ESD Special Education Program Implementation Guide

·r Special Education
Program Implementation
Guide
(V@T@tt Public Schools

Special Services
202 Alder St.
Everett, WA 98203
Phone: 425-385-5250 Fax: 425-252-7769
Revised September 2009

EVERETT PUBLIC SCHOOLS
r PROCEDURAL IMPLEMENTATION GUIDELINES

FOR SPECIAL EDUCATION
TABLE OF CONTENTS
MISSION AND VISION 7
SPECIAL EDUCATION TOOLKIT 9
ROLES AND RESPONSIBILITIES 13
SPECIAL SERVICES CONTACT INFORMATION ]6

• Administrative Offices 17
• Teacher/Classroom 18
BEHA"lOR/DISCIPLINE 22
• FBA/SIP 23
• Aversive Interventions 24
• Use of Safe Rooms 25
r: •Safe Room Monitoring Checklist 26

•Manifestation Determination 28
• Removal of Special Education Students 29
• Home Tutor Forms 31
CHILD-SPECIFIC EOUIPMENT RECOMMENDATION 32

• Recommendation form 33
ELL 34
• ELL Middle Schoo) Course Descriptions 35
• ELL Parent Questionnaire 36
• Procedures for collecting information 37
• ELL/Special Education: Questions to consider 38
ESY 39
• Everett Public Schools ESY Timelines/Guidelines 40
• ESY Definitions 41
• ESY Referral Form 42
• ESY Updated Health History Form 43
• ESY Assurance Letter 44
2
EV ALUATION AND ELIGIBILITY 45
r: • Evaluation Q and A
• Evaluation/Reevaluation
46
47
• Pre-referral, Referral and Evaluation 49
• Handicapping Codes 50
• Process for Placement for Transfer Students Within and Out of District 51
• Professional Judgment 52
• SLD Procedures 53
• Use of the Developmentally Delayed Eligibility Category 54
GRADUATION 56
• Changing graduation date 57
• Revised graduation date forrn 58
• "Kevin's Law" 59
• Graduation requirements and IEP determined graduation 60
INDIVIDUAL EDUCATIONAL PROGRAMS 61

• Administrations Role at IEP Meetings 62
• IEP Q and A 63
• Required Participants 68
• Goals and Objectives 70
• IEP General Introduction and Reminders 71
~ • Present Level of Performance IEP 72
• Progress Reports 73
• Services to students with disabilities 75
• Summary of Service Matrix 76
• Transition Planning 77
• Use of Related Services for OT/PT 80
• What if a student does not make progress? 82
INTERPRETERS 83
• Purpose of interpreters 84
• Four roles of the interpreter 84
• Tips for the professional interpreter 84
MEDICAID PROCEDURES 85
• Sample Therapy Log 86
• Code Definitions 87
PLACEMENT PROCEDURES 91
• School assignments and program placements 92
• Establishing educational placement 92
• Checklist for referring a student for a self-contained placement 94
• Guiding questions for placement in self-contained program
r: 95
"7"1
r' PRESCHOOL 97
• Determining Child Outcomes Summary Rating Scores 98
• Developmental Screeners 99
• Early Childhood Outcomes Reporting Q and A 100
• COSF Qand A 105
• Important things to remember for COSF 107
• Decision Tree for Summary Rating Discussion 108
• Tool for On-Going Data Collection 111
• Blank COSF Forms 118
• Entry Outcome Example I - Therapy Only 122
• Entry Outcome Example 2 - Preschool Student 126
PRIVATE AND HOME SCHOOLED STUDENTS 133

• Special Education Services for private school and home school students 134
• Evaluation 134
• IEP 135
PSYCHOLOGIST PROCEDURES 137

• Overload Procedures 138
• Test Kit Acquisition Procedures 139
• Test Protocol Procedures 140
RESOURCES 141
REVOCATION OF CONSENT FOR SPECIAL EDUCATION SERVICES 143

• Documentation 144
• Services 144
• Records 145
• Discipline 145
• Re-Entry 145
RISER INFORMATION 146

• Chart for risers 147
• Decision Diagram for Evaluations and for Risers 148
• Rising from Preschool Programs 149
• Kindergarten Program Options lSI
SAFETY NET 153
• 1 est 1'.][ i\CQUlSmOn rroceoures

ST ATE ASSESSMENTS 155
• Special Education State Assessment Testing Options by grade level 156
• Continuum of Cognitive Development and Assessment Options for grades 3-8 157
• Continuum of Cognitive Development and Assessment Options for diploma
(grades 10-12) requirements 158
TRANSPORTATION 159
• Pickup/Drop Offlnformation 160
VISION SERVICES 161

• Information about Vision Services 162
ADDENDUM 163
• Everett Public Schools District Special Ed Policy 164
USEFUL INTERNET LINKS

• WAC-172A- Rules for the Provision of Special Education Students
http://www.kI2.wa.us/SpecialEd/regulations.aspx
• Procedural Safeguards in English, Cambodian, Korean, Russian, Spanish, Vietnamese
http://www.kI2.wa.us/SpeciaIEd/pubdocsiPS .doc
("" " ,
Mission and Vision
6
MISSION AND VISION
MISSION
The goal of the Special Services Department is to ensure that each student with a disability learns in the
least restrictive environment and is provided an educational program that is reasonably calculated to
provide meaningful educational benefit.
VISION
I. Instructional programs and services will be tailored to individual student needs, driven
by on going data collection, and result in academic and functional learning.
Indicators:
• Professional development opportunities with a focus on instruction
• Evidence ofan increase in tire use ofdata collection systems
• High quality specially designed instruction
• Increased graduation rates
• Measure of Student Progress (MSP grade 3-8) High School Proficiency Exam
(HSPE), Portfolio (WAAS) score improvement
• Curriculum based assessments improvement
• State data, student indicators
Strategies/Plan of Action:
1. Professional Development - Special Education Professional Development calendar
2. Interface w/district initiatives - On time graduation, curriculum and alignment and
articulation of Sp. Ed. curriculum /assessrnent
3. Unique curriculum for Life Skills at all levels
4. WAAS Portfolio training at all levels
5. SECURE training for teachers and paraeducators
6. Preschool curriculum
II. All Special Services statT members are part of the same team. We will work collaboratively
to build systems and structures that support student learning.
Strategies/action plan:
I . Related services job alike meetings
2. PBS Teachers curriculumlinstructional strategies
2. Caseload committees - SLP and aT/pI's meeting with Special Services staff
3. Related Services leads meeting with Special Services staff and consult with certificated staff
on Issues
4. Preschool curriculum review
7
r" MISSION AND VISION
III. In order to better serve students our practices are guided by federal and state law.
Indicators:
• Reduced Due Process

• Reduced and/or successful mediations
• Safety Net - increase the total grant amount; increase total number of compliant
IEP's
• Random file reviews: decrease % of errors
Strategies!Action Plan
1. New IEP Forms

2. State Module Training
3. File review checks: random sampling
4. Special Services staff support IEP compliance
5. Special Services staff provide induction of new staff: rEP preparation and delivery
6. SEAS and Medicaid training
7. Streamline Medicaid paperwork
8. Staff survey
9. Staff handbook training
10. On-going IEP writing workshops
8
Special Education Toolkit
9
SPECIAL EDUCATION TOOLKIT
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Special Education Toolkit

Behavioral Interventions: Depending on the behavioral issue. Special Services staff, the school
counselor, or the school psychologist can all be of assistance. Some behaviors will be more specific
to one specialty or another. For example, if you need assistance with a student who has difficulty
making friends and acts out because of this, your school counselor would be the person to consult.
For a student with attention problems, the school psychologist could help. For a student that has
difficulty sitting or fidgets constantly, your occupational therapist. or student assistant team members
could help you devise strategies to assist your student.
Child Abuse Report Forms: Each school has a standard procedure for completing child abuse
report forms. Please check with yourprincipal to learn the building protocol. Thedistrict is required
to keep an archival history of all child abuse report forms. The special services office maintains that
history.
Classroom Supplies: Routine classroom supplies like paper, pencils, ink cartridges, are covered by
the schools. Special education teachers should receive classroom budget as any other teacher or
department within the building. The GOAL program and preschool assessment team receive their
supplies from special services.
$200 per Teacher Material Allowance: per section 9.14 Special Education Workload/Incentives:
"Psychologist, SLP, OT/PT and Classroom teachers in the Special Services department will be
reimbursed up to $200 annually from their school or Special Services department budget for the
purchases of classroom related supplies and materials." Classroom teachers access their budget from
the school secretary, and related service personnel receive reimbursement from Special Services.
Process for Reimbursement:

Intent: Materials are to support program instruction and should be used in that calendar school year.
Attach receipts or complete the Receipts Reimbursement Voucher which can be found online.
through the building secretary. or Donna Moran.
Curriculum Questions: The Special Services staff assigned to your school or program can assist
you with questions regarding the acquisition curriculum specific to special education. The building
principal can assist, as well as the curriculum department, with any general education curriculum
you require for your classroom .
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ESY Procedure: An administrator is assigned the responsibility for Extended School Year
programs. SEAS holds all forms required to document the need for ESY services. In early spring.
the times. dates and deadlines, as well as the administrator in charge will be communicated to all
special education staff via e-mail. If you are unsure of the process, or need assistance in making a
determination of ESY services for a student , please contact a Special Services administrator.
Evaluation: School psychologists can assist you with questions or concerns regarding the evaluation
of students for special education services.
File Information/Copies of student records: Special education confidential records are all housed
in the Special Services office. If you need a copy of a student IEP, or evaluation, please call or e-
mail the record secretary and she will send it to you. The tum around is very fast, and there is no
need for you to make a trip to Special Services to make copies.
Functional Behavior Assessments: The student's case manager in conjunction with the
psychologist assigned to your school can assist you with the development of a functional behavior
assessment (FBA). Please remember that the development of a FBA is a team process.
General Education Modifications for Special Education Students: Any issues with general
education teacher's failure to make necessary modifications should be brought to the attention of the
building administrator assigned to special education.
Home Bound Students: One of the secretaries in the Special Services office is in charge of securing
teachers to assist students on home bound status. They may be students who through accident or
illness need tutoring at horne. They could also be students with IEP's who have disciplinary actions
that have prevented them from attending school. When a .student is on home bound status, the tutor
works with the general education or special education teacher to provide lessons during the
exclusion. The teacher is also responsible for grading completed work, and for entering any credits
earned during the time the student is tutored.
fEP Questions: Beginning teachers will be given specific training in writing compliant !EP's. Any
teacher who has Safety Net eligible students will be notified of their Safety Net status and given
additional assistance to insure the IEP will meet all guidelines for Safety Net submission. If
questions or problems arise, even during an IEP meeting, please call for help. Workshops are
scheduled monthly to assist with IEP questions.
Legal Questions: If you have questions of a legal nature. please contact a Special Services director.
If you have an attorney attending an IEP meeting, contact the Special Services office immediately.
If an attorney shows up unexpectedly, please stop the meeting and contact your building principal or
the Special Services office for further direction.
II
Paraprofessional Assistance: If you believe you need additional assistance in your classroom,
please contact your school principal. The principal will contact the special services office if he or she
feels the classroom is not adequately staffed. In any case, the principal and special services will
assist in problem solving.
Paraprofessional Assignments to Programs: The Special Services directors will determine the
assignment of paraprofessionals to programs within a building. The SS directors work with the
building administrator in charge of special education and will provide the breakdown as to program
(Resource, PBS, etc.) FTE allocations. The build ing administrator in charge of special education will
work in conjunction with the department head and the teachers to determine individual classroom
assignments.
Paraprofessional Assignment within the Building: The principal works with the special education
teachers to determine the appropriate division of paraprofessional resources to each classroom. The
paraprofessionals are to be assigned to assist special education teachers with students or to assist
special education students who require extra help in general education classrooms. Special education
paraprofessionals shall not be assigned to general education classrooms to alleviate issues with
unequal distribution of special education students.
Procedural Questions: The Program Implementation Guide (PIG) should be used as your first
resource for procedural questions.
SEAS Assistance: SEAS is our web based software program for IEP and evaluation production , as
well as reporting functions. Penny Bravo can assist with any issues concerning the SEAS program.
She can assist you with computer issues or "work-a rounds" should there be a breakdown in the
network.
Teacher /Service Provider Caseload Assignments: The building administrator in charge of special
education and department leads work together with teachers to determine the division of students for
caseload assignments. When the assignment to a specific teacher is completed, the principal or
department lead contacts the Special Services office to align the caseloads for reporting.
Transportation Questions: Administrators within the Special Services office are available to assist
with questions concerning transportation issues for students.
Unhappy/Disgruntled Parents: Unhappy or disgruntled parents will always be a pan of the special
education world. Please do not bear the brunt alone. If you are having a problem with a parent or
family, please let your supervisor know so that they can provide you with some support. Your
special education administrator can assist as well with tips and strategies, and eventually a plan to
work with the family.
12
Roles and Responsibilities
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13
r" "
ROLES AND RESPONSIBILITIES
(P'
" DIRECTOR OF SPECIAL SERVICES
The director is responsible for overall leadership and management of special education services. This
includes the management of budgets, personnel, program and monitoring for compliance with state and
federal mandates.
SPECIAL SERVICES SPECIALIST

