[ X ] Initial Assessment [ ] Reassessment [ ] 3-Year Reevaluation
Student’s Name: Dominique Flores / District ID: / State ID: / Grade: 3 / Sex: F
Native Lang: Spanish / Ethnicity: Hispanic / Birth Date: 7/21/01 / Age: 8-7
District: Anywhere SD / School: Happytime Elementary School
Parent/Guardian Name: Sylvio and Roberta Flores / Home Phone: 208-333-3333
Address: 1199 Smiley Avenue
Native Language: Spanish / Daytime Phone: 208-444-4444
Parent/Guardian Name: N/A (see above) / Home Phone:
Address:
Native Language: / Daytime Phone:
1. EVALUATION TEAM INFORMATION
Names of All Evaluation Team Members Invited to Attend / Position or Title / Agreement with ReportAnnabelle White / Special Education Teacher / [ X] Yes [ ] No
Gloria Roosevelt / Principal / [ X] Yes [ ] No
Billy Brumback / 3rd Grade Teacher / [ X] Yes [ ] No
Sally Ada / School Psychologist / [ X] Yes [ ] No
Irene Clark / ELL Consultant / [ X] Yes [ ] No
Sylvio Flores / Parent / [ X] Yes [ ] No
Roberta Flores / Parent / [ X] Yes [ ] No
Sonia Williams / Interpreter / [ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
[ ] Yes [ ] No
Note: Each member must indicate whether the report reflects that member’s conclusions. Any evaluation team member who disagrees with the conclusions of this team report must attach a separate written statement of his or her conclusions.
Student’s Name: Dominique Flores / District ID: / State ID: / Grade: 3 / Sex: F
Native Lang: Spanish / Ethnicity: Hispanic / Birth Date: 7/21/01 / Age: 8-7
District: Anywhere School District / School: Happytime Elementary School
A. Student does not make sufficient progress in response to effective, evidence-based instruction and intervention for the child’s age or to meet state-approved grade level standards in one or more of the following areas:
Academic Area(s) of Concern
_X_Basic Reading Skills / __Oral Expression / __Written Comprehension / __Math Calculation__Reading Comprehension / _X_Reading Fluency / __Listening Comprehension / __Math Problem Solving
Information shared by the parent(s)
Student Strengths: Dominique likes school and playing with her friends according to Mrs. Flores. Dominique is very interested in soccer and is looking forward to playing on a city league team this Spring. Dominique does well in math.Student Needs: Dominique is becoming frustrated with reading. She has to be encouraged to do her homework and to read nightly.
The student’s parents were notified about:
· state and school district policies regarding the amount and nature of student performance data that would be collected and the general education services that would be provided, / Yes No
· strategies for increasing the student’s rate of learning, and / Yes No
· their right to request an evaluation. / Yes No
Parents were provided data-based documentation of repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress during instruction. / Yes No
1. Data that establishes that the core curriculum is effective for most students.
For each of the assessments, list the percentage of students within the student’s grade level who meet grade-level performance benchmarks. (May include ISAT, IRI, Grade Level Curriculum Based Measures, other measures)
Name of Assessment / Area Assessed / Date / PerformanceBenchmark / Percentage of Grade level peers meeting performance benchmark / Target Student performance level
Idaho Reading Indicator
(Spring, 2nd grade) / Reading / 4/09 / 3-Benchmark (92+ cwpm)
2-Strategic (66-91 cwpm)
1-Intensive (0-87 cwpm) / 71% benchmark (3)
15% strategic (2) 14%intensive (1) / 1 (20 cwpm)
Idaho Reading Indicator
(Fall, 3rd Grade) / Reading / 9/09 / 3-Benchmark (77+ cwpm)
2-Strategic (49-76 cwpm)
1-Intensive (0-48 cwpm) / 65% benchmark (3)
15% strategic (2)
20% intensive (1) / 1 (18 cwpm)
Document date:2/22/10 Eligibility Report –Specific Learning Disability Page ___ of ___
Student’s Name: Dominique Flores / District ID: / State ID: / Grade: / Sex:
Native Lang: Spanish / Ethnicity: Hispanic / Birth Date: 7/21/01 / Age: 8-7
District: Anywhere School District / School: Happytime Elementary School
2. Information documenting that the student was provided with appropriate instruction in the general education setting by qualified personnel prior to or as a part of the referral process.
