Shasta County Community Advisory Committee 2012-13 A PARENT’S GUIDE TO SPECIAL EDUCATION Compiled and Edited by: Shasta County Special Education Local Plan Area (SELPA) and Shasta County Community Advisory Committee (CAC) 1644 Magnolia Avenue Redding, CA 96001 Telephone (530) 225-0100 Fax (530) 225-0105 www.shastacac@gmail.com 2 3 CONTENTS What Is Special Education? ................................................................................. 5 Laws Affecting Special Education ....................................................................... 6 Least Restrictive Environment ............................................................................ 7 Referrals To Consider Need For Special Education .......................................... 7 Continuum Of Least Restrictive Environment Program Options ................... 8 Special Education Programs & Services ............................................................ 8 Procedure for Referral and Placement ............................................................. 10 Community Advisory Committee...................................................................... 13 Community Programs & Referral Resources .................................................. 14 Other Resources .................................................................................................. 14 Local Education Agencies & Schools Within Shasta County ......................... 15 Selected Programs in the Shasta County SELPA ............................................ 18 Special Education Glossary ............................................................................... 20 4 What Is Special Education? Special Education is an individualized education program designed to help students reach their potential. It is provided for students birth through maximum school age, generally through the 21st year, who qualify according to the laws and regulations developed by the state and federal government. It is the goal of the Shasta County Special Education Local Plan Area to assist parents and local education agencies to develop educational programs and transitional services for students with exceptional needs. Students receive special education instruction and services according to their specific needs. Placement in special education programs is only considered after the resources of the general education programs have been considered, and appropriately utilized. A common way of reviewing the use of general education resources is the Student Study Team. Most schools have a general education team that addresses family and school concerns regarding individual students’ academic, behavior, attendance or health problems. Such teams may have different names and procedures at different schools (Student Study Team, Student Support Team, etc.); however, regardless of name, all are similar in function. Such teams typically include general education and special education teachers, administrators, parents, and educational support staff. Their job is to explore all available resources which might assist a child, and make recommendations for classroom modifications, accommodations and supports. These teams may also recommend referral for special education evaluation if other recommended interventions have been unsuccessful. 5 Laws Affecting Special Education Federal Public Law 108-446, more commonly known as the Individuals with Disabilities Education Act (IDEA), guarantees certain fundamental rights to all children with disabilities. The purpose of the IDEA is to “ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living.” IDEA mandates that all children with disabilities are provided: A culturally unbiased, valid assessment. A free and appropriate public education (FAPE) in the least restrictive environment (LRE). Transition services, as appropriate, to be addressed in the Individual Education Program. Procedural Safeguards to ensure parent and child rights. The classifications for disabling conditions are: Autism Deaf Deaf-Blindness Emotional Disturbance Established Medical Disability (3-5) Hearing Impairments (including deafness) Intellectual Disability Multiple Disabilities Orthopedic Impairment Other Health Impairment Specific Learning Disability Speech & Language Impairments Traumatic Brain Injury (acquired) Visual Impairment (including blindness) The State of California has adopted Laws and Regulations to comply with the IDEA. All school districts in the Shasta County Special Education Local Plan Area are required to provide a free appropriate public education for all individuals with disabilities, ages birth to maximum school age, generally through the 21st year or earn a high school diploma. 