SAMPLE LETTER:

FIRST REFERRAL FOR SPECIAL EDUCATION ASSESSMENT

INSTRUCTIONAL NOTE:
To request assessment to determine whether your child is eligile !or s"ecial education
ser#ices$ sumit a %RITTEN LETTER to the School &istrict S"ecial Education &irector'
Cc the "rinci"al$ teacher or others in#ol#ed with your child(s education' Tell the school
district that you are concerned aout your child(s educational "rogress$ and rie!ly why$ and
that you are ma)ing a re!erral !or assessment !or s"ecial education ser#ices'
*ou will want to retain +ROO, o! the letter(s deli#ery' Consider sending the letter
-return.recei"t requested/ !rom the "ost o!!ice' Or hand deli#er and as) that your letter
e date stam"ed and a co"y o! this gi#en to you e!ore you lea#e' Or !a0 your letter and
"rint your -success!ul transmission/ !a0 re"ort and !ollow u" y "hone to ensure the letter
was recei#ed'
A %RITTEN letter triggers an im"ortant timeline under the Indi#iduals with &isailities
Act 1I&EA2 law:
3 ,rom the time the school district recei#es your letter$ the school district has 45 calendar
days 1not counting large school holidays2 to "resent you with an Assessment +lan !or your
consent'
3 ,rom the time you recei#e an Assessment +lan$ you ha#e 45 calendar days 1i! you wish to
ta)e them2 to as) all the questions you need to !eel com!ortale to gi#e -in!ormed consent/
y signing the "lan'
3 ,rom the time you consent to the Assessment +lan$ the district has 67 days 1not counting
large school holidays2 to assess your child and hold the !irst Indi#iduali8ed Education +lan
1IE+2 meeting'
In an initial IE+ meeting$ you and administrati#e$ educational$ and assessor team memers
will discuss the assessment results and ma)e a determination whether the child quali!ies !or
s"ecial education ser#ices' I! your child quali!ies$ an IE+ document will e de#elo"ed'
I! your child is currently enrolled y you in "ri#ate school$ you must request assessment
!rom the school district in which the "ri#ate school is located$ e#en i! this is not the
district in which you li#e' 1New when I&EA law was reauthori8ed in 977:'2
- - - - - SAMPLE LETTER TAILOR TO YOUR CHILDS NEEDS - - - - - -
;s' <e# <lue =+arent Name>
Address
City$ State$ ?i" Code
Tele"hone Numer
&ate =I;+ORTANT: This "rocess is dri#en y timelines'
&ate e#erything and note how it was deli#ered@mail or !a0' Email is not recommended>
ATTN: ;r' Aary Areen
&irector o! S"ecial Education
Local Uni!ied School &istrict
Address
City$ State$ ?i" Code
&ear ;r' Areen:
I am the "arent o! Bohn <lue$ who is =C> years old and is currently enrolled at the =Regular
Elementary School> in the =C> grade' ;y child has not een !unctioning well in school and I
am concerned aout his educational "rogress' I am writing to ma)e a re!erral !or
assessment !or s"ecial education ser#ices as allowed under the child !ind oligations o! the
Indi#iduals with &isailities Act 1I&EA2 and Cali!ornia Education Code Secs' 5679D$ 56E74$
56E79$ and 56E941a2 and 5 Cali!ornia Code o! Regulations 1C'C'R'2 Sec' E794' Fe may e
eligile !or s"ecial education assistance' I am requesting that Bohn e gi#en a
com"rehensi#e assessment y the school district in all areas o! sus"ected disaility$ and
that an IE+ meeting e scheduled !or him' Some o! my concerns are stated elow'
INSTRUCTIONAL NOTE:
In e#ery request !or INITIAL assessment$ you should include a "aragra"h requesting that
your child also e e#aluated under the "ro#isions o! Section 57: o! the Rehailitation Act
!or any -disaling condition/ that would require accommodations and.or ser#ices to enale
your child to ene!it !rom "ulic education to the e0tent that students without disailities
do' 1Fowe#er$ &O NOT agree to sustitute a 57: Assessment !or a s"ecial education
assessment'2 Such a "aragra"h might read as !ollows:
As "art o! the assessment "rocess$ I also request that my child e assessed under Section
57: o! the Rehailitation Act o! 4DGE to determine whether he should e identi!ied as
handica""ed "ursuant to that law and to determine what$ i! any$ accommodations might e
required in his educational "rogram in the e#ent that he does not quali!y !or s"ecial
education ser#ices$ or in addition to s"ecial education ser#ices' This is also to request that
the =Local Uni!ied School &istrict(s> 57: Coordinator e "resent at the IE+ meeting to
discuss the results and recommendations o! the Section 57: assessment'
INSTRUCTIONAL NOTE 3 O+TIONAL: *ou may wish to gi#e s"eci!ic e0am"les o!
