ALBUQUERQUE PUBLIC SCHOOLS - ces



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Name of School

School Address

Area Code/Phone Number

PSYCHOEDUCATIONAL EVALUATION REPORT

|Name: |       |Student ID Number: |      |

|Birth Date: |      |Registered School: |      |

|Gender: | |Residence School: |      |

|Age: |      |Grade: |      |

|Parent/Guardian: |      | | |

|Address: |      | | |

| |     , New Mexico | | |

| | 87      | | |

|Phone Number: |      | | |

|Ethnicity: |      |Referral Date: |      |

|Home Language: |      |Date of Consent: |      |

|Primary Language: |      |Testing Date(s): |      |

|Language Proficiency: |      |Report Date: |      |

EVALUATOR

     

Licensed Educational Diagnostician

Licensed School Psychologist

ASSESSMENTS [List all tests given]

     

     

     

     

     

REFERRAL INFORMATION

      was referred for an educational evaluation by . Notification of referral information indicates concern(s) in the area(s) of      .

EDUCATIONAL HISTORY

A review of school records at       revealed      

HEALTH RECORD REVIEW

The school nurse completed a vision and hearing screening on       which revealed that       vision.       the hearing screening.      

A review of a current health assessment completed by the school nurse revealed that current health is      .

PARENT INTERVIEW

      interviewed on      .      

STUDENT ASSISTANCE TEAM

The student was presented to the Student Assistance Team by      . According to information collected during Student Assistant Team meeting(s),      

Fidelity of Instruction

Confirmation of Fidelity of Instruction involving Tier I and Tier II interventions were confirmed by the principal on      . Tier I interventions involved      . Tier II interventions included      .

Confirmation of Fidelity of Instruction involving Layer 1, Layer 2, and Layer 3 interventions were confirmed by the principal on      . Layer 1 interventions involved      . Layer 2 interventions included      . Layer 3 interventions included      .

Tier I interventions were implemented during       grade. grade teacher reported concerns with      . Tier I interventions were reported to include the following:

|Interventions |Duration |Outcome |

|      |      weeks | |

|      |      weeks | |

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|      |      weeks | |

|      |      weeks | |

Tier II interventions were implemented. Tier II interventions provide targeted, supplemental, individual, research-based support for a student who is performing below expectation and for whom Tier I instructions and interventions have proven insufficient. Tier II interventions were implemented for      .

A Tier II reading intervention, using       was implemented to improve      . This Tier II intervention was implemented to improve skills involving      . This intervention was implemented for       minutes,       to       days per week. Results of Tier II interventions were reported as follows:

|Date |Outcome |Date |Outcome |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

A Tier II math intervention, using       was implemented to improve      . This intervention was implemented in for       minutes,       to       days per week. Results of Tier II interventions were reported as follows:

|Date |Outcome |Date |Outcome |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

A Tier II written language intervention, using       was implemented to improve      . This intervention was implemented in for       minutes,       days per week. Results of Tier II interventions were reported as follows:

|Date |Outcome |Date |Outcome |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

|      |      |      |      |

Multi-Layered System of Supports

MLSS Is a holistic intervention framework that intervenes quickly when students need additional support. It involves working with a variety of community, family, & health/wellness professionals to provide coordinated supports. MLSS involves layers of support which can occur simultaneously. MLSS aligns all interventions to Common Core State Standards.

Layer I of the MLSS model provides universal interventions which include high quality, differentiated core instruction aligned to Common Core State Standards. Implementation of Layer I interventions provide high quality differentiated instruction via Culturally and Linguistically Responsive Instruction. It includes a system that includes Positive Behavioral Interventions and supports. It provides universal Screening Assessment to identify students whose needs are not met by Layer I interventions alone.

The following Layer I interventions were implemented:

|Layer I Interventions |Duration |Outcome |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

|      |      weeks |      |

Layer 2 Intervention in the MLSS model is provided for students not making expected academic or behavioral progress, including students who are insufficiently challenged academically. Core Curriculum and instruction that is individualized and includes targeted evidenced based interventions to support academic or behavioral improvement are implemented. Evidenced based interventions and data-driven instruction are provided in small group learning centers, and/or instruction with reading or math coaches. Health and wellness interventions, if needed, may include social or behavioral contracts or small group social work interventions. Frequent communication with parent(s) or guardians regarding assessed student progress is mandatory.

The following Layer 2 interventions, duration, and outcomes were as follows:

|Layer 2 Interventions |Test Date |Outcome |Test Date |Outcome |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

Layer 3 interventions include core curriculum and instruction and intensive and individualized evidenced-based interventions. Layer 3 may be provided for a longer duration and may be provided more frequently in smaller groups. Intensive intervention may include, but not limited to pullout services provided by a reading specialist. (Note: Not during core instruction time). Push-in services are provided by a behavior specialist, counseling services, or interventions provided by the general education teacher in the classroom. Frequent communication (at lease biweekly with parent(s) or guardians is mandatory regarding assessed student progress. The following Layer 3 interventions, duration, and outcomes were as follows:

|Layer 3 Interventions |Test Date |Outcome |Test Date |Outcome |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

|      |      |      |      |      |

Progress monitoring and district information was reported by the Student Assistance Team.

|MAP | | | | |

|Term |Subject |Grade |RIT |Percentile |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

|       |Math |      |      |      |

| | | | | |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

|       |Reading |      |      |      |

I-station Testing       Grade

|Subject |Index Score |Percentile |

|Overall Reading |      |      |

|Text Fluency |      |      |

|Comprehension |      |      |

|Vocabulary |      |      |

|Spelling |      |      |

Review of Factors Which Could Impact Performance

State evaluation guidelines require a review of relevant factors that could impact a student’s progress in the school setting. Cultural, linguistic, environmental and socio-economic factors are considered.

