BAKERSFIELD CITY SCHOOL DISTRICT
SPECIAL EDUCATION DIVISION
714 Williams St.Bakersfield, CA 93305
661-631-5863
FAX 661-324-1996
Psycho-Educational Report
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Initial
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Triennial
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Other Assessment
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Parent Request
Student (SID):
DOB:
Grade:
Ethnicity:
Parent/Guardian:
Address:
Date Consent Sent:
Date Report Written:
Current Placement:
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Search & Serve
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Other
School:
Age:
Gender:
Student Language:
Home Language:
Phone Number:
Date Consent Received:
Date of IEP Meeting:
Assessors
School Psychologist:
Special Ed. Teacher:
General Ed. Teacher:
School Nurse:
CONFIDENTIALITY STATEMENT
All information contained in this report is confidential and cannot be released without the expressed written consent from the
parent/legal guardian. This report is not to be placed in the student’s cumulative file.
REASON FOR REFERRAL:
{For initials}
!Student was referred for a psycho-educational evaluation through the Multi-Tiered System of Support (MTSS) out of the (teacher/parent)’s concern
due to poor academic progress in the areas of ???. !Student is being assessed for a suspected disability in the area(s) of ??? Other areas of concern
include ???
The Multi-Tiered System of Support (MTSS) considered !Student’s learning conditions and determined that the appropriate classroom modifications
were unsuccessful in re-mediating his deficient academic skills, and that a special education referral is appropriate.
{For triennials}
The purpose of this three year reevaluation assessment will be to determine current estimates of cognitive ability, academic levels, and eligibility status
for special education. The assessment was conducted according to Federal and California Department of Education guidelines which require that all
children in special education be given a comprehensive psycho-educational evaluation every three years. The objectives of this evaluation were to: a)
measure how much progress this student has made by comparing previous assessment information with current assessment information, b) determine
whether continued qualification for special education services exists; and c) provide assessment information for the Individualized Education Program
Team to discuss any necessary changes in this student’s program. The information will be presented to the IEP team and used when considering how
to best help this student learn and perform effectively in the classroom. The data collected will assist the multidisciplinary team in determining the
student’s qualifications and/or needs for special education services under federal and state education guidelines. !Student is being assessed for a
suspected disability in the area(s) of ??? Other areas of concern include ???
This evaluation will target the following areas:
1) An estimate of functioning level
2) Identify student’s current academic performance level
3) Evaluate whether or not this student meets eligibility criteria for special education instruction or services
A student’s performance in school is the product of many factors. Some of the more pertinent factors include: school attendance, parent participation
in the education process, cognitive abilities, health, motivation, teaching style, peer relations, academic self-esteem, and study skills. No evaluation can
fully account for all the factors affecting a particular student’s learning. This evaluation meets the requirements in the area of assessment related to the
suspected disability, necessary for the determination of eligibility for special education only, and is not be considered all inclusive.
The data discussed and represented in this report will assist the Individualized Education Plan (IEP) team in determining placement and support services.
EVALUATION PROCEDURES/INSTRUMENTS:
The following instruments/techniques were utilized in this assessment.
Background Information
● Record Review
● Review of TSS Documentation
● Interview (Teacher /Parent)
● Observation
Ability Status
● Children’s Category Test (CCT)
● Differential Ability Scales, Second Edition (DAS-2) – Early Years
● Differential Ability Scales, Second Edition (DAS-2) - School Years
● Kaufman Assessment Battery for Children, Second Edition (KABC-II)
● Kaufman Brief Intelligence Test, Second Edition (KBIT-2)
● Stanford-Binet Intelligence Scales, Fifth Edition (SB5)
● The Wechsler Abbreviated Scale of Intelligence -2nd Ed. (WASI-II)
● Wechsler Intelligence Scale for Children –V (WISC-V)
● Wechsler Preschool and Primary Scale of Intelligence – IV (WPPSI-IV)
● Woodcock Johnson IV: Tests of Cognitive Abilities (WJ-IV)
● Woodcock-Johnson IV Tests of Early Cognitive and Academic Development (ECAD)
● Comprehensive Test of Nonverbal Intelligence-2 (CTONI-2)
● Leiter International Performance Scale-Third Edition (Leiter-3)
● Naglieri Nonverbal Ability Test – Individual (NNAT-Individual)
● Primary Test of Nonverbal Intelligence (PTONI)
● Test of Non-Verbal Intelligence –4 (TONI-4)
● Universal Nonverbal Intelligence Test (UNIT)
● Wechsler Nonverbal Scale of Ability (WNV)
Processing Status
● Cognitive Assessment System, Second Edition (CAS-2)
● Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2)
● Developmental Test of Visual Motor Integration Skills (VMI)
● Motor-Free Visual Perception Test-4 (MVPT-4)
● Test of Auditory Processing Skills-4 (TAPS-4)
● Test of Visual-Perceptual Skills, Third Edition (TVPS-3)
● Test of Information Processing Skills (TIPS)
● Wide Range Assessment of Memory and Learning-2 (WRAML-2)
Adaptive Behavior Status
● Adaptive Behavior Assessment System, Third Edition (ABAS -3)
● Autism Diagnostic Observation Schedule-2 (ADOS 2)
● Autism Spectrum Rating Scale (ASRS)
● Childhood Autism Rating Scale (CARS-2)
● Developmental Profile, Third Edition (DP-3)
● Gilliam Autism Rating Scale – Third Edition (GARS-3)
● Vineland Adaptive Behavior Scales, Third Edition (VABS-3)
Social/Emotional/Behavioral Status
● Assessment System of Empirically Based Assessment: Teacher Report Form for ages 6 – 18 (ASEBA)
● Assessment System of Empirically Based Assessment: Child Behavior Checklist for Ages 6 – 18 (ASEBA)
● Assessment System of Empirically Based Assessment: Youth Self-Report for Ages 11 – 18 (ASEBA)
● Behavior Assessment System for Children – Third Edition (BASC-3)
● Conners, 3rd Edition (Conners-3)
● Emotional Disturbance Decision Tree (EDDT)
● Pragmatic Language Scale Inventory (PLSI)
● Scale for Assessing Emotional Disturbance, Second Edition (SAED-2)
● Social Skills Improvement System Rating Scales (SSIS)
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●
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Social Skills Improvement System Rating Scales - SEL Edition (SSIS-SEL)
Social Responsiveness Scale-2 (SRS-2)
Academic Status
● Bracken Basic Concept Scale – Third Edition – Receptive (BBCS-3:R)
● Bracken Basic Concept Scale-Third Edition-Expressive (BBCS-3:E)
● Bracken School Readiness Assessment – Third Edition (BSRA-3)
● Brigance III – Standardized
● Kaufman Survey of Early Academic and Language Skills (K-SEALS)
● Kaufman Test of Educational Achievement, Third Edition (KTEA-3)
● Woodcock Johnson IV:Tests of Achievement (WJIV)
BACKGROUND DATA/SCHOOL HISTORY:
{Sample Wording}
!student is a 4-year, 10-month old male. !student is a kindergarten student at !School in the Bakersfield City School District (BCSD). Pupil was
referred for a psycho-educational assessment to determine if he/she qualifies for special education services due {insert suspected disability}
Pupil was referred for a triennial re-evaluation to determine the most appropriate placement/services at this time. !Student was initially referred and
found eligible for Special Education services on date. !Student is receiving specialized academic instruction as a student with a Specific Learning
Disability and Speech and language Impairment
!Student’s learning problems are not believed to be primarily the result of cultural, environmental, or economic disadvantages, limited school
attendance, or limited English proficiency.
