Info in RED is for info only – Remove all text in RED before submitting
| Student Name | School | ||
| Student ID# | Grade | ||
| Date of Birth | Age | ||
| Parents/Guardians | |||
| Address | |||
| Telephone | |||
| Evaluator | Date of Report |
REASON FOR REFERRAL: Information to include (but not limited to):
- Why student was referred
- IAT/RtI info (dates, recommendations and results)
- Data that gauges student’s progress compared to age/grade level peers
- Information from teachers
- Parent concerns
- Outside interventions/assessments
Example was referred for evaluation by the campus referral committee and his mother due to concerns about difficulties with spelling and math. Example was referred to the IAT team in October of second grade. Interventions in the classroom had consisted of small group and individual instruction for review of math facts. Mrs. Example informed the IAT, at that time, that she had Example evaluated by a private psychologist when he was in first grade due to problems with inattention and math. The psychologist informed Mrs. Example that Example was too young to be identified with any condition but did display “at risk” characteristics. Mrs. Example provided the IAT with a copy of the report. The results are presented in the Sociological section of this FIE. Example also received private tutoring during the summer in between first and second grade at the University of Houston, specifically in the area of math (three weeks). From October to May of second grade, additional interventions were done and Example failed the second grade math benchmark (68%). He did receive a passing grade in math (74). During the fall of his third grade year, Example continued to struggle in math and benchmark assessments declined (65% and 58%). Therefore, Example was referred for a Full and Individual Evaluation. The purpose of this evaluation is to identify Example’s strengths and weaknesses, determine if he displays a disability condition, and identify educational needs and strategies to promote academic progress.
SOCIOLOGICAL: Information to include (but not limited to):
- School History
- Occupation(s) of parents
- Marital status of parents
- Activities of family
- Number of children in home
- Changes within the last three years
- Activities student participates in after school
- Educational progression (any gaps in education)
- Relevant family history
- Review of any critical development which could impact the student’s classroom performance
Example is an 8:11 year old student currently enrolled in third grade at Main Street ES. He lives with his biological parents and does not have any siblings. His father works in computer software at IBM and his mother works in accounting at a church. Example participates in many activities with his family, including going to movies, playing games, taking trips, and watching television.
Example started day care at the age of 2, attending five days a week for six hours each day. He attended a church school for pre-kindergarten and kindergarten. He began first grade at Main Street ES (Houston ISD) and currently remains enrolled there as a third-grade student. He has consistently struggled academically in math and has difficulties with spelling. He is considered a good reader.
DO SOCIOLOGICAL FACTORS IMPACT THE STUDENTS ABILITY TO ACCESS THE GENERAL EDUCATION CURRICULM?
HEALTH:
- Developmental history
- Previous medical diagnosis
- Medications
- Specific health concerns or medical issues (as reported by parents)
- Degree to which child can participate in physical activities
- Vision acuity and hearing results (with or without correction)
- Data of vision/hearing screenings
Mrs. Example reported that Example was a planned pregnancy and that she was under a doctor’s care. During pregnancy, she was on bed rest for one month due to high blood pressure. There were no delivery or birth complications. Example weighed six pounds ten ounces at birth and reached all developmental milestones within age expectations. He has had no significant illnesses and is considered in good health. His unaided vision was 20/20 (right) and 20/30 (left) on the Snellen eye chart, as determined by Ms. Jones (Main Street Elementary School Nurse) on November 2, 2020. Additionally, Example passed the school’s hearing screening (unaided) on November 3, 2020.
DO HEALTH FACTORS IMPACT THE STUDENTS ABILITY TO ACCESS THE GENERAL EDUCATION CURRICULM?
LANGUAGE:
Report on the language of the home and the student; background information on bilingual education if relevant.
DO SOCIOLOGICAL FACTORS IMPACT THE STUDENTS ABILITY TO ACCESS THE GENERAL EDUCATION CURRICULM?
CLASSROOM OBSERVATION: Information to include (but not limited to):
- Date observed
- Class observed (area of concern)
- Observed by whom?
- Time of day
- Number of students in class
- What was the student required to do in the class (task and expectations)?
- What was his/her work product (correct answer?)