Instruction and Intervention Provided:Academic Area / Core Instruction/ Intervention / Duration
(how many weeks) / Frequency
(how often per week) / Intensity
(minutes per session)
Reading / Whole classroom instruction with differentiated small groups using district research-based reading curriculum: Treasures. In addition Dominique receives small group direct instruction with the ELL teacher an additional 20 minutes daily using Triumphs, a supplement to the Treasures curriculum designed to support ELL learners. / 20 weeks during 09-10 school year / Daily / 90 minutes per day
Reading / Small group direct instruction with Reading Specialist using Read Naturally to help build fluency skills. / 9/7/09 – 10/30/09 / Daily / 20 minutes daily
Reading / Small group (3 other students in group) direct instruction with reading specialist using a research based comprehensive reading intervention program, My Sidewalks. / 10/30/09 - present / Daily / 45 minutes daily
Reading / Core instruction with classroom teacher and supplemental small group direct instruction in reading since kindergarten with reading specialist, Title 1 teacher, or ELL teacher. / Beginning in the middle of kindergarten and continuing through 2nd grade. / Daily / 20 – 30 minutes daily
The evaluation team determines that the student’s learning difficulty is not due to lack of instruction.
· The student was provided appropriate instruction by qualified personnel in reading, including the essential components of reading, instruction which includes explicit and systematic instruction in (A) phonemic awareness; (B) phonics; (C) vocabulary development; (D) reading fluency, including oral reading skills; and (E) reading comprehension strategies. / Yes No· The student was provided appropriate instruction by qualified personnel in math / Yes No
3. Data-based documentation of repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress during instruction and intervention.
Attach to the evaluation report, a copy of the student’s progress monitoring graph. The graph must include the aimline, trendline, decision points, student’s rate of improvement, and national or local norm (50% percentile) for grade level peers.
Summary of the data demonstrating the student’s progress during instruction and intervention:· Dominique has been receiving core instruction and differentiated small group instruction in reading from the general education teacher with the district research based curriculum (Treasures) for an hour daily since kindergarten.
· In addition, since the middle of the school year in kindergarten she has been receiving additional supplemental small group direct instruction in reading from 20 – 30 minutes daily by the reading specialist, ELL teacher, or Title 1 teacher.
· Since the beginning of the 2009-2010 school year (past 20 weeks), she has been receiving core instruction and differentiated small group instruction in her third grade classroom, supplemental instruction in a small group with other ELL students in a companion curriculum designed for ELL students for 20 minutes daily. An individual intervention plan was designed by the Intervention/Problem Solving Team on 9/7/09. 20 minutes daily with the reading specialist to increase reading fluency was added to her day. Dominique’s progress was monitored weekly. After 8 weeks, progress monitoring data indicated that Dominique was not making sufficient progress and her intervention was intensified. Dominique began working with the reading specialist in a group with three other students using an intensive research-based comprehensive reading program called My Sidewalks.
· The attached progress monitoring graph from the 09-10 school year indicates that Dominique is making sporadic growth and her current rate of improvement in reading is not sufficient to close the gap between her current performance and grade level expectations.
Progress monitoring results support a skill deficit that is resistant to instruction: __X_Yes ___No
Document date: Eligibility Report –Specific Learning Disability Page ___ ofStudent’s Name: / District ID: / State ID: / Grade: / Sex:
Native Lang: / Ethnicity: / Birth Date: / Age:
District: / School:
4. Observation of academic and behavior functioning in the area of difficulty:
Include documentation of the results from an observation of the student during routine classroom instruction. (In the case of a student less than school age or out of school, the student must be observed in an environment appropriate for the student’s age). The observation should be conducted in a general education environment in which the suspected disability would be manifested.
