3. ELIGIBILITY DETERMINATION (All 3 following criteria must be documented to support eligibility)
Evaluation Team Assessment Summary: (Summarize the findings and document the disability based on Idaho
state criteria from the various forms of evaluation used to determine a present level of performance, including
assessments, observations, interviews, standards, and other relevant and current documentation.)
This evaluation indicates that Jack is within -1.0 standard deviation of the mean on standardized language assessments. He is
demonstrating average receptive and expressive language skills as compared to his typically developing peers. The developmental
assessment and classroom observations showed that Jack’s skills in the social/emotional domain are limited in social interactions with
peers and independent participation in classroom routines. Skills in the social/emotional developmental domain are below that of same age
peers. The results of the adaptive behavior measure show that Jack is having delays in his ability to manage his behaviors to meet the
social expectations of school. In addition, he also shows delays in the area of social emotional skills to cope with and manage everyday
routines and expectations. He is showing a delay in both social-emotional as well as adaptive (self-help) behaviors that meet the criteria for
eligibility as a student with a developmental delay. He is eligible and in need of special education services to be able to benefit from his
exposure to the general curriculum.
Adverse Effect on Educational Performance: (Indicate evidence of the effect of the disability on the student’s
performance.)
Jack is demonstrating average receptive and expressive language skills, therefore Jack’s language skills do not present with an adverse
effect. Jack’s limited social interaction skills are having an adverse effect on his ability to participate in school social routines and learning
opportunities the same as his peers. Jack lacks the ability to cope and manage his behaviors when the setting, expectations or people
around him have changed or if the routine is broken or changed. Jack’s delays in his ability to manage his behaviors to meet the social
expectations of school are adversely affecting is ability to participate in a general education setting.
Need for Specially Designed Instruction: (Describe resources necessary to support the student to access and
progress in the general education curriculum.)
Currently, Jack is not exhibiting a documented need for specialized instruction in the area of receptive and expressive language to help him
adequately access the general curriculum. Jack does need direct instruction in the areas of social interactions with peers and participation in
social routines in a classroom setting. He needs a structured learning environment that will provide him the opportunities for direct
instruction intervention and the opportunities for facilitated and guided practice of social skills.
4. ELIGIBILITY DETERMINATION
In consideration of the reported information, the evaluation team finds the student [X] is [ ] is not eligible under
the category ___Developmental Delay___________________________.
Eligibility Example-Developmental Delay