Spanish Forms
Common ESE Forms
Common MIS Forms
(MIS #722) - Reimbursement Form For After Hours IEP/TEIP Conference
(MIS #710) - Procedural Safeguards Review
(MIS #522) - Trainer Pay for Instructional/SRP Training
(MIS #524) - Employee Stipend Payment
(MIS #791) - Authorization for Release of Records
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Download a sample Team Analysis of Data for Autism Spectrum Disorder(ASD)
When considering an ASD referral, the ASD screening form is a planning tool for the team.
]]>Download a copy of the 2012-13 ESE Program Boundaries. (updated 5/8/12)
These podcasts were designed for the Guidance Secretary or other staff responsible for processing ESE auditable paperwork.
]]>(revised 9/09)
Table of Contents
The purpose of this course is to enable students with disabilities to further develop the career knowledge and skills necessary to identify their career options, access community resources and practice work-related behaviors. The course will provide guided practice and experiences in school and community work situations aimed at further progress toward achieving the student’s desired post-secondary goals related to a career.
Prior to writing a student’s T/IEP, the case manager should consult the JP/TS regarding the decision to place the student in Career Experience. The case manager should take the following into consideration regarding his/her decision to recommend a student for Career Experiences.
Career Preparation course has been taken, or can be taken concurrently with the Career Experiences course.
The student must be able to demonstrate good grooming skills including a willingness to wear a uniform appropriately if asked.
The student must be able to control his/her behavioral outbursts including inappropriate language.
The student has average attendance.
Because this experience is considered a training, the student must understand that he/she will rotate through several different job classifications at a given site.
The student should participate in shadowing the off-campus site prior to placement.
For certain placements, students may have to undergo background checks, immunizations and/or drug testing prior to or as a condition of placement.
The student should understand that the off-campus placement does not guarantee paid employment.
The student should be selected and placed based upon an expressed attainable career interest.
As a result of the guidelines listed above and depending on the student’s needs, consideration should be given to having the student’s first work experience be an on-campus non-paid assignment to determine his/her readiness to work in an off campus assignment.
A letter describing the program will be provided to the parents by the JP/TS at the T/IEP conference. It is always the best practice for the JP/TS or Transition Assistant to be present during the T/IEP to assist in writing the present level statement and goals, to answer any concerns of the parent or student, to supply a copy of the rules of conduct and to have all necessary forms completed and signed.
In addition to the “Guidelines” for selecting students for Career Experiences, the following preparations should be made with students attending the off- campus non-paid program.
List all anticipated job classifications for the school year on the Non-Paid Career Experiences Agreement and JPP Evaluation form.
Insure that there are adequate job classifications to cover the number of periods the student is assigned (e.g. 2 periods, 3 job classifications).
Enter the date the evaluation was performed (non-paid) or the date of the weekly visit (paid).
Determine if the 11 work- related behaviors are appropriate for the individual student. Changes may be made to any one of the eleven behaviors based on the student’s needs. If changing a behavior, strike out the behavior not needed and write the new behavior.
Each week, the JP/TS, TA, or employer/supervisor should circle the number on the rating scale that describes the student’s performance for that behavior.
Total the column and multiply by 2 to compute the weekly grade.
Check the box “student performs with job duty modifications” if a student is unable to perform the job task in its entirety due to the significance of his disability.
Only check the box “student performs with assistance” if minimal assistance or accommodations are required. The use of a task sheet to keep multiple step directions in order is an example of a minimal accommodation.
Comments should be noted for all one and two ratings. Comments are also encouraged for five (excellent) ratings. Comments should always be constructive and unbiased observations that can assist agency personnel in determining the level of support a student may need.
When using the Grading Criteria checklist, 50% of the Career Experiences/ Placement grade should be derived from the employer evaluation. Using all or some of the criteria from the checklist, the remaining 50% is identified by the JP/TS in collaboration with the TA.
The JP/TS and student will need to discuss and finalize selected items from the JPP grading criteria and give each a corresponding percentage weight. The grading criteria developed with the student must be established and shared prior to assigning any grades for the quarter and may change quarterly based upon the student’s needs.
ESE Teacher / Case Manager / JP/TS
Transition Assistant
Parent / Guardian
Employer
Student
Return to District ESE Procedures Page
Table of Contents
A student who has dual-sensory impairments affecting both vision and hearing, the combination of which causes a serious impairment in the abilities to acquire information, communicate, or function within the environment.
A student who has a degenerative condition which will lead to such an impairment.
Refer to Referral and Evaluation Section for information regarding general intervention procedures.
