Screening for Entitlement to Special Assessment Conditions
STUDENT’S NAME
NSN
DATE
YEAR LEVEL
 Notes
The candidate has:
Psychometric test Date:
o WISC IV
o Woodcock Johnson III
o Stanford-Binet 5
o Other - ………………………………
Percentile:
FSIQ:
GIA /GAI:
Description:
Discrepancies between cognitive ability and academic performance, as identified by:
 school reports

other (name)
A history of interventions at primary school such as:
 Reading Recovery

Learning support

RTLB

RTLit

Other
Persistent learning difficulties, as identified by:
 an independent assessment


standardised school entry tests: eg
midYIS, asTTle, PAT
literacy and numeracy national
standards
learning support

other

Uneven performance – strengths in some areas and significant weaknesses in others:
 examples attached
A history of difficulties with the acquisition and development of literacy skills:
Discrepancies between oral language ability and written language, as identified by:
 PAT scores

dictated and unassisted writing tasks

other (name
Discrepancies between oral/aural comprehension and reading comprehension, as identified by:
 PAT scores

Other (name)
This student’s learning difficulties are not the result of:
Vision or hearing impairments (these are not
learning difficulties)
Lack of educational opportunity
Low general intelligence
Lack of motivation (although this may be the
result of a SLD)
ESOL
Indicators to help determine appropriate Special Assessment Conditions
READER – documented evidence of at least two of:
Discrepancy between oral comprehension
and reading comprehension
Reading speed (reads continuous text or
sentences at a speed which is below average
for their age)
Decoding difficulties (comprehends
continuous text or sentences at a level which
is below average for their age)
Reading accuracy (untimed reading accuracy
is below average for their age)
Results of school testing: Reading

Neale
Date tested:

PROBE
Date tested:

Burt
Date tested:

…….
Date tested:
Reading comprehension:
Reading speed / rate:
Reading accuracy:
Reading age:
Reading comprehension:
Reading age:
Reading accuracy:
Reading age:
Reading comprehension:
Reading speed / rate:
Reading accuracy:
WRITER – documented evidence of at least three of:
Spelling which prevents communication
(largely illegible to someone who is unfamiliar
with it evidenced by % of errors
unrecognisable as target word)
Handwriting – (pace and production slower
than average for their age)
(Lack of) punctuation which prevents
communication (writing is incomprehensible
to someone who is unfamiliar with it)
Discrepancy between oral expression and
written expression (evidenced by marked
difference in fluency, coherence and
sophistication of expression)
COMPUTER - if this is the student’s usual means of writing to accommodate their learning needs
Results of school testing:
Writing / Computer use


Handwriting: Date written:
Patoss Speed
Handwriting date:
Typing date:
Results of school testing: Spelling





Schonell
SAST
Peters
……………
Date tested:
Date tested:
Date tested:
Date tested:
Readable / legible (shown to several teachers)
WPM:
WPM:
Age:
Age:
Age:
Age:
EXTRA TIME – for external assessment, at least two of the following (and only if entered for all the external
standards in an examination session for which the time allowance is 3 hours)
Slow processing
Slow reading
Slow writing
Results of psychometric and school testing:




WISC IV
Woodcock Johnson III
Stanford-Binet 5
Neale
Date tested:
Decision:
Extra time
Processing speed score:
Reading rate:
Proceed with application for SAC for assessment for national qualifications
Provide learning support only
Signed:
Date

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