Humble Independent School District€¦ · Web view2013-10-17 · Please review the enclosed document entitled “Notice of Parent Rights,” which informs you of your rights under

Examiner’s Records for Dyslexia

Updated 2013

09/13

Humble Independent School DistrictGeneral Education Process for Identification of Students with Dyslexia

Student ___________________________________________________

Process ActivityDocument using Examiner’s Records for Dyslexia

Date Results/Comments

Step

ID

ata

Gat

heri

ng

Cumulative Folder Review (Form CFR)

Intervention History Review—(attach copies of intervention documents/progress monitoring)

Teacher Observation Data (Form TOD)

Current Writing and Work Samples

Collect Reading Assessment/Running Record—(can include QRI-3 or 4, Universal Screening Assessment, or alternate benchmark assessment)

Classroom Teacher Interventionist

Begin to complete Data Review (Form DR)

Step

IIFo

rmal

Ass

essm

ent

Parent Consent Letter/Notification of Rights

Parent Information Data (Form PID)

Administer Reading Assessments (Benchmark)

Comprehensive Test of Phonological Processing - 2 (CTOPP-2)

Test of Written Spelling – 5 (TWS-5)

Test of Word Reading Efficiency (TOWRE-2)

Gray Oral Reading Tests (GORT-5)

Step

III

Eva

luat

ion District Review (if necessary)

504 Committee Review of Data/Determine: Identification of Dyslexia Eligibility under Section 504

Step

IVPl

acem

ent

Determine Appropriate Instructional Program and Accommodations/Modifications (if any)

Parent Notification/Placement

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

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

Place Dyslexia Information and Update Form in student cum folder (Form IUF)

Teacher Meeting/General Ed. Staff

09/13 1 Dyslexia Process Checklist

Humble Independent School DistrictStep I Data Gathering—Cumulative Folder Review

Student Name: Grade: Teacher:Vision passed / failed Date of most current information:Hearing passed / failed Date of most current information:Were glasses prescribed for schoolwork? yes / no If yes, does student wear glasses daily?

yes / noFamily History of Reading Difficulties yes / no If yes, specify if suspected or diagnosed:

Attentional Issues yes / no If yes, specify if suspected or diagnosed:

Behavioral Difficulties yes / no If yes, explain:

Health/Medical History(Please note any relevant medical history)

Comments:

Language of the home (if other than English):Language of family members(when more than one language is spoken in the home):

MotherFatherSiblingsOthers in home

English Language Learner’s Educational HistorySpecify Alternative Language Programming/Grade (Two-Way BE, Developmental BE, Transitional BE, ESL Content, ESL Pull-Out, Parent Denial)

PKK12345Other:

Has this child been identified as a migrant student?

yes / no If yes, explain:

List schools/districts student has attended and make note of any lapses.PK Duration of lapseK Duration of lapse1 Duration of lapse

2 Duration of lapse3 Duration of lapse4 Duration of lapse5 Duration of lapseOther

Has student attended school in another country?

yes / no If yes, where and how long:

Has the student ever been retained? yes / no Explain:

Has this student been formally identified under 504, special education, and/or speech for behavioral or academic concerns?

yes / no If yes, list here:Date services initiated:Discontinued:

Current Academic Progress Reports excellent / average / poor

If poor, explain:

Handwriting Legibility excellent / average / poor

09/13 2 Form: CFR

Humble Independent School DistrictIntervention(s) (school) Describe and attach plan and dataLevel 1:

Level 2:

Intervention(s) (private) Describe and attach plan/data

Summer School:List as: A (Attended) DNA (Recommended- did not attend)

K ____________1 ____________2 ____________

Other:

3 ____________4 ____________5 ____________

Student’s most current gradesDate: As of ________________

Reading ________ Lang Arts _________ Spelling ___________Math __________ Science___________ Soc Studies _________

Stat

e A

sses

smen

t Grade 3 Reading Score _____

Pass / Fail Math Score _____Pass / Fail

Grade 4 Reading Score ____

Pass / Fail Writing Pass/Fail Score ____Composition Score: ____ Math Score _____

Pass / Fail

Grade 5

Reading 1st AdminScore _____ Pass / Fail

2nd Admin Score _____ Pass / Fail

3rd AdminScore _____ Pass / Fail

Math 1st Admin Score _____ Pass / Fail

2nd AdminScore _____ Pass / Fail

3rd AdminScore _____ Pass / Fail

List additional grade level State Assessment results.

