Examiner’s Records for Dyslexia - Humble … · Web view... Test of Written Spelling – 4 (TWS-4) Test of Word Reading Efficiency (TOWRE) Gray Oral Reading Tests (GORT-4) Part

Examiner’s Records for Dyslexia

Humble ISD

Humble Independent School District

Process Checklist for (Student)

General Education Process for Identification of Students with Dyslexia

Process Activity Date Results/Comments

Part

ID

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Gat

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ay b

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two-

step

pro

cess

) Data Review Cumulative Folder

Core Team File

Teacher Observation Data Form

Identification Profile

Writing Sample

Reading Inventory (QRI-3 or 4)

Committee Recommendation

Part

IIR

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men

datio

n fo

r A

sses

smen

t

Parent Permission Documentation

Parent Information Data Form

Comprehensive Test of Phonological Processing (CTOPP)

Test of Written Spelling – 4 (TWS-4)

Test of Word Reading Efficiency (TOWRE)

Gray Oral Reading Tests (GORT-4)

Part

III

Evalu

ation

District Review (if necessary)

504 Committee/Core Team/Special Service Team Recommendation/Documentation Characteristic Profile of Dyslexia

Part

IV P

lace

men

t

Determine Classroom Accommodations/ Modifications and TAKS Bundle

Parent Notification/Placement

Permission/Documentation/Distribution of Accommodation Plan (if any)

Copy Dyslexia Information and Update Form (submit to District Dyslexia Elementary Reading/Language Arts Coordinator, ISC, within 10 days)

Place Dyslexia Information and Update Form in student cum folder

Teacher Meeting/General Ed. Staff

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Humble ISD

Identification Profile for Dyslexia

Part I Data Gathering: Data Review

Student Name School

Student ID# Grade Date of Birth

Years Retained Male/Female

Date of Screening Completed by

Directions: Consult other staff members such as teachers, counselor, nurse, etc., and available data. Check statements that are applicable. Please attach Teacher Observation Data Forms, Writing Sample(s), and Reading Inventory results. If all of these items are supportive, then proceed to Part II.

_______ Student is currently receiving accelerated instruction (Literacy Support/Basic Skills, tutoring, ESL class, retention, summer school, private tutor, etc.) in addition to regular Language Arts or English class.

_______ Student appears to have adequate mental ability.

_______ Student has received near and far point screening of vision and all recommendations for treatment have been followed.

_______ Student has received additional screening for hearing, and all recommendations for treatment have been followed.

_______ Student is proficient in the English language. (Refer to LPAC data.) If not, consult with bilingual child study team to determine if further screening is needed.

_______ Student has attended school on a regular basis. If this item is not checked, complete the support data below.

Days present _______Days absent _______Number of schools attended _______

_______ Student is reading one or more years below grade level.Classroom reading level is _______Reading Inventory Level _______ Instrument used _______Reading/LA Grades (Report Card) _______TAKS _______


Humble ISD

Part I Data Gathering: Teacher Observation Data Form

Student Name ___________________________________ Date ______________________

Teacher/Subject _____________________________________________ Grade _________

Directions: mark each characteristic: Y = Yes N = No ? = Don’t Know

Y N ? Characteristics1. Student fails to learn to read, write, or spell with typical approaches used

in classroom.2. Student requires an inordinate amount of time to complete reading tasks

due to text level.3. The student’s difficulty in reading, writing and spelling is unexpected for

his ability, age, and grade level.4. Student may lose comprehension in the struggle with the mechanics of

reading.5. Student may have difficulty reading single words in isolation.

6. Student may have difficulty hearing sounds in words.

7. Student may have inaccurate and labored oral reading.

8. Student may have difficulty learning the names of letters and their associated sounds.

9. Students may have difficulty with learning and reproducing the alphabet in correct sequence (in either oral or written form).

10. Student has extreme difficulty with learning to spell.

11. Student may learn to spell a list of words sufficiently well to pass weekly test but does not retain.

12. Student may have letter reversals; rotations and/or transpositions; add or omit whole syllables in reading, writing, and/or spelling.

13. Student may have adequate ability to express self orally but written composition content appears to be below his or her potential.

14. Student may have unusual difficulty with handwriting and motor skills.

15. Student requires an inordinate amount of time to complete written assignments.

16. Student has difficulty copying accurately from near-point, i.e., desk work.

17. Student has difficulty copying accurately from far-point, i.e., boardwork.

18. Student has difficulty remembering and following directions.

Totals

Accommodations and modifications provided by classroom teachers:

Please return to Dyslexia Instructional Support by _____________________.


HUMBLE INDEPENDENT SCHOOL DISTRICT

PARENT/GUARDIAN CONSENT FOR DYSLEXIA ASSESSMENT

Dear Parents:

Your child, _____________________, is currently placed in the ______________________program in grade______. __________________ continues to exhibit difficulty in learning to read, write, and spell despite the adjustments made to his/her instructional program.

