Tevie Miller Early Education Parent/Guardian Inquiry Form 2015 – 2016
Program Information
Tevie Miller Early Education Program provides educational programming for children from 2 ½ - 5 years of age who are currently presenting with mild/moderate or severe language delays. The Early Education Program consists of both ECS (preschool) classrooms and kindergarten classrooms. Both of the ECS and kindergarten classrooms are characterized by a collaborative class model including a Certified Teacher, Educational
Assistant and Speech Language Pathologist. An Occupational Therapist also works part-time in each of the classrooms. Please see below for further information about each learning environment.
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ECS
half-day program (morning and afternoon classes)
10 – 11 children per class (all with diagnosed speech language delays)
Children attend school from Tuesday – Friday
Once a month each child has scheduled Family-Oriented Programming Sessions (FOPS).
These are home, school or community visits with the child, parent/guardian and classroom team. FOPS are a requirement of the Tevie Miller Early Education ECS program.
Transportation via yellow school bus is an option for children accessing Program Unit Funding
(children with diagnosed severe language delays)
Instruction is informed by Individualized Program Plans
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Kindergarten
Full-day program
14 – 16 children per class (all with diagnosed speech language delays)
Children attend school from Tuesday – Friday
Transportation via yellow school bus is an option for children accessing Program Unit Funding
(children with diagnosed severe language delays)
Instruction is informed by the Alberta Education Kindergarten Curriculum along with
Individualized Program Plans
Tevie Miller Early Education focuses on speech/language development. If a child is requiring individualized support and supervision during programming hours , Tevie Miller may not be the most suitable placement for your child. Many other Early Education Programs are available in Edmonton specializing in working with children who require more intensive individualized support. Further information regarding other programs can be provided if requested.

Tevie Miller Early Education Parent/Guardian Inquiry Package 2015 – 2016
Please complete the following information:
Child’s Legal First Name: ________________________ Child’s Legal Last Name: ______________________
Date of Birth: ______________________ Male or Female (please circle)
Parent/Guardian First Name: ___________________Parent/Guardian Last Name: _______________________
Address: ________________________________________ City: ____________________________________
Postal Code: _______________________ Email: ___________________________
Phone: ____________________________
If your child currently attends another school or program, please indicate which program below:
________________________________________________________________________________________
Process to Follow:
1) Have your child’s speech language reassessed after March 1, 2015 (Alberta Education requires that all speech language reports be no older than 6 months on September 1, 2015)
2) Complete the Tevie Miller Early Education Parent Questionnaire (attached)
3) Collect any other assessment reports (such as those from the Preschool Assessment Services Clinic, PLAI
Program, CASA Child and Adolescent Mental Health, 1,2,3 Go Program etc.)
4) Submit all assessment reports and the questionnaire form to Tessa Morris, Assistant Principal (via email, fax or in person)
Email: Tessa.Morris@epsb.ca
Fax: 780 - 436 - 0385
Address: 6240 113 Street - the administrative assistant at the front desk will be available to collect the documents.
Please note: Due to both school and district responsibilities, Tessa won’t be able to meet with families regarding inquiries about the program. Upon receiving the documents listed above, she will contact families to follow-up. The
Parent Questionnaire and assessment reports does not guarantee placement in our Early Education program.
Children are accepted into the program based on assessment information, other individual learning needs, and available spots.

Tevie Miller Early Education Parent Questionnaire
This questionnaire is to assist with finding the best possible classroom for your child. Please answer the following questions carefully and contact Tessa Morris, Assistant Principal if you have any questions.
Social/Emotional Development –
Check all that apply:
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My child enjoys social games such as patty-cake, peek-a-boo, tickles etc.
My child engages in pretend play with stuffed animals, action figures, dolls etc. (example: pretend to
 feed a doll, pretend to drink from a play cup etc)
 My child enjoys watching moving parts such as spinning wheels of toys, fans, opening and closing doors
My child currently plays on his/her own and doesn’t initiate activities with others though may watch
 other children nearby
 My child currently explores toys/objects by putting them in his/her mouth
My child is able to sit and attend to activities for periods of up to 5 minutes
 My child is able to sit and attend to activities for periods of up to 20 minutes
 My child currently struggles to regulate his/her emotions and at times will hit others, throw/break toys and/or bang his/her head on the floor –
Please circle : this occurs – on a daily basis, once every few days, once a week, once a month)
 My child may wander or run away if not supervised carefully
 My child is shy and tends to become anxious when around groups of people
Communication –
Check all that apply:
 My child currently communicates using gestures (waving bye, shaking head “no”)
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My child currently communicates by leading people to requested objects
 My child currently uses American Sign Language and/or pictures (PECS) to communicate
My child currently enjoys repeating sounds, words, phrases or scripts from the TV/iPad when not asked
 to do so
 My child responds to his/her name when people other than me call him/her
My child is able to complete 1-word directions (“come,” “stop,” “wait” etc)
 My child is able to complete 1-step routine directions (example: “sit in your chair,” “put away your toys”)
 My child is able to understand a multi-step direction (example: "go upstairs, brush your teeth and put your pyjamas on")
 My child is able to answer basic questions (yes/no, what, where questions)
 My child has language though struggles to get his/her message across because of his/her speech sound delay

Tevie Miller Early Education Parent Questionnaire (continued)
 My child is able to communicate verbally either in English or another language ( Please circle : less than
20, 20-50, 50-75, 75 +)
 My child is able to understand our native language though not yet English
Gross Motor (physical skills) -
Check all that apply:
 My child enjoys climbing on things (such as furniture, playground equipment)
 My child walks on his/her own
 My child is able to go up and down stairs on his/her own (holding hand rail)
 My child has been followed by a Physical Therapist through Alberta Health Services Early Intervention
Program *please send any assessment reports to Tessa
Self-Help Skills –
Check all that apply:
 My child is able to take off his/her shoes independently
 My child is able to put on his/her shoes independently
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My child is able to put on his/her coat (with some help to zip zipper)
 My child is able to take off his/her coat independently
My child is currently wearing diapers/Pull-Ups during the day
My child sits on the toilet though hasn’t started urinating in the toilet yet
 My child is starting to urinate in the toilet
 My child is toilet trained and urinates and has bowel movements in the toilet
 My child is able to use a spoon/fork on his/her own (without help from an adult)
 My child is able to drink from an open cup (without help from an adult)