Cultural factors include cultural practices which could impact a student’s performance on a test or in school. Commitment to time, movement, affect, and reliance on the manner in which one communicates are some of the variables considered during the instructional day and testing.

Linguistic factors include the student’s dominant language, language spoken in the home, and language(s) of instruction. The student’s first language and exposure to a second language are important variables to consider. The duration and frequency of a second language other than English is subject to investigation to determine if a student has acquired language proficiency in English before attempting to measure academic or intellectual abilities.

Environmental factors include conditions, forces, or external stimuli which impinge upon a student’s ability to succeed in the school setting or during testing.

Socio-economic factors which could impact health, nutrition, attitude, or exposure toward learning are also reviewed.

[Report if these factors are present or not and discuss if these factors are impacting performance and how]

EVALUATION

DESCRIPTIONS OF TEST SCORES

One or more derived scores are used to report standardized test results. Some of these scores and their definition are as follows:

• Relative Proficiency Index (RPI) is a criterion referenced measure which provides information about the relative predicted ease or difficulty with which a student will be likely to perform similar grade or age level work. An RPI of 5/90 means the student is predicted to perform at a 5% success level while the average peers would perform at a 90% success level.

• Percentile (%ile) A score that gives the rank of a student compared with others of the same age (e.g. a percentile of 70 means the student’s scores is equal to or greater than 70 out of 100 students of the same age).

• Age Standard Score (SS) An age standard score is a measure of a student’s standing compared with others of the same age. Standards scores have a mean of 100 and a standard deviation of 15.

• Age Equivalent (AE) A score that reflects a student’s performance in terms of the age level at which the score falls. An age equivalent of 3-4 means the student made the same score by the average child who is 3 years 4 months of age.

• Scaled Score This is a type of standard score with a mean of 10 and a standard deviation of 3, typically used to report subtests results for intelligence scales.

• Standard Error of Measurement (SEM) A standard error of measurement is an estimate of the amount of error associated with a student’s obtained score and is directly related to the reliability of a test.

• T-Score A T-Score is a standard score based on a distribution with a mean of 50 and a standard deviation of 10.

• V-Scale A score with a mean of 15 and a standard deviation of 3, unique to subdomain scores.

CLASSROOM OBSERVATION(S)

[Discuss any classroom observations provided by SAT for reading/math/written language]

ASSESSMENT OBSERVATIONS

      was evaluated in       session(s) at      .       demonstrated      . wear glasses during the testing. Rapport was to establish. The testing environment was adequate for the administration of all test instruments. Test results to be valid estimates of current skill levels.      

Remote Testing Procedures

Qualified professionals (diagnosticians, school psychologists, speech and language therapist, occupational therapists, and social workers) have been granted limited and revocable permission to utilize appropriate and non-public teleconferencing and tools to assist in remote testing, due to the constraints of COVID-19. Extensive communication was provided to the parent prior to testing. During the time of remote testing, there additional stressors present for the family or the student (e.g. loss of employment, additional family members living in the home, deaths in the family or any loss of family, friends, or neighbors). The student received test workbook protocols by mail in a sealed envelope which was not opened until the day of testing. Technology for remote testing included a computer with screen sharing capability, a 15-inch computer monitor, an additional monitor to enable dual-monitor access, reliable high-speed internet, a built-in computer camera, mouse, and head set with attached microphone.

      was evaluated in       session(s) at      .       demonstrated      . wear glasses during the testing. Rapport was to establish. The testing environment was adequate for the administration of all test instruments. (Explain why) technical difficulties occurred during the remote testing session. (Document any deviations from standardization here). To support the validity of test findings, two evaluators were present for all parts of the testing. Test results to be valid estimates of current skill levels.      

ASSESSMENTS

[Insert test charts and analysis]

EVALUATION SUMMARY

Discuss all data including parent, school data, teacher data, and formal testing. Include family history of dyslexia if applicable.

ELIGIBILITY CRITERIA

The Eligibility of is being considered. The Eligibility Determination Team will use the December 2018 New Mexico Technical Evaluations and Assessment Manual (TEAM) guidelines to determine eligibility(ies).

Insert Disability Definition

Determination of eligibility is made by members of an Eligibility Determination Team (EDT) and requires a student meet evaluation criterion and demonstrates a need for special education services. An EDT meeting will be held to review all available information related to the student.

|Your Name and Credentials |

|Licensed Educational Diagnostician |

|Licensed School Psychologist |

An interpretation of the results of this assessment was conducted on       with      .

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