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.
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