ARC Chairperson Resources SY 2011-12
Conference Summary Minutes Outline
Initial Evaluation and Eligibility Meeting
Purpose of Meeting:
To discuss results of an individual evaluation
Other possible purpose: To develop, review, and/or revise the student’s IEP and make placement decisions
Note: Be prepared for the meeting having read the report, highlighting relevant details regarding the eligibility
decision. Determine prior to the meeting who would be sharing information and who would be taking minutes
that are part of the “official record.” It is recommended that at least one other ARC member take additional
minutes that might be included in the final version in case the official recorder missed an important supporting
statement.
Sample statements provided are intended to provide some (not all) examples of statements that may be used on
the Conference Summary. They are not intended to be used exactly as worded here but rather as samples that
should be edited to fit the particular student and situation being documented.
Introduction/Roles of ARC Participants and Purpose for Meeting (Record Review Items #15-#21)
(Sample statement) All members of the ARC invited to the meeting were present and introductions were made.
The purpose of the meeting was to discuss the evaluation/written assessment report conducted by school
personnel and to determine _______________’s possible eligibility for special education (and related) services.
Parent Rights (Record Review Item #29)
(Sample statement) Parents were provided a written copy of the procedural safeguards with a verbal explanation
of those rights given by _______________________________. Parents had questions regarding their rights if
their child was not eligible for special education services. The ARC Chairperson again reviewed the section on
State Complaint Procedures and how disagreements regarding decisions could be resolved.
Section I: Description of Procedures (Record Review Item #24)
Review of the Written Assessment Report – The ARC should have a hard copy of the evaluation written report
and of the eligibility determination form(s) at this time to reference and use as a guide for discussion. All ARC
members should have reviewed the written assessment report prior to the meeting to become familiar with its
contents and be prepared to participate in the discussion.
If parents have not already received a copy of the report (which is recommended), be sure to provide a copy at this
time.
Introductory explanation of the report:
(Sample statement) _________________________ was evaluated for a suspected disability in the area of
_____________________. The evaluation information was gathered through multiple sources including
(Examples may be behavior observations, parent interview, standardized achievement tests, etc.) ___________
and included assessment in the areas of _________________ (Examples may be academic achievement,
cognitive ability, etc.). Assessments were administered by a variety of qualified school personnel including the
guidance counselor, special education teacher, and school psychologist. ____________________ was tested in
______________ which is his native language as determined by the home language survey.
Be sure to check each box under Section I of the Conference Summary used as a basis of the decision(s). Check
the box of each description which correlates with types of assessment in the written assessment report.
Section II: Parent Concerns and Input (Record Review Item #46)
Be sure to check Parent Input box in Section I on the conference summary.
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
1
ARC Chairperson Resources SY 2011-12
(Sample statement #1) Mr. and Mrs. ________________ reported that they had had ____________ evaluated for
dyslexia at the Shedd Academy and had a report confirming her eligibility. The chairperson asked for the school
to have a copy of the report for ______________’s record and asked for ____________’s parent to summarize
the results. The LEA Representative explained that in order to determine the presence of a learning disability, the
state regulations and district policies require the use of standardized instruments that were administered by
qualified personnel as determined through district procedures. Since the individuals at Shedd Academy did not
have the evidence of such qualifications, the committee would consider the report but could not use it as a basis
for ____________’s eligibility decision. (This would be considered an option refused with explanation.)
(Sample statement #2) Mr. and Mrs. __________________ had taken their daughter, ________________, to
Step One, an independent diagnostic/consultative agency, in Louisville which conducted a very thorough
evaluation of _____________’s needs at the request of her parents. Mr. and Mrs. _________________ shared a
copy of the final report with the ARC members. This report was reviewed by the ARC and determined to
evidence the same conclusions regarding _________________’s disability as was found in the district evaluation.
(Sample statement #3) Mr. and Mrs. _____________________ reported to the ARC that even though they were
divorced, they would continue to work together in supporting __________________’s educational needs and
would expect to both be invited to all meetings pertaining to their child.
