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04/17 First City School 1231 5th St NW Bemidji, MN 56601 (218) 333-3458 EVALUATION REPORT (Page l of 22) Initial Evaluation Student name: JN Date of Birth: 10/11/2000 X Reevaluation School: First City School Grade: 10 Date of this report: 4/18/2017 Student ID: BACKGROUND INFORMATION Special Education File Review Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher JN has been receiving special education support services for Specific Learning Disabilities (SLD) since 5 th grade. He was referred for the initial evaluation by his parents due to concerns with the increased difficulty for him to complete assignments. JN qualified under the Oral Language/Expression and Math Calculation Skills area. Currently Jordan is working on improving his math skills, personal management skills, listening comprehension skills and productivity skills. Past Evaluation Results: Ability: Evaluation Report 12/1/11 (5 th Grade)- JN completed the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV) and the Leiter International Performance Scale Revised for the evaluation. He achieved a Full Scale IQ score of 86 (low average), a Verbal Comprehension Index score of 98 (average), a Perceptual Reasoning Index score of 88 (low average), a Working Memory Index score of 91 (average), and a Processing Speed Index score of 75 (below average). On the Leiter-R, JN achieved a Full Scale IQ score of 84 (below average). Academic: Evaluation Report 12/1/11 (5 th Grade)- JN completed the Woodcock Johnson III Tests of Achievement (WJ-III) for the evaluation. He achieved an Oral Language Cluster score of 66 (low), a Broad Reading Cluster score of 81 (below average), a Broad Math Cluster score of 71 (below average), a Broad Written Cluster score of 72 (below average), a Basic Reading Skills Cluster score of 88 (low average), a Reading Comprehension Cluster score of 86 (low average), a Math Calculation Skills Cluster score of 59 (low), a Basic Writing Skills Cluster score of 74 (below average), and a Written Expression Cluster score of 81

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04/17

First City School1231 5th St NWBemidji, MN 56601(218) 333-3458

EVALUATIONREPORT

(Page l of 22)

Initial Evaluation Student name: JN Date of Birth: 10/11/2000

X Reevaluation School: First City School Grade: 10

Date of this report: 4/18/2017 Student ID:

BACKGROUND INFORMATIONSpecial Education File ReviewReviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

JN has been receiving special education support services for Specific Learning Disabilities (SLD) since 5 th

grade. He was referred for the initial evaluation by his parents due to concerns with the increased difficulty for him to complete assignments. JN qualified under the Oral Language/Expression and Math Calculation Skills area. Currently Jordan is working on improving his math skills, personal management skills, listening comprehension skills and productivity skills.

Past Evaluation Results:Ability: Evaluation Report 12/1/11 (5th Grade)- JN completed the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV) and the Leiter International Performance Scale Revised for the evaluation. He achieved a Full Scale IQ score of 86 (low average), a Verbal Comprehension Index score of 98 (average), a Perceptual Reasoning Index score of 88 (low average), a Working Memory Index score of 91 (average), and a Processing Speed Index score of 75 (below average). On the Leiter-R, JN achieved a Full Scale IQ score of 84 (below average).

Academic: Evaluation Report 12/1/11 (5th Grade)- JN completed the Woodcock Johnson III Tests of Achievement (WJ-III) for the evaluation. He achieved an Oral Language Cluster score of 66 (low), a Broad Reading Cluster score of 81 (below average), a Broad Math Cluster score of 71 (below average), a Broad Written Cluster score of 72 (below average), a Basic Reading Skills Cluster score of 88 (low average), a Reading Comprehension Cluster score of 86 (low average), a Math Calculation Skills Cluster score of 59 (low), a Basic Writing Skills Cluster score of 74 (below average), and a Written Expression Cluster score of 81 (below average). Some areas of weakness included: Reading Fluency (62), Story Recall (49), Understanding Directions (81), Calculation (66), Math Fluency (66), and Spelling (69).

Communication: Evaluation Report 12/1/11 (5th Grade)- On the Peabody Picture Vocabulary Test Fourth Edition (PPVT-IV), JN achieved a Total Test score of 81 (low average); on the Clinical Evaluation of Language Fundamentals Fourth Edition (CELF-IV), JN achieved a Total Test score of 72 (below average); on the Auditory Processing Abilities Test (APAT), JN achieved a global Score of 89 (low average); on the Test of Problem Solving, JN achieved a Total Test score of 87 (low average).

Sensory Integration: Evaluation Report 12/1/11 (5th Grade)- The Sensory Profile was completed for this evaluation. JN achieved “Definite Difference” ratings on the Sensory Seeking Scale (T=65) as reported by his mother. As reported by his classroom teacher, JN demonstrated problems in Inattention/Distractibility.

Functional Skills: Evaluation Report 12/1/11 (5th Grade)- The Behavior Rating inventory of Executive Function (BRIEF) and Conners Third Edition were both completed for the evaluation. On the BRIEF, concerns were noted in the areas of Inhibit (T=76, 71), Initiate (T=65, 78), Working Memory (T=69, 76),

Plan/Organize (T=77, 72), Organization of Materials (T= 66, 67), and Monitor (T=69, 74). On the Conners-III, JN achieved Clinical ratings on the following Index/Combination Scores: ADHD Index (99%, 93%), Restless Index (T=90, 74), Total Index (T=79, 69).

Social/Emotional Behavoiral: Evaluation Report 12/1/11 (5th Grade)- The Behavior Assessment Systems of Children Second Edition was completed (BASC-II). Areas of concern: Hyperactivity (T= 65, 69), Somatization (T=70, 73), Attention Problems (T= 69, 73), Learning Problems (T= 68), Social Skills (T= 39, 31), Study Skills (T= 30).

Reason for Referral

At an Evaluation Results Meeting held November 11, 2014, the team reviewed evaluation results and criteria for a student with a specific learning disability, emotional or behavioral disorder, and other health services. The team determines that JN did not meet initial criteria as a student with an emotional behavioral disorder; however he did continue to meet criteria as a student with a specific learning disability. In review of the other health disabilities criteria, JN exhibited significant concerns related to work completion, and could qualify for services under this category pending documentation of an attention deficit hyperactivity disorder (ADHD) medical diagnosis. The team will re-consider this categorical area after proper documentation is received by the district. The following report incorporates the results from the most current evaluation and any information that may have been provided by the N family.

Information Reported by Parents Interviewed March 28th, 2017 by Bryan Anderson, Special Education teacher.

JN’s mother stated that mornings are very difficult for him, and it’s a power struggle to get him up and to school. She believes that because of his depression, he doesn’t know how to deal with issues so he tells people to leave him alone. She has been told that his anger is typical in adolescent boys.