di!!iculties and concerns you$ teachers or doctor ha#e noted' I! you ha#e a s"eci!ic
diagnosis$ re"orts or e#aluations already$ you may want to include them with your letter' *ou
may want to attach doctor(s documentation or re"ort i! you elie#e this will hel" your school
district understand your child(s disaility.needs$ or state that you ha#e this documentation
and can ma)e it a#ailale to the school district' *ou may want to include CA Star test
results$ sam"les o! written wor)$ re"ort cards$ etc' that su""ort your reasons !or concern'
*ou may want to get the classroom teacher to gi#e you concrete e0am"les and wor)
"roducts in writing that su""ort the need !or !urther in#estigation o! the child(s "rolems'
The U'S' Congress in I&EA law s"eci!ically chose to use the term -educational "rogress$/ a
road term to encom"ass all )inds o! "rogress a child is e0"ected to ma)e in school' Concern
is not limited to academic "rogress alone' It can mean motor "rolems$ social "rolems$
eha#ior issues$ academic "er!ormance concerns$ sensory o#erwhelm$ etc' <elow are some
e0am"les$ ut use your own e0am"les'>
Fere are some o! my concerns related to Bohn(s educational "rogress:
Testing: ;y child is in :
th
grade and scoring elow asic in the State tests in math$
des"ite doing all the homewor) and trying his est'
;otor: ;y child has e0treme di!!iculty with !ine motor tas)s and cannot write
su!!iciently well to com"lete classroom assignments in the time allotted'
<eha#ior.Sociali8ation: ;y child is ha#ing eha#ior di!!iculties that are im"airing
his aility to succeed in the classroom en#ironment' ,or e0am"le$ he can(t )ee" his
hands to himsel!$ sit still$ can(t resol#e con!licts or sociali8e in an age a""ro"riate
way$ he is eing disci"lined regularly$ going to the o!!ice$ etc'
S"eci!ic &isaility or Fealth Issues: ;y child has a diagnosis o! 1name disaility
such as Autism$ &ysle0ia$ &iaetes$ Se#ere Allergy$ etc'$ i! a""licale'2 This a!!ects
his educational success ecause 1e0clusion$ "er!ormance$ etc2'
Transition Ser#ices: I am concerned that my child does not ha#e the s)ills
necessary to success!ully transition into the community or college a!ter graduation
or com"letion o! high school' ,or e0am"le$ he cannot alance a chec)oo)$ ta)e
"ulic trans"ortation$ etc' The assessment should e0amine his social$ educational$
emotional$ career and inde"endent li#ing s)ills in order to de#elo" an a""ro"riate
transition "lan in his IE+'
O+TION: I! you )now "articular areas you thin) need to e assessed or )now s"eci!ic tests
your child may need$ you might add e0am"les tailored to your child$ li)e the !ollowing:
In addition to the ty"ical school district e#aluations$ I s"eci!ically request that the =Local
Uni!ied School &istrict> conduct the !ollowing e#aluations o! my son$ Bohn:
An e#aluation y an Augmentati#e and Alternati#e Communications 1AAC2 s"ecialist
!or children who are non3#eral communicators' To my )nowledge$ the district does
not ha#e on sta!! any e0"erts in this !ield' I ha#e een recommended to =<arara
<rown$ +h'&'> in non3#eral communication$ and unless the district has a com"arale
e0"ert$ I am requesting that you contract with =&r' <rown> to do the non3#eral
communication e#aluation o! my son'
An Occu"ational Thera"y 1OT2 assessment to determine how to su""ort Bohn(s need
!or "ro"er "ositioning !or learning due to his ortho"edic im"airment$ and to hel"
su""ort his high sensiti#ity to sensory stimuli'
An Assisti#e Technology 1AT2 assessment to determine the a""ro"riate tools$
strategies and ser#ices that may e necessary to assist my child in accessing and
ene!iting !rom his educational "rogram'
A ,unctional <eha#ioral Assessment 1,<A2 to determine the triggers and !unction o!
my son(s eha#ioral di!!iculties in order to de#elo" a +ositi#e <eha#ioral Su""ort +lan
1<S+2 and goals to enale him to learn to re"lace di!!icult eha#iors with acce"tale
eha#iors so that he may ma)e educational "rogress'
I loo) !orward to recei#ing an Assessment +lan in 45 days !or my re#iew and consent so that
the e#aluations can "roceed' I loo) !orward to these e#aluations eing com"leted "rom"tly
and an IE+ meeting within 67 days to discuss the results and "lan !or Bohn(s su""orted
education'
INSTRUCTIONAL NOTE: Request that assessment.e#aluation re"orts e "ro#ided to you
<E,ORE the IE+ meeting' An IE+ meeting is not a good !orum to learn "otentially u"setting
in!ormation' Also$ recei#ing re"orts in ad#ance hel"s you "re"are your questions aout the
e#aluations e!ore the IE+' This ma)es !or a more e!!icient IE+ meeting and ensures your
!ull "artici"ation' A "arent has a right to -any and all/ records a school district has on your
child under the ,amily Educational Rights H +ri#acy Act 1,ER+A2'
Also$ "lease ensure that I get co"ies o! the assessment re"orts at least 5 days e!ore the
IE+ meeting so that I will ha#e adequate time to re#iew them and "re"are any questions I
may ha#e !or the team'
Sincerely$
<e# <lue$ "arent o! Bohn
Cc: =a""ro"riate memers o! your child(s educational team>