!Student is a ??? year old (ethnicity) (male/female) who lives with his ??? who holds educational rights. !Student is the (oldest/youngest) child in the
family and his/her primary language is English/Spanish. There is/is not a family history of learning difficulties. !Student in ??? grade and attended ???
schools since his beginning his educational career.
Health & Developmental History
Personal and Social History
Educational History/Interventions
School Year
Grade
School (District):
School (District):
School (District):
School (District):
CURRENT SCHOOL PERFORMANCE:
Attendance
The table below indicates ??? school attendance record.
School Year
2012-2013
2013-2014
2014-2015
2015-2016
2016-2017
2017-2018
2018-2019
2019-2020
2020-2021
2021-2022
School
Date Enrolled
Grade
Absences
Partial Day
Date Left
Current Grades
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The table below indicates !Student’s current grades.
Subject
Grade
Reading
Analyze Grade Level Text
Vocabulary
Reading Comprehension
C
N
S
N
Writing
Creates Multiple-Paragraph Composites
Grammar/Usage
Spelling
Edit/Revise
C+
N
N
S
N
Mathematics
Basic Facts
Problem Solving
Number Sense
Algebra and Function
C
N
N
N
N
Science
History-Social Science
C+
A+
Disciplinary History
The table below reflects !Student’s discipline history.
Date
District
Reported/Incident/Particulars
STATE TESTING
The California State Testing Results are as follows:
Year
ELA Test Type
Mastery Level
Scale Score
Math Test Type
Mastery Level
Scale Score
LANGUAGE PROFICIENCY DATA
English Language Proficiency Assessments for California (ELPAC)
The English Language Proficiency Assessments for California (ELPAC) is the required state test for English language proficiency (ELP) that must be
given to students whose primary language is a language other than English. State and federal law require that local educational agencies administer a
state test of ELP to eligible students in kindergarten through grade twelve. The California Department of Education (CDE) transitioned from the
California English Language Development Test (CELDT) to the ELPAC as the state ELP assessment in 2018. The ELPAC is aligned with the 2012
California English Language Development Standards. It consists of two separate ELP assessments: one for the initial identification of students as
English learners (ELs), and a second for the annual summative assessment to measure a student’s progress in learning English and to identify the
student's level of ELP.
The English Language Proficiency Assessments for California (ELPAC)
Date Administered:
ELPAC
Oral Language
Written Language
Listening
ASSESSMENT INFORMATION
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Speaking
Reading
Writing
Overall
ELPAC Level
Level 4
Bridging - Requires light
linguistic support
Level 3
Expanding-Requires
moderate linguistic support
Bridging - Requires light
linguistic support
Level 2
Expanding-Requires
moderate linguistic support
Level 1
Emerging - Requires
substantial linguistic support
What Students Can Typically Do at Each Level
Students at this level have well developed English skills.
• They can usually use English to learn new things in school and to interact in social situations.
• They may occasionally need help using English.
Students at this level have moderately developed English skills.
• They can sometimes use English to learn new things in school and to interact in social situations.
• They may need help using English to communicate on less-familiar school topics and in lessfamiliar social situations.
Students at this level have somewhat developed English skills. • They usually need help using
English to learn new things at school and to interact in social situations.
• They can often use English for simple communication.
Students at this level are at a beginning stage of developing English skills.
• They usually need substantial help using English to learn new things at school and to interact in
social situations.
• They may know some English words and phrases.
UNDERSTANDING SCORES
How Scores are reported throughout this report
Standard Score
131 and above
121 to 130
111 to 120
90 to 110
80 to 89
70 to 79
69 and below
Percentile Range
98 and 99.9
92 to 97
76 to 91
25 to 75
9 to 24
3 to 8
0.1 to 2
Interpretation
Very Superior
Superior
High Average
Average
Low Average
Low (Borderline)
Very Low/Lower Extreme
Throughout this evaluation numbers will be utilized to define levels in a variety of areas. Many of the scores are reported by what have been termed
standard scores. For most of the tests in the battery, standard scores have a mean of 100 and a standard deviation of 15. Standard scores show how
well this student did compare to a group of individuals of approximately the same age from across the United States. Generally speaking the highest
possible score is 150, and the lowest possible score is 40. Half of all individuals administered these instruments will score less than 100, and half
will score more than 100.
For all measures, a percentile is also given. This shows where each individual ranks in the national comparison group. If, for example, the percentile
rank is 45, it would mean that the individual scored higher than approximately 45 out of 100 individuals’ his or her age.
Many of the tests in this battery also generate subtest scores. Some subtests use the same standard score criteria described above, while others,
generate standard scores called scaled scores. As with standard scores, scaled scores show how well an individual did compared to others the same
age across the United States on the individual subtests. The highest possible score on a subtest is 19, and the lowest possible score is 1. Half of all
individuals will score less than 10, and half will score more than 10. Scores 4 and below are considered deficient; 5 to 6 borderline; 7 to 8 below
average; 9 – 11 average; 12-13 above average; 14-15 superior; 16-17 very superior.
Finally, some of the tests in this battery utilize T-scores. T-scores show how well an individual did compared to others the same age from across the
United States on the individual subtests. T-Scores generally range from 10-90. Half of all individuals will score below 50, and half will score more
than 50.
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Como se reportan los puntajes
Standard Score
131 and above
121 to 130
111 to 120
90 to 110
80 to 89
70 to 79
69 and below
Percentile Range
98 and 99.9
92 to 97
76 to 91
25 to 75
9 to 24
3 to 8
0.1 to 2
Interpretation
Muy Superior
Superior
Alto de Promedio
Promedio
Bajo de Promedio
Bajo
Muy Bajo de Promedio
A través de esta evaluación los puntajes se utilizan para definir los niveles en una variedad de áreas académicas. Muchos de los resultados de los
puntajes son reportados de acuerdo con los términos de los puntajes estándares. Para la mayoría de los exámenes en las pruebas, los puntajes
estándar tienen un punto medio de 100 y una desviación estándar de 15. Los puntajes estándar demuestran cuán bien desempeñó el estudiante en
comparación con un grupo de estudiantes aproximadamente de la misma edad por todo Estados Unidos. En términos generales la puntuación más
alta posible es de 150 y la puntuación más baja posible es de 40. La mitad de todos los estudiantes que se le administra estas pruebas logra un
puntaje menor de 100 y la otra mitad de estudiantes logra un puntaje mayor de 100.