Special Services Specialists assist principals and teams with all aspects of special education for
elementary and secondary students.
SPECIAL EDUCATION TEACHERS

Special education teachers have the responsibility for supporting and monitoring all students who have
an individualized education program (IEP) and are assigned to them. They plan, manage, and teach
i~structional content and are responsible for writing lEP's for students. They are typically, the IEP case
manager. In addition, the special education teacher is responsible for follow up and evaluating or
monitoring the IEP goals and objectives. The special education teacher serves as a resource for other
teachers in the building.
SCHOOL PSYCHOLOGISTS
School psychologists provide support for teachers, support staff, administration, students and parents.
They are responsible for the evaluation of students who have special needs and work with IEP teams to
develop appropriate interventions.
r:
( SPEECHILANGUAGE PATHOLOGISTS (SLP)
SLPs work with students throughout the district to evaluate student needs and provide services in the
areas of language, articulation, voice and fluency.
EDUCATION AUDIOLOGIST
The educational audiologist is responsible for hearing screening throughout the district and provides
support to students who have hearing impairments.
GENERAL EDUCATION TEACHERS

The general education teacher is responsible for the progress of all students placed in his/her classroom.
The teacher may serve on building teams and collaborates with special education staff to develop and
implement interventions designed to meet the special needs of individual students.
VISION SPECIALIST
The Teacher of the Visually Impaired is a special education teacher who works with children who have
vision impairments and provides them with specially designed instruction, accommodations and
modifications.
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ROLES AND RESPONSIBILITIES
r DEAF AND HARD OF HEARING TEACHER

The Deaf and Hard of Hearing (DHH) Teacher works with teams and students who have substantial
hearing loss.
OCCUPATIONAL AND PHYSICAL THERAPISTS (OT/PT)

Occupational and physical therapists provide services to facilitate development of fine motor and gross
motor skills enabling students to gain benefit from their education program. They evaluate students and
develop and implement program interventions and make recommendations. OT/PT services may be
provided as a stand alone service if the child qualifies as orthopedic impaired.
SCHOOL NURSE
Nurses oversee health screening, wellness education. and compliance with all state laws pertaining to
school health and immunization standards. They are providers of medical services and are members of
evaluation groups as needed. They serve as liaison among school family. community and medical
practitioners.
15
Special Services
Contact Information
16
SPECIAL SERVICES CONTACT INFORMATION
r Special Services X 5250
Administrators
Executive Director Director
Kris McDowell Kim Durkin
X 5250 X 5256
Specialist, Elementary Programs Specialist, Secondary Programs

Karen De Jong Jan Bakken
X 5255 X 5272
Secretaries
Executive Assistant Administrative Assistant

Donna Moran Susie Halsey
X 5251 X 5257
Office Secretary Records Secretary (Record Requests)

Teny Brundage Vanessa Coile
("'" X 5254 X 5277
Student Records Secretary (North) Student Records Secretary (South)

Hyesook Johnson Jodie Moyer
X 5260 X 5261
Other Important Phone Numbers

Birth to 3 & Preschool Support Assistive Technology
Kelly Marks Barb Lark
X 5264 X 5484
System Analyst (SEAS) Special Services Registered Nurse

Penny Bravo Linda Gardner
X 5262 X 5273
Teacher of Visually Impaired Teacher for DHH

Terri Lang Patti Hall
X 5268 X 5918
Audiologist
Eileen Hensler
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X 5274
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. Elementarv Resource Room Teachers
Cedar Wood Jill Meyers 7782
Emerson Charlene Osborne 6274
Forest View Tara Anderson 7961
Garfield Joan Reichenberger 4746
Hawthorne Janea Trautmann 4644
Jackson Lani Walker 5679
Jefferson Elizabeth Klassen 7426
Lowell Doreen Khan-Calhoun 5335
Madison Cheryl Fernandez 5978
Mill Creek Katie Temple 6816
Monroe Diane O'Neill 7381
Penny Creek Glenna Dujenski 7256
Silver Firs Tara Anderson 6541
Jill Meyers 6541
Silver Lake Barbara Hauschel 6985
View Ridge Shauna Rowe 5461
Woodside Amber Stogsdill 7840
Diane O'Neil
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~ Elementary Extended Resource Room Teachers
\ Forest View Elizabeth Parks (I) 7958
Laurie Warren (P) 7900
Garfield Teresa Belles (I) 4724
Dolly Gay (P) 4752
Jefferson Rebecca Bjorgen (I) 7433
Stacy Clark (P) 7432
Silver Lake John DeBenedetti (I) 6900
Michelle Ulke (P) 6943
Elementary Life Skills Teachers

Mill Creek Debbie Frickey (1).",,-,,,,('<, ,)~,,J-,}848
Amanda Zech (P)Y.. r~ . ti'821
View Ridge April Weitkamp (I) <r 5462
Brenda Kelly (P) 5468
Elementarv PBS Teachers

Jackson Charlotte Cochran (I) 5671
Kate McDonald (P) 5680
Penny Creek Celeste Gates (I) 7258
Leah Kennedy (P) 7262
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Middle School Resource Room Teachers

Eisenhower Becky Kristiansen 7604
Maureen Hayden 7610
Evergreen Carmen Boggs 5815
Sherry Mickelson 5818
Kim Liebscher 5885
Gateway Lance Palmer 6791
Heatherwood Crystal Hill 6422
Marian Higa 6423
North Tammi Clugston 4937
Kim Fitzgerald 4938
Middle School Extended Resource Room Teachers

Eisenhower Joyce Watson 7605
Gateway Peggy Thesing 6731
Heatherwood David Bergeson 6425
North Kim Slavens 4933
Middle School Life Skills Teachers

Evergreen Dani Curtiss 5801
Carol Legowik-Zohn 5802
Gateway Teri Wright 6733
Middle School PBS Teachers

Eisenhower Joann Foster 7643
Evergreen Joe Coverson 5814
Heatherwood Mark Dalbeck 6430
North Deb Bodeau 4913
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r:. High School Resource Room Teachers
Cascade Kristy Brantner 6167
Tennielle Anderson 6187
Kari Anderson 6183
Debbie Gomes 6169
Everett Deidre Smith-Aikens 4523
Terry Norris 4513
Mary Jo Veneziani 4463
Trish Percival 4523
H.M. Jackson Michaelle Frank 7127
Kim Woodrum 7185
Steve Black 6473
Sequoia Maureen Malley 5167
High School Extended Resource Room Teachers

Cascade Jamie Jensen 6032
Everett Maryann Owens 4465
Terry Norris 4400
H.M. Jackson Emily Sisson 7061
~ High School Lif~ Sldll§ T~ach~n

. Everett Roschele Wagoner 4572
Gayle Anderson 4577
H.M. Jackson Doug Sohn 7124
Emily Glutting 7125
High School PBS Teachers

Cascade John Erickson 6102
Kip Brierly 6103
Everett Beth Watson-East 4578
Adita Matlock 4579
H.M. Jackson Jeff Weiss 7159
Debbie McMenamy 7157
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r Preschool Teachers
Cedar Wood Honey Niemann 7723
Kitty Welsh 7722
Emerson Nancy Hall 6221
Hawthorne Julie Bowers 4618
Debbie Halliday 4620
Lowell Pam Ozanne 5325
Diane Turnbull 5321
Silver Firs Diane Cressell-Lerner 6525
Connie Barnes 6526
View Ridge Erica Basile 5454
Pam Nodus 5455
Developmental Kindergarten Teachers

Silver Firs Holly Winters 6527
View Ridge Pat Demetruk 5452
Pam Nodus 5455
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BehaviorlDiscipline
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BEHAVIOR/DISCIPLINE
FBA/BIP
Functional Behavior Assessment and Behavior Intervention Plans
A functional behavior assessment (FBA) is a used to identify the function of student behavior and is
used in all special education programs to develop a behavior intervention plan (BlP). Any student who
has behavioral concerns that are interfering with their learning and it is identified on the IEP, must have
an FBAIBIP. After positive interventions have been used, data has been taken over time and it becomes
necessary for aversive interventions, then an aversive intervention plan must be added to the IEP before
any aversive interventions can be used.
A behavior intervention plan (BIP) is a plan, agreed upon by the lEP team that is added to the IEP that
describes how the student's environment will be altered and identifies positive behavioral strategies to
be used. It also identifies the skills that will be taught and the data collection to be used to evaluate and
monitor the student's progress.
Who completes the FBA and BJP (i.e. who calls tire meeting to get process started)?
The teacher is the IEP case manager, and should be the case manager for the FBA and BIP. Sometimes
the FBA is developed as part of the evaluation process; in that case the psychologist may take leadership
on the FBA. In any case it is essential that the student's teachers (and parents and at times the student)
provide input into the FBA and BIP.
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BEHAVIORIDISCIPLINE
r A versive In1erventions
Aversive intervention means the systematic use of stimuli or other treatment which a student is known to
find unpleasant for the purpose of discouraging undesirable behavior on the part of the student. WAC
392-172A-83120
What are some examples aversive interventions?

Anytime you remove a student to isolation. to a safe room. or you physically restrain them, is considered
an aversive intervention. An aversive intervention plan (AlP) must be developed, signed and in place
before you can isolate a student or restrain them and remove them to a safe room. The AlP must also
include the maximum duration of any isolation or restraint and the conditions under which the aversive
intervention is used.
Positive behavioral supports interventions must be attempted and described in the IEP prior to the
determination that the use of aversive intervention is a necessary part of the student's program.
Aversive interventions should only be used as a last resort and must be closely monitored and reviewed
every three months (WAC 392-172A-0313S). An Aversive Intervention Plan must be developed at the
IEP meeting which must include a school psychologist or other certificated employee who understands
the appropriate use of the aversive interventions
Aversive interventions which are prohibited are: (WAC-172A-03125)
• Withholding of food or liquids

• Electrical current
• Throwing, kicking, burning, or cutting a student
• Striking a student with a closed fist
• Shaking a student under the age of three
• Threatening a student with a deadly weapon
• Denying hygienic care
• Isolation except under specific conditions set up in the AlP
• Medication
• Noise - no student may be forced to listen to noise or sound that the student finds painful
• Noxious sprays
• Physical restraint except under the considerations set up in the AlP
• Taste treatment
• Water treatment
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A • • ,... _ _ ... . ,... . _ ~ ....._ . _ _ .... ......... _ .......... _ .... _ _ -. ............ ..- ..... _ _ ...... I ... J ... • .. ...,.., . . . . . . . . . . .,~ ..
BEHAVIOR/DISCIPLINE
Use of Safe Rooms (An Aversive Intervention)
Not all schools have safe rooms, but those that do must follow certain guidelines.
• Positive interventions must be attempted and described in the lEP (FBA/BJP) prior to the use of
aversive interventions
• No child may be placed in a safe room without an aversive intervention plan (ALP) which is
included in the IEP and the Prior Informed Consent of the child's parents/guardians.
• The IEP and ALP must establish when and how the parents/guardians are to be advised ofthe
instances in which their child requires the use of the safe room.
• The safe room may only be utilized by staff members who have been instructed in the procedures
of its use.
• Three times a year (September, January, and June) safe rooms will be reviewed by a Special
Services Administrator and signed off by the case manager (pg. 22)
• Safe rooms need to be monitored for use and physical conditions in order to provide sound and
effective interventions that result in the decreased need to use these facilities.
• Classroom teams should establish clear protocols about when, where, and how students are
directed to the safe room.
• Students need to know why they are going to the safe room and what is required of them to rejoin
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their classmates.
Set a time limit for the student to remain in the room to calm down and return to class without
endangering other students and staff. Staffmembers monitoring the room must decide whether
the student has composed him/herselfsufficiently to return to class with minimal risk to other
students/staff. Otherwise, the principal or designee must give written approval to keep the
student in the room for a longer period oftime. .
• Documentation must be completed on each use of the safe room that indicates:
o Name of student
o Date and time of the incident
o Length of time the student spent in isolation
o What re-entry activities were completed
o Other noteworthy details
• This data can serve as a useful tool to evaluate the successfulness of the isolation intervention.
During the use ofisolation in the safe room, the safety and dignity ofthe student must
be respected at all times. Students must be constantly monitored and all isolation
rooms must be in perfect working order. Any problems must be reported to the
maintenance department ofyour building and Special Sen/ices immediately.
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BEHA VIOR/DISCIPLINE
Everett Public Schools Safe Room Monitoring Checklist

To be reviewed three times per school year
School: _
Safe Room Location: _
Staff member responsible for monitoring the safe room: _
1st Review 2nd Review 3rd Review

