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Demographics
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10 points
The report provides the
- students name
- student’s gender
- student’s grade level
- school name
- student’s date of birth
- student’s chronological age
- date of assessment
- name of assessor
- name of teacher
- language spoken by student
- report date
- student’s ethnicity
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8 points
The report provides some (at least 9) but not all demographic data.
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6 points
The report provides 8 or less pieces of demographic data, or the data is not reflective of the data provided for this section.
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Score of Demographics,
/ 10 |
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Reason for Referral
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10 points
Clear reason for referral is listed and includes:
- name of person/s who initiated the referral
- the reason for the referral,
- the concern that is spurring the assessment, and
- what is hoped to be gained by the referral).
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3 points
General referral listed, but it is not clear who requested the assessment or why it was requested or what the concern is. May include 3 of the 4 items listed in Exceeds Standardcolumn.
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2 points
Statement is missing or 2 or less of the 4 items are missing or the data is not reflective of the data provided for this section.
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Score of Reason for Referral,
/ 10 |
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History: School History, Interventions, & Report Cards
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20 points
The report provides:
- the names of the school the child attended and the grade level at each school.
- interventions that have been attempted to support the students and the outcomes of those interventions.
3.report card data for each year starting with the most recent and indicating the trimester/semester/semester grades as well as the number of days absent/tardy for each year. You can summarize the report cards by listing the general areas (reading, writing, math, speaking and listening, art, PE, science, social science). You do not need to provide each subset for reading. You can also list the range for each area such as 1-2 in Reading. Make sure you provide a key for the grades, so the reader is able to understand what the ratings mean. You can also summarize the teacher comments listed in the report cards (look for themes).
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17 points
The report includes most of the required criteria, but data may be brief/limited. The school names may bey missing, or the grade level at the school is not listed.
The interventions may be missing one of the interventions/supports provided and/or the data regarding the outcome of the interventions are not clear or are minimally reported.
Report card data may be missing or has been cut and pasted from the actual report cards and the data may be difficult to read or understand.
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13 points
The report is missing a significant portion of the required criteria.Data may be brief/limited.
The school names may be missing for more than one year or the grade level at the school (more than one) is not listed.
Interventions, supports, data outcomes may be missing. Outcomes of the interventions are not clear, minimally reported, or missing.
The report cards may be cut and pasted from the actual report cards and/or the data is difficult to read or understand. More than one year of report cards may be missing or the data is not reflective of the data provided for this section.
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Score of History: School History, Interventions, & Report Cards,
/ 20 |
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Developmental History
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20 points
Developmental History includes
Date of most recent visit to the pediatrician and outcome
- Information about the most recent hearing and vision screening as reported by the family (do NOT include the information from the school nurse here).
- Services the child is receiving currently (therapy)
- Family Health History
- Childs pregnancy and delivery data (if it is unknown, note that the data was not available)-make a note if the biological mother used any substances during pregnancy.
- Current Health History-provide information about any diagnosis or medications the child takes as well as if the child wears glasses/contacts and hearing aid support-provide any medical data shared by the family
- data regarding developmental milestones: were they met on time or were they early/delayed (you may need to look at the expected timelines for the developmental milestones to be able to answer this question).
- Chores/child responsibilities in the home
- Discipline methods that work and do not work for the child
- Students temperament (what makes the child happy/sad
- Share what activities the student enjoys doing
- List any problems/issues the family may be or has experienced that may impact the student at school (divorce, death in the family, fires, etc.). If there are none, note that.
- Relationships: how is the student with siblings/peers
- List the areas of mild and serious concern as noted by the parent(s)/caregiver(s).
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17 points
The developmental history may include 11 of the 14 criteria or the data in each section is limited.
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13 points
The development history includes 10 or less of the 14 item. Data may be limited or nonsensical or the data is not reflective of the data provided for this section.
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Score of Developmental History,
/ 20 |
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Health Assessment of Nurse
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10 points
- The name of the nurse is identified.
- The date of the health assessment is included.
- The findings of the vision (near and far) screening are included.
- The findings of the hearing screening are included.
- Medication information is shared (if taking meds, they are listed; if none are taken, it is noted that medication has not been prescribed.)
- Immunization status is provided.
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8 points
At least 5 of the 6 items from the “Exceeds Standard” are included.
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6 points
Four or less tems from the “Exceeds Standard” are included.
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Score of Health Assessment of Nurse,
/ 10 |
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Interviews
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20 points
The report provides detailed information gathered from the interviewees. The report must include notes gathered from the parent, teacher, and student.