- Describe any demonstrated behaviors relevant to the purported academic deficit area. If you note some specific characteristics (e.g., latency, frequency of certain behaviors) then time and/or count
- Upon completion of the observation, should: ask teacher if performance and behavior observed are typical for this student, review the work sample or product is there is one, ask teacher if this is similar to other students
- Click here for Classroom Observation/Observation Questions to Consider
Example was observed in Ms. Smith’s math class on Friday, February 12, 2011 at 8:30a.m. by Mary Jones, Educational Diagnostician. He was cooperative with teacher directions. During the first part of the observation, he completed a calculation worksheet. He remained attentive and a review of the worksheet indicates that he obtained a score of 90%. When the group completed the sheet, the teacher instructed the group as a whole in problem solving. She put a word problem on the board and went through the steps of completing it. The students were then divided into small groups and had to complete five-word problems involving multiple steps of addition and subtraction. Example was very quiet in his group and listened as his peers discussed the problems. He wrote down the final answer to three problems based on what his peers had decided. Ms. Smith then came over to the group and asked Example to explain the answer to problem three. He could not do so. A peer then helped explain how the answer was derived. Upon completion of the observation, the teacher was asked if the observation was typical of Example’s daily performance. She stated that it was.
ACHIEVEMENT:
Grades for 2017-18:
| Subject | Grading Period 1 | Grading Period 2 | Grading Period 3 | Grading Period 4 | Grading Period 5 | Grading Period 6 |
| Reading | ||||||
| Math | ||||||
| Science | ||||||
| Social Studies |
Historical Grades:
| Subject | 2014-15 | 2015-16 | 2016-17 |
| Reading | |||
| Math | |||
| Science | |||
| Social Studies |
State Assessments: delete this if child is not of STAAR age/grade
| Assessment | Grade | Level II Satisfactory | Level III Advanced | Scale Score |
| STAAR Reading | 3 | Yes | No | 2342 |
Analysis of Grades, State/Local Assess History, and Teacher Info:
A review of Example’s grade history indicates that he has been successful in most academic subjects except reading and math. While he did pass math in second grade, he did so with an overall average of 72. Current third grade averages show the same pattern, indicating average performance in most academic subjects except for reading and math. Currently, Example is failing math and has done so for two consecutive grading periods. State assessment (Istation) indicates delayed development in reading. Local assessment indicates below average performance in Reading and Language and significantly below average performance in Math with a pattern of declining math scores. An analysis of the local assessment (Stanford) reveals difficulty in completing word problems, understanding basic math concepts, using tables and graphs correctly, solving problems involving sequence of steps, choosing the appropriate operation to complete a problem, and solving problems with missing elements.
A brief interview with Example’s math teacher, Ms. Smith, indicates that he needs one-to-one assistance when completing word problems and has much difficulty understanding how to transform a word problem into a basic operation; yet, Example can solve basic calculation problems. For example, Ms. Smith reports that if given the problem 34 – 17 = X, he would be able to solve it correctly. However, if given a word problem such as “Mary has 34 apples. She gave 10 to Robert and 7 to Sally. How many does she have left?” He would not be able to solve this problem. Mrs. Smith states that Example tries hard but is getting more frustrated in math class.
Woodcock Johnson Tests of Achievement – Fourth Edition (WJIV ACH)
This is a comprehensive individually administered, norm-referenced test for measuring academic achievement for individuals from 2 to 90+ years of age. Delete rows below if you have no data to report
Date:
| Test/Subtest | Standard Score | 90% Confidence Interval | %ile | *W Score |
| Letter-Word Identification | ||||
| Word Attack | ||||
| BASIC READING | ||||
| Passage Comprehension | ||||
| Reading Recall | ||||
| READING COMPREHENSION | ||||
| Calculation | ||||
| Math Facts Fluency | ||||
| MATH CALCULATION | ||||
| Applied Problems | ||||
| Number Matrices | ||||
| MATH PROBLEM SOLVING | ||||
| Writing Samples | ||||
| Sentence Writing Fluency | ||||
| WRITTEN EXPRESSION | ||||
| Oral Reading | ||||
| Sentence Reading Fluency | ||||
| READING FLUENCY | ||||
| Spelling |
*W Score – equal interval scale of academic skill used to measure academic progress
Information to include (but not limited to):
- Description of what the subtest measures – use the “Achievement Subtest Description” document in Blackboard
- Describe any modifications to standardized administration
- MOST IMPORTANTLY: Describe the student’s present levels of performance within the context of enrolled grade level standards (i.e. decoding difficulties with long vowel patterns, difficulty using context clues to determine meaning of missing word, and ability to multiply with regrouping) – what he/she could and could not do
- Include examples of errors without referring to actual items in the test
READING
The Letter-Word Identification and Word Attack tests measure sight vocabulary, phonics, and the structural analysis of words. Example was able to decode nonsense words with VC and CVC spelling patterns. She had difficulty decoding nonsense words with long-vowel patterns, such as CVVC and CVCe. Example’s iStation phonemic awareness results were at the 9th percentile for students her age. She exhibited delays in the areas of decoding short vowel and long vowel patterns.