General education intervention procedures and activities are required for students in grades kindergarten through twelve. However, some requirements may by waived for students suspected of having a dual sensory impairment if a team, comprised of qualified professionals and the parent, determines that general education interventions are not appropriate due to the nature and severity of the sensory impairments. This is documented on an In-school Staffing form (MIS #433). Review of existing data is mandatory prior to a referral and cannot be waived.
For prekindergarten age children, minimum General Education Intervention requirements include review of existing social, psychological, and medical data, with referral for a health screening when the need is indicated.
NOTE: The general education rule should not be construed to either limit or create the right to FAPE or delay an appropriate evaluation of a student suspected of having a disability.
A student is eligible for a special program for students with dual-sensory impairments if ALL of the following criteria (A, B and C) are met:
A. One or more of the following visual impairments:
B. One or more of the following hearing impairments:
C. One of the following:
Ages served: Birth-22
Refer to Referral and Evaluation Section.
The minimum evaluations that must be conducted to determine eligibility shall include:
When a student is being considered for a deaf or hard-of-hearing program, the evaluation process shall include an evaluation team made up of the speech/language pathologist, classroom teacher, teacher of deaf or hard-of-hearing, school psychologist, audiologist, and if recommended by the staffing committee, the reading specialist, school nurse, school social worker and other concerned personnel. For children age birth-to-three served in the home, the team shall include the speech/language pathologist, child find specialist, teacher of the deaf or hard-of-hearing, school psychologist, audiologist, and preschool resource teacher, and if recommended, may include the school social worker. The role of the team is to confer and make a joint recommendation regarding eligibility as well as any special considerations for program placement.
Audiologists, optometrists and/or ophthalmologists have the primary responsibility for evaluating the hearing loss and vision loss, respectively, and may be considered part of the evaluation team by means of their written reports.
Each team member will participate in a Team Analysis of Data (TAD) to document the team’s conclusions and eligibility recommendation. A dissenting team member must submit a separate statement stating his/her conclusions and recommendations.
Refer to Eligibility and Placement Section for information regarding eligibility procedures.
Download Dual Sensory Impaired DSI) TAD
Refer to Discontinuation and Dismissal Section for information regarding procedures.
In School Staffing (MIS #443)
Consent for Evaluation (MIS #425)
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A visually impaired child is
NOTE: The term visual impairment does not include students who have learning problems that are primarily the result of visual perceptual and/or visual motor difficulties.
Refer to Referral and Evaluation Section
General education intervention procedures and activities are required for students in grades kindergarten through twelve. However, some requirements may by waived for students suspected of having a visual impairment if a team, comprised of qualified professionals and the parent, determines that general education interventions are not appropriate due to the nature and severity of the sensory impairment. This is documented on an In-school Staffing form (MIS #433). Hearing screenings and a review of existing data are mandatory prior to a referral and cannot be waived.
For prekindergarten age children with hearing concerns, minimum General Education Intervention requirements include hearing screening, and a review of existing social, psychological, and medical data, with referral for a health screening when the need is indicated.
NOTE: The general education rule should not be construed to either limit or create the right to FAPE or delay an appropriate evaluation of a student suspected of having a disability.
A student is eligible for a special program for the visually impaired if the following medical and educational criteria are met:
Refer to Referral and Evaluation Section.
A written report of an examination conducted by a Florida licensed optometrist or ophthalmologist describing:
The diagnosis and etiology of the condition
The prognosis and treatment regimen
The degree of visual impairment (near/distance and corrected/uncorrected acuity measures for the left eye, right eye and both eyes; measures of field of vision)
The medical implications (recommendations for lighting levels, physical activity, use of aids or use of glasses, as appropriate)
For children birth to five (5) years of age or students who are otherwise unable to be assessed, a medical assessment describing visual functioning shall be documented when standard visual acuities and measure of field of vision are unattainable.
A comprehensive assessment of skills known to be impacted by visual impairment, shall include, but is not limited to: functional vision evaluation, learning media assessment, and, if appropriate, orientation and mobility assessment.
Documented observations of functional vision by the teacher of visually impaired or an appropriately trained diagnostician that indicate any special considerations for environmental adjustments such as preferential seating undertaken in the classroom or large print materials. Such documentation may include standardized low vision assessments and/or observations by the teacher of visually impaired.
A review of medical reports, if applicable and/or available.
The evaluation team is minimally comprised of the parent, a basic education teacher, a teacher of the visually impaired, and a medical eye doctor. Optometrists and/or ophthalmologists have the primary responsibility for evaluating the vision loss and may be considered part of the evaluation team by means of their written reports.
