preschool
Child Find Committee about preschool students, a bilingual specialist representative
collaborates during the child study screening or local screening committee meeting to
explore linguistic and cultural variables that need to be considered.
Who needs a language dominance testing?
All limited English Language Learners (ELL) who are being considered for special
education must have been previously considered for a language dominance assessment by
the Multidisiplinary team (RTI team, Sit team etc.). The referring source should contact
the Multidisiplinary team to determine the appropriateness of a language dominance
assessment and initiate consideration for such assessment.
For preschool-age ELL children, a bilingual specialist participates in the Preschool Child
Find child study and/or local screening committee meeting. During these collaborative
meetings, the committee examines language and cultural variables that should be
considered before further testing are recommended.
ELL students, already in special education programs, who are due for reevaluation and
transitioning preschool class-based or home-resource students, may need a language
dominance test before further testing is initiated. When a previously administered
language dominance test has determined that the student undergoing evaluation is
English dominant, a second language dominance test is not needed as long as the ELL
student in question has remained in an English-speaking educational environment since
the first Language dominance test was conducted. Upon request, the bilingual specialist
will provide a waiver letter explaining why the Language dominance test is or is not
required in these cases.
The language dominance test may vary in form and context from student to student
according to individual needs and backgrounds. While the majority of ELL students
require complete language dominance testing, some cases may only require language
3
dominance confirmation. Others may require only first language analysis and in a few
cases only require telephone consultations or a waiver. Since many variables affect
whether or not a language dominance test is needed and which type of assessment is
appropriate, any questions or concerns should be discussed with the Bilingual Specialist.
What is the purpose of a language dominance test?
Language dominance is a pre-referral procedure conducted by the Bilingual Specialist to:
Determine home language proficiency and skills
Establish English proficiency and skills within the second language acquisition
continuum
Identify dominant language(s), if any, for the purpose of further evaluation and
assessment, if needed
Address referral concerns, using second language acquisition research and
Bilingual or second language learner perspective
Recommend effective classroom strategies and interventions when needed.
The language dominance test provides information that will help the school determine
appropriate interventions. Reports may also confirm the need to consider further testing.
Subsequently, language dominance test results help the multidisciplinary team determine
if special education evaluation should be initiated and in what language(s) further
assessment should be conducted.
When should a language dominance test be requested?
A language dominance test should be requested during Tier one of the pre- referral
process (See three tier steps of interventions). The language dominance test is a pre-
referral procedure that must be completed before parent consent for further evaluation is
granted. Thus, the language dominance report helps the school determine the need for
further action and identifies the appropriate language for testing, if assessment is
indicated.
What are the components of a language dominance test?
The language dominance test consists of a variety of formal, standardized assessment
instruments and alternative measures. Tests are administered in both English and the
students home language, by the bilingual specialist and if needed a trained interpreter. A
report is submitted to the schools Multidisiplinary team.
Each language dominance test is tailored to the specific student according to his or her
age, grade level, length of time in the United States and/or in English-speaking schools,
and the concerns stated in the referral. The assessment explores academic areas that tap
into both languages and higher-level thinking skills. The assessment can include
evaluating the students receptive and expressive vocabulary, oral communication ability,
reading comprehension, story retelling ability, and writing skills, among other domains.
4
The length of the Language dominance test varies depending on the literacy level of each
individual student.
Formal assessment instruments include:
Woodcock Munoz Language Survey (WMLS-R)
1. Picture Vocabulary-measures expressive semantic tasks at the single-word level
2. Verbal analogies measures the ability to comprehend and verbally complete a
logical word relationship.
3. Letter word identification measures the subjects reading identification skills
with isolated letters and words that appear in large type on the subjects side of
the Test Book.
4. Dictationmeasures prewriting skills and measures the subjects ability to
respond in writing to a variety of questions pertaining to letterforms, spelling,
punctuation, capitalization, and word usage.
5. Understanding Directions-- understanding directions measures aspects of oral
language including listening skills, lexical knowledge, and working memory.
6. Story Recall---measures aspects of oral language including listening skills,
meaningful memory, and expressive language. The task requires the subject to
recall increasingly complex stories that are presented using an audio recording.
7. Passage Comprehension--passage comprehension measures how well a subject
understands written discourse as it is being read.
Bilingual Verbal Ability Test (BVAT)
1. Picture Vocabularymeasures the ability to name familiar and unfamiliar
pictures objects.
2. Oral Vocabularymeasures knowledge of word meanings.
3. Verbal Analogiesmeasures the ability to comprehend and verbally complete a
logical word relationship.
Who should request a language dominance test?
While individual teachers, counselors, administrators, other school personnel, parents, or
primary caregivers may request consideration for a language dominance assessment,
referrals must show evidence that the school has followed Tier one of the RTI process.
The process requires that a group of educators or a team at the school level discuss
concerns and that a consensus on the need for a Language dominance assessment be
reached after other interventions have been systematically implemented. The members of
an in-school problem solving team, including the referring source (s) and ESL teacher,
are best able to initiate consideration for a language dominance assessment and serve as a
contact for the Bilingual Specialist in Special Services.
Melissa Eldridge
Bilingual Specialist
Special Services
Oklahoma City Schools
WAIVER FOR LANGUAGE DOMINANCE TESTING
Initial Re-evaluation
STUDENT REFERRED FOR TESTING:
Date Received: __________________________________
Name of Student:___________________________Date of Birth: ____________ Age_______
School: _ __ _ ________ Grade: _______ ID# _____________________
Classroom Teacher (case worker): __ _______________________
Reason for Request: __ ________________
* Requested by:_____ ___________________________
Language Spoken At Home: ____ ___________________________________
Reason for Waiver:
Recommendation:
It is recommended the placement team should consider information from this evaluation along
with any other evaluations and pertinent information, including the Bilingual Classroom
Communication Profile (BCCP) and the WIDA Test for consideration for assessment.
Melissa Eldridge, Bilingual Specialist Date:
Special Services
OKLAHOMA CITY PUBLIC SCHOOLS
Educating Students for Life-Long Learning and Responsible Living
LINDSEY NICOLE HENRY SCHOLARSHIP
HB 1744 is a law (70 S.D. 13-102.2) that amended the LNH Scholarship Act
beginning August 26, 2011. Section A of the Act allows the parent/guardian of a public
school student with a disability to exercise their parental option and request to have an
LNH Scholarship awarded for their child to enroll in and attend a private school, if the
child is on an Individualized Education Program (IEP) prior to the request and has spent
the previous school year in attendance at a public school in the state by being reported
by a school district for funding purposes during that year.
You must formally withdraw your child from the public school district where he or she is
enrolled upon receipt of approval for the LNH Scholarship. Failure to withdraw your child
from the district may affect your eligibility status to receive the scholarship.
Application Procedure
1. The parent must first choose an approved private school. Approved Pri vate
Schools List
2. The LNH Scholarship Application must be submitted by the parent/guardian to the
Oklahoma State Department of Education (OSDE) by mail or fax, with the required
documentation, by December 1 of the year that parent/guardian is seeking the
scholarship. All applications received after December 1, beginning with the 2010-2011
school year, will be processed for the following school year.
3. The application process must be completed with the OSDE each year that the
parent/guardian chooses to participate in LNH Scholarship.
To request the LNH Scholarship for your child with a disability, please submit a
completed copy of the LNH Scholarship Application (available below) with all required
documentation to the OSDE. You may also call (405) 521-4865 to receive an
application packet by mail.
Please contact Anita Eccard, Associate State Director at (405) 521-4865.
Educating Students for Life-Long Learning and Responsible Living
To: Parent or Legal Guardian of a Public School Student with a Disability
From: Michele Miller-Hayes, Director of Special Services
Erin Trussell, Private School Special Services Coordinator
Date: August 4, 2011
Subject: Notification of Educational Options Available through the Lindsey
Nicole Henry Scholarship for Student with Disabilities
House Bill 3393 is a law (70 S.D. 13-102.2) that became effective August 27, 2010.
The bill created a scholarship for use at a private school accredited by the State Board of
Education for students with Individualized Education Programs (IEPs).
HB 1744 is a law (70 S.D. 13-102.2) that amends the LNH Scholarship Act beginning
August 26, 2011. Section A of the Act allows the parent/guardian of a public school
student with a disability to exercise their parental option and request to have an LNH
Scholarship awarded for their child to enroll in and attend a private school, if the child
was on an IEP prior to the request and has spent the previous school year in attendance at
a public school in the state by being reported by a school district for funding purposes
during that year. Exceptions will apply to a student who is a child of a member of the
United States Armed Forces who transfers to a state from out of state or from a foreign
country pursuant to the permanent change of station orders.
Section B of the Act requires the parent/guardian to notify the OSDE directly of the
intent to participate in the LNH Scholarship program. The parent/guardian must make
this request by completing the application process to provide necessary eligibility and
accountability information annually.
The LNH Scholarship Application will be available online to parents/guardians on the
Oklahoma State Department website at www.sde.state.ok.us and can also be downloaded
and mailed or faxed to the OSDE for the parent/guardians convenience. Applications
received after the December 1 deadline will be considered for the following school year.
If you have additional questions about the LNH Scholarship Application process,
please contact Anita Eccard, Associate State Director at (405) 521-4865.
Educating Students for Life-Long Learning and Responsible Living
Knh gi: Ph Huynh hoc Ngi Bo H Hc Sinh Khuyt Tt trng Cng Lp
Ngi Gi: Michele Miller-Hayes, Gim c Dch V c Bit
Charleen Hudson, Phi Tr Vin Dch V c Bit T Thc
Ngy: 4 thng Tm, 2011
Ni Dung: Thng Bo cc kh nng tu chn ca Hc Bng Lindsey Nicole
Henry cho Hc Sinh Khuyt Tt
D Lut 3393 l lut (70 S.D. 13-102.2) c hiu lc t ngy 27 thng Tm, 2010. D lut
cp hc bng dng cho trng t c B Gio Dc Tiu Bang chp nhn i vi Chng
Trnh Gio Dc C Nhn (Individualized Education Programs - IEPs).
HB 1744 l lut (70 S.D. 13-102.2) b tc cho o Lut Hc Bng LNH bt u ngy 26
thng Tm, 2011. Khon A ca o Lut cho php ph huynh/ngi bo h c con em l hc
sinh khuyt tt hc trng cng lp c hnh s quyn chn la ca mnh v yu cu c cp
Hc Bng LNH con em ca h c th ghi danh v theo hc trng t, nu tr trong
chng trnh IEP trc khi yu cu v theo hc trng cng lp nm trc thuc tiu bang
c phn b bo co nhm xin tin trong nm qua. Hc sinh c hng ngoi l l con em
ca Qun Lc Hoa K, ngi c thuyn chuyn ti t tiu bang khc hoc t nc ngoi
thay i ni lm vic thng trc.
Khon B ca o Lut yu cu ph huynh/ngi bo h phi thng bo trc tip cho B Gio
Dc Tiu Bang (OSDE) l mun tham gia chng trnh Hc Bng LNH. Ph huynh/ngi bo
h thc hin yu cu ny bng cch hon tt mu n cung cp nhng thng tin cn thit v
vic hp l v trch nhim hng nm.
n xin Hc Bng LNH c trn mng in ton ca Tiu Bang Oklahoma ti
www.sde.state.ok.us ph huynh c th ti n xung sau tu nghi c th dng in tn
hoc gi th cho B Gio Dc. n np sau ngy hn nh 1 thng Mi Hai s coi nh dng
cho nm hc ti.
Nu qu v c thc mc g v tin trnh xin Hc Bng LNH, vui lng lin lc vi Anita
Eccard, Ph T Gim c Tiu Bang in thoi s (405) 521-4865.
Vietnamese
Educating Students for Life-Long Learning and Responsible Living
Para: Padre o guardin legal de un estudiante de la escuela pblica con una inhabilidad
De: Michele Miller-Hayes, Directora de Servicios Especiales ,
Erin Trussell, Coordinadora de Servicios Especiales para las Escuelas Privadas
Fecha: 4 de agosto de 2011
Asunto: Notificacin de las opciones educativas disponibles por medio de la beca de Lindsey
Nicole Henry (LNH) para estudiantes con inhabilidades
El Proyecto de Ley de la Cmara 3393 es una ley ( 13-102.2 de 70 S.D.) que entr en vigor el 27 de
agosto de 2010. El Proyecto de Ley cre una beca para el uso en una escuela privada que haya sido
acreditada por la Direccin de Educacin Estatal para los estudiantes que estn en un programa
educativo individualizado (IEP).
El Proyecto de Ley de la Cmara 1744 es una ley ( 13-102.2 de 70 S.D.) que enmend la beca de LNH a
partir del 26 de agosto de 2011. La seccin A del Acto permite que el padre o guardin de un estudiante
con una inhabilidad que asiste a una escuela pblica ejercite su opcin parental para pedir una beca de
LNH. La beca le puede ser otorgada a un nio para que se inscriba y asista a una escuela privada
siempre y cuando el nio ya haya estado en un IEP antes de solicitar una beca, el ao pasado escolar
haya asistido a una escuela pblica dentro del estado y haya sido reportado por ese distrito escolar para
los propsitos de financiamiento durante ese ao. Las excepciones aplicarn a un estudiante que sea un
nio de un miembro de las fuerzas armadas de de los Estados Unidos que se transfiera a un estado de
otro estado o de un pas extranjero conforme al cambio permanente de las rdenes del puesto.
La seccin B del acto requiere que el padre o guardin le notifique al Departamento de Educacin del
Estado directamente de su intencin de participar en el programa de la beca de LNH. El padre o
guardin debe hacer esta peticin anualmente siguiendo el proceso de la solicitud. Este proceso es
necesario para los propsitos de elegibilidad y rendicin de cuentas.
La solicitud para la beca de LNH estar disponible para los padres o guardianes en la Internet en la
pgina Web del Departamento de Educacin del Estado de Oklahoma (OSDE) en: www.sde.state.ok.us.
Tambin puede bajarse y enviarse por correo o por fax al OSDE para la conveniencia del padre o
guardin. Las solicitudes recibidas despus del plazo del 1 de diciembre sern consideradas para el
prximo ao escolar.
Si usted tiene preguntas adicionales sobre el proceso para solicitar la beca de LNH, favor de ponerse en
contacto con Anita Eccard, Directora Adjunta del Estado al (405) 521-4865.
MANIFESTATION DETERMINATION
Remember: All steps on the Discipline Procedure Form are prerequisite to the
Manifestation Determination.
All change of placement requires a Manifestation Determination within 10 school days. The
TEAM must consider all relevant information in the childs file including IEP, teacher
observations, FBA, and BIP. In addition consider the following: assessment data,
strengths/needs, psychological evaluations, attendance, grades, parent and teacher input.
Key factors to consider when discussing possible suspension are:
1. Is the students misconduct a result of the disability?
2. Is the students misconduct a result of inappropriate placement or services?
3. Is the BIP appropriate?
4. Does the FBA address this type of incident or referral?
If the manifestation review indicates deficiencies in the areas listed above, immediate steps
need to be taken.
It may be determined that the behavior was not a manifestation of the childs disability, if the
review of relevant information (listed above) determines that the conduct in question was not
caused by or have a direct relationship to the childs disability.
Parents have the right to challenge the findings of the manifestation review. The only exception
is alternative placement due to drugs, weapons, or serious bodily injury.
If a suspension of more than 10 days is documented or determined appropriate, the IEP TEAM
shall determine and record in the IEP appropriate special education services to be provided
during the suspension, including any change to a more restrictive placement before such a
change occurs. Long-term suspension does not relieve a building of its responsibility to
educate the student.
Consider after school hours, Saturday school, in-school suspension, online school, or
in-house alternative placement.
Refer to p. 205 of the Special
Education Handbook.
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
OSDE Form 9 Page 1 of 2
BIRTHDATE: ___________________ GRADE ____________ AGE ___________ DATE: _______________________
MONTH/DAY/YEAR MONTH/DAY/YEAR
PARENT(S):_________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) __________________________
HOME ADDRESS: ___________________________________________________________ DISTRICT/AGENCY: _____________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
TO BE COMPLETED BY THE SCHOOL
Referral Date____________ School Contact Person _________________________________ Phone _______________________
Medical concerns about this child are as follows:
At school
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
At home
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
NOTE: Consent for Release of Confidential Information with parent signature, is required.
TO BE COMPLETED BY A LICENSED MEDICAL DOCTOR, DOCTOR OF OSTEOPATHY, OR
ADVANCED REGISTERED NURSE PRACTITIONER (ARNP)
Information in the following areas would be helpful to the school and parents in planning for the childs educational needs. Please
respond as appropriate, including any applicable medical diagnoses.
General health:
Motor functioning:
Neurological findings:
Allergies:
MEDICAL REPORT
Medical Report
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
Dietary considerations:
Vision (attach eye report):
Hearing:
Medications, including purpose:
Other pertinent information:
Please indicate ways in which any of the above may adversely affect behavior.
Is further medical evaluation or treatment planned for any specific area?
In what ways may your medical findings affect the schools educational or behavioral planning?
In what ways can school personnel facilitate ongoing communication with you?
If the child is involved in the Systems of Care program, please describe.
This information will be maintained in accordance with the Family Educational Rights and Privacy Act (34 CFR Part 99) and
Individuals with Disabilities Education Act (IDEA).
Medical or epidemiological information or records which identify any person as having a communicable or venereal disease (such
as hepatitis, syphilis, gonorrhea, and the human immunodeficiency virus [also known as AIDS]) shall be strictly classified as
confidential pursuant to Title 63 O.S. 502.2.
Physicians or ARNPs name address, and telephone number
(typed or stamped)
_________________________________________________
Physicians/ARNPs Signature
_________________________________________________
Date
OSDE Form 9 Page 2 of 2
MEDICATION
IDEA 2004 prohibits LEA (Local Education Agency) personnel from requiring parents to
medicate their child as a condition of attending school, receiving an evaluation, or
receiving services.
Doctors order must be on file to dispense medication and provide tube feedings.
Medical plans are necessary for directions if the nurse is absent. Best practice is to have
a three tier plan in place. (i.e. nurse, secretary, teacher)
For regular education students that may need a 504 plan refer to 504 section.
If you have any questions contact your school nurse or Debbie Johnson, Health Services
at 587-0250.
Refer to p. 17 of the Policy and
Procedure Manual for more
information.
