STUDENT NAME:
SISD ID#: / GRADE:
COMMITTEE MAKING DECISIONS:
504 / DYSLEXIA / RtI
Date of Committee Meeting:
STAAR Version Assigned By Committee / READING
ENG I & II / MATH
ALGEBRA I / SCIENCE
BIOLOGY / SOC. STUD.
U S HIS / WRITING
English – Paper
English – Online
Spanish Available grades 3 – 5: w/o Linguistic Accommodations
ONLINE ACCOMMODATIONS : QUALIFIED STUDENTS ONLY / READING
ENG I & II / MATH
ALGEBRA I / SCIENCE
BIOLOGY / SOC. STUD.
U S HIS / WRITING
TEXT-TO-SPEECH
LANGUAGE & VOCABULARY SUPPORTS
CONTENT SUPPORTS
SUPPLEMENTAL MATERIAL – Blank Punnett Square – Bio Only
WRITING CHECKLISTS – Writing, English I & English II Only
DESIGNATED SUPPORTS
STUDENTS MUST MEET TEA QUALIFICATIONS TO RECEIVE THE FOLLOWING: / READING
ENG I & II / MATH
ALGEBRA I / SCIENCE
BIOLOGY / SOC. STUD.
U S HIS / WRITING
Individualized Structured Reminders
Amplification Device
Projection Device
Manipulating Test Materials
Oral/Signed Admin [ALL]
Oral/Signed Admin [PARTS AT STUDENT’S REQUEST]
Spelling Assistance
Math Manipulatives
Calculation Device Grades 3 – 7 Math & 5 & 8 Science
Basic Transcribing
Supplemental Aids
Extra Time
Large Print
Dictionary Grades 3, 4, 5 Reading & 4 Writing ALL Sections
Braille
DESIGNATED SUPPORTS
REQUIRING TEA APPROVAL (ARF REQUIRED) / READING
ENG I & II / MATH
ALGEBRA I / SCIENCE
BIOLOGY / SOC. STUD.
U S HIS / WRITING
Complex Transcribing / N/A / N/A / N/A
Math Scribe / N/A / N/A / N/A
Extra Day
TELPAS: / TEA requires All LEP students including parent denials participate in every domain. EXEMPTIONS ARE RARE & MUST BE DOCUMENTED. / Listening / Yes / No
Speaking / Yes / No
Writing / Yes / No
Reading / Yes / No
COMMITTEE CHAIR (Please Print) / CAMPUS / COMMITTEE CHAIR’S SIGNATURE / DATE SIGNED
CTC ASSIGNED DATA ENTRY IN TESTHOUND (Please Print) / CTC’s SIGNATURE / DATE ENTERED

REVISED: 10/15/2016 ACCOMMODATION DOC FOR 504/DYSLEXIA/RtI ASSESSMENT