When JN gets around his friends, he typically demonstrates a very energetic and upbeat image. His parents expressed concerns if he was developmentally ready for his current grade level or if he should have been held back. They indicated that JN typically demonstrates immature traits and social skills. Even though he shows signs of depression in school, he constantly seeks the attention of his peers; and often demonstrates the same behavior even after being reprimanded and/or receiving a consequence for it.

During his pre-school years, JN received language therapy for six weeks. He had difficulty with articulation, intonation and phonology. JN has also had issues with hearing. Throughout his elementary hearing screening, JN fails the initial screen test but passes the second screening process conducted by the school nurse in a more isolated setting. JN displays hearing impairments at home, many times not responding to various family members directly talking to him if he not facing them.

JN also has a tendency to zone in on electronic stimulus, becoming unresponsive to anyone or anything in his environment while engaged with a phone, iPad, kindle, television or gaming platform. His parents are unable to attain his attention unless they provide a physical stimulus such as touching his shoulder or head.

Review of Records/Educational HistoryReviewed By: Bryan Anderson Special Education Teacher

Preschool: During the preschool screening, JN completed the Early Screening Inventory. He achieved a score of 22, which falls within the Average range. He achieved a score of 20 on the Ages and Stages Questionnaire, which falls within the Normal range. It was noted on the summary form that JN had tubes

in his ears. He had a hole in his right ear from the tube and had been seen by an ENT. No concerns were indicated.

Kindergarten: As reported on the Communication Arts Mastery Checklist, JN was able to master 76 out of 120 skills (first trimester), 125 out of 128 skills (second trimester) and 146 out of 151 skills (third trimester). In the area of Mathematics, JN was able to master 38 out of 42 skills (first trimester), 55 out of 66 skills (second trimester) and 64 out of 66 skills (third trimester). In the categories of work and study skills JN received a “Satisfactory” rating in most areas. He demonstrated concerns in the areas of Listening with Focused Attention, Sitting Still to Listen, and Taking Time to Work Carefully. JN did receive Title I Reading Program Intervention Services starting in September of his Kindergarten year. He attended 4 days a week. He was also enrolled in the Extended Day Kindergarten program. He was absent 6 days of the school year.

First Grade: In a review of his report card, JN achieved “Satisfactory” ratings in all areas of Mathematics. In the area of Reading, JN received “Satisfactory” ratings in all skill domains except the following: knowing high frequency words, using appropriate handwriting skills, using proper spacing, capitalization and punctuation skills. JN achieved “Satisfactory” ratings in all Behavior and Work Skills. Some concerns were noted in music for listening attentively and following directions. He was enrolled in the Title Reading and Reading Recovery programs. JN was absent one day.

Second Grade: JN received “At Grade Level” markings in all areas of Writing and most skills in Math. Concerns in reading included: asking questions and responding to text, reading independently and using a variety of strategies. He demonstrated difficulties in listening attentively, staying on task and completing work. Music and Gym noted concerns in listening attentively, managing conflict and continuing to work despite frustration. He was enrolled in the Title Reading Lab program. JN was absent one day and tardy twice.

Third Grade: JN received an “Assisted” rating in all skill areas of Reading. He did achieve a rating of “Independent” in reading with understanding, using word recognition skills and using reading strategies by the end of third trimester. In Spelling, JN received “Developing” marks for spelling with accuracy. In Writing, he received “Developing” marks in organization, conventions and correct form, size and spacing. JN achieved marks of “Independent in Math for the categories of math facts and understanding concepts. He received “Assisted” marks for using problem solving strategies. In Science, Art and Technology he received “Assisted” marks. In the area of Behavior and Work Skills, JN received marks of “Needs Improvement” in following directions, staying on task, effort, organizational skills, working neatly and following rules. In Music concerns were noted for listening carefully. He continued his enrollment in the Title Reading Lab program. JN was absent 7 days.

Fourth Grade: JN achieved “At Grade Level” marks Health and Art. He received “Near Grade Level” marks in Reading, Mathematics, Social Studies and Science. He achieved “Below Grade Level” markings in English. Areas of concern in English included: applying spelling rules, applying capitalization/punctuation rules, applying grammar/usage rules, and writing legibly. In Math, the following concerns were noted: knowing math facts, working with accuracy and understanding concepts. In the area of Behavior and Social Skills, JN struggles with demonstrating appropriate behavior throughout the first trimester. During the second and third trimesters he achieved a “Satisfactory” mark in this area. Music continued to report concerns of listening attentively. JN was absent 12.5 days and tardy twice.

Fifth Grade: JN did not receive any “At Grade Level” or “Near Grade Level” marks. JN was demonstrating skills “Below Grade Level” throughout the school year in all areas of academics. Behaviorally, JN demonstrated “Satisfactory Minus” grades for the first two trimesters. He earned “Needs Improvement” marks for listening attentively, using time wisely, staying on task, organization, and completing and returning assignments. JN was referred for a special education services evaluation. Areas assessed included Intellectual, Academics, Behaviors, ADHD Screening and Sensory. JN qualified for

services under the Specific Learning Disabilities category. He missed 14 days of school and was tardy 46 times.

Group Achievement Test Scores/Statewide Testing Information:Reviewed By: Bryan Anderson Special Education Teacher

Minnesota Comprehensive Assessment (MCA):Grade: 7 6 5 4 3Reading: 739 Does Not

Meet 630 Does Not Meet 550 Meets 431 Does Not Meet 353 Meets

Math: 737 Does Not Meet 641 Doe Not Meet 549 Partially Meets 441 Partially Meets 349 Partially Meets

Science: 555 Meets

NWEA (Measure of Academic Progress):Grade: 7 6 5 3 2Reading: 218 (220) 210 (216) 186 (199) 171 (190)Math: 223 (231) 215 (226) 217 (221) 195 (203) 190 (191)Language: 206 (216)

*the normalized scored for peers his age appear in the parenthesis

Educationally Relevant Medical FindingsReviewed By: Bryan Anderson Special Education Teacher

During his pre-school years, JN received language therapy for six weeks. He was enrolled in a speech program at the Sanford Clinic with therapy sessions twice a week for a total of 2 hours. He had difficulty with articulation, intonation and phonology.

JN has also had issues with hearing. JN has failed the initial screen test administered by the school nurse the past seven years, but passed the second screening process conducted by the school nurse in a more isolated setting.

JN is on Vyvanse for his ADHD, Fluoxetine for depression, and Clonidine to help him sleep at night. However there is still no medical documentation from a licensed doctor or mental health specialist regarding a relevant medical diagnosis in his current file. Upon questioning his parents, they indicated that they had submitted the paperwork to the school.

Special ConsiderationsJN’s language, cultural, economic or environmental background does not indicate that special adaptations in assessment procedures are needed. JN’s physical and sensory status does not indicate that special accommodations are needed for the assessment process.