Para todas las medidas, también se da un percentil. Este demuestra en qué nivel está clasificado cada estudiante en el grupo de la comparación
nacional. Si, por ejemplo, el nivel del percentil es de 45, esto significa que el estudiante logró un puntaje más alto de aproximadamente 45 de cada
100 estudiantes de su edad.
Muchas de las pruebas de esta batería también generan los puntajes de las subpruebas. Algunas subpruebas usan los mismos criterios de los puntajes
estándar descritos anteriormente, mientras que otras, generan los puntajes estándar llamados escala de puntajes. Al igual que con los puntajes
estándar, la escala de puntajes muestran cuán bien desempeñó el estudiante en las subpruebas individuales en comparación con los demás estudiantes
de la misma edad en todo Estados Unidos. El puntaje más alto posible en una subprueba es de 19 y el puntaje más bajo posible es de 1. La mitad de
todos los estudiantes logran un puntaje menor de 10 y la otra mitad obtiene un puntaje mayor de 10. Los puntajes de 4 y menor de 4 se consideran
deficientes; de 5 a 6 puntaje límite; de 7 a 8 abajo del promedio; de 9 a 11 promedio; de 12 a 13 arriba del promedio; de 14 a 15 superior; de 16 a 17
muy superior.
Finalmente, algunas de las pruebas en esta batería usan puntajes T (T-score). Estos puntajes muestran cuán bien desempeñó el estudiante en las las
sub pruebas individuales en comparación con los demás estudiantes de la misma edad por todo Estados Unidos. Los puntajes T generalmente
fluctúan de 10 a 90. La mitad de todos los estudiantes logra un puntaje bajo de 50 y la otra mitad logra un puntaje más de 50.
PREVIOUS ASSESSMENT RESULTS
Date:
Examiner:
District:
Tests:
Disability:
Placement:
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Results/Recommendations
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Services:
Date:
Examiner:
District:
Tests:
Disability:
Placement:
Services:
Date:
Examiner:
District:
Tests:
Disability:
Placement:
Services:
Results/Recommendations
Results/Recommendations
CURRENT ASSESSMENTS
STATEMENT OF LINGUISTIC AND TEST VALIDATION
In order to comply with Education Code 56320, the following will be considered regarding the procedures and materials used during the present
evaluation:
Trained and knowledgeable personnel will conduct all assessments. The pupil will be assessed in areas related to the suspected disability. Assessment
materials will be selected so as not to be racially, sexually, or culturally discriminatory. All assessments will be administered in the student’s primary
language, or with the use of an interpreter, and in accordance with the instructions provided by the producer of each test, unless otherwise stated. If the
student is sufficiently fluent in English, though not a native English speaker, tests were administered in English. The tests used have been validated
for the specific purpose for which they were developed. If adequate norms are not available, it was so noted and cautions were given regarding test
interpretation. Tests and other assessment materials may include those tailored to assess specific areas of educational need and not merely those which
are designed to provide a single general intelligence quotient. The assessment provided results that accurately reflect the student’s aptitude, achievement
level, or any other factors the tests purport to measure, and not the pupil’s impaired sensory, manual, or speaking skills. Intelligence tests have not
been administered to African-American students in accordance with policy of the State of California Department of Education. Alternative assessments
will be used to determine the cognitive/learning abilities of African-American students and described within the assessment report.
The identification of a student with exceptional needs will not result primarily from limited English proficiency, a lack of academic instruction,
temporary physical disabilities, social maladjustment, or environmental, cultural or economic factors.
HEALTH SCREENING
{sample Wording}
A review of school records indicates that !Student passed his/her vision and hearing screening on (date). A review of !Student’s health history as
completed by the parent indicates ???. No other known health conditions, syndromes, or disorders that would significantly impair or impact !Student’s
academic progress where shared at the time of the writing of this report that are believed to significantly impact Jonah’s educational performance at
this time.
A Health Screening completed by the District Nurse on DATE indicated that !student’s far and near vision screening was passed (R 20/20 L 20/20, far
vision). Hearing is within normal limits. General health is reported as “good.” Height, weight, and BMI are in the normal range for age and gender.
According to the Health Summary report completed by school nurse dated on DATE, !Student passed/failed his/her vision and hearing screening on
DATE.
Please refer to Health Summary report for further details.
TESTING OBSERVATIONS
{sample Wording}
!student entered the testing environment in an open manner. Because !he/she had known and worked with this examiner previously, rapport was easily
established. Grooming, attire and hygiene were age appropriate. Eye contact was good and both attention and effort were well sustained throughout
the testing session. !student appeared to be well oriented in time and place. !student stated that he/she does not use drugs or alcohol. !student presented
as quiet, compliant, and respectful across a number of testing sessions. Persistence to task was well maintained. !student stated that his/her favorite
activities at school were…. When asked what he/she would wish for if he/she had three wishes, !student replied…..
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did they attempt the tasks/willing to participate
change in their behavior during easier and difficult tasks (same with verbal and nonverbal)
During the tasks that were perceived to be easier, !Student …. responded quickly and accurately
When tasks were perceived to be challenging… slower pace, fidgeting, off-task bx
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student was perceived to become frustrated, as observed by, banging hand on desk, verbalizing that the task was difficult, asking to
be done
Student appeared
No behaviors were displayed that were problematic or that would otherwise differentiate this student from others in a similar setting. Thus, test results
are believed to present a valid and reliable estimate of his/her current level of functioning.
the reader is cautioned … scores may not be the best representation of his/her overall ability.
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CLASSROOM OBSERVATIONS
{sample Wording}
~ include the date, time and length of observation, the setting and the activity; pupil-to-teacher ratio; instructional, physical, and interpersonal variables;
and measurable, quantifiable data such as intervals on task and off-task, intervals in seat or out of seat, percentage of compliance with instructions and
directives, etc.
!student’s on-task behavior was measured in the classroom using 15-second momentary interval recording. For the purpose of this observation, “ontask” was defined as following directions within five seconds of a teacher directive, head oriented toward the teacher or student asking/answering a
question, raising a hand to answer or ask a question, head oriented toward appropriate materials (i.e., book, paper, etc.) during class work time, using
pencil appropriately, etc. “off-task” was defined as not following directions, talking to another student without permission, out-of-seat without
permission, looking around the room when the teacher is talking to the class, not looking at or writing from appropriate materials, etc. !students ontask behavior was observed during an art activity and was compared to other randomly-chosen students in the same activity. During the 20-minute
observation session, !student was observed to be on task during # percent of the intervals measured, as compared to # percent on-task of the intervals
measured for the comparison student(s).