Date Date Date
Staff
Is familiar with students' individual behavioral IEP
coals and Behavior Intervention Plan
AlP's (Aversive Intervention Plan) have been
reviewed (required 3 times in 9 months)
Procedure review of specific behavioral
instructions to the student that continued
engagement in the problem behavior will lead to a
safe room direction
Procedures for directing and/or escorts student to
the safe room
Procedures for monitoring student visually and
auditorilv at all times while in the safe room
Time Limits for safe room use have been
established and procedures for a time extension
include: building principal's signature and parent
notification
Staff members know the process for control of the
safe room door during the time it is occupied by a
student
Staff members know how to redirect student
effectively to de-escalate and complete behavioral
reauirements to exit the safe room
When student has calmed, staff knows to debrief
with studentand other staff members
Takes data on incident to indude: student name,
date, duration of safe room use and positive
behavior interventions used.
Safe Room
Is adeauate size for students usinQ it
Is clean
Is properly ventilated
Is properly lit with switch outside of room
-» , Is a comfortable temperature
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Has sturdy walls, ceiling, and door
Is free from protrusions
Has a door that closes snugly, must be held
closed from the outside and will open
automatically when no one is holding it
Has a window so student can be within staff
eyesight
Is in an area where student will not disturb others
Has a safety basketover the liqht inside the room
Trained Staff (Name/Titfe): Date: _
Trained Staff (Name/Title): Date: _
Trained Staff (Name/Title): Date: _
Certifying Administrator or Designee: _
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BEHAVIORIDISCIPLINE
Manifestation Determination
Within 10 school days of any decision to change the student's placement (i.e. removal for more that 10
consecutive school days or more than 10 total school days in a school year constitutes a pattern of
exclusion) the lEP team shall meet to determine:
• If the conduct in question was caused by or had a direct and substantial relationship to,
the student's disability, or
• If the conduct in question was the direct result ofa failure to implement the IEP.
WAC 392-1 72A-05145(5)
• Interim Alternative Educational Setting (IAES)
School district personnel may remove a student for up to 45 school days without regard to whether
misconduct is a manifestation of the disabil ity, in cases involving: (i) possession of a dangerous weapon;
(ii) knowing possession of illegal drugs or controlled substances; or (iii) infliction of serious bodily
injury upon another person while at school, on school premises, or at a school function. WAC 392-
172A-05145 (7)
Note: Serious bodily injury is not just fighting; it involves very serious, life long injuries to a student.
If the behavior for which the student is disciplined was a manifestation of their disability, an FBA and
( ' BIP must be conducted by the IEP team or if it has already been developed, it must be reviewed and
, modified as necessary, to address the behavior. If the team determines that the behavior was not a
manifestation of the student's disability, the FBA/BIP is not always required.
Reminder: The IEP team including the school psychologist must be present at the manifestation
meeting. If a student is out more than 10 days and at the meeting it is determined the placement will be
home tutoring for up to 45 days, a request for Home Tutor must be completed the same day. A copy of
the form can be found on the next page. The building administrator must sign the "Request for Home
Tutor" form and the home tutor coordinator at Special Services must be contacted by phone at
extension 5250 and follow up with sending in the completed form to Special Services.
,~
\
28
REMOVAL OF SPECIAL EDUCATION STUDENTS
A B C D E
-<II
I:
~
-=
'0
( Jj
Oldd may bepbad up to .. 5 H..nae hold",/1lJ 20 reb",,1 d~,'lI
-==
I: ..Lool da'tl IIIlAESdetenlll..... of ......... aruf dcdaIoa iuued
.2 lrr lEP IraaI ../In 10uhooI cbyo of haario&
WACJ9H1ZA" ....m 8 WACm ·II1A4SI6GlJIW 7
y
"Cl
~
-
·u=
Wllhln to .dtaal d"l'l' ",I."""t
mcmhcn of lEP
WAC19J.1_IUW
,.lIJftcoodutt
......u...._ dctumJ"",1oD
!
WllbilllO "h.ol aI'S, n:lmlll
me",bon of JEP IlWIlalllduct
mo"lfeotml.... deurmlmllo.
WACJ91.lnACSIUlJI 9
If b.orinS aff/oc.ocr•••• thdd
1'. ...01 10 aD oppmpriat.1AES
for up ,,, 45 oda....1 do,.
WACJ9I ·'nACSI_llIIl to
~
--
c.
(Jj
e If ......ll. .~don, ... u<t ...ndua If _aIfacadG". mull CDtldua

=
~
FllAlBIP prouu aruf mu",
dalLl to pnm..uopfaeemcDl
fllA/lIlP _ and rctlIrtI
drILl '" prnfoDi PIaocrEIIl
e uoI... dlada:uul p>ftftl ...... w.... 4S oby lAI!S) ODin.
S
~
10........ of Placemlll dlmlct """ parrll' acrce IG
WAC:m-lnMlJl41l61 11 chaap af ph,......"t
CI: WACJnmA~IUI61 if
'-l
--
Z
.J
Q.,
I\cmowl may p,ouod ..hl'DUI
any oducaJhmal ..",ku up I" 10
tom""",, ..hool "YO
\VACJU·172AGII4U4:1W 12
l\cll1owllDlll' proreool. bUI thlLl
ootltled '0 ..
",I... 01...........01
lrr ochoolcumuhlo. will. 1eU1o..
,.Cf1l' JlUn<XJIlll 13
U nat ...."Il.mlla". wild lOAy
be .....-, but 001,,1001 ,.
ICme .. dclOnttlard lrr IBP It ....
WACmm.UIHIUh.dCf.lO t4
If llollllAllllctlllll.1Io .hlld DlDV
be RIIIOft'd. ba caddcd 10
ICm... "'.umloed by lEP lram
WACJ91-1l2A4SIUW ,04 HJ(/) 14
l'raccdlll1l DlDV bo rep ••c.d If
dlant.. hell.... "lu,nlllC rblll!
II ouboloodallr 11kal, lD, .1.1"
Iojury ,. tbc cLUd 0
WACJIII-'l2A4SJ6l!l111d
n
15
u
v:
Q
~
- A "rI..."", of pl..."mll-Io (I) a ........at for ,ban 10coftNCUtlve.moot d4),,"
0. Ill. strlH af .. _.10 ....1...11111''''. a poUt... l:cc:uue"'cy I<rlIIf lDOn:"'" fOtchool d4)'lI1a ••drllO' 1C'f. hQUlo tho thild'.
b.hovlo. It .. milo. 10 pn:vlolllilldllen.. ",,01 boca of furon.ud. ... Ibo I.o;rb of eACb ..mow!. lb••0001."",ulI. of II..... ",,01 lb. PrIldaoilY ., tbc rcDll1wlllo on.....,"10••• WAC 39H nA05155.
n •• opdoDi pmmtcd ....... II&IW1U: thor .... dlolrlct
permllall:lo.
I. uublo 10 ohWlI .....01.. a=rccmcnl 10 a diaD" Df pia......".. Any .......w1 fru....... curreat placemea' .... od 10 lrr dI. mcmbcn of cho IEI' Cum 10
-><
0 la ""dltlaD lD.... opdo<Ia preHaecd ..... "oc ADy II-. rebool ofHdoIamay ..... co oln:alo "co,", cmIcrI" .......... a daIIdwlth a dbalrll/ty from.mool ... '0 daanp a chlld'l ca__ eduadow pIaa:mnt If ......
11.11.... "'or malalamlos lb. thUclia .he .....-r od....doaal ~laa .... Il'1o oular:uu1al1y IiRIv'" .aalllD 101,," '0 tho thUd or otIoon..64 Fed. Rq. 11415lMxd. 11, 19991.
() 2001 DIONNE&. RORIC~ All RlOI-m; RESERVED

:r: 8/14/01 BASED ON NEW STME REGUIATlONS DIONNE
t.IJ &RORICK
=
L c.
1 TIlls column is (or I he removal of II loss or im"''Ilnnenl of a bodill' functlon, review all relevant tnfonuaricn in the srudcms wlrhour disahlluies, except Ihar
special educatlon snulenr lor ten (J 0) organ or melllalli,clllt\'. studenr's ruo, Including lh. IEI', lilly the district II11UiI provide services which
cumulanveschool dny,; or less in the 5.1111e reacher Obse[\'lliions, mul any relevant enable rhe snuleut 10 l"llIicipnte ill the
5 This column is for rhc remova] of II
school \'ellr for ~ \oiolaliou of school rules. infonllluiun provided bl' Ihe parellll to general currlcuhun lind 10 plogress
slIIdenr 10 An Interim A hcrnnrive
deternune If: (n) rhe conduce was caused loward Ihe conls In ehe smdem's IEP,
2 Thls cohunn is for ,he removnl of n educanonn] seuh'll (AES) \\'h."
hy. or h:1l1 a dlfl~cr and sulwanriAI 111e chlld IIlllst also receive, as
specl:11 educatlon student lor more rlmn Illalnllllnlnll the (llnent placeiuenr of R
rel1rlonshlp 10, lit. child's disnl»liry; or appropri,1le, n FBA and behovioml
ren (10) etlllllllnlR'. schocl days in Ihe dliW is subslantinlly IikeJv 10 resull in
(1)) I( the conduct In quesrion IYIIS the lnrervennon senices lind modiflcarions,
same school Vl:lIr lur \'Iollllion of school Injnry to Ihe child or OIher6.
direct result of the r1isll!cr's f.1i1ulC 10 mar are designed to Address the behavior
niles when the remu\",1 docs not
6 all the same dAy lhat 11 decision ro implement the IEP. If either of these vlulntion so Ihnr lr does Ilot recur. School
constlrute II "dlllnge of placement," (See
rake dlsclplinllry action b Illude, the delenllillalinns is Illude, the conduct personnel III consulrarlon with a leasrcue
etollnirilln on tronr.]
districr mllsr nOlil\' the peresus of the mUll bedetermined 10be a m':lhifesllltiou of rhe child's teachers derennlne rhe
3 This column Is fnr the removal of a decision and prevlde the parents the of the child's dis.1bllfty. necc:ssal\' sen'lces and lite locadon of
special edueuten srudenr for more thnn procedural ssfegunrdsnotice. services.
ren (10) cumnlath'e school dill'S in the
10 If the henrlng oflkc{ derermlnes
7 If the LEA believes rh:1I lIlailllainlng Ih:1I Illainrnininn rhe l~hi"I's current 14 If 1111' cnnducr was not A
same school year for vtolnriou of school
n child's currenr placemeur Is plaremenr Is 6l1bslllnliull\' likely ro resulr manlfeslatlon of the child's dis.,hIlIIY. lhe
rules when the removnl :,Iso consnnues a
subslllnrially likely 10 resulr in Injury to In Illjury 10 the child or ethers, the student IIlny be subject to the same
"change of placement." (See deftnnton on
the child 01 others, rhe LEA mllY request hearing omcer mAy order 11 dumge of disciplinary consequences AS would be
trolll.)
an expedited due proc~'5.S hearing. TIle placelllelll 10 all npproprnue Interim applicable to smdenls Wilham dis.'Ibililies,
4 1111s column is for the n:mo\",1 of II hearing musr be held whh!n 20 school nlrcnlAtlvc eJIlL1uionni sellillg (AES) for except Ihal Ihe dimici must provlzle
sruclelll ro an Illlerllll ahemnlh 'e days of the reqllcsl nnd n decision Issued nOImore rI'AO 4; school dll\'S. serrtces wilieh enable ti,.
Slllrlclll 10
educalional serdng llAES) for misconduct by Ihe hcprlng omcer wilhln 10 schoul participate In Ihe Ileneralcurriculum And
al school or school funcclons Idating ro
11 If the conducr WA6 a tlllllll{esration of
d.1\'S of the hearing. ro progn:ss ro,,-ard Ihe gD.11s in Ihe
the child's dis;lbillry, .he IEP tealll IIlllS1
WCil\lOru, drugs or Quslng seriou. bodily slIldenr's IEP. 11le snldcnr IIIUst IIIsa
S 11le siudent IlIl1y br removed ro an ellher (lJ candllct a FBA nnd Implement
injlll)'. "Weapon" Is c1efined as a da1cc, recel"e, as approprlarc, a FDA and
IAES dCllmni"o:<! by rhe IEI' "'am lor up a BIP (or Ihe child: or (2) (C\'iew a BlP
irumuuenr, m.:uc:rial, or ,ubsllInce, beha\10ml Inren'l!nrion 5c:n'lces and
10 'IS school days. 11le dilrrier musr alrady in placeand lIlodifyii necessary 10
anlmaro or inanlmale, Ihal is used (or, or modifiClrlona, thaI are designed 10
pro\id. senoiees which enablc Ihe: 5111llenr address Ihe behavior. nle child mUSI be
is [(:adlly capable of. musing dl:llrll or nddress rho beha\ior \iolarion 50 thar II
10 palllclpal. In Ihe ccneml curriculum remme<! 10 the prn'lous placcment unless
serious bodily Injury, excepl tllnl dIe 101m does nOIrecur. The IEP 1Cl\1Il detennines
and to proglC$S toward the g0.11s In Ih. the dlsmcr and pan,nrs agree 10 A chanCC
docs nOI include: II \'ockel knife with a lhe necessary sen'lces and Ihe location of
slIIdent's IEI'. 11le stuclent 1IlllS1 Also of p1acetnclll as purl o( moollYlng rh.
blado of less rhan IWO and one·h.1If (2\.i) sen;cc s.
recei\'e, as apl>roprlale, a FBA nnd IlIP.
WJ
--
inches In lenglh. The drugs exception
~ applies when Ih. smdenr Imowlngly
behavloml Inrerventlon selYices and
12 The dlSlTlct does nOIhave 10 pro\'ide
15 If Ihe dlsTricr belia'l:S rhnt lClIInllng
modlficnrlons, thlll ~r. designed to II.e chill! '0 Ihe I>fL,\;OllS "lac...menr I.
...J poss.sses or u&c:s illegAl drugs, or sells or Any se[\·I~..s to a apecialedUCOriOIl studenr
Q.. addres.! Ih. helmvlor \'Iolallon SO Ih:" Ir &ub&lanrlally lil.ely ro result in injury ro
solicits the snle of II conlrollcil 61lbstRnce who has been remn\'ed 1T0m his or her
does nor r.cllr. 11le IEP tcalll deremrin.s the child or others, rhe .IiSllicllllny repear
whilc AI school or n school (unCIion. The current placemenl for lell (10) cUlllulati\'e
U
-
en
Q
C2
lenll "collllolled suhst:lIlc...• Includ.s
presctlptlon drullS; The rerm "illegal
drugs" doos nor. ·Serious bodily hljUry"
is d...l1ned as II bodily Injury which
dIe neceunry sen'lces. The lAES may
cOlllinue lip 10 4S school dAYS evon jf the
condllcr Is detmnlned 10 be a
ll1aul{esratlon of the child's dlsllbillty.
school .1;11'1 or less In the SlUlle school
year, as long as sef\'lces are not pro\'ided
10slIIdenlJwhhom .Iisnbillties.
rhe procedures I>y requesllng IInorher
cXI'"diled clue process henring.
o
-
;;>
~
lnvob·...s (a) s\lbSlnnlial risl: of denrh, (b)
exlt<mc ph\.. kal ",,,Ill, (c) pfOllaeted 01
ohviolls disfigurelllcllI, or ld) I>rOtracted
9 Wilhin 10 school da\'S of lTiggcrlllB
Ihls column, Ihe dlsrrlct, parenrs. and
rela'llnt melllbers of the IEP temn must
13 If Ihe relllovnl does nor corulhull: n
change of plm:emenr, rhe studellt lIlay be
subjecl 10 the smne disciplinary
conseqllences liS would be applicable to
:c
WJ
=
L L.
BEHAVIOR/DISCIPLINE
REQUEST FOR HOME TEACHER
Reason for requested service and needed documentation: Date Requested: _

