10

10.16.3019 CRITERIA FOR SPECIFIC LEARNING DISABILITY

Yes No When provided learning experiences appropriate to the student's age and ability levels, the student's rate of achievement relative to the student's age and ability levels remains below expectations; and

Yes No The student does not achieve commensurate with his or her age and ability levels in one or more of the areas listed in (1) (b).

Area(s): ________________________________________

(1) (b) The student has a severe discrepancy between intellectual ability and

achievement, that is not correctable without special education and

related services, in one or more of the following areas:

Yes No oral expression Yes No listening comprehension

Yes No written expression Yes No basic reading skill

Yes No reading comprehension Yes No mathematics calculation

Yes No mathematics reasoning

Yes No At least one team member other than the student's regular education teacher has observed the student's academic performance in the regular classroom setting. In the case of a student of less than school age or out of school, a team member has observed the student in an environment appropriate for a student of that age.

Documentation of the learning disability determination:

Yes No Includes a statement of the relevant behavior noted during the observation of the student. (34 CFR 300.543);

Yes No Includes a statement of the relationship of that behavior to the student’s academic functioning;

Yes No Includes a report of one or more intervention techniques specific to the individual student.

Yes No Includes educationally relevant medical findings, if any, that have been considered.

Yes No If appropriate, states the basis for concluding that the use of standardized test instruments would not be valid whenever alternatives to norm referenced tests are utilized to determine a severe discrepancy.

EXCLUSIONARY FACTORS:

The student may not be identified as having a specific learning disability if the severe discrepancy between ability and achievement is primarily the result of a

visual, hearing, or motor impairment; cognitive delay; emotional disturbance; environmental or economic disadvantage; or cultural difference.

DEFINITIONS:

A severe discrepancy is defined as a 50 percent or higher probability of a two standard deviation discrepancy between general cognitive ability and achievement in one or more of the areas identified in (1) (b) when adjusted for regression to the mean. Error in test measurement requires judgment for students who score near two standard deviations below the population mean. When exercising this judgment, consideration of additional information, such as classroom performance relative to the student's performance on norm referenced tests, shall be used as the basis for determining the severe discrepancy.

Alternatives to norm referenced tests, such as curriculum-based assessments, shall be utilized to determine severe discrepancy whenever cultural factors, test conditions, size of test item sampling for the student's age, or other factors render standardized assessment results invalid. When utilizing alternative assessment procedures, a determination must still be made that a discrepancy between ability and achievement exists at a level of severity similar in size to the discrepancy that would have otherwise been found as described in the above paragraph..

Student Name: _________________ CST Date: __________

10.16.3020 CRITERIA FOR SPEECH-LANGUAGE IMPAIRMENT

Yes No The student has a significant deviation in speech such as fluency, articulation or voice, or

Yes No The student has a significant deviation in the ability to decode or encode oral language which involves phonology, morphology, semantics or pragmatics or a combination thereof.

Yes No Documentation of the student's interpersonal communication effectiveness in a variety of educational settings by the teacher, parent, speech-language pathologist, and others as appropriate supports the adverse educational effect of the speech-language impairment or oral communication in a classroom or school setting.

EXCLUSIONARY FACTORS:

The student may not be identified as having a speech-language impairment if the speech or language problems primarily result from environmental or cultural factors.

DEFINITIONS:

The student has a significant deviation in oral performance if the student's performance on standardized test is two standard deviations below the population mean, or between 1.5 and two standard deviations below the population mean, and there is documented evidence over a six month period prior to the current evaluation of no improvement in the speech-language performance of the student even with regular classroom interventions.

For articulation, a significant deviation is consistent articulation errors persisting one year beyond the highest age when 90 percent of the students have acquired the sounds based upon specific developmental norms.

If norm-referenced procedures are not used, alternative assessment procedures shall substantiate a significant deviation from the norm.

Student Name: _________________ CST Date: __________

10.16.3010 CRITERIA FOR CHILD WITH DISABILITIES

Yes No The child is 3, 4, or 5 years old and;

Yes No Meets the criteria for one or more disabilities in ARM 10.16.3011 through 10.16.3022.

Yes No The student experiences a severe delay in development. (At the discretion of the local educational agency, a student may be identified as being a child with disabilities if the student experiences a severe delay in development.)