INTERVIEWS
Teacher Interview
A teacher input questionnaire was completed by !Student’s general education teacher (DATED).
Strengths.
Academic areas
IEP components
Needs and Accommodations
Subject
Current Performance
Areas to Improve
Comparison to Classmates
Math
Reading
Writing
Accommodations:.
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Extended time for tests/Assignments
Alternative/Short-Answer
Oral Tests
Increased Feedback
Modified assignments
Peer Tutor/Buddy
Highlighted Text
Assignment Notebook
Alternative Materials
Variety of Instruction
Partition/Study Carrel
Token Economy
Positive Praise
Visual Schedule
Fidget Object
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Frequent Breaks
Large Print
Reduced paper/pencil paper tasks
Repeated Review/Drill
Small Group
Preferential Seating
Parent/Teacher Conference
Taped Text
Calculator
Use of Manipulatives
Graphic Organizers
Individual Attention
Token Board
Contract/Behavior Plan/Log
Other:
Parent Interview
???
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COGNITIVE FUNCTIONING/PROCESSING:
Alternative Assessment for African-American:
Although a determination concerning this student’s aptitude or intelligence is provided in this report, a published, standard test of intelligence was
not given. Instead an alternative method was used to make this determination and estimates the student’s ability. Therefore, the students’ acquisition
of general factual knowledge in multiple content areas was used to make this determination. It is assumed that if a students’ performance
demonstrates he/she has performed within the average range in one or more areas, then this information can be used to support a conclusion that the
student should learn commensurate with this level in other areas, namely in academic achievement.
The Differential Ability Scales, Second Edition (DAS-II) is a standardized measure of intellectual ability, which has a mean of 100 and a standard
deviation of 15. The mean is the average score based on the standardization sample and the standard deviation is the average variation of scores from
the mean. This test is intended for individuals aged 2 years 6 months to 17 years 11 months. Results are expressed in five components: the Verbal
Composite Score, which provides information about verbal abilities utilizing reasoning comprehension and knowledge of word meanings; the
Nonverbal Reasoning Score, which provides information about knowledge of relationships and patterns among figures or numbers; the Spatial Score,
which provides information about short term recall of visual and spatial relationships, nonverbal reasoning, and spatial visualization; the Special
Nonverbal Composite (SNC), which measures ability of students with limited speech and language abilities and is obtained by combining the Nonverbal
Ability Composite Score and the Spatial Composite Score; and the General Conceptual Ability Score (GCA), which measures cognitive abilities that
are important to learning such as general intelligence, scholastic aptitude, and readiness to master school curriculum. The GCA is obtained by
combining the Verbal, Nonverbal, and Spatial Composite Scores, and is considered the best measure of cognitive ability on the test. On this measure
the Standard Scores are interpreted as follows: 70-79 Low; 80-89 Below Average, 90-109 Average, 110-119 Above Average. T-Scores are interpreted
as follows: 30-36 Low; 37-42 Below Average, 43-56 Average, 57-62 Above Average.
Date Administered: DATE
DAS-II Scale
Score
Verbal
Word Definitions
Verbal Similarities
Nonverbal Reasoning
Matrices
Sequential & Quantitative Reasoning
Spatial
Recall of Designs
Pattern Construction
Standard Score:
T-Score:
T-Score:
Standard Score:
T-Score:
T-Score:
Standard Score:
T-Score:
T-Score:
General Conceptual Ability (GAC)
Standard Score:
Percentile
Rank
90% Conf.
Interval
Descriptor
!Student was administered the Differential Ability Scales, Second Edition, School Age (DAS-2) on 9/20/16. On the DAS-2, !Student obtained a GAC
score of 106 which placed his/her overall ability within the Average range. The scores are reported with a 90% confidence, which indicated that 90
times out of 100 his/her score will fall between 101 and 110. !Student’s overall performance was ranked at the 66 th percentile. On this measure,
!Student’s composite and subtest scores were all commensurate making this a reasonable measure of his/her overall abilities.
The Verbal composite is designed to measure !Student’s verbal abilities utilizing reasoning, comprehension, and knowledge of word meanings.
!Student’s verbal ability fell within the Average range and above 61% of his/her peers (Verbal SS: 104; 90% confidence interval: 96-111). The
Verbal composite is comprised of the following subtests: Word Definitions and Verbal Similarities. The Word Definition (T-Score: 52) subtest
measures knowledge of word meaning as demonstrated through spoken language. The Verbal Similarities (T-Score: 53) subtest asks the student to
describe how three things are similar or go together which measures their verbal reasoning and verbal knowledge.
The Nonverbal Reasoning composite is designed to measure !Student’s nonverbal abilities utilizing visual input, verbal encoding of the visual
stimuli, and integration of the visual and verbal processing system to solve problems. !Student’s nonverbal ability fell within the Average range and
above 58% of his/her peers (Nonverbal Reasoning SS: 103; 90% confidence interval: 97-109). The Nonverbal composite is comprised of the
following subtests: Matrices and Sequential & Quantitative Reasoning. The Matrices (T-Score: 50) subtest shows the student an incomplete matrix
and asks the child to select among the four or six choices figures that compete the matrix. This measures her perception and application of
relationships among abstract figures. The Sequential & Quantitative Reasoning (T-Score: 55) subtest asks the student to provide the missing number
that completes a pattern series. This measures the detection of sequential patterns in numbers.
The Spatial composite is designed to measure complex visual-spatial processing. !Student’s spatial ability fell within the Above Average range and
above 75% of his/her peers (Spatial SS: 110, 90% confidence interval: 104-115). The subtests that comprise this composite are Recall of Designs
and Pattern Construction. Recall of Designs (T-Score: 54) measures the student’s short-term recall of visual and spatial relationships by asking the
student to reproduce line drawings that are presented for 5 seconds and then removed. The Pattern Construction (T-Score: 58) subtest measures the
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student’s visual-perceptual matching in copying block patterns and nonverbal reasoning and spatial visualization in reproducing designs with color
blocks.
PROCESSING INFORMATION
The Comprehensive Test of Phonological Processing, Second Edition (CTOPP-2) is a comprehensive norm-referenced test that measures
phonological processing abilities related to reading. This test is designed to assess phonological awareness, phonological memory, and rapid naming.
Those with deficits in one or more of these areas may have more difficulty reading than those who do not. The CTOPP-2 identifies those who may
benefit from instructional activities to enhance their phonological skills.
Scaled Score
Standard Score
Percentile
Phonological Awareness
Elision
Blending Words
Phoneme Isolation
Phonological Memory
Memory for Digits
Non-word Repetition
Rapid Symbolic Naming
Rapid Digit Naming
Rapid Letter Naming
Rapid Non-Symbolic Naming
Rapid Color Naming
Rapid Object Naming
Alternative Phonological Awareness
Blending Non-words
Segmenting Non-words
Supplemental Subtests
Blending Non-words
Segmenting Non-words
Phonological Awareness refers to an individual’s awareness of and access to the sound structure of his or her oral language. This cluster is a
combination of Elision (saying a word after dropping designated sounds), Blending Words (combining sounds to form words) and Phoneme Isolation
(identifying target sounds in words). Specifically, !Student was able to ???. !Student had difficulty with ???