( ) Medical (parent signature required and a doctor's note)
( ) Special Education Discipline (please attach a copy of the discipline form)
( ) Compensatory (Reason: Date: )
(Requires a Director's signature) _
) IEP Determined (requires medical, IEP and Director's signature)
STUDENT'S NAME SCHOOL _
REASON: ----------:----:---:-iI;--:--------:-------:--:--------
(If due to discipline, please note the date of the IOlh day of suspension/expulsion.) _
DISABILITY (if applicable). GRADE LEVEL. _
PARENT'S NAME _
ADDRESS _
HOME # WORK # CELL # _
r:
\ TUTORREQUE~EDBY: _
TUTORING BEGINNING DATE REQUESTED: _
TEACHER CONTACT AT THE SCHOOL: _

(This person must be willing to work with the tutor to assure that the tutor receives all assignments for
the student.)
NUMBER OF DAYS PROJECTED TO BE OUT:

Medical Special Ed (beyond 10 days) _
IEP Determined Compensatory _
OFFICE USE ONLY:

(Required packet complete Yes__ No_ _ If not complete date school notified -')
Number of hours per week assigned Number of weeks assigned _

(3.5 hours per week are provided for direct instruction to student)
NAME OF TUTOR ASSIGNED PHONE: _
BEGINNING DATE .ENDING DATE _
31
Child-Specific Orders
32
CHILD-SPECIFIC
CHILD-SPECIFIC EQUIPMENT RECOMMENDATION

DATE:
STUDENT 008: CA:
SCHOOL: TEACHER/GRADE:
EQUIPMENTffECHNOLOGY
RECOMMENDED:
PRODUCT INFORMATION/VENDOR/PRICE
LIST SHIPPING CHARGES:
r RATIONALE:
IEP TEAM MEMBERS' SIGNATURES
Teacher INTERVE/1mONIST
Teacher NURSE
SLP PSYCHOLOGIST
OT/PT PRINCIPAL
S8 RECOMMENDATION:
DIRECTOR'S SIGNATURE J>ATE, _
f '.PLEASE FORWARD THIS FORM TO: DONNA MORAN AT SPECIAL SERVICES
33
ELL
~I
34
ELL
~
r,
ELL Middle School Course Descriptions
Beginning ELL Reading:

This course introduces students to phonetic sounds of the English language and basic English grammar.
They will learn basic reading skills aligned with the EALRS.
Beginning ELL Language Arts:

Develop oral and written competence in understanding and generating simple sentences, questions and
commands. Develop basic vocabulary including common nouns and verbs. Scaffolded learning using
modified general education curriculum will be implemented as well as incorporating the Visions literacy
curriculum (intro level and level A).
Intermediate ELL Language Arts:

Students will work with level Band C Visions curriculum as well as general education curriculum with
the necessary scaffolding for this level. They will also learn the English language structures and forms
of writing.
Advanced ELL Language Arts:

The course parallels language arts content offered in general education. Scaffolding of materials will be
necessary at this level for success in general classes. Emphasis is placed on English language structures
r and forms of writing.
Beginning ELL History:

Students will get oriented to American classrooms. The class will focus on survival vocabulary, foods,
jobs, careers, local agencies, and community services. Students develop communication skills by
learning key vocabulary and sharing information about their countries. Students will be provided with
necessary information regarding course work and school expectations.
Intermediate ELL History:

th
The course parallels the 7 grade history courses that are offered in general education. The main area of
study will be Washington State History. Emphasis will be placed on developing the reading, writing and
study skills necessary to be successful in general education.
35
ELL
English Language Learners

Parent Questionnaire
Pre-referral Process
(interpreter should ask the questions and write down their responses)
I. What strengths do you notice developing in your child?
2. Which language did your child learn first?
3. How long have they been speaking, reading and writing your native language?
4. Which language is used by your child at home most frequently?
5. Which language do you use with your child most frequently?
6. Which language do adults use with each other most frequently?
7. How well does your child understand non-English speakers in the family?
8. Does he/she respond in English or native language?
9. Does your child have difficulties expressing himself/herself or being understood?
10. Does your child have difficulty explaining or describing things in the native language or
English?
11. Does your child follow directions at home?
12. Do you feel your child understands what he/she is told at home? Explain.
13. Does your child have difficulty paying attention for long periods of time at home? (playing
games, reading, etc)
14. Does your child have difficulty pronouncing words in your native language?
15. What does your child like about school?
36
ELL
(',....------------------------------,
Procedures for collecting information
1. Family history/information: Interview parents with an interpreter present (Use Parent questionnaire)
2. Collect the following Student information:

-Country of Origin
-US entry date
-School entry date
-WLPT II data for each year in WA
-Other assessment data
-Education in native country
-Student work samples
3. Documented time line of:

-ELL strategies (2-3/6 week of interventions with pre/post data)
-Differentiated Instruction
-Parent contacts/how often
4. Classroom Observations: (provide examples)

-Teacher
-Reading Specialist/other CST member
5. Contact ELL Facilitator/Categorical Programs:

-After following the above procedures and before the evaluation process begins please invite
Sue Dedrick or the ELL facilitator to the meeting.
37
ELL
r Questions to consider before referring a child who
is culturally and Jinguistically diverse:
• Is there evidence of identified developmental delays or disability (Cerebral palsy.

Hydrocephalus, Down syndrome)?
• Is the child having difficulty communicating effectively at home or in the cultural

community, compared to same-age peers?
• In comparison to peers who are also learning English, is the child failing to make
progress in learning English based on a variety of data?
• Is a language other than English used in the home/care giving environment?
• Is English also spoken in the home environment?
• What is the child's dominant language? Who uses English and the other language(s)
with the child, and how often are each used?
• What is the child's level of proficiency (receptive/expressive) in English and in their

home language?
• Does the child know how to read and write in their home language?
• Did the child attend a school in which their home language was taught or used? e.g.
Religious school, weekend school, cultural center
• Where was the child born?
or "
'.
38
~I
ESY
r:
39
ESY
Everett Public Schools
ESY Timeline
Due Date EXTEI\DED SCHOOL YEAR GUIDELINES Person Responsible
IEP Time Determine whether data demonstrates need for ESY IEPTcam
Services and document need under the ESY section of IEP
Before! After Document present level of performance on objectives Teachcr/scrvice

Extended before or after Winter break. Spring break. or other providers
school breaks extcndcabreakS-
--_.o;;--
April I IEP discussion about ESY recommendation IEP Team
• Share formative/summativc data that
supports recommendation
• Complete paperwork and have fEP members sign
o Copy goals and objectives (if appropriate)
And highlight those that need focus
o Indicate frequency ofOT/PT therapy needs
o Document equipment that needs to be transferred
o Doeument AAC equipment ne~d§
MAY I ESY paperwork is DUE in the 5S office rEP Coordinator

*One application form per student
June/Last day All staff recommending ESY services should IEP Coordinator
of school send instructional material that correlates with makes sure team members
recommended goals. AAC equipment (per AAC have complied
Coordinator approval) and adapt ive equipment to
55. marked: ESY
• Highlight:
o Name of student
o IEP Coordinator
o School where materials should be
returned
September File ESY paperwork in students file: Attach the IEP team members
Assurance Letter to the fEP who referred student to
ESY
40
ESY
ESY Definitions
Data Collection Any systematic method of documenting skill

levels related to IEP goals and objectives
Extended School ESY refers to special education and related services beyond
Year (ESY) the normal calendar school year for students with disabilities. The
determination of whether a child with a disability needs ESY services
must be made by the IEP team annually. ESY is a set of activities
designed to assure maintenance of the student's learning skills or
behavior, not the teaching of new skills or behaviors.
The IEP team determines the need for extended school year services
through analysis of regression, recoupment time, rate of progress, and
emerging skills with evidence to support the need.
Emerging Skills Few, if any, gains are made during the regular school year. Skill is in the
process of emerging when they are at beginning levels of mastery.
Interruption Any extended break in the instructional period
(*'. Learned SkJJls Levels of achievement that have been acquired and that can be
demonstrated through informal or formal assessment
Maintain To remain at a certain level of functioning
Post-Break Skill Level measured immediately after the

Level interruption in the instructional period
Pre-Break Skill Level measured immediately before the

Level interruption of the instructional period
Recoupment The recovery of skills or behaviors to a level demonstrated before

interruption of services specified on the IEP
Regression A significant loss of skills or behaviors if educational services are

interrupted in any area specified on the IEP
Reference Chart for Average Recoupment

Source: Peoria Unified School District #11
Length of Break Average Recoup Time
11-12 week summer break 20-30 instructional days/ 6 weeks
2 week winter break 3-4 instructional days
41
Extended School Year Services (ESY) Referral Form
Special Services
.
Les:al Name of Student Student to Date or Birth

School Current Classroom - - - - - JEP Coordinator
--------
Parcnt(s)/Guardian _
Address _ - _
City/State/Zip _
'Criteria
Yes No
I. Did the stud ent experience regression. meaning loss of skills or behaviors. when
services were interrupted? (e.g. over school breaks. hospitalization. etc.) LJ LI
2. Did the student recoup/recover skills or behavior to the level demonstrated LI Cl
before interruption of services specified on the IEP?
3. Do you have evidence to show that the rate of progress impacted the student's LJ CJ
ability to meet goals and objectives?
Decision
Based on consideration of the following documentation, the IEP team recommends this
student receive ESY services in the following areas:
o SLP
o OT/PT Frequency times/week
LJ Reading
LJ Math
o Written Language
o Vision
o Hearing
o Behavior
Student goal and objective pages are attachedfor each recommended area: Yes No
Student Health Plan is attached (pg.2): o CJ
Building Administrator Date Name/Position Date
Name/Preschool Date Name/Position Date
42
* Submit one application/arm per student
ESY

Health Services
Updated Health History for Extended School Year (ESY)
Date: _
Student Name: 008: -:-:-:____ StudenllD _
School: School Year: Grade : _
ParenUGuardian : Phone #: Alternative #
Licensed Health Care Provider: Phone: ----=:---- ------
_
Dear Parent/Guardian:
Please update your childs current medical history for their ESY summer school program:
Diagnosis/Syndrome: _
Are there any special accommodations that should be considered?
Current medlcatlonsfTreatmens: (*Please Included Licensed Health Care Provider order If

medication/treatment will be administered during summer school. The current school year form Is
adequate as long as there are no changes for the summer)
RN
Comments _
Parent/Guardian Comments:
•Any medication taken al school requires an aUlhorization signed by Licensed Heallh Care Provider and Parent/Guardian. This form is
available in the school's Health Room or office .
·Slate law (RCW 28.A.21 0.260) requires written permiss ion from a licensed heallh caro
professional prescribing within the scope of hislher prescriptive authorily prior to any
prescription or over the counter medication may be dispensed al school. The required form is
available from the school office or health center.
"ute sav ing medication for life threatening conditions such as severe aUerglc reactions and diabetes are required to have a licensed
heallh care provider's ortler, care plan, and the medications prior 10 altending school.
··State law (WAC 392.380-045) requires that PRIOR 10 attendance at school, the
parent/guardian of each child with a Iife-threlltening health cnndition including. but not
limiled to: diabetes, life threatening allergies (food, insect stings, ate.) ana severe
asthma. present both medication and treatment order(s) addressing the condition(s) to
the school each school year prior to aUending.
RN SignatureJdate Parent/Guardian SignaturoJDate
43
ESY
ESY Assurance Letter