MEEGS
MULTIDISCIPLINARY EVALUATION AND ELIGIBILITY GROUP
SUMMARY
Team members:
Parent
Qualified Examiner
Special Education Teacher(s)
Must have certification, registry, or emergency endorsement in the
disability category listed on page 1 of the MEEGS. Contact your Special
Services Supervisor if no one in your building has the necessary
certification/registry.
Regular Teacher
Others may include (SLP, bilingual specialist, OT, PT, etc.)
If Speech / Language Impairment is identified as a disability, the SLPs
attendance is mandatory.
Eligibility
Not eligible - implement recommendations
Eligible - implement IEP process
Refer to p. 61 of the Special
Education Handbook.
MODIFICATIONS
The IEP team should determine what modifications should be made in the regular
classroom to ensure student success. Specific modifications should be addressed in the
IEP per subject and location. Regular teachers must be given information regarding
specific modifications and/or accommodations for each student they serve who receives
special education services.
Examples:
Shortened assignments (break assignments into segments)
Contracts
Positive consequences (stickers, pens, etc.)
Peer tutor
Highlight key words/phrases
Organizers
Timers
Take home tests/assignments
Hands on activities/assignments
Alternative assignments
Taped lessons/tests/answers
Behavior sheets
Assigned study area
Seating arrangements
Allow movement when possible (errands, standing to work, etc.)
Oral tests/assignments
Open book exams
Extra time for tests/assignments
Reduced complexity of assignments
OSDE Form 6 Page 1 of 1
NOMBRE DEL NIO: ____________________________________________________ ID. DE ALUMNO: ___________________
PRIMER NOMBRE SEGUNDO NOMBRE APELLIDO
FECHA DE NACIMIENTO: ___________________ GRADO: ____________ EDAD: ___________ FECHA: __________________
MES / DA / AO MES / DA / AO
PADRE(S):___________________________________________________________________________________________________
TELFONO: (TRABAJ O) _______________________ (CASA) ________________________ (OTRO) ______________________
DIRECCIN: ___________________________________________________________ DISTRITO /AGENCIA: ______________
CALLE / APARTADO POSTAL CIUDAD ESTADO C. POSTAL
PARA: _______________________________________________________________________________________________________
PADRE/MADRE Y NIO (SI SE ESTN CONSIDERANDO LOS SERVICIOS DE TRANSICIN)
Nos gustara reunirnos con usted para platicar sobre:
Evaluacin / elegibilidad / identificacin de discapacidad que requiere servicios de educacin especial.
Colocacin / Programa de Educacin Individualizada (IEP).
Transicin desde los servicios de intervencin temprana a la educacin preescolar.
Revisin de la colocacin / IEP.
Reevaluacin para determinar si hay discapacidad y su naturaleza, el grado de educacin especial y servicios relacionados necesarios.
Consideracin de los servicios de transicin necesarios (a partir del 9no grado o al cumplir los 16 aos de edad, lo que ocurra primero).
Consideracin de los servicios de Ao Escolar Extendido (ESY).
Otras opciones a considerar (si corresponde): _______________________________________________________________________________
LUGAR DE LA REUNIN (Edificio / Sala)
DIRECCIN
el a las
FECHA HORA
Esta reunin nos dar la oportunidad de platicar sobre el programa educativo de su nio y cualquier cambio que pudiera ser necesario para poder
brindarle los servicios apropiados. Se debe invitar a los alumnos a asistir a las reuniones con el fin de considerar los servicios de transicin que
comenzarn a ms tardar cuando se desarrolla el primer IEP durante el noveno grado del alumno o al cumplir los 16 aos de edad, lo que ocurra
primero. Como padre, usted decidir si su nio menor de edad asistir. Se puede invitar a la reunin a representantes de agencias que podran ser
responsables de brindar los servicios de transicin, previo consentimiento por escrito de los padres. Segn su discrecin o la discrecin de la agencia,
podran tambin ser miembros del Equipo IEP otros individuos que tengan conocimiento o experiencia especial sobre el nio.
Las personas indicadas abajo deben asistir: Las personas seleccionadas abajo estn invitadas a asistir:
Padre/Madre Proveedor(es) de servicios relacionados Representante de Parte C de IDEA
Maestro de educacin regular Consejero de rehabilitacin vocacional Otro ______________________
Maestro de educacin especial Alumno Otro ______________________
Representante administrativo Examinador calificado Otro ______________________
Por favor comunquese con la persona en la direccin, nmero de telfono o direccin de correo electrnico que se indican abajo antes del
_____/_____/_____ para confirmar si se puede reunir en el lugar y la hora acordados mutuamente sugeridos, o si se deberan hacer otros arreglos que
le sean convenientes. Si ninguno de los padres puede asistir, la agencia pondr a disponibilidad de los padres otros mtodos de participacin,
incluyendo llamados telefnicos individuales o en conferencia y copias del IEP. El programa y servicios educativos de su nio no sern modificados
antes de la reunin para poder garantizarle a usted la oportunidad de participar. Se harn arreglos para contar con servicios de
traduccin/interpretacin si usted as lo solicita. Los padres cuentan con proteccin bajo los derechos y garantas de procedimiento. Si tiene alguna
pregunta sobre este aviso o sobre sus derechos, por favor comunquese con la persona que se indica en este formulario. Puede buscar recursos
adicionales en el documento Derechos de los Padres en la Educacin Especial: Aviso de Derechos y Garantas de Procedimiento. Para conseguir
una copia, comunquese con <llenar con maestro de educacin especial>.
DE: ____________________________________________________________________________________________________
FIRMA DEL FUNCIONARIO DEL DISTRITO / AGENCIA PBLICA DISTRITO / AGENCIA TELFONO FECHA
___________________________________________________________________________________________________________
CALLE / APARTADO POSTAL CIUDAD ESTADO CDIGO POSTAL CORREO ELECTRNICO
SCHOOL USE ONLY: Notice sent by: U.S. Mail Date Mailed __________
Personal Delivery Date Delivered __________
Translation/interpretation needed? Yes No If yes, specify how and when provided:____________________________
School/public agency officials signature verifies that parent(s) have received an explanation in their native language or other mode of communication to
accommodate the parent(s) understanding their rights.
AVISO DE REUNIN
GIY THNG BO CUC HP
TN CA A TR:___________________________________S TH HC SINH:____________________
TN TN LT H
NGY SINH:_____________________ LP:__________TUI:__________ NGY:____________________
THNG/NGY/NM THNG/NGY/NM
PH HUYNH:________________________________________________________________________________
S IN THOI: (S LM)___________________(NH)_______________(S KHC)_________________
A CH NH:___________________________________________________QUN/C QUAN:____________
A CH NG/S HP TH THNH PH TIU BANG S M VNG
GI TI:____________________________________________________________________________________
PH HUYNH V A TR (NU DCH V CHUYN TIP C XEM XT)
Chng ti mun gp qu v tho lun:
Gim nh/iu kin hng/nhn nh khuyt tt cn gio dc c bit
t ch/Chng Trnh Gio Dc C Nhn (IEP)
Chuyn tip t nhng dch v can thip sm ti lp mu gio
Duyt xt vic t ch/IEP
Ti gim nh n nh s khuyt tch v bn cht, mc gio dc c bit v nhng dch v lin h cn thit.
Xem xt nhng dch v chuyn tip cn thit (Bt u trong lp chin hay khi t 16 tui, ty theo ci no ti trc)
Xem xt nhng dch v cho Nin Hc Ko Di (ESY)
Xem xt nhng la chn khc (nu thch nghi): ____________________________________________________
A IM CUC HP (Ta nh/Phng) A CH
Vo ngy___________________________________ vo lc__________________________________________
NGY GI
Cuc hi tho ny s to mt c hi tho lun chng trnh gio dc ca con qu v v nhng s sa i no cn thit cung cp
nhng dch v thch nghi. Nhng hc sinh phi c mi ti tham d nhng cuc hp vi mc ch xem xt nhng dch v chuyn
tp bt u khng tr hn IEP u tin c hoch nh trong lo chin ca hc sinh hay khi t 16 tui, ty theo ci no ti trc. L
ph huynh, qu v s quyt nh l tr v thnh nin c tham d hay khng. (Nhng) i din t nhng c quan c th c trch nhim
cung cp nhng dch v chuyn tip phi c mi ti bui hp, vi s ng thnh vn ca ph huynh.. Ty theo quyt nh ca qu
v hay c quan, nhng c nhn khc m c hiu bit hay chuyn mn c bit v a tr cng c th l mt thnh vin ca i IEP.
Nhng ngi di y phi thamd: Nhng ngi c chn di y c mi tham d:
Ph huynh (Nhng) Ngi Cung cp Dch v Lin h i din IDEA Phn C
Thy dy Gio dc Thng C vn Phc hi Hun ngh Ngi khc_________
Thy dy Gio dc c bit Hc sinh Ngi khc_________
i din Ban Qun l Trc nghim vin kh nng Ngi khc_________
Xin lin lc ngi a ch hay s in thoi di y trc ngy ____/____/____ cho bit qu v c th gp vo gi v a im
c ngh hay cn s sp xp no khc thun tin cho qu v. Nu c hai ph huynh khng thamd c, c quan phi sp xp
nhng phng cch tham gia khc cho ph huynh, k c tho lun c nhn hay ha mbng in thoi v nhng bn sao ca IEP.
Chng trnh gio dc v dch v cho con emqu v s khng thay i trc cuc hp qu v c c hi tham gia. Phin dch/thng
dch s c sp xp nu c s yu cu. Ph huynh c s bo v theo nhng th tc bin php an ton. Nu qu v mun hi g v
giy thng bo ny hay nhng quyn hn ca qu v, xin lin lc vi ngi c tn trong trong bn ny. Nhng ngun thng tin thm c
th tm thy trong tp Quyn hn ca Ph huynh trong Chng trnh Gio dc c bit: Thng bo nhng Th tc Bin php An ton.
c mt bn, xin lin lc <autofill special education teacher>.
T:__________________________________________________________________________________________
CH K CA VIN CHC KHU HC/C QUAN CNG KHU HC/C QUAN S IN THOI NGY
A CH NG/HP TH THNH PH TIU BANG S M VNG
CH TRNG GHI VO Y M THI: Giy bo gi bng: Bu in Hoa k Ngy gi____________________
a tay Ngy a tay________________
Cn thng dch/phin dch vin? C Khng Nu ghi c, cho bit cung cp cch no v khi no:_______________
Ch k ca vin chc trng/c quan cng xc nhn l (nhng) ph huynh nhn c bn gii thch bng ngn ng gc ca h hay bng mt
phng cch truyn t khc gip h hiu nhng quyn hn ca h.
OSDE Mu 6 Trang 1 ca 1 trang
NOTIFICATION OF MEETING
The Notification of Meeting:
10 days notice is recommended unless parent waives this
right.
Must be early enough to ensure parents have opportunity to
attend.
Meeting is scheduled at a mutually agreed upon time and
place.
2 attempts one personal contact (documented home visits,
phone calls, video conference, mail, email) & a written contact
(Notification of Meeting) mailed through US Mail = due
diligence.
The Notification of Meeting must include checked boxes
indicating the purpose(s) of the meeting
A written notice is required for a referral for reevaluation, request
for parent consent, manifestation determination, and when a
parent is not present.
Hold meeting if the parent does not show for the meeting after due
diligence. This meeting must be held on date and time specified on
the previous notification of meeting. Send the Written Notice of
Meeting, copy of the IEP, and Parent Rights.
Refer to p. 60 of the Special
Education Handbook.
To: Superintendents, District Test Coordinators, and Special Education Directors
From: Maridyth McBee, Assistant State Superintendent of Assessment and Accountability;
Rene Axtell, Assistant State Superintendent of Special Education Services
Date: February 28, 2013
RE: Phase out plan and timeline for the elimination of the Oklahoma Modified Alternate
Assessment Program (OMAAP), Grades 3-8 and End-of-Instruction (EOI)
The Oklahoma State Department of Education (OSDE) has been in a state of transition to the
Partnership for Assessment of Readiness for College and Careers (PARCC) since the adoption of
the Common Core State Standards (CCSS) in the Spring of 2010. The purpose of this memo is
to outline the specific changes regarding the assessment options for students with
disabilities discussed by the previous memo dated February 5
th
, 2013 (link below). These
changes will have an impact upon students with disabilities, Individualized Education Programs
(IEPs), assessment, and student results.
1. Beginning with the 2013-2014 school year, the OMAAP will not be an assessment option for
first time test takers.
Students with disabilities who were previously eligible for alternate assessments based on
modified academic achievement standards will be included in the high-quality assessment
based on grade-level academic achievement standards beginning with the 2013-2014
school year.
2. Students who were previously administered the OMAAP EOIs during 2012-13 or earlier
and were unsuccessful will have the opportunity to retake an OMAAP in the same subject area
in order to apply a modified proficiency score.
This option will remain in place through the 2015-2016 school year for every student
who participated in the OMAAP for the first time prior to the start of the 2013-2014
school year. This timeframe will provide students the opportunity to retake the OMAAP
in the same subject area in order to apply a modified proficiency score.
What do these changes mean for Oklahoma students with disabilities and assessments during
SY 2013-14?
All students who are first time test takers within a subject area must either participate in
the Oklahoma Core Curriculum Test (OCCT) or the OAAP assessment.
Core Instruction should focus on the new Oklahoma C3 Standards.
Placement decisions should focus on the least restrictive environment that affords a
student access to the Oklahoma C3 Standards and core content curriculum.
Instructional and Assessment Accommodations should focus on providing appropriate
access that does not decrease learning expectations.
TIMELINE*
2013-2014 2014-2015 2015-2016
2016-2017 and
beyond
All first time test takers
in a subject area must
participate in the OCCT
or OAAP.
All first time test takers
in a subject area must
participate in the OCCT
or OAAP.
All first time test takers
in a subject area must
participate in the OCCT
or OAAP.
All students, including
second time test
takers, must
participate in the
OCCT or OAAP for
all subjects.
Any student who
participated in the
OMAAP during the
2012-2013 school year
or earlier and was
unsuccessful has the
option to retake the
OMAAP in the same
subject area in order to
apply a modified
proficiency score for
ACE graduation
requirements.
Any student who
participated in the
OMAAP during the
2012-2013 school year
or earlier and was
unsuccessful has the
option to retake the
OMAAP in the same
subject area in order to
apply a modified
proficiency score for
ACE graduation
requirements.
Any student who
participated in the
OMAAP during the
2012-2013 school year
or earlier and was
unsuccessful has the
option to retake the
OMAAP in the same
subject area in order to
apply a modified
proficiency score for
ACE graduation
requirements.
There will be no
OMAAP option in
any subject area
available for second
time test takers.
*The number of students needing to utilize the OMAAP for a modified proficiency score will
decrease substantially over these school years. The focus of IEP and LIEP teams should be on
selecting appropriate accommodations in order for students to be successful in the regular
assessment.
OSDE Formulario 4 Pgina 1 de 1
NOMBRE DEL NIO:_________________________________________________ ID DEL ESTUDIANTE:______________________
PRIMER INICIAL APELLIDO
FECHA DE NACIMIENTO______________ GRADO: ____________ EDAD:____________ FECHA: ________________________
MES/DIA/AO MES/DA/AO
PADRE(S):________________________________________________________________________________________________
TELFONO: (TRABAJ O) _______________________ (DOMICILIO) ________________________ (OTRO) _____________________________
DOMICILIO: ____________________________________________________ DISTRITO/AGENCIA: ______________________
DIRECCIN/APARTADO POSTAL CIUDAD/ESTADO CDIGO POSTAL
Se solicita consentimiento para lo siguiente:
Evaluacin inicial
Reevaluacin
Enmienda/Modificaciones al Programa de Educacin Individualizada (IEP)
Acceso ayudas pblicas o seguro (debe obtenerse cada vez que el organismo pblico intenta acceder; debe ser
voluntario por parte del (de los) padre(s)).
Asistencia equipo del IEP: dispensa para un miembro del equipo del IEP, total o parcial
________________________________________ __________________________________________ _______________________
(Nombre del miembro dispensado) (Representante del LEA) (Fecha)
Miembros de organismo(s) externo(s) que financia(n) o presta(n) servicios de transicin secundarios para
asistir a reuniones del IEP
_____________________________________________________ _______________________a ____________________________
(Organismo) (Fecha) (Fecha)
_____________________________________________________ _______________________a ____________________________
(Organismo) (Fecha) (Fecha)
PADRE(S):
Se explican los procedimientos de valoracin que se utilizarn para evaluar las reas de funcionamiento en la notificacin escrita a los
padres, OSDE Formulario 8. He recibido una explicacin de la evaluacin propuesta y los procedimientos de evaluacin que se
utilizarn. Estoy al tanto de las protecciones dispuestas segn las garantas procesales. He recibido una copia de los Derechos de los
padres en educacin especial: Notificacin de las garantas procesales _______________ (iniciales de los padres).
Por recursos adicionales, comunquese con su organismo de educacin local (LEA) al nmero telefnico que sigue. Tambin puede
comunicarse con el Departamento de Educacin del Estado de Oklahoma (OSDE), Servicios de Educacin Especial (SES) al (405) 522-
3248 o visitando el sitio Web del OSDE-SES Web en <www.sde.state.ok.us>.
_____________________________________________________________________________________________________________
FIRMA DEL PADRE FECHA
DE: _______________________________________________________________________________________________________
FIRMA DEL FUNCIONARIO DEL DISTRITO/ORGANISMO PBLICO TELFONO FECHA
_______________________________________________________________________________________________________
DIRECCIN/APARTADO POSTAL CIUDAD ESTADO CDIGO POSTAL
USO ESCOLAR
NICAMENTE:
Notificacin enviada por: Correo de EE. UU. Fecha envo __________
Entrega en mano Fecha entrega __________
Se necesita traduccin/interpretacin? S No Si s, especificar cmo y cundo se necesita:__________________________
La firma del funcionario de la escuela/organismo pblico confirma que el(los) padre(s) han recibido una explicacin en su lengua nativa u otra forma de
comunicacin de modo que el(los) padre(s) entienda(n) sus derechos.