!Student’s score (is within normal limits/indicates a normative deficit/indicates a normative strength).
Phonological Memory refers to coding information phonologically for temporary storage in working or short-term memory. This cluster is a
combination of Memory for Digits (repeat a series of numbers ranging in length from two to eight digits) and Non-word Repetition (repeating nonwords that range in length from 3 to 15 sounds). Specifically, !Student was able to ???. !Student had difficulty with ???
!Student’s score of ??? (is within normal limits/indicates a normative deficit/indicates a normative strength).
Rapid Symbolic Naming is the ability to efficiently retrieve phonological information from long-term or permanent, memory and quick and
repeated execution of sequence of operations. This cluster is a combination of Rapid Digit Naming (speed of naming numbers) and Rapid Letter
Naming (speed of naming letters). Specifically, !Student was able to ???. !Student had difficulty with ???
!Student’s score of ??? (is within normal limits/indicates a normative deficit/indicates a normative strength).
Rapid Non-Symbolic Naming is the ability to efficiently retrieve phonological information from long-term or permanent, memory and executing a
sequence of operations quickly and repeatedly using objects and colors. This cluster is a combination of Rapid Color Naming (speed of naming a
series of different colored blocks) and Rapid Object Naming (speed of naming a series of objects). Specifically, !Student was able to ???. !Student
had difficulty with ???
!Student’s score of ??? (is within normal limits/indicates a normative deficit/indicates a normative strength).
Alternative Phonological Awareness
This cluster is a combination of Blending Non-words (combining speech sounds to make non-words) and Segmenting Non-words (say the separate
phonemes that make up a non-word). Specifically, !Student was able to ???. !Student had difficulty with ???. !Student’s score of ??? (is within
normal limits/indicates a normative deficit/indicates a normative strength).
Supplemental Subtests
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Supplemental Subtests include; Blending Non-words (combining speech sounds to make non-words) and Segmenting Non-words (saying the
separate phonemes that make up a non-word). Specifically, !Student was able to ???. !Student had difficulty with ??? (personalize this section based
on analysis of the student’s responses).
!Student’s score ??? (is within normal limits/indicates a normative deficit/indicates a normative strength).
The Developmental Test of Visual-Motor Integration-6 (VMI-6) is a paper and pencil test in which a student is asked to copy a series of
increasingly complex designs printed in a test booklet. The VMI is designed to assess the extent to which an individual can coordinate hand and eye
coordination. This skill is important for performing such tasks as copying from the board or from the text. On the VMI standard scores ranging from
85-115 (+- 4) are considered to fall within the average range.
Subtest
Visual Motor Integration
Visual Perception
Visual Motor
Hand Dominance
Standard Score
Percentile Rank
Descriptor
The Test of Auditory Processing Skills-4 (TAPS-4) is an individually administered assessment for individuals aged 5 through 21. It is designed to
provide information about language processing and comprehension skills across three intersecting areas: phonological processing, auditory memory,
and listening comprehension.
Processing Oral Directions: ability to hear a short scenario that contains a direction and then respond to what the person in the scenario is
supposed to do.
Word Discrimination: ability to discern phonological differences and similarities within word pairs.
Phonological Deletion: ability to hear a word and repeat the word without the identified syllable or phoneme.
Phonological Blending: ability to determine how well the student can synthesize a word given the individual phonemes.
Number Memory Forward: ability to retain simple sequences of auditory information.
Number Memory Reversed: ability to retain and manipulate simple sequences of auditory information.
Word Memory: ability to retain and manipulate simple sequences of auditory information.
Sentence Memory: ability to retain details in sentences of increasing length and grammatical complexity.
Auditory Comprehension: ability to understand spoken information.
ADAPTIVE BEHAVIOR INFORMATION
Vineland Domain Level
Domains
Communication
Daily Living Skills
Socialization
Adaptive Behavior Composite
Standard Score
Rated By: Date Rated:
90% Conf Int
Descriptor
Domains
Communication
Daily Living Skills
Socialization
Adaptive Behavior Composite
Standard Score
Rated By: Date Rated:
90% Conf Int
Descriptor
The Vineland - 3 Domain Level Form is a standardized measure of adaptive behavior. The Vineland-3 Domain-Level Form measures the things that
people do to function in their everyday lives. Whereas measures focus on what the examinee can do in a testing situation, the Vineland-3 focuses on
what he/she or she actually does in daily life. The Vineland-3 is a norm based instrument and thus the examinee’s adaptive functioning is compared
to that of others !Students’s age.
!Student’s adaptive functioning skills were measured by VADS-3 and rated by his/her mother and classroom teacher to gather information about
his/her functioning in the home and schools setting. The Vineland utilizes three domains to estimate an overall Adaptive Behavior Composite
(ABC). The three domains are Communication, Daily Living Skills, and Socialization. Based on rater’s responses, !Student’s overall adaptive skills
fell in the Low range (Parent ABC SS 71; Teacher ABC SS 60). Based on the obtained responses, !Student appears to require moderate to high adult
assistance when completing age level tasks.
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The Communication domains measures how well !Student listens and understands, expresses speech, and reads and writes. Rater’s responses placed
!Student’s Communication skills in the Moderately Low range (Parent SS 72; Teacher SS 75). !Student is observed to require adult assistance and
reminders to pay attention to a 15 minute task, follow instruction with two unrelated actions, and use compound sentences. Further, !Student was
reported to have difficulty understanding sarcasm, give complex directions, and use details when recalling events. At this time he/she is observed to
be able to copy his/her name independently, read sentences of three or more words out loud, and says complete home address correctly.
The Daily Living Skills domain assesses !Student’s performance on the practical, everyday tasks of living. In the home setting based on rater’s
responses, !Student’s Daily Living Skills score fell within the Low range (SS 66). Based on the responses provided by the teacher, !Student’s skill
set fell within the Moderately Low range (SS 55). !Student is observed to require adult assistance with staying on task, wiping his/her nose, and
asking for help when he/she does not understand something. Based on mother’s responses, !Student requires adult reminders to put his/her clothes on
right side forward, look both ways when crossing the street, and understanding general safety rules.
!Student’s score on the socialization domain reflects his/her functioning in social situation. This domain covers !Student’s interpersonal
relationships, play and leisure activities, and coping skills in social situations. Based on mother’s responses, !Student’s socialization skills fell within
the Moderately Low range (SS 82). Based on the responses provided by the teacher, !Student’s socialization score fell within the Low range (SS 52).
In the home setting, mother reported that !Student is able to join other children to play with, make-believe, and apologize after hurting feelings.