EVALUATION RESULTS

Tests Administered

1. Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV).2. Woodcock-Johnson IV Tests of Achievement. 3. Behavior Assessment Scale for Children (BASC).

4. Psychological Processing Checklist (PPC).

Intellectual Functioning: Test: Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). Date: March 27th, 2017Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

On the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV), a measure of intellectual and cognitive functioning, JN obtained a Full Scale IQ score of 70. With 95% confidence, JN’s true score should fall between 66 and 67. This places him in the Below Average/Normative Weakness range and at the 2nd percentile when compared to peers his age.

JN was evaluated by Bryan Anderson, Special Education Teacher, on March 27th, 2017 using the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). Testing was done in the special education classroom, with only the teacher and JN present. JN came to the initial testing session willing and was cooperative in completing the first four tasks. Rapport was easy to establish with JN, however it was not sustained throughout all of the testing. JN did commit an inappropriate behavior during testing and was visited by the principle. When testing was attempted a second time, JN did answer and try to solve easy problems but gave up easily on difficult tasks. He did not continue despite encouragement. JN often moved in a slow, lethargic manner and kept his head down throughout most of the testing. Thus, the results of the testing are not considered valid or reliable. The subtests that appear to be reliable and valid at this time include the Block Design, Similarities, Digit Span, and Picture Concepts.

The average subtest score is 10, standard deviation is 3, and the average subtest range is 7 to 13. The average IQ or Index score is 100, standard deviation is 15, and the average range is 85-115. Processing standard scores below 85 are considered a normative weakness.

Verbal Comprehension Score Perceptual Reasoning ScoreSimilarities 10 Block Design 8Vocabulary 6 Picture Concept 9Comprehension 4 Matrix Reasoning 6

Working Memory Processing SpeedDigit Span 7 Coding 1Letter-Number 3 Symbol Search 3

Index/Quotient Domain Score LevelFull Scale IQ 70 Below AverageVerbal Comprehension 81 Below AveragePerceptual Reasoning 86 Low AverageWorking Memory 71 Below AverageProcessing Speed 56 Low

Description Overview of Tests Administered Verbal Comprehension Reasoning (Crystalized Intelligence) domain measures verbal reasoning,

concept formation, or breadth and depth of acquired knowledge. It’s the ability to reason with previously learned information. It develops with educational experience. Throughout the verbal tasks, JN was required to compare and verbally draw conceptual similarities between words (Similarities), define words (Vocabulary), answer questions about social behaviors (Comprehension), and answer questions about general facts (Information).

Perceptual Reasoning Abilities (Fluid Intelligence/Visual Processing) tasks require on to examine and thinkg about things such as designs and pictures, and how to solve problems without using

words. The perceptual reasoning tasks can be broken down into two different processing areas: fluid intelligence and visual processing. For the non-verbal tasks, JN was required to make designs with blocks (Block Design), choose two or three pictures to form a categorical group (Picture Concepts), and select a missing portion to finish a matrix puzzle (Matrix Reasoning).

Working Memory Abilities is the ability to hold information in immediate memory and store it long enough to manipulate the information. Working memory requires divided attention. Working memory is important for recording new learning, connecting new and existing knowledge, transform and manipulate information, as well as hold information while memories are being retrieved from long-term memory. JN was required to recall numbers in ascending and backwards order (Digit Span) as well as recall a series of numbers and letters (Letter-Number).

Processing Speed Abilities is one’s ability to perform automatic thinking tasks while maintaining focused attention, especially under pressure. Processing speed abilities are important for the efficient processing of information, quickly perceiving information for encoding, and completing rote or automatic tasks quickly. It also impacts pace or retrieval of information and general rate of work completion. The processing speed tasks JN was required to complete included quickly copying symbols that were paired with numbers according to a key (Coding) and identifying the presence of a target symbol in a group of symbols (Symbol Search).

 

Academic Performance:Test: Woodcock Johnson Tests of Achievement (WJ-IV). Date: March 13th, 2017Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher The Woodcock-Johnson Tests of Achievement -Fourth Edition (WJ-IV ACH) is a standardized test of achievement that measures academic skills in the areas related to reading, math, and written language as compared to age or grade mates.  Results in the table below are reported as standard scores and percentile ranks. 

The WJ-IV ACH reports results as ranges based on standard scores with a mean of 100 and standard deviation of 15. The Average range includes standard scores from 90 to 109. Below the average range, standard score ranges are: Low Average 80 to 89; Low 70 to 79; Very Low 69 and below. Above the average range, standard score ranges are: High Average 110 to 119; Superior 120 to 129; Very Superior 130 and above.

JN was evaluated by Bryan Anderson, Special Education Teacher, on March 13th, 2017 using the Woodcock Johnson IV Normative Update Tests of Achievement (WJ-IV NU). Testing was done in the special education classroom, with only the teacher and JN present. JN’s level of conversational proficiency, cooperation, activity, attention and concentration were typical for his age level. JN appeared mostly at ease during testing, becoming fidgety and anxious when dealing with more complex tasks. While he did attempt more complex tasks, he gave up easily when he anticipated failure. JN was slow and careful in his responses, often rereading or asking for clarification on instructions he did not understand. He was uncooperative at times and overall seemed lethargic throughout the examination.

On the Letter-Word Identification test JN identified initial items rapidly and accurately but had difficulty applying phoneme-grapheme relationships to latter items. On the Applied Problems test he solved initial problems with no observed difficulty but demonstrated increasing difficulties solving the latter items. For the Spelling test he spelled words in a laborious manner (non-automatic). On the Passage Comprehension test JN appeared to read passages slowly and had difficulty identifying a correct word (struggled with application of syntactic and semantic cues). For the Calculation test JN solved problems slowly and demonstrated less automaticity with the latter items. JN’s Writing Samples sentences were inadequate (run-ons, incomplete sentences, awkward syntax, or limited content). On the Word Attack test he identified initial items rapidly and accurately and identified more difficult items through increased application of

phoneme-grapheme relationships. For his Sentence Reading Fluency test, JN appeared to read sentences at a rate typical for peers. On his Math Facts Fluency test JN solved problems slowly. On the Sentence Writing Fluency test JN had trouble formulating or writing sentences quickly.

According to the WJ-IV, JN’s ability to apply academic skills is within the Below Average range. His fluency with academic tasks is within the Deficient Range. His standard score in Basic Reading is Average. He scores Low Average in reading fluency and Below Average in broad reading. JN scores in the Deficient range in Broad Mathematics, Math Calculation Skills, Broad Written Language and Written Expression.