The content must be written in a way that is cohesive and kind to others who will read the report. If the parent makes a negative comment about the teacher or the teacher makes a negative comment about the parent or child, it is written in a way to maintain a civil response from the readers.
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17 points
The report provides sparse information on home, family setting, and student interests. The report is missing one interview or negative comments are not rewritten to maintain a civil tone from parent, teacher, or student.
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13 points
The report provides limited information on home, family setting, and/or student interests. The report is missing two interviews or negative comments are not rewritten to maintain a civil tone from parent, teacher or student, or the data is not reflective of the data provided for this section.
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Score of Interviews,
/ 20 |
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Testing Session Observations
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10 points
Report addresses student affect, reality contact, hygiene, resistance or attention to task, eye contact, compliance, and other relevant testing observations.
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8 points
Observations are incomplete, or irrelevant (i.e., comments about the curliness of a student’s hair, or the cute way she giggles).
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6 points
Observations are missing or the data is not reflective of the data provided for this section.
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Score of Testing Session Observations,
/ 10 |
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Classroom Observation Part 1: Classroom Description
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5 points
The report describes the classroom setting including four aspects:
- Identifies the date and time of the observation (make this up)
- Explains how the desks/tables are organized
- Provides details about how the classroom looks
- Identifies where the target student is located based on the front of the classroom.
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4 points
The report includes at least three of the four items listed in the “Exceeds Standard” category.
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2 points
The report is missing is missing two or more of the descriptions listed in the Exceeds Standard category, or the data is not reflective of the data provided for this section.
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Score of Classroom Observation Part 1: Classroom Description,
/ 5 |
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Classroom Observation Part 2: Classroom Activity
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5 points
The report describes the activity and lesson occurring during the observation and includes three parts:
- the location of the teacher (moving about room, standing in front of room, seated at desk, etc.).
- the lesson being taught (math, ELA, science, etc.)
- a description of the lesson structure (lecture; group work; me do, we do, you do; teaching with questions asked of students; choral repetition of materials; etc.)
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4 points
The report includes at least two of the three items listed in the Exceeds Standard category.
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2 points
The report is missing two or more of the descriptions listed in the Exceeds Standard category, or the data is not reflective of the data provided for this section.
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Score of Classroom Observation Part 2: Classroom Activity,
/ 5 |
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Classroom Observation Part 3: Student Behavior
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5 points
The report includes all three aspects listed below:
- notes how the student responds to questions ( raises hand, sits quickly, digs in desk, talks to peers, etc.)
- notes the posture of the student, (e.g., sitting in chair, walking about the room, looking toward the speaker, engaging in tasks asked of the class, etc.).
- notes the general percentage of time the student is on-task and notes what the student is doing if the student is off-task (e.g., talking with peers, digging in desk, walking about the room, playing with materials, etc.)
*Make sure to describe the student behavior using language that describes the behavior (what it looks like) but does NOT imply internal thoughts of the student (e.g., bored, angry, sad, happy, etc.).
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4 points
The report includes at least two of the three items listed in the Exceeds Standard category.
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2 points
The report is missing two or more of the descriptions listed in the Exceeds Standard category,or the data is not reflective of the data provided for this section.
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Score of Classroom Observation Part 3: Student Behavior,
/ 5 |
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Classroom Observation Part 4: Overall Student Engagement
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5 points
Report provides a summary that includes two aspects:
- Notes the general percentage of time the target student is on-task and provides the percentage of time the MAJORITY of the students in the class are on-task. (Remove outliers, those who are completely disengaged and those that are overly engaged.)
- Includes a statement that indicates if the target students on-task behavior was consistent with the majority of the class, less on-task, or more on-task.
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4 points
Report includes at least one of the two items listed in the Exceeds Standard category
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2 points
Section is missing or both items are missing (the section is listed, but the content provided does not align with the rubric)or the data is not reflective of the data provided for this section.
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Score of Classroom Observation Part 4: Overall Student Engagement,
/ 5 |
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Data Consistency Statement and Assessment List
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10 points
Statement covers the following four items:
- indicates if the test measure is valid and reliable
- indicates if based on the childs performance during the assessment, if you believe the results of the assessment are valid and reliable and if not (child was preoccupied or child refused the assessment, etc.) a note is made about that
- includes a complete statement about the qualifications of the personnel who conducted the assessments
- and lists ALL tests administered, as well as other areas of relevant assessment with full names of the assessments and abbreviations, if they are used later in the report as an abbreviation.
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8 points
One of the four components from the “Exceeds Standard” category is missing.