Provide the most recent years of TELPAS composite scores (if applicable):

TE

LPA

SSc

ores

Year______ Year________ Year________ Year________ListeningSpeakingReadingWriting

Attendance(number of absences)

Grade____# of days____





Grade____# of days___

Grade____# of days_____




Other information: Kinder 1st 2nd 3rd 4th 5thHERSI/HILSEOY Text LevelDBA History

GT Assessment(if applicable)

09/13 3 Form: CFR

Humble Independent School District

Step I: Data Gathering: Teacher Observation Data Form

Student Name Date

Teacher/Subject Grade

Please check applicable statements AND include examples if possible.

The student displays average ability to learn in the absence of print and receives the same classroom instruction that benefits most children; however, the student continues to struggle with some or all of the many facets of reading and spelling. Think about:

o Does the student exhibit age-appropriate oral language skills, including listening comprehension, vocabulary development, the ability to follow directions, and the ability to tell a story?

o Does the student exhibit age-appropriate reading comprehension even though his or her word reading skills in isolation are deficient?

o Is the student’s ability to learn in subjects that are not as heavily reliant on reading, such as science, social studies, and math, grade-appropriate?

o Is the student’s ability to comprehend information read aloud to him/her age-appropriate?

o If the student were not asked to read or interact with print, would he/she appear to be age/grade-appropriate?

In addition to the above statement, the student may exhibit the following characteristics. These examples may be associated with dyslexia if they are unexpected for the individual’s age, educational level, and cognitive abilities. Based on your classroom observations, please check applicable statements AND include examples if possible.

The student: Fails to understand that words come apart Has difficulty learning the letter names and their corresponding sounds Has difficulty decoding single words in isolation Has difficulty spelling phonetically Reads dysfluently (choppy and labored) Relies on context to recognize a word

Has a history of reading and spelling difficulties Avoids reading aloud Reads most materials slowly; oral reading is labored, not fluent Avoids reading for pleasure May have an inadequate vocabulary Has difficulty spelling

Requires an inordinate amount of time to complete written assignments. Has difficulty copying accurately from near-point. ( i.e. desk work) Has difficulty copying accurately from far-point. (i.e board work) Has difficulty remembering and following directions.

09/13 4 Form: TOD


Has adequate ability to express self orally but written composition content appears to be below his/her potential.

Rate the student’s behavior in relation to other students of the same AGE. For each behavior, mark: 1=Poor, 2=Below Average, 3=Average, 4=Above Average, 5=Superior, N=Not observed

1 2 3 4 5 NWorks cooperatively with others

Appropriate attention and concentration

Compliance with teacher directives

Brings necessary materials to class

Fidgets, squirms or seems restless

Completes tasks on time

Stays on task, is easily redirected

What have you done differently in your classroom to meet this student’s educational/behavioral needs?

What were the results of these efforts?

Other Academic Concerns:

Attach recent student writing samples, current grades, and classwork.

09/13 5 Form: TOD


Please return to ___________________________________ by _________________

09/13 6 Form: TOD


Parent/Guardian Dyslexia Assessment Consent Form (School Copy)Date Sent/Mailed: Student’s Name:Campus: Grade: Student ID:Parents:Address:Home Phone: Work Phone:

Dear Parents:

We have carefully reviewed your child’s school records and information from teachers. At this time your child 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.

