ARC Meeting Checklist - Initial Referral - Speech

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Conference Summary Guide
Speech/Language Initial Referral
It is strongly suggested that you use the following headings in your conference summary
notes to ensure that all information is covered and easily able to be found!
PURPOSE OF MEETING
o
o
o
o
What is the purpose of the meeting?
 The purpose of the meeting is to review a referral and determine if the data supports a
suspected disability and the need for an evaluation for special education.
Procedural Safeguards
 A copy of the Procedural Safeguards was given to the parent. __________reviewed the
Procedural Safeguards with the parents.
Was someone in the meeting that was not on the notice? If so, document that the
parent/guardian gives permission for them to be there.
 Attending the meeting, but not on the Notice of ARC is ___. The parent gave permission
for ____ to attend the meeting.
If someone was not in attendance, but was on the Notice of ARC then note:
 Parent was informed that ____ would not be able to attend. Excusal form was signed by
parent before meeting.
NOTE: An initial referral meeting cannot be held without the parent. If the parent cannot attend –
a home visit should be conducted. A phone conference should not be held for this type of
meeting.
REVIEW REFERRAL
o
o
Review the referral including the primary area of concerns.
Document that the student received research-based instruction and interventions in the
regular education setting by qualified personnel.
 ____received research-based interventions to address the concerns of
_______in the general education setting by qualified staff. The documentation,
including repeated assessments, is attached to the referral.
o
Analysis of referral information – summary of information that supports
SAMPLE:
 Progress monitoring collected during the intervention period demonstrated limited
progress in articulation and language. Analysis of the progress monitoring
revealed that _______ on average is only able to produce /f/ correctly in all word
positions with ___% accuracy when provided the interventions of __________.
In the area of language, ____ has demonstrated the ability to answer listening
comprehension questions with an average of ____% accuracy even after the
following interventions have been implemented: _________.While some
progress is noted, his/her articulation and language skills continue to be fbelow
same age peers. ARC members agree that existing information supports a
OPS – Conference Summary Guide
October 2013
suspected disability and accept a referral for an evaluation in the area of speech
sound production and language.
OR summary of information does NOT support


o
SAMPLE
Progress monitoring collected during the intervention period demonstrated
significant progress in articulation and language. Analysis of the progress
monitoring revealed that _______ on average was only able to produce /f/ with
___% accuracy, however is currently able to produce /f/ with ____% accuracy
when provided the following interventions: __________. In the area of language,
____ has demonstrated the ability to answer listening comprehension questions
with an average of ____% accuracy which shows a significant improvement.
The interventions are working in the area of speech sound production and
language. As a result, the committee members agree that existing information
does not support a suspected disability at the current time.
The parents were given a copy of the referral and summary of interventions.
If referral is accepted, document that parent gave permission to evaluate and evaluation
planning plan was completed to plan assessment.
OPS – Conference Summary Guide
October 2013
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