 

Standard Score

(68% Band)Age Equivalent Grade Equivalent

BROAD READING SKILLS 84 (81-87) 10.6 5.0

Letter Word Identification 90 (86-94) 11.5 6.0

Passage Comprehension 75 (70-80) 8.11 3.5

Sentence Reading Fluency 87 (82-92) 10.8 5.2

BASIC READING SKILLS 93 (90-96) 10.8 5.2

Letter Word Identification 90 (86-94) 11.5 6.0

Word Attack 98 (93-103) 13.0 7.6

READING FLUENCY 87 (82-92) 10.8 5.3

Oral Reading 90 (86-93) 10.9 5.3

Sentence Reading Fluency 87 (82-92) 10.8 5.2

BROAD MATHEMATICS 77 (74-81) 10.0 4.6

Applied Problems 99 (95-104) 13.7 8.2

Calculation 79 (75-83) 10.1 4.7

Math Facts Fluency 68 (62-74) 8.10 3.4

MATH CALCULATION SKILLS 72 (68-76) 9.4 3.9

Calculation 79 (75-83) 10.1 4.7

Math Facts Fluency 68 (62-74) 8.10 3.4

BROAD WRITTEN LANGUAGE 73 (70-76) 9.4 3.9

Spelling 79 (75-83) 9.9 4.3

Writing Samples 78 (73-83) 8.8 3.3

Sentence Writing Fluency 74 (67-81) 9.2 3.7

WRITTEN EXPRESSION 74 (73-83) 8.11 3.5

Writing Samples 78 (73-83) 8.8 3.3

Sentence Writing Fluency 74 (67-81) 9.2 3.7

ACADEMIC SKILLS 81 (79-84) 10.4 4.9

Letter Word Identification 90 (86-94) 11.5 6.0

Spelling 79 (75-83) 9.9 4.3

Calculation 79 (75-83) 10.1 4.7

ACADEMIC FLUENCY 76 (72-80) 9.8 4.2

Sentence Reading Fluency 87 (82-92) 10.8 5.2

Math Facts Fluency 68 (62-74) 8.10 3.4

Sentence Writing Fluency 74 (67-81) 9.2 3.7

ACADEMIC APPLICATIONS 82 (78-85) 10.1 4.7

Applied Problems 99 (95-104) 13.7 8.2

Passage Comprehension 75 (70-80) 8.11 3.5

Writing Samples 78 (73-83) 8.8 3.3

 Description Overview of Tests Administered

Basic Reading Skills is a combined measured of JN’s oral sight-word reading skills and his ability to apply phonics skills to pronounce unfamiliar printed words.

Reading Comprehension is a combined measure of JN’s ability to comprehend passages while reading silently and ability to verbally reconstruct story content that was read silently.

Reading Fluency is a combined measure of oral reading skills and the ability to quickly read and comprehend sentences silently.

Broad Mathematics is a comprehensive measure of math achievement, including math calculation skills, problem solving, and the ability to solve simple addition, subtraction, and multiplication facts quickly.

Math Calculation Skills is a combined measure of math computational skills and the ability to do simple math calculations quickly.

Math Problem Solving is a combined measure of math problem solving using story problems, understanding of math vocabulary, and reasoning with number patterns.

Broad Written Language is a broad-based measure of JN’s written language achievement, including spelling, the quality of written sentences, and speed of writing.

Written Expression is a combined measure of meaningful writing and writing speed. 

Social, Emotional, BehavioralTest: Behavior Assessment Scale for Children (BASC) Date: March 22nd, 2017Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

The Behavior Assessment System for Children, Third Edition (BASC-3) is a multimethod, multidimensional system used to evaluate the behavior and self-perceptions of children and young adults aged 2 through 25 years. The BASC-3 includes teachers rating forms that measure adaptive and problem behaviors in the school setting; parent rating forms that measure adaptive and problem behaviors in community and home settings; and student self-report forms. To give valid ratings, respondents should have had considerable contact with the child (e.g. a month of daily contact or 6 to 8 weeks of several days a week observation.)

The classifications in this report are based on T-scores obtained using general norms with a mean of 50 and a standard deviation of 10. This means that the average score range falls between 41-59. On the clinical scales, T-scores of 70 and above fall in the Clinically Significant range suggesting a high level of maladaptive behavior and T-scores of 60-69 fall in the At-Risk range. On the Adaptive Scales, T-scores of 30 and below fall in the Clinically Significant ranges suggesting an absences of adaptive behavior and T-scores of 31-40 fall in the At-Risk range.

JN was evaluated by Bryan Anderson, Special Education Teacher, on March 22nd, 2017 using the Behavior Assessment System for Children, Third Edition (BASC-3). Testing was done in the special education classroom, with only the teacher and JN present. JN’s level of conversational proficiency, cooperation, activity, attention and concentration were typical for his age level. JN appeared mostly at ease during testing. JN was slow and careful in his responses, often rereading or asking for clarification on instructions he did not understand.

JN obtained a V index score of caution, indicating that he may or may not have been fully attentive when completing the rating form, or that he did not fully understand the questions.

School Settings: Based on the results, concerns for JN are noted in the areas of: Hyperactivity, Conduct Problems, Depression, Atypical Behaviors, Withdrawal, Learning Problems, Attention Problems, Adaptability, Social Skills, Leadership Skills, Study Skills and Communication Skills. Specifically, JN is being very disruptive to other in class as reported by his teachers. He also has a short attention span, is easily distracted, annoys others, does not follow classroom rules or procedures, lies, cheats, bullies, call others names and uses foul language at school.

Home Setting (Parent Report): Based on the results, concerns for JN were noted in the areas of: attention-problems, adaptability, social skills, leadership skills, and activities of daily living. In a review of response items, JN’s mother reports that at home, JN is observed to often argue and has a short attention span. She is aware that JN “sometimes” uses tobacco, uses foul language, lies, breaks the rules, and annoys others on purpose.

Home Setting (Student Report): Based on the results, JN identifies the following concerns for himself: attitude towards school and teachers, need to seek sensations, depression, sense of inadequacy, locus of control. Attention problems, hyperactivity, a typicality, self-esteem and relationship with parents. He also notes concerns in the areas of: mania, anger control and ego self.

