MONITOR CHECKLIST FOR DEAF-BLINDNESS

_____Annual ARD within last year (to include VI ARD/IEP or IFSP Supplement)

_____VI IEP

_____*Parent’s Explanation of Safeguards

_____*Parent’s Release of Confidential Information

_____Parent’s Resource Sheet each year

_____*Parent’s Permission to Test

_____ Parent’s Release for information to Texas Education Agency, etc.

_____*Notice of ARD

_____Ophthalmologist Report (with CIA Eligibility Report, Part A attached)

  1. indication of no vision or serious vision loss
  2. visual field
  3. visual acuity
  4. prognosis

_____Functional Vision and Learning Media Assessment (with CIA Eligibility

Report Part B: Functional Vision Report attached)

  1. an evaluation of performance of tasks in variety of environments using near and far vision
  2. recommendation concerning low vision evaluation
  3. recommendation concerning need of O & M evaluation

_____Learning Media includes:

  1. appropriate learning media
  2. statement of need for ongoing assessment to determine learning media
  3. determination if student is “functionally blind”
  4. if student is “functionally blind,” documentation of strengths/weaknesses in braille skill

_____ARD summary addresses (when appropriate)

  1. low vision evaluation (every 3 years)
  2. orientation and mobility evaluation (every 3 years)
  3. assistive technology

_____*Modification sheet/coordinate with IEP

_____Orientation and Mobility Report (if applicable)

  1. *learning competencies which identify the need for the related service
  2. *documentation that the service will enable the student to benefit from instruction
  3. *a recommendation for the specific service(s) to be offered

_____*”Statement of Need for Transition Services” (on or before age 14)

_____*Individual Transition Plan (16 years or older)

_____*Vocational Testing (14 years or older)

_____*Graduation Plan

*General District Requirements (not VI specific)

Clarification for Eligibility for Deaf-Blind
  1. Meets the eligibility criteria for auditory impairment and visual impairment.

Or

  1. Meets the eligibility criteria for a student with a visual impairment and has a suspected hearing loss that cannot be demonstrated conclusively, and if a speech/language therapist, certified speech and language therapist, or licensed speech language pathologist indicates there is no speech at an age when speech would normally be expected.

Or

  1. Has documented hearing and visual losses that, if considered individually, may not meet the requirements for auditory impairment or visual impairment, but the combination of which adversely affects the student’s educational performance.

Or

  1. Has a documented medical diagnosis of a progressive medical condition that will result in concomitant hearing and visual loss that, without special education intervention, will adversely affect the student’s educational performance.

Region XIII ESC Austin, Texas