6 Students receiving special education and related services have the right to be educated with non-disabled peers to the maximum extent appropriate. They participate, as appropriate, in all school programs and activities and general education activities as determined by the IEP team. Special education programs and related services are provided to students with disabilities at no cost. To the extent possible, these services are provided in settings at, or close to, the student’s neighborhood school. Least Restrictive Environment Each student has the right to be educated in the least restrictive environment which promotes, to the maximum extent appropriate, interaction with the general education population in a way that is appropriate to the needs of both. Referrals to Consider Need for Special Education Referrals for consideration of need for special education services are encouraged from parents, teachers, private schools, community agencies and any individual within the community who suspect that a child has a disability which might adversely impact his/her educational performance. Special education services are available for any child within the SELPA from birth through age 21 who is determined to have an eligible condition, and whose educational needs cannot be met with modification of the regular instruction program. Any person wishing to make a special education referral should contact the child’s District of Residence. Requests for testing require educational right’s holder 7 Continuum of Least Restrictive Environment Program Options Specialized instruction complementing regular classes (e.g. Designated Instructional Services (DIS) including but not limited to Speech/Language Therapy, Adapted Physical Education, Occupational Therapy, Resource Room or Resource Specialist Program, infant program services in the natural setting) Instruction in other settings (e.g. in the community for older high school students) Special classes (e.g. Special Day Class on public school campus, special classes for preschool students) Special schools (e.g. California School for the Deaf) Nonpublic schools Instruction in home or hospital Special Education Programs & Services Early Intervention Services In Collaboration With Far Northern Regional Center (FNRC) – Early Intervention Services offers services to infants and toddlers who require special education. Early Intervention services for the infant/toddler are specified on the child’s Individual Family Service Plan (IFSP) and may include, as appropriate: counseling; home visits; special instruction; speech therapy and audiology; occupational therapy; physical therapy; medical services (for diagnostic purposes); early identification, screening and assessment services; other health services and social work services, as needed. Preschool Program – The Preschool Program provides educational services for preschool children between the ages of 3-5 and focuses on the young child and his/her family. Resource Specialist Services – Students receiving these services remain in the general education classroom for the majority of the day. They may be served in the general education program with the resource teacher providing consultation or collaboration services within the general education classroom. The Resource Teacher works with the general education staff to provide curriculum assistance. Students may also receive individual or small group 8 instructional services in a pull out program. Students can also receive indirect services in a consultation model. Special Day Classes (including Accommodations & Modifications) - These classes provide services to students who have intensive instructional needs that cannot be met within the general education program. Services from an SDC teacher may be provided across a variety of environments. Designated Instructional Services (DIS) and related services are provided only when deemed necessary by the IEP Team to help a student benefit from his or her instructional program. DIS Services include, but are not limited to: Language & Speech Deaf & Hard of Hearing Services Orientation & Mobility Instruction in Home & Hospital Health & Nursing Services Specialized Designed Vocational Education & Career Development Adapted Physical Education Vision Services Counseling Services Physical & Occupational Therapy Transportation Nonpublic Schools – A nonpublic school is a private, nonsectarian school certified by the California Department of Education that enrolls individuals who have exceptional needs and whose needs are unable to be met by public education. They employ at least one fulltime teacher with an appropriate special education credential and are certified by the State Department of Education. School districts are required to consider all appropriate special education settings within the public school environment before recommending nonpublic school placement. State Operated Special Schools – Residential Schools for the blind, deaf, and neurologically disabled, offer complete diagnostic evaluations and residential school programs for individuals with extraordinary needs. Referrals to such programs are arranged upon the recommendation of the IEP team. 9 Extended School Year – The extended school year session may be recommended for individuals with unique exceptional needs to prevent significant loss of skills. Services are determined on an individual basis by the IEP team. Vocational / Transitional Programs: Vocational and Transitional programs and services are available to provide training and readiness experiences in diversified occupations. They are planned