DEFINITIONS:

A severe delay in development means:

The child functions at a developmental level two or more standard deviations below the norm in any one area of development or 1.5 standard deviations below the norm in two or more areas of development; and

The areas of development include one or more of the following areas: cognitive development, physical development, communication development, social and emotional development, or adaptive functioning skills.

Student Name: _________________ CST Date: __________

10.16.3012 CRITERIA FOR COGNITIVE DELAY

Yes No The student has a significantly subaverage general intellectual functioning, and

Yes No Corresponding deficits in adaptive behavior and educational performance, especially in the area of application of basic academic skills in daily life activities.

Yes No The presence of subaverage general intellectual functioning must occur between conception and the 18th birthday.

DEFINITIONS:

"General intellectual functioning" means performance on a standardized intelligence test that measures general cognitive ability rather than one limited facet of ability.

"Significantly subaverage general intellectual functioning" is defined as two or more standard deviations below the population mean on a standardized intelligence test. Error in test measurement requires clinical judgment for students who score near two standard deviations below the mean.

“Deficits in adaptive behavior” is defined as significant limitations in the student's effectiveness in meeting the standards of personal independence, interpersonal communication, and social responsibility expected for the student's age/grade peers and cultural group as measured by standardized instruments or professionally recognized scales.

Student Name: _________________ CST Date: __________

10.16.3018 CRITERIA FOR OTHER HEALTH IMPAIRMENT

Yes No The student has limited strength, vitality or alertness, including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia or tuberculosis; and

Yes No The condition adversely affects the student's educational performance.

Yes No The student has a medical diagnosis of a chronic or acute health problem. (REQUIRED)

DEFINITIONS:

"Adversely affect the student's educational performance" means that there is evidence that measures of student performance (e.g., achievement tests, grades, behavioral assessments, analysis of classroom assignments, or criterion-referenced tests, etc.) indicate a pattern of educational attainment that can wholly or in part be attributed to the disabling condition.

Student Name: _________________ CST Date: __________

10.16.3016 CRITERIA FOR HEARING IMPAIRMENT

Yes No An audiological report documents a permanent hearing loss in excess of 20 dB better ear average in the speech range (500, 1,000, 2,000 Hz), unaided, or

Yes No A history of fluctuating hearing loss which has interrupted the normal acquisition of speech and language and continues to adversely affect educational performance.

DEFINITIONS:

Student Name: _________________ CST Date: __________

10.16.3015 CRITERIA FOR EMOTIONAL DISTURBANCE

A condition which includes one or more of the following characteristics is present:

Yes No An inability to build or maintain satisfactory relationships with peers and teachers;

Yes No Inappropriate types of behavior or feelings under normal circumstances, including behaviors which are psychotic or bizarre in nature or behaviors which are atypical and for which no observable reason exists;

Yes No A general, pervasive mood of unhappiness or depression, including major depression and dysthymia, but excluding normal grief reactions;

Yes No A tendency to develop physical symptoms or fears associated with personal or school problems, including separation anxiety, avoidant disorder and overanxious disorder;

Yes No Schizophrenia.

Each of the conditions above shall meet the criteria of having been present:

Yes No To a marked degree,

Yes No Over a long period of time, and

Yes No Adversely affecting the student's educational performance.

Yes No The student has been observed in more than one setting within the educational environment; and

Yes No The local education agency has planned and implemented one or more positive behavioral interventions specific to the individual student.

Interventions shall not unnecessarily delay appropriate identification when it can be shown through a student's social or developmental history, compiled directly from the student’s parents or from records when the parents are not available, the existence of characteristics that clearly identify emotional disturbance.

EXCLUSIONARY FACTORS:

The student may not be identified as having emotional disturbance if:

Delays in educational performance are primarily due to visual impairment, hearing impairment, orthopedic impairment, cognitive delay, health factors, cultural factors or limited educational opportunity.

Common disciplinary problems may exist in conjunction with emotional disturbance, but cannot be used as the sole criteria for determining the existence of an emotional disturbance.

The term emotional disturbance does not apply to students who are socially maladjusted, unless it is determined that they meet the criteria for emotional disturbance.