Special Services
202 Alder St. Everett, WA 98203
Extended School Year 20
Date - - - - - - - -
To the Parent(s)/Guardian(s) of _
Your child received Extended School Year services at over the summer of 20
The ESY personnel who provided the services and the facilitator of the ESY site have signed below
indicating provision of the services identified on the ESY form when your child was in attendance.
Days Present: _ Days Absent: _
If you have any questions, you may call your child's school when school reconvenes in the fall, or
C Special Services attention at
Sincerely,
Name/Title Name/Title
Name/Title ESY Facilitator
• Copy to: Parent, Special Services, IEP team, ESY Facilitator

• To be attached to IEP at the conclusion ofESY services
44
Evaluations and
Eligibility
~
\
"
45
~ EVALUATION AND ELIGIBILITY
~
These are answers to frequently asked questions:
Professional judgment - okay or not, if so when? ,

As with the past WACs, professional judgment is acceptable in rare cases where (a) properly validated
tests are not available, or (b) for SLD eligibility, in cases where the evaluation results do not appear to
accurately represent the student's intellectual and academic abilities. Ifyo II are considering qualifyillg
a student using professionaljudgment, you must contact Special Services (SS) well in advance oftile
evaluation meeting.
Iftire special education teacher lias good data on tire student's current level ofperformance, are we
obligated to administer standardized tests in each area ofdisability? Most re-evaluation's should not
be mere file reviews. The IEP team can determine what additional information is needed for each re-
evaluation.
*Remember, that the purpose of the re-evaluation is to (a) establish continued eligibility in each area
using the three-prong test: tire student (1) has a disability which (2) results in a significant adverse
educational impact, such that (3) the student requires specially designed instruction.
(b) provide present levels in each area
Does a re-evaluation have to be done if there will be a significant change in placement, program, or
SCilOOi?
Yes, it there is a significant change in minutes or a move to a more restrictive environment, a re-
evaluation will be needed. lfthe change is insignificant (e.g. a change of 225 mpw to 250 mpw), a re-
evaluation would not be expected. A Prior Written Notice (previously known as Notice of Action) and
an IEP revision would be sufficient in this example.
How does tire inability to contact biological parents impact the timeline ofan evaluation?
Regarding the obligation to attempt to locate biological parents of foster children for consent for initial
evaluations: Once the team has made a decision to assess, they will seek the biological parent's consent.
If they have documented reasonable and multiple attempts to obtain consent, they can move on to
seeking consent from the state-appointed guardian. Remember that after you notify the family of a
decision to assess, you will not actually start the evaluation time clock until you receive consent.
r-
\
46
EVALUATIONS AND ELIGIBILITY
REEV ALUATIONS or EVALUATION AMENDMENTS

(1-
1 ------ -------------------
IDEA regulations: §300.300 through §300.311

Washington Administrative Codes: WACs 392-172A-03005 through 392-172A-03080
OSPI's Technical Assistance Paper (TAP) 5: Questions about Initial Evaluations and Reevaluations
Reevaluations are conducted at least once every three years. Reevaluations are conducted in order to
determine:
I. Whether a student continues to be eligible for the special education and related services listed
in the IEP,
2. Whether the student is eligible in an area for which he or she is not currently receiving
services,
3. The student's current level of educational functioning, and
4. Whether changes should be made to the student's educational program (significant changes in
levels or types of services or changes to more or less restrictive educational settings).
The reevaluation must look at all relevant areas of student functioning. The district's current evaluation
needs to address all areas of a student's disability and contain present levels of performance in all
eligibility areas, in order to meet the standards for evaluations identified in the federal and state
regulations.
~ While the state discourages districts from frequently amending evaluations, there are some situations in
\
. which it advisable to amend the evaluation rather than conduct a whole new one. These include:
1. The evaluation was recently completed (roughly within the last year) and the team has received
new information (e.g . a report from a private provider or independent evaluator).
2. The evaluation was recently completed and the team has decided to gather new information
(for example, when considering either a significant change of placement or a change in the
types or levels of service).
The value ofan evaluation amendment over a reevaluation that only looks at one or two areas of
student functioning is that it does not reset tire triennial evaluation time clock. Therefore the district
always has a standing evaluation that looks at all relevant areas of student functioning.
ANY EVALUATION WHICH RESETS THE TRIENNIAL EVALUATION TIMELINE MUST

ADDRESS ALL AREAS OF FUNCTIONING FOR WHICH THE STUDENT IS RECEIVING
SERVICE PLUS ANY AREAS ABOUT WHICH CONCERNS HAVE BEEN RAISED.
47
A few simple guidelines for the use of evaluation amendments:
• Only amend an evaluation that is relatively recent. If the next triennial evaluation is due within
12 months or so it might make more sense to conduct a fuJI reevaluation.
• When conducting a re-evaluation in order to consider adding or deleting a service, be sure to
address not only the domain in question but any related areas as well.
• If there has already been one amendment to a given evaluation or reevaluation. consider
conducting a full reevaluation rather than doing a second amendment.
• The whole lEP team should be involved in considering an evaluation amendment; the discussion
should not be limited to those directly involved with the service area in question.
• Do not use the evaluation amendment to change disability category. You must use tile full
evaluation process to (1) change a student's disabilitJ' category, (2) exit Q student completely
from special education, or (3) make a student eligible for special education if they are not
currently eligible (even if they have been eligible in the past).
As with any evaluation, it is up to the IEP team to determine what constitutes the evaluation (or
evaluation amendment). It is not a requirement to administer new testing as part of the evaluation if
other appropriate. valid, reliable, and robust data is available for consideration. Remember that you
cannot qualify students for services or exit students from services based on curriculum-based measures,
tests normed against the population of a given school, or the student passing or failing to pass state or
district mandated tests . However, these tests should be used when considering adverse educational
r' impact.
When adding or deleting services the team is still required to use the WA C guidelines for establishing
eligibility: The team must use the three-prong test to determine if, in the given area, tile student (1)
has a disability which (2) results ill Q significant adverse educational impact, such that (3) the student
requires specially designed instruction.
When amending an evaluation, use all of the paperwork that would normally accompany an evaluation:
• Invitation to Attend a Meeting
• Evaluation and Re-evaluation Plan and Consent
• Individual Documentation of Assessment Results
• Evaluation Amendment Report
• Prior Written Notice (previously known as Notice of Action)
As with any evaluation. the amendment of an evaluation will trigger an IEP team meeting to consider
the new information and determine if changes to the IEP are necessary. This meeting does not have to
be a separate meeting as long as the whole IEP team is present. the team follows the established process
for an IEP meeting, and any required IEP paperwork is completed.
48
PRE-REFERRAL INTERVENTION, REFERRAL. AND EVALUATION PROCESSES
GENERAL EDUCATION SPECIAL EDUCATION
Pre-Referral I Intervention Referral Evaluation
llmeline Oepands lltIlheptanle ollhe s1udefll,lhe natule 01 25scl1Dol d8fS from dale ofreleIra!lo Decision toAssess (as 35scilotlI dayslrom dalepatents ptovfde ccnsenllo evalualelo
llle COllalms and Illenalure 01 lite InleM!ll1/olls dOClllll8l1ted bY aNoIfce 01 AcIIonI IIIedate litewriUen evaluatloo rellim Iscomll!eled and sIlIned
PloceSSes and • Delermlne lIIenalure 01100 concern; express in • Document rea:ipt 01 signed consenl toevaluale (date s1amp ar
Piocedutes terms orobslllYable measurable bellavlClS t For K·12 sludenl5. psychologisl provides Iliareferla!!oml write dale ofreceipt)
• Devise an lntlllYentlon(s) toaddress lIiebehav1ors. tolhoreferring parl1 (ohen thegl!l1lllal edlilaclter or • Galher quanlilalive and qualftiilive Inrormalion ahoullhe
• Collect data on !hesuccess ofIhe inlervenlion counselor) who completes and relums 10 schcol slude1llhraugh obslllYation, anecdotal records, dassroam
• 11 the firsllnlerVenlion is unsua:esslul, try atleasl psychologist. data, and norm-relerenced siandllldized lesls
IV,ll OIhers rorreasonable periods ofl!me, t The 2S school day time6ne begins when the relenalls • All evalualors prepare individual dDcumenlallon orresults
Cll!Illdingdata made orwilen tile psychc!oglsl receives the signed and • The case manager prepa1es anevalua1lan reporl wI1ich
• Try Ihe lnlemmlim fur alelISllIIilble I18'icd urtime dated referral eddresses e/lgiriIily and ~1ilIlUI1lng rel:DII1l1lenda
(46weeksl t Parents aleprovided anelice 01 relemJ andNaIIr:s of
Procedural Safeguatds
• Dalals cotleded rrom individuals lamHlar ~';Ih tho sludefll
Schoolpm-reIerralpmcesses have If VlllieJyof (signed Mulual Exchallges are required 10 oblain dala from
names, such 85 SIT (Studenl IntervenUon Telllll), non·schooI provldm)
SAT(School Assls/BIICII Tlfam), FOe (Focvs of
Qmcem~ RTI (Response faInteMltllion), etc.
Tearn DecIsion • A !earn meelIng isconvened iodetermine If • AIll/erral review meeling Is heldduring which a • A mul~.Qsdp&naJY learn Onduclfng parents) meets IOcflscuss
fnlervenUons, accommodatlans and modifications mullldlsclp9r1ary l8am(lIlcluding parents) delennInes Ihe evalua!lon reports anddelermine whetllBr Ihe studeJll
are SIlc:ces&lul. IIlnlelVentlons have not been whelher lheIe isreason 10 suspeclll1a1 adlsabifity Is qualifies asastudent willi adlsab!Iil1 acccrding tolhoWA~
sua:esslullttestudenl may bere/erred for sJll!dal prosent and evaIuaIion iswarranted byasking:
~llon evaluation • Parents are notified viaNolice 01 Action oIll1e district's J Does lheSIUdenI meet e/lgIbl51y CllIelIa lorone rJIhi
declsIon 10 l!'JaJuale orIlllIevaJuale !he sludent 14 W".C cbablltycalegories?
• IrthO leam deddesID evatuae, anevalualion plan Is 2 Do!!s lIle dIsaI;ffity adwersely Impadeduca1IllnGI
deve/Qped wi1h the parenJs' input arod Ihe parenls are performance?
asked 10 ll'oYide wrillen COIlSenllO evaluate 3 Does !he studen1 require specially designed
inslM:lIon kI Older toIeam Inschool
If /he prB-f8ferraJ inlerveIllion (IIOteSS has resuRed inrobusl dallf (egBll1ing fhlJ success ofpre-refetraI i1118IVBlItions, • Allpill1les villll part!cipaleln Ihe developmon1 DIllie evahratlun
/he "We" 01dais /hal isIhlffinal step in/he pnHlffertal PlllCllSS ClI/lbeIhssame tBView lhat is IhlffimIi slep inIha andagree willi irsconduslons sign and dale Ihe wrIUen report
(lJ{emIIPIOtIISS. /Iis noIll!!alSSaI}' to have /Iva sepelile meetings if UIe ptlHefemll inIl11W11fion fIIO"SS resul/s In • Myparly whodisasrees wilh allorpalloIlhe evaJualion may
lJdequale infamralion 011 whlth 10 base a Dec/sian 10Assess. wri1e aolSSelltlng cplnllln 10 beallached 10 lIIeevaluallun
• Parents are lIIovlded wilh aClIPY ollhereport andaNllllca 01
AdIan relledilllleva!ualian findinas
Talgel Sludenls who struggle with academic, social, Students wlll1 clear and signiflClll1l disabilities, &data from Vlell- Sludenls forwham Iherols reason 10 believe adlsabifdy exislS
Sludenls Ofo!hel luncUonal sknJs wllo ma1,easanali1 execuled Inlerventions have no! been successful, should be broughl lhaladversely Impa<;ts educallanalller!OImance and necessltales
be successful Ingeneral education dasses toleam Immedlalel1. specially deslgned lns\IUClion
(wlUI orwlthOlll atlXlI1Imodatlons,
mollincallons, CI specially designed
InsllUctionl
l. l.
Handicap Codes
01 DEVELOPMENTAL DELAY
02 EMOTIONAL BEHAVIORAL DISABLED
03 ORTHOPEDIC IMPAIRMENTS
04 HEALTH IMPAIRED
05 SPECIFIC LEARNING DISABILITY
06 MR -MILD/MODERATE/SEVERE
07 MULTIPLE DISABILITIES
r 08 DEAFNESS
09 HEARING IMPAIRMENT
10 VISUAL IMPAIRMENT
11 DEAF-BLINDNESS
12 COMMUNICATION DISORDERS
13 AUTISM
14 TRAUMATIC BRAIN INJURY
50
Process for Placement for Transfer Students Within and Out of District
I. The neighborhood school registers students and requests records. The school psychologist
secures and reviews special education records.
2. If it appears that services (primarily SLP, RR, OT/PT) can be provided at the neighborhood
school, the current team members meet to determine the appropriateness of the sending schools
evaluation and IEP. The IEP and evaluation may be accepted, revised or rewritten. This is
accompanied by a Prior Written Notice (previously known as Notice ofAction).
3. For students in need of self-contained programs (these are District programs even if they are
located at the neighborhood school, including developmental preschool), please contact Special
Services.
4. When placement has been verified, the Director will send an email to both teams including the
principals and psychologists. The psychologist of the sending school will contact the school
psychologist of the receiving program to exchange information and arrange a placement meeting.
No placement meeting is needed if a student moves in during the summer.
5. The sending school psychologist is responsible for completing and submitting the required
paperwork which would include:
a. Verification of Out of District Eligibility with all necessary special education records
attached
b. Medicaid Eligibility Verification
c. Authorization/or Release ofRecords (if used)
d. Prior WrittenNotice (previously known as Notice ofAction)
e. IEP or IEP revision (ifneeded)
.f Invitation to Attend the Meeting (if needed)
af
g. Evaluation Amendment needed)
6. When a student transfers from another district, the psychologist must send in the original sign-
off paper work, immediately, so that Special Services can add the new student to caseload and
start serving them without delay.
51
Use of Professional Judgment to Find Students Eligible for Special Education
Professional judgment to qualify students for special education should be used sparingly and can only be
used under specific circumstances.
Professional judgment is noted in WAC 392-172A-03020 with the following reference "if properly
validated tests are unavailable, each member of the group shall use professional judgment to
determine eligibility based on other evidence of the existence of a disability and need for special
education." This must be documented in the evaluation report.
Professional judgment is also noted in the WAC's section concerning procedures for identifying
students with Specific Learning Disabilities. WAC3 92-172A-03070 (2), states "Where the evaluation
results do not appear to accurately represent the student intellectual ability or where the
discrepancy between the student's intellectual ability and the academic achievement does not
appear to be accurate upon application of the discrepancy tables, the evaluation group, may apply
professional judgment in order to determine the presence of a specific learning disability. Data obtained
from formal assessments, reviewing of existing data, assessments of student progress. observation of the
student, and information gathered from all other evaluation processes for the student being identified for
a specific learning disability must be used when applying professional judgment to determine if a severe
discrepancy exists."
( ' " . . ...the group shall document in a written narrative an explanation as to why the student has a severe
. discrepancy. including a description of all data used to make the determination through the use of
professional judgment."
Remember that the evaluation process is intended to establish eligibility according to the WACs; it is not
about getting a child extra help or pleasing a particular member of the school team. Scores from the
WASL, now called the Measurement of Student Progress (MSP). or High School Proficiency Exam
(HSPE) or other District mandated tests are part of the evaluation data but not the sole reason to qualify
a student for special education services. A past history of special education is not a reason to continue in
special education.
Professional judgment should only be used when the multi-disciplinary evaluation team has compelling
evidence that the student should qualify for special education because the student has a disability which
creates a significant adverse educational impact, such that specially designed instruction is required
(accommodations and modifications alone have been proven to be inadequate to assure the student's
progress in the general education curriculum).
If an)' member ofa multidisciplinary evaluation team is considering using professional judgment to
qualify a student for SDI in any area, they 1II11St contact appropriate staffat Special Services, well in
advance ofthe evaluation meeting.
52
W A State Adopted SLD Procedures
WAC 392-1 72A-03045