Parent & Teacher Scales

Clinical Scales: clinically significant ≥70; at-risk= 60-69; average ≤ 59Teacher Teacher Teacher Teacher Parent

Externalizing Composite 55 64* 67* 72* 53

Hyperactivity 57 57 68* 68* 55

Aggression 54 59 59 61* 47

Conduct Problems 52 75* 71* 84* 57

Internalizing Composite 39 46 46 54 47

Anxiety 39 39 42 39 36

Depression 42 51 56 62* 52

Somatization 43 51 43 59 55

Behavioral Symptoms Index 53 63* 65* 72* 57

Atypicality 47 54 65* 72* 57

Withdrawal 49 61* 55 66* 57

Learning Problems 64* 66* 71* 90* -

Attention Problems 64* 80* 68* 78* 63*

Adaptive Skills: clinically significant ≤30; at-risk = 31-40; average ≥41

TeacherTeacher Teacher Teacher Parent

Adaptive Skills 41 25* 34* 25* 39*

Adaptability 51 27* 39* 31* 50

Social Skills 32* 26* 32* 28* 37*

Leadership 44 29* 36* 29* 36*

Activities of Daily Living - - - - 36*

Functional Communication 51 31* 42 25* 43

Student Self Report

Clinical Scales: clinically significant ≥70 and at-risk = 60-69; average ≤ 59

School Problems 81*Internalizing Composite 70*

Attitude to School 76* A typicality 68*

Attitude to Teachers 82* Locus of Control 66*

Sensation Seeking 65* Social Stress 62*

Inattention/Hyperactivity 74*Anxiety 62*

Attention Problems 82* Depression 78*

Hyperactivity 60* Sense of Inadequacy 79*

Emotional Symptoms Index 69*Somatization 52

Adaptive Skills: clinically significant ≤30 and at-risk = 31-40; average ≥41

Personal Adjustment 47

Relations with Parents 39*

Interpersonal Relations 56

Self-Esteem 32*

Self-Reliance 63

Test: Behavior Evaluation Scale Third Edition (BES-III). Date: October 31st, 2014.Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

The BES-III is designed to measure a child’s social, emothional, and behavioral development as it compares to others the child’s age and gender. The average Index score is 100 with an average of 85 to 115. Index scores of 1 to 84 are in the At Rick range. Index scores of 70 or lower are considered to be Clinically Significant. The average scale score is 10 and the average range is 7 to 13.

Scale/Index Domain Teacher Teacher Teacher Teacher ParentLearning Problems 7 4* 3* 3* 4*Interpersonal Problems 12 10 6* 7 12Inapropriate Behaviors 11 8 9 7 9Unhappiness/Depression 13 7 9 7 10Physical Symptoms/Fears 11 11 13 6* 8Behavior Quotient 101 88 88 81* 89

School Setting: JN’s Behavioral Quotient scores fall generally in the Average range when compared to others his same age. JN’s teacher report that the following behaviors are often occurring across settings: difficulty attending to tasks, failing tests/quizzes, does not follow directions, has difficulty getting organized, refuses to complete assignments, is reluctant to start tasks, disrupts the work of others, unwilling to communicate feelings, absent and tardy from class, does not obey teacher directives, does not consider consequences of his choices, off task, exhibits excessive fatigue, difficulty concentrating, disinterested in activities, shows no emotion and has difficulty applying knowledge he knows to new problems and situations.

Home Setting: JN’s Behavioral Quotient score on the Parent Form falls within the Average range when compared to peers his age. He did score in the At Risk ranged on Learning Problems. This suggests that there are concerns with his attention skills and learning. In a review of response items, JN’s mother reports that he does not complete his schoolwork, does not study, is careless and irresponsible, and has difficulty with sustaining attention.

Test: Psychological Processing Checklist (PPC). Date: February 28th, 2017.Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

The Psychological Processing Checklist (PPC) asks students, parents and teachers to rate observable and measurable characteristics and behaviors of the child in the classroom to evaluate if a processing disorder is likely. Understanding a child’s level of functioning in specific areas is an important part of any assessment for children who are experiencing difficulties with learning. Basic psychological processing disorders are often revealed in a child’s difficulties with listening, thinking, speaking, reading, writing, spelling, or math activities. The PPC asks students, parents and teachers to rate observable and measurable characteristics.

JN was evaluated by Bryan Anderson, Special Education Teacher, on February 28th, 2017 using the Psychological Processing Checklist (PPC). Testing was done in the special education classroom, with only the teacher and JN present. JN’s level of conversational proficiency, cooperation, activity, attention and concentration were typical for his age level. JN appeared mostly at ease during testing. JN was slow and careful in his responses, often rereading or asking for clarification on instructions he did not understand.

The PPC items are grouped, for scoring and interpretive purposes, into ten areas:

1. Acquisition of Information: JN, his parents and his teacher reported that JN learns best through a multiple senses. Hearing information is the least effective input. As JN has an attention disability.2. Organization: JN reported that he is very disorganized, frequently needing help or reminders with materials needed for work, where to locate those materials, locker and desk organization, as well as aligning homework neatly. JN’s parents reported that he is lacking in information categorization, making notes or outlines, and editing or revising work. JN’s teacher confirmed these observations, stating that she has to continually provide reminders to JN for these tasks.3. Planning and Sequencing: JN reported that he lacks strong planning and sequencing skills and does need help getting information before working on a project. JN’s parents reported that JN needs support to prioritize tasks, use planning skills, and creating a logical story. JN’s teacher indicates that JN functions at below average levels in planning and sequencing, and requires support in many planning and sequencing areas throughout his education.4. Working Memory: JN, his parents and his teacher reported that he functions at below average to average levels in working memory. JN does not have immediate retrieval of information, but can call upon memory if given an adequate amount of time5. Visual Processing: JN, his parents and his teacher reported that he functions at average levels in visual processing.6. Auditory Processing: JN and his parents report that he needs support in repeating spoken directions and asking for directions to be repeated. JN’s teacher reported that he needs support with remembering verbal information and recalling information presented verbally. 7. Processing Speed: JN, his parents and his teacher reported that he functions at below average levels in processing speed.8. Expression- Verbal and Nonverbal: JN and his teacher reported that he functions at average levels in expression. JN’s parents report that he needs assistance in written communication.9. Transfer of Information: JN and his teacher reported that he functions at below average levels in transfer of information. JN’s parents report that he needs assistance in writing sentences of varying length and complexity, finding more than one way to answer and differentiate details from key concepts.10. Motor control for Written Tasks: JN and his teacher reported that he functions at above average levels in motor control. JN’s parents report that he needs assistance in erasing mistakes.

Summary: JN has difficulties with starting tasks, assignments or problem solving situations. His teachers report that he is often easily distracted, has trouble concentrating, doesn’t complete tasks, and needs assistance from adults to stay on task. JN requires frequent reminders to start and remain on task with schoolwork and will need instruction on self-monitoring techniques he can implement to improve in this area. JN has difficulty holding an appropriate amount of focus for an age appropriate amount of time. JN reports that he does have a short attention span, doesn’t hand in homework, forgets what he is supposed to do, frequently forgets instructions easily and is absentminded. He will need support in implementing strategies to remain on task in class through the use of teacher cues and self monitoring techniques. JN has significant difficulty with planning and organizing information such as setting goals or carrying them out. He underestimates the amount of time needed to complete tasks, becomes overwhelmed by academic projects, and his written work is poorly organized, and he rarely turns in work to be graded. JN has difficulties keeping his materials organized, and is unable to find things needed to complete tasks. JN will require specific instruction in organizational methods.