DEFINITIONS:

Student Name: _________________ CST Date: __________

10.16.3011 CRITERIA FOR AUTISM

Yes No Documentation supports the existence of a developmental disability that was generally evident before the student was three years of age; and

Yes No The student has communication difficulties in verbal and nonverbal communication and social interaction.

Yes No Assessments document the presence of significant delays in verbal and nonverbal communication and social interaction.

Significant delays in verbal communication are manifested by at least one of the following:

Yes No Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime);

Yes No In students with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.

Yes No Significant delays in nonverbal communication are manifested by a marked impairment in the use of multiple nonverbal behaviors such as eye to eye gaze, facial expression, body postures, or gestures to regulate social interaction.

Significant delays in social interaction are manifested by at least one of the following:

Yes No Failure to develop peer relationships appropriate to developmental levels;

Yes No Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., lack of showing, bringing or pointing out objects of interest);

Yes No Lack of social or emotional reciprocity;

Yes No Lack of varied, spontaneous, make‑believe play or social imitative play appropriate to developmental level.

A student who manifests the characteristics of autism after age three could be identified as having autism if the criteria for significant delays in verbal communication and significant delays in social interaction are met.

The following information is provided to assist the Child Study Team, but is not required for identification of a student with autism:

Other characteristics often associated with autism may include restricted, repetitive and stereotyped patterns of behavior, interests and activities, as manifested by one or more of the following:

Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;

Apparently inflexible adherence to specific nonfunctional routines or rituals;

Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole‑body movements);

Persistent preoccupation with parts of objects.

EXCLUSIONARY FACTORS:

The student may not be identified as having autism if the student's educational performance is adversely affected primarily because the student has an emotional disturbance.

Student Name: _________________ CST Date: __________

10.16.3017 CRITERIA FOR ORTHOPEDIC IMPAIRMENT

Yes No The student is diagnosed by a qualified medical practitioner having an orthopedic impairment.

Yes No The impairment is severe; and

Yes No The impairment adversely affects the student's educational performance.

DEFINITIONS:

The term orthopedic impairment includes impairments caused by congenital

anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by

disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from

other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause

contractures).

Student Name: _________________ CST Date: __________

10.16.3014 CRITERIA FOR DEAFNESS

Yes No An audiological report documents that hearing loss is so severe that the student is impaired in processing linguistic information, with or without amplification, to the extent that prevents the auditory channel from being the primary mode of learning speech and language.

Yes No The student's educational performance is adversely affected as documented by specific examples:

______________________________________________________________________________________________________________________________________________________________________________

The results and analysis of a current assessment of language development, as

measured by standardized tests or professionally recognized scales appropriate

to age level and administered individually is required to show an impairment in

processing linguistic information prior to identification.

DEFINITIONS:

Student Name: _________________ CST Date: __________

10.16.3021 CRITERIA FOR TRAUMATIC BRAIN INJURY

Yes No The student has an acquired injury to the brain caused by external physical force which substantially limits the student's functional or psychosocial ability or both and the student's ability to learn or participate in the general education curriculum.

EXCLUSIONARY FACTORS:

The student may not be identified as having a traumatic brain injury if the injury to the brain is congenital, degenerative, or caused by birth trauma.

DEFINITIONS:

The term traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas such as cognition, language, memory, attention, reasoning, abstract thinking, judgment, problem-solving, sensory, perceptual, and motor abilities, psycho-social behavior, physical function, information processing, and speech.

Student Name: _________________ CST Date: __________

10.16.3022 CRITERIA FOR VISUAL IMPAIRMENT

Yes No The student has a visual acuity of 20/70 or less in the better eye with correction or field of vision which at its widest diameter subtends an angle of no greater than 20 degrees in the better eye with correction.

Student Name: _________________ CST Date: __________

10.16.3013 CRITERIA FOR DEAF-BLINDNESS

The student:

Yes No Meets the criteria in ARM 10.16.3022 for visual impairment;

Yes No Meets the criteria in ARM 10.16.3020 for speech-language impairment;

Yes No Meets the criteria in ARM 10.16.3016 for hearing impairment or in ARM 10.16.3014 for deafness; and

Yes No Is experiencing severe delays in communication and other developmental and educational skills such that services designed solely for students with deafness or for students with blindness would not meet the student's educational needs.

Student Name: _________________ CST Date: __________