Each team member shall participate in a Team Analysis of Data (TAD) to document the team’s conclusions and eligibility recommendation. A dissenting team member must submit a separate statement stating his/her conclusions and recommendations.
Refer to Eligibility and Placement Section for information regarding eligibility procedures.
Download a sample TAD for VI
Refer to Discontinuation and Dismissal Section.
The T/IEP team must consider Braille instruction for students with visual impairments and address this in the present level statement of the T/IEP. If the T/IEP team determines instruction in Braille is not appropriate, there should be some explanation included. The team must consider both current and future needs of the student when making decisions regarding Braille instruction.
Students who are eligible for Visually Impaired ONLY must follow regular Next Generation Sunshine State Standards (Common Core).
The district will register all students who are Visually Impaired for services from the Florida Instructional Materials Center for the Visually Impaired. This must be done annually and is contingent on a current eye medical. Other support services may include, but are not limited to:
Provision of specialized textbooks, learning materials, assessment materials, and equipment; and
Cooperative planning with the Division of Blind Services, including parent involvement activities.
Reevaluation shall occur at least every three (3) years and shall include a minimum of a medical eye examination within the last calendar year, functional vision assessment, learning media assessment, and, if appropriate, any other formal evaluations addressed in the initial evaluation.
NOTE: The medical aspect of a reevaluation for students with bilateral anopthalmia may be waived by a written recommendation of a physician.
Students who have a current T/IEP indicating the receipt of visually impaired services may be transferred to our district.
These students must be brought to the team to discuss the required evaluation to meet eligibility guidelines for the state of Florida. An eye medical completed within the past 12 months by a Florida licensed physician is required to consider eligibility. Additional evaluation(s) may be recommended by the T/IEP team. The school-based team must make every attempt to assist the parent/guardian in procuring the required medical evaluation. Consent for Evaluation (MIS #425) is obtained if additional evaluation beyond the medical is recommended.
If medical and educational evaluation results indicate the need for Exceptional Student Education (ESE) Services, the student will continue to meet eligibility criteria.
If medical and educational evaluation results are incomplete or do not indicate the need for ESE Services, the student will be dismissed from ESE, or discontinued from Visually Impaired if the student remains eligible for other areas of ESE). The educational team may consider referral for a 504 Plan pending medical documentation of need if the student does not meet ESE eligibility criteria.
Refer to Discontinuation and Dismissal Section for information regarding procedures.
Audiobooks LearningAlly.org
Technical Assistance Paper for VI
In School Staffing (MIS #443)
Consent for Evaluation (MIS #425)
]]>Return to District ESE Procedures Page
Table of Contents
A student who is deaf or hard-of-hearing has a hearing loss, aided or unaided, that impacts the processing of linguistic information and adversely affects performance in the educational environment. The degree of loss may range from mild to profound.
Refer to Referral and Evaluation Section for information regarding general intervention procedures.
General education intervention procedures and activities are required for students in grades kindergarten through twelve. However, some requirements may by waived for students suspected of having a hearing impairment if a team, comprised of qualified professionals and the parent, determines that general education interventions are not appropriate due to the nature and severity of the sensory impairment. This is documented on an In-school Staffing form (MIS #433). Vision screenings and a review of existing data are mandatory prior to a referral and cannot be waived.
For prekindergarten age children with hearing concerns, minimum General Education Intervention requirements include vision screening, and a review of existing social, psychological, and medical data, with referral for a health screening when the need is indicated.
NOTE: The general education rule should not be construed to either limit or create the right to FAPE or delay an appropriate evaluation of a student suspected of having a disability.
A student is eligible for a Deaf/Hard of Hearing if ALL of the following criteria (A, B and C) are met:
A. Evidence of a documented permanent or fluctuating hearing threshold level based on one of the following:
B. Evidence that the hearing threshold level interferes with progress in any of the following:
C. The student requires specially designed instruction and/or related services (e.g., speech-language therapy, audiology, assistive technology services) to meet the unique needs of the student
Assistive technology service means any service that directly assists a student with a disability in the selection, acquisition, or use of an assistive technology device. The term includes:
Ages served: Birth-22
Refer to Referral and Evaluation Section.
Audiological evaluation: Appropriate audiometric instruments will be used by the audiologist to determine the degree and type of hearing loss and documented in an audiological report. The report shall reflect background information about the hearing loss, amplification, and any other pertinent information.