Please review the enclosed document entitled “Notice of Parent Rights,” which informs you of your rights under Section 504. If your child is identified as dyslexic, he/she may qualify as a student with disabilities under 504. If you CONSENT to the evaluation, please check the “consent” statement, sign and return one copy of this letter. If you REFUSE consent, please check the “refuse consent” statement, sign, and return one copy of this letter. Keep the other copy of this letter and the Notice of Parents’ Rights for future reference.

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. If you have any questions, please feel free to contact your child’s teacher. Thank you for your assistance.

Sincerely,

_________________________________________

******************************************************************************************As the parent/legal guardian of the above referenced student, I have received notice of my Section 504 parent rights, and I understand that this is not an offer of a Special Education evaluation.

I hereby give CONSENT for the dyslexia assessment to be administered.

I hereby REFUSE consent for the 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 Date

09/13 7 Form: Dyslexia Parent Consent

Date as completed2 copies sent to parentNotice of Rights included1 copy signed and returned


Parent/Guardian Dyslexia Assessment Consent Form (Parent Copy)

Dear Parents:

We have carefully reviewed your child’s school records and information from teachers. At this time your child 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.

Please review the enclosed document entitled “Notice of Parent Rights,” which informs you of your rights under Section 504. If your child is identified as dyslexic, he/she may qualify as a student with disabilities under 504. If you CONSENT to the evaluation, please check the “consent” statement, sign and return one copy of this letter. If you REFUSE consent, please check the “refuse consent” statement, sign and return one copy of this letter. Keep the other copy of this letter and the Notice of Parents’ Rights for future reference.

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. If you have any questions, please feel free to contact your child’s teacher. Thank you for your assistance.

Sincerely,

_____________________________________

******************************************************************************************As the parent/legal guardian of the above referenced student, I have received notice of my Section 504 parent rights, and I understand that this is not an offer of a Special Education evaluation.

I hereby give CONSENT for the dyslexia assessment to be administered.

I hereby REFUSE consent for the 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 Date

09/13 8 Form: Dyslexia Parent Consent

Humble Independent School DistrictStep II: Recommendation for Assessment: Parent Information Data Form

Student’s Name: Grade: Male FemaleCampus: DOB:Parent(s): Address:Home Phone: _ Work Phone:

The information requested will greatly assist the 504 Committee in evaluation of your child. If you have additional information that you want the Committee to consider (and that is not requested here) please feel free to attach additional pages. Please return this form to _______________________________ by _______________.

General InformationMother’s Name: Occupation:Father’s Name: Occupation:Do both parents live in the student’s home? Yes NoIf not, with whom does the student live?

Name Relationship to child

Other children in the home: (attach additional page if necessary)Name Age Relationship

______ ___________________________ ___________________________ ___________________________ _____________________

Other adults in the home:Name Relationship to Student_______________________________________________ ____________________________________________________________________________ _____________________________

The primary language spoken at home is ______________________

How long has the child lived in the United States? _______________

Have there been any important changes within the family during the last three years? (For example, changes, moves, births, deaths, serious illnesses, separations, divorce)________________________________________________________________________________________________________________________________________________________________________________________________________

Describe the student’s behavior at home with peers, siblings, neighbors, parents. (For example, is he/she generally well-behaved, passive or aggressive, social or a loner, affectionate or withdrawn, etc.)________________________________________________________________________________________________________________________________________________________________________________________________________

Do any family members have learning problems? If yes, please explain.________________________________________________________________________________________________________________________________________________________________________________________________________

Compared to other children in the family, this child’s development was: (check one) Slower About the same Faster

At what age did your child:Attend to the speaker: ____ Babble/imitate sounds: ____ Use single words: ____Use 2-3 word phrases: ____ Start to name objects: ____ Use words to make requests: ____

09/13 9 Form: PID


09/13 10 Form: PID


Academic Information

Please check the appropriate box for the following questions: Yes No

Does your child like to be read to? ____ ____Can your child rhyme words? ____ ____Can your child follow spoken directions? ____ ____Can your child tell a story? ____ ____Can your child answer questions about a story he or she has heard? ____ ____

