DOCUMENTATION OF INTERVENTION/EVALUATION RESULTS
(SPECIFIC LEARNING DISABILITY)
(Required as of the 2010-2011 School Year)
Complete for initial evaluations, reevaluations, or a review of an independent or outside evaluation when a specific learning disability is suspected.
As part of the evaluation process, relevant behavior noted during observation in the child’s age-appropriate learning environment, including the general education classroom setting for school-age children, and the relationship of that behavior to the child’s academic functioning and educationally relevant medical findings, if any, must be documented.
PROBLEM IDENTIFICATION / STATEMENT OF PROBLEM:
Using baseline data, please provide an initial performance discrepancy statement for all identified areas of concern in the relevant domains (academic performance; functional performance; cognitive functioning, communicative status (for ELL students includes an explanation of ELL status and any change in linguistic status); social/emotional status/functioning, motor abilities, health, hearing and vision) including information about the student’s performance discrepancy prior to intervention. Attach evidence.