The Passage Comprehension and Reading Vocabulary tests measure comprehension, vocabulary, and reasoning. In addition to the KTEA-3, a DIBELS reading fluency probe was administered. Example read a 3rd grade passage at 56 correct words per minute, which is below average for her grade level in mid-3rd grade. On the third grade Reading STAAR, Example correctly answered 27% of the Understanding/Analysis of Literary Texts questions. Additionally, she correctly answered 34% of the Understanding/Analysis of Informational Texts. These results are consistent with educational data indicating basic reading and reading comprehension to be significant weaknesses for Example.
WRITTEN EXPRESSION
The Broad Written Language cluster provides a measure of written language achievement including spelling of single-word responses, fluency of production, and quality of expression. The Spelling test required Example to spell words from dictation and this was his lowest score within this cluster. She spelled words phonetically (differents for difference; coff for cough). On the Writing Fluency test, Example was given three words and a picture and had to write simple sentences in a 7-minute time period. Example scored within the Average range. The Writing Samples test measures the ability to convey ideas in writing and requires the production of meaningful written sentences in response to both oral and written item directions. On this test, Example constructed simple sentences, and the lack of elaboration led to a lower point value (e.g., when asked to write a sentence describing a picture showing a boy opening a present of a model airplane, Example wrote, Her dad brought her a present); thus, the lack of details does not allow the reader to know the stimulus which is the requirement of good writing. Several sentences had spelling errors and some word omissions (e.g.,The baby chick came of its shell; The seal is blanceing a ball on its head). While Example’s overall score is low average, the major factors contributing to this are poor spelling and lack of sentence elaboration. A brief interview with her teacher indicated that Example’s classroom performance is adequate and that more emphasis on sentence writing will occur throughout 3rd grade and especially in 4th grade as preparation is made for STAAR. Example’s third grade Writing STAAR results indicated that she editing and revising her writing by answering 15 out of 16 items correctly. Thus, written expression is not considered an area of suspected disability.
MATH
The Math Calculation Skills cluster is a measure of computational skills and automaticity with basic math facts and is comprised of the Calculation (math sheet with various problems to be solved) and Math Fluency (simple arithmetic problems that must be solved within a 3-minute time limit) tests. Example’s Math Calculation Skills score falls in the Average range Example does know his math facts and can solve problems involving simple addition and subtraction and also some problems with regrouping (e.g., 476+61+2,611; 48-19). She is able to solve simple multiplication problems as well (e.g., 5 x 3). On the third grade Math STAAR, she correctly answered 21% of the Computations and Algebraic Relationship questions.
The Math Reasoning cluster includes the Applied Problems and Quantitative Concepts tests and provides a measure of mathematical knowledge and reasoning. Example’s score in this cluster falls in the Low Average range. The Applied Problems test involves solving math word problems by recognizing the operations to be applied and then applying such operations. He/She was able to consistently answer math word problems that involved one-step and the operation of addition or subtraction. Example demonstrated difficulty when problems required multiple steps and operations. The Quantitative Concepts test requires knowledge of math symbols, concepts and vocabulary, and the ability to engage in sequencing. Example had difficulty solving for a missing number in a sequence (e.g., 8 __ 24 32). Her third grade Math STAAR results indicated that she correctly answered 32% of the Numerical Representation and Relationship questions. These results are consistent with educational data indicating math problem solving to be a significant weakness for Example.
EDUCATIONAL RECOMMENDATIONS: Do not list too many recommendations. Only provide salient recommendations that are applicable to this student. Delete the hyperlinks below – they are only for your reference.
*Need ideas? See http://www.ldanatl.org/aboutld/parents/ld_basics/ld.asp
http://www.as.wvu.edu/~scidis/learning.html
http://www.ldonline.org/indepth/teaching
http://www.naset.org/2622.0.html
http://www.ncsu.edu/counseling_center/resources/academic/ld_screening/ld_strategies.htm
http://learningdisabilities.about.com/od/instructionalmaterials/qt/instructhomesch.htm
In the area of reading: Make recommendations only in the area(s) of the deficit(s)
<at least 3 recommendations for Basic Reading Skills>
<at least 3 recommendations for Reading Fluency>
<at least 3 recommendations for Reading Comprehension>
In the area of written expression:
<at least 3 recommendations for Written Expression>
In the area of math,
<at least 3 recommendations for Basic Math Skills>
<at least 3 recommendations for Math Reasoning>
<your signature here>
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Graduate Student Examiner
