Assistive Technology

Case Manager/ Compliance Facilitator checklist

Pre- assessment process

Case Manager emails AT chairperson with verbal student referral.

(cc to Compliance Facilitator)

Case Manager completes referral form.

The referral form is available online at http://www.lcsd2.org

Case Manager makes two copies of completed referral form (one

for sped student file and one for the AT chairperson).

Case Manager makes a copy of student’s schedule to send with AT

referral form. Give/send these forms to your Compliance Facilitator.

Compliance Facilitator sends referral form with student schedule to

AT chairperson. AT chairperson will then assign a team leader.

Compliance Facilitator makes a note in student file/ SEAS that

referral has been sent.

Compliance Facilitator makes up packet with parent letter,

permission to photograph form and permission to test form. (Parent
letter, permission to photograph print off from LCSD2 web site,
permission to test form print off from SEAS)

Send packet to parent. (Note in file/SEAS when sent)

Compliance Facilitator contacts AT team leader as soon as signed

permission is received from parent. (Check to make sure all paperwork
has been signed). Send copies to AT team leader.
Assessment Process
Case Manager

Compliance Facilitator contacts AT team leader as soon as signed

permission is received from parent. (Check to make sure all paperwork
has been signed). Send copies to AT team leader.

Case Manager plans with team leader for the assessment day. (AT
chairperson will let you know who the team leader for the assessment is)
Be sure to cc this info to your Compliance Facilitator.

Case Manager collects work samples prior to the assessment day.

Case Manager needs to let the student, teachers, paras and principal
know what to expect. Also let them know the day and time that the
assessment will take place. (THIS IS A VERY IMPORTANT PART OF
THE ASSESSMENT)
Expectations:
 The team will consist of 3 to 4 people.
 Observations will take pace in multiple settings.
 Interviews will be conducted with all people involved with
student.
 Student will be pulled for trials.

Case Manager needs to confirm that everything is in place with the

team leader and the parent/s the day before assessment takes place.

Brainstorm Session (This is done by the student’s case manager)

Case Manager now needs to set up time, place, and contact all
participants. (Parents, case facilitator, classroom teacher, and team
leader. May also include principal, student, and others as needed.)

Brainstorm session held. Case Manager implements trials and

completes assessment log. (Case Manager will receive the log at the
brainstorm session.)
Final steps

AT team leader sends final report to Compliance Facilitator.

Compliance Facilitator sends report to parents, and shares with Case
Manager and other service providers as appropriate. Compliance
Facilitator documents in SEAS.

After trials are completed and data is collected on trials,

Compliance Facilitator consults with IEP team to determine if
addendum will be completed to document AT needs, or if IEP will be
convened to document AT needs.

July 2010