Do you think your child is having difficulties in school? If yes, please explain:________________________________________________________________________________________________________________________________________________________________

____ ____

What do you think is causing your child’s difficulties at school?________________________________________________________________________________________________________________________________________________________________________________________________________

When did you first notice the difficulties?________________________________________________________________________________________________________________________________________________________________________________________________________

What is your child’s attitude towards reading?________________________________________________________________________________________________________________________________________________________________________________________________________

Does your child receive any additional help with reading in school or outside school (current or previous)? If so, please describe.________________________________________________________________________________________________________________________________________________________________________________________________________

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

Additional Information: Is there any other information about your student or family that you would like the Section 504 Committee to consider? If so, please provide it here.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_____________________________________________________Signature of Parent Date

_____________________________________________________Signature and Position of Person Assisting (if any) Date

09/13 11 Form: PID


Student Date Examiner’s Name

Record of ScoresComprehensive Test of

Phonological Processing-2 (CTOPP-2)Raw Scaled Descriptive

Subtests Score Score Term

Core1. Elision (EL)

2. Blending Words (BW)

3. Phoneme Isolation (PI)

4. Memory for Digits (MD)

5. Nonword Repetition (NR)

6. Rapid Digit Naming (RD)

7. Rapid Letter Naming (RL)

Supplemental

8. Blending Nonwords (BN)

9. Segmenting Nonwords (SN)

Composites

EL BW PI Sums Compositeof SS Scores

PhonologicalAwareness ___ ___ ___

RD RLRapid Symbolic Naming ___ ___ _________

BN SNAlternate Phonological Awareness ___ ___

Test of Written Spelling (TWS-5)

Descriptive TermRaw Score

Standard Score

Gray Oral Reading Tests (GORT-5)

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

Raw %ile Scaled DescriptiveTotal Rank Score Term

Rate Accuracy Fluency Comprehension

Sum of Scaled Scores

Sum of Oral Reading Oral Reading DescriptiveScaled Scores %ile Rank Index (ORI) Term

Test of Word Reading Efficiency (TOWRE-2)

Raw Scaled DescriptiveSubtest Score Score Term

I. Sight Word Efficiency

II. Phonemic DecodingEfficiency

Sum of Scaled Scores

Total Word Reading EfficiencyIndex (TWRE)

09/13 12 Formal Assessment Data Overview

+

Humble Independent School DistrictClassification Overview of Assessments

Guide to Interpreting CTOPP-2 SubtestStandard Scores

Guide to Interpreting CTOPP-2Composite Scores

Standard Scores Descriptive Terms Standard Scores Descriptive Terms17-20 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 for Interpreting GORT-5Scaled Scores

Guidelines for Interpreting the GORT-5Oral Reading Quotient

Scaled Scores Descriptive Terms Index Scores Descriptive Terms17-20 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-2 Subtest and

Total Scaled Scores

Guide to Interpreting Test of Written Spelling

(TWS-5) Standard Scores

Scaled Scores Descriptive Terms Standard Scores Descriptive Terms131-165 Very Superior >129 Very Superior121-130 Superior 120-129 Superior111-120 Above Average 110-119 Above Average90-110 Average 90-109 Average80-89 Below Average 80-89 Below Average70-79 Poor 70-79 Poor35-69 Very Poor <70 Very Poor

09/13 13 Formal Assessment Data Overview

Humble Independent School DistrictData Review and Recommendation for Dyslexia Assessment

Today’s Date: Student’s Name:Campus: Grade: Student ID:Date of Referral: Examiner/Title:Referral Reason: Teacher Referral Outside Evaluation

Parent Referral Transfer ARD Referral

By regulation, the Section 504 Committee is a group of knowledgeable people. List each member attending and check the area of knowledge each provides. Use this chart to document proper attendance. Each type of knowledge must be present for the Committee to be properly constituted under Texas laws for Dyslexia purposes, and Federal law for Section 504 purposes. Note that Committee members can have more than one type of knowledge. For each member, check all boxes of knowledge that apply. (Attach an additional sheet if necessary.)