CONSENTIMIENTO DE LOS PADRES
Mu 4 OSDE Trang 1 ca 1
TN A TR: ____________________________________________________S TH HC SINH: ______________________
TN/TN LT/H
NGY SINH: _______________________LP: ________________ TUI: _______________ NGY: ______________________
THNG/NGY/NM THNG/NGYNM
PH HUYNH:_____________________________________________________________________________________________
IN THOI (S LM): _______________________ (NH) ________________________ (KHC) ______________________
A CH NH: ___________________________________________________________ QUN/C QUAN: _________________
A CH NG/HP TH THNH PH TIU BANG S M VNG
S ng ca ph huynh c yu cu cho iu sau y:
Gim nh s khi
Ti gim nh
Tu chnh/S i cho Chng Trnh Gio Dc C Nhn (IEP)
Tip cn Tr Cp Cng Cng hay Bo Him (Phi c s ng mi ln c quan cng cng mun tip cn; s
ng ca ph huynh phi l t nguyn.)
S c hin din ca nhm IEP: S min hin din ca mt thnh vin IEP, nguyn b hay mt phn
________________________________________ __________________________________________ _______________________
(Tn ca Thnh vin c Min) (i din LEA) (Ngy)
Thnh vin ca c quan ngoi ti tr hay cung cp dch v chuyn tip th yu tham d nhng bui hp
IEP
____________________________________________________ _______________________ti ____________________________
(C quan) (Ngy) (Ngy)
_____________________________________________________ _______________________ti ____________________________
(C quan) (Ngy) (Ngy)
PH HUYNH:
Nhng th tc gim nh c dng c lng nhng chc nng c gii thch trong Giy Thng Bo cho Ph Huynh, Mu 8
OSDE. Ti c gii thch s gim nh ngh v nhng th tc gim nh c dng. Ti thng hiu nhng s bo v trong
nhng th tc bo v an ton. Ti nhn c mt bn Quyn Hn ca Ph Huynh trong Chng Trnh Gio Dc c Bit: Thng
Bo v nhng Th Tc Bo V An Ton. _______________ (Tn tt ca ph huynh)
bit thm thng tin xin lin lc vi c quan gio dc a phng (LEA) s in thoi di y. Qu v cng c th lin lc B
Gio Dc Oklahoma (OSDE), Dch V Gio Dc t Bit (SES) s (405) 522-3248 hay ving a ch mng ca OSDE-SES
<www.sde.state.ok.us>.
_________________________________________________________________________________________________________
CH K CA PH HUYNH NGY
T: _______________________________________________________________________________________________________
CH K CA VIN CHC KHU HC/C QUAN CNG KHU HC/ C QUAN IN THOI NGY
_________________________________________________________________________________________________________
A CH NG/HP TH THNH PH TIU BANG S M VNG
CH TRNG HC
GHI Y M THI:
Thng bo gi bng: Bu in Ngy gi __________
a tay Ngy a __________
Cn thng dch/phin dch? C Khng Nu c, ni r cung cp cch no v khi no:________________________
Ch k ca vin chc nh trng/c quan cng xc nhn rng ph huynh nhn c gii thch bng ngn ng chnh ca h hay bng phng cch truyn thng
khc gip ph huynh hiu quyn hn ca h.
S NG CA PH HUYNH
Parent Contact Form Details
The Record of Parent Contact Form should be utilized to document each
contact made with the parent/guardian.
This form is used to document all attempted contacts.
Parent Contacts should be documented in the online IEP platform. If a
paper copy is used, send the original to records.
OSDE Form 2 Page __ of __
NAME OF CHILD: ____________________________________________________STUDENT ID: ___________________________
FIRST MIDDLE LAST
BIRTHDATE: __________________ DISTRICT/AGENCY: ______________________________________________________
MONTH/DAY/YEAR
PARENT(S):__________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) ___________________________
HOME ADDRESS: ____________________________________________________________________________________________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
SPECIAL INSTRUCTIONS: _____________________________________________________________________________________
_____________________________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other______________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other______________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other ______________
Results:
Person Making Contact:
RECORD OF PARENT CONTACT
OSDE Form 2 Page __ of __
NAME OF CHILD: _________________________________________________STUDENT ID:
FIRST MIDDLE LAST
SPECIAL INSTRUCTIONS:
____________________________________________________________________________________________________________
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other___________________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other___________________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other
_______________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other
_______________
Results:
Person Making Contact:
RECORD OF PARENT CONTACT
PARENTS RIGHTS IN SPECIAL EDUCATION:
NOTICE OF PROCEDURAL SAFEGUARDS
As the parent(s) of a child who is receiving
or may be eligible for special education and
related services, you have certain rights
according to State and federal laws. If you
have questions about these rights and
procedural safeguards, please contact your
school district, or the Oklahoma State
Department of Education (OSDE), Special
Education Services (SES). These rights and
procedural safeguards are in accordance
with Federal Law, the Individuals with
Disabilities Education Act (IDEA) 2004.
In general, a copy of the procedural
safeguards must be given to you (or your
young adult who has reached the age of
majority18 years of age unless a guardian
has been appointed by a Court) only one
time per year, except that a copy must also
be given to you: upon initial referral or your
request for evaluation; upon the filing of a
State administrative complaint or due
process hearing complaint; upon your
request and if your student is subject to a
disciplinary change of placement. Your
school district may place a current copy of
the procedural safeguards notice on its Web
site if such Web site exists.
The procedural safeguards notice must
include a full explanation of the procedural
safeguards, written in a language
understandable to the general public, and
provided in your native language or other
mode of communication you use, unless it is
clearly not feasible to do so. If your native
language or other mode of communication is
not a written language, your school district
must ensure that the notice is translated
orally or by other means in your native
language or other mode of communication;
you understand the content of the notice;
and that there is written evidence that these
requirements have been met.
PRIOR WRITTEN NOTICE TO PARENTS
Your school district must provide prior
written notice to you each time it proposes
or refuses to initiate or change the
identification, evaluation, educational
placement of your child or the provision of a
free appropriate public education (FAPE) to
your child.
The notice must include:
A description of the action your
school district proposes or refuses to
take.
An explanation of why your school
district proposes or refuses to take
the action.
A description of any other options
that the Individualized Education
Program (IEP) Team considered and
the reasons why those options were
rejected.
A description of each evaluation
procedure, assessment, record, or
report your school district used in
2
INDEPENDENT EDUCATIONAL
EVALUATION
You have the right to obtain an independent
educational evaluation (IEE) for your child.
If you request an IEE, the school district
must provide you information about where
an IEE may be obtained.
An independent educational evaluation
means an evaluation conducted by a
qualified examiner who is not employed by
the school district responsible for the
education of your child.
IEE at public expense means that the school
district either pays for the full cost of the
evaluation or ensures that the evaluation is
otherwise provided at no cost to you.
Whenever an IEE is at public expense, the
criteria in which the evaluation is obtained,
including the location of the evaluation and
the qualifications of the examiner, must be
the same as the criteria that the school
district uses when it initiates an evaluation.
You have the right to an IEE at public
expense if you disagree with an evaluation
of your child obtained by your school
district. However, the school district may
initiate a due process complaint hearing to
show that its evaluation is appropriate. If the
final decision is that the evaluation is
appropriate, you still have the right to an
IEE, but not at public expense.
The school district may require you to
provide them prior notice before you obtain
an IEE at public expense; however, the
school district may not fail to pay for an IEE
if you do not notify the school district that
an IEE is being sought.
If you obtain an IEE at private or public
expense, theresults of the evaluation must
be considered by the school district in any
decision made with respect to the provision
of a FAPE to your child, and may be
presented as evidence at a due process
hearing regarding your child.
If a hearing officer requests an IEE as part
of a hearing decision, the cost of the
evaluation must be at public expense.
EDUCATION RECORDS-PERSONALLY
IDENTIFIABLE INFORMATION
An education record is information that the
school maintains that contains personally
identifiable information on your child.
Personally identifiable information includes:
the name of your child, your name, or other
family member names; the address of your
child; a personal identifier, such as your
child's social security number or student
number; or a list of personal characteristics
or other information that would make it
possible to identify your child with
reasonable certainty.
ACCESS RIGHTS
Each school district must permit you to
inspect and review any educational records
which are collected, maintained, or used by
your school district. The school district must
comply with your request without
unnecessary delay and before any meeting
regarding your childs IEP, a resolution
session or impartial due process hearing, and
in no case, more than 45 days after the
request has been made.
The right to inspect and review educational
records under this section includes:
Your right to a response from the
school district to your reasonable
requests for explanations and
interpretations of the records.
8
Page __ of __
PHYSICAL RESTRAINT DOCUMENTATION FORM
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
BIRTHDATE: ___________________ GRADE: ____________ AGE: ___________ DATE: ______________________
MONTH/DAY/YEAR MONTH/DAY/YEAR
PARENT(S):_________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) __________________________
HOME ADDRESS: ___________________________________________________________ DISTRICT/AGENCY: _____________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
Date of Incident: _________________________ Location: ____________________________________________________________
MONTH/DAY/YEAR
Beginning Time: ________________________________________ Ending Time: _________________________________________
School personnel involved in incident (additional documentation may be attached if determined necessary):
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe the students activity and behavior immediately preceding the behavior that prompted the use of physical restraint:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe efforts of school personnel to de-escalate the situation, and alternatives to physical restraint that were utilized prior to the use
of physical restraint:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Provide a description of the physical restraint utilized:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe the actions of the student and school personnel that occurred during the physical restraint:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OSDE Form 12
Page __ of __
Describe observed student and school employee behaviors that followed the physical restraint:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe de-escalation techniques and interventions utilized following the physical restraint:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe any injuries to the student or school employees:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe future alternatives to physical restraint that will be utilized:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signatures:
Person Completing Form: ____________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Notification to Parent:
Type: _____________________________ Time: _______________________ By whom: ________________________________
Date Information Provided to Parent: _________________________________ By whom: _________________________________
Page __ of __
Findings of debriefing meeting:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
*Individuals who disagree may submit separate statements presenting their conclusions. (Complete Comment Form as necessary).
If parent(s) did not attend the meeting, explain other methods to ensure parent participation and/or child as appropriate (e.g.,
conference call, videoconference, home visit): _____________________________________________________________________
PLACEMENT
Placement in special education programs is determined by:
IEP teams consideration of least restrictive environment
(LRE) and students need
Eligibility category is not the determining factor in deciding
placement.
The IEP team determines placement.
The students categorical eligibility can be different from the
program placement.
The placement decision is based on the students individual
strengths and needs.
The placement must be in the least restrictive environment.
Examples of possible placement options:
Eligibility Emotionally Disturbed
Placement Specific Learning Disabilities Program/Mild-
Moderate
Eligibility Other Health Impaired
Placement Program for the Emotionally Disturbed
These placements are both legal and appropriate. Teachers can
service students who are not under their certification/registry areas.
However, teachers must have certification and/or registry in the
students categorical disability area in order to be a case manager of
that student and sign the IEP.
Contact your Instructional Supervisor if you need assistance.
PROCEDURAL SAFEGUARDS
(Parent Rights)
OKCPS requires a copy of the procedural safeguards (Parent Rights)
be given to the parents of a child with a disability at least one time per
year.
A copy must be given to the parents in the following situations:
initial referral
parental request for an evaluation
initial eligibility/re-evaluation
IEP
filing of a State complaint/request for a Due Process
parent request
Refer to p. 59 of the Special
Education Handbook.
PROCEDURES FOR REQUESTING A ONE-ON-ONE ASSISTANT:
1. A STUDENT MUST HAVE A BEHAVIOR INTERVENTION PLAN IN PLACE BEFORE REQUESTING A ONE-ON-
ONE ASSISTANT.
2. THE BEHAVIOR INTERVENTION PLAN MUST BE WORKED FOR 4-6 WEEKS. IF IT IS NOT WORKING, YOU
MUST SHOW DATA ON ONE OF THE APPROVED DATA COLLECTION FORMS ATTACHED, OF THE
INTERVENTIONS AND BEHAVIOR BEING SHOWN BY THE STUDENT.
3. PLEASE THEN SEND THIS FIRST BIP AND DATA TO mvmiller-hayes@okcps.org AND AN OBSERVATION
WILL BE SCHEDULED.
4. YOU MUST THEN WRITE A NEW BEHAVIOR INTERVENTION PLAN AND WORK THIS BIP FOR 4-6 WEEKS.
IF IT IS NOT WORKING, YOU MUST SHOW DATA ON ONE OF THE APPROVED DATA COLLECTION FORMS
ATTACHED, OF THE INTERVENTIONS AND BEHAVIOR BEING SHOWN BY THE STUDENT.
5. WHEN BOTH BIPS BECOME UNSUCCESSFUL, YOU WILL NEED TO TURN IN THE FOLLOWING FORMS TO
Michele Miller-Hayes. THESE FORMS NEED TO BE FILLED OUT COMPLETELY. THEY MUST BE
SCANNED AND E-MAILED TO mvmiller-hayes@okcps.org OR SENT THROUGH SCHOOL MAIL. (PLEASE
NO FAXES AS THEY ARE DIFFICULT TO READ)
a. BOTH BEHAVIOR INTERVENTION PLANS
b. ALL DATA COLLECTED TO SHOW THAT THE BIPS WERE UNSUCCESSFUL, INLCUDING THE
MANDATORY DATA COLLECTION FORMS. ALSO INCLUDE ANY LESSON PLANS THAT DOCUMENT
WHAT REPLACEMENT BEHAVIOR HAS BEEN TAUGHT TO THE STUDENT.
c. APPLICATION FOR ONE-ON-ONE ASSISTANT
6. ONCE ALL OF THESE FORMS HAVE BEEN RECEIVED, THEY WILL BE REVIEWED AND A DECISION WILL
BE MADE WHETHER TO PASS THIS ON TO THE ASSISTIVE TECHNOLOGY TEAM FOR FURTHER ASSISTANCE
OR IF THE IEP TEAMS NEEDS TO CONSIDER A ONE-ON-ONE ASSISTANT.
* * PLEASE NOTE THAT I F THE PACKET OF I NFORMATI ON RECEI VED I S
NOT COMPLETE, I T WI LL NOT BE ACCEPTED AND WI LL BE RETURNED
TO THE SENDER FOR FURTHER I NFORMATI ON* * *
PROCEDURES FOR REQUESTING IDEA PD FUNDS
Follow your standard building procedures to request professional development
funds.
If additional funds are required then request funds through Special Services
following the guidelines below.
REQUEST FOR PROFESSIONAL LEAVE AND TRAVEL
PROCEDURES:
1. Both Request for Leave and Request for Conference Attendance forms are
required if professional leave is being requested.
2. Attach a copy of the brochure or flyer regarding the requested professional leave.
3. Paperwork must be submitted to your immediate supervisor at least four (4)
weeks prior to requested conference.
REQUEST FOR IDEA FUND PROCEDURES:
Funds are made available to assist districts in implementing continuing education for
teachers and related services personnel. Personnel who attend conferences may be
asked to share information with other staff members, and to present information at
inservices. Approval of funding is based on the Annual Needs Assessment of the District
and equal representation from various certification areas.
1. Follow your standard building procedures to request professional development
funds.
2. If additional funds are required then request funds through Special Services
following the guidelines below.
3. Both Request for Leave and Request for Conference Attendance forms must be
completed for all requested professional leave.
4. Signatures of the Applicant, their immediate supervisor, and the Director of Special
Services are required. Reimbursement will not be granted if the Director of
Special Services does not approve funds.
5. Attach a copy of the brochure or flyer regarding the requested professional leave.
6. Paperwork must be submitted to your instructional supervisor at least four (6)
weeks prior to requested conference.
7. Once signatures are received on completed paperwork, approval by the Senior
Human Resource Officer and the Superintendent will be requested.
8. When approval by the Senior Human Resource Officer and the Superintendent is
received, a copy of all approved and signed paperwork will be e-mailed to the
applicant.
9. Upon receipt of approved paperwork, applicant can proceed to finalize plans (i.e.,
register, etc.). Applicants are responsible for initial payment of registration
fees.
After the conference, the applicant
10. Completes a Conference Attendance Summary Report form.
11. Completes an Expense Report form and attaches the original itemized
receipts of payment. NOTE: Just a credit card receipt for a meal will not be
accepted. The receipt must show individual meal items ordered. Receipts are to
be taped to 8 x 11 paper in date order.
a. Hotel receipt must be in applicants name and show a zero balance. If
more than one staff member attends the same conference, rooms
must be shared (two people per room). If both applicants are going to
pay for their share of the room and request reimbursement, each receipt
must be in each individual applicants name; show the amount that
individual paid, and show a zero balance.
b. Rental cars are not reimbursable.
c. Applicants are limited to $40.00 per day for meals. NOTE: $40.00 per day
is not cumulative. (Does not include adult beverages)
d. Applicants will only be reimbursed for meals while traveling to and from and
during out-of-district conferences. Meals purchased outside of the
location of the conference are not reimbursable (i.e., you go to an
attraction while on professional leave for a conference; you cannot be
reimbursed for meals eaten there.).
12. Attach verification of attendance (i.e., an agenda, a name badge, a certificate,
etc.).
13. Completed paperwork and attachments are then submitted to the Special
Services Department.
14. When all paperwork is received, Special Services will process the request for
reimbursement. Reimbursement will be limited to the approved itemized
requested amounts.
PLEASE DO NOT USE A HIGHLIGHTER ON YOUR RECEIPTS
PROGRESS REPORT
Online IEP platform progress report forms are required.
Under IDEA, the parents/guardians of a special education student
must be notified of their childs progress towards meeting their IEP
goals 5 to 9 weeks special education progress reports must be on the
same time line of delivery as regular education progress reports.
The frequency of informing/reporting to parents about the progress
must be included in the IEP.
Refer to p. 101 of the Special
Education Handbook.
OSDE Form 1
NAME OF CHILD: ____________________________________________________STUDENT ID: _________________________
FIRST MIDDLE LAST
BIRTHDATE: __________________ DISTRICT/AGENCY: ____________________________________________________
MONTH/DAY/YEAR
PARENT(S):________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) _________________________
HOME ADDRESS: __________________________________________________________________________________________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
SIGNATURE PURPOSE FOR ACCESSING RECORDS DATE
RECORD OF ACCESS TO EDUCATIONAL RECORDS
OSDE Form 2 Page __ of __
NAME OF CHILD: ____________________________________________________STUDENT ID: ___________________________
FIRST MIDDLE LAST
BIRTHDATE: __________________ DISTRICT/AGENCY: ______________________________________________________
MONTH/DAY/YEAR
PARENT(S):__________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) ___________________________
HOME ADDRESS: ____________________________________________________________________________________________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
SPECIAL INSTRUCTIONS: _____________________________________________________________________________________
_____________________________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other______________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other______________
Results:
Person Making Contact:
Date (Month/Day/Year) Purpose of Contact:
Method of Contact:
Mail Email Phone
Other ______________
Results:
Person Making Contact:
RECORD OF PARENT CONTACT
RE-EVALUATION PROCESS
The completed three year reevaluation/eligibility is due on, or before, the three year
anniversary of the previous evaluation/eligibility.