CommunicationThere are no concerns with communication ability as reported by his family or staff members, so there is not a need for formal testing in this area.

Motor Ability There are no concerns with motor ability as reported by his family or staff members, so there is not a need for formal testing in this area.

Functional SkillsTest: Functional Behavioral Assessment Profiler Checklist (FBA). Date: October 31st, 2014.Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

The FBA Profiler is a norm-referenced and criterion-referenced behavior rating scale designed to identify problems or target behaviors, suggest hypothesized function of behavior, and provide a screening of possible mental health issues. Behavioral concerns which are noted to be At Rick are those that fall just outside the Average or Normal range and represent moderate or emerging behavioral difficulties. Behavioral concerns which are rated as Clinically Significant are those that fall significantly beyond the average or normal range and represent behaviors which are severely discrepant from the general population. Separate norms were used for this evaluation.

Average T-Score is 50. Average range is 40-60. The At Risk range includes scores from 61-69. The Clinical range is 70 and above.

Index: Teacher Teacher Teacher Teacher Parent StudentInternalizing Problems Composite 54 65 61* 75* 53 71*Off Task 60* 66* 69* 77* 69* 81*Social Withdrawn 51 59 55 59 45 64*Passive Aggressive 44 53 48 65* 43 65*Somatic Issues 52 58 52 58 46 54Externalizing Problems Composite 55 57 65* 66* 48 75*Disruption 53 47 63* 66* 49 57Rule Breaking 58 61* 71* 64* 50 77*Active Aggression 46 53 53 49 43 52Defiance 59 63* 63* 72* 51 89*

Behavioral Concerns Observed in the School Setting: JN’s teachers report that he is not completing school work, lies, annoys others, does not follow through with instructions, does not like being told what to do, lacks interest, seems depressed, does not follow rules, does not engage in work that requires mental energy, sustained attention or effort, talks too much in class, seems angry, has difficulty concentrating, seems tired and lacks energy, delayed or slow body movements, skips school, is frequently absent from school, seems forgetful and has difficulty organizing tasks/assignments.

Behavioral Concerns Observed in the Home Setting (Parent): JN’s mother identified concerns in the area of off task behaviors. She reports that he often fails to give close attention to details, is reluctant to engage in activities that require sustained effort and attention, loses things, has difficulty staying focused, does not complete schoolwork and does not follow instructions.

Behavioral Concerns Observed in the Home Setting (Student): JN reports that he often has trouble following the following behaviors: he doesn’t pay attention to details, is fidgety/squirmy, is depressed, has difficulty organizing tasks/assignments, is easily annoyed with others, sleeps a lot during the day, seems to do things over and over, has headaches, is angry, talks too much in class, loses things, feels he needs to get back at others, does not participate in sports or organizations, is easily distracted, feels tired and lacks energy, feels anxious, does not follow rules, feels worthless, has difficulty concentrating, has thoughts of suicide and death, stays out past curfew, argues with adults, lacks interest or pleasure in most daily activities, is frequently absent from school, feels irritated, very sensitive to sound, most problems in life are not his fault, doesn’t like change, shows little emotions to others, doesn’t like to listen to people or authority or follow instructions, and often uses foul language.

Test: Behavior Rating Inventory of Executive Function (BRIEF). Date: October 31st, 2014.Reviewed By: BG, School Psychologist, Bryan Anderson Special Education Teacher

The BRIEF is a standardized, questionnaire designed to better understand a child’s executive function skills. Executive functions are mental processes that direct a child’s thoughts, actions, and emotion particularly during problem solving.

The Average T-Score is 50 and the average range is 40-60. Scores of 65-69 are Moderately Elevated. Scores above 70 are considered to be Clinically Elevated for someone of the child’s age.

Index Teacher Teacher Teacher

Teacher Parent Student

Behavioral Regulation 52 67* 67* 80* 46 65*Inhibit 61* 75* 83* 86* 48 69*Shift 45 75* 50 84* 51 66*Emotional Control 45 45 56 62 43 60Metacognition 76* 83* 85* 107* 57 70*Task Completion 72* 88* 80* 101* 49 69*Working Memory 84* 84* 84* 97* 74* 73*Plan/Organize 72* 81* 75* 95* 56 63Organization of Materials 64 64 70* 116* 49 65*Monitor 68* 73* 87* 96* 51 44Global Executive Composite 68* 80* 81* 102* 54 69*

Inhibit: The Inhibit Scale assesses a student’s inhibitory control with impulsivity. JN’s scores on this scale fall generally in the Highly Elevated range for someone his age. This would suggest that JN has difficulty resisting impulses and considering consequences before acting. In his classes, JN is often told to stop his inappropriate behaviors. He often interrupts other’s work and gets into trouble when unsupervised. As reported by his mother, JN is able to control his impulsive responses.

Shift: The Shift Scale assess a student’s ability to transition from a situation or activity as circumstances demand. It involves one’s ability to tolerate change, be flexible in problem solving, shift attention or change focus on a topic. JN’s scores on this scale fluctuate. He is able to handle change in Science and English classes but demonstrated difficulty in Math or Social Studies. JN has also identified this area of concern. In a review of his teachers, JN often gets stuck on topics, has trouble getting used to new situations, and can’t get past disappointments. JN reports getting upset when plans are changed, getting stuck on topics and inabilities to derive other ways to solve problems. As reported by his mother, JN is able to be flexible and tolerate change.

Emotional Control: The Emotional Control Scale assesses a student’s ability to regulate or control emotional responses to situations. JN’s scores on this scale fall within the Average range when compared to his peers. JN demonstrated appropriate ability to regulate emotions. He does not have frequent outbursts or mood changes or stays upset for excessive periods of time. As reported by his mother, JN is able to modulate and regulate his emotional responses to situations and experiences.

Initiate/Task Completion: The Initiate Scale reflects a student’s ability to begin a task independently. JN’s score on this scale falls within the Significantly Elevated range compared to peers his age. JN has difficulties with starting tasks, assignments or problem solving situations. He needs frequent cues to reminders from adults in order to begin. Initiative weaknesses may also be a sign of depression which may need to be examined by a mental health professional. JN’s mother reports that he is able to start chores at home.

Working Memory: The Working Memory Scale measures the capacity to hold information in mind for the purpose of completing a task, generate goals and complete goals, and planning and organizing. JN’s scores on this scale fall within the Significantly Elevated range when compared to peers his age. JN has difficulty holding an appropriate amount of focus for an age appropriate amount of time. His teachers report that he is often easily distracted, has trouble concentrating, doesn’t complete tasks, and needs assistance from adults to stay on task. JN reports that he does have a short attention span, doesn’t hand in homework, forgets what he is supposed to do, forgets instructions easily and is absentminded. JN’s mother reports that he has difficulties sustaining attention and focus.