(Sample statement #4) When asked by the ARC Chair if they felt the evaluation results and written assessment
report were accurate, Mr. and Mrs. _____________________ said they agreed with the results of the testing and
that it described their child’s abilities and challenges.
Section IIIC: Eligibility/Continued Eligibility (Record Review Items #25 and #26)
Explanation of results: (Do not include as the only statement: “Refer to written assessment report.” Provide a
short summary of the test results which were discussed as is provided in the following examples.)
 Social-developmental history
(Sample Statement #1) A review of the social-developmental history completed by __________’s mother
indicates that ________________ lives with his family. The only stressful event in the past 12 months was the
death of his grandfather who had an extended illness. It was noted that ________________ was in daycare prior
to kindergarten and repeated first grade. His health was rated overall as being good. He is only on medication
for common allergies. ________________ likes to spend time with his family and friends, going to the park, and
participating in sporting activities, including baseball and soccer. He also participates in his church youth
group.
 Individual standardized test results (including interviews, rating scales, commercial tests)
(Sample statement #1) Per the written assessment report, the Woodcock-Johnson Tests of Achievement indicated
that ___________ evidences a notable difference between her ability to do math calculations and what might be
expected for a student with her cognitive abilities. Though given a systematic series of interventions provided in
the general classroom setting and in small group settings, _________ was unable to demonstrate sufficient
progress to benefit from this level of intervention.
(Sample statement #2) ______________is functioning at least two standard deviations below his same grade
peers in the areas of cognition, academic achievement and adaptive behavior. He appears to have notable
challenges in daily living skills that require independence. Overall academic skills are approximately three
grade levels below his current grade, and his cognitive abilities are below the second percentile.
(Sample statement #3) According to the results of the behavior rating scales, the teacher and parent rated
______________in the clinically significant range for externalizing behaviors. The standard score on the parent
report was _____ and on the teacher report was ______. These scores were consistent with how the student rated
himself. ________________ received interventions through the school’s Check and Connect Program and an
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
2
ARC Chairperson Resources SY 2011-12
individual behavior contract. These were continued through the evaluation process, with progress indicating
behavior significantly and consistently below that of his peers and exhibited across settings.
 Behavior observations
(Sample statement for suspected disability in SLD for written expression) An observation of
________________’s expressive writing skills was conducted in his English class as the students were required to
complete on-demand tasks. ___________________ did not complete the task during the allotted time when the
rest of his peers had been able to do so, and the teacher later reported that he had left out significant details
required in the rubric.
 Academic and/or Behavioral History (This may include district/statewide assessments.)
(Sample statement #1) The regular education teacher reported that current classroom-based assessments and
observations reveal _________ is struggling with basic math calculation with his performance continually
falling below that of his grade peers. MAP scores over the past three years indicate that he consistently performs
in the first percentile in math as compared with both national and district norm. On AIMSweb he has performed
consistently below peers, scoring in the lowest ten percent of his grade as measured by this curriculum-based
measurement. He has scored at the novice level in math on state assessments since the third grade.
Eligibility Decision:
This decision includes criteria for the specific disability, adverse effect, and exclusionary factors. Be sure to use
the appropriate eligibility determination form with you to guide the discussion.
 Eligibility criteria – Do the student’s assessment results meet the eligibility criteria in state regulations
and district procedures?
(Sample statement #1-OHI) ________________ received 12 weeks of intervention demonstrating that her
progress was below the expected goal on 5 of the 6 points of reference. ________________’s difficulty with
completing tasks, maintaining focus and contributing to on-topic discussions was further evidenced by parent and
teacher input, observations, and existing data. Based on the analysis of the above evaluation data and comparing
it to the eligibility criteria as referenced in state regulations and district procedures, ___________________ does
meet eligibility requirements in the area of Other Health Impairment with a diagnosed condition of Attention
Deficit Disorder which impacts his limited alertness in the educational environment as noted by the physician.

Adverse Effect – Is the child’s progress impeded to the extent that his/her educational performance is
significantly and consistently below similar-age peers?