The purpose of this letter is to request your permission for the Humble Independent School District to complete an assessment of your child to determine eligibility for services specifically designed for students who exhibit characteristics of dyslexia. When the assessment is completed, you will be invited to attend a meeting to discuss the results and, should your child qualify for these services, to assist us in planning an individualized program.

Attached is a pamphlet for your information titled “Notice of Parent and Student Rights Under 504, the Rehabilitation Act of 1973.” If your child is identified as having characteristics of dyslexia, he/she may qualify as a student with disabilities under 504.

Please sign and return this letter indicating that permission for dyslexia assessment is granted and you have received your copy of the 504 pamphlet. If you have any questions, please feel free to contact your child’s teacher. Thank you for your assistance.

Sincerely,

_____________________________________

**************************************************************************Parent/Guardian Consent

I grant my permission for the I do not grant permission for the dyslexia assessment to be administered. dyslexia assessment to be administered.

I have received the 504 Pamphlet titled “Notice of Parent and Student Rights under 504, The Rehabilitation Act of 1973.”

_________________________________Parent/Guardian’s Signature

_________________________________Student’s Name

_________________________________Date


Humble ISD

Part II Recommendation for Assessment: Parent Information Data Form

Student’s Name Grade Age Date of Birth

Person Being Interviewed/Surveyed Relationship Interviewer, if applicable Date

1. List three positive strengths of your child.

2. How did your child’s early language development compare to that of other children?

3. At what age did your child:Attend to the speaker Use two-three word phrases Babble/imitate sounds Start to name objects Use single words Use words to make requests

4. Describe your child’s early reading experiences at home and school.

5. Does your child like to be read to? Yes NoCan your child rhyme words? Yes NoCan your child follow spoken directions? Yes NoCan your child tell a story? Yes NoCan your child answer questions about a story he or she has heard? Yes No

6 What is your child’s attitude toward reading?

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Part II Recommendation for Assessment: Parent Information Data Form

7. Does your child receive any additional help with reading in school or outside school? If so, please describe.

8. Describe how your child deals with homework assignments (time, attitude, need for help…).

9. Describe any reading or learning problems experienced by family members.

10. Describe any specific illnesses, accidents, and/or allergies.

11. Describe any difficulty your child has with balance, following directions, etc.

12. Is there any additional information about your child that you would like to provide? Please explain.

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Student Date Examiner’s Name

HUMBLE INDEPENDENT SCHOOL DISTRICTSUMMATIVE REPORT FOR DYSLEXIA ASSESSMENT

Record of ScoresComprehensive Test of

Phonological Processing (CTOPP)Raw Std.

Subtests Score Score

CoreI. Ellision (EL)

II. Blending Words (BW)

III. Memory for Digits (MD)

IV. Rapid Digit Naming (RD)

V. Nonword Repetition (NR)

VI. Rapid Letter Naming (RL)

Supplemental

VII. Rapid Color Naming (RC)

VIII. Phoneme Reversal (PR)

IX. Rapid Object Naming (RO)

X. Blending Nonwords (BN)

XI. Segmenting Words (SW)

XII. Segmenting Nonwords (SN)

Composites

EL BW MD RD NR RL Sums Composite of SS Scores

PhonologicalAwareness ___ ___

PhonologicalMemory ___ ___

Rapid Naming ___ ___

RC RO BN SN

Alternate Phonological Awareness ___ ___

Alternate Rapid Naming ___ ___

Test of Written Spelling (TWS-4)

Raw Score

Standard Score


Pretest Post test

Story Rate Accuracy Fluency Comprehension # Score Score Score Score

1 ____ + ____ = ____ ____

2 ____ + ____ = ____ ____

3 ____ + ____ = ____ ____

4 ____ + ____ = ____ ____

5 ____ + ____ = ____ ____

6 ____ + ____ = ____ ____

7 ____ + ____ = ____ ____

8 ____ + ____ = ____ ____

9 ____ + ____ = ____ ____

10 ____ + ____ = ____ ____

11 ____ + ____ = ____ ____

12 ____ + ____ = ____ ____

13 ____ + ____ = ____ ____

14 ____ + ____ = ____ ____

TotalScores

StandardScores

Sum of Fluency and Comprehension Standard Scores

Oral Reading Quotient (ORQ)


Raw Std.Subtest Score Score

I. Sight Word Efficiency

II. Phonemic DecodingEfficiency

Sum of Standard Scores




Classification Overview of Assessments

Guide to Interpreting CTOPP Subtest Standard Scores Guide to Interpreting CTOPP Composite Scores

