Checklist for File Review of Previously
Determined Eligibility
For Use with Special Education Transfer Students
This checklist can be used when special education students move into a district to ensure that the eligibility determination and necessary documentation is
consistent with district eligibility guidelines and practices and Article 7 requirements. The checklist is organized into sections for general evaluation
requirements as well as criteria for specific eligibility areas (e.g., Cognitive Disability, Emotional Disability, Other Health Impairment, and Autism Spectrum
Disorder).Considerations for students from linguistically and culturally diverse backgrounds are included. Completion of this checklist can assist the district in
determining whether reevaluation is needed to ensure the appropriateness of the eligibility area. Parts of this document, modified with permission, were
provided by N. Zimmerman, Southside Special Services of Marion County
Developed by the Effective Evaluation Resource Center.
Student Move-in File Review Checklist
Student:
Name of Reviewer:
Date of review:
School/Grade:
Current Disability Area(s):
Move in Date:
District/Date of Initial Eligibility determination:
District/Date/Suspected Disability for previously conducted evaluations:
Available Medical/Mental Health info (type, date, IEP/eval):
General Evaluation Criteria
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Multidisciplinary Team
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
The M-team included at minimum:
 School Psychologist (required except for
DD and LSI)
 Teacher licensed in area of disability (or
a knowledgeable specialist)
 General Education Teacher for SLD
511 IAC 7-40-5 (b)
General evaluation requirements
Assessment was administered in the
student’s native language or mode of
communication and in the form most likely
to yield accurate information, unless clearly
not feasible to do so.
511 IAC 7-40-3 (e)(1)(A)
 Current native language proficiency level
for EL, LAS Links
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Technically sound assessments were selected
and administered by trained and
knowledgeable personnel, for the purposes
for which the measures are valid and
reliable, in accordance with any instructions
provided by the producer.
511 IAC 7-40-3(e)(1)(C-D)
 English tests not translated for EL
Assessments were selected and administered
so as not to be discriminatory on a racial or
cultural basis.
511 IAC 7-40-3 (e)(1)(B)
 Nonverbal considered for EL
 Interpreted through C-LIM
For students with sensory, manual or
speaking impairments, assessments were
selected and administered to best ensure
accurate results regarding aptitude,
achievement, etc. rather than reflecting the
student’s sensory, manual or speaking skills.
511 IAC 7-40-3(e)(3)
 Interpret through C-LIM for EL
 Consider solely verbal and/or nonverbal
assessment for sensory impairments
Assessment of current academic achievement
Current academic achievement was
assessed. 511 IAC 7-40-3 (e)(4)(C),
511 IAC 7-32-2 definition
 Reading, math, writing
 EL : in both languages if possible but not
translated
Developed by the Effective Evaluation Resource Center.
ALL DISABILITY AREAS
Any other assessments & info needed to determine eligibility and/or inform the CC
If YES, record:
If NO, record:
Article 7 Requirements and
Cultural and Language Proficiency
 Document/Date
 Document/Date
Considerations
 Summary of Evidence
 Summary of Evidence, including
concern or missing evidence
The disability adversely affects the
student’s educational progress, defined
as having consistent and significant
negative impact on the student’s
academic achievement, or functional
performance, or both.
511 IAC 7-41-1 (a)
511 IAC 7-41-3 (a)(4)
511 IAC 7-41-7 (a)
511 IAC 7-41-10 (a)(2
Eligibility Determination
Lack of appropriate instruction in reading
(including explicit and systematic
instruction in phonemic awareness,
phonics, vocabulary development,
reading fluency and reading
comprehension) is not the determining
factor.
511 IAC 7-40-6 (b) (1) (A)
Lack of appropriate instruction in math is
not the determining factor.
511 IAC 7-40-6 (b) (1) (B)
Limited English Proficiency is not the
determining factor.
511 IAC 7-40-6 (b) (1) (C)
No single measure or assessment is the
sole criterion for determining eligibility.
511 IAC 7-40-6 (c) (2)
511 IAC 7-40-3(e)(2)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
Criteria Specific to Cognitive Disability (CD)
Is there evidence
to support this
item in the file?
YES or NO
Assessment of cognitive ability & functioning
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
If YES, record:
 Document/Date
 Summary of Evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
A Cognitive disability is manifested during
the developmental period.