Signature of Committee Member Position/Title This member has knowledge of…The ChildThe Meaning of the Evaluation DataThe Reading ProcessDyslexia InstructionDistrict, State & Federal GuidelinesThe ChildThe Meaning of the Evaluation DataThe Reading ProcessDyslexia InstructionDistrict, State & Federal GuidelinesThe ChildThe Meaning of the Evaluation DataThe Reading ProcessDyslexia InstructionDistrict, State & Federal GuidelinesThe ChildThe Meaning of the Evaluation DataThe Reading ProcessDyslexia InstructionDistrict, State & Federal GuidelinesThe ChildThe Meaning of the Evaluation DataThe Reading ProcessDyslexia InstructionDistrict, State & Federal Guidelines

Data ReviewUse the data gathered in Step I to determine the following:Refer to Forms CFR, TOD, and Intervention Review documentation. Yes NoThe student has received conventional (appropriate) reading instruction.The student demonstrates characteristics of dyslexia, demonstrating difficulties in one or more areas of reading and/or the related area of spelling, including phonemic awareness and manipulation, single-word decoding, reading fluency, and learning to spell, that is unexpected for the student’s age/grade.The student has adequate intelligence (an average ability to learn in the absence of print or in other academic areas).The student’s lack of progress was not due to socio-cultural factors such as language differences, irregular attendance, or lack of experiential background.

Based on a preponderance of evidence, the Committee shall recommend a formal assessment for Dyslexia.The Committee recommends a formal assessment for dyslexia.If no, return to Level III/Intervention Team to determine next steps.

09/13 1 Assessment Overview

Humble Independent School DistrictStep I: Data Gathering (Historical Data)



Domains to Assess Data SourcesScore/Level

Check OneStrength

(Above Average/ Average)

Weakness(Below Average/

Poor)

Underlying Cognitive Processes (Difficulties in phonological and phonemic awareness are typically seen in students with dyslexia and impact a student’s ability to learn letters and the sounds associated with letters and letter combinations, learn the alphabetic principle, use the sounds of the letters and letter combinations to decode words and to accurately spell.)Phonological Processing

Phonological Awareness1

HERSI- PA Inventory

Other:

Rapid Symbolic Naming2 Other:

Academic SkillsLetter Knowledge-names & associated sounds

HERSI-Letter IDHERSI-Dictation Task

Other:

Reading real words in isolation HERSI-Word TestOther:

Decoding non-sense words Other:Reading Fluency

Fluency (Oral Fluency Rubric)

Running RecordsDRA

Other:

AccuracyRunning Records

DRAOther:

Written Spelling3

HILS/WTW-Spelling InventoryWriting Samples

HERSI-Writing VocabularyOther:

Additional Areas (may be present)

Reading Comprehension

DRA/Running RecordsDBAs

State AssessmentOther:

Written Composition

Writing SamplesDBAs

State AssessmentOther:

1Note: Because previous effective instruction in phonological/phonemic awareness may remediate phonological awareness skills in isolation, average phonological awareness scores alone do not rule out dyslexia. Ongoing phonological processing deficits can be exhibited in word reading and/or written spelling.2Rapid symbolic naming may or may not be weak, but if deficient, will impact a student’s ability to automatically name letters and read words and to read connected text at an appropriate rate. On-going rapid naming/fluency deficits can also be exhibited on the GORT-5 and TOWRE-2, where tasks are timed. A deficit in reading rate alone would NOT be sufficient to identify dyslexia.3An isolated deficit in spelling would NOT be sufficient to identify dyslexia.

After Step I: Data Gathering of Historical Data is complete, refer to the statements on Assessment Overview, page 1, to determine if formal assessment for dyslexia is necessary.