He/she is observed to require adult assistance with providing additional explanation, playing games that require skills, and controlling his/her anger.
In the school setting, !Student is observed to require adult assistance in playing with a peer, moving away from aggressive children, and using words
to express his/her distress. However, he/she is observed to ask to play with others and is able to show happiness towards others. Further, in the
school setting !Student is observed to have difficulty controlling his/her anger and taking turns when playing games.
SOCIAL/EMOTIONAL/BEHAVIORAL FUNCTIONING
The Gilliam Autism Rating Scale-3 is norm referenced screening instrument that is designed to identify individual’s age 3 through 22 years of age
who have severe behavioral problems that may be indicative of autism. The GARS-3 is composed of six subscales. The Restricted/Repetitive
Behaviors subscale measures stereotyped behaviors, fixated interests, routines, or rituals. The Social Interaction subscale measures social
behaviors. The Social Communication subscale measures an individual’s response to social situations and understanding of intent of social
interaction and communication. The Emotional Response subscale measures extreme emotional responses to everyday situations. The Cognitive
Style subscale measures idiosyncratic fixated interests, characteristics, and cognitive abilities. The Maladaptive Speech subscale measures deficits
and idiosyncrasies in verbal communication.
Parent
Teacher
Date Rated:
Subscales
Scaled Score
Date Rated:
%tile
Scaled Score
%tile
Restricted/Repetitive Behaviors
Social Interactions
Social Communication
Emotional Response
Cognitive Style
Maladaptive Speech
Index: Autism Index Standard Score
DESCRIPTION
The Behavior Assessment System for Children – Third Edition (BASC-3) is a rating scale that is designed to look at different aspects of a
student’s behavior and emotions that may be interfering with his or her learning. It requires someone who knows the student well to rate his or her
behaviors. Clinical scores are grouped into the following ranges: Low (not exhibited), Average (no concern), At-Risk (monitor), Clinically
Significant (further assessment may be warranted). Adaptive scores are grouped: Very High (very highly adaptive); High (highly adaptive); Average
(average in adaptability); At-risk (monitoring of adaptability warranted); and Clinically Significant (further assessment may be warranted).
Composite and index definitions are listed in the table below.
BASC-3
Externalizing Problems Composite
Hyperactivity- Tendency to be overly active, rush through work or activities, and act without thinking.
Aggression:Tendency to act in a hostile manner(verbal/physical) that is threatening to others
Conduct Problems:Tendency to engage in anti-social , rule breaking behavior (destroying property)
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Internalizing Problems Composite
Anxiety:Tendency to be nervous, fearful, or worried about real or imagined problems
Depression: Feelings of unhappiness, sadness, and stress that may result in an inability to carry out everyday activities or may bring on thoughts of suicide
Somatization-Tendency to be overly sensitive to and complain about relatively minor physical problems or discomforts.
School Problems Composite
Attention Problems- Tendency to be easily distracted and unable to concentrate more than momentarily.
Learning Problems:Presence of academic difficulties, particularly understanding or completing homework.
Adaptive Skills Composite
Adaptability:Ability to adapt readily to changes in environment
Activities of Daily Living: Skills ability to perform basic tasks in an acceptable and safe manner.
Functional Communication-Ability to express ideas and communicate in a way others can understand
Social Skills: Ability to interact successfully with peers, adults, school, and community
Leadership: Skills associated with accomplishing academic, social, or community goals, including the ability to work with others.
Study Skills: The skills that is conducive to strong academic performance, including organizational skills and good study habits.
Behavior Symptoms Index
Hyperactivity-Tendency to be overly active, rush through work or activities, and act without thinking.
Aggression:Tendency to act in a hostile manner (verbal/physical) that is threatening to others.
Depression: Feelings of unhappiness, sadness, and stress that may result in an inability to carry out everyday activities or may bring on thoughts of suicide
Attention Problems:Tendency to be easily distracted and unable to concentrate more than momentarily.
A typicality:Tendency to behave in ways that are considered “odd” or associated with psychosis
Withdrawal:Tendency to evade others to avoid social contact
BASC-3 Scale Ranges
Clinical Scales
T-Scores
70+
60-69
41-59
31-40
Interpretation
Clinically Significant
At-Risk
Average
Low
Adaptive Scales
60-69
41-59
31-40
0-30
High
Average
At-Risk
Clinically Significant
{INSERT TABLE}
The BASC-3 was given to !Student’s teacher and parent to provide their perspective of !student’s observed behaviors in the school and home setting.
As measured by the BASC-3, the responses provided by the raters were ranked as ‘Acceptable’ in terms of providing consistent responses and did not
rate the !Student’s behaviors extremely negative.
Externalizing
According to !Student’s teacher, !Student is observed to demonstrate Externalizing behaviors that fell within the range (T-Score #, #nd %tile).
According to !Student’s parent, !Student is observed to demonstrate Externalizing behaviors that fell within the range (T-Score #, # %tile). Teacher’s
perception on Externalizing behaviors included Aggressive and Conduct Problems within the range and Hyperactivity behaviors in the range.
Parent’s perception on these behaviors included Aggressive behaviors within the range and Hyperactivity and Conduct Problems within the range.
Both raters perceive !Student to demonstrate a short attention span who can become easily distracted from class work.
Internalizing
In terms of internalizing behaviors, both raters perceived !Student’s behaviors to fall within the range in all areas measured in the Internalizing
composite (Teacher: T-Score #, # %tile; Parent: T-Score #, # %tile), except teacher perceived his/her Somatization behaviors to fall in the range and
his/her parent perceived his/her Anxiety behaviors to fall within the range.
School Problems
!Student’s School Problems were observed by his/her teacher and his/her parent to fall within the range to range, respectively (Teacher: T-Score #, #
%tile). Specifically, !Student’s teacher responses indicated that !Student’s Attention Problems fell within the range and his/her Learning Problems
within the range. !Student’s parent perceived both his/her Attention Problems and Learning Problems within the range. !Student’s teacher reported
that !Student demonstrates unusual difficulty comprehending and completing schoolwork in a variety of academic areas and that these problems may
disrupt academic performance and functioning in these areas.
Behavioral Symptoms Index (BSI)
The BSI measures the accumulation of the above information along with Atypicality and Withdrawal behaviors. !Student’s overall behaviors
according to his/her teacher’s responses fell within the range where as his/her parent responses rated his/her behaviors within the range (Teacher: TScore #, # %tile; Parent: T-Score #, # %tile). His/her teachers reported that !Student engages in behaviors that are considered strange or odd and
generally seems disconnected from his/her surroundings.
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Adaptive Skills
!Student’s Adaptive Skills were observed to fall within the range according to both raters (Teacher: T-Score #, # %tile; Parent: T-Score #, # %tile).