(Sample statement #1-OHI) In addition to meeting the eligibility criteria for Other Health Impairment, the
impact of this disability is evidenced in difficulty in sustaining his attention to tasks including written assignments
and classroom lectures or discussions that require his independently completing and participating in a task that
other students can do without prompting. These challenges are specifically manifested in difficulty with staying
on topic during a writing assignment and contributing only when called on during a class discussion. When the
teacher does call on __________________, he is not aware of the preceding discussion and frequently has not
attended to the question that was asked.

Exclusionary Factors – Has the student received appropriate instruction in reading and math? Is the
student identified as being Limited English Proficient? If yes, is his limited proficiency in the English
language the barrier to his learning/behavior or is it the identified disability? Are there any
environmental, cultural, or economic factors that are the root cause for the learning/behavior problems?
(Sample statement #1-OHI) The ARC identified no environmental, cultural or economic factors that could be the
basis for his difficulty in attending. School records reveal that _____________ has received appropriate
instruction in both reading and math since kindergarten.
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
3
ARC Chairperson Resources SY 2011-12
Other Eligibility Sample Statements for Various Disability Categories: (From Karen Frohoff, DoSE, Mason
County School District, Kentucky)
(Sample statement #2-MMD) _____’s cognitive performance and adaptive behavior is at least two standard
deviations below the mean. Testing results indicate low achievement in reading, reading comprehension, reading
fluency, math, and written expression consistently impact learning in content classes. Adaptive behavior
information gathered from the assessments and parent/teacher input support ____’s problems with interactions in
social settings with peers and with independence in the home and community. Based on these results, the ARC
determined that _____ meets eligibility criteria in the area of Mild Mental Disability. ____needs multiple visual
prompts such as graphic organizers to support learning in content areas and elective classes. ____ has difficulty
maintaining a schedule. He responds well to direct instruction and relies on verbal and visual cues to support his
learning. His academic and functional skills are at the 3rd grade level which is significantly below his 8th grade
peers.
The ARC reviewed possible social and cultural factors that may have impacted ______’s progress and
determined these are not mitigating circumstances. ____ has had appropriate instruction in reading and math
but his cognitive delays and delays in adaptive behavior skills across home, school, and community settings have
significantly impacted his rate of learning compared to peers. The ARC determined that ____ requires specially
designed instruction to support his access to and progress in core content areas and functional skills to support
his ability to benefit from direct instruction and independent/functional learning activities.
(Sample statement #3-FMD) ________’s characteristics of cognitive delay and adaptive behaviors that are three
standard deviations or more below the mean have adversely impacted _______’s achievement in reading, reading
comprehension, reading fluency, math, written language and adaptive behavior. ____ requires extensive
modifications and accommodations to learn core content concepts. Based on the assessment results, _____ meets
eligibility criteria as a student with a Functional Mental Disability. _____benefits from adult and peer prompts
to help guide him during transitions throughout the day. _____’s academic skills are between a preschool and
kindergarten level in reading and at 2nd grade level in math. _____’s adaptive behavior is similar to a 5 to 7 year
old student and he requires constant supervision in unstructured settings. Due to his disability, _______ is not
able to identify danger and is trusting of all adults. He is a follower and wants to do everything the other high
school students are doing.
The ARC reviewed possible social and cultural factors that may have impacted ______’s progress and
determined these are not mitigating circumstances. ____ has had appropriate instruction in reading and math
but his cognitive delays and delays in adaptive behavior skills across home, school, and community settings have
significantly impacted his rate of learning compared to peers. The ARC determined that ____ requires specially
designed instruction to support his access to and progress in core content areas and functional skills to support
his ability to benefit from direct instruction and independent/functional learning activities.
(Sample statement #4-EBD) The ARC reviewed ____’s history of emotional and behavior issues across settings
which have existed for a period of time greater than six months. It was determined that these issues have
impacted his achievement in reading, reading comprehension, reading fluency, math and written expression.
Based on all of the assessment information, it was determined that ____meets eligibility in the area of Emotional
Behavioral Disorder. ____ requires extensive modifications, accommodations and positive behavioral supports
to learn core content due to his explosive behavioral issues that impact this ability to attend, accept, and
participate in instructional activities.