according to the student’s post-secondary goals and transition services on the IEP, and based on each student’s needs and abilities. Transition services may include Employment Training, Vocational Assessment, ROP, WorkAbility I, Supported Employment, and Life Skills Education. Support services may include special transportation, job coaching, leisure skills training, mobility training, or access to community resources. By age 16, or younger if determined appropriate by the IEP team, post-secondary IEP goals are developed jointly by the student, school and family in the IEP process. Agencies are included in the IEP meeting when appropriate. Procedure for Referral and Placement Notification Of Referral & Procedural Safeguards: Upon initial referral for evaluation for special education, the parent of a public school student will receive: 1) a written Notice of Referral for special education evaluation, and a copy of Special Education Procedural Safeguards (frequently referred to as Parent and Child Rights). The Procedural Safeguards form provides information to the parent related to the child’s right to receive a free and appropriate public education (FAPE) and contains information related to the educational agencies' legal responsibilities, including those related to evaluation, and the parent’s legal rights related to 10 special education. Educational personnel generally provide the parent with a verbal explanation of the Procedural Safeguards and will explain them in more detail upon request. Evaluation & the Following Team Meeting: Upon referral to determine Special Education eligibility, the District will, within 15 days, develop a proposed plan addressing all areas of suspected disability. This Assessment Plan will be presented to the parent for review and approval. After the signed Assessment Plan is returned to the school, qualified educational personnel have a maximum of 60 days within which to complete the student evaluation and to hold an IEP meeting. By the team meeting, the parent is required to receive a copy of the District’s Evaluation Report. At the IEP meeting, the results of the educational evaluation are shared with the team members and a determination of the student’s qualification or non-qualification for special education is made. If the IEP team determines that the child requires special education services, an IEP is cooperatively developed with the parent. The IEP represents the District’s offer of free appropriate public education (FAPE) for the child. If the child does not qualify for special education services, the results of the meeting and eligibility determination are documented and the team discusses other district programs, services, accommodations and modifications which might appropriately address the child’s educational needs. ADR/Due Process: If disagreement arises surrounding a child’s educational program and services that cannot be resolved through the IEP process, the parent and/or school district may elect to utilize any of the following: SELPA Alternative Dispute Resolution (ADR) Facilitated IEP State Mediation State Due Process Hearing 11 ADR (Alternative Dispute Resolution) utilizes services of a neutral third party in all stages of a dispute, which might include trained resource parents, SELPA staff, or a panel of one or two trained mediators, who will work closely with the district and parents to help resolve any conflicts. To inquire about the SELPA ADR process call the Shasta County SELPA Office at (530) 225-0100 Facilitated IEP Process – The role of an IEP Facilitator is to ensure that the IEP Team interacts respectfully, the perspectives of all participants are heard, and the IEP team focuses on future actions. An IEP Facilitator serves the whole group rather than an individual, and assists the group with the process of the IEP meeting rather than the content of the IEP. The agenda for a facilitated IEP meeting is the IEP process, and the focus of the meeting is the student and his or her needs. Although the use of ADR of the Facilitated IEP Process is encouraged, they do not preclude using more formal solutions listed above which include a state mediator and/or a Hearing Officer that would preside over a mediation or hearing. In regards to compliance complaints or Due Process Hearings, more information is included in the Parent Notice of Procedural Safeguards; or, you can call the SELPA Office at 225-0100. In order to file for mediation or a Due Process Hearing, contact: Office of Administrative Hearings Attn: Special Education Division 2349 Gateway Oaks Drive, Suite 200 Sacramento, CA 95833-4231 Phone: (916) 263-0880 Fax: (916) 376-6319 www.oah.dge.ca.gov It is the intent of Shasta SELPA to be in compliance with state and federal laws and regulations in regards to Special Education. However, if a parent believes there is a violation of federal or state law or regulation governing Special Education, a written complaint 12 may be filed with the District Superintendent or local administrator or appropriate program. If you wish to file a complaint with the California Department of Education, you should submit your complaint