Evaluation of developmental skills or academic achievement: Evaluation shall include information on the student’s developmental or academic strengths and weaknesses. Instruments may include the current editions of the LAP-D, K-ABC, WIAT, WJTA, K-TEA, or other appropriate instruments. For preschool age children, the Batelle Developmental Inventory-2nd Ed. (BDI-2) may be used to assess developmental levels.
Evaluation of social development: Evaluation shall include information about the development of the student’s social skills. Instruments may include, but are not limited to, the Meadow/Kendall Social-Emotional Assessment Inventory, the Social Skills Rating System, the Matson Evaluation of Social Skills for Deaf and Hard-of-Hearing, or other appropriate instruments, such as checklists, scales, questionnaires, and/or social history. Information gathered from pragmatic language assessment and BDI-2 (for preschool age children) may also be used to gather data on social skills development.
Evaluation of receptive and expressive communication: Evaluation of receptive and expressive communication shall be completed by a speech/language pathologist and documented in a speech and language evaluation report (MIS #730).
A comprehensive nonverbal assessment of intellectual functioning (or developmental scales, if more appropriate, for children under age seven): Assessments of cognitive functioning shall be completed by a certified school psychologist or licensed psychologist. Tests to determine cognitive functioning shall be selected from non-verbal performance scales standardized on, or adapted for, students who are deaf or hard-of-hearing. The evaluation should emphasize the student’s level of functioning (i.e., low average to average) and relative strengths and weaknesses in key developmental areas. Assessment instruments may include, but are not limited to, current editions of the Leiter International Performance Scale, Hiskey-Nebraska, K-ABC, Performance subtests from the WISC III and/or SBIS V, C-TONI, UNIT, CID Preschool Performance Scale, Matrix Analogies Test-Expanded Form, TONI, and Developmental Profile II.
A documented observation by a teacher of the deaf or hard-of-hearing in educational environment and, as appropriate other settings to document the student’s learning or behavioral areas of concern. The observation shall also reflect accommodation needs relating to the hearing impairment.
NOTE: Evaluations shall take into consideration the student’s intellectual functioning, degree of hearing loss, and method of communication. Students who wear or have been prescribed hearing aids and/or assistive listening devices (school-owned or personal FM systems) should utilize them during evaluations. Students who have never been prescribed hearing aids may be evaluated without them. Specific hearing/audiological recommendations for students during psychological testing can be obtained from the district audiologist. Non-verbal communication and/or an interpreter will be used for evaluation of students when appropriate.
When a student is being considered for a deaf or hard-of-hearing program, the evaluation process shall include an evaluation team made up of the audiologist, speech/language pathologist, classroom teacher, teacher of deaf or hard-of-hearing, school psychologist, and if recommended by the staffing committee, reading specialist, school nurse, school social worker and other pertinent personnel. For children age birth-to-three served in the home, the team shall include the audiologist, speech/language pathologist, child find specialist, teacher of the deaf or hard-of-hearing, school psychologist, and preschool resource teacher, and if recommended, may include the school social worker. The role of the team is to confer and make a joint recommendation regarding eligibility as well as any special considerations for program placement.
The audiologist has the primary responsibility for evaluating the hearing loss and may be considered part of the evaluation team by means of their written reports.
Each team member will participate in a Team Analysis of Data (TAD) to document the team’s conclusions and eligibility recommendation. A dissenting team member must submit a separate statement stating his/her conclusions and recommendations.
Refer to Eligibility and Placement Section for information regarding eligibility procedures.
Download a sample TAD for DHH
Refer to Discontinuation and Dismissal Section.
In School Staffing (MIS #443)
Initial Speech/Language Evaluation Report (MIS #730)
]]>ability grouping - Class or group assignment based on observed behavior or performance. Ability grouping is not the same as tracking.
accelerated learning - A strategy of progressing through education at rates faster or ages younger than the norm.
advanced placement (AP) - A program developed by the College Board where high schools offer courses that meet criteria established by institutions of higher education. In many instances, college credit may be earned with the successful completion of an AP exam in specific content areas.
authentic assessment - Evaluating student learning through the use of student portfolios, performance, or observations in place of, or in conjunction with, more traditional measures of performance such as tests and written assignments. The process allows students to be evaluated using assessments that more closely resemble real world tasks, such as a scientific experiment to demonstrate understanding of the laws of motion. Bloom’s Taxonomy - Developed in 1956 by Benjamin Bloom, the taxonomy is often used to develop curriculum for gifted students. There are six levels within the taxonomy that move from basic to high levels of thinking. These include knowledge, comprehension, application, analysis, synthesis, and evaluation.
cluster grouping - A grouping assignment for gifted students in the regular heterogeneous classroom. Typically, five or six gifted students with similar needs, abilities, or interests are “clustered” in the same classroom which allows the teacher to more efficiently differentiate assignments for a group of advanced learners rather than just one or two students. Click here for more information.
creativity - The process of developing new, uncommon, or unique ideas. The federal definition of giftedness identifies creativity as a specific component of giftedness.