The ARC reviewed possible social and cultural factors that may have impacted ______’s progress and
determined these are not mitigating circumstances. ____ has had appropriate instruction in reading and math
but his emotional and behavioral issues across home, school and community settings have significantly impacted
his rate of learning compared to peers. The ARC determined that ____ requires specially designed instruction
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
4
ARC Chairperson Resources SY 2011-12
and positive behavioral interventions to support his access to and progress in core content areas, functional skills
and home, school, community social settings.
(Sample statement #5-Autism) ____exhibits delayed expressive and receptive language skills, poor executive
functioning skills, sensory concerns, and delayed social skills with peers and adults. These skill deficits have
impacted ____’s achievement in reading, reading comprehension, reading fluency, communication, math, written
language and adaptive behavior. According to the results of the evaluation, ____ meets the eligibility criteria as
a student with Autism. ___requires extensive modifications and accommodations to learn core content concepts
and to participate in social activities within the school including riding the bus, eating in the cafeteria,
participating in PE and gym activities, engaging in reciprocal conversations, and understanding appropriate
interactions with adults and peers.
The ARC reviewed possible social and cultural factors that may have impacted ______’s progress and
determined these are not mitigating circumstances. ____ has had appropriate instruction in reading and math
but his communication delays and delays in adaptive behavior skills across home, school and community settings
have significantly impacted his rate of learning compared to peers. The ARC determined that ____ requires
specially designed instruction to support his access to and progress in core content areas and functional skills.
He requires significant adaptations and modifications to his environment and instructional delivery modalities to
support his ability to benefit from direct instruction and independent/functional learning activities.
(Sample statement #6-SLI) According to the evaluation results, ____ is not able to effectively communicate with
peers and adults. He constantly needs to repeat his words, sentences and phrases to his listener. Although his
speech production of one word utterances does not indicate a significant problem, his connected speech is not
intelligible to his listener. Due to not being understood, he exhibits frustration, and the natural flow of
communication between communicative partners is impeded. The ARC agreed that ____meets eligibility criteria
for Speech Language Impairment. _____’s articulation errors significantly impact his progress and
communication in all oral activities including academic, social and extra-curricular opportunities.
The ARC reviewed possible social and cultural factors that may have impacted ______’s progress and
determined these are not mitigating circumstances. ____ has had appropriate instruction in speech through
modeling; his articulation errors have significantly impacted his oral communication skills compared to peers.
The ARC determined that ____ requires specially designed instruction and positive behavioral interventions to
support his access to and progress in core content areas, functional skills and home, school, community social
settings.
Complete Eligibility Determination Form. The “Supporting Evidence” boxes on the Eligibility
Determination Form may include some of the statements from the explanation of evaluation results and the
eligibility decision section (refer to above samples).
If the ARC determines the student to be eligible for special education services, proceed to Section
IIID. Individual Education Program.
Sample statements for a student who is determined to not be eligible:
 Eligibility criteria
(Sample statement for a student who is determined to not meet the eligibility criteria)
________________ received 12 weeks of intervention demonstrating that her progress was below the expected
goal on 5 of the 6 points of reference. ________________’s difficulty with completing tasks, maintaining focus
and contributing to on-topic discussions was not evidenced in all academic classes. Her difficulty was much
more pronounced in subject classes that she listed as being uninteresting to her or saw no connection to everyday
activities. Based on the analysis of the above evaluation data and comparing it to the eligibility criteria as
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
5
ARC Chairperson Resources SY 2011-12
referenced in state regulations and district procedures, ___________________ does not meet eligibility
requirements in the area of Other Health Impairment even though he has a diagnosed condition of Attention
Deficit Disorder. It was noted that the physician’s diagnosis was made without input from school personnel.
 Adverse Effect
(Sample statement for a student who meets the eligibility criteria but there is no adverse effect)
The results of the assessment data indicate that ____________ does meet the eligibility criteria for Other Health
Impairment under Attention Deficit Disorder. However, the ARC was unable to determine a specific and
consistent impact of this disability across environments. In his favorite classes, he participates in class
discussions and shows the ability to complete his assignments without prompting.
