EVALUATION REPORT

Students Name: Bo Casey

EVALUATION REPORT (ER) School Age

Student Name: Bo Casey

Date of Report (mm/dd/yy): 10/28/15 Date Report Provided to Parent/Guardian/Surrogate: 10/28/15
Student Birth Date: 4/16/2002 Age: 13 Grade: 08
Local Education Agency (LEA): Indiana Area School District
School Student is Attending: Indiana Area JH School
Current Educational Program: Blended Home Schooled-Regular Education at IJHS
County of Residence: Indiana Phone (Home): (724) 999-9999
Name and Address of Parent/Guardian/Surrogate: Phone (Work):
Dan and Sally Casey
12345 Snap Street
Indiana, PA 15701

Other Information: N/A

Complete Sections 1 through 6 for all students.

If determining eligibility for Specific Learning Disability (SLD), the SLD component near the end of this
document must be completed and used to complete Sections 5 and 6.

1. REASON(S) FOR REFERRAL:

Bo was referred for evaluation by his mother, due to concerns for his overall reading and writing
achievement. Bo is a partially home schooled student, where his mother is his teacher. She reported
that Bo is also easily distracted and has a hard time paying attention in reading class. Bo also attends
several classes at IJHS.

2. SOURCES OF EVALUATION DATA In interpreting evaluation data, the school must draw upon a variety of
data sources, including those listed below, and carefully consider the information obtained. Document the
information obtained from the sources below.

A. Evaluations and information provided by the parent of the student (or documentation of LEAs
attempts to obtain parental input):
Bos mother noted that he has always struggled with reading and he took forever to read and recognize
numbers. He has not experienced any significant injuries or illnesses that could be impacting his
educational progress. She noted that he is diagnosed with ADD and is not currently taking any
medications. Bos strengths include math, hes athletic and a hard worker. Currently, Bo struggles
with reading, writing and focusing. His mother reported that his reading has improved a lot this past
year. At times, Bo becomes anxious when he feels like he has too much to do in school. Additionally,
his mother feels that he may be dyslexic and has dysgraphia.

OUTSIDE EVALUATION DATA:

Bo was seen by Lisa Hammett Price, PHD, CCC-SLP at the Indiana University of Pennsylvania (IUP)
Speech and Language and Hearing Clinic. She recommended that Bo receive a more comprehensive
evaluation in order for additional information to be collected to determine Bo's areas of need.

B. Observations Include teacher observations and observations by related services providers, when
appropriate:

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Bo was also seen by Emily Harford at The Literacy Center at IUP, in August of 2011, and attended the
IUP Summer Reading Program. She reported the following:

"Bo has shown he is a strategic reader and wants to increase his reading abilities. When working, he
tried to read the correct word and slowed down to reread a phrase to aid in decoding the word. He had
an understanding of different vowel patterns and word attack strategies, however has difficulty
applying this knowledge to his reading. Bo appears to have the most success decoding while engaged in
isolated activities, as opposed to reading connected text. When reading connected text, Bo substituted
long vowel sounds and vowel variant with short vowel sounds. While Bo has made improvements, more
work is needed in this area in order to increase Bo's reading abilities.

Bo has made gains in his reading fluency. His words correct per minute has increased by 11 words. He
showed that he was able to read with expression through various activities. When reading on-level
text, Bo was able to read using correct phrasing and chunking of text. However, when uninterested or
intimidated with the material, he reverted to reading word-by-word and lost focus very quickly. While
Bo has increased his reading fluency, his reading rate still fell within the at-risk level.

When reading Bo has shown he has strong reading comprehension. When asked to describe what he has
read or heard, he was able to provide an accurate, thorough description. The final area of concern for
Bo is his reading motivation and ability to focus on the activity with which he is engaged. Bo
continuously stated his disinterest in reading. While engaged in reading connected text, Bo had
difficulty keeping focused with the text. This inability to focus inhibited Bo's ability to accurately use
various reading strategies and read with fluency. Based on Bo's comments and teacher observations, it
appeared that most of Bo's lack of reading motivation is caused by his lack of focus and confidence. If
Bo were able to increase his reading confidence and focus, motivation will likely increase as well, which
will help improve his reading."

Bo was assessed using the Woodcock-Johnson III Normative Update Tests of Achievement, Form C by
Susan Richman when he was in 3rd grade. This assessment indicated that Bo's Brief Achievement fell in
the very limited range with a percentile of 3. In the area of Letter-Word Identification, Bo performed
equal to or better than 15% of her peers in a national grouping. In the area of Applied Problems, Bo
performed at the 71st percentile. A weakness was observed in the area of his Spelling skills. In this
area, Bo performed equal to or better than <.1% of his same age peers.

2011 EVALUATION RESULTS

Bo was also evaluated by the Indiana Area School District on November 30, 2011. Assessment results
are reported below. At the time, Bo qualified as a student with a specific learning disability in reading.
However, he did not enroll in a public school and did not receive learning support services at that time.

TEST OF COGNITIVE ABILITY:

To measure Bo's cognitive functioning Mrs. Peace, School Psychologist, administered the Wechsler
Intelligence Scale for Children-fourth edition (WISC-IV). The WISC-IV consists of ten subtests that are
separated into four domains: Verbal Comprehension, Perceptual Reasoning, Working Memory, and
Processing Speed. The Full Scale IQ is calculated from a combination of ten subtest scores that are
considered the most representative estimate of global functioning.

*Assessment results are reported in terms of standard scores, scaled scores and percentiles. Standard
scores are based on a mean score of 100 with a standard deviation of 15. The average range for these
scores is 90 to 109. Scaled scores are based on a mean score of ten with a standard deviation of three.
The average range of these scores is 8 to 12. A mean score falls at the 50th percentile with the average
range of these scores between the 25th and 75th percentiles.*

Scale Composite Score Percentile Rank Qualitative Description

Verbal Comprehension 96 39 Average
Perceptual Reasoning 100 50 Average
Working Memory 94 34 Average

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Processing Speed 83 13 Low Average

Full Scale 97 40 Average

WEAVER (Co-taught English) - Bo displays a positive attitude in class. I've never seen him complain or
resist redirection. Bo struggles with written expression, organization skills, and keyboarding skills.
Behaviorally, Bo is quiet, but friendly. Bo initially struggled to keep up with the class, was behind on
assignments, and often had trouble staying with the rest of the class on Chromebook tasks. (He had
difficulty logging in and keyboarding.) His current grade is 98.25%, but this is with lots of extra support
in an adapted CT class. Bo has benefited greatly from being placed in the Learning Support Teacher's
eTime room. He receives extra help with English assignments and studies with the teacher or IA. I
believe Bo would benefit from the services and programming within the special education/learning
support programming. This would give him an opportunity for small class sizes and more direct
instruction with regard to his specific reading and writing needs.

BAXTER-OSLO (Co-taught English) In English Bo is attentive, volunteers to answer questions and

completes his work. He currently needs reminders to stay focused, and encouragement to write more
than he does at the first try. Behaviorally, he is very polite, friendly, and cooperative. Despite the fact
that Bo receives As on most of his work, he still requires a lot of intervention and support that the co-
taught classroom can provide. The support from the eTime classroom teacher also provides
opportunities for one-on-one support for larger assignments, tests and quizzes.

LEMMON (Reading substitute) - Bo is pleasant and hard-working. He puts forth a good, consistent
effort. Bo needs help decoding words, pronouncing words, and comprehending what he reads. This is
much of what we are working to achieve in class. He needs extra time to decide how to put his
thoughts in writing. He is asked to write short (5 line) journal entries almost daily in my class. Often he
struggles to get 3 lines. Behaviorally, Bo is very pleasant and respectful. He is often smiling and has
positive conversations with his peers. To help him become more successful he has been provided:
Changes in seating to minimize distractions; restating the question and providing cues to improve
comprehension; allowing him more time to write. For the assignments Bo has completed so far, he has
received 3/3, 8/8 and 11/13. This translates to 92%. I feel that Bo would benefit from the resources
available from the Learning Support program with receiving extra help and extra time in the resource
room. The Instructional Aid is also a tremendous help to Bo during the class period. I feel it would be
beneficial for Bo to complete the i-Ready reading diagnostic test to assess his current reading level so
that the books he reads independently are at his level.

HOMESCHOOL Bos mother completed the Teacher Input Form Initial Evaluation and noted that she
is using the Saxon Algebra for Math instruction. Bo receives his reading instruction at the Jr. High
this year, and she is providing some spelling instruction with a mix of 3rd grade words. She reported
that according to his last Terra Nova assessment taken in 5th grade, he was 2 years behind in reading
and his listening skills came up at the 1st grade level. He performed within the 8th grade level in math.
She noted that math is his strongest subject. Bo requires constant physical activity (sports or other
movement) to help him maintain his focus and concentration. She added that he is very scattered and
easily distracted. He also requires assistance with his reading, writing and spelling skills. His grammar
in writing is poor, but he can write orderly. To help him be more successful, his mother reported that
she enrolled him in English and reading at the Jr. High to provide additional supports in those classes.
She also has used fluency tests in the past, they read frequently, and has attempted many different
curriculums, even specific for students with dyslexia; however, they were not beneficial. Additionally,
he was tested for an Auditory Processing Disorder but the findings did not indicate any difficulties with
his auditory processing skills. Socially, Bo loves to talk and is very social with his peers. However, at
times he has difficulty with self-control. His strengths were listed as: math, personable, happy and
very good problem solving skills.

PREVIOUS ASSESSMENT INFORMATION CONTINUED:

TESTS OF ACADEMIC ACHIEVEMENT:

The Wechsler Individual Achievement Test-III (WIAT-III) was administered to measure Bo's academic
achievement. The WIAT-II is an individually administered achievement test for children, adolescents,

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and adults. The subtests within this assessment are closely related to activities that the individual is
currently completing within the classroom. Bo was only given the reading subtest of this test at the
request of his mother.

Cluster/Test Standard Score Percentile Rank Qualitative Description

Reading Comprehension 85 16 Low Average
Word Reading 75 5 Borderline
Pseudoword Decoding 85 16 Low Average
Oral Reading Fluency 58 .3 Mildly Impaired
Total Reading 73 4 Borderline

C. Recommendations by teachers:
English - I believe Bo would benefit from the services and programming within the special
education/learning support programming. This would give him an opportunity for small class sizes and
more direct instruction with regard to his specific reading and writing needs.

Reading - I feel that Bo would benefit from the resources available from the Learning Support program
with receiving extra help and extra time in the resource room. The Instructional Aid is also a
tremendous help to Bo during the class period. I feel it would be beneficial for Bo to complete the i-
Ready reading diagnostic test to assess his current reading level so that the books he reads
independently are at his level.

Homeschool - Teach new information in short amounts, help him with studying, instruction in spelling
and increasing his reading and writing skills.

D. The students physical condition (include health, vision, hearing); social or cultural background;
and adaptive behavior relevant to the students suspected disability and potential need for special
education:
According to school health records, Bo has no records of any hearing or vision screenings due to being a
homeschooled student. Information provided on the emergency card noted that he wears glasses for
reading. It was also reported that he has a bee sting allergy and he demonstrates asthma like symptoms
with allergy or exercise. No other medical conditions or significant medical history was noted.

E. Assessments Include, when appropriate, current classroom based assessments; aptitude and
achievement tests; local and/or state assessments; behavioral assessments; vocational technical
education assessment results; interests, preferences, aptitudes (for secondary transition); etc.:
COGNITIVE ABILITIES
To measure Bo's cognitive functioning Mrs. Blumenthal, Certified School Psychologist, administered the
Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V). The WISC V provides a comprehensive
measure of overall intellectual ability, as well as other useful specific cognitive domains that impact
performance in the classroom and beyond. This assessment utilizes the iPad for presentation and
student responses. The Full Scale IQ (FSIQ) is the most reliable score and is derived from a sum of 7
subtest scaled scores. The FSIQ is usually considered the score that is most representative of general
intellectual functioning (g). Bos FSIQ fell within the Average Range and was better than or equal to
63% of his peers (FSIQ=105). There is a 95% chance that his overall cognitive abilities will fall between
99 and 110 (Average to High Average range).

Bo was extremely cooperative and engaged in all tasks presented; however, he has some significant
variability among his Composite scores. Scores ranged from a high of Fluid Reasoning standard score of
118 to a Processing Speed standard score of 77. Therefore, his FSIQ should be interpreted with extreme
caution. When students demonstrate variability among scores, it is suggested that a General Abilities
Index score is used to determine a better estimate of overall cognitive skills. The General Ability Index
(GAI) combines the Verbal Comprehension and Perceptual Reasoning portions of the assessment, which
are the two areas that are closely related to global functioning. The GAI provides an estimate of
general ability with reduced emphasis on working memory and processing speed. Bos GAI fell within
the High Average Range, and was better than or equal to 84% of his same aged peers (GAI = 115).

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When looking at his ability to access and apply acquired word knowledge by verbally answering
questions, he performed in the High Average range (Verbal Comprehension Index = 111, 77th
percentile). The application of this knowledge involves verbal concept formation, reasoning and
expression. High Verbal Comprehension scores indicate a well-developed verbal reasoning system with
good word knowledge acquisition, successful information retrieval, poor ability to reason and solve
verbal problems and ineffective communication of knowledge. Items within this index include a task
where Bo was read two words that represent common objects or concepts and asked to describe how
they are similar. Additionally, he was provided vocabulary words that he was asked to define. These
tasks also measure crystalized intelligence, find of knowledge, learning ability, verbal expression, long-
term memory, and degree of vocabulary development. Other abilities that may be used during these
tasks include auditory perception and comprehension, and abstract thinking.

Bo's ability to evaluate visual details and to understand visual spatial relationships to construct
geometric designs from a model fell within the High Average range (Visual Spatial Index = 114, 82nd
percentile). Visual Spatial Index scores demonstrate a capacity to apply spatial reasoning and analyze
visual details. For Block Design, working within a specified time limit, the student views a model
and/or picture and uses two-color blocks to replicate the design. For the Visual Puzzles subtest, a
student has a specified time limit where they view a completed puzzle and selects three response
options that when combined, reconstruct the puzzle.

Bos strongest performance fell within the Fluid Reasoning Index (FRI) which measured his ability to
detect the underlying conceptual relationships among visual objects and to use reasoning to identify
and apply rules (FRI = 118, 88th percentile, High Average Range). A strength with Fluid Reasoning
indicates a well-developed ability to determine conceptual information from visual details and to
effectively apply that knowledge. Bo was asked to view an incomplete matrix or series and select the
response option that completed the matrix or series. Additionally, Bo viewed a scale with missing
weight(s) and selects the response option that keeps the scale balanced. This task requires him to
apply the quantitative concept of equality to understand the relationship among objects and apply the
concepts of matching, addition, and/or multiplication to identify the correct response. Quantitative
reasoning tasks involve reasoning processes that can be expressed mathematically, emphasizing
inductive or deductive logic.

3. IF AN ASSESSMENT IS NOT CONDUCTED UNDER STANDARD CONDITIONS, DESCRIBE THE EXTENT TO

WHICH IT VARIED FROM STANDARD CONDITIONS (including if the assessment was given in the students
native language or other mode of communication):
Bo's performance fell within the High Average range when looking at his ability to register, maintain and
manipulate visual and auditory information in his conscious awareness (Working Memory Index = 110,
75th percentile). The Working Memory Index measures the ability to identify visual and auditory
information, maintain it in temporary storage and re-sequence it for use in problem solving. The
student is read a sequence of numbers and recalls the numbers in the same order (Forward), reverse
order (Backward) and ascending order (Sequencing). The shift in one task to another requires cognitive
flexibility and mental alertness. All Digit Span tasks require registration of information, brief focused
attention, auditory discrimination, and auditory rehearsal. For this task, Bo viewed a stimulus page
with one or more pictures of namable objects for a specified time and then selected the pictures (in
sequential order, if possible) from options on a response page. Picture Span measures visual working
memory and working memory capacity.

Bos weakest performance occurred when looking at his speed and accuracy of visual identification,
decision making and decision implementation, while working under time constraints. He performed
within the Very Low range and greater than or equal to 6 percent of his same aged peers (Processing
Speed = 77). Bo worked within a specified time limit and used a key to copy symbols that corresponded
with simple geometric shapes or numbers. He had a difficult time completing this task quickly. He
wrote all the symbols correctly; however, he completed a low number of items within the two minute
time frame. This may have negatively impacted his score in this area. In addition to processing speed,

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the subtest measures short-term visual memory, procedural and incidental learning ability,
psychomotor speed, visual perception, visual-motor coordination, visual scanning ability, cognitive
flexibility, attention, concentration, and motivation.

Additionally, Bo scanned search groups and indicated whether target symbols are present, while
working within a specified time limit. He performed much better on this subtest and his performance
fell within the Average range. In addition to visual-perceptual (i.e. visual identification and matching)
and decision-making speed, the subtest involves short-term visual memory, visual-motor coordination,
inhibitory control, visual discrimination, psychomotor speed, sustained attention, and concentration.
With a significant weakness in his Processing Speed, Bo may require additional time to process most
tasks that involve visual scanning, sustained attention and concentration, visual-motor coordination,
and decision making. It is not uncommon that students diagnosed with Attention Deficit/Hyperactivity
Disorder score poorly on this composite as they have a difficult time coordinating all of the necessary
cognitive functions successfully to complete each task within the time constraints.

ACADEMIC ASSESSMENT
Bos academic achievement was measured with the Wechsler Individual Achievement Test Third
Edition (WIAT-III) on by Beth Blumenthal, school psychologist. The WIAT-III includes subtests that
measure listening, speaking, reading, writing and mathematics skills. Assessment results are reported in
terms of standard scores and percentiles. Standard scores are based on a mean score of 100 with a
standard deviation of 15. The Average range for these scores is 85 to 115. A mean score falls at the
50th percentile with the Average range of these scores between the 15th and 85th percentiles. A
percentile rank tells how the student performed in comparison to their same-age peers within a
national grouping.

Bos performance on the WIAT-III included the following results:

TOTAL READING SS = 74; 4th Percentile: Low Range
BASIC READING SS = 82; 12th Percentile: Below Average Range
- Word Reading SS = 81; 10th Percentile: Below Average Range
- Pseudoword Decoding = 83; 13th Percentile: Below Average Range
READING COMPREHENSION AND FLUENCY SS = 68; 2nd Percentile: Low Range
- Reading Comprehension SS = 77; 6th Percentile: Below Average Range
- Oral Reading Fluency SS = 64; 1st Percentile: Low Range

READING Overall, Bos reading skills fell within the Low Range (Total Reading = 74, 4th percentile).
He struggled to complete most tasks within the reading composite. When looking at his ability to read a
list of sight words, and read nonsense words, Bo performed within the Below Average Range. Bo
typically made several attempts at each word or nonsense word before finally producing his answer.
His ability to read grade level text and answer comprehension questions also fell within the Below
Average Range. Bo performed better on questions that required literal answers versus those that
required him to make inferences. Bos most difficult task occurred when he was required to read grade
level passages out loud while being timed (Oral Reading Fluency SS = 64). His ability to read fluently
was better than or equal to 1 percent of his same aged peers. Bo was not able to read the eighth or
seventh grade passages within the required time limits; therefore he was presented with the sixth grade
passages. Although he did not complete the sixth grade passage within the time requirement, the limit
for reversing grade levels was reached. At the sixth grade level, Bos accuracy and oral reading rate
fell within the Very Low Range and equal to or greater than 1 percent of his peers.

MATHEMATICS SS = 105; 63rd Percentile: Average Range

- Math Problem Solving SS = 104; 61st Percentile: Average Range
- Numerical Operations SS = 105; 63rd Percentile: Average Range

MATHEMATICS Bos math skills appear to be a strength compared to his reading abilities. His overall
Math scores fell within the Average Range and better than or equal to 63% of his same aged peers. Bo
was asked to: solve un-timed math problems related to everyday applications (basic addition,
subtraction, multiplication skills, time, money, word problems, etc.). On these tasks, Bo worked
diligently and used scrap paper to complete various problems. Bo performed comparably on both tasks,

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as his performance fell in the Average Range for both subtests. He was asked to solve problems that
were read to him along with written or pictorial representations of the problems (Math Problem Solving
=104; 61st percentile), as well as to solve basic problems in paper pencil format (Numerical Operations
= 105, 63rd percentile). When evaluating his errors, Bo had difficulty completing problems that involved
addition with two-digit numbers (basic math operations); adding negative integers (basic math
operations); fractioned word problems (algebra); solving simultaneous equations (Algebra); recognizing
prime numbers (algebra); multiplication of fractions (algebra); solving three-step equations (algebra);
solving simplified quadratic equations (algebra); solving simultaneous equations (algebra); finding
functions (algebra); and finding sides of a triangle (geometry).

WRITTEN EXPRESSION = 76; 5th Percentile: Below Average Range

- Sentence Composition SS = 92; 30th Percentile: Average Range
- Spelling SS = 73, 4th Percentile: Low Range
- Essay Composition SS = 74, 4th Percentile: Low Range

WRITTEN EXPRESSION During the writing tasks, Bo was asked to combine information from two or
three sentences into single sentences that mean the same thing; write meaningful sentences that use
specific words; write single words that are dictated within the context of a sentence; write a
composition within 10 minutes. Overall, Bos writing skills fell within the Below Average Range
(Written Expression SS=76, 5th percentile). When writing individual sentences that contained a target
word, Bo performed within the Below Average range. His writing was legible, but were very basic in
nature and contained frequent spelling errors. At times, he used incorrect punctuation when writing a
question. When asked to combine sentences into one sentence that meant the same thing, Bo
performed within the Average range (Sentence Combining SS = 102, 55th percentile). He was able to
use the models to help with spelling and he used punctuation and sentence structure within age
appropriate limits. When engaged in a spelling task, he performed within the Low range and performed
better than or equal to 4 percent of his same aged peers. He spelled word phonetically and had
difficulty with consonant blends and silent letters. For example, Bo spelled suspect as suspeked,
known as nown and stationary as stashanary. When Bo was instructed to write an essay about
his favorite game he completed the essay in the allotted 10 minutes but only wrote four sentences. Bo
wrote about soecr. While he included at least three reasons why he liked the game (as instructed),
his essay did not elaborate on his reasons, or provide supporting details/sentences to those reasons. His
performance fell within the Low Range and was better than or equal to 4 percent of his same aged
peers (Essay Composition SS = 74).

Overall, when comparing Bos academic skills with his overall cognitive abilities (GAI=115) he is
demonstrating a significant weakness with regard to his reading comprehension, reading fluency, basic
reading (sight words and decoding), and written expression skills. Bo exhibits scores that are
statistically discrepant from his cognitive abilities in all above academic areas.

4. DETERMINING FACTORS A student must not be found to be eligible for special education and related
services if the determining factor for the students disability is any of those listed below. Respond Yes or No
to, and provide evidence for, each determining factor below.

Yes X No Lack of appropriate instruction in reading, including the essential

components of reading instruction. Provide evidence:
According to his Home School records, which are reviewed by Indiana
School District administrators, Bo has received appropriate instruction in
reading.

Yes X No Lack of appropriate instruction in math. Provide evidence:

According to his Home School records, which are reviewed by Indiana
School District administrators, Bo has received appropriate instruction in
math.

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Yes X No Limited English proficiency. Provide evidence:

According to Bo's mother, Bo's first language is English and English is the
language primarily spoken within the home.

NOTE: IF DETERMINING ELIGIBILITY FOR SPECIFIC LEARNING DISABILITY, COMPLETE THE

DETERMINATION OF SPECIFIC LEARNING DISABILITY COMPONENT AT THE END OF THIS
DOCUMENT BEFORE COMPLETING SECTIONS 5 and 6.

Complete Sections 5 and 6 for all students.

5. SUMMARY OF FINDINGS/INTERPRETATION OF EVALUATION RESULTS Considering all available evaluation

data, record the teams analyses of the students functioning levels.

A. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT Describe the students present levels, strengths,
and the resulting academic needs, when appropriate. Include communicative status, motor abilities,
and transition needs as appropriate. For students with limited English proficiency (LEP), include
current level(s) of English language proficiency in reading, writing, speaking and
understanding/listening:
Bos performance on the WIAT-III included the following results:
TOTAL READING SS = 74; 4th Percentile: Low Range
BASIC READING SS = 82; 12th Percentile: Below Average Range
- Word Reading SS = 81; 10th Percentile: Below Average Range
- Pseudoword Decoding = 83; 13th Percentile: Below Average Range
READING COMPREHENSION AND FLUENCY SS = 68; 2nd Percentile: Low Range
- Reading Comprehension SS = 77; 6th Percentile: Below Average Range
- Oral Reading Fluency SS = 64; 1st Percentile: Low Range
MATHEMATICS SS = 105; 63rd Percentile: Average Range
- Math Problem Solving SS = 104; 61st Percentile: Average Range
- Numerical Operations SS = 105; 63rd Percentile: Average Range
WRITTEN EXPRESSION = 76; 5th Percentile: Below Average Range
- Sentence Composition SS = 92; 30th Percentile: Average Range
- Spelling SS = 73, 4th Percentile: Low Range
- Essay Composition SS = 74, 4th Percentile: Low Range

Bo demonstrates a strength with regard to his math skills. He also has strong Fluid Reasoning skills,
Visual Spatial skills and General Abilities with regard to his cognitive skills. His academic needs include
increasing his oral reading fluency skills, decoding skills, reading comprehension and written expression
skills.

There are no known needs with regard to his communicative abilities, motor skills or any other areas.
Bo has indicated that he was not sure what he wanted to do after high school, but he demonstrated
interest in a career in engineering or a machinist. His dream job would be to become a professional
bass fisherman. It would benefit Bo to conduct a career inventory within the school based
programming, if he continues to be dually enrolled at IASD.

B. PRESENT LEVELS OF FUNCTIONAL PERFORMANCE Describe the students present levels, strengths,
and the resulting functional and developmental needs, when appropriate:

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Bo appears to be performing appropriate to his age and grade level in terms of his functional
development. His mother reported that he will sometimes need reminded to brush his teeth or put on
deodorant, but nothing atypical for his age.

C. BEHAVIORAL INFORMATION Include social and emotional status and behavioral strengths and
needs, when appropriate:
BEHAVIORAL RATING SCALES
To assess Bos behavioral, social and emotional needs, Bo was provided a copy of the Behavior
Assessment Scale for Children, Second Edition (BASC-2). This assessment is designed to evaluate the
behavior/self professions of students age 2 to 18 years and can determine if there is a need for any
additional follow-up or behaviors of concern. Scores in the Clinically Significant range indicate an
elevated level of maladjustment; however, ratings in the At-Risk or Borderline range suggest there
may be a need for concern but not severe enough to warrant formal treatment or a potential problem
that may require regular monitoring.

Bo completed the BASC-2 self report- adolescent (SRP-A) in which he reported no Clinically
Significant scores. He reported scores within the At Risk range with regard to Sensation Seeking
and Hyperactivity. Some of his responses regarding Sensation Seeking include: I like to take chances; I
would rather be a police officer than a teacher; I like it when my friends dare me to do something; I
like to play rough sports (almost always); I like to experiment with new things; I like to ride in a care
that is going fast (almost always); and I like to be the fist one to try new things (almost always).
Responses within the Hyperactivity domain included: I have trouble standing still in lines; I have trouble
sitting still; I sometimes talk while other people are talking; Sometimes I feel like I have to get up and
move; people tell me to be still; sometimes people tell me that Im too noisy.

6. CONCLUSIONS Determination of Eligibility and Educational Needs

Complete A or B or C.

A. The student does not have a disability and therefore is NOT ELIGIBLE for special education.
OR
B. The student has a disability but does not need specially designed instruction, and therefore is
NOT ELIGIBLE for special education.
OR
C. X The student has a disability AND is in need of specially designed instruction, and therefore IS
ELIGIBLE for special education.
1. Disability Category
Primary disability category: Specific Learning Disability - all areas of reading; written
expression
Secondary disability category(s), if any:
2. Recommendations for consideration by the IEP team to enable the student to participate as
appropriate in the general education curriculum (including special considerations the IEP
team must consider before developing the IEP, measurable annual goals, specially designed
instruction, and supplementary aids and services):
Overall, when comparing Bos academic skills with his overall cognitive abilities (GAI=115) he
is demonstrating a significant weakness with regard to his reading comprehension, reading
fluency, basic reading (sight words and decoding), and written expression skills. Bo exhibits
scores that are statistically discrepant from his cognitive abilities in all above academic
areas. Based on Bo's performance on the academic and cognitive assessments, he qualifies
for special education services as a student with a specific learning disability (all areas of
reading). The team needs to discuss what programming will best meet his needs. It is
recommended that he begin to receive replacement reading within the learning support
classroom, as well as continuing with learning support English to increase his writing skills as

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well. In other classes, accommodations will have to be made to help him with the grade level
texts. Providing the opportunity for books on tape and having tests read aloud (when not
assessing for reading comprehension/fluency) will be essential in other general education
classes. Additionally, using speech to text programs will also help Bo produce longer answers
and/or essays that he could go back and edit at a later time.

If Bo were to enroll in a full time public school, some suggestions for general classroom
procedures and/or accommodations could include, but are not limited to:
Break down longer directions into simpler chunks.
Discuss the need for extended time on tests/assignments as necessary.
Read tests, quizzes, directions out loud.
Provide access to books on tape for general education classes
Possibly provide a written timeline of due dates and help break down longer assignments
into more manageable parts.
Reduce homework to include work he has mastered or that he can complete independently.
Check often for comprehension. If necessary, have Bo repeat expectations/directions back
in his own words.
Encourage Bo to underline the key words of directions, paragraphs, questions, etc.
Use color and highlighting to accentuate certain important words or phrases on worksheets
OR Have Bo underline or highlight directions.
Present the assignment in parts (e.g., 5 math problems at a time, one paragraph due as
part of a 5 paragraph essay, etc). Give reinforcement for each completed part before giving
the next part.

Agreement and Disagreement

required ONLY when evaluating
Evaluation Team Participation students for specific learning
disability.

Evaluation Team Participants* Title Agree Disagree**

Dan Casey Parent

Sally Casey Parent
Andrew Weaver Special Education Teacher
Robin Baxter-Oslo English Teacher
Erica Ashcroft Guidance Counselor
Beth Blumenthal
Ms. Moss

* A certified school psychologist is required for evaluation of the following disability categories: Autism,
Emotional Disturbance, Mental Retardation, Multiple Disabilities, Other Health Impairments, Specific Learning
Disability or Traumatic Brain Injury. A certified school psychologist is not required for Deaf-blindness, Deaf
and Hard of Hearing, Speech/Language Impairment, Visual Impairment, and Orthopedic Impairment.

** For specific learning disability only, if a team member disagrees with the teams conclusion related to the
identification of the student as having a specific learning disability, the member must submit a separate
statement presenting the members dissent to the LEA. This information must be attached to the Evaluation
Report. Please submit this statement to:

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LEA Representative Name Phone Number

Email Address
A copy of the Procedural Safeguards Notice is available upon request from your childs school. This document
explains your rights, and includes state and local advocacy organizations that are available to help you understand
your rights and how the special education process works.

For help in understanding this form, an annotated Evaluation Report is available on the PaTTAN website at
www.pattan.net Type Annotated Forms in the Search feature on the website. If you do not have access to
the Internet, you can request the annotated form by calling PaTTAN at 800-441-3215.

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DETERMINATION OF SPECIFIC LEARNING DISABILITY

NOTE: This component must be completed when determining eligibility for Specific Learning Disability.
The information must be attached to and/or incorporated into Sections 5 and 6 of the completed
Evaluation Report.

Provide documentation for items 1-10.

1. The student does not achieve adequately for the students age or does not meet State-approved grade-
level standards in one or more of the following areas when provided with learning experiences and
scientifically based instruction appropriate for the students age or State-approved grade level standards
and level of English language proficiency: oral expression, listening comprehension, written expression,
basic reading skill, reading fluency skills, reading comprehension, mathematics calculation, and
mathematics problem-solving.
The findings of this evaluation would indicate that Bo is not performing adequately to his age and grade level
in the areas of basic reading skills, reading fluency skills and reading comprehension.

2. Check below to identify the process(es) used to determine eligibility.

Response to Scientific Research-Based Intervention (RtI). Document the criteria below.

The student does not make sufficient progress to meet age or State-approved grade-level standards
in one or more of these areas: oral expression, listening comprehension, written expression, basic
reading skill, reading fluency skills, reading comprehension, mathematics calculation, and
mathematics problem-solving:

X Severe Discrepancy between Intellectual Ability and Achievement. Document the criteria below.

The student exhibits a pattern of strengths and weaknesses in performance, achievement or both
relative to age, standards or intellectual development:
According to the WISC-V, Bo's GAI falls in the high average range. A significant discrepancy
appears to exist between Bo's average ability level and his achievement in all areas of reading.
He demonstrated strengths with regard to his math, fluid reasoning, and visual spatial skills.

3. The instructional strategies used and the student-centered data collected:

Bo's mother noted that she has purchased many different programs to try to improve his reading and
spelling. Currently, he is enrolled in a reading class and English class at the Jr. High to help increase his
reading and writing skills.

4. The educationally relevant medical findings, if any:

Bo is currently diagnosed with ADHD. There are no additional reported educationally relevant medical
findings.

5. The effects of the students environment, culture, or economic background:

It would appear that the student's environment, culture or economic background does not affect Bo
educational progress.

6. Data demonstrating that prior to referral or as part of the referral process for a specific learning
disability, the students regular education instruction was delivered by qualified personnel, including the
English as a Second Language (ESL) program, if applicable:

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Bo receives his core instruction in a home school setting with his mother as his primary instructor. His
home school binder is reviewed and approved yearly by school district administrators. While here at
the Jr. High, he receives instruction from highly qualified teachers who are supervised by the building
principal.

7. Data based documentation of repeated assessments of achievement at reasonable intervals, reflecting

progress during instruction, which was provided to the parents:
Bo was given the WJ-III assessment when he was in 3rd grade. Bo was also evaluated using several
different reading assessments, while participating in the IUP Summer Reading Program. A formal
evaluation was conducted in 2011 as well. His home school program is evaluated with a standardized
assessment at the end of each year as well.

8. An observation in the students learning environment (including the regular classroom setting) to
document the students academic performance and behavior in the areas of difficulty. Note the
relationship of that behavior to the students academic functioning:

Information from Bo's reading and English teachers are within this report. His mother also provided
information regarding his performance and behaviors while instructed at home.

9. Other data, if needed, as determined by the evaluation team:

None at this time.

10. Include a statement for each item below to support the conclusions of the evaluation team that the
findings are not primarily a result of

Visual, hearing, motor disability:

There are no visual, hearing or motor disabilities reported that would affect Bo's academic
functioning.
Mental retardation:
According to the WISC-V, an individually administered assessment of intellectual functioning,
Bo is not functioning within the range considered for an intellectual divisibility.
Emotional disturbance:

There are no reported emotional issues affecting Bo's academic functioning and progress.

Cultural factors:

There appear to be no cultural factors affecting Bo's academic functioning and progress.

Environmental or economic disadvantage:

There appear to be no environmental or economic disadvantage affecting Bo's academic
functioning and progress.
Limited English proficiency:
It is reported that English is Bo's first language and that English is also the language primarily
spoken within the home.

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Upon completion of the SLD Component, attach and/or incorporate this information into Sections 5 and 6
of the completed Evaluation Report.

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