Revaluations are required for dismissal of any student from special education services,
unless parent revokes consent. (See Revocation document)
Fast-tracking with no standardized test data is not recommended.
It is the case managers responsibility to initiate the Review of Existing Data (REDs) for
the re-evaluation process as well as contacting the School Nurse for screenings, notifying
the School Psychologist and other service providers, as well as scheduling all meetings.
Complete the initial portion of the REDs forms on-line.
Print a copy of the REDs and send to the school nurse for a vision and hearing screening.
Print and deliver a copy for each of the students regular education teacher(s) to complete
their assessment and/or grade information.
Follow up with all personnel in 1-2 weeks.
Working in conjunction with the school psychologist, schedule and complete the
Notification of Meeting process allowing for due diligence.
Proceed with the re-evaluation meeting with the IEP/eligibility team in attendance.
Remember to include Related Service providers if needed.
The School Psychologist / Related Service provider will assist the team in determining
what new assessments may be needed to maintain special education eligibility. Proceed
with testing or determine the student is still eligible.
Written notice is required.
Refer to pp. 132 137 of the
special Education Handbook.
REMOVAL FROM SPECIAL SERVICES
An IEP team must complete a re-evaluation before a student can be removed from special
education services. This re-evaluation may consist of a complete evaluation or the review
of existing data. The team must determine the student no longer meets the criteria for a
special education category.
If removal is considered:
1. Invite the parent
2. Complete the IEP Review and Review of Existing Data to determine if
additional assessments are needed. If additional assessment(s) are
needed, removal from special education services cannot proceed until
assessments are completed and the eligibility is complete. If the student is
no longer eligible for services, the student is removed from services.
3. If the parent does not attend the eligibility meeting, Written Notice must be
sent to the parent(s), along with a copy of the eligibility and parent rights.
The team must wait 10 days before removing the student from services.
REVOCATION of CONSENT
REMOVAL FROM SPECIAL SERVICES UPON PARENTAL
REQUEST
If a parent or a student 18 years of age request to be removed from Special Education the
team needs to complete this request on an Parent Revocation of Consent for Services.
Invite the parent/student and make note of the removal request.
Inform the parent/student and document that they will lose all safeguards of
Special Education to include discipline procedures in comment section or
comment form.
Have the parent/student document their request in writing and attach into
EXCEED.
If the parent/student chooses not to come, complete the Written Notice to Parents
and send all copies to the parent/student.
Send the original documents to the Records Office.
Refer to pp. 184 185 of the
Special Education Handbook.
RESPONSE TO INTERVENTION (RtI)
FOR LD AND OHI REFERRALS
Target populations should be students that are performing at or below the 10
th
percentile
or have standard scores below 80. The tiered process should begin as soon as possible
so that students do not become further delayed. Remember that determinants for a
disability cannot be related to a students racial, cultural and language background, and
cannot be the result of lack of instruction in reading or math. Interventions should be
implemented for all students experiencing learning difficulties but the above
circumstances cannot be a determinant for a disability.
TIER 1
A three-tier approach is being used with first tier involving regular classroom instruction
and interventions available to all students.Tier one involves a recommended intervention
with research-based methods utilizing resources available to students having problems
learning to read, do math or written instruction. This could be through a tutorial program,
reading interventionist, HOSTS, small group intervention, etc. This intervention should be
documented with progress monitoring. The Dibels program does this as does Benchmark
assessment.
Tier one interventions should last for approximately 4-6 weeks. Documentation should be
at least weekly and plotted through a program such as interventioncentral.org, AimsWeb
or Dibels documentation.
TIER 2
Tier two recommended times should be 9 to 12 weeks, or until the student has made
enough progress to return to general instruction. (Recommended intervention should be
50-100 intervention sessions).
This intervention level would include;
(a) Systematic, direct and explicit instructions with modeling, multiple examples,
and feedback to the student.
(b) Pacing to match skill level,
(c) multiple opportunities to participate and respond and
(d) direct feedback.
Methods would include; specifically designed instruction directed at the area of weakness,
small group instruction, no more than 3-5 students, and/or peer interaction groups.
TIER 3
Students should only be referred to Tier three (Referral for a comprehensive evaluation), if
they show a marked lack of progress. Research collected by the National Reading
Committee has shown significant progress for 85% of students when this approach is
used. If you have questions please contact your Student Intervention Team or school
psychologist.
Retention, Report Cards, and Grading
It is the responsibility of the IEP team to ensure the IEP is appropriate
and meeting the individual educational needs. In the event that a
student is not achieving as anticipated the IEP team must reconvene
to determine the appropriateness of the IEP.
A student with disabilities may be given a failing grade for the
following:
Refusal to complete work within the childs capability
Poor attendance not related to a medical condition
Report cards should not indicate that the student is in special
education. There should not be any information on a special
education students report card that is not on a regular students report
card. Instructional levels should not be included unless instructional
levels are included for all students.
The Highly Qualified (HQ) teacher of record is responsible for
assigning the grades. Non HQ special education teachers provide
grades to regular education teachers for averaging.
RETENTION
Retention should not be considered because of parent request, inappropriate
education, insufficient time in special education, failure to implement modifications/
accommodations documented in the IEP, or an inappropriate IEP (see Reading
Sufficiency Act for mandatory retention policy and/or exclusion).
Gather current information (grades, attendance, work samples, behavior referrals,
regular class progress notes, etc.)
Schedule conference
Perform due diligence
Convene IEP team
Review students status
Review current information
Review current IEP
Were modifications/accommodations in the regular classroom
implemented?
Complete IEP Review and IEP with recommendations and program changes
Retention
Non-retention
RETENTION is an IEP team decision ONLY in the following instances:
Excessive absences not related to disability
Refusal to complete work on the students instructional level
When is retention inappropriate?
Documented modifications were not made in regular class
The disability is the primary reason for lack of progress
Peer ages are markedly different
Retained previously
IEP was not reviewed when student was demonstrating difficulty
Student has met graduation and transition requirements by state and district
guidelines
Absences required due to medical issues (this situation may require homebound
services)
Absences due to suspensions
THE DECISION TO RETAIN OR NOT RETAIN SHOULD ALWAYS BE
INDIVIDUALIZED AND STUDENT CENTERED
If needed, refer to Grade Adjustment procedures.
OSDE Form 3 Page __ of __
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
BIRTHDATE: ___________________ GRADE: ____________ AGE: ___________ DATE: ______________________
MONTH/DAY/YEAR MONTH/DAY/YEAR
PARENT(S):_________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) __________________________
HOME ADDRESS: ___________________________________________________________ DISTRICT/AGENCY: _____________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
BUILDING: __________________________ SITE CODE: __________IEP TEACHER OF RECORD: ________________________
Review by a group of qualified professionals and parent(s) does not require a meeting (34 CFR 300.305).
If existing records, assessments, or information must be obtained from other sources, the following forms may be utilized: Authority to
Transfer Education Records, Consent for the Release of Confidential Information, Medical Report, and/or Vision Report, as appropriate.
Parental consent is required for when utilizing the Consent for the Release of Confidential Information form.
SPECIFY PRESENTING CONCERN(S):
DATA REVIEW
(Check reasons)
Consideration for Initial Evaluation
Consideration for Reevaluation
Other (Explain) __________________
Building/Site Level Review of Existing School Information:
Present Levels of Educational Performance (or Age-Appropriate Activities for Preschool Children)
Grades/Progress Reports Work Habits
Work Samples
Assessments of Achievement
Attendance History Number of Days Absent This Year
Behavior Concerns or Discipline Reports
Observations in Classroom or in Age Appropriate Settings
Describe Interventions, Instructional Strategies, and Child-Centered Data Collected (e.g., Response to Intervention [RtI], reduced
homework assignment, bilingual interpreter)
Other Information:
Concerns/Special Considerations of Parent(s) or other sources
What are the specific referral concerns/questions to be answered? _______________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
REVIEW OF EXISTING DATA (RED)
OSDE Form 3 Page __ of __
RED
NAME OF CHILD: _____________________________________________STUDENT ID: _________________________________
FIRST MIDDLE LAST
Complete only the areas needed for this child.
AREA
EVALUATION
PROCEDURES
PERSON/AGENCY
QUALIFICATIONS
DATE
(of information)
COMMENTS, FINDINGS,
EDUCATIONAL NEEDS
PARENT INFORMATION
CONCERNS/COMMENTS
Existing
New Information
DEVELOPMENTAL
Existing
New Information
ADAPTIVE BEHAVIOR
______HOME ______SCHOOL
______AGE APPROPRIATE SETTING
Existing
New Information
SOCIOCULTURAL
Existing
New Information
HEALTH/MEDICAL
Existing
New Information
VISION
Existing
New Information
HEARING
Existing
New Information
MOTOR
Existing
New Information
COMMUNICATION/SPEECH
AND LANGUAGE
Existing
New Information
OSDE Form 3 Page __ of __
RED
NAME OF CHILD: _____________________________________________STUDENT ID: ___________________________________
FIRST MIDDLE LAST
AREA EVALUATION
PROCEDURES
PERSON/AGENCY
QUALIFICATIONS
DATE
(of information)
COMMENTS, FINDINGS,
EDUCATIONAL NEEDS
ACADEMIC:
LISTENING COMPREHENSION
Existing
New Information
ORAL EXPRESSION
Existing
New Information
BASIC READING SKILLS
Existing
New Information
READING COMPREHENSION
Existing
New Information
READING FLUENCY
Existing
New Information
WRITTEN EXPRESSION
Existing
New Information
MATHEMATICS CALCULATION
Existing
New Information
MATHEMATICS PROBLEM SOLVING
Existing
New Information
OSDE Form 3 Page __ of __
RED
NAME OF CHILD: _____________________________________________STUDENT ID: ___________________________________
FIRST MIDDLE LAST
AREA
EVALUATION
PROCEDURES
PERSON/AGENCY
QUALIFICATIONS
DATE
(of information)
COMMENTS, FINDINGS,
EDUCATIONAL NEEDS
ASSISTIVE TECHNOLOGY
Existing
New Information
PERCEPTUAL/PROCESSING
Existing
New Information
INTELLECTUAL/COGNITIVE
Existing
New Information
FUNCTIONAL BEHAVIOR
ASSESSMENT
Existing
New Information
PSYCHOLOGICAL
SOCIAL/EMOTIONAL
Existing
New Information
VOCATIONAL
Existing
New Information
OBSERVATION IN CLASSROOM
OR OTHER ENVIRONMENT
Existing
New Information
OTHER
Existing
New Information
OSDE Form 3 Page __ of __
NAME OF CHILD: _____________________________________________STUDENT ID: ______________________________________
FIRST MIDDLE LAST
Background Information:
Native Language/Mode of Communication Primary Language of Home
List Schools Previously Attended
List Grade(s) Repeated Remedial/Other School Services
Previous Individualized Evaluation(s)/Date(s)
Special Education Services None Previous Disability Category
Student Received SoonerStart or Other Early Intervention Services: Yes No
If Yes, Describe
Pertinent Medical or Health Information
List Medication Taken Regularly Reason
Describe Physical Limitations or Motor Impairments _________________________________________________________________
Services Provided By Outside Professionals/Agencies Yes No Previously Currently
Describe Services
Screening Information:
Date of Last Visual Test/Screening Results
Describe Vision Problems Aids/Devices
Date of Last Hearing Test/Screening Results
Describe Hearing Problems Aids/Devices
Date of Last Speech/Language Test/Screening Results
Describe Speech/Language Problems Aids/Devices
Developmental Screening Results
Describe Developmental Problems
Other Screening Results
Team/Group Recommended Action:
Consultation Services
Additional Assessments for Initial Evaluation
Additional Assessments for Reevaluation
No Additional Assessments Needed
SIGNATURES: (Sign and date when each person reviews. Dates may vary since a meeting is not required for review of existing data and information.)
Regular Education Teacher Date
Special Education Teacher Date
Administrative Representative Date
Other/Qualified Professional Date
Parent(s) Date
Comments/Concerns
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
RED
OSDE Form 3 Page __ of __
NAME OF CHILD: _____________________________________________STUDENT ID: ______________________________________
FIRST MIDDLE LAST
DOCUMENTATION OF INTERVENTIONS
Targeted Behavior/Skill:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Goal:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Interventions Attempted:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Frequency and Duration:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Treatment Integrity Data:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Type of Measure Used to Define Outcome:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Was goal accomplished? Yes No
Recommended Action:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
RED
OSDE Form 13
Page __ of __
SECLUSION DOCUMENTATION FORM
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
BIRTHDATE: ___________________ GRADE: ____________ AGE: ___________ DATE: ______________________
MONTH/DAY/YEAR MONTH/DAY/YEAR
PARENT(S):_________________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) __________________________
HOME ADDRESS: ___________________________________________________________ DISTRICT/AGENCY: _____________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
Date of Incident: _________________________ Location: ____________________________________________________________
MONTH/DAY/YEAR
Beginning Time: ________________________________________ Ending Time: _________________________________________
Describe the location utilized for this seclusion incident:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
School personnel involved in incident (additional documentation may be attached if determined necessary):
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe the students activity and behavior immediately preceding the behavior that prompted the use of seclusion:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe efforts of school personnel to de-escalate the situation, and alternatives that were utilized prior to the use of seclusion:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Provide a description of the seclusion incident:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
OSDE Form 13
Page __ of __
Describe the actions of the student and school personnel that occurred during the use of seclusion:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe observed student and school employee behaviors that followed the use of seclusion:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe de-escalation techniques and interventions utilized following the use of seclusion:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe any injuries to the student or school employees:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe future alternatives to the use of seclusion that will be utilized:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signatures:
Person Completing Form: ____________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Witness: __________________________________________________________ Date: _____________________________________
Notification to Parent:
Type: _____________________________ Time: _______________________ By whom: ________________________________
Date Information Provided to Parent: _________________________________ By whom: _________________________________
OSDE Form 13
Page __ of __
Notification to Site Administrator:
Type: _____________________________ Time: _______________________ By whom: ________________________________
Findings of debriefing meeting:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
Signature: ____________________________________________ Date: ___________________________ Agree *Disagree
*Individuals who disagree may submit separate statements presenting their conclusions. (Complete Comment Form as necessary).
If parent(s) did not attend the meeting, explain other methods to ensure parent participation and/or child as appropriate (e.g.,
conference call, videoconference, home visit): _____________________________________________________________________
Seclusion Documentation Details
OKCPS Special Education Policy and Procedures 2010
Excerpt from the Oklahoma State Department of Education based on HR 4247
Seclusion:
Seclusion is defined as any involuntary confinement of a student in a room or area in
which the student is physically prevented from leaving, including areas that are blocked
by other objects or staff.
Seclusion should never be used for the purposed of discipline, punishment, to force
compliance, or as a convenience for staff. Nor should it be used to manage behavior.
The same criteria applies to seclusion as to restraint: imminent risk of harm/danger,
positive behavior interventions strategies and less restrictive measures did not de-
escalate the risk of danger, and the seclusion lasts only as long as necessary to resolve
the risk of danger/harm while waiting for the arrival of your building crisis intervention
team or law enforcement.
If you are using a time out area the following guidelines must be followed:
The area must be of adequate size permitting the student to sit or lie down.
It must have adequate lighting.
The area must be equipped with heating, cooling, ventilation, and lighting
systems that are comparable to those in other rooms throughout the building.
The student must be monitored by school personnel at all times, with the
ability to see and hear the student.
Student must be allowed to go to the restroom upon request.
Student must be permitted water to drink if requested.
Immediate action must be taken if the student displays signs of medical
distress.
In the event that seclusion becomes necessary for a student by an OKCPS employee
the following documentation must occur.
1. Complete the OKCPS Educational Services incident/accident Report and follow
all established procedures.
2. Complete the SDE Seclusion Documentation Form. Place a copy of the report in
the students confidential folder, provide a copy to the parents, and fax a copy to
405-587-0623 attention Michele Miller-Hayes.
3. Hold a de-briefing meeting within 2 school days of the restraint incident (and prior
to any extended break from school).
Attendance must include: All individuals involved in the incident, a
building administrator, the parents/guardian, the student, and the
witness that was not involved with the actual seclusion.
The de-briefing should focus on alternatives to seclusion, how to
avoid future use if seclusion, and the antecedent events that led to
the use of the seclusion. A copy of the minutes of the meeting must
be placed in the students confidential file, a copy given to the
parent, and a copy faxed to 405-587-0693 attention Michele Miller-
Hayes.
I. LANGUAGE
Language Dominance
Language Test Administered and Results
Name of Test
(Subtest)
T
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S
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a
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.
D
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.
R
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S
c
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e
S
t
a
n
d
.
S
c
o
r
e
%
i
l
e
Name of Test
(Subtest)
T
e
s
t
M
e
a
n
S
t
a
n
d
.
D
e
v
.
R
a
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c
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e
S
t
a
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d
.
S
c
o
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%
i
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e
Expressive Language Sample Anal ysis
II. SPEECH
Articulation Test Administered
Articulation Summary
p m n w h b g k f d j t l r v s z S
+
S
d3 D
Initial
Medial
Final
Consonant Blends:
Vowels:
Deviant Phonological Processes
Oklahoma City Public Schools
Speech Language Evaluation Summary Report 1 of 2
Student ID# Sex BD CA
Neighborhood School Grade Ethnicity
Date of Referral Date of Evaluation
Date
2 of 2
Student
Fluency: Does / does not interfere with communication.
Voice: Referral to physician is / is not indicated.
Oral mechanism: A cursory oral peripheral exam revealed that the structures of the oral mechanism appear / do
not appear to be adequate for speech.
Summary:
Speech-Language Pathologist
OKCPS Social Workers: Linking Home, School, and Community
Thank you for visiting our website. We are a small group of Masters Level Social Workers that
have been hired by OKCPS Special Services Department to serve students on Individualized
Education Plans (IEPs). We are here to build bridges between the school, home, and
community. We work as liaisons and collaborate with students, OKCPS staff/teachers, mental
health professionals, other professionals involved, and family members.
School social workers are dedicated to improving school systems and alleviating the systemic
barriers to learning and graduation. Much of our work is done behind the scenes. We get to
know the student and their situation from a holistic view and then begin to determine next
steps. Because of our mental health background, we are comfortable in de-escalation and crisis
intervention. We offer individual support to students and provide services to groups as well.