511 IAC 7-41-3 (a) (1)
Cognitive assessment included an
individually administered norm-referenced
measure. If not possible, a criterionreferenced measure
designed/adapted/modified for CD was used
by knowledgeable professional/s.
511 IAC 7-41-3 (e)(1)(A)
Assessments were selected and administered
so as not to be discriminatory on a racial or
cultural basis.
511 IAC 7-40-3 (e)(1)(B)
 Nonverbal considered for EL
 Interpreted through C-LIM
Assessment of functional skills or adaptive behavior
Functional skills or adaptive behavior is
assessed across various environments by
multiple sources.
 A primary source for adaptive behavior
for initial (& re-eval) is a parent or
primary caretaker
 Interviews, instead of rating scale
completion, used when possible
 Parent interview about functioning in
the home may be critical for EL
511 IAC 7-41-3 (e)(1)(C)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Assessment of social and developmental history
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Social developmental history, including:
 communication
 social interaction
 motor skills
 responses to sensory experiences
 relevant family & environmental info
 parent interviews, instead of family
history forms, used when possible
511 IAC 7-41-3 (e)(2)
Eligibility Determination
Is current eligibility is well supported in documentation?
Suspect different or additional eligibility?
NO  stop
YES  stop
Eligibility identification accurately matches
assessment results:
 Mild cognitive disability1
 Moderate cognitive disability2
 Severe cognitive disability3
NO  need to reevaluate
YES  list suspected disabilities & why suspected:
Next Steps:
1
Mild cognitive disability has cognitive functioning that generally falls 2 standard deviations below the mean, and manifests delays in adaptive behavior
consistent with the mild cognitive disability. 511 IAC 7-41-3 (b)
2
Moderate cognitive disability has cognitive functioning that generally falls 3 standard deviations below the mean, and manifests delays in adaptive behavior
consistent with the moderate cognitive disability. 511 IAC 7-41-3(c)
3
Severe cognitive disability has cognitive functioning that generally falls 4 or more standard deviations below the mean, and manifests delays in adaptive
behavior consistent with the severe cognitive disability. 511 IAC 7-41-3 (d)
Developed by the Effective Evaluation Resource Center.
Criteria Specific to Emotional Disability (ED)
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
Assessment of emotional and behavioral functioning
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Emotional and behavioral functioning is
described in detail and assessed across
various environments and sources
 best practice is parent, teacher, and selfreport scales
 clinical interview of student
 broad and narrow band assessments as
appropriate for the student needs and
concerns
 analysis of discipline record and
attendance over time
511 IAC 7-41-7-7(b)(1)(B)
Assessment of social and developmental history
Social developmental history, including:
 communication
 social interaction
 responses to sensory experiences
 relevant family & environmental info
 patterns of emotional adjustment
 unusual or atypical behaviors
 parent interviews, instead of family
history forms, used when possible
511 IAC 7-41-7 (b)(2)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Assessment of functional behavior
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
A process that uses data to identify patterns
in the student’s behavior and the purpose or
function of the behavior for the student.
Examples would include:
 report or functional behavior analysis
that identifies potential functions for
specific behaviors
 teacher, parent, and student ratings
and/or interviews
 observation data, systematic
observations
511 IAC 7-32-41 definition
Includes an analysis of any interventions
used to address the behaviors leading to the
referral for the educational evaluation
 RTI plans
 Progress data
 Behavior contracts
 Behavior plans
 General education interventions
511 IAC 7-41-7 (b)(3)
Eligibility Determination
Evaluation should address whether the
student’s inability to learn or progress is
caused by:
 cognitive
 sensory
 health factors
511 IAC 7-41-7 (b)(5)(A)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
The student exhibits one or more of the
following over a long period of time and to a
marked degree:
 a tendency to develop physical
symptoms or fears associated with
personal or school problems
 a general pervasive mood of
unhappiness or depression
 an inability to build or maintain
satisfactory interpersonal relationships
 inappropriate behavior or feelings under
normal circumstances
 episodes of psychosis
 best practice would include specifying (in
ed evaluation report and IEP) which of
the characteristics apply to the student
511 IAC 7-41-7 (a)
Is current eligibility is well supported in documentation?
Suspect different or additional eligibility?
NO  stop
Next Steps:
Developed by the Effective Evaluation Resource Center.