• Districts must develop procedures for the identification of SLO which may include:
o A severe discrepancy between intellectual ability and achievement: or
o A process based on a student's response to scientific, research-based intervention; or
o A combination of both
*Everett will continue to use severe discrepancy.
WAC 392-172A-03055
• Adds reading fluency skills to the areas in which students may have SLO.
• Adds limited English proficiency to the factors that must be ruled out when determining
whether a student has SLD .
• Requires that the evaluation team ensure underachievement, shown by a student suspected of
having SLD, is not due to lack of appropriate instruction in math or reading and consider:
*Data that demonstrate that prior to, or as part of, the referral process the student was provided
appropriate instruction in general education setting, delivered by qualified personnel;
*Data based documentation of repeated assessments of achievement at reasonable intervals,
reflecting formal assessment of student progress during instruction.
r:
. WAC 392-172A-03055(3)
The group determines its findings are not primarily the result of:
-A visual, hearing, or motor disability;
-Mental retardation ;
-Emotional disturbance;
-Cultural factors;
-Environmental or economic disadvantage; or
-Limited English proficiency.
SLD Determination - Observations
WAC 392-172A-03075
Districts must ensure that:
The student is observed in student's learning environment, including the general education
setting, to document academic performance and behavior in the area of difficulty.
53
Use of the Developmentally Delayed Eligibility Category
In general. it is best to give a child a disability category other than developmentally delayed ifthere is
evidence of'another disability. Best practice is to use DD sparingly as an initial category/or grades
K-3 students.
Per WAC 392-17A-OI035

1. The term "developmentally delayed" means a student between age three to eight who demonstrate
a delay on a standardized norm reference test, that includes :
a. Two standard deviations below the mean in one or more of the five developmental areas
(cognitive, communication, physical, social/ emotional or adaptive development) or
b. One and one half standard deviations below the mean in two or more of the five
developmental areas or
2. In making eligibility decisions teams need to remember that students must meet all 3 of the
criteria....
I. Is there a disability? Use norm reference tests and WAC guidelines to determine if there is
a disability.
2. Adverse educational impact - Does the disability effect learning at this time, this can't be
speculative. There needs to be evidence that the student has failed to learn in this area because
,. .. .. ..... . .. .. . . . . . ..... . -
of the disability . Has the student been instructed in this area?
3. In need of specially designed instruction - The student needs specially designed
instruction that is different in content methodology and/ or delivery from what is available in
the general ed. setting and the accommodations or modifications are insufficient to address
learning needs. This cannot be speculative. What is the evidence that general education has
failed?
3. School Districts using the category "developmentally delayed" for students three to eight may also
use any other eligibility category.
4. Students who qualify under the developmentally delayed category must be reevaluated before age
nine and determined eligible for services under one of the other eligibility categories.
5. Life skills students may have Developmental Delayed (DO) eligibility with pre-academic goals.
Teams must evaluate to determine whether the student requires specially designed instruction in reading.
written expression, and/or math.
• Consider the three prongs of the three prong test. You need to establish that there is not only a
disability, but an adverse educational impact and need for specially designed instruction in the
area(s) of reading, writing, and/or math.
• A severe discrepancy need not be established for students below first grade as the diagnostic
tests and discrepancy tables are only designed for students with specific learning disabilities in
Grades 1 and above.
54
EV ALVATIONS AND ELIGIBILITY
• Teams may choose to evaluate reading, writing, or math to determine eligibility for preschool
students with significant language delays or other factors which may lead to academic delays.
Areas of developmental delay - Definitions. The five developmental areas for the purpose of applying
eligibility criteria to developmentally delayed children are:
I. Cognitive development: Comprehending. remembering. and making sense out of one's

experience. Cognitive ability is the ability to think and is often thought in terms of
intelligence;
2. Communication development: The ability to effectively use or understand age- appropriate

language including vocabulary, grammar, and speech sounds;
3. Physical development: Fine and/or gross motor skills requiring precise, coordinated. use of
small muscles and/or motor skills used for body control such as standing, walking, balance,
and climbing;
4. Social or emotional development: The ability to develop and maintain functional

interpersonal relationships and to exhibit age appropriate social and emotional behaviors; and
5. Adaptive development: The ability to develop and exhibit a~e appropriate self-help skills ?
including independent feeding, toileting, personal hygiene and dressing skills.
55
Graduation
56
GRADUATION
Changing the Graduation Date
During the lEP cycle that a special education student turns 16 (or more specifically, the lEP when the
student is 15 years old), the IEP team may change the student's graduation date to a projected year that
is beyond their first four years of attending high school. Special education students have the right to
complete their credits, graduation requirements, or if they are cognitive delayed, they may continue with
transition goals until they age out of the public school system at the age of21.
Please follow the following procedure for letting the registrar know about any changes in graduation
dates:
Bring the Projected Graduation Date Form ( on the next page) to the 15 year old student's IEP meeting,
consult with the team, and if there are any changes, fill out the form and give it to the building
administrator or designee at the meeting. The administrator or a designee will give the form to the
registrar who will change the graduation date in the district data base. Remember: this can only be
th
done before the student's 16 birthday for an official change on the transcript! If you make
adjustments after the 16th birthday, it will only be reflected on the IEP and not on the school records.
*When a graduation date has been changed, it then means the graduation is IEP determined.
18-21 Year Old Programs:
GOAL: Gaining Ownership ofAdult Lives: Designed to be a link between high school and adult life.
GOAL provides a sequence of school based experiences and training to assist a trainee with special
needs to become more self-reliant and independent. GOAL is located at Cascade High School
STRIVE: Students Transitioning Responsibly into Vocational Experiences: For students in the life
skills program transitioning from high school to adult life. STRIVE provides a sequence of school based
vocational experiences and training for life skills students. STRIVE is located at HM Jackson High
School and Everett High School.
57
GRADUATION
Special Services Revised Graduation Date Form
(For high school {EPs only when the student is age 15 or younger)
During the IEP cycle that a special education student turns 16 (or more specifically, the lEP when the
student is 15 years old), the IEP team may revise the student's graduation date to a projected year that is
beyond their first four years attending high school. Special education students have the right to complete
their credits, graduation requirements. or continue with transition goals (cognitively delayed students)
until they age out of the public school system at the age of 21.
Since this revised graduation date can only be used for on time graduation purposes before the student
turns 16 years old, IEP teams need to consider this extension in the secondary transition plan no later
than this rEP cycle. If the student is not meeting their credits or has significant cognitive delays, be sure
that your team considers extending this date. The student can always graduate earlier than the revised
date but the date cannot be extended for on time graduation purposes after this IE? cycle.
Secondary Special Education Teacher,

Please fill out the information below if the IEP team determined that a revised (projected,
extended, or anticipated) graduation date is necessary during this IEP cycle. Please give
the form to your administrator for their authorization.
Student
Name
Original
Graduation Date
Revised
Graduation Date
Administrator Date
Signature
High School Administrator,
This form has been developed for on time graduation purposes and will be authorized for
use by your registrar when you have signed off following the IEP meeting.
High School Registrar,

The "revised graduation date" listed above extends this student's graduation year beyond
their fourth year in high school. The signature of the administrator authorizes you to
change the student's graduation year to the revised date.
(*Graduation requirements are based on the student's first year of high school)
* Form on SEAS: Revised Graduation Date Form
Original to registrar/cum file
Copy to 55
Copy to school sped file
58
GRADUATION
Graduation, Walking and IEP Students

"Kevin's Law"
A question has arisen about special education students' participation in commencement exercises. Here
is the text from a summary ofESHB 1050, also known as Kevin 's Law, which provides for students
with IEPs to participate in commencement activities even if one or more graduation requirement is
pending.
By September 1,2007 students receiving special education services who have IEPs providing for
special education or related services beyond the fourth year of high school and who have
attended fOUT years of high school must be allowed to participate in commencement exercise
with their graduating class.
A student's participation in commencement exercises must not affect the student's future ability
to receive a high school diploma, a certificate of individual achievement, or a certificate of
academic achievement.
Beginning July 1,2007, school districts must have policies and procedures that permit students
receiving special education services under an IEP to participate in a graduation ceremony and
receive a certificate of attendance. Participating in a graduation ceremony does not entitle a
student to a high school diploma or a certificate of individual achievement.
59
GRADUATIO~
Graduation Requirements and IEP Determined Graduation
Students at Everett Public High Schools can earn 6.0 credits per year. The school year is divided into
two semesters with six classes being offered daily, each earning 0.5 credit per semester. A total of22
credits are required to receive a high school diploma. Online HS classes may be incorporated into the
school day. or for a fee be taken to gain more than 6 credits during the school year, as an adjunct to the
student's schedule.
Graduation requirements:
Subject Area Credits
English 3.5
World History 1.0
US History 1.0
Washington State History .5 (or other SS if this was met in high school)
Government .5
Math 3.0
Science 2.0
Physical Education. 1.5
Health. 0.5
Fine &. Performing Arts Lo
Career and Technical Education (CTE) 1.0
Culminating Exhibition 0.5
Electives 6.5
TOTAL . 22.0
* If continuing on to 4-year College, students should earn 24 credits which include three credits of
science, and two years of world language.
In addition to course requirements, students must also successfully complete the state mandated
Culminating Exhibition during their senior year, they must pass the reading and writing portion of the
High School Proficiency Exam (HSPE), if they do not pass the math portion of the HSPE, they must
earn an additional 2.0 credits of math after grade ten.
Students in the Class of 2013 will be the first to be required to pass reading, writing, math and science
assessments.
IEP Graduation vs. Standard Graduation
Whenever an IEP team changes the graduation requirements for a student, the graduation then
becomes an IEP determined graduation. For example, when a student has a modified
Culminating Exhibition and passes the HSPE at a Basic level, then it becomes an IEP determined
r graduation.
\
60
Individual Education
r Programs
61
fE P' s
The Ro le of the Ad rnin istnHor o r Ad mi nis t rn tivc Design ee