Many times you will find us in IEP meetings advocating for students. We can help mediate and
facilitate the IEP team coming together in the best interests of the student with a peaceful
approach.
In 1943 the National Association of Visiting Teachers (NAVT) became the American Association
of School Social Workers (AASSW), and in 1955 AASSW merged with six other social work
associations to form the National Association of Social Workers (NASW). Thus, school social
work has been a vital part of the social work profession. (NASW Standards for School Social
Work Services)
If you have s student that you feel would benefit from our services please go to the OKCPS
Special Services website to see which social worker is assigned to your school. You may also
download a referral form from that site.
Contact Penny Holloway at pholloway@okcps.org.
SPECIAL EDUCATION COURSE GUIDE
Special Ed Teacher must be HQ to teach core subjects (it is very difficult to be able to build a HOUSSE
in high school core subjects, especially more than one HOUSSE). Teachers who are not HQ should be
doing inclusion/co-teaching.
All courses have been revised to match certification and graduation requirements of the district.
College Prep only has one additional requirement than the standard diploma 1 extra technology credit.
The only students who should be encouraged to sign the opt out letter would be portfolio students.
These students are generally not college bound. All other students have the right to attend college free
thru Oklahomas Promise without having mandatory remediation courses.
Special Education Students must receive core subjects by a HQ teacher (certification), and should be
instructed using the district adopted textbooks. All special ed students are required to take and pass 4 of
7 EOIs utilizing OCCT or end-of-year project. Portfolio students are required to pass 4 of 7 EOIs.
All students should take the Plan and Explore with the exception of Portfolio students who take the Life
Skill Inventory or Choose and Take Action transition assessment.
HQ special education teachers with certification in each core subject area may rotate the students with
behavioral needs through these classes.
iOKCPS courses require a certified teacher of record.
Special education students should be included in Ramp-up and/or Navigator courses.
Special education students can be double blocked for remediation of target skills.
Reading course titles (9000 series) should focus on the 9 elements of reading.
Special education classrooms should reflect the elementary and secondary regular education programs
such as: ACT/Americas Choice, GE, Core Knowledge, Marzano methodologies.
Please refer to HB 1756
See Student Handbook for current graduation requirements.
STATE MANDATED ASSESSMENT
Every student in a tested grade level in an Oklahoma public school must
participate in testing as required by the 2001 Federal Legislation No Child Left
Behind (NCLB). All standardized testing information must be documented in the
IEP. All students will be administered in either of the following:
Regular Assessment
Regular Assessment is used with students who can successfully participate
in testing without modifications or accommodations.
Regular Assessment with Accommodations
Regular Assessment is used with students who can successfully participate
in testing when making the State approved testing accommodations.
Modified Assessment (OMAAP) is for second time testers only who have
previously taken the Modified Assessment and have scored limited knowledge or
unsatisfactory. SEE SDE Phase out Memo.
Portfolio (OAAP)
Students participating in the OAAP are among the most severe students
with disabilities and should not exceed a small percentage (1%) of the
special education population. This group may include students with varying
disabilities; emphasis is on the students who are participating in the CARG-
A skills and functional skills. These students must have a cognitive
disability to take the Portfolio Assessment.
Each subject area must be identified on the IEP as an educational need
and a CARG-A goal and two benchmarks must be written to address the
need.
Grades and Subjects Assessed
* Required subjects to be assessed
Grades 3-8
Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8
Math * * * * * *
Reading * * * * * *
Science *
Geography *
End-of-Instruction (EOI)
*Required subjects to be assessed
Students should be taking the EOI test when they are enrolled in the
course or have already taken the Course.
Please note:
High School students must pass four of seven EOIs to receive their diploma.
Al gebra I and English II are required to take and pass.
Two of the following five can make up the other two EOIs:
Al gebra II, Biology, English III, Geometry, US History
Social
Studies
* *
Writing * *
Al gebra I English II Biology US History
* * * *
STUDENT ENROLLMENT
Students suspected of having a disability entering Oklahoma City Public Schools
without records will be enrolled in their home or special transfer school.
The school must contact the previously attended school to confirm special
education status and placement. Request that the previous school send the
confidential records as soon as possible, current IEP and eligibility.
If the previously attended school confirms by phone that the student is eligible for
services and confirms placement, the case manager must (within seven school
days from enrollment):
Convene the IEP team
Formulate an IEP
When confidential records are received, the school psychologist assigned to the
building must review the records, complete an Outside Agency Review, and
send a copy to Special Services Room 309.
The case manager must:
Review the Outside Agency Review
Convene the IEP team
Review out-of-district IEP, complete an IEP Subsequent or Not
Subsequent within 7 days of E-1
.
If a subsequent IEP was done on the verbal information received from the
previous district, and it is appropriate no additional paperwork is required.
A copy of out-of-district confidential records must be mailed to
the Special Services Records Office.
It is inappropriate to refuse enrollment.
OSDE Form 11
NAME OF CHILD: _________________________________________________ AGE: _________________________________
FIRST/MIDDLE/LAST
BIRTHDATE: ___________________________________ DATE OF GRADUATION: _________________________________
MONTH/DAY/YEAR
DISTRICT/AGENCY: ______________________________ DATE OF SUMMARY: ____________________________________
STUDENT SUMMARY OF PERFORMANCE
Summary of Academic Achievement and Functional Performance: Provide the most recent evaluation data, current
grades, GPA, levels of functioning, and progress made toward achieving postsecondary goals related to training, education,
employment, and independent living skills.
Recommendations for assisting the student in meeting his or her postsecondary goals: Provide information about
activities, modifications, accommodations, assistive technology, and strategies that enable the student to be successful in
reaching their postsecondary goal(s).
SUMMARY OF PERFORMANCE (SOP)
The special education teacher, in cooperation with other IEP team members, must
provide a SOP for all young adults on an IEP who will graduate with a standard
high school diploma or will exceed the age of eligibility, up to age 22.
When completing the SOP, the team must consider:
Age/grade levels proficiency is shown in core or elective subjects.
How the young adult functions in social settings, with peers or
independently.
Skills/abilities the young adult has to live independently.
Work skills that the young adult possesses.
Recommendations stated on the SOP must include things that have, and will
continue to assist the young adult in achieving postsecondary goals; education,
living, independence etc.
The team should start the process for completing the SOP at least 60 to 90 days
prior to convening for the Graduation Event.
The SOP does not take the place of a three-year re-evaluation. It is a tool that is
provided to young adults prior to leaving high school to assist with transition to
post-secondary activities. If the student has been fast tracked or does not have
appropriate testing information, within the last 4 years, then a re-evaluation is
warranted.
The SOP should be reviewed and discussed at the Graduation IEP meeting.
Copies of the SOP, IEP Review, sample letter, and evaluation data should be
given to the student at the Graduation meeting.
Refer to pp. 107 of the Special
Education Handbook for more
information.
OCPS FORM M
OKLAHOMA CITY PUBLIC SCHOOLS
SURROGATE LETTER OF APPOINTMENT
___________________________________________ has been trained to act as a
Surrogate Parent.
This training included:
Information regarding State and Federal requirements for the education of children
with disabilities;
Parent responsibilities/rights;
Due process procedures;
Procedures of the Oklahoma City Public Schools including the forms used to
document procedural safeguards;
Information about the childs ability and needs;
The surrogate parent has the responsibility of representing the handicapped child in all
matters relating to:
The identification, evaluation, and educational placement of the child, and
The provision of a free, appropriate public education for the child.
Written information and training for skill and knowledge as a Surrogate Parent have been
provided by:
Person conducting the training _____________________________________________
Agency Oklahoma City Public School District I-89
Address 900 North Klein, Oklahoma City, OK 73106
Date of Training ___________________________ Location Administration Building
ASSIGNMENT
I understand the responsibilities of acting as a Surrogate parent. I have no interest that conflicts with the
interests of this child. I understand and accept the need for confidentiality, and will in no circumstances
duplicate, disseminate or verbalize to unauthorized persons any information obtained regarding this child.
When I no longer serve as surrogate, I will return to the Oklahoma City Public Schools all personally identifiable
education/evaluation records relating to this child.
SIGNATURE____________________________________________DATE_______________
ADDRESS_________________________________________________________________
CHILDS NAME________________________________________DOB_________________
SCHOOL SITE _____________________________________________________________
SCHOOL CONTACT PERSON ________________________________________________
See pp. 182 of
the Special
Education
Handbook
Surrogate Parents
A surrogate parent is needed when the student is a ward of the state and no
longer in parents custody.
Parent means one of the following:
Natural or adoptive parent of the child
Foster parent
Guardian (but not the state if the child is a ward of the state)
Individual acting in the place of a natural or adoptive parent with whom the
child lives (grandparent, aunt, or other relative)
Individual who is legally responsible for the childs welfare
Each local school district or public agency must ensure that the rights of a child
with a disability are protected by assigning a surrogate parent when:
No parent can be identified;
The parent cannot be located after reasonable efforts;
The child is a ward of the State and the parents rights have been
terminated or;
The child is an unaccompanied homeless youth as defined by the
McKinney-Vento Homeless Assistance Act.
The child is temporarily awaiting foster care placement.
How do you obtain a surrogate parent?
1. Complete a Request for Surrogate Parent (Form 10) and fax to Kristen
Pelletier, Special Services, 297-6594.
2. A copy of Record of Effort to Contact Parents detailing efforts to contact
parents should accompany the request.
3. A trained surrogate parent will be assigned and a Surrogate Letter of
Appointment (Form M) will be sent to the school.
4. The Surrogate Letter of Appointment form must be signed by the assigned
surrogate.
5. A copy of the Surrogate Letter of Appointment will need to be placed in the
students confidential folder at the school, a copy given to the assigned
surrogate, and the original sent to Kristen Pelletier, Special Services, 297-
6594.
The surrogate parent should be given adequate notice (at least 10 days) for the
meeting.
The surrogate parent should be given adequate notice
(at least 10 days) for the meeting.
Refer to pp. 63 67 of the Policy
and Procedure Manual for more
information.
A surrogate that has been trained by another district must have a follow-up
training from OKCPS.
Request for Surrogate Parent
Childs Name: ____________________________________________________ Date: ____________________________
Address: _________________________________________________________ Date of Birth: _____________________
School: ______________________________________________ Principal: ____________________________________
This child is thought to be in need of a surrogate parent for one of the following reasons:
_________ Parent rights have been terminated and he/she is a ward of the court.
Case Workers Name: ____________________________________________ Phone: ___________________
Agency: ________________________________________________________________________________
_________ He/She qualifies under the McKinney-Vento Act as homeless.
Case Workers Name (if applicable): __________________________________________________________
Agency: _________________________________________________ Phone: _________________________
_________ Parent cannot be found. Every reasonable effort has been made (Record of Parent Contact) to discover the
whereabouts of the parents. To my knowledge, parents have not given explicit or tacit approval to anyone to
act as a parent to the child.
Person completing this form ________________________________________________ Date: _____________________
Reviewed by Principal _____________________________________________________ Date: ____________________
Reviewed by Director of Special Services ______________________________________ Date: ____________________
--------------------------------------------------------------------------------------------------------------------------------------------------
Surrogate Needed? ________ Yes ________ No Date Surrogate Appointed ________________________________
Name of Surrogate _________________________________________________________________________________
Address: ________________________________________________ Telephone No.: ____________________________
* Fax completed form to Kristen Pelletier at 297-6594. Make sure the Record of Parent Contact is included.
6/11/2013
Special Services revised 7/2013
Task Anal ysis
TASK: _________________________________
Student Name: ___________________ 5 = No Prompting
3 = Partially Prompted
1 = Continuous Prompting
R = Refused to Attempt
Date Recorded:
Staff Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Average prompting
level required
Notes/Instructions:
SD =
Teach 1 step at a time
Enter a 1 in all steps not being taught. The average should be calculated by adding the total score for all steps and
dividing by the total number of steps (total score divided by 10)
TIME SAMPLING
Student: Dates: ___/___/___
Behavior: __________________________________
Definition: _____________________________________________________________
______________________________________________________________________
Time/Interval Monday Tuesday Wednesday Thursday Friday
TRANSFER OF PARENTAL RIGHTS
Beginning at least one year before the student reaches the age of
majority (18 years of age), a statement must be included and initialed on the IEP that
the student and parents have been informed that all educational rights will transfer to
the student upon reaching the age of majority.
Refer to p. 114 of the Policy and
Procedure Manual for more
information.
TRANSFERS
LEGAL TRANSFER (Not an open transfer student)
Legal transfer students are those students who do not reside in the Oklahoma City
Public School District, but attend a school within the Oklahoma City Public School
District, and have documentation (an approved transfer) that they have legally
transferred into our district. Contact Jennifer Goldman in Student Support Services 587-
0438 or jlgoldman@okcps.org .
If you have any of these students, they must obtain an approved transfer
through Student Services at the Administration Building (Room 202) and
through their resident district.
Do not enroll an out of district student without an approved emergency
transfer, or an approved open transfer. The parent will have a copy of the
approved transfer.
The resident district must be invited to all meetings in regard to the students
special education services.
Emergency Transfers Please contact Jennifer Goldman in Student Support Services.
SPECIAL TRANSFER
Special transfer students are those students who do reside in the Oklahoma City Public
School District, but who attend a school other than their home area school due to
program availability. Al l special transfers are processed through the Special
Services Department.
All students should be enrolled in their home school, however if an
appropriate program is not available the building administrator should contact
Special Services @ 587-0431.
Special transfers should not be considered based on parent requests.
Refer to the OKCPS Student Handbook.
Special Services Procedure
reviewed 7/2013
TRANSITION ASSESSMENT
Transition assessments are required beginning at 14 years of age.
To assist children in making informed decisions about their postsecondary
goals, vocational assessments, including interest, aptitude and ability.
Assessment results must be incorporated into the IEP and considered as one
of many components in making transition planning decisions.
Transition Assessments:
OKCPS utilizes: (cumulative folder)
Explore 8th grade
Plan 10th grade
These assessments may be utilized as an alternative EOI.
KeyTrain/WorkKeys
Choose and Take Action Software
For Severe/Profound
Life Skill Inventory (freethis address works in Chrome and Firefox, but not
Safari) http://www.dshs.wa.gov/pdf/ms/forms/10_267.pdf
TRANSITION SERVICES
Transition is designed to help students with disabilities move from school to a
variety of post-secondary options. Successful transition is facilitated through a
continuum of instructional strategies, an interdisciplinary team of service providers,
the utilization of technology and requisite skills for self-determination, independent
living, education and employment.
Parent permission must be obtained prior to inviting other agency representatives,
who may be providing transition services, to the IEP meeting.
At age 16 or 9
th
grade(whichever comes first), Begin by planning for needed
transition services including helping the student and family identify long-range and
post-secondary outcomes or goals and designing the high school experience to
assist the student in developing skills and becoming linked to the resources
needed to move toward those goals.
At age 16, student must be referred to Vocational Rehabilitation.
Transition Areas:
Instruction academic, vocational, independent living skills, continuing
education, technical education
Community experiences independent recreation, family supported
recreation, participation recreation, local clubs and day-programs
Employment and post-secondary adult living objectives employment with
and without support, sheltered employment
Daily living skills income/resources, medical services, transportation,
appropriate socialization skills
Vocational Evaluation informal assessments, formal assessments, job
sampling
All coordinated activities that promote movement toward post secondary life must
be addressed in the IEP on the transition page and include goals. Objectives are
only required for those students participating in the alternative assessment OAAP
program.
The Summary of Performance (SOP) must be completed and a copy provided to
the student upon graduation and/or aging out.
Refer to p. 121 of the Policy and
Procedure Manual for more
information.
Transition Timeline Checklist 2013-
2014
Student ___________________ ID # ______________
Case Manager ______________________
_____ Age 6 refer eligible children to DDSD services (waiting list is now 10 years)
_____ Age 14 - begin mandated Transition Assessments: Plan, Explore, Casey Life Skills, or
Choose & Take Action. Make sure DDSD is in place.
_____ Vocational educational opportunities must be discussed beginning at the age of 16. You
must document provision of the necessary information regarding vocational
opportunities to the young adult and the parent(s) and develop a plan to implement by
graduation.
_____ The IEP contains Transition Planning and Goals to meet the students post-secondary
career expectations (education/training/work study, employment, and independent
living, as needed) by age 16. There must be one annual transition IEP goal to address
each component of the postsecondary goal. OJT, Goodwill, Tinker, Tech Now etc.
_____ Permission has been obtained to invite outside transition related service providers to
the IEP meeting. Metro Tech should attend students IEP meeting.
_____ Age 16 upload a copy of the vocational rehabilitation (VR) application in Exceed and
give a copy to the parent, indicate month, day, year and person making the referral.
Educate parents that if they have not been contacted in 60 days they should call VR.
_____ By the age of 17, document that the young adult and the parent(s) have been informed
of rights that will transfer to the young adult upon reaching the age of majority, 18
years.
_____ Graduation planning (January) would include the same procedures as non-disabled
students: enough time to purchase announcements, robes, rings, attend ceremonies
etc.
_____ Prior to graduation the Exit IEP must be completed as well as the SOP. Copies of the Exit
IEP, SOP, Re-eval information, and example letter are to be given to the student/parent
at the time of meeting.
NSTTAC Indicator 13 Checklist Form A
(Meets Minimum SPP/APR Requirements)
Percent of youth with IEPs aged 16 and above with an IEP that includes appropriate measurable postsecondary goals that are annually
updated and based upon an age appropriate transition assessment, transition services, including courses of study, that will reasonably
enable the student to meet those postsecondary goals, and annual IEP goals related to the students transition services needs. There also
must be evidence that the student was invited to the IEP Team meeting where transition services are to be discussed and evidence that,
if appropriate, a representative of any participating agency was invited to the IEP Team meeting with the prior consent of the parent or
student who has reached the age of majority. (20 U.S.C. 1416(a)(3)(B))
1. Are there appropriate measurable postsecondary goals in the areas of
training, education, employment, and, where appropriate, independent living
skills?
Y N
Can the goals be counted?
Will the goals occur after the student graduates from school?
Based on the information available about this student, do the postsecondary goals seem appropriate for this student?
If yes to all three guiding questions, then circle Y OR if a postsecondary goal is not stated, circle N
2. Are the postsecondary goals updated annually? Y N
Were the postsecondary goals addressed/ updated in conjunction with the development of the current IEP?
