BISMARCK PUBLIC SCHOOLS SPECIAL EDUCATION DEPARTMENT ARTICULATION/PHONOLOGICAL IMPAIRMENT WORKSHEET Determination of Disability: (Student’s name) meets special education eligibility under the category of Articulation/Phonological Impairment. Based on the team’s assessment, (Student”s name) is in need of special education services due to the level, condition, and educational impact of the impairment. Qualifying Criteria: The team shall determine that a student is eligible for special education services in the area of Articulation/Phonological Impairment when a student’s total score on the ND Guidelines Articulation Severity Rating Scale indicates a Moderate (79 points) or Severe (10-12 points) level impairment. Contributing factors to the scale’s total scores include: a measures of intelligibility OR percent consonants correct, an assessment of speech sounds, an assessment of phonological processes, and social/emotional impact. Intelligibility OR Percent Consonants Correct (Age 5+): [ ] 90% or more OR 85-100% = typical – (0 pts.) [ ] 80-90% OR 65-84% = mild – (1 pt.) [ ] 70-80% OR 50-64% = moderate – (2 pts.) [ ] less than 70% OR 0-49% = severe – (3 pts.) Assessment of Speech Sounds: [ ] 86-100+ (50%ile) – (0 pts.) [ ] 78-85 (16%ile) – (1 pt.) [ ] 70-77 (7%ile) – (2 pts.) [ ] Less than 70 (2%ile) – (3 pts.) Assessment of Phonological Processes: [ ] No processes in error – (0 pts.) [ ] One or more of the following error processes occur in 40% or more available opportunities: (glides of liquids; cluster reductions with /l/, /r/, /w/; vowelization of post-vocalic liquids (/r/, /l/) – (1 pt.) [ ] One or more of the following error processes occur in 40% or more of available opportunities: (weak syllable deletion, cluster reduction with /w/, fronting of velars); Presence of Level 1 processes at 20% or greater – (2 pts.) [ ] One or more of the following error processes occur in 40% or more of available opportunities: (initial consonant deletion; final consonant deletion; stopping; depalatization of final singletons); Presence of Level 1 and/or 2 processes at 15% or greater – (3pts.) Stimulability: [ ] 90% of the sound errors are stimulable – (0 pts.) [ ] 60-89% of the sound errors are stimulable -- (1 pt.) [ ] 50-59% of the sound errors are stimulable – (2 pts.) [ ] Less than 50% of the sound errors are stimulable – (3 pts.) Educational Impact: [ ] Articulation skills are adequate for the student’s participation in educational settings – (0 pts.) [ ] Articulation skills are developing and can be addressed in the general educational settings – (1 pt.) [ ] Articulation skills have an effect on the student’s ability to participate in educational settings – (2 pts.) [ ] Articulation skills have a significant impact on the student’s ability to participate in educational settings – (3 pts.) Total Points: Data For Determining Eligibility was gathered from (List multiple resources): [ ] Speech sample [ ] Contextual probe [ ] Structured observation [ ] Classroom work [ ] Other curriculum/academic results [ ] Standardized test(s) [ ] Teacher/Child/Parent reports, interviews, or checklists LAST REVISED 1/6/16 BISMARCK PUBLIC SCHOOLS SPECIAL EDUCATION DEPARTMENT NOTE: Teacher, child, and parent reports, interviews, or checklists are not sufficient evidence by themselves and must be supported with additional data. LAST REVISED 1/6/16