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6 points
Two of the four components from the “Exceeds Standard” category are missing.
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Score of Data Consistency Statement and Assessment List,
/ 10 |
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Test Battery/Score Explanation
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15 points
Test Battery is explained (what does the battery measure), composite scores are defined, and an overview of the assessment tool is provided.
Scores obtained from the test battery are explained for all scores scaled Scores, index/standard/composite, percentiles, etc. The deceptive category (average, high average, etc.) is provided with the scores.
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13 points
Test Battery is generally described. Report may miss one composite area (but not more than one).
Themajority of scores provided on the measure are included, but may miss one (scaled scores, standard/index/composite scores, percentiles, etc.).
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10 points
Test Battery is not clearly explained.It may include an overview of the measure, but misses more than one composite/standard/index score.
Not all scores (scaled scores, T scores, percentiles, etc.) are defined (missing more than two that are provided in the report).
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Score of Test Battery/Score Explanation,
/ 15 |
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Cognitive Data
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15 points
Each discreet instrument is described and both data and interpretations are given in logical, understandable terms.
Test data is scored correctly (95% or higher) and reflected as such in the report.Report includes all scaled scores and composite/index scores of items assessed/administered.
Data provided for each subtest and composite area are reflective of if the scores are cohesive/consistent in each Index/Composite area and if they are not, the data is explained, and follow-up information is provided to address the inconsistencies.
The composite/index scores are explained with an indication of the students skill level (well-developed, developed, less-developed, or under-developed) in those areas (compared with the majority of his or her same-aged peers).
If scores are inconsistent (in a given area) an explanation of the inconsistent score is provided and steps taken to address the inconsistency (future assessment or provide additional assessment data provided to assist in addressing the inconsistency)
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13 points
Instruments are not well delineated, data is incomplete, or interpretations are not intelligible to the layperson. Little or no analysis is provided. Test data is scored incorrectly (85-94% correct). The report includes no more than one missing score (scales, index/composite/etc.) for the items administered.
The data provided are mostly reflective of the scores and those that are consistent are noted as such and the skill of the child is defined (developed or under-developed/less-developed skill). If there are inconsistencies (such as a high and low score in a given processing area), they are noted as well as the steps taken to address those inconsistencies.
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10 points
The section is an incomprehensible mishmash of tests & interpretations. Test data is scored incorrectly (84% or lower correct) and reflected as such in the report, or the data is not reflective of the data provided for this section.
Little to no analysis is provided related to the scores and skills or the data provided about a given skill are incorrect (e.g., Processing Speed is defined incorrectly) or the score data is incorrect.
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Score of Cognitive Data,
/ 15 |
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Achievement/Academic Data
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15 points
Each discreet instrument is described and both data and interpretations are given in logical, understandable terms. Evidence of specific error analysis is present. Test data is scored correctly (95% or higher) and reflected as such in the report.
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13 points
Instruments are not well delineated, data is incomplete, or interpretations are not intelligible to the layperson. Little or no analysis is provided. Test data is scored incorrectly (85–94% correct) and reflected as such in the report.
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10 points
This section of the report is an incomprehensible mishmash of tests & interpretations. Test data is scored incorrectly (84% or lower correct) and reflected as such in the report.
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Score of Achievement/Academic Data,
/ 15 |
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Auditory Processing Data
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15 points
Each discreet instrument is described and both data and interpretations are given in logical, understandable terms. Evidence of specific error analysis is present. Test data is scored correctly (95% or higher) and reflected as such in the report.
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13 points
Instruments are not well delineated, data is incomplete, or interpretations are not intelligible to the layperson. Little or no analysis is provided. Test data is scored incorrectly (85–94% correct) and reflected as such in the report.
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10 points
This section of the report is an incomprehensible mishmash of tests & interpretations. Test data is scored incorrectly (84% or lower correct) and reflected as such in the report.
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Score of Auditory Processing Data,
/ 15 |
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SLD Eligibility Criteria
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15 points
Discrepancy SLD criteria is explained, data related to this criterion is provided and a clear indication is made if the student is eligible with a SLD which includes which processing deficit is identified and which academic area was identified. (If student is not eligible, you can still identify which processing area/s and academic area/s are developed/less-developed). If the data do not support SLD eligibility, it must be clearly explained why the eligibility criteria have not been met. This section must include the exclusionary factors and a statement regarding if the student needs special education services (only if the data support eligibility).
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13 points
Discrepancy SLD criteria is explained, data related to this criterion is provided, but with vague language regarding eligibility. Processing deficits are not clearly defined. Academic area/s is/are not clear and specific. (If student is not eligible, processing and academic area will not be identified.)