a t IEP Mee t ings
The Washington Administrative Co des (\-VACs) stipu late that each IEP team inc ludetA repr esentative of
the sc hoo l distr ict or public agency who: (a) is q ualifi ed to provide, or supervise the provision of. specia lly
desi gn ed instruction to meet the unique needs of spec iaJ education students; (b) is knowledgeabl e about
the general curriculum: and (c) is knowledgeab le abo ut thc availability of resources of the school district
or oth cr public age ncy". The responsibil ity to repres ent the school di strict at IEP meetings falls to the
princ ipa l o r program mana ger of the school; that adm inistrator may appoint at his or her discretion one or
mo re designees to fill the role. Designees should at mi nimum be certificated staff members in the schoo l;
the most common designees are assistant principals, head teachers, and departmen t heads. Designees act
with the aut horit y and responsibilit y of the administrator and must fulfill the expecta tions stipulated in the
WACs .
Primarily, the role of the administrator or ad ministrati ve designee is to make sure the lEP team meeting is
professi onal. respectful, positive, and procedura lly appropriat e (mee ting all of the conditions for lEP
meetings specified in the WACs and IDEA). Th e ad ministrator or admini stra tive designe e also commits
build ing resources for student needs as appropriat e.
The ad ministrative designee sho uld assure that all IEP membe rs are present. At minimum an IEP team
requires the special education teacher. a general educ ation teacher, the relevan t thera pists, and the parent s.
Older students should also be invited as appro priate. When the fEr team has made a minimum 01'3
attempts 10 schedule meetings with parents and either parents arc non -respon sive or they arc unable to
coord inate their schedules to att end by the IEP d ue date. the IEP team may se nd the paren t a copy of the
written invitation and hold the IE? meeting without th e parents. In these cases the team must
comm unicate clea rly and in writing to the paren t usin g the Prior Written No tice (previously known as
Notice of Action) that they are willin g to convene aga in at a time of mutual convenience to discuss the
IEP w ith the parents and amend it i f necessary to inc lude parental input. They may also offer parents
alterna te means of participation, such as usc of a speakerphone. If the purp ose of the meeting is to
develop an init ial lEP, the team ma y not begin provid ing IE? services until the parent has signed the
documen t to con sent placement in special education. If the meeting is to develop an annual lEP. the
school may con tinue serving the student following th e meeting.
62
IEP's
r: Frequently Asked Questions:
1. What is the administrator's responsibility toward IEP meetings?

An administrator or administrative designee is required to attend all IEP meetings. Given the complexity
of schedules, it is understood that administrators must sometimes arrive late or leave early from meetings.
If an administrator cannot attend for the whole meeting, the parents must be given the opportunity to take
advantage of the administrator's presence to address issues of concern.
Signature on the IEP indicates participation in the IEP meeting and in development ofthe IEP. Jfyou did
not attend the IEP meeting, do 110t sign the IEP! The presence of a special education facilitator or director
does not relieve the school of its responsibility to send an administrator or designee.
2. What are our program obligations to special education students?

School districts are obligated to provide a special education program that is "reasonably calculated to
provide meaningful educational benefit" in the least restrictive environment. The IEP is the legally
binding document that describes the program and services that enable the student to benefit from his or her
education. In a legal sense, a student's "program" is defined by his or her IEP. The IEP is also a
"billable" document in that it generates funds which enable us to provide services. Errors in the IEP or the
process of developing the IEP or delays in completing and filing IEPs can result in fines and lost revenue
for the district.
Courts have repeatedly made clear that school districts are not obligated to provide the "best" services or
"maximize" learning for students with disabilities, nor are they allowed to design programs that only
confer "minimal" educational benefit. Rather the obligation of the district is to assure that "meaningful"
learning is possible. Educational programs described by IEPs should be consistent with recognized
research-based instructional practices, should be guided by data (as identified in the present level of
performance portion of the IEP and IEP progress reports) and should take place in the least restrictive
environment (LRE). The least restrictive environment is the program in which the student can (I)
participate meaningfully and relatively independently (with accommodations and modifications as
appropriate) in the classroom's learning and social activities (2) that has the greatest contact with general
education curricula and typical peers.
Schools are conceptually distinct from medical providers in that school districts are not expected to
remediate underlying medical problems. Related services and therapy SDI (specially designed
instruction) in schools are intended to enable a student to access his or her educational program.
3. What ifa parent asks that the IEP specify a particular curriculum or instructional methodologyt
We do not write specific curricula or instructional methodologies into IEPs. Courts have consistently
ruled that instructional methodology is entirely at the discretion of school districts. Teaching staff may
use any appropriate methodology which has proven successful with similar students in the past and which
is reasonably calculated to provide meaningful educational benefit. The IEP team should craft goals that
address particular skills to be learned and are not dependent on specific curricula or methodology.
63
lEP's
4. What do we do if tile parent brings an advocate?

Parents are entitled to advocates at IEP meetings. Advocates should be made welcome at an fEP meeting,
but it should be clear that they are not fEP team members with power to sway decisions. Ask advocates
to introduce themselves, tell what agency they are from, describe their qualifications if appropriate, and
explain their role at the meeting. There have been times when advocates, particularly those who are
private service providers, misunderstand the limits of their authority. They may attempt to dictate IEP
goals (and objectives for students who take the WAAS State Portfolio Assessment) or insist on particular
methodologies, data gathering or reporting systems, or levels of service. In these cases, please gently
remind them that the teacher is the IEP case manager, the school's service providers will write the goals
(with input from other IEP team members) and design instructional and data-collection systems that
address the student's needs and make sense in a classroom context, and IEP team members will determine
appropriate levels of service. School staff members may not discuss students with advocates or provide
them any documents regarding students (even when given verbal permission by a parent) unless we have
in our possession a current "Mutual Exchange of Information" form signed by the parent.
5. What do we do if tile parent brings an attorney?

We do not conduct IEP meetings with a family's attorney present unless the school district also has an
attorney present. Most parents notify the IEP team in advance if they plan to bring an attorney. When
hearing that an attorney is coming building staff must notify the special services department (by
contacting the special education director). The special education director will inform Everett's legal
r--.
,
counsel. We then scheduie the IEP meeting for a time when our attorneys can aiso be present. lfa parent
shows up with an attorney we did not expect, please stop the meeting. Give the parents an opportunity to
reschedule the meeting at a time when our attorney can attend, or invite them to ask their attorney to leave
so that the meeting can go forward. If it wiII not be possible to conduct a rescheduled meeting in time for
an IEP deadline, inform the parents the meeting will proceed with or without them, but without their
attorney, and let them know the team can meet again at a later date to amend the IEP if necessary. If the
parent has brought an "advocate" you suspect to be an attorney, ask directly what that person's role is in
the meeting, and ask directly if they are now or have ever been an attorney. If they have been, stop the
meeting until the individual has left the room.
On rare occasions we may agree to allow IEP meetings with family attorneys present and our attorneys not
present. These meetings are those when it has been determined that the legal issues are already resolved
or the attorney is present primarily because of non-school issues (i.e. parenting disputes). It is up to our
legal representatives and the Special Services departments to make the determination about whether to
send our attorney to the IEP meeting when the parents' attorneys wiII be present.
6. What if a parent wants to audiotape or videotape all IEP meeting?

We do not allow recording of fEP meetings except in cases in which parents can make a reasonable
request for accommodations due to difficulties with reading. The legal basis for our refusal to allow
taping of meetings is federal civil rights laws that prohibit recording without the permission of all parties.
Since it is often uncomfortable for staff members to refuse parent requests for taping (and still maintain
positive relationships) it is the administrator's job to refuse taping on behalf of the team.
64
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7. What do we do if the parent disagrees with our proposed IEP or placement?
The school district's client is the student, not the parent. The IEP team has an obligation to craft an
educational program that IEP team members believe to be in the student's best interest and that meets the
standard of "reasonably calculated to provide meaningful educational benefit" in the least restrictive
environment for the student. The parent as an IEP team member, should have full input in any discussion
of the services the school district may provide, and other IEP team members should listen to and consider
parent input. However, the parent cannot negate an IEP by disagreeing with any part of it. The IEP is
essentially an offer of what the IEP team believes to be an appropriate educational program. If a parent
refuses to sign an initial IEP we cannot deliver IEP services to that student, but the IEP still stands as the
district's offer of services. A parent's threat to sue the district or keep the child out of school or refuse to
allow him or her to attend the program should not pressure an IEP team to write things in the IEP which
(a) are not necessary or (b) will result in a program that wiII not adequately meet the student's needs.
Parents may indicate their disagreement with any part of the IEP on the signature form or on a note to be
attached to the IEP. Most parent disagreement with IEPs is about placement. The IEP team must offer the
placement they believe to be the least restrictive environment in which the student can learn and gain
independence, even if the parent wants or is demanding a different placement.
If there is strong disagreement between parent and school IEP team members, it is appropriate to explain
to parents the two options available to them. One is to go through mediation with the district. Mediation
is provided by Sound Options (206-842-2298) and is funded by the state so that the mediator can remain
neutral. Either the school district or the parent can request mediation. The parent also has the right to due
process through the courts, and the parent should be provided with a copy of the Interim Notice of
Procedural Safeguards which explain these rights. If a parent says they already have a copy of the
safeguards, offer them another one and make sure they have initialed the part of the IEP that indicates they
have been given this document.
9. What if the parent wants their child to get services for which they are not eligible or wants to refuse
services for which the)' are eligible?
Specially designed instruction (SOl) may only be provided for students who have met the eligibility
criteria in the area of service. Each area of eligibility identified in the present level of performance
statement must generate goals and SDI minutes in the summary of services matrix. If a parent or other
IEP team member believes a student is eligible for services in a new area, a school psychologists must
arrange for (and conduct if appropriate) an evaluation to determine eligibility and amend the student's
evaluation to make the child eligible before such services can be added to an IEP.
Similarly, the school district must offer services in all areas in which the student qualifies. Parents of
students and adult students may not cherry-pick (some, but not all) services. See Revocation Section. In
response to federal guidance effective December 31, 2008 parents of students with LEPs may revoke
consent for special education and related services.
65
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( 10. What if the parent wants to include additional documentation (written statements, etc.) in the IEP?
Sometimes parents bring into an IEP meeting documents written by themselves and others that they want
included in the IEP (reports, anecdotes, lists of behaviors or challenges or suggestions, etc.). These can be
included as attachments to the IEP. The attachment is available for people to read but does not become
part of the legaJly binding contract that is the IEP.
11. What if the parent refuses to sign the IEP?

If a parent refuses to sign the IEP, first explain that by signing the IEP they are only affirming that they
participated in its development. They may also add a note on the signature page or attach a note
indicating their disagreement with parts of the IEP. Sometimes it is appropriate to make a note on the
Prior Written Notice (previously known as Notice of Action) in the "other factors" section that the parent
disagreed with some aspect ofthe IEP. Make sure all other IEP team members who participated in the
document's development sign the IEP and the case manager files it with the Special Services department
as usual. In the case of annualiEPs, we do not need a parent's signature in order for the student to
continue receiving IEP services as described in the IEP . In the case ofan initia/IE? if the parent does
not sign consent to initiate services, we may not provide special education. In these cases be sure that the
Prior Written Notice (previously called the Notice of Action) that goes out at the end of or after the
meeting indicates that we are refusing to provide special education services because the parent has refused
consent to implement the IEP.
In some cases a parent may ask to take the signature page home with them to think about the IEP and
( ' promise to send it back when they have signed. Never send home the original signature page. Instead,
, make an additional copy of the signature page; the original will be filed with the IEP document drafted at
the table and the copied page with the additional signature can be sent to Special Services when it is
received.
12. What should parents take away with them when they leave the JEP meeting?
The IEP document that begins as the IEP draft and usuaJly has handwritten changes is the official IEP.
One IEP team member should collect all of the changed pages, have the IEP case manager or another
member initial and date all handwritten changes, and copy the IEP before the parent leaves the meeting so
that the parent takes away a copy of what was agreed at the table. The service providers should still write
the changes (exactly as written at the meeting) in SEAS and may send the clean copy home as a courtesy.
Even when there is a clean copy, however, the document completed at the table is the officiallEP and is
the one that will be before the court should there be any legal challenges.
Following the IEP meeting, the parent should be provided with a Prior Written Notice (previously called
the Notice of Action) that documents decisions made at the IEP meeting. Make sure that the Prior Written
Notice indicates both what the team has agreed to do , and where appropriate, what the team has refused to
do. The Prior Written Notice can go home with the parent when they leave the meeting or can be sent
home within five days. If the meeting was more difficult than anticipated or any team member is unsure
how to word the Prior Written Notice, please let the parent know you will be sending home the notice
within a few days and call your special education director for assistance with the wording.
66
IEP's
r- 13. When do l need to seek help or guidance/rom or notify tile Special Services department?
Notify your special education supervisor immediately if:
I. A parent tells you they will be bringing an attorney to the meeting. or
2. A parent or IEP team member alleges that the school or a particular staff member is not serving the
IEP. or
3. A parent asks for private schooling, tutoring, or other private services at district expense, or
4. A parent requests an Independent Educational Evaluation or says they want additional testing at
district expense , or
5. You need assistance in drafting language for an IEP document, or
6. You are considering adding student-specific resources to an IEP or requesting additional staff
support for a classroom, or
7. A student for whom extraordinary resources are being provided (i.e. a I: I paraprofessional)
changes programs or leaves your school.
67
IEP's
IEP Meetings: Required Participants
WAC 392-172A-03095 requires that districts ensure the IEP team for each child with a disability
includes:
I. The parent of the child.
2. At least one general education teacher of the child (if the child is. or may reasonably be.
participating in the general education environment).
3. At least one special education teacher of the child, or if appropriate at least one special
education provider of the child.
4. A representative of the district who:
• Is qualified to provide. or supervise the provisions of, specially designed instruction