in writing to: California Department of Education Special Education Division Procedural Safeguards Referral Service 1430 N Street, Suite 2401 Sacramento, CA 95814 Attn: PSRS Intake Community Advisory Committee The Shasta County SELPA’s Community Advisory Committee (CAC) is made up of special and general education parents, teachers, representatives of local agencies, administrators and other persons interested in the education of individuals with disabilities. The CAC acts as an advisory group to the Shasta County SELPA. Responsibilities include: Advising the SELPA and reviewing the SELPA Local Plan Making recommendations on annual priorities to be addressed under the plan, acting in support of individuals with exceptional needs and assisting in the evaluation of how well the SELPA is meeting the needs of children Assisting in parent education and recruiting parents and other volunteers who may contribute to the implementation of the local plan. Encouraging public involvement in the development and review of the SELPA Local Plan. Assisting in organizing and conducting public information meetings and participating in the development of public information and community resource brochures. All meetings are open to anyone interested. We encourage your participation. The location and time of the meeting can be verified by calling the Shasta County SELPA at 225-0100 or online at www.shastacac@gmail.com. 13 Community Programs & Referral Resources In addition to the following key community programs and agencies, a complete list is available under the Community Advisory Committee (CAC) section of the Shasta SELPA website at www.shastacoe.org/selpa Other Resources Today most resources related to special education are on the internet. The following websites contain useful information: Shasta County SELPA Website www.shastacoe.org/selpa California Department of Education (CDE) www.cde.ca.gov Special Education Division of CDE http://www.cde.ca.gov/sp/se/ Council for Exceptional Children (CEC) http://www.cec.sped.org//AM/Template.cfm?Section=Home IDEA Resources of the US Dept of Education http://www.ed.gov/policy/speced/guid/idea/idea2004.html Disability Rights of California Phone: (800) 776-5746 www.disabilityrightsca.org Office of Civil Rights www.hhs.gov/ocr Norcal Services for the Deaf Phone – Voice: (530) 221-1689 Phone – TTY: (530) 223-2571 Phone – Fax: (530) 221-8143 www.norcalcenter.org Rowell Family Empowerment Center of Northern California 962 Maraglia Redding, CA 96002 Phone: (530) 226-5129 Fax: (530) 226-5141 Toll Free: (877) 227-3471 www.empoweryourfamily.org 14 Local Education Agencies & Schools Within Shasta County Anderson Union High School District Anderson Adult Anderson Community Day Anderson Union High Anderson New Technology High North Valley Continuation High Oakview High West Valley High Bella Vista Elementary School District Bella Vista Elementary Black Butte Union School District Black Butte Elementary Black Butte Junior High East Valley Community Day Cascade Elementary School District Anderson Heights Elementary Anderson Middle Cascade Community Day Meadow Lane Elementary South County Community Day Verde Vale Elementary Castle Rock Elementary School District Castle Rock Elementary Columbia Elementary School District Columbia Elementary Mountain View Middle Columbia East Valley Community Day Cottonwood Union Elementary School District Cottonwood Community Day East Cottonwood Elementary North Cottonwood Elementary West Cottonwood Jr. High Cottonwood Creek Charter School Enterprise Elementary School District Alta Mesa Elementary Boulder Creek Elementary June Street Community Day Lassen View Elementary Mistletoe Elementary Parsons Jr. High Rother Elementary Shasta Meadows Elementary 15 (530) 378-0568 (530) 365-3334 (530) 365-1985 (530) 365-2741 (530) 365-3100 (530) 365-6054 (530) 365-6895 (530) 347-7171 (530) 549-4415 (530) 549-4415 (530) 474-3125 (530) 474-3125 (530) 474-3441 (530) 474-3125 (530) 378-7000 (530) 378-7050 (530) 378-7060 (530) 378-7056 (530) 378-7030 (530) 378-7056 (530) 378-7040 (530) 235-0101 (530) 235-0101 (530) 223-1915 (530) 223-4070 (530) 221-5224 (530) 223-4070 (530) 347-3165 (530) 347-3123 (530) 347-3071 (530) 347-1698 (530) 347-3123 (530) 347-7200 (530) 224-4100 (530) 224-4130 (530) 224-4140 (530) 224-4236 (530) 224-4160 (520) 224-4160 (530) 224-4190 (530) 224-4170 (530) 224-4180 Fall River Joint Unified School District Burney Elementary Community Day Burney Elementary Burney Jr./Sr. High Fall River Community Day Fall River Elem. Community Day Fall River Elementary Fall River Jr./Sr. High Mountain View Continuation High Mt. Burney Special Ed Center Soldier Mtn. Continuation High French Gulch-Whiskeytown Union Elem Dist French Gulch-Whiskeytown Elementary Gateway Unified School District Buckeye School of the Arts Central Valley High Gateway Community Day Grand Oaks Elementary Mountain Lakes High Rocky Point Charter Shasta Lake Middle Shasta Lake Alternative Grant Elementary School District Grant Elementary Happy Valley Union School District Happy Valley Community Day Happy Valley Elementary Happy Valley Primary Igo-Ono-Platina School District