If yes, then circle Y OR if the postsecondary goals were not updated with the current IEP, circle N
3. Is there evidence that the measurable postsecondary goals were based on
age appropriate transition assessment(s)?
Y N
Is the use of transition assessment(s) for the postsecondary goals mentioned in the IEP or evident in the students file?
If yes, then circle Y OR if no, then circle N
4. Are there transition services in the IEP that will reasonably enable the
student to meet his or her postsecondary goals?
Y N
Do the transition services listed in the students IEP that the student needs to reach the postsecondary goals include, as needed,
instruction, related service(s), community experience, development of employment and other post-school adult living objectives, and if
appropriate, acquisition of daily living skills and provision of a functional vocational evaluation
If yes, then circle Y OR if no, then circle N
5. Do the transition services include courses of study that will reasonably
enable the student to meet his or her postsecondary goals?
Y N
Do the transition services include courses of study that align with the students postsecondary goals?
If yes, then circle Y OR if no, then circle N
6. Is (are) there annual IEP goal(s) related to the students transition
services needs?
Y N
Is (are) an annual goal(s) included in the IEP that is/are related to the students transition services needs?
If yes, then circle Y OR if no, then circle N
7. Is there evidence that the student was invited to the IEP Team meeting
where transition services were discussed?
Y N
For the current year, is there documented evidence in the IEP or cumulative folder that the student was invited to attend the IEP Team
meeting, (e.g. a letter inviting the student to the meeting)?
If yes, then circle Y OR if no, then circle N
8. If appropriate, is there evidence that a representative of any participating
agency was invited to the IEP Team meeting with the prior consent of the
parent or student who has reached the age of majority?
Y N NA
For the current year, is there evidence in the IEP that representatives of any of the following agencies/services were invited to
participate in the IEP development including but not limited to: postsecondary education, vocational education, integrated
employment (including supported employment), continuing and adult education, adult services, independent living or community
participation for the postsecondary goals?
Was prior consent obtained from the parent (or student who has reached the age of majority)?
If yes to both, then circle Y
If no invitation is evident and a participating agency is likely to be responsible for providing or paying for transition
services and there was consent to invite them to the IEP meeting, then circle N
If it is too early to determine if the student will need outside agency involvement, or no agency is likely to provide or pay
for transition services, circle NA
If parent or individual student consent (when appropriate) was not provided, circle NA
Does the IEP meet the requirements of Indicator 13? (Circle one)
Yes (all Ys or NAs for each item (1 8) on the Checklist or No (one or more Ns circled)
______________________________________________________________________________________
Prepared by the National Secondary Transition Technical Assistance Center (NSTTAC)
September, 2006; updated July, 2009; updated May, 2012
2
Instructions for Completing NSTTAC Indicator 13 Checklist
1. Are there appropriate measurable postsecondary goals in the areas of training, education,
employment, and, where appropriate, independent living skills?
Find the postsecondary goals for this student
If there are appropriate measurable postsecondary goals that address Training after high
school, Education after high school, and Employment after high school, and (where
appropriate) independent living Skills after high school and if the identified postsecondary
goals for Training, Education, and Employment, and (where appropriate) Independent Living
Skills appear to be appropriate for the student, based on the other information regarding
Present Levels of Academic and Functional Performance and / or the students strengths,
preferences, and interests, circle Y
If a students postsecondary goals in the areas of Training and Education address both
training for a career and other education after high school (e.g., enrollment in an adult
education program focused on both job and independent living skills; enrollment in a college
program in preparation for a career in architecture), circle Y
it may not always be necessary for the student to have separate postsecondary goals for
training and education in these instances. Based on the individual needs of the student and
the students plans after leaving high school, it may be reasonable for an IEP Team to
interpret the areas of training and education as overlapping in developing postsecondary
goals for a student. In these instances, an IEP Team could develop a combined
postsecondary goal in the areas related to training and education. Employment is a distinct
activity from the areas related to training and education, and each students IEP must include
a separate postsecondary goal in the area of employment. For further information see
Questions and Answers on Secondary Transition, Revised September 2011, OSEP, Retrieved
http://idea.ed.gov/explore/view/p/%2Croot%2Cdynamic%2CQaCorner%2C10%2C).
If there are postsecondary goals that address Training after high school , Education after high
school, and Employment after high school, and (where appropriate) Independent Living Skills
after high school, but these goals are not measurable, circle N
If there is misalignment between the students postsecondary goals, based on the information
available (e.g., present levels of performance, student strengths, student interests, student
preferences), circle N
If there is not a postsecondary goal that addresses Training after high school, circle N
If there is not a postsecondary goal that addresses Education after high school, circle N
If there is not a postsecondary goal that addresses Employment after high school, circle N
2. Are the postsecondary goal(s) updated annually?
If the postsecondary goals for Training, Education, Employment, and where appropriate
Independent Living Skills are documented in the students current IEP, circle Y
If the postsecondary goals for Training, Education, Employment, and where appropriate
Independent Living Skills are not documented in the students current IEP, circle N
If this is the students first IEP that addresses secondary transition services because the
student just turned 16, it is considered an update for purposes of this checklist, so circle Y
3. Is there evidence that the measurable postsecondary goals were based on age appropriate
transition assessment(s)?
Find where information relates to assessment(s) and the transition component on the IEP
(either in the IEP or the students file)
For each postsecondary goal, if there is evidence that at least one age appropriate transition
assessment was used to provide information on the student's needs, strengths, preferences, and
interests regarding the postsecondary goals circle Y
______________________________________________________________________________________
Prepared by the National Secondary Transition Technical Assistance Center (NSTTAC)
September, 2006; updated July, 2009; updated May, 2012
3
For each postsecondary goal, if there is no evidence that age appropriate transition
assessment(s) provided information on the students needs, taking into account the students
strengths, preferences, and interests [regarding the postsecondary goals,] circle N
If a postsecondary goal area was addressed in item #1, but was not measurable and if there is
age appropriate transition assessment information, from one or more sources, regarding the
students needs, taking into account the students strengths, preferences, and interests
[regarding this postsecondary goal], circle Y
If a postsecondary goal area was addressed in item #1, but was not measurable and if there is
not age appropriate transition assessment information provided on the students needs, taking
into account the students strengths, preferences, and interests [regarding this postsecondary
goal], circle N
4. Are there transition services in the IEP that will reasonably enable the student to meet his or her
postsecondary goals?
Find where transition services/activities are listed on the IEP
For each postsecondary goal, is there a transition service such as instruction, related service,
community experience, development of employment and other post-school adult living
objectives, and if appropriate, acquisition of daily living skill(s), and provision of a
functional vocational evaluation) listed that will enable the student to meet the
postsecondary goal, circle Y
For each postsecondary goal, if there is no transition service that relates to a specific
postsecondary goal, (a) type of instruction, (b) related service, (c) community experience, (d)
development of employment and other post-school adult living objective, (e) if appropriate,
acquisition of a daily living skill, or (f) if appropriate, provision of a functional vocational
evaluation listed in the IEP that will enable the student to meet the postsecondary goal, circle
N
If a postsecondary goal area was addressed in item #1, but was not measurable and there is a
transition service that will enable the student to meet that postsecondary goal, circle Y
If a postsecondary goal area was addressed in item #1, but was not measurable and there is no
transition service listed that will enable the student to meet that postsecondary goal, circle N
5. Do the transition services include courses of study that will reasonably enable the student to meet
his or her postsecondary goals?
Locate the course of study (instructional program of study) or list of courses of study in the
students IEP
Are the courses of study a multi-year description of coursework from the students current to
anticipated exit year that is designed to help achieve the students desired post-school goals?
If yes, go to next instruction bullet. If no, circle N
Do the courses of study align with the students identified postsecondary goals? If yes, circle
Y. If no, circle N
6. Is (are) there annual IEP goal(s) that is (are) related to the students transition services needs?
Find the annual goals, or, for students working toward alternative achievement standards, or
States in which short-term objectives are included in the IEP, short-term objectives on the IEP
For each of the postsecondary goal areas circled Y in question #1, if there is an annual goal or
short-term objective included in the IEP related to the students transition services needs,
circle Y
For each of the postsecondary goals mentioned in question #1, if there is no annual goal or
short-term objective included in the IEP related to the students transition services needs,
circle N
If a postsecondary goal area was addressed in #1, but was not measurable, and an annual goal
is included in the IEP related to the students transition services needs, circle Y
If a postsecondary goal area was addressed in #1, but was not measurable, and there is no
annual goal included in the IEP related to the students transition services needs, circle N
______________________________________________________________________________________
Prepared by the National Secondary Transition Technical Assistance Center (NSTTAC)
September, 2006; updated July, 2009; updated May, 2012
4
7. Is there evidence that the student was invited to the IEP Team meeting where transition services
were discussed?
Locate the evidence that the student was invited, (e.g., a copy of the students invitation to the
IEP conference) Was the student invitation signed (by the LEA) and dated prior to the date of
the IEP conference. If yes, circle Y. If no, circle N
8. If appropriate, is there evidence that a representative of any participating agency [that is likely
to be responsible for providing or paying for transition services] was invited to the IEP Team
meeting with the prior consent of the parent or student who has reached the age of majority?
Find where persons responsible and/or agencies are listed on the IEP
Are there transition services listed on the IEP that are likely to be provided or paid for by an
outside agency? If yes, continue with next instruction bullet. If no, circle NA.
Was parent consent or student consent (once student has reached the age of majority) to invite
an outside agency(ies) obtained? If yes, continue with next instruction bullet. If no, circle NA
If a postsecondary goal area was addressed in item #1, but was not measurable and there is
evidence that agency(ies) for which parent/student had given their consent to invite, were
invited to the IEP meeting to discuss transition, circle Y
If a postsecondary goal area was addressed in item #1, but was not measurable and there is no
evidence that agency(ies) for which parent/student had given their consent to invite, were
invited to the IEP meeting to discuss transition, circle N
If it is too early to determine if this student will need outside agency involvement, circle NA
Does the IEP meet the requirements of Indicator 13?
If all Ys or NAs for each item (1 8) on the Checklist, then circle Yes
If one or more Ns are circled, then circle No
TRANSPORTATION
The need for and the type of transportation is to be determined by the IEP
team. FAPE must be provided to each and every student with a disability
as documented in the students IEP.
Once transportation is listed in the related service area on the IEP the
information will roll to TRMS which then rolls to Transportation.
If transportation is needed to or from home at any time other than the
normal AM and PM services, the buildings Special Services Instructional
Supervisor must approve.
Suspension from the bus is recorded as a day of suspension if the child
cannot attend school due to lack of transportation.
FIELD TRIPS Transportation expenses for field trips cannot be billed to
the Special Services Department unless approved prior to the field trip by
Michele Miller-Hayes. This request must be faxed to Michele at 587-0623
2 weeks prior to the field trip. The request must be completed in addition
to any Transportation office requirement Field trip expenses will not be
approved unless they are curriculum based and support specific transition
goals within the IEP.
Refer to p. 138 139 of the
Policy and Procedure Manual for
more information.
NonRegulatoryGuidanceontheIDEAPartBRegulationsRegardingParentalConsentfortheUseof
PublicBenefitsorInsurancetoPayforServicesundertheIDEA,IssuedFebruary14,2013,and
EffectiveMarch18,2013
ThisguidanceprovidesStateeducationalagencies,localeducationalagencies,parentadvocacy
organizations,andotherinterestedpartieswithinformationonthenewregulationsrelatedtoparental
consentfortheuseofpublicbenefitsorinsurancetopayforservicesunderPartBoftheIndividuals
withDisabilitiesEducationAct(IDEA).ThenewregulationswerepublishedintheFederalRegisteron
February14,2013,andareeffectiveonMarch18,2013.ThenewregulationsamendtheDepartments
regulationsin34CFR300.154(d)(2)(iv)thatwerepublishedintheFederalRegisteronAugust14,2006.
Thepriorregulationsrequiredthepublicagencyresponsibleforprovidingafreeappropriatepublic
educationtoachildwithadisabilityundertheIDEAtoobtainparentalconsenteachtimeaccessto
publicbenefitsorinsurance(e.g.,Medicaid)wassought.Thenewregulationshavetwobasic
requirements.First,thepublicagencymustnotifyparentsinwritingofanumberofsafeguardsto
protecttheirrightsbeforethepublicagencyaccessesthechildsorparentspublicbenefitsorinsurance
topayforservicesundertheIDEAforthefirsttimeandannuallythereafter.34CFR300.154(d)(2)(v).
Second,thepublicagencymustobtainaonetimewrittenconsentfromtheparentthatmeetsthe
requirementsof34CFR99.30and300.622,andalsospecifiesthattheparentunderstandsandagrees
thatthepublicagencymayaccessthechildsorparentspublicbenefitsorinsurancetopayforspecial
educationorrelatedservicesunderpart300(servicesundertheIDEA).34CFR300.154(d)(2)(iv).
Belowwedescribethenewregulationsandprovideguidanceonimplementingthesenewregulations,
includingrequirementspertainingtochildrenwithdisabilitieswhosepublicbenefitsorinsurancehave
previouslybeenaccessedbyapublicagencyandchildrenwithdisabilitieswhotransfertoanewschool
withinanewpublicagencyortoanewschoolwithinthesamepublicagency.
Q1.Whatareapublicagencysobligationsunderthenewregulationswithrespecttonotifying
parentsoftheirrightsandobtainingconsentfromaparenttoaccessthechildspublicbenefitsor
insurance(e.g.,Medicaid)?
A1.Underthenewregulations,apublicagencymustobtainparentalconsentbeforethepublicagency
accessesachildsorparentspublicbenefitsorinsuranceforthefirsttime.Thisisaonetimeconsent,
i.e.,thepublicagencyisnolongerrequiredtoobtainparentalconsenteachtimeaccesstopublic
benefitsorinsuranceissought.Thenewregulationsalsorequirethatthepublicagencyprovidewritten
notificationtothechild'sparents,consistentwithnew300.154(d)(2)(v),beforeparentalconsentis
obtained(seeQ2).34CFR300.154(d)(2)(iv).
Q2.Whataretheparentalnotificationrequirementsunderthenewregulations?
A2.Priortoaccessingachildsorparentspublicbenefitsorinsuranceforthefirsttime,andannually
thereafter,apublicagencymustprovidewrittennotification,consistentwith300.503(c),tothechilds
parents,thatincludes:
1)Astatementoftheparentalconsentprovisionsin300.154(d)(2)(iv)(A)(B);
2)Astatementofthenocostprovisionsin300.154(d)(2)(i)(iii);
3)Astatementthattheparentshavetherightunder34CFRpart99andpart300towithdrawtheir
consenttodisclosureoftheirchildspersonallyidentifiableinformationtotheagencyresponsiblefor
theadministrationoftheStatespublicbenefitsorinsuranceprogram(e.g.,Medicaid)atanytime;and
4)Astatementthatthewithdrawalofconsentorrefusaltoprovideconsentunder34CFRpart99and
part300todisclosepersonallyidentifiableinformationtotheagencyresponsiblefortheadministration
oftheStatespublicbenefitsorinsuranceprogram(e.g.,Medicaid)doesnotrelievethepublicagencyof
itsresponsibilitytoensurethatallrequiredservicesareprovidedatnocosttotheparents.34CFR
300.154(d)(2)(v).
Thenotificationmustbewritteninlanguageunderstandabletothegeneralpublicandinthenative
languageoftheparentorothermodeofcommunicationusedbytheparent,unlessitisclearlynot
feasibletodoso.34CFR300.503(c).Thenotificationalsomustbeprovidedbeforeparentalconsentis
obtained.34CFR300.154(d)(2)(iv).
Whilethenewregulationsrequirethepublicagencytoprovidethefirstwrittennotificationtothe
parentspriortoaccessingthechildsorparentspublicbenefitsorinsuranceforthefirsttime,the
regulationsdonotspecifywhenthesubsequentannualwrittennotificationmustbeprovidedtothe
parents.Thisisbecausepublicagenciesneedtohavetheflexibilitytodeterminethetimingofthe
annualwrittennotification(seeQ3).
Q3.Howshouldapublicagencyprovidethewrittennotificationtoparents?
A3.Thereareanumberofwaysinwhichthepublicagencymayprovidetherequiredwritten
notificationtoparents.
Thewrittennotificationmaybe:
1. Mailedtotheparents,or
2. Emailedifrequestedbytheparents,andifconsistentwithStateorpublicagencypolicies,or
3. ProvidedatanIEPTeammeetingifthemeetingoccurspriortothefirsttimeapublicagency
accessesachildsorparentspublicbenefitsorinsurance,or
4. Providedthroughothermeansdeterminedbythepublicagency,solongasallofthewritten
notificationrequirementsinthesenewregulationsaremet.Thisincludestherequirementthat
thepublicagencyprovidewrittennotificationbeforeobtainingparentalconsent.
Q4.Whataretheparentalconsentrequirementsunderthenewregulations?
A4.Consistentwith34CFR99.30oftheregulationsimplementingtheFamilyEducationalRightsand
PrivacyAct(FERPA)andtheIDEAPartBconsentrequirementsin34CFR300.622,apublicagencymust
obtainparentalconsentbeforereleasingachildspersonallyidentifiableinformationfromeducation
recordsforbillingpurposestoapublicbenefitsorinsuranceprogram(e.g.,Medicaid)forthefirsttime.
Undernew300.154(d)(2)(iv)(B),thisconsentmustalsoincludeastatementspecifyingthattheparent
understandsandagreesthatthepublicagencymayaccessthechildsorparentspublicbenefitsor
insurancetopayforservicesunderpart300.Becausethisconsentmustbeinwriting,thepublicagency
wouldtypicallyuseaconsentform.Thisparentalconsentformmustspecify:
1. Thepersonallyidentifiableinformationthatmaybedisclosed(e.g.,recordsorinformationabout
theservicesthatmaybeprovidedtoaparticularchild),
2. Thepurposeofthedisclosure(e.g.,billingforservicesunderpart300),
3. Theagencytowhichthedisclosuremaybemade(e.g.,theStatespublicbenefitsorinsurance
program(e.g.,Medicaid)).34CFR300.154(d)(2)(iv)(A),and
4. Thattheparentunderstandsandagreesthatthepublicagencymayaccessthechildsor
parentspublicbenefitsorinsurancetopayforservicesunderpart300.
Q5.Mustapublicagencymodifyitsconsentformstocomplywiththenewparentalconsent
requirement?
