Name of Student:
Name of person conducting the evaluation: __________________________________
Qualifications to Evaluate: Licensed Learning Disabilities / Emotional Disturbance / Cognitive Disabilities Teacher
Areas to Be Evaluated:
Academic Skills
Pre-Academic Skills
Developmental Skills
Behavioral
Self-Concept
Other:
Description of Tests and Other Evaluation Measures:
BATTELLE DEVELOPMENTAL INVENTORY (BDI)
The BDI is a comprehensive instrument that can be used for screening, diagnosis, evaluation, and program development of children from birth to
age 8.
DIAGNOSTIC ACHIEVEMENT BATTERY-THIRD EDITION (DAB 3)
The DAB-2 is intended to accomplish four goals: (a) to identify those students who are significantly below their peers in the areas of spoken
language (listening and speaking), written language (reading and writing), and mathematics and who, as a result, may profit from supplemental or
remedial help; (b) to determine the particular kinds of component strengths and weaknesses that individual students possess; (c) to document
students' progress in specific areas as a consequence of special intervention programs, and (d) to serve as a measurement device in research
studies of the academic achievement of elementary school children.
GRAY ORAL READING TESTS-DIAGNOSTIC (GORT D)
The GORT-D is used to evaluate oral paragraph reading. It evaluates reading rate, accuracy, and comprehension. It also rates a students miscue
analysis.
GRAY ORAL READING TEST-FOURTH EDITION (GORT 4)
The GORT-3 is used to evaluate oral reading speed and accuracy along with accounting for comprehension abilities.
KEYMATH-3
This is a Diagnostic Inventory of Essential Mathematics is an individually administered instrument that can provide a comprehensive assessment of
a students understanding and application of important mathematics concepts and skills.
OBSERVATION
TEST OF EARLY WRITTEN LANGUAGE-Second Edition (TEWL 2)
The selection items measure several different aspects of writing: transcription, conversions of print, communication, creative expression, and record
keeping. This instrument is used to assess children who are suspected of having writing problems and to identify those who are performing at a
level significantly below that of their peers.
TEST OF EARLY READING ABILITY-Third Edition (TERA 3)
This is a measure of a child's ability to attribute meaning to printed symbols, their knowledge of the alphabet and its function, and their
understanding of the conventions of print.
TEST OF EARLY MATHEMATICS ABILITY-Third Edition (TEMA 3)
This is designed to measure the child's informal mathematics in the areas of concepts of relative magnitude, counting skills, and calculation skills. It
formally measures the child's competence in knowledge of convention, number facts, calculation skill, and base ten concepts.
TEST OF READING COMPREHENSION- Third Edition (TORC 4)
The TORC-3 is used to identify students whose scores are significantly below those of their peers, to determine areas of relative strength and
weakness across reading comprehension abilities, and to document overall progress in reading development.
TEST OF WRITTEN LANGUAGE- Third Edition (TOWL 4)
The TOWL-3 is a test of written composition. It measures a student's writing competence through both essay-analysis formats and traditional test
formats.
WOODCOCK JOHNSON PSYCHO-EDUCATIONAL BATTERY-III
This battery consists of eleven individually administered tests that have been nationally standardized. This test evaluates a student in the areas of
reading, written language, math, and spelling.
Revised 2/15/2013
AUTISM DIAGNOSTIC OBSERVATION SCHEDULE (ADOS)
The Autism Diagnostic Observation Schedule (ADOS) is the “gold standard” for assessing and diagnosing autism and pervasive developmental
disorder (PDD) across ages, developmental levels, and language skills.
BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN (BASC) – Teacher/Student
This instrument is designed to provide standardized descriptions of behavior rather than diagnostic inferences. High scores on the descriptive
dimensions behavior problems should not automatically be equated to a particular diagnosis or inferred disorder.
FUNCTIONAL BEHAVIORAL ASSESSMENT – Teacher/Student
This form is used to obtain information from parents/teachers/student regarding behaviors exhibited in the home setting/school setting.
MULTIDIMENSIONAL SELF-CONCEPT SCALE (MSCS)
The MSCS is used to assess global self-concept and six content-dependent self-concept domains that are functionally and theoretically important
in the social-emotional adjustment of youth and adolescents.
Observation
THE SOCIAL RESPONSIVENESS SCALE-2 (SRS-2)
The Social Responsiveness Scale-2 (SRS-2) is used in the school setting to assist in the programming of students who appear to have
characteristics associated with the educational diagnosis of autism. The Social Responsiveness Scale-2 (SRS-2) is a questionnaire that covers
the various dimensions of interpersonal behavior, communication, and repetitive/stereotypic behavior. The SRS can be used both as a screener
and as an aid to clinical diagnosis. Results are pertinent to identification of Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental
Disorder Not Otherwise Specified (PDD-NOS).
Revised 2/15/2013