Criterion-Referenced Testing - An assessment that compares a student’s test performance to their mastery of a body of knowledge or specific skill rather than relating their scores to the performance of other students. curriculum compacting - After showing a level of proficiency in the basic curriculum, a student can then be allowed to exchange instructional time for other learning experiences.
differentiation - Modifying curriculum and instruction according to content, pacing, and/or product to meet unique student needs in the classroom.
dual enrollment - Most often refers to high school students taking college courses, often for college credit. Dual enrollment is viewed as providing high school students benefits such as greater access to a wider range of rigorous academic and technical courses, savings in time and money on a college degree, promoting efficiency of learning, and enhancing admission to and retention in college.
English Language Learner (ELL) – Students who require academic, cultural, social, and support services due to limited English language proficiency.
Education Plan (EP) – The plan is developed to identify a gifted student’s present level of performance, academic strengths, interests, and areas of need. The plan is used by both the teacher and student to measure the student’s progress toward identified individual goals over a three year period.
enrichment - Activities that add to or go beyond the existing curriculum. Activities may occur in the classroom or in a separate setting. flexible grouping - An instructional strategy where students are grouped together to receive appropriately challenging instruction. True flexible grouping permits students to move in and out of various grouping patterns, depending on the course content. Grouping can be determined by ability, size, and/or interest.
gifted inclusion - The practice of providing specialized instruction to gifted eligible students within a heterogeneous classroom (basic education) during specific assignments or activities that address their Education Plan goals.
independent study - A self-directed learning strategy where the teacher guides or facilitates and the student plays a more active role in designing and managing his or her own learning.
International Baccalaureate (IB) Program - A demanding pre-university program where, upon completion, students can earn college credit. IB emphasizes critical thinking and understanding of other cultures or points of view. A diploma is awarded at the completion of the IB program which allows graduates access to universities worldwide.
learning styles - Preferred way(s) in which individuals interact or process new information across the three domains of learning identified in the taxonomy of education objectives: cognitive (knowledge), psychomotor (skills), and affective (attitude). An individual’s preferred learning style is how he/she learns best.
Parallel Curriculum Model (PCM) - A curriculum modification strategy to meet the needs of gifted students in terms of depth, complexity, and novelty. This model has four simultaneous pathways of development: Core or Basic Curriculum, Curriculum of Connections, Curriculum or Practice, and the Curriculum of Identify.
Present Level of Performance Statement (PLEP) - A required summary in a gifted student’s Education Plan (EP) that describes: student strengths, interests, performance on district wide assessments, statewide assessments, and need for specialized instruction. It is used to assist with developing a student’s measurable goals, benchmarks, and determining required services.
portfolio assessment – As an alternative or supplement to traditional measures of giftedness, portfolios offer a collection of student work over time that can help to determine achievement and progress. Many of the elements found in portfolios cannot be captured by a standardized test. Social Economic Status (SES) - A measure of an individual’s or family’s relative economic and social ranking.
social-emotional needs - Gifted and talented students may have affective needs that include heightened or unusual sensitivity to self-awareness, emotions, and expectations of themselves or others, and a sense of justice, moral judgment, or altruism. Counselors working in this area may address issues such as perfectionism, depression, underachievement, or career planning.
Scholastic Reading Inventory (SRI) - A computer-based reading program that provides educators with a fast, effective way to assess student reading levels.
telescope - To cover the same amount of materials or activities in less time, thereby allowing more time for enrichment activities and projects that better suit the interests, needs, and readiness levels of gifted students.
tiered assignments - A differentiated instructional strategy in which all students work toward the same goal, but activities are geared toward each student’s level of understanding.
twice exceptional - A term used to describe a student that is both gifted and disabled. These students may also be referred to as having dual exceptionalities or as being GT/LD. Click here for more information.
underachieving - A term used to describe the discrepancy between a student’s performance and their potential or ability to perform at a much higher level.
]]>This wiki will be used to post information, manuals, and documents that relate to Exceptional Student Education (ESE) services. This space is designed to provide information to both staff and parents. Major divisions appear below.
If you have any questions or suggestions regarding the wiki site, please contact Dave Law at dlaw@pasco.k12.fl.us.
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