Raters responses rated !Student’s Adaptability behaviors to fall within the range; Social Skills and Leadership fell within the range; Functional
Community behaviors fell within the range. In Study Skills, his/her teacher perceives his/her behaviors to fall within the range . !Student’s teacher’s
reported that !Student’s has been observed to have difficulty adapting to changing situations and being soothe when upset. In addition, !Student is
observed to have difficulty understanding where to get information when needed.
The Scale for Assessing Emotional Disturbance, Second Edition (SAED-2) is a standardized, norm-referenced scale that assists in the
identification of children with emotional disturbance. The Rating scale was designed so that educational personnel could accurately and efficiently
evaluate the emotional and behavioral problems of students in the educational settings. It contains 45 clearly stated items describing specific
observable, and measurable emotional and behavioral problems comprise six problem subscales corresponding to significant parts of the federal
definition of ED. The five problem subscales include inability to learn, relationship problems, inappropriate behavior, unhappiness or depression,
physical symptoms or fears, and the sixth problem subscale captures the federal definition of socially maladjusted condition. The results gained from
this rating scale can be used, along with other assessment data to identify a student as ED. Results also can help determine whether a student is
socially maladjusted and not ED and whether a student’s problems adversely affect their educational performance.
Teacher
Paraprofessional
Date Rated:
Subscales
Scaled Score
Date Rated:
%tile
Scaled Score
%tile
Inability to learn
Relationship Problems
Inappropriate Behavior
Unhappiness or Depression
Physical Symptoms/Fears
Index Standard Score
ACADEMIC STATUS
The Kaufman Test of Educational Achievement, Third Edition (KTEA-3) is an individually administered, comprehensive measure of educational
achievement for individuals ages 4 through 25 and students in grades pre-kindergarten through 12. The Individuals with Disabilities Education
Improvement Act of 2004 (IDEIA, 2004) specifies eight areas of achievement to assess for identification of specific learning disabilities: oral
expression, listening comprehension, written expression, basic reading skills, reading comprehension, reading fluency, mathematics calculation, and
mathematics problem solving. The KTEA-3 measures each of these eight areas.
Administered By:
Date Administered:
Subtest/Composite
Standard Score
Conf Interval
Percentile
Descriptor
Grade Equivalent
Listening Comprehension
Oral Expression
Reading Composite
Letter & Word Recognition
Reading Comprehension
Math Composite
Math Concepts & Applications
Math Computation
Written Language Composite
Written Expression
Spelling
Reading Composite
Letter & Word Recognition: The student identifies letters and reads grade-appropriate words.
Nonsense Word Decoding: The student pronounces made-up words.
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Reading Comprehension: The student reads symbols, words, sentences, and passages appropriate to his or her grade level, and then responds to
comprehension questions.
Math Composite
Math Concepts & Applications: The student solves math problems that relate to real life situations and assess skills such as number concepts, arithmetic,
time and money, and measurement.
Math Computation: The student solves written math calculation problems.
Math Fluency: The student writes answers to simple arithmetic problems within a time limit. Problems include addition and subtraction, and for later
items, multiplication and division.
Written Language Composite
Written Expression: The student hears a story presented with pictures in a booklet and completes the story by writing letters, words, sentences, and (for
students in grade 1 or higher) an essay.
Spelling: The student writes single letters and spells words dictated by the examiner.
Writing Fluency: The student writes simple sentences, each one describing a different picture, within a time limit.
Oral Language Composite
Listening Comprehension: The student listens to sentences or passages, and then responds to comprehension questions.
Oral Expression: The student says a sentence to describe a photograph. Later items require the use of specific words or phrases.
Parent Information/Independent Assessment, If any:
The family did not provide any independent assessments to be reviewed and considered as part of this assessment.
5 CCR § 3030. Eligibility Criteria.
(a) A child shall qualify as an individual with exceptional needs, pursuant to Education Code section 56026, if the results of the assessment as required
by Education Code section 56320 demonstrate that the degree of the child's impairment as described in subdivisions (b) (1) through (b) (13) requires
special education in one or more of the program options authorized by Education Code section 56361. The decision as to whether or not the assessment
results demonstrate that the degree of the child's impairment requires special education shall be made by the IEP team, including personnel in accordance
with Education Code section 56341(b). The IEP team shall take into account all the relevant material which is available on the child. No single score
or product of scores shall be used as the sole criterion for the decision of the IEP team as to the child's eligibility for special education.
SUMMARY:
{sample Wording}
!Student is a ??? year old living at home with (his/her) parents and siblings. !Student is the ??? child. !Student’s primary language is reported as
English/Spanish. !Student is in the ??? grade and has attended ??? schools since enrolling in school.
Health…
Current assessment results indicate that !Student’s estimated learning ability appears to lie in the ??? range of functioning as measured by ???.
Behaviorally...
Academically, !Student is ??? Thus, it appears that a significant discrepancy exists between !Student’s learning ability and academic performance in
??? and ??? when considering the measurement error.
STATEMENT OF SPECIAL EDUCATION ELIGIBILITY
Does the student have a qualifying disabling condition? ???
State and federal laws outline disability categories or disabling conditions under which a student may be eligible for special education and related
services:
Autism
Intellectual Disabilities
Specific Learning Disability
Deafness
Multiple Disability
Speech/Language Impairment
Deaf/Blindness
Orthopedic Impairment
Traumatic Brain Injury
Other Health Impairment
Visual Impairment
Hard of Hearing
Emotional Disturbance Established Medical Disability (3-5 years olds)
The school psychologist recommends that the IEP team consider the following disability categories and eligibility criteria when determining
placement and services:
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (1) Eligibility Criteria as a student with Autism.
(1) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident
before age three, and adversely affecting a child's educational performance. Other characteristics often associated with autism are engagement in
!Student:Psycho-Education Evaluation
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repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory
experiences.
(A) Autism does not apply if a child's educational performance is adversely affected primarily because the child has an emotional disturbance,
as defined in subdivision (b) (4) of this section.
(B) A child who manifests the characteristics of autism after age three could be identified as having autism if the criteria in subdivision (b) (1)
of this section are satisfied.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (2) Eligibility Criteria as a student identified with deaf-blindness.
(2) Deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other
developmental and educational needs that they cannot be accommodated in special education programs solely for children with deafness or children
with blindness.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (3) Eligibility Criteria as a student identified with deafness.
(3) Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or
without amplification that adversely affects a child's educational performance.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (4) Eligibility Criteria as a student with an Emotional Disturbance.
(4) Emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked
degree that adversely affects a child's educational performance:
(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
(F) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is
determined that they have an emotional disturbance under subdivision (b) (4) of this section.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (5) Eligibility Criteria as a student with a Hearing Impairment.
(5) Hearing impairment means an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance
but that is not included under the definition of deafness in this section.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (6) Eligibility Criteria as a student with an Intellectual Disability.
(6) Intellectual disability means significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior
and manifested during the developmental period that adversely affects a child's educational performance.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (7) Eligibility Criteria as a student with Multiple Disabilities.