Igo-Ono Elementary Platina Elementary Indian Springs School District Indian Springs Elementary Junction Elementary School District Junction Elementary Junction Middle Millville Elementary School District Millville Elementary Mountain Union School District Montgomery Creek Elementary North Cow Creek School District North Cow Creek Elementary Oak Run Elementary School District Oak Run Elementary 16 (530) 335-4538 (530) 335-5189 (530) 335-2279 (530) 335-4576 (530) 336-7154 (530) 336-5551 (530) 336-5551 (530) 336-5515 (530) 335-5189 (530) 335-3852 (530) 336-7159 (530) 359-2151 (530) 359-2151 (530) 245-7900 (530) 225-0420 (530) 275-7075 (530) 275-7016 (530) 275-7040 (530) 275-7000 (530) 225-0456 (530) 275-7020 (530) 275-7131 (530) 243-4952 (530) 243-0561 (530) 357-2134 (530) 357-2111 (530) 357-2111 (530) 357-2131 (530) 396-2841 (530) 396-2841 (530) 352-4341 (530) 337-6219 (530) 337-6219 (530) 547-3274 (530) 547-3274 (530) 547-5494 (530) 547-4471 (530) 547-4471 (530) 337-6214 (530) 337-6214 (530) 549-4488 (530) 549-4488 (530) 472-3241 (530) 472-3241 Pacheco Union School District Pacheco Community Day Pacheco Elementary Prairie Elementary Redding School District Bonny View Elementary Cypress Elementary Juniper Elementary Manzanita Elementary Monarch Learning Center (Charter) Redding Community Day Sequoia Middle Stellar Charter Tech/Home Study Sycamore Elementary Turtle Bay Elementary Shasta County Office of Education Camp Latieze Chrysalis Charter Early Childhood Services Magnolia Independent Learning Center Monte Vista Oasis Community Richard B. Eaton School Shasta Independent Learning Center Special Education/EXCEL Academy Whiskeytown Environmental School Shasta Union Elementary School District Shasta Elementary Shasta Union High School District Enterprise High Enterprise Plus High Foothill High Foothill Plus High Freedom High Community Day North State Independence High Pioneer Continuation High Shasta Adult Shasta High School Shasta High Plus High Shasta Secondary Charter Home University Prep Whitmore Elementary School District Whitmore Elementary 17 (530) 365-3335 (530) 365-7056 (530) 224-4585 (530) 365-1801 (530) 225-0011 (530)-225-0030 (530) 225-0040 (530) 225-0045 (530) 225-0050 (530) 247-7307 (530) 225-0011 (530) 225-0020 (530) 245-7730 (530) 225-0055 (530) 225-0035 (530) 225-0200 (530) 225-0241 (530) 547-9726 (530) 225-2999 (530) 225-0163 (530) 224-3209 (530) 225-0360 (530) 225-0371 (530) 225-0300 (530) 225-0303 (530) 225-0111 (530) 243-1110 (530) 243-1110 (530) 241-3261 (530) 222-6601 (530) 245-2714 (530) 547-1700 (530) 245-2715 (530) 245-2660 (530) 245-2760 (530) 243-1880 (530) 245-2626 (530) 241-4161 (530) 245-2716 (530) 245-2600 (530) 245-2790 (530) 472-3243 (530) 472-3243 Selected Programs in the Shasta County SELPA GREAT Partnership (Gateway, Redding, and Enterprise Achieving Together) 3450 Tamarack Road Redding, CA 96003 (530) 225-0411 Adaptive PE Specialist Assessment Team Occupational Therapist Preschool Classes SH/SDC (K-8) Shasta County Office of Education Special Education 3711 Oasis Road Redding, CA 96003 (530) 225-0303 ED Programs (K-8) EXCEL Academy/ERC (K-12) D/HH Programs (K-8) D/HH Preschool Dual Language Class Infant/Early Intervention Program Itinerant Autism Services Itinerant D/HH Services VI/Mobility Program 18 The High School Consortium (Anderson, Gateway and Shasta UHSD) 2200 Eureka Way Redding, CA 96001 (530) 241-3261 Adult Transition Program Enterprise High School Shasta High School South County Consortium (Cascade, Cottonwood, Happy Valley, Pacheco) 1645 Mill Street Anderson, CA 96007 (530) 378-7000 Adaptive P.E. SDC Pre K Class (Moderate/Severe) Shasta Union High School District 2200 Eureka Way Redding, CA 96001 (530) 241-3261 Catalyst Regional Program (For 9-12 graders with educational-based social, emotional, and/or behavioral intervention needs) 19 Special Education Glossary Adapted Physical Education (APE) – a related service provide by a licensed physical education specialist to special education students who have needs that cannot be adequately satisfied in other physical education programs as indicated by an assessment and evaluation of motor skills performance and other areas of need. Assessment – an evaluation that involves observation and testing of students in order to identify areas of strength and needs to develop an appropriate educational program and to monitor progress in an ongoing special education program. Assistive Technology Device – any item, piece of equipment, or product that is used to increase, maintain or improve functional capabilities. Attention Deficit Hyperactivity Disorder (ADHD) – A chronic disorder that has a medical diagnosis. It causes excessive activity, impulsivity and difficulties with focusing. Audiological Services – related services provided by a licensed audiologist who identified students with hearing impairments. Autism – a disability relating to a child’s difficulty to communicate and often unique and ritualistic behaviors. Behavior Intervention Plan – a specific behavior plan developed by an IEP Team to address serious or assaultive behaviors. Communication Handicap/Impairment – a disability related