Connecticut
|Student First Name | |Student Last Name | |
|Student Date of Birth | |Student SASID Number | |
|Date Assessment Completed | |Check: ________ Pre |_________ Post |
| | | | |IF B-1 MASTERY = 0 |
| |REQUIRED SUB-TESTS | | |COMPLETE ALTERNATE SUB-TESTS A-1, 1-2, A-3 AND A-4 |
Sub-Test |Mastery
Highest Item Demonstrated |Number of Missed Items BEFORE Mastery | |Sub-Test |Mastery
Highest Item Demonstrated |Number of Missed Items BEFORE Mastery | |B-1 | | | |A-1 | | | |B-2 | | | |A-2 | | | |B-4 | | | |A-3 | | | |B-10 | | | |A-4 | | | |C-1 | | | | | | | |C-3 | | | | |IF D-3 MASTERY = 0 COMPLETE ALTERNATE SUB TEST D-2 | | |D-3 | | | | | | | |D-6 | | | |Sub-Test |Mastery Item |Missed Items | |D-7 Points | | | |D-2 | | | |D-7 Names | | | | | | | |D-10 | | | | | | | |D-11 | | | | | | | |D-12 | | | | | | | |E-1 | | | | |IF D-7 MASTERY = 0 COMPLETE ALTERNATE SUB TEST D-1 | | |G-1 | | | |Sub-Test |Mastery |Missed | |G-3 | | | |D-1 | | | |G-6 | | | | | | | |H-1 | | | | | | | |H-2 | | | | | | | |H-3 | | | | | | | |H-4 | | | | | | | |This document is used for data entry purposes only. This recording sheet may be used to assist in the data collection for the Early Childhood Outcome (ECO) requirement. This recording sheet should NOT be used in place of the Brigance IED-III (2013) Assessment Manual or IED-III Record Booklet. This document may be printed out.
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