(7) Multiple disabilities means concomitant impairments, such as intellectual disability-blindness or intellectual disability-orthopedic impairment,
the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of
the impairments. “Multiple disabilities” does not include deaf-blindness.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (8) Eligibility Criteria as a student with an Orthopedic Impairment.
(8) Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes
impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other
causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (9) Eligibility Criteria as a student with an Other Health Impairment.
(9) Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that
results in limited alertness with respect to the educational environment that:
(A) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy,
a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and
(B) Adversely affects a child's educational performance.
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This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (10) Eligibility Criteria as a student with a Specific Learning Disability.
(10) Specific Learning Disability means a disorder in one or more of the basic psychological processes involved in understanding or in using
language, spoken or written, that may have manifested itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical
calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The
basic psychological processes include phonological processing, attention, visual processing, auditory processing, sensory-motor skills, cognitive
abilities including association, conceptualization and expression.
The pupil may be determined to have a specific learning disability if he/she 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, using appropriate assessments, consistent with 34 C.F.R. sections 300.304 and 300.305.
Consistent with California Education Code, the Bakersfield City School District has endorsed the use of the Pattern of Strengths and Weaknesses
(PSW) model for identifying a Specific Learning Disability (SLD). For students for whom a special education eligibility of SLD is being considered,
using the PSW approach, the following is examined:
1. Student exhibits a pattern of cognitive or processing strengths, indicated by a pattern of abilities in the average or above ranges
2. Students exhibits both significant cognitive and academic weakness(es)
3. A research-based link exists between the cognitive and academic weakness(es)
Supporting evidence supports that the following cognitive processing deficits directly impact the following academic areas:
Cognitive Weakness
AcademicWeakness
4. The student requires special education to access the core curriculum
Based on a review of records, interviews, and standardized assessment it is believed that !Student presents with a severe discrepancy between his/her
cognitive levels and academic performance in math calculation, math reasoning, and written expression. Although !Student does not present with a
pattern of cognitive level in the average range he/she does present with consistent scores that result in a personal strength for him. Thus it is in this
psychologist opinion that !Student continue qualifying for special education services as a student with a Specific Learning Disability (SLD) as he/she
appears to require specialized academic instruction to assist him/her in making progress.
In addition to the above-mentioned criteria, specific learning disabilities do not include learning problems that are primarily the result of:
● visual, hearing, or motor disabilities,
● intellectual disability,
● emotional disturbance,
●
environmental, cultural, or economic disadvantage,
● limited English proficiency
● limited school experience,
● poor school attendance, or
● lack of appropriate instruction in reading or math
Based on the data that was gathered, it is reasonable to conclude that one of more of the above factors do/do not greatly contribute to !Student’s
observed learning difficulties.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (11) Eligibility Criteria as a student with a Language or Speech Disorder.
(11) A pupil has a language or speech disorder as defined in Education Code section 56333, and it is determined that the pupil's disorder meets one
or more of the following criteria:
(A) Articulation disorder.
1. The pupil displays reduced intelligibility or an inability to use the speech mechanism which significantly interferes with communication and attracts
adverse attention. Significant interference in communication occurs when the pupil's production of single or multiple speech sounds on a developmental
scale of articulation competency is below that expected for his or her chronological age or developmental level, and which adversely affects educational
performance.
2. A pupil does not meet the criteria for an articulation disorder if the sole assessed disability is an abnormal swallowing pattern.
(B) Abnormal Voice. A pupil has an abnormal voice which is characterized by persistent, defective voice quality, pitch, or loudness.
!Student:Psycho-Education Evaluation
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(C) Fluency Disorders. A pupil has a fluency disorder when the flow of verbal expression including rate and rhythm adversely affects communication
between the pupil and listener.
(D) Language Disorder. The pupil has an expressive or receptive language disorder when he or she meets one of the following criteria:
1. The pupil scores at least 1.5 standard deviations below the mean, or below the 7th percentile, for his or her chronological age or developmental level
on two or more standardized tests in one or more of the following areas of language development: morphology, syntax, semantics, or pragmatics. When
standardized tests are considered to be invalid for the specific pupil, the expected language performance level shall be determined by alternative means
as specified on the assessment plan, or
2. The pupil scores at least 1.5 standard deviations below the mean or the score is below the 7th percentile for his or her chronological age or
developmental level on one or more standardized tests in one of the areas listed in subdivision (A) and displays inappropriate or inadequate usage of
expressive or receptive language as measured by a representative spontaneous or elicited language sample of a minimum of 50 utterances. The language
sample must be recorded or transcribed and analyzed, and the results included in the assessment report. If the pupil is unable to produce this sample,
the language, speech, and hearing specialist shall document why a fifty utterance sample was not obtainable and the contexts in which attempts were
made to elicit the sample. When standardized tests are considered to be invalid for the specific pupil, the expected language performance level shall be
determined by alternative means as specified in the assessment plan.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (12) Eligibility Criteria as a student with a Traumatic Brain Injury.
(12) Traumatic brain injury means an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability
or psychosocial impairment, or both, that adversely affects a child's educational performance. Traumatic brain injury applies to open or closed head
injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problemsolving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech.
(A) Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.
This evaluation suggests that !Student does/does not meet the 5 CCR § 3030 (13) Eligibility Criteria as a student with a Visual Impairment.
(13) Visual impairment including blindness means an impairment in vision that, even with correction, adversely affects a child's educational
performance. The term includes both partial sight and blindness.
Does the Student Need Special Education and Related Services?
If the student has met one of the disabilities or impairments listed above, the student is eligible for special education and related services if:
The student does/does not require specially-designed instruction and services which cannot be provided with modification of the regular school
program.
Basis for Determination of Eligibility
❏ Psycho-educational Evaluation utilizing multiple measures as described within this written report.
❏ Relevant behavior related to academic function noted during classroom observation as described within this report
❏ Educationally relevant medical findings
The final determination of services and education programming are the responsibilities of the Individualized Education Program Team. Under
California Department of Education guidelines, statistical data is only one criterion that must be met in order to qualify a student as an individual with
exceptional needs. Other factors that may be the primary cause of a student’s academic deficits must be ruled out prior to assuming that a disability
exists. These factors are cultural, economic, and/or environmental detriments, limited English, lack of instruction in reading or math, temporary
disability, or social maladjustment. To the extent that any or all of these conditions may be shown to be the primary cause of a student’s academic
problems, a student may not be found to be an individual with exceptional needs. It is this psychologist’s opinion that the assessment results through
this evaluation were not significantly affected by environmental, cultural, or economic disadvantage known at this time. Any information that becomes
available at a later date that may affect this conclusion should be considered.
Recommendations:
________________________
Adriana Frausto, M.S.
School Psychologist
Special Education Division
Bakersfield City School District
_________
Date
!Student:Psycho-Education Evaluation
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!Student:Psycho-Education Evaluation
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