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10 points
Discrepancy SLD criteria is not explained or is only minimally explained. Data is not consistent with the eligibility, or processing or academic areas are not identified.
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Score of SLD Eligibility Criteria,
/ 15 |
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IEP SLD Eligibility Form
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15 points
All of the items listed below are complete and correct on the form.
- Student name
- Date of birth
- IEP date (list it as the due date for the assignment-even if you turn it in early)
- School name
- Check initial (not 3-year re-eval)
- If the data supports eligibility, check the A box in Section I; If the data does not support eligibility leave Section I blank.
- If the data supports eligibility select the correct academic area that aligns with the assessment findings (e.g., oral expression, basic reading, etc.). If the data does not support eligibility leave this section blank.
- Section II: Check yes or no to align with the assessment findings. If you check yes, then select the correct processing area/s; if you check no, leave the processing areas blank.
- Section III: Mark the exclusionary factors yes or no for all items.
- Section IV: Check the first box to indicate the psychoeducational evaluation (your report) is what is being used to come to the eligibility determination; leave the other box (other) blank.
- Section V: Summarize the behavior noted through the classroom observation and testing session (summarize in 1-2 sentences).
- Section VI: List if there are any diagnosis noted for the student; if none, write NA.
- Section VII: Check yes or no for the two questions (to align with the assessment findings). If the data does not support eligibility, mark no on both of these boxes.
- Sign your name and title (School Psychology Student) and include the date you signed it.
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13 points
At least 12 of the items listed from the “Exceeds Standard category are completed with no more than 4 errors across all aspects.
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10 points
Less than 12 of the items from the Exceeds Standard category are completed with no more than 5 errors across all aspects.
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Score of IEP SLD Eligibility Form,
/ 15 |
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Summary/Conclusions
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15 points
The summary is concise, accurate, and describes manifested strengths and weaknesses. It includes a summary of the reason for referral, general themes noted from report cards and attendance, themes discovered from the interviews, and observations. The cognitive battery data is clearly explained addressing where the students skills are (using index/composite areas-think CHC Theory). No new data is provided in this section.
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13 points
The summary is either:
- too long/too vague
- the summary is a cut-and-paste of the report
- themes are minimally discussed.
- the cognitive battery summary is limited and provides a few of the cognitive areas but not all of them.
- and/or content is provided in this section or the summary.
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10 points
The summary is missing several aspects noted in the Exceeds Standard column. Themes may be missing, and/or data is provided but it is nonsensical, or the data is not reflective of the data provided for this section.
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Score of Summary/Conclusions,
/ 15 |
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Instructional Recommendation
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15 points
Recommendations are specific to the needs of the student and described in plain terms. There is a relationship between error patterns and recommendations. Recommendations can be reasonably implemented by school personnel. There may also be recommendations for further assessment by OT, PT, or SLP.
Report does NOT recommend aides or 1:1 support from an adult on the report.
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13 points
Recommendations are non-specific or are too complicated to be realistically implemented by classroom teachers.
There is little or no relationship between error patterns and recommendations.
Report does NOT recommend aides or 1:1 support from an adult on the report.
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10 points
Recommendations are missing or not at all related to the manifested needs of the student.
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Score of Instructional Recommendation,
/ 15 |
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Signature
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5 points
Your name and title are listed (school psychology student) w/ date of report listed and another signature line for School Psychology Student Supervisor.
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4 points
Two of the 4 items from the Exceeds Standard category are present.
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2 points
One or none of the 4 components from the Exceeds Standard category are present.
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Score of Signature,
/ 5 |
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Spelling/Grammar
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10 points
There are few to no grammar/spelling/punctuation errors in the report. The report is written in third person (no reference to me, or I, or we). The students name remains the same throughout the entire report and all corresponding pronouns reflect the student. The
parent(s)/caregiver(s)names are consistent throughout the report.
Font/spacing is consistent throughout the report.
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8 points
Report contains some grammar/spelling errors.
Gender confusion in report (student identified as female or male and later in the report is referred to as by the wrong pronoun). Report uses something other than third person narrative.
There is confusion regarding the names of the student and/or parent(s)/caregivers(s) in the report (I.e., listing student as Mark and later referring to student as Maria). There are some inconsistencies with fonts/spacing in report sections.
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6 points
There is a large amount of grammar/spelling/punctuation errors throughout the report and/or significant errors regarding gender reference, name usage, point of view, and/or font/spacing inconsistencies.
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Score of Spelling/Grammar,
/ 10 |