Assessment Report
LOS ANGELES UNIFIED SCHOOL DISTRICT
Division of Special Education – Related Services
LANGUAGE AND SPEECH
PRESCHOOL ASSESSMENT REPORT
|Student Name: | |Date of Report: | |
|Date of Birth: | |School of Attendance: | |
|Age: | |School of Residence: | |
|Eligibility: | |Grade: | |
|Medical Diagnosis: | |Current Class Placement: | |
|Primary Language: | |Teacher: | |
| | |Assessor: | |
| | |Assessment Date(s): | |
Reason for Referral
Educationally Relevant Health, Developmental and/or Medical Findings
Educational History/Interventions
Parent Interview
Classroom Observation/Teacher Interview
Tests and Validity of Assessments Utilized During the Assessment
|Testing and assessment materials and procedures used for the purposes of assessment and placement of individuals with exceptional|
|needs are selected and administered so as to not be racially, culturally, or sexually discriminatory. Tests have been validated |
|for the specific purpose for which they are used and administered by trained personnel in accordance with the instructions of the|
|producer.[34 C.F.R. 300.532(e)] |
Language Background
comes from non-English speaking home: YES NO
Languages spoken at home other than English: [pic]
by mother father siblings other: [pic]
Other information related to language background:
Oral Peripheral Exam
An oral peripheral exam was conducted as part of this assessment: YES NO
An oral peripheral exam includes a visual inspection of the oral mechanism and assesses range of motion, planning and coordination of movements of speech articulators.
Results of oral peripheral exam:
Articulation/Phonology
articulation skills were found to be within developmental limits: YES NO
Assessment Measures:
• Informal Observation
• Parent Report
• Goal Progress/Classroom Data
• Formal Articulation Test:
Name: [pic]
Error sounds/patterns include:
overall speech intelligibility is judged to be:
[pic]% to familiar listeners
[pic]% to unfamiliar listeners
Current level of speech articulation/phonology functioning:
Language
Language skills appear to be within developmental limits: YES NO
Language skills were assessed using the following informal/formal assessment tools:
• Observation & Informal Tasks:
• Sampling of spontaneous language:
• Parent Report:
• Goal Progress/Classroom Data:
• Formal Language Test(s): Name: [pic]
Current level of receptive/expressive language functioning:
Pre-Communication Behaviors Observed/Reported:
|Pre-Communication Behaviors |Skill Observed/Reported |Skill Not Yet Observed |Comments |
|Joint attention | | | |
|Non-verbal turn-taking | | | |
|Cause and effect | | | |
|Goal directed behavior | | | |
|Object function | | | |
|Intentional communication | | | |
Pragmatic Functions Observed/Reported:
|Pragmatic Functions |Skill Observed/Reported |Skill Not Yet Observed |Example |
|Requesting | | | |
|Greeting | | | |
|Labeling | | | |
|Questioning | | | |
|Call Attention | | | |
|Responds to direct questions | | | |
|Takes turns in conversation | | | |
Receptive Skills:
|Receptive Skills |Skill Observed/Reported |Skill Not Yet Observed |Example |
|Identifies objects | | | |
|Gives toys on verbal request | | | |
|Prepositions in, on | | | |
|Follows simple 1-step directions | | | |
|Follows simple 2-step directions | | | |
|Identifies basic concepts: e.g. shapes, colors, | | | |
|body parts | | | |
Expressive Skills Observed/Reported:
|Expressive Skills |Skill Observed/Reported |Skill Not Yet Observed |Example |
|Communicative point | | | |
|Yes/No head nods | | | |
|Use of basic signs/gestures | | | |
|1-2 Word Utterances | | | |
|2-3 Word Utterances | | | |
|4+ Word Utterances | | | |
|Asks and answers who, what, where questions | | | |
Sample Utterances:
If student comes from a non-English background, assessment of language skills was administered in the student’s primary language: YES NO
Discussion regarding English Learner factors:
Voice:
Based on observation of student and parent report, voice is an area of suspected communication concern:
YES NO
If yes, results of assessment:
Fluency:
Based on observation of student and parent report, speech fluency is an area of suspected communication concern:
YES NO
If yes, results of assessment:
Validity of Assessment Findings
Including environmental, cultural, or economic factors on performance
| |The student was cooperative and the assessment results are a valid indicator of student performance. |
| |Assessment was administered in the student’s native language or other mode of communication to ensure that the measurement |
| |reflects the student’s ability rather than English language skills. |
| |Assessment results may have been affected by: |
Summary
Conclusion
|For Students with SLI or no identified special education eligibility |
| |Based on the Language and Speech assessment, which included evaluation of relevant functional, developmental and academic |
| |information, student does not meet eligibility criteria for Speech and Language Impairment for his/her chronological age or |
| |developmental level according to the California Code of Regulations § 3030 and § 3031. |
| |Based on the Language and Speech assessment, which included evaluation of relevant functional, developmental and academic |
| |information, student does meet eligibility criteria for Speech and Language Impairment for his/her chronological age or |
| |developmental level according to the California Code of Regulations § 3030 and § 3031 and may need special education and related |
| |services support. Results indicated disorder in areas of: |
| | Articulation Voice Fluency Language |
|For students with a special education eligibility (or suspected eligibility) other than SLI (Speech and Language Impairment), this formal |
|assessment, which included evaluation of relevant functional, developmental and academic information, indicates that: |
| |The student may need Language and Speech (LAS) support. |
| |The student does not demonstrate a need for Language and Speech (LAS) support. |
The final determination of the need for LAS (Language and Speech) support will be made by the IEP team. It is the responsibility of the IEP Team to establish special education eligibility, placement and instructional setting to meet Federal and State Special Education laws and regulations.
|Report Prepared By: | |
|Title of Assessor: | |
|Signature: |___________________________________ |
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