Plan/Organize: The Plan and Organize Scale measures a student’s ability to manage current and future demands. It may involve setting and achieving goals, developing sequential steps to solve a problem, or bringing order to information. JN’s score on this scale falls within the Significantly Elevated range. JN has significant difficulty with planning and organizing information such as setting goals or carrying them out. JN often forgets to complete his assignments or doesn’t hand them in. He underestimates the amount of time needed to complete tasks, becomes overwhelmed by large projects, and his written work is poorly organized. JN’s mother reports that he is able to plan and organize information at home.

Organization of Materials: The Organization of Materials Scale measures orderliness of play, work and storage spaces (such as desks, rooms, lockers, backpacks, etc.). JN’s score on this scale falls within the High Average to Highly Elevated ranges. JN has difficulties keeping his belongings and materials organized, doesn’t have them readily available for assignments, and is unable to find things needed to compete tasks. JN’s mother reports that he is able to be responsible for his belongings and can keep things organized at home.

Monitor: The Monitor scale measures a student’s ability to monitor tasks and behaviors. JN’s scores fall in the Highly Elevated range for someone his age. JN often makes mistakes in his work, does not edit his work, leaves his work incomplete, and completes his work in a sloppy manner. He does not seem to understand how his behavior affects others. JN’s mother reports that he is able to monitor his behavior as well as other peers his age.

Summary: Based on the results of the BRIEF, JN exhibits difficulty with aspects of executive function skills, which is confirmed by JN and his teachers. Concerns are noted with his ability to inhibit impulsive responses, transitions, initiate tasks or assignments, sustain focus and attention, plan and organize information, organize his materials and belonging, and monitor work and behaviors. JN continues to demonstrate a need for support in developing his executive function skills. JN’s mother reports concerns in the area of working memory/sustaining attention.

Physical StatusThere are no concerns with physical ability as reported by his family or staff members, so there is not a need for formal testing in this area.

Sensory StatusVision and Hearing Status: No concerns notes with vision and hearing, although historically JN has initially failed the first hearing screening administered by the school nurse. He has passed the second screening each year. JN passed the vision and hearing screenings in October 2014.

Transition, including Vocational Test: Post-Secondary: Interests and Choices portion of the Brigance Transition Skills InventoryDate: April 10th, 2014.Reviewed By: Bryan Anderson Special Education Teacher

Completed by: JN

Educational Interests: JN has a good understanding of the importance of graduating from high school, and at this time he wants to work with computers, work in construction or become a mechanic.

Career Interests: JN completed a survey addressing career interests and the following is a summary of his responses. JN would rather work alone. He would like a job where he could stand or walk and prefer not doing the same task. He would rather do a task himself instead of directing others. He would like to work outdoors where it is noisy. He likes to earn money. JN would prefer a career where he completed tasks at the same rate. He would rather share his ideas by talking. He prefers to work with tools. He would prefer a career that requires physical energy and where he works during the daylight hours. He prefers to share his ideas by talking. He would like to work in a casual setting and prefers to work with objects. He would rather make things than sell them. He does not know what kind of training he needs.

Career Choices: JN would like to work in construction, become a mechanic or work with computers. He enjoys playing computer games and being involved in activities outside. At this time JN is unsure about the specifics to prepare for a career.

Work Ethics and Attitudes: JN completed a survey where he answered 20 questions pertaining to work ethics and attitudes. Of the 20 questions he answered, JN’s responses indicated that he does not have a good understanding of positive work ethics and attitudes. His responses indicated that he thought it is OK to call in sick where you are not, use drugs during breaks, be late for work, question your boss and not be willing to accept criticism from your boss.

EVALUATION SUMMARY

Because JN has already been receiving special education services under the Specific Learning Disability category, and has not been making adequate progress toward his goals, he continues to remain eligible for special education services under the same category. The following outlines his current levels of performance and how they relate to this determination.

Working Memory: On the WISC-V, JN achieved a Working Memory Index Score of 71 (below average); on the BRIEF, he achieved Working Memory Scale scores that placed him in the Clinically Significant range. JN has difficulty time holding information in his working memory and recalling multiple steps or directions. He typically forgets to turn in assignments, has trouble linking new information to previously learned information and leaves started assignments incomplete.

Speed of Processing: On the WISC-V, JN achieved a Processing Speed Index score of 56 (low), on the WJ-IV, he achieved a Math Fluency subtest score of 68 (low) and a Sentence Fluency subtest score of 74 (below average). JN has a difficult time getting going on tasks at home. In school, he has problems keeping up in class, getting assignments done in a timely manner, calculation speed and accuracy, math fact fluency, verbal fluency and writing fluency.

Acquisition of Information (Attention): On the BASC-II, JN achieved Attention Problem Scores that placed him in the Clinically Significant range. JN struggles to initiate and sustain attention and focus both at home and at school. He is easily distracted and distracts his peers. He does not identify this behavior as inappropriate in the school setting.

Organization: On the BRIEF, JN received Plan/Organize Scale, Organization of Materials and Monitor Scale scores that placed him in the Clinically Significant range. His mother also indicated that he has difficulty getting and staying organized in a home setting. JN’s teachers confirmed that he has difficulty getting organized, and also stated he has difficulty handing in his homework, producing neat and legible work, and needs constant adult help to start projects and stay on task.

Planning/Sequencing: On the BRIEF, JN received Plan/Organize and Initiate/Task Completion Scale scores that placed him in the Clinically Significant range. JN has a difficult time planning and organizing his classroom work. He is unable to break down tasks into smaller, manageable units, he gets overwhelmed by large assignments, starts things at the last minute and frequently is unable to finish tasks.

Social Interactions: JN’s parents indicate that JN typically demonstrates immature traits and social skills. He constantly seeks attention; and often demonstrates the same behavior even after being reprimanded and/or receiving a consequence for it. He also struggles with any type of time constraints, which increase his anxiety to a level where he is unable to focus. These behaviors were also observed by his classroom teacher or by the special education staff administering the evaluation tests.

The team recommends the following for the general education setting: JN needs extra services and support in Mathematics (Broad Mathematics, Fact Fluency, and Calculation), Language Arts (Broad Written Language, Writing Samples, and Sentence Writing Fluency), and Passage Comprehension. JN also needs Life Skills programming that would include strategies for Organization, Self Monitoring and Completion of Work.

In conclusion, the team found that JN continues to qualify for special education services in the area of Specific Learning Disabilities, receiving services for Math, Language Arts and Life Skills.