A5.No,notnecessarily.Inimplementingthenewparentalconsentrequirement,apublicagencymay
chooseeitherto:
1. Modifyitsexistingforms.Apublicagencymayaddthestatementthattheparentunderstands
andagreesthatthepublicagencymayaccessthechildsorparentspublicbenefitsorinsurance
topayforservicesunderpart300,totheconsentrequiredunder34CFR99.30and300.622
regardingthereleaseofpersonallyidentifiableinformationtoapublicbenefitsorinsurance
program(e.g.,Medicaid)forbillingpurposes;or
2. Developanewform.Apublicagencymaydevelopanewconsentformthatincludesthe
statementthattheparentunderstandsandagreesthatthepublicagencymayaccessthechilds
orparentspublicbenefitsorinsurancetopayforservicesunderpart300.
Q6.Mayapublicagencyacceptdigitalorelectronicsignatureswhenobtainingconsentunderthenew
parentalconsentrequirements?
A6.Apublicagencymayacceptdigitalorelectronicsignatureswhenobtainingtheparentalconsent
requiredunder34CFR99.30and300.622,asdescribedinnew300.154(d)(2)(iv)(A).Under34CFR
99.30(a),theparentalconsentthatmustbeobtainedbeforedisclosureofpersonallyidentifiable
informationmustbesignedanddated.Under34CFR99.30(d),thisconsentmayincludearecordand
signatureinelectronicformthat:
1. Identifiesandauthenticatesaparticularpersonasthesourceoftheelectronicconsent;and
2. Indicatessuchpersonsapprovaloftheinformationcontainedintheelectronicconsent,i.e.,
disclosureofthechildspersonallyidentifiableinformationtotheagencyresponsibleforthe
administrationoftheStatespublicbenefitsorinsuranceprogram(e.g.,Medicaid)forbilling
purposestopayforservicesunderpart300.
Additionally,undernew300.154(d)(2)(iv)(B),theelectronicconsentmustincludeastatementthatthe
parentunderstandsandagreesthatthepublicagencymayaccessthechildsorparentspublicbenefits
orinsurancetopayforservicesunderpart300.
Q7.Arethereanysituationsinwhichapublicagencyisnotrequiredtoobtainanewparentalconsent
underthenewregulations?
A7.Yes.Underthesenewregulations,andnotwithstandingtheannualwrittennotification
requirements,apublicagencyisnotrequiredtoobtainanewparentalconsentifthefollowing
conditionsarepresent:
1. Thereisnochangeinanyofthefollowing:thetype(e.g.,physicaltherapyorspeechtherapy)of
servicestobeprovidedtothechild;theamountofservicestobeprovidedtothechild
(frequencyorduration);orthecostoftheserviceschargedtothepublicbenefitsorinsurance
program(e.g.,Medicaid);and
2. Apublicagencyhasonfileaparentalconsentthatmeetstherequirementsoftheprior
300.154(d)(2)(iv)(A)and34CFR99.30and300.622.Thiswouldincludeaparentalconsenton
filethathasbeengivendirectlytoanotheragency,suchastheStateMedicaidagency.
Q8.ForchildrenwithdisabilitiescurrentlyservedundertheIDEA,whatmustapublicagencydoto
implementthenewparentalnotificationandconsentrequirements?
A8.Thefirsttimeaftertheeffectivedateoftheseregulationsthatthereisachangeinthetypeor
amountoftheservicestobeprovidedtothechildorachangeinthecostoftheservicestobecharged
tothepublicbenefitsorinsuranceprogram,thepublicagencymustfirstprovidetheparentsthewritten
notificationdescribedinnew300.154(d)(2)(v)beforeaccessingthechildsorparentspublicbenefitsor
insurance.Thepublicagencythenmustobtainparentalconsent,consistentwithnew
300.154(d)(2)(iv)(B),statingthattheparentunderstandsandagreesthatthepublicagencymayaccess
thechildsorparentspublicbenefitsorinsurancetopayforservicesunderpart300.Thepublicagency
mustobtainanewparentalconsentcontainingthisexplicitstatementfromtheparentevenifthepublic
agencyhasonfileaconsentprovidedtoanotheragency,suchastheStateMedicaidagency.Oncethe
publicagencyobtainsthisonetimeconsent,thepublicagencyisnotrequiredtoobtainparental
consentbeforeitaccessesthechildsorparentspublicbenefitsorinsuranceinthefuture,regardlessof
whetherthereisachangeinthetypeoramountofservicestobeprovidedtothechildorachangein
thecostoftheservicestobechargedtothepublicbenefitsorinsuranceprogram(e.g.,Medicaid).
However,thepublicagencymustannuallythereafterprovideparentswiththewrittennotification
describedinnew300.154(d)(2)(v).Thisannualwrittennotificationwillhelpensurethatparents
understandtheirrightswhenapublicagencyusestheirortheirchildspublicbenefitsorinsuranceto
payforservicesrequiredundertheIDEA.
Q9.Whatstepsmayapublicagencytakeunderthenewregulationsifparentshavepreviously
declinedtoconsenttotheuseofpublicbenefitsorinsurancetopayforservicesundertheIDEA?Ifa
parentcontinuestorefusetoconsentorwithdrawsconsent,whatareapublicagencysobligations?
A9.Ifaparentpreviouslydeclinedtoprovideconsent(orwithdrewconsent)todisclosepersonally
identifiableinformationtotheStatespublicbenefitsorinsuranceprogram(e.g.,Medicaid)forbilling
purposes,thepublicagencymaymakereasonablerequests,afterprovidingthewrittennotification
describedinnew300.154(d)(2)(v),toobtaintheparentalconsentrequiredundernew
300.154(d)(2)(iv).However,aparentswithdrawalofconsentorrefusaltoprovideconsentunder34
CFRpart99and300.622todisclosepersonallyidentifiableinformationtotheagencyresponsiblefor
theadministrationoftheStatespublicbenefitsorinsuranceprogram(e.g.,Medicaid)doesnotrelieve
thepublicagencyofitsresponsibilitytoensurethatallrequiredservicesareprovidedatnocosttothe
parents.34CFR300.154(d)(2)(v)(D).
Q10.WhatareapublicagencysobligationstoprovideparentalnotificationwhenachildhasanIEP
butthepublicagencyhasnotpreviouslysoughttoaccesstheparentsorchildspublicbenefitsor
insurance(e.g.,Medicaid)topayforservicesundertheIDEA,andthepublicagencyseekstoaccess
thechildsorparentspublicbenefitsorinsuranceforthefirsttime?
A10.Oncethenewregulationsbecomeeffective,ifapublicagencyseekstoaccessthechildsor
parentspublicbenefitsorinsurancetopayforservicesundertheIDEAforthefirsttime,thepublic
agencymustprovidetheparentsthewrittennotificationdescribedinnew300.154(d)(2)(v)andthen
obtainparentalconsentconsistentwithnew300.154(d)(2)(iv)beforethepublicagencymayaccessthe
childsorparentspublicbenefitsorinsuranceforthefirsttime.Ifparentalconsentisobtained,the
publicagencymustprovidethewrittennotificationtotheparentsannuallythereafter.
Q11.WhatareapublicagencysobligationstoprovideparentalnotificationwhenachildhasanIEP
andthepublicagencyhaspreviouslybilledthechildsorparentspublicbenefitsorinsurance
program(e.g.,Medicaid)topayforservicesunderpart300?
A11.Evenifthereisnochangeinthetypeoramountofservicestobeprovidedtothechildorinthe
costoftheservicestobechargedtothepublicbenefitsorinsuranceprogram(e.g.,Medicaid),oncethe
newregulationsbecomeeffective,thepublicagencymustprovidethewrittennotificationdescribedin
new300.154(d)(2)(v)totheparentsbeforethepublicagencymayaccessthechildsorparentspublic
benefitsorinsurance.Thepublicagencyalsomustprovidethiswrittennotificationtotheparents
annuallythereafter.
Q12.Whatareapublicagencysobligationstoprovideparentalnotificationandobtainparental
consentunderthenewregulationsinsituationswhereachildtransferstoanewschoolwithinanew
schooldistrict?
A12.Theresponsibilityforprovidingwrittennotificationandobtainingparentalconsentpriortothe
disclosureofpersonallyidentifiableinformationforbillingpurposestotheStatespublicbenefitsor
insuranceprogram(e.g.,Medicaid)andbeforeaccessingachildsorparentspublicbenefitsor
insuranceforthefirsttimerestswiththepublicagencyresponsibleforprovidingafreeappropriate
publiceducationtothechild,notwiththeindividualschool.Thus,ifachildwithanIEPwhowasenrolled
inaschoolwithinonepublicagencytransferstoaschoolwithinanewpublicagency,thenewpublic
agencyresponsibleforeducatingthechildmustprovidetheparentswiththewrittennotification
describedinnew300.154(d)(2)(v)toinformtheparentsoftheirrightsandprotectionswhenaccessto
theirortheirchildspublicbenefitsorinsuranceissought.Thenewpublicagencythenmustobtain
parentalconsent,consistentwithnew300.154(d)(2)(iv),todisclosepersonallyidentifiableinformation
tothepublicbenefitsorinsuranceprogram(e.g.,Medicaid)forbillingpurposesandpriortoaccessing
thechildsorparentspublicbenefitsorinsuranceforthefirsttime.Thisnewconsentmustincludethe
statementspecifyingthattheparentunderstandsandagreesthatthenewpublicagencymayaccessthe
childsorparentspublicbenefitsorinsurancetopayforservicesunderpart300.Onceparentalconsent
hasbeenobtainedforthenewpublicagencytoaccessthechildsorparentspublicbenefitsor
insuranceforthefirsttime,noadditionalparentalconsentisrequiredforthenewpublicagencytobill
thechildsorparentspublicbenefitsorinsuranceprogram(e.g.,Medicaid)inthefuture,regardlessof
whetherthereisachangeinthetypeoramountofservicestobeprovidedtothechildorinthecostof
theservicestobechargedtothepublicbenefitsorinsuranceprogram.However,thenewpublicagency
mustprovidethewrittennotificationdescribedinnew300.154(d)(2)(v)totheparentsannually
thereafter.
Q13.Whatareapublicagencysobligationswithrespecttoprovidingparentalnotificationand
obtainingparentalconsenttoaccessachildsorparentspublicbenefitsorinsuranceifthechild
transferstoanewschoolwithinthesameschooldistrict?
A13.Ifachildtransferstoadifferentschoolwithinthesamepublicagency,anyparentalconsentthat
thepublicagencypreviouslyobtainedthatmeetstherequirementsinnew300.154(d)(2)(iv)would
continuetoapply.Thepublicagencywouldcontinuetoprovidetheparentsthewrittennotification
describedinnew300.154(d)(2)(v)annually.AsnotedinQ12,thisisbecausetheresponsibilityfor
providingwrittennotificationandobtainingparentalconsentpriortothedisclosureofpersonally
identifiableinformationforbillingpurposestotheStatespublicbenefitsorinsuranceprogram(e.g.,
Medicaid)andbeforeaccessingachildsorparentspublicbenefitsorinsuranceforthefirsttimerests
withthepublicagencyresponsibleforprovidingafreeappropriatepubliceducationtothechild,not
withtheindividualschool.
Vocational Rehabilitation
OJT Work Study Procedures
2011-12
Once student is approved for Vocational Rehabilitations -Student Work Study
Program (SWS) please follow the directions below.
Case Manager locates the on-site job, duties and certified monitoring personnel.
New Progress Monitoring form is attached (progress reporting is required and
must accompany each timesheet).
Instruct and/or assist the student with the following Student responsibilities as
indicated within their IEP and provide a copy of the attached OJT work study
application procedures as needed for support.
Student shall go on-line and complete a Classified/Support Appli cation for
employment with OKCPS.
http://www.okcps.org or may go to 900 N. Klein, Human Capitol for assistance
click on Job Opportunities (located on the right side in dark blue)
click on the box that says click here to apply online or to check district
vacancies
Go to the bottom of page click on Create New Account
Complete all fields, be sure to select (under Applicant Type) the
classified/support box
Create a username and password (student choice)
Click save and next
Click login
Click accept
Locate and click (top of page, the tab labeled) Application and complete the
application by using the save and next buttons located at the bottom of each
page.
must list references, school personnel are acceptable
once you reach the SUCCESS page click next and look for the Title of OJT
Work Study
click view/apply
click apply for the job Notify your Case Manager that you have completed your
application
Retrieve from your teacher and complete the three required forms for
employment: W-2, I-9 and the Loyalty Oath. Return them to your teacher for
processing.
Fax: 297-6594 or Scan and Email the following documentation to
receive student timesheets, progress forms and timesheet cutoff
dates to
mvmiller-hayes@okcps.org.
1. Name of student that completed the Job Application
2. OJT Student Work Study (SWS) authorization form (from your VR Counselor)
do not allow the student to begin working before the date listed on this form
(they cannot be paid).
3. Three forms (Loyalty Oath, W-4, and the I-9) will need to be completed by the
student and signed by Jeff Newton (OKCPS Transition Specialist).
Approval with the VR counselor and process the application.
Three forms (Loyalty Oath, W-4, and the I-9) will need to be completed by the
student and signed by Jeff Newton (OKCPS Transition Specialist)
Room 310, Michele Miller-Hayes
OKCPS, Special Services
900 N. Klein
Student will be provided timesheets and the timesheet due dates when they sign their
contract.
Vocational Rehabilitation
OJT Work Study Procedures for Students
Student shall go on-line and complete a Classified/Support Application for employment with
OKCPS to begin the OJT Work Study Program.
Go to http://www.okcps.org or go to 900 N. Klein, Human Capitol, room 209 for
assistance
Click on Job Opportunities (located on the right side in dark blue)
Click on the box click here to apply online or to check district vacancies
Go to the bottom of page, click on Create New Account
Complete all fields, be sure to select (under Applicant Type) the classified/support
box
Create a username and password (student choice, must be minimum of 6 characters)
Click save and next
Click login
Click accept
Locate and click (top of page) tab labeled Application and complete the application by
using the save and next buttons located at the bottom of each page.
You must list references, school personnel are acceptable
Once you reach the SUCCESS page click next and look for the Title of OJT Work
Study
Click view/apply
Click apply for the job
Notify your teacher that you have completed your application
Retrieve from your teacher and complete the three required forms for employment: W-
2, I-9 and the Loyalty Oath. Return them to your teacher for processing.
Once you have completed all of these requirements your teacher will be sent copies of your
blank timesheets and progress monitoring form.
Continued student responsibilities:
Complete your timesheets daily and submit them to your teacher by the date indicated
on the bottom of the timesheet. (submission of timesheet after this date will delay your
payment). Please make sure your name is on the timesheet.
Pick up your progress monitoring document every two weeks to submit with your
timesheet
ENJOY YOUR WORKING REWARDS (pay)!
VOCATIONAL REHABILITATION REFERRALS
Procedure for vocational rehabilitation referrals/services:
The parent/student must be given a copy of the referral at the time the student
turns 16 and is referred. This document needs to be scanned and attached into
online IEP platform.
Teachers should explain to the parent/student that they will receive a letter within
60 days from the Department of Rehabilitation Services, DRS.
The parent/student must respond to this letter in order to be
considered for services.
Teachers should place all referrals in designated mailbox that each high school set
aside for DRS counselor.
For additional follow-up, a copy of the referral should be placed in a mailbox
designated for the buildings assigned Social Worker, if applicable.
DRS counselor picks up referrals on a weekly basis.
Refer to p. 159 of the Policy and
Procedure Manual for more
information.
Objective
Student
Targets
Th %
KEY: TRIAL BY TRIAL: (+) =
Correct, (-) = Incorrect, NR = No Response, P = Prompt % = Number correct/Number correct+Number Incorrect+ Prompt
ESTIMATION: (1) = 0-25%, (2) = 26-50%, (3) = 51-79%, (4) = 80-100%
ESTIMATION & TRIAL BY TRIAL DATA
Student: Date ___/___/___
Weekly Data: Schedule Activity __________________
Week Of: ___/___/___ to
___/___/___
Estimation
M T W
WRITTEN COMPLAINT
Building Response Procedures
When a WRITTEN COMPLAINT concerning the special education program of a
student is received at the building level, it must be sent to your Instructional
Supervisor in the Special Services Department. Special Services will assist in
addressing the complaint using the following Oklahoma City Public Schools Policy
on Complaint Procedures.
1. A written acknowledgement will be mailed to the parties involved.
2. The Instructional Supervisory staff will investigate the complaint by an on-
site visit or phone conversation to determine the facts of the complaint.
Activities to assist in the resolution of the complaint may include technical
assistance, consultation, mediation conferences, IEP conferences, or other
interventions.
3. If resolved with all parties, a written acknowledgement of the resolution will
be mailed to all parties.
4. If it is determined that further review is needed, additional facts will be
gathered through interviews, review of records, or other investigation
procedures. After the facts are gathered, the District will report, in writing,
the findings of the facts. Included in the findings will be a conclusion and
decision indicating the means of correcting any substantiated violations.
Complainants have the right to have the State Department of Education review the
Districts decision regarding the complaint.
Investigation and resolution of the complaints filed with the District or the State
Department of Education shall be completed within 60 calendar days from receipt
of the formal written complaint. Extensions of time lines may be granted only if
exceptional circumstances exist regarding a specific complaint.
The Districts complaint procedures are filed with the Department of Education and
must be followed.
OSDE Form 8 Page 1 of 2
NAME OF CHILD: ____________________________________________________STUDENT ID: __________________________
FIRST MIDDLE LAST
BIRTHDATE: ___________________ GRADE ____________ AGE ___________ DATE: ______________________
MONTH/DAY/YEAR MONTH/DAY/YEAR
PARENT(S):_____________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________ (OTHER) ________________________
ADDRESS: ___________________________________________________________ DISTRICT/AGENCY: ___________________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
To: _______________________________________________________________________________________________________
PARENT or YOUNG ADULT (If young adult has reached age of majority)
This notice is to inform you of the school districts intent as follows:
DESCRIPTION OF ACTION: PROPOSED OR REFUSED
To initiate or change the following:
Identification of your child as having a disability which requires special education services
Evaluation/Reevaluation to determine disability and nature, extent of special education and related services needed
Educational placement
Provision of a Free and Appropriate Public Education (FAPE)
Parent Revocation of Consent
Other ____________________________________________________________________________________________
Explanation of the proposal or refusal:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Reason(s) for the proposal or refusal:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Description of any options considered and reasons refused:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Description of each evaluation procedure, test, record, or report used as a basis for the proposed or refused action:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Description of any other factors relevant to the proposal or refusal:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Parents have protection under the procedural safeguards. Additional resources can be located within the Parents Rights in Special
Education: Notice of Procedural Safeguards. To obtain a copy, contact <autofill special education teacher>.