 Exclusionary Factors
(Sample statement for a student who meets eligibility criteria and for whom there is an adverse effect, but there
are exclusionary factors that impact the difficulties)
Although _______________ meets eligibility criteria for OHI based on an Attention Deficit Disorder, the parent
reported that since the family moved in with the grandparents due to the loss of the father’s job,
________________ started demonstrating these behaviors which were not a problem when the family lived in
their own home.
Other Eligibility Sample Statement for Student Not Eligible: (From Karen Frohoff, DoSE, Mason County
Public Schools, Kentucky)
(Sample statement for student who is being dismissed from DD)
The ARC reviewed the integrated report for assessment, teacher and parent interviews, interventions, classroom
observations and reports from the University of Kentucky Medical Center. ___ has a diagnosis of ADHD and
received services the past three years under Developmental Delay. ___ is seen by a therapist at UK on a monthly
basis to monitor his medications. ___ currently takes 18 mgs. of Concerta one-time per day. ____ has graduated
from the social skills groups at UK and is not enrolled in any outside counseling or therapy.
____ is currently functioning in the average range in all academic areas according to the recent evaluation
results. He gets along well with his peers and is participating in the after school archery program. He has two
close friends at school and participates in scouts as an extra-curricular activity. It is reported that he is
developing leadership skills in school and is able to take redirection from adults without demonstrating
frustration or anger. ____ has developed a tool kit of strategies to assist with his ADHD characteristics. He uses
a planner and his cell phone to keep track of course assignments and homework. He turns in work in a timely
manner and is passing all classes with a B average. If ___ gets anxious regarding an assignment or activity in
class, he will request adult assistance and will ask for clarification.
The ARC discussed ____’s diagnosis and determined that at this time there is no adverse impact on his
educational and social performance. ____’s diagnosis does not significantly impact his progress or his ability to
access the core content. The ARC is in consensus that ___ does not meet eligibility as a student with a disability
under OHI. The ARC was unable to identify any adverse impact academically and/or socially for ___ in the
school setting.
Complete Eligibility Determination Form. If the ARC determines the student to not be eligible for special
education services, proceed to Section VI. Other Actions Relevant to the Action which might include a
discussion of continuation of the interventions and progress monitoring/formative assessment in the
general education setting as well as other options rejected. Following this discussion, conclude the meeting.
Section IIID: Individual Education Program (Be sure to include parent input regarding IEP.)
(Sample opening statement regarding the reason for writing an IEP for this student-Record Review Items #25,
#36, and #27). Based on the results of the evaluation and the identified adverse effect of the disability, the ARC
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
6
ARC Chairperson Resources SY 2011-12
agreed that _______________ needs special education services in order to benefit from instruction in the general
curriculum at her grade level. A draft IEP was presented for discussion by the ARC which included suggestions
for annual goals and specially designed instruction aligned with information in the written assessment report.
 Present Levels and Special Factors (Record Review Items #33 and #34)
(Sample statement) Using the information from the written assessment report and input from ARC members who
have worked most closely with ___________, the ARC discussed the present level of performance statements as
drafted by school personnel, including special factors. The parent expressed concerns about how __________’s
behavior appears to interfere with his ability to learn. The ARC concluded there was sufficient evidence from
observations to include this as a special factor.
If the student is Grade 8 or age 13 years + 1 day, refer to the annual review Conference Summary
Minutes Outline which includes related notes.

Annual Goals, Benchmarks/Short-term objectives, Progress Monitoring (Record Review Items #35, #37,
and #38)
(Sample statement) Annual goals and short-term objectives were discussed targeting the identified areas of
_________________. The parent noted that they wanted an additional benchmark to address
________________________’s inability to take turns with peers. Progress will be measured by scoring
rubrics, checklists, and will be shared with the parent on a quarterly basis when the student receives his
report card.
 Specially Designed Instruction (Record Review Items #36)
(Sample statement #1) The ARC determined that ________________ would need special individualized
instruction in the use of assistive technology as recommended through the evaluation in order to meet the annual
goal in written expression.
(Sample statement #2) The special education teacher presented options for SDI that included choral reading and
direct instruction in reading. The committee agreed that these strategies are the most supportive for reading
instruction.