Standard Scores Classification Standard Scores Classification17-20 Very Superior 131-165 Very Superior15-16 Superior 121-130 Superior13-14 Above Average 111-120 Above Average8-12 Average 90-110 Average6-7 Below Average 80-89 Below Average4-5 Poor 70-79 Poor1-3 Very Poor 35-69 Very Poor

Guide for Interpreting GORT-4 Standard Scores Guidelines for Interpreting the GORT-4 Oral Reading Quotient

Standard Scores Classification Standard Scores Classification17-20 Very Superior >130 Very Superior15-16 Superior 121-130 Superior13-14 Above Average 111-120 Above Average8-12 Average 90-110 Average6-7 Below Average 80-89 Below Average4-5 Poor 70-79 Poor1-3 Very Poor <70 Very Poor

Guide to Interpreting TOWRE Subtest and Total Standard Scores

Guide to Interpreting Test of Written Spelling (TWS-4) Standard Scores

Standard Scores Classification Standard Scores Classification131-165 Very Superior >130 Very Superior121-130 Superior 121-130 Superior111-120 Above Average 111-120 Above Average90-110 Average 90-110 Average80-89 Below Average 80-89 Below Average70-79 Poor 70-79 Poor35-69 Very Poor <70 Very Poor


Humble Independent School DistrictSUMMATIVE REPORT FOR DYSLEXIA ASSESSMENT

Characteristic Profile of Dyslexia

Name Date

Campus Grade Retained: N / Y

Referral Reason: Teacher Referral Outside Evaluation Parent Referral ARD Referral Transfer

Standard Score Classification * Percentile

1. UNDERLYING CAUSE (need one or more qualifiers):PHONOLOGICAL PROCESSING – COMPOSITE SCORE:

Phonological Awareness (CTOPP) (COMPOSITE)Phonological Memory (CTOPP) (COMPOSITE)Rapid Naming (CTOPP) (COMPOSITE)

2a. PRIMARY CHARACTERISTICS (need three or more qualifiers in 2a and 2b):WORD RECOGNITION (TOWRE)DECODING (TOWRE)ORAL READING FLUENCY (GORT-4)

Rate (GORT-4)Accuracy (GORT-4)

SPELLING (TWS)2b. SECONDARY CONSEQUENCES

READING COMPREHENSION (GORT-4)3. COGNITIVE ABILITY (must be average to above

average; the student must have average ability to learn in the absence of print): Difficulties the student exhibits in reading should be unexpected in relation to the student’s other cognitive abilities and the provision of effective classroom instruction.

COEXISTING FACTORS/COMPLICATIONS: Circle one:Vision / Hearing passed / failedTeacher Reports of Classroom Concerns yes / noAcademic Progress Reports excellent / average / poorIntervention (school) (attached and reviewed) yes / noIntervention (private) (attached and reviewed) yes / noPositive Family History of Reading Difficulties (suspected / diagnosed) yes / noAttentional Issues suspected / diagnosedHandwriting Legibility excellent / average / poorBehavioral Difficulties reported / unreportedTAKS Scores from Grade _________ Reading ( ) P / F Math ( ) P / F Writing ( ) P / FAttendance (note excessive absences) Grade____ # of days_____ Grade____ # of days_____ Grade____ # of days_____

Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge (Adopted by the International Dyslexia Association Board of Directors, November 12, 2002).

In order to qualify for “direct” dyslexia services in HISD, a student must exhibit one qualifier in section 1, a minimum of three qualifiers in section 2a and/or 2b, and one qualifier in section 3. (Qualifier = Below the “average” classification)



Student Date of Birth Grade

Age School Date of Assessment

Compiled by

REASON FOR ASSESSMENT

TESTS ADMINISTERED

Assessment OverviewComprehensive Test of Phonological Processing (CTOPP)

The Comprehensive Test of Phonological Processing (CTOPP) assesses three kinds of phonological processing - phonological awareness, phonological memory, and rapid naming:

o Phonological Awareness – an individual’s awareness of and access to the sound structure of his or her oral language (Mattingly, 1972).

o Phonological Memory – refers to coding information phonologically for temporary storage in working or short-term memory. When you attempt to remember a phone number you have looked up as you make your way to the phone, you are storing the number temporarily in working memory. You probably do so not by storing a visual representation of the sequence of digits (although you may be able to do this if you try), but rather by storing a phonological representation of the sounds of the digit names.

o Rapid Names – refers to efficient retrieval of phonological information from long-term permanent memory.