Humble Independent School DistrictAssessment Overview

Student Date of Birth Grade

Age School Date of Assessment

Compiled by

REASON FOR ASSESSMENT

TESTS ADMINISTERED

Comprehensive Test of Phonological Processing (CTOPP-2)The Comprehensive Test of Phonological Processing (CTOPP-2) 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 Rapid Naming – refers to efficient retrieval of phonological information from long-term permanent memory.

The subtests that make up the CTOPP-2 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 Elision (EL) – This 34-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 33-item subtest measures an individual’s ability to combine sounds to form words.

o Rapid Digit Naming (RD) – This 36-item subtest measures the speed with which an individual can name numbers.

o Rapid Letter Naming (RL) – This 36-item subtest measures the speed with which an individual can name letters.

The CTOPP-2 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-5)The Test of Written Spelling (TWS-5) 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.



Gray Oral Reading Tests (GORT-5)The Gray Oral Reading Tests (GORT-5) is a norm-referenced, reliable, and valid test of oral reading rate, accuracy, fluency, and comprehension. Performance on the GORT-5 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 scaled scores. After these scores are recorded, the sum of scaled scores is converted to the overall Oral Reading Quotient (ORQ) – the best measure of a student’s overall oral reading ability.

Test of Word Reading Efficiency (TOWRE-2)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 non-words that can be accurately decodes within 45 seconds.

Benchmark AssessmentThe Benchmark Assessment System is a standardized, comprehensive assessment that is used to measure a student’s literacy strengths and needs. Students are assessed in the following components:

o Phonological Awareness Taskso Blending Words – Students hear and say the individual sounds in a word and then blend

the sounds to say the word. This ability helps students take words apart to solve them.o Segmenting Words - Students say a word and then say the individual sounds separately

but in sequence. This ability helps students in both spelling and decoding.o Letter Recognition – Students say the names of the alphabet by recognizing the shapes of

uppercase and lower case letters. o High Frequency Words – Students read a list of high-frequency words. This assessment will tell

the extent of the student’s knowledge of high-frequency words as well as the particular words they know. Their substitutions will tell what word parts students notice.

o Writing Picture Names – Students say words slowly and write the sounds they hear. This assessment gives information about whether students can say words slowly, think about the sounds in the words, and record some of them by remembering and writing associated letters.

o Word Writing – Students write all of the words they can write within a designated time limit. This assessment will give you a rich inventory of what students can control in terms of writing.

Reading Record – Students read and talk about a series of benchmark books. This assessment gives valuable information about the student’s reading processing, fluency, and comprehension.



Step II: Formal Assessment

Domains to Assess Data Sources

Scaled/ Standard

Score/Level

Check OneStrength

(Above Average/ Average)

Weakness(Below Average/

Poor)

Underlying Cognitive Processes (Difficulties in phonological and phonemic awareness are typically seen in students with dyslexia and impact a student’s ability to learn letters and the sounds associated with letters and letter combinations, learn the alphabetic principle, use the sounds of the letters and letter combinations to decode words and to accurately spell.)

Phonological Processing Phonological Awareness1

CTOPP-2Elision, Blending Words, &

Phoneme IsolationBenchmark PA- Blend/Segment

Other:

Rapid Naming2CTOPP-2

Rapid Digit & Rapid LetterOther:

Academic SkillsLetter Knowledge-names & associated sounds

Benchmark-Letter RecognitionBenchmark-Picture Names

Other:

Reading real words in isolation

TOWRE-2Sight Word Efficiency

Benchmark High Freq WordsOther:

Decoding non-sense wordsTOWRE-2

Phonemic Decoding EfficiencyOther:

Reading Fluency GORT-5Oral Reading Quotient

Rate GORT-5 Rate Scaled ScoreOther:

AccuracyGORT-5 Accuracy Scaled Score

Benchmark-Reading RecordOther:

FluencyGORT-5 Fluency Scaled Score

Benchmark-Reading RecordOther:

Written Spelling3

TWS-5Test of Written Spelling

Benchmark- Word WritingOther:

Additional Areas (may be present)Reading Comprehension GORT-5 Comprehension Scaled Score