YES  stop
NO  need to reevaluate
YES  list suspected disabilities & why suspected:
Criteria Specific to Other Health Impairment (OHI)
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
Assessment of functional skills or adaptive behavior
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Functional skills or adaptive behavior is
assessed across various environments by
multiple sources.
 A primary source for adaptive behavior
for initial (& re-eval) is a parent or
primary caretaker
 Parent interview about functioning in
the home may be critical for EL
 Interviews, instead of rating scale
completion, used when possible
511 IAC 7-41-10 (b)(1)(B)
Assessment of social and developmental history
Social developmental history, including:
 Communication
 social interaction
 responses to sensory experiences
 relevant family & environmental info
 parent interviews, instead of family
history forms, used when possible
511 IAC 7-41-10 (b)(2)
Systematic Observation
An observation that is conducted to measure
specific, well-defined behaviors using
structured recording procedures
511 IAC 7-32-96 definition
Completed across various environments
511 IAC 7-41-10 (b)(3)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
Is current eligibility is well supported in documentation?
Suspect different or additional eligibility?
NO  stop
Next Steps:
Developed by the Effective Evaluation Resource Center.
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Eligibility Determination
YES  stop
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Eligibility determination accurately reflects
having limited strength, vitality, or alertness,
including a heightened alertness to
environmental stimuli, that results in limited
alertness with respect to the educational
environment
511 IAC 7-41-10 (a)
Impairment is due to documented chronic or
acute health problem
511 IAC 7-41-10 (a)(1)
NO  need to reevaluate
YES  list suspected disabilities & why suspected:
Criteria Specific to Autism Spectrum Disorder (ASD)
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
Assessment of functional skills or adaptive behavior
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Functional skills or adaptive behavior is
assessed across various environments by
multiple sources.
 A primary source for adaptive
behavior for initial (& re-eval) is a
parent or primary caretaker
 Parent interview about functioning in
the home may be critical for EL
 Interviews, instead of rating scale
completion, used when possible
511 IAC 7-41-1 (c)(1)(B)
Assessment of language
Language skills are assessed and include:
 receptive
 expressive
 pragmatic
 social communication
 language proficiency tests in both
languages should be completed if
student is bilingual
511 IAC 7-41-1 (c)(1)(C)
Language assessment included an
individually administered normreferenced measure. If not possible, a
criterion-referenced measure
designed/adapted/modified for ASD was
used by knowledgeable professional/s.
511 IAC 7-41-1 (c)(1)(C)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Assessment of motor skills and sensory responses
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Generally conducted by occupational
therapist
511 IAC 7-41-1 (c)(1)(D)
Assessment of social and developmental history
Social developmental history, including:
 communication
 social interaction
 motor
 responses to sensory experiences
 relevant family & environmental info
 patterns of emotional adjustment
 unusual or atypical behaviors
 parent interviews, instead of family
history forms, used when possible
511 IAC 7-41-1 (c)(2)
Systematic Observation
An observation that is conducted to
measure specific, well-defined behaviors
using structured recording procedures
511 IAC 7-32-96 definition
Completed across various environments
511 IAC 7-41-1 (c)(3)
Eligibility Determination
Evaluation report discusses
characteristics of ASD that is generally
evident before three years of age
511 IAC 7-41-1 (a)
Developed by the Effective Evaluation Resource Center.
Is there evidence
to support this
item in the file?
YES or NO
If YES, record:
 Document/Date
 Summary of Evidence
If NO, record:
 Document/Date
 Summary of Evidence, including
concern or missing evidence
Article 7 Requirements and
Cultural and Language Proficiency
Considerations
Eligibility identification accurately
matches assessment results with
significant delays in:
 verbal,
 nonverbal, or
 pragmatic communication, and
 social interaction
511 IAC 7-41-1 (a)
Evaluation should address whether the
student’s inability to learn or progress is
primarily caused by:
 an emotional disability
 blindness or low vision
 deaf-blindness
 cognitive disability
unless the characteristics of ASD are
demonstrated to a greater degree than is
normally attributed to these disabilities
511 IAC 7-41-1 (b)
Is current eligibility is well supported in documentation?
Suspect different or additional eligibility?
NO  stop
Next Steps:
Developed by the Effective Evaluation Resource Center.
YES  stop
NO  need to reevaluate
YES  list suspected disabilities & why suspected: