ALBEMARLE COUNTY PUBLIC SCHOOLS



ALBEMARLE COUNTY PUBLIC SCHOOLS

DEPARTMENT OF SPECIAL SERVICES

401 McINTIRE ROAD

CHARLOTTESVILLE, VIRGINIA 22902

(434) 296-5885

ELIGIBILITY SUMMARY ADDENDUM

FOR IDENTIFICATION OF A LEARNING DISABILITY

Student:       Date:      

The Patterns of Strengths and Weaknesses (PSW) model was the primary model used for this evaluation.

I. PRESENCE OF A DISORDER

(Utilize the PSW Worksheet to identify the appropriate cognitive factors)

Indicate below evidence to suggest the existence of one or more disorders of the basic psychological processes involved in understanding or in using language, spoken or written (which may include conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia).

     

II. MANIFESTATION OF DISORDER

Explain how the disorder manifests itself in the imperfect ability of the student to listen, think, speak, read, write, spell or to do mathematical calculations. Please provide the data and source of your information.

     

III. ASSURANCES (All responses must be “No”)

(If an answer is “Yes”, stop. The student cannot meet the criteria of a student with a specific learning disability.

Exhibited learning problems are primarily the result of visual, hearing, or motor disabilities Yes No

Exhibited learning problems are primarily the result of intellectual disabilities; Yes No

Exhibited learning problems are primarily the result of emotional disabilities; Yes No

Exhibited learning problems are primarily the result of environmental, cultural, or economic disadvantage. Yes No

IV. AREA(S) OF CONCERN

(Utilize the PSW Worksheet to identify the areas of low achievement below.)

A. The child does not achieve adequately for the child's age or to meet Virginia-approved grade-level standards in one or more of the following areas:

Oral expression;

Listening comprehension;

Written expression;

Basic reading skills;

Reading fluency skills;

Reading comprehension;

Mathematical calculations;

Mathematical problem solving.

NONE (The student does not meet the criteria of a student with a specific learning disability)

B. The student was provided with learning experiences and instruction in each of the above

noted areas appropriate for the child's age or Virginia-approved grade-level standards.

(This refers to the core instruction in Virginia Approved standards) Yes No

(If the answer is “no” the student cannot meet the criteria for a student with a Specific Learning Disability)

C. The child exhibits a pattern of strengths and weaknesses in performance, achievement,

or both, relative to age, Virginia-approved grade-level standards, or intellectual development,

that is determined by the group to be relevant to the identification of a specific

learning disability, using appropriate assessments. (Attach PSW worksheet) Yes No

(If the answer to “C” is “no” the student cannot meet the criteria for a student with a Specific Learning Disability)

(If the answer to “C” is “yes” – describe below)

Describe the pattern of strengths and weaknesses:

     

V. RESULT

If ALL of the conditions above are “Yes”, this student meets the Federal, State and Local definition of this particular disability category. It is the “first prong” of the three step eligibility process.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download