ELIGIBILITY DETERMINATIONATTACH RELEVANT ELIGIBILITY VERIFICATION CHECKLIST(S) COMPLETED BY THE TEAM TO THIS REPORT

Date of Evaluation Report: April 3rd, 2017

Eligible: __X_Yes ____ No

____ Evaluation⇨ (Must meet initial criteria) __X_ Reevaluation⇨ (Must address criteria components)

Information about each item must be sought from the parent and included as part of the evaluation data. The evaluation data must confirm that the disabling effects of the child’s disability occur in a variety of settings. The child must receive two interventions prior to evaluation unless the parent requests an evaluation or the team waives the requirement due to urgency. Based on information in the Evaluation Report and the student file, a pupil has a specific learning disability and is in need of special education and related services when the pupil meets the criteria in A, B, and C OR A, B, and D below.

A. Documentation of Inadequate Achievement The child does not achieve adequately in one or more of the following areas in response to appropriate classroom instruction: _____Oral Expression _____Listening Comprehension _____Written Expression __X__Basic Reading Skills __X__Reading Comprehension __X__Reading Fluency __X__Mathematics Calculation _____Mathematical Problem Solving

AND

____The child does not make adequate progress to meet age or state-approved grade-level standards in one or more of the areas listed above when using a process based on the child's response to scientific, research-based intervention;

OR ___X_The child exhibits a pattern of strengths and weaknesses in performance, achievement, or both, relative to age, state-approved grade-level standards, or intellectual development, that is determined by the group to be relevant to the identification of a specific learning disability (SLD).

AND

___X_Documentation to support this finding must be both representative of the pupil's curriculum and useful for developing instructional goals and objectives. Documentation includes evidence of low achievement from the following sources, when available: ___X_Cumulative record reviews _____Class work samples _____Anecdotal teacher records ___X_Statewide and district-wide assessments ___X_Formal, diagnostic, and informal tests ___X_Results from targeted support programs in general education ___X_Curriculum based evaluation results

B. Information Processing The child has a disorder in one or more of the basic psychological processes, which includes an information processing condition that is manifested in a variety of setting by behaviors such as inadequate: __X_Acquisition of information __X_Organization __X_Planning and sequencing __X_Working memory, including verbal, visual, or spatial _____Visual and auditory processing __X_Speed of processing _____Verbal and nonverbal expression _____Transfer of information _____Motor control for written tasks (pencil and paper assignments, drawing, and copying) _____Other: ________________________________________________

C. Severe Discrepancy The child demonstrates a severe discrepancy between general intellectual ability and achievement in at least one of the identified areas of achievement. The demonstration of a severe discrepancy shall not be based solely on the use of standardized tests. The instruments used to assess the child’s general intellectual ability and achievement must be individually administered and interpreted by an appropriately licensed person using standardized procedures. For initial placement, the severe discrepancy must be equal to or greater than 1.75 standard deviations below the mean on a distribution of regression scores for the general population at the student's chronological age.

General Intellectual Ability Assessment Measure: Woodcock Johnson Tests of Achievement (WJ-IV). Date: March 13th, 2017

Cluster Area Composite Score Oral Expression ___90________ Listening Comprehension ___75________ Written Expression ___74 _______

Basic Reading Skills ___93________ Reading Fluency Skills ___87________ Reading Comprehension ___75________ Mathematical Calculation ___79________ Mathematical Problem Solving ___99 ________

D. Inadequate rate of progress in response to scientific research-based intervention (SRBI) The child demonstrates an inadequate rate of progress in response to intensive SBRI and the following components are documented:_____ Rate of progress is measured over at least 7 school weeks on a minimum of 12 data points; _____ Rate of improvement is minimal and continued intervention will not likely result in reaching

age or state-approved grade-level standards; _____ Progress will likely not be maintained when instructional supports are removed; _____Level of performance in repeated assessment of achievement falls below the child’s age or

state approved grade-level standards; and _____ Level of achievement is at or below the 5th percentile on one or more valid and reliable

achievement tests using either state or national comparisons. Local comparison data that is valid and reliable may be used in addition to either state or national data, but if it differs from either state or national data, the group must provide a rationale to explain the difference.

Based on the information included in this report, the student:

A. does not meet the eligibility criteria for special education for the following reason(s):

Does not have a disabilityDoes not demonstrate need for special education service at this timeLearning difficulty is primarily due to lack of instruction in reading or math or to limited English proficiencyNo longer qualifies for special education services.Is no longer eligible under developmental delay criteria and does not meet other eligibility criteria

B. does meet eligibility criteria for special education for the following reason(s):

Meets entrance criteria for the disability(ies) indicated below (initial evaluation)X Continues to have a disability and demonstrate a need for special education service (reevaluation)

Qualifies through a team override in accordance with 3525.1354 for the following disability(ies)

(P) indicates primary disability and (S) indicates secondary disability(ies):

Autism Spectrum Disorders Deaf/Blind Physical ImpairmentBlind/Visual Impairment Developmental Delay Severely Multiply ImpairedCognitive Impairment Emotional/Behavioral Disorder X Specific Learning Disability

(SLD)Deaf/Hard of Hearing Other Health Impairment Speech/Language Impairment

Traumatic Brain Injury If a team member disagrees with the decision in A or B, a statement as to the reason must be attached.

Team members and checkboxes are requiredonly for SLD evaluation and for an override of any criteria

AGREEMENTWITH

CONCLUSIONS

SIGNATURE TITLE YES NO

Parent

Regular Education Teacher (K-12)

Special Education Teacher

District Representative

Student (by grade nine or age 14)

Others

Review of Eligibility Determination To determine compliance with eligibility determination, one of the following MUST be checked._X_ The documentation supports the team decision.___ The documentation does not support the team decision.

EDUCATIONAL NEEDS/RECOMMENDATIONS

Special Education Needs that Derive from the Disability:1. JN needs to improve his mathematical calculation skills2. JN needs to improve his mathematical facts fluency3. JN needs to improve his reading comprehension skills4. JN needs to improve his written expression skills5. JN needs to improve his personal management skills6. JN needs to improve his self-control/behavioral skills

Adaptations/Modifications:The IEP team should consider the following adaptations/modifications to allow the student access to the general education curriculum

1. Preferential Seating- JN needs to sit in close proximity to the classroom teacher instructing, to ensure he is focused on instruction, better understands directions and is staying on task

2. Classroom instructors and/or special education staff will check with JN frequently to ensure comprehension of classroom instruction

3. JN will be allowed to take tests within a quiet, non-distracting environment. Special education and regular education teachers will determine where he will complete his tests.

4. JN will have access to a calculating devise that will assist him in completing grade level math calculation tasks, such as in Science, where grade level mathematics and formulas are required to complete work.

5. Accommodations for state reading, science and math testing in a small group6. Accommodations for district testing in a small group