Name and Title of Observer:Sally Ada, School Psychologist / Date Conducted:
1/10/10
Location of Observation:
3rd grade classroom, reading; ELL supplemental instruction in reading; reading specialist intensive intervention in reading. / Duration of Observation:
20 minutes in classroom; 20 min. in ELL supplemental instruction; 20 minutes in intensive intervention with reading specialist. Total of 1 hour observation.
Summary of relevant behavior and relationship of behavior to academic functioning in the area of difficulty during observation:
During general education classroom instruction, Mr. Brumback was randomly calling on different students to read passages from the story. Students were asked to predict what might happen and were asked other comprehension questions. Dominique appeared to attend to the discussion but was not following along with the reading in her book. She sat quietly in her desk which was in the front row of the classroom. She did look at the illustrations in the book, but seldom looked at the print. She was observant and looked to other students for visual cues – when they turned the page of their book, she then turned the page of the book. During the class discussion, Dominique did not raise her hand or volunteer any answers. She was quiet and not disruptive, however was not fully engaged.
During small group direct instruction in the ELL support group, Dominique participated with four other students in discussing vocabulary from the passages that the students would be reading the next day in their general education classroom. The ELL teacher prompted students to relate experiences from their background experiences to the vocabulary and concepts that would be discussed the next day in the story. Dominique participated appropriately in this group. She was on-task, attentive, and participated by sharing her own experiences and guessing about possible outcomes presented. The teacher presented flash cards with words and phrases from the story. Dominique’s oral reading fluency and word recognition was very poor compared to the other students. She needed assistance to decode most of the words and when the same words were presented a second time, she again needed help to decode most of the words. The other students occasionally needed help decoding the word but in most all cases, recognized the word when it was presented a second time.
Dominique was also observed for 20 minutes of the time she was working in small group direct instruction with four other students and the reading specialist. The teacher presented the objective for the lesson and then quickly prompted students to review several of the phonics rules they had been working on that week, then asked them to demonstrate application of the rule with the flash cards she presented. All the students, including Dominique, were successful in reading the words on the card although Dominique’s rate of response was much slower than her peers. Students then were provided text that contained the words for practice. Although the other students were fluent at reading the text, Dominique struggled. She had difficulty identifying words in the text that she had just read correctly on the flash cards.
5. Educationally relevant medical findings, if any
Dominique’s parents report she has no medical issues that would impact her learning or education.Document date: 2/22/10 Eligibility Report –Specific Learning Disability Page ___ of
Student’s Name: Dominique Flores / District ID: / State ID: / Grade: / Sex:
Native Lang: Spanish / Ethnicity: Hispanic / Birth Date: 7/21/01 / Age: 8-7
District: Anywhere School District / School: Happytime Elementary School
B. Evidence of low achievement in one or more areas (copy table as needed):
_X_Basic Reading Skills / __Oral Expression / __Written Comprehension / __Math Calculation__Reading Comprehension / _X_Reading Fluency / __Listening Comprehension / __Math Problem Solving
Area / Date / Name of Assessment / Composite/Cluster or
Subtest / SS / %ile / Evaluator/Title
Reading / 1/19/10 / WJ III / Basic Reading Skills / 82 / 12 / Ms. Annabelle White, Special Education Teacher
Description of assessment measure, validity statement, and interpretive information:
The Woodcock-Johnson III is a norm-referenced, standardized, individual test of achievement. It was administered to obtain normed information regarding Dominique’s academic achievement in reading compared to same-aged peers. Rapport was easily established with Dominique. She followed directions and appeared to be putting forth her best effort. Although Dominique often demonstrated a slower response time. Results should be considered an accurate representation of her current achievement level in reading. The Letter-Word Identification, Word Attack, and Reading Fluency subtests were administered to Dominique and those subtest score combine to provide a cluster score of Basic Reading Skills. Standard scores have a mean or average score of 100 and standard deviation of 15. Dominique received the following standard scores on the reading subtests administered:
Subtest Standard Score 95% Confidence Interval Percentile Classification
Letter-Word Identification 85 81 - 89 16 Low to Low Average
Word Attack 78 74 - 82 7 Low
Reading Fluency 78 74 - 82 7 Low