to receptive (understanding) language or expressive (speaking) language to the degree that it interferes with the child’s ability to learn. Deaf and hard of Hearing are also considered as communicatively handicapped individuals, but are designated under categories of Deaf and Hard of Hearing, not Speech impaired. Compliance Complaint – a complaint against a public school agency filed by a parent or other individual, or by a public agency or organization when that individual or individuals believes that the public education agency has violated federal or state law or regulations relating to special education. Developmental Delay (DD) – a term used to describe significant delays in the development of a child. Due Process – the procedures used to make sure that parents and educators make fair decisions about the identifications, assessment, and placement of children with disabilities. 20 Extended School Year – extension of the school year beyond the regular school calendar to assist students in meeting their IEP goals. Fair Hearing/Due Process Hearing – a formal hearing, made by an outside individual, which is called by parents or school district personnel to resolve a disagreement about a child’s special educational program, Fine Motor Skills – those skills involving hand use of the use of small muscle groups (drawing, writing, cutting, manipulating items, etc.). Gross Motor Skills – those skills involving the use of large muscle groups (rolling, sitting, walking, etc.) Hearing Impairment – a disability that affects hearing and interferes with a child’s ability to understand or use language, consequently affecting the ability to learn. Inclusion – this term is primarily used to refer to the belief that instructional practices and technological supports are presently available to accommodate all Students in the schools and classrooms they would otherwise attend if not disabled. Inclusion encourages special education services delivered in the form of training and technical assistance to general education teachers. Individuals with Disabilities Education Act (IDEA) – Passed in July of 1990 (formerly called P.L. 994-142) All procedural safeguards shall be established and maintained by each non-educational and educational agency that provides education, related service, or both to children who are individuals with exceptional needs. Individual Education Program (IEP) – a written document that states a student’s current level of educational performance, specifies annual goals and short-term instructional objectives, and identifies appropriate services needed to meet those goals. The IEP is developed by a team, including the parents and cannot be implemented without their written approval. Individual Family Service Plan (IFSP) – All agencies plan for the educational needs of children from ages birth to three and this involves the Team approach, but replaces the IEP. It is a service plan that addresses the needs of the child and the family and is multi-agency focused. Individual Transition Plan (ITP) – These are planned activities in a student’s IEP as they move from education to adult life. It is required by federal law that students age 16 have an ITP, and by age 14, if the IEP Team feels it appropriate. 21 Intellectual Disability (ID) - a developmental disability or delay that affects a child’s ability to learn and to function independently in his/her environment; it can be mild, moderate or severe. Low Incidence (LI) – a severe disabling condition with an expected incidence rate of less than one percent of total school population. The severe disabling conditions are: deaf, blind, deaf/blind, severe orthopedic impairments, or any combination thereof. Mainstreaming – implementing the participation of special education students in the regular education program. Occupational Therapy (OT) – related service provided by a licensed occupational therapist who assists children with fine motor activities and everyday tasks like eating, dressing and other independent living skills. Orientation and Mobility (O/M) – a related service provided by an orientation and mobility specialist who teaches children with visual impairments how to know their position in space and to move about safely in their environment. Orthopedic Handicap/Impairment (OH/OI) – a physical disability that limits the mobility of a child. Physical Therapy (PT) – therapy provided by a licensed specialist in the area of gross motor development including mobility and posture. Specific Learning Disability (SLD) – a severe discrepancy exists between the intellectual ability and achievement in one or more academic areas and is due to a disorder in one or more of the following psychological processes: attention, visual, auditory, sensory-motor skills and cognitive abilities. Traumatic Brain Injury (TBI) – Established prior to age 18, an acquired injury to the brain caused by an external physical force, resulting in a partial or total disability on one or more of the following areas: cognition; language; judgment; sensory; perceptual and motor abilities; memory; attention; reasoning; physical function; and psychosocial behavior. 22