The issues addressed in this notice will go into effect on: _____________________________ as the local educational agency has
MONTH/DAY/YEAR
determined that this be considered a reasonable amount to provide the parent(s).
FROM: ____________________________________________________________________________________________________
SIGNATURE OF DISTRICT/PUBLIC AGENCY OFFICIAL DISTRICT/AGENCY TELEPHONE DATE
___________________________________________________________________________________________________________
STREET ADDRESS/P.O. BOX CITY STATE ZIP
SCHOOL USE ONLY: Notice sent by: U.S. Mail Date Mailed __________
Personal Delivery Date Delivered __________
Translation/interpretation needed? Yes No If yes, specify how and when provided:____________________________
School/public agency officials signature verifies that parent(s) have received an explanation in their native language or other mode
of communication to accommodate the parent(s) understanding their rights.
WRITTEN NOTICE TO PARENTS
OSDE Form 8 Page 2 of 2
NAME OF CHILD: ____________________________________________________STUDENT ID: _________________________
FIRST MIDDLE LAST
Evaluation procedures to be utilized in assessing these areas of functioning are explained on this form. Qualified professionals will conduct
evaluation procedures to provide additional information, to the extent appropriate, on the basis of a review of existing evaluation data and input
from the parents. Additional information may be needed to determine whether a child has or continues to have a particular disability; present levels
of performance and educational needs; whether the child continues to need special education and related services; or whether any additions or
modifications to the special education and related services are needed to meet the annual goals in the IEP and to participate as appropriate in the
general curriculum. The appropriate extent of the reevaluation has been reviewed by the IEP team, with opportunity for parent participation and
input.
Descriptions of Evaluation Procedures (Check additional areas proposed for this child)
HEALTH/MEDICAL: Health and medical history, information about childs health and medical status or medical diagnostic
evaluation to determine a medically related disability.
VISION: Assessment of visual acuity, field of vision, and vision functioning as necessary to determine a vision-related
disability.
HEARING: Assessment of hearing functioning and extent of hearing impairment as necessary to determine a hearing-related
disability.
MOTOR: Assessment of gross and/or fine motor skills and abilities in relation to educational needs.
COMMUNICATION/LANGUAGE: Speech skills (including articulation, voice, fluency, and oral-motor) and/or receptive
and expressive language skills and abilities (including phonology, morphology, syntax, semantics, and pragmatics).
ACADEMIC ACHIEVEMENT: Assessments to measure academic achievement in such areas as listening comprehension,
oral expression, basic reading skills, reading comprehension, reading fluency, mathematics calculation, mathematics problem
solving, and written expression skills.
INTELLECTUAL/COGNITIVE: Individually administered assessment of childs ability to learn, including overall mental
ability and cognitive functioning.
PERCEPTUAL/PROCESSING: Childs abilities to perceive and/or process information through visual, auditory, and
sensorimotor means.
DEVELOPMENTAL: Assessment of childs developmental history, skills, and abilities in relationship to expectations for the
age group.
PSYCHOLOGICAL, SOCIAL/EMOTIONAL: Information collected and assessments of the childs social skills/emotional
status, psychological concerns, and behavior (may include data collection, rating scales, behavioral observations, interviews,
personal inventories, and projective tests).
FUNCTIONAL BEHAVIOR: Information collected and assessments of the childs functional behavior (may include data
collection, rating scales, behavioral observations, interviews, and personal inventories).
ADAPTIVE BEHAVIOR: Assessment of childs general behavior in the school and home settings (may include adaptive
behavior skills and activities in the community).
SOCIOCULTURAL: Collection of information and procedures to consider potential influence of sociocultural background or
cultural, linguistic diversity.
OBSERVATION IN CLASSROOM/OTHER ENVIRONMENT: Observations of childs performance and functioning in the
classroom and/or other appropriate settings.
VOCATIONAL: Assessment of vocational interests, aptitudes, and skills.
ASSISTIVE TECHNOLOGY
OTHER CONCERNS AND ASSESSMENTS:
Written Notice to Parents
OSDE Formulario 8 Pgina 1 de 2
NOMBRE DEL NIO: _______________________________________________ ID. DEL ESTUDIANTE: ___________________
PRIMERO MEDIO APELLIDO
FECHA DE NAC.: ___________________ GRADO ____________ EDAD ___________ FECHA: _____________
MES/DA/AO MES/DA/AO
PADRE(S):_________________________________________________________________________________________________
TELFONO: (TRABAJ O) ______________________ (DOMICILIO) ______________________ (OTRO) __________________
DIRECCIN: _________________________________________________________ DISTRITO/AGENCIA: _________________
DIRECCIN/CASILLA POSTAL CIUDAD ESTADO CDIGO POSTAL
Para: ______________________________________________________________________________________________________
PADRE o J OVEN ADULTO (Si el joven adulto alcanz la mayora de edad)
Esta notificacin tiene como cometido informarle acerca de la decisin del distrito escolar:
DESCRIPCIN DE LA ACCIN: PROPUESTA O DENEGADA
Para iniciar o cambiar lo siguiente:
Identificacin de su hijo como portador de una discapacidad que requiere servicios educativos especiales.
Evaluacin/reevaluacin para establecer la discapacidad y la naturaleza, el grado de educacin especial requerido y los
servicios relacionados necesarios.
Determinacin del programa de estudios.
Provisin de Educacin Pblica Gratuita y Apropiada (FAPE).
Revocacin del consentimiento parental.
Otro ____________________________________________________________________________________________
Explicacin de la propuesta o la denegatoria:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Motivo(s) de la propuesta o la denegatoria:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Descripcin de cualquiera de las opciones consideradas y las razones por las cuales fueron denegadas:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Descripcin de cada procedimiento de evaluacin, prueba, registro o informe utilizado como base para la accin propuesta o
denegada:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Descripcin de cualquiera de los otros factores relevantes para la propuesta o la denegatoria:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Los padres gozan de proteccin bajo las salvaguardias procesales. Se presentan recursos adicionales en Derechos de los Padres en
Educacin Especial: Notificacin de las Salvaguardias Procesales. Para obtener una copia, contacte con <autocompletar profesor de
educacin especial>.
Los asuntos tratados en esta notificacin entrarn en vigor a partir del _____________________, segn el plazo estipulado por la
MES/DIA/AO
agencia educativa como apropiado para la adecuacin de la respuesta del(de los) padre(s).
DE: ____________________________________________________________________________________________________
FIRMA DEL FUNCIONARIO DE LA AGENCIA PBLICA/DISTRITO DISTRITO/AGENCIA TELFONO FECHA
___________________________________________________________________________________________________________
DIRECCIN/CASILLA POSTAL CIUDAD ESTADO CDIGO POSTAL
EXCLUSIVAMENTE
PARA USO
ESCOLAR::
Notificacin enviada por:
Correo EE. UU. Fecha del envo __________
Entrega personal Fecha de la entrega __________
Se necesita traduccin/interpretacin? S No Si s, especificar cmo y cundo:____________________________
La firma del funcionario escolar/de la agencia pblica certifica que el(los) padre(s) recibi(eron) una explicacin en su lengua
materna u otro modo de comunicacin para la cabal comprensin de sus derechos.
NOTIFICACIN ESCRITA A LOS PADRES
OSDE Formulario 8 Pgina 2 de 2
NOMBRE DEL NIO: _____________________________________________ ID. DEL ESTUDIANTE: _____________________
PRIMER MEDIO APELLIDO
En este formulario se explican los procedimientos de evaluacin que se utilizarn para evaluar estas reas de funcionamiento. Distintos
profesionales calificados realizarn los procedimientos de evaluacin a los efectos de proporcionar informacin adicional, como mejor proceda, a
partir de la revisin de los datos evaluativos existentes y las devoluciones de los padres. Cabe la posibilidad de se requiera informacin adicional
para determinar si un nio tiene o contina teniendo una discapacidad particular, sus niveles actuales de rendimiento y sus necesidades educativas,
si el nio persiste en su necesidad de educacin especial o servicios relacionados, o si es necesario introducir adiciones o modificaciones a la
educacin especial o los servicios relacionados para cumplir con los objetivos anuales en el IEP y para participar, segn corresponda, en el
programa de estudios general. El alcance adecuado de la reevaluacin fue debidamente analizado por el equipo del IEP y los padres tendrn la
oportunidad de participar y hacer sus devoluciones.
Descripciones de los procedimientos de evaluacin (Marcar las reas adicionales propuestas para este nio)
SALUD/MDICA: Antecedentes sanitarios y mdicos, informacin sobre el estado de salud y mdico del nio o evaluacin
mdica diagnstica para determinar una discapacidad clnicamente relacionada.
VISIN: Evaluacin de la agudeza visual, el campo visual y el funcionamiento visual, segn corresponda, para determinar una
discapacidad relacionada con la visin.
AUDICIN: Evaluacin del funcionamiento auditivo y el alcance de la discapacidad auditiva, segn corresponda, para
determinar una discapacidad relacionada con la audicin.
MOTORA: Evaluacin de las habilidades y competencias motoras gruesas y/o finas con relacin a las necesidades educativas.
COMUNICACIN/LENGUAJE: Habilidades comunicativas (inclusive la articulacin, la voz, la fluidez y las habilidades
orales-motoras) y/o las habilidades y las competencias del lenguaje expresivo (inclusive la fonologa, la morfologa, la sintaxis,
la semntica y la pragmtica).
RENDIMIENTO ACADMICO: Evaluaciones para medir el rendimiento acadmico en distintas reas como la comprensin
auditiva, la expresin oral, las habilidades de lectura bsicas, la comprensin lectora, la fluidez en la lectura, el clculo
matemtico, la resolucin de problemas matemticos y las habilidades de expresin escrita.
INTELECTUAL/COGNITIVA: Evaluacin individual de la capacidad de aprendizaje del nio, inclusive la capacidad mental
global y el funcionamiento cognitivo.
PERCEPTIVA/DE PROCESAMIENTO: Las habilidades del nio para percibir y/o procesar informacin a travs de medios
visuales, auditivos y sensoriomotores.
DEL DESARROLLO: Evaluacin de los antecedentes de desarrollo del nio, sus habilidades y sus aptitudes con relacin a las
expectativas para el grupo etario.
PSICOLGICA, SOCIAL/EMOCIONAL: Recopilacin de informacin y evaluaciones de las habilidades sociales/el estado
emocional del nio, las inquietudes psicolgicas y el comportamiento (puede incluir recopilacin de datos, escalas de
valoracin, observaciones comportamentales, entrevistas, inventarios personales y proyectivas).
COMPORTAMIENTO FUNCIONAL: La informacin recopilada y las evaluaciones del comportamiento funcional del nio
(puede incluir recopilacin de datos, escalas de valoracin, observaciones comportamentales, entrevistas e inventarios
personales).
COMPORTAMIENTO ADAPTATIVO: Evaluacin del comportamiento general del nio en la escuela y el mbito domstico
(puede incluir habilidades de comportamiento adaptativo y actividades en la comunidad).
SOCIOCULTURAL: Recopilacin de informacin y procedimientos para considerar la potencial influencia de los
antecedentes socioculturales o la diversidad cultural y lingstica.
OBSERVACIN EN EL AULA/OTROS MBITOS: Observacin del desempeo del nio y su actuacin en el aula y otros
mbitos pertinentes.
VOCACIONAL: Evaluacin de los intereses vocacionales, las aptitudes y las habilidades.
TECNOLOGA ASISTENCIAL
OTRAS INQUIETUDES Y EVALUACIONES:
Notificacin escrita para los padres
OSDE Mu 8 Trang 1
TN A TR: ____________________________________________________TH HC SINH: ________________________
TN TN LT H
NGY SINH: ___________________ LP ____________ TUI___________ NGY: _______________________
THNG/NGY/NM THNG/NGY/NM
(CC) PH HUYNH:____________________________________________________________________________________
IN THOI: (S) _______________________ (NH) ________________________ (KHC) _______________________
A CH: ___________________________________________________________ KHU HC/C QUAN: __________________
NG/HP TH THNH PH TIU BANG S VNG
Gi:
_________________________________________________________________________________________________________
PH HUYNH hay NGI TRNG THNH (Nu tui trng thnh)
Giy ny c mc ch thng bo v nh ca khu hc nh sau:
M T HNH NG: NGH HAY T CHI
khi xng hay thay i nh sau:
Nhn nh con qu v c khuyt tt cn dch v gio dc c bit
Gim nh/Ti gim nh n nh s khuyt tt v tnh cht, mc gio dc c bit v cc dch v lin h cn thit
t lp vo chng trnh gio dc
Quy iu ca Gio dc Cng cng Min ph v Thch hp (FAPE)
Thu hi s ng ca Ph huynh
Khc ____________________________________________________________________________________________
Gii thch ngh hay t chi:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
(Cc) l do ca ngh hay t chi:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
M t cc s la chn khc c xem xt v l do t chi:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
M t mi th tc gim nh, trc nghim, ghi h s, hay bo co c dng lm cn bn cho hnh ng ngh hay t chi:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
M t bt c yu t no khc hu quan vi ngh hay t chi:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Ph huynh c s bo v da theo cc th tc bo v an ton. Cc ngun thng tin thm c th tm thy trong tp Quyn ca Ph
huynh i vi Gio dc c bit: Thng bo Nhng Th tc Bo v An ton. c mt bn, xin lin lc <autofill special
education teacher>.
Cc vn cp n trong giy thng bo ny s c hiu lc t ngy: _____________________________ v c quan gio dc a
THNG/NGY/NM
phng coi l c thi gian hp l cung cp cho (cc) ph huynh.
T: ____________________________________________________________________________________________________
CH K CA VIN CHC KHU HC/C QUAN CNG CNG KHU HC/C QUAN IN THOI NGY
___________________________________________________________________________________________________________
NG/HP TH THNH PH TIU BANG S VNG
TRNG S DNG
M THI:
Thng bo gi bng: Bu in Ngy gi __________
a tay Ngy a __________
Cn thng dch/phin dch? C Khng Nu ghi c, ni r cung cp cch no v khi no:___________________
Ch k ca vin chc nh trng/c quan cng cng xc nhn l (cc) ph huynh nhn s gii thch bng ngn ng gc ca h
hay bng mt phng cch truyn thng khc gip (cc) ph huynh hiu quyn ca h.
GIY THNG BO PH HUYNH
OSDE Mu 8 Trang 2
TN A TR: ____________________________________________________TH HC SINH: _________________________
TN TN LT H
Cc th tc gim nh dng nh gi nhng phm vi chc nng c gii thch trong bn ny. Cc chuyn gia kh nng s thc hin cc th
tc gim nh cung cp cc thng tin b tc, cho ti mc hp l, trn cn bn duyt xt cc d liu gim nh hin thi v nhng kin ca
ph huynh. C th cn cc thng tin thm n nh xem mt a tr c hay tip tc c mt khuyt tch r rt no hay khng; mc thnh
tch hin ti v cc nhu cu gio dc; xem a tr c tip tc cn gio dc c bit v cc dch v lin h hay khng; xem c cn b tc hay
sa i gio dc c bit t mc tiu hng nm trong IEP v tham gia nu thch hp vo chng trnh gio dc tng qut hay khng. Mc
thch hp ca s ti gim nh c duyt xt bi nhm IEP, vi c hi cho ph huynh tham gia v gp kin.
M t cc Th tc Gim nh (nh du thm cc phm vi ngh cho a tr ny)
SC KHE/Y T: Lch trnh sc khe v bnh l, thng tin v sc khe v bnh l ca a tr hay gim nh chn bnh n
nh khuyt tt lin quan n bnh l.
TH GIC: nh gi tinh ca mt, tm nhn, v chc nng nhn cn thit n nh mt khuyt tt lin quan n th gic.
THNH GIC: nh gi chc nng ca thnh gic v mc thnh khuyt l iu cn thit n nh khuyt tt lin quan n
thnh gic.
C VN NG: ng gi nng khiu v kh nng vn ng th v/hay tinh vi tng quan vi nhu cu gio dc.
TRUYN THNG/NGN NG: Nng khiu ni (k c pht m, ging, s tri chy, v vn ng ming) v/hay nng khiu
v kh nng thu nhn v biu l ngn ng (k c m v, hnh thi, c php, ng ngha, v thc liu).
THNH QU HC VN: nh gi o thnh qu hc vn trong nhng phm vi nh hiu bit khi nghe, biu l li ni,
nng khiu c cn bn, hiu bit khi c, s c tri chy, ton, gii ton, v nng khiu biu l khi vit.
TR TU/NHN THC: nh gi ring bit kh nng hc hi ca tr, k c kh nng tr tu v chc nng nhn thc tng
qut.
CM NHY/HP TH: Kh nng ca tr cm nhy v/hay hp th thng tin qua phng cch nhn quan, thnh gic, v
cm gic vn ng.
PHT TRIN: nh gi qu trnh pht trin, nng khiu, v kh nng trong mi quan h ng la tui ca a tr.
TM L, X HI/XC CM: Thng tin thu thp v nh gi nng khiu x giao/tnh trng xc cm ca a tr, cc lo ngi
tm l, v hnh v (c th bao gm thu thp d liu, thang biu phn loi, quan st hnh vi, phng vn, kim k c nhn, v trc
nghim x nh).
HNH VI CHC NNG: Thng tin thu thp v nh gi hnh vi chc nng ca a tr (c th bao gm thu thp d liu,
thang biu phn loi, quan st hnh vi, phng vn, v kim k c nhn,).
HNH VI THCH NGHI: nh gi hnh vi tng qut ca a tr trng v nh (c th bao gm nng khiu v sinh hot
hnh vi thch nghi trong cng ng).
X HI VN HA: Thu thp thng tin v th tc xem xt tim nng nh hng ca nn x hi vn ha hay s a dng v
vn ha, ngn ng.
QUAN ST TRONG LP/KHUNG CNH KHC: Quan st thnh qu v chc nng ca a tr trong lp v/hay khung
cnh khc thch hp.
HNG NGH: nh gi chiu hng ngh, kh nng, v nng khiu.
K THUT TR GIP
CC LO LNG V GIM NH KHC:
Giy Thng Bo Ph Huynh