Benchmark- Reading RecordWritten Composition Other:

1Because previous effective instruction in phonological/phonemic awareness may remediate phonological awareness skills in isolation, average phonological awareness scores alone do not rule out dyslexia. Ongoing phonological processing deficits can be exhibited in word reading and/or written spelling.2Difficulties in rapid naming may or may not be weak, but if deficient, will impact a student’s ability to automatically name letters and read words and to read connected text at an appropriate rate. On-going rapid naming/fluency deficits can also be exhibited on the GORT-4 and TOWRE, where tasks are timed. A deficit in reading rate alone would NOT be sufficient to identify dyslexia.3An isolated deficit in spelling would NOT be sufficient to identify dyslexia.After Step I: Data Gathering and Step II: Formal Assessment are complete, refer topage 6 to determine eligibility for dyslexia services.



Use the data gathered in Steps I and II to determine the following: Yes NoDoes the student exhibit a deficit in phonological/phonemic awareness?

If the assessment data does not indicate a deficit in phonological/phonemic awareness, is there a history of the student having difficulty with phonological/phonemic awareness?

If there is a previous history, is there data to indicate intervention was provided in this area?

Does the student exhibit weaknesses in the ability to read words in isolation with automaticity?Does the student exhibit difficulties with reading accuracy when reading connected text?Does the student exhibit difficulties with reading rate when reading connected text?Does the student exhibit academic weaknesses in spelling?Are the academic weaknesses and the deficits in phonological awareness unexpected for the student in relation to the student’s other cognitive abilities (the ability to learn in the absence of print) and unexpected in relation to the provision of effective classroom instruction?

Texas Dyslexia Law EligibilityIn making the determination of dyslexia eligibility, the committee reviewed the evaluation data from Step I and II.Based on the data, mark each area of consideration with “Agree” or “Disagree.”

Agree DisagreeThe student has received conventional (appropriate) reading instruction.The student has experienced as unexpected lack of appropriate progress in the areas of reading and written spelling.The student has adequate intelligence (has average ability to learn in the absence of print or in other academic areas.)Based on the data gathered and reviewed from Steps I and II, the preponderance of evidence shows that the student exhibits characteristics associated with dyslexia; ANDThe student’s lack of progress was not due to socio-cultural factors such as language differences, irregular attendance, or lack of experiential background.

If the Committee marked “Agree” in response to each of the preceding five statements, the student is identified as having dyslexia and is eligible for services under the Texas Dyslexia law. If the Committee answered any of the previous five statements with “Disagree,” the student is not eligible under the dyslexia law based on Blue Book criteria, and can only receive dyslexia services through action of a Section 504 Committee or ARD Committee when such services are required to provide the student with a free appropriate public education (FAPE). Note that a student can be identified as having dyslexia by Section 504 Committee or ARD Committee even if Texas Dyslexia Law requirements are not met. This is not, however, a common result.



Committee Recommendations Based on the evaluation and

assessment data from Steps I and/or II, we believe that this student does not meet the eligibility requirements for dyslexia.

Based on the evaluation and assessment data from Steps I and II, we believe that this student does meet the eligibility requirements for dyslexia.

Based on the evaluation and assessment data from Steps I and/or II, we believe that this student:o exhibits severe dyslexia or

related disorders; oro displays additional

factors/areas complicating their dyslexia

and should be referred for assessment within the Special Education Program.

Return to Intervention Team to determine instructional needs.

Individualized, Intensive, Multisensory Reading Instruction (specify)

______________________________________________________________________________

Referral for SpecialEducation Assessment

Determine 504 Eligibility(Refer to SSS SpEd/504 Flowchart)

Accommodations: Yes NoIf yes, see 504 Accommodation Plan

Comments:


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.

09/13 9 Form: IUF

Documents

Humble Independent School District€¦ · Web view2013-10-17 · Please review the enclosed document entitled “Notice of Parent Rights,” which informs you of your rights under