The subtests that make up the CTOPP all measure some aspect of phonological processing. The format for each subtest was selected after careful consideration of practical matters (e.g., ease of administration and scoring), and the actual items that make up the subtests were based on results of experimental investigations and statistical research. Subtests include:

o Ellision (EL) – This 20-item subtest measures the extent to which an individual can say a word, then say what is left after dropping out designated sounds.

o Blending Words (BW) – This 20-item subtest measures the extent to which an individual can match sounds.

o Memory for Digits (MD) – This 21-item subtest measures the extent to which an individual can repeat a series of numbers ranging in length from two to eight digits.

o Rapid Digit Naming (RD) – This 72-item subtest measures the speed with which an individual can name the numbers on two pages.

o Nonword Repetition (NR) – This 18-item subtest measures an individual’s ability to repeat nonwords that range in length from 3 to 15 sounds.

o Rapid Letter Naming (RL) – This 72-item subtest measures the speed with which an individual can name the letters on two pages.


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The CTOPP subtests were combined in such a way as to form composites to represent the constructs of phonological awareness, phonological memory, and rapid naming.

Test of Written Spelling (TWS-4)

The Test of Written Spelling (TWS-4) is a norm-referenced test of spelling. It has two equivalent forms (A and B). The test is administered using a dictated word format. The raw score is the number of items scored correct. The standard score is a transformation of raw scores that establish a common mean score and standard deviation.


The Gray Oral Reading Tests (GORT-4) is a norm-referenced, reliable, and valid test of oral reading rate, accuracy, fluency, and comprehension. Performance on the GORT-4 yields the following scores:

o Rate – the amount of time taken by a student to read a storyo Accuracy – the student’s ability to pronounce each word in the story correctlyo Fluency – the student’s Rate and Accuracy Scores combinedo Comprehension – the appropriateness of the student’s responses to questions about the

content of each story reado Overall Reading Ability – a combination of a student’s Fluency (i.e., Rate and

Accuracy) and Comprehension Scores

The scores of rate, accuracy, fluency, and comprehension are summed and converted to standard scores. After these scores are recorded, the standard scores for fluency and comprehension are summed and converted to the overall Oral Reading Quotient (ORQ) – the best measure of a student’s overall oral reading ability.


The Test of Word Reading Efficiency (TOWRE) is a measure of an individual’s ability to pronounce printed words accurately and fluently. The test measures both the ability to sound out words quickly and accurately and the ability to recognize familiar words as whole units or sight words. The TOWRE contains two subtests. The Sight Word Efficiency (SWE) subtest assess the number of real printed words that can be accurately identified within 45 seconds, whereas the Phonemic Decoding Efficiency (PDE) subtest measures the number of pronounceable printed nonwords that can be accurately decodes within 45 seconds.

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Humble Independent School DistrictSUMMATIVE REPORT FOR DYSLEXIA ASSESSMENT

Summary of Assessments

(Name/Title) Date


Humble ISD

Analysis of Assessment Results for Dyslexia

Student Campus Date

Committee Members: (Name and Title)

After reviewing the information from Parts I and II, we believe that this student will be able to make instructional growth within the regular classroom and does not appear to be dyslexic.

Regular Reading Instruction

After reviewing the information from Parts I and II, we believe that this student needs instructional help in reading, but the student does not appear to need a pull-out dyslexia class.

Accelerated Reading Services____ Basic Skills/Literacy

Support____ Tutorials____ Summer School____ Other:

Approved Accommodations: TAKS Accommodations (Bundle) Yes No

After reviewing the information from Parts I and II, we believe that this student exhibits characteristics of mild to moderate dyslexia or related disorders and can be helped with specialized dyslexia instruction within the General Education program.

Dyslexia Class

Approved Accommodations: TAKS Accommodations (Bundle) Yes No

After reviewing the information from Parts I and II, we believe that this student exhibits characteristics of severe dyslexia or related disorders and should be referred for assessment within the Special Education Program.

Referral for Special Education Services

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Analysis of Assessment Results for Dyslexia

Dyslexia Review

Campus Committee Recommendation:

District Reviewer:

Date:

District Level Review:

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DO NOT DISCARD

Humble Independent School DistrictDyslexia Information and Update Form *

(Place in student cum folder)

Name DOB

Student ID

Originating Campus Grade Date

Examiner & Title Assessment Date

Did Not Qualify Qualified (Check all that apply and complete next section.)

504 Special Education Direct Services (placed in pull-out Dyslexia Intervention Program) Monitor Only Placed in Alternate Accelerated Intervention (Please describe.)

Parent Refused Services Other

Yes: ♦ First Lesson Date

♦ End of Year or Transition Update

Date Lesson Completed Date Lesson Completed Date Lesson Completed

♦ Exit Date Lesson Completed

Comments:

* Copy submitted to District Dyslexia/Elementary Reading/Language Arts Coordinator, ISC within 10 days of Placement Meeting. In addition, update at end of the year or program exit.

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Documents

Examiner’s Records for Dyslexia - Humble … · Web view... Test of Written Spelling – 4 (TWS-4) Test of Word Reading Efficiency (TOWRE) Gray Oral Reading Tests (GORT-4) Part