Supplementary Aids and Services, Program Modifications, Testing Accommodations
(Record Review Items #39, #40, #41, #42)
(Sample statement #1) ________________ will have access to additional adult support in the regular education
classroom with modified tests and study guides. The school personnel will have specialized training in responding
to medical conditions related to seizures. The ARC completed the Accommodations Determination Form to
specify appropriate test accommodations for ______________. The first option for accommodations was the use
of assistive technology to allow __________ to be as independent of adult assistance as possible.
(Sample statement #2) The ARC determined that __________________ is eligible for Alternate Assessment; he is
able to communicate with words and gestures. Current data indicate that ______________’s cognitive and
adaptive performance inhibit his being able to complete the requirements of the general curriculum with typical
accommodations allowed for the general state assessment. He will be participating in the non-diploma program.
The ARC completed the Alternate Assessment Determination form, and the parent was given a copy of the Parent
Guide.
 Least Restrictive Environment (Record Review Item #43)
(Sample statement #1) ________________ will participate in all regular education core content classes. He
will be removed from a general education non-core class for two periods a week to receive speech services in the
resource room.
(Sample statement #2) _____ will not participate in the general education core content classes of math, reading,
science, and social studies. She will receive instruction for her core content classes in the resource room.
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
7
ARC Chairperson Resources SY 2011-12
 Special Education and Related Services (Record Review Items #44 and # 45)
(Sample statement) ____________________ will primarily receive special education services in a co-teaching
classroom for ____________ minutes per day in the area of reading. Services in a resource room to provide
more individual pre-teaching of vocabulary concepts will be provided for (Student’s Name) 30 minutes a week.
 Extended School Year Services (Record Review Item #48)
(Sample statement) Since this is an initial IEP for ____________________, there is no data to determine this
would be a need at this time. Should ________________ exhibit notable problems with regression and
recoupment of achieved skills, the ARC will reconvene at that time to review progress data and determine need
for services.
If the student is Grade 8 or age 13 years + 1 day, refer to the annual review Conference Summary
Minutes Outline which includes related notes. (Record Review Items # 49a-i, #50, and #51)
Section IIIE: Placement Options (Record Review Item #53)
(Sample statement) The ARC first discussed ________________’s placement full time in a regular education
classroom. It was determined that the regular education setting allows for _______________ to have the
opportunity to learn from same age/grade peers in order to generalize skills in a natural setting.
However,___________ will also need to receive services in a resource setting for pre-teaching concepts since he
has difficulty with content vocabulary. (Refer to other samples in the LRE Justification Statements document.)
When calculating how much of the day _______________ will be removed from the general education classroom
setting, it was determined that he will be in a regular education setting for more than 80% of the day.
Section IIIF: Potential Harmful Effects (Record Review Item #52)
Make sure you check one of the two boxes. If there are harmful effects, complete the explanation in the space
provided.
(Sample statement) Even though __________________ may have difficulty with pacing his assignments in the
general education class, he will have additional time to complete an assignment which would compensate for this
issue.
Section VI: Other Factors Relevant to the Action (Record Review Item #28)
Be sure to check one of the two boxes.
(Sample statement for other factors) The ARC discussed possible complications that may arise from upcoming
changes in medication for __________________’s seizure disorder.
Consent for Special Education and Related Services
(Sample statement) The parents signed the consent for CCSD to provide special education in the area of
______________________. No related services are needed at this time.
Other options rejected: (Record Review Items #27 and #28)
(Note that the above sample statement for “Placement” was also an example of an option rejected.)
(Sample statement #1) No options were discussed that the ARC rejected.
(Sample statement #2) The ARC discussed and determined that additional adult support was not needed for
____________ because she may become unnecessarily dependent on this rather than learning to rely on more
natural supports (e.g., peers) as documented through data collected during observations.
Review the conference summary and obtain signatures. (Record Review Items # 19 and #21)
Disclaimer: This resource was developed as a guide for ARC Chairpersons in conducting a meeting which includes
compliance documentation. It should not be considered a legally required document.
8