to meet the unique needs of children with disabilities;
• Is knowledgeable about the general education curriculum,
• Is knowledgeable about the availability of resources of the district
r 5. An individual who can interpret the instructional implications of evaluation results. The
team member can be one of the persons described in 2 - 4 above.
6. At the discretion of the district, other individuals who have knowledge or special expertise
regarding the child. including related services personnel as appropriate.
7. If appropriate, the student with a disability.
The purpose of the general education teacher is to speak to what is typical for students of that age and
grade level, to describe the student's performance in the general education setting. to address grade
appropriate curricula and to help design accommodations. They also need to give input into the
development of positive behavioral intervention strategies. General educators can be excused from the
meeting after their input is given and the parents have had an opportunity to ask them questions.
The principal can ask someone to be the District representative as long as they are not sharing
assessment data or acting in another capacity. If a decision is being made regarding something that is
a monetary commitment, it is imperative that Special Services be informed prior to and a
representative is in attendance at the meeting.
68
IEP's
Parents may bring anyone to the IEP meeting who has knowledge of the child. If an attorney is coming,
parents must give us prior knowledge. If an attorney shows up at a meeting without your knowledge,
please call special services as the meeting may need to be rescheduled.
The law emphasizes parental involvement in placement decisions. We must ensure that parents are
afforded the opportunity to be members of a team that makes decisions regarding educational
placements of their student. WAC 392-1 72A-03 I 15.
For Secondary Teams
• The child must be invited to attend if the IEP meeting will involve discussion of post
secondary goals and necessary transition services.
• If transition will be discussed, with the prior consent of the parents or adult
student, the district must invite a representative of any other agency that is likely to be
responsible for providing or paying for transition services.
• If the student does not attend an IEP meeting related to transition services, the district
must take other steps to ensure that the student's preferences and interests are
considered.
Other Considerations
WAC 392-1 72A-03 I I0(7) speaks to the fact that districts must ensure that parents or adult students
understand the proceedings at the IEP meeting, including having an interpreter for deaf or ELL families.
Phone conferences are allowed if neither parent can attend an IEP meeting, or if you are making an
amendment to the IEP.
If students attend a private school, the District must invite the general education teacher of that child.
Please contact the Special Services Department immediately if parents or their advocates purpose to
record (audiotape or videotape) an rEP meeting.
69
IEP's
Goals and Objectives (if \\'AAS Portfolio Student)
Goal statements:
• Identify an area in which eligibility has been clearly established; remember the evaluation drives
the IEP.
• Describes a functional skill to be learned and strengthened
• Goals must be aligned with the needs identified in the present levels of performance
• Must have a baseline, target, and unit on measure....words such as from .....to ... by.....are
helpful
• Goals must be measurable
• Goals must be instructional in nature describing a skill to be learned
• Be careful to not describe a behavior (unless it is a behavioral goal!) such as ...student will rum
in 80% of their daily work. this is a behavior not instructional
• If the student has 1:1 paraprofessional support, the goals need to reflect the skill deficit that
drives the need for a J: 1 paraprofessional.
Objectives:
Objectives are now only required for students who will take the WAAS Portfolio assessment. There are
~ no changes il§ to h9W ths 9bjs~tiYS§ should bs writren.
70
IEP's
IEP's General Introduction and Reminders
WAC 392-172A-03090 - WAC 392-172A-03115 are the new WAC's concerning IEP's
IEP's are written for student eligible for special education when the evaluation team determines that the
3 criteria have been met, including:
Is there a disability?
Does this disability adversely affect education?
Does the student require specially designed instruction?
Reminders:
• Data must drive both eligibility and IEP team decisions

• Teams must not make recommendations (in evaluations or IEP meetings) that are inconsistent
with data or not supported by data
• Data must be collected frequently during the instructional process to inform subsequent
instructional decisions and for accurate progress reporting
• Progress reporting should also be based on data collected on student progress on IEP goals and
objectives
r For General Education Teachers
• rEP case managers (special education staff) must make hard copies of each child's
accommodations and modifications pages available to all general education teachers who work
with the student
• Get general education teachers to sign and date a copy of the page to acknowledge receipt of the
documents and awareness of the accommodations and modifications
Behavior and lEP's
• All students who have behavior goals to address significant behavior issues must have a FBA
(Functional Behavior Analysis) and BIP (Behavior Intervention Plan)
• FBA's and BIP's are IEP documents and should be updated annually with the students IEP
• Any student where the resulting decision confirmed that the behavior was a manifestation of
their disability, must have an FBA and BIP
Protocol at IEP meetings
• If the team is thinking of recommending something that requires budget authority, please contact
Special Services prior to the meeting or invite a Director to the meeting
• We are all a part of the same team. If one member feels strongly that they would like to
advocate for services or make other IEP/evaluation recommendations that may not be supported
r
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by the group, please let Special Services know in advance.
71
IEP's
IEP's: Present Levels of Academic Achievement and Functional Performance (PLAAFP)
The present level of performance statement:
• Must address all areas that the student qualifies for service and address functional skills
• Should be complete enough to "paint a picture of the child" to someone who doesn't know the
child and explain any high needs
rd
• Should be specific. "The child is reading at a 3 grade level as measured by the ORA" is
specific. "The child enjoys reading and tries hard" does not give enough information to write a
good goal
• Should address academic skills even if students do not qualify in academic areas
• Describes the effect of the disability on involvement and progress in general curriculum for each
service area identified
• Contain actual current data, for example test scores, curriculum - based measures, Performance
Expectations, State Assessment scores, District based assessments as well as descriptive
statements
• If student has 1:1 paraprofessional explain the continued need
• Remember to state adverse educational impact and need for specially designed instruction
72
IEP's
Progress Reports
District policy on grading and Progress Reports # 2412P, states:

Grades K-5 - report card issued three times a year
Secondary - Report cards are issued each trimester at middle school level and each semester at
the high school level. Progress reports go home to parents at the same time as general education
report cards. If you work with High School students check with that particular school as some send
reports home more frequently then required. In these cases IEP progress reports are due at the
semester and at the end of the IEP cycle (if more than I month from a semester end).
Special education progress reports document progress on the Measurable Annual Goal page of our
forms. Progress Notes will have to contain specific data ofthe student's progress from the original
baseline scores. Do not only write "making progress", instead you must be specific and
demonstrate the progress with data in measureable terms.
• Progress reporting should be based on data collected on student progress toward the IEP goals
and objectives
• IEP progress reports must be based on student performance data and must be completed and sent
to parents at every grading period
• Hard copies of IEP progress reports should be sent to the Special Services office every time they
are provided to the parent
The Progress Report should also contain:

1. The goal number and the language of the actual goal. Parents can refer to their copy of the
IEP for reference.
2. Evaluation Method. When referencing Method/Criteriafor Evaluating Progress you need to
use the former IEP EVALUATION METHOD CRITERIA of: A. Written Observation/Log
B=Written Performance C=Oral Performance D= Criterion Referenced Test E= Time
Sample/Chart F= Demonstration/Performance G= Portfolio H= Formal testing I = Rubric
Goal # Measurable Annual Goal Method/Criteria for Evaluating Prozress Notes

l. Sue will increase her writing I=Rubric (I I-09) Sue is
skills from writing 3 of 52 upper/ writing 6 of the
lower case letters to 40 of 52 letters 52 upper/lower
in correct formation by (date) as case letters and
measured by Everett Public Schools 31 of the 52
4:4 Writing Rubric. letters in correct
formation
General Education Progress Reports
All students in the Everett Public Schools receive a general education report card, regardless of which
program the IEP is served. Student's grades in general education are based on general education
,.. classroom expectations unless:
(
73
r: fEP's
• The team selects alternate grading options on the IEP. The Accommodations, Modifications
and Assistive Technology page allows team to select:
o Modified Grading "base grades on individual progress and effort rather than general
education expectations"
o Other: which may include the statement: "Student is recommended for an "S"
(satisfactory) or "NC" (no credit) grade instead ofa letter grade."
• Elementary resource room students generally have grades based on general education classroom
expectations.
• Extended resource room students should also have grades marked on the general education
report card. Again, the IEP classroom accommodation page dictates how the grading will work.
Report Card Grading: The team can check modified grading on the new IEP forms. The IEP team
will identify the grading modification per student needs. Generally, resource room students will be
graded on general education grade level expectations.
II!'A-----=====================~-------__,
( I Questions regarding fEP Teams and Meetings
Does it matter what level general education teacher attends an IEP meeting?
The purpose of the general education teacher is to discuss typical development and typical curricula for
a student of the same age. .
What ifyou (as Special educator) recommend an accommodation or modification, but teacher
disagrees?
The general education teacher, as a member of the IEP team, has the right to express disagreement with
any proposed accommodation or modification. However, if the IEP team recommends particular
accommodations and modifications the general education teacher cannot refuse to provide them.
Are the accommodations and modifications page requiredfor Life Skills students who may attend a
PE or music class with general education peers?
If the student requires accommodations and modifications to participate meaningfully in classes the
student's IEP team should complete the page and provide it to the appropriate teachers.
Who on the evaluation/Ilil" team makes sure that the regular education teachers get a copy of
classroom accommodations - how is it determined who the case manager is?
The case manager is the special education teacher. except for therapy-only students (in which case it is
the serving therapist). It is the case manager's responsibility to make sure copies of the
accommodations and modifications pages are distributed to the student's other teachers.
74
IEP's
Services to Students with Disabilities
ACCOMMODATIONS SUPPLEMENTARY RELATED SER VICES SPECIALLY

AND AIDS A~D SERVICES DESIGNED
MODIFJCATIONS INSTRUCTION
Definition Changes in the Support services to Direct quantifiable Direct instructional
environment or adults working with support services to or on services to students that
conditions of student students and/or behalf of students that are characterized by
work (accommodations) equipment, materials. or are required in order for modifications in
and/or changes in the other supports to enable the student to benefit content, delivery, or
task or nature of the students to access meaningfully from their methodology and are
work (modifications) instruction in their least specially designed delivered by (or under
that enable students to restrictive environments. instruction. the direct supervision of)
access general or special certificated staff
education. members with
appropriate
endorsements.
Requirements Presence of a disability IEP team decision that IEP team decision that Evaluation team
that impacts one or more the aids or services are without these services determines that the
major life activities (e.g, necessary in order for the student will be student (1) has a
learning, participation in the student to access his unable to access his or disability (meets the
school). or her educational her specially designed eligibility criteria in the
J:Jrg~'fi)m: imtrueuon Geals and WAC§) thai (2)
IEP eligibility is not objectives arc not adversely impacts
required for required for related educational performance
accommodations and services but the services (usually -1.5 SD or more
modifications. must bear a direct below the mean on
relationship to the norm-referenced tests).
specially designed and (3) requires
instruction described in specially designed
the student's goals and instruction in order to
objectives. learn in that skill area.
Examples Changes in seating, Consultation. training. Transportation, Instruction (di ffering
books on tape, assistive supports to parents. paraprofessional from general education
technology. interpreter assistive technologies. support, nursing in content. delivery. or
services. shortened or services . sign language methodology) delivered
altered assignments. interpreters. to students to enable
alternate forms of them to learn the skills
demonstrating skills. identified in their goals
and objectives.
WAC 392-lnA-OI185 WAC 392-lnA-11155 WAC 392-1 72A-O1175
(3)(c) and WAC 392-
InA-OI035
75
IEP's
Summarv of Service Matrix
The summary of services matrix is the page that tells the areas of specially designed instruction with
minutes. dates, etc.
Remember :
• Each area of SDI needs to be listed separately

• Evaluations show what areas they qualify for (science, PE are not SDI)
• If the student has a one to one paraprofessional, write that under related service as one to one
paraprofessional educator full minutes if the student has them for all classes and lunch
• Always put minutes, if it is a high needs class (Positive Behavior Support, Extended Resource,
Life Skills) you can put under related services "shared paraprofessional educator support" with
the full amount of minutes.
• Make sure you have the projected start and end dates
• State the location of services
• State the certificated staff position of who is responsible for the services, do not write "staff",
state either the special education teacher, SLP, QT, PT, etc.
SLP's do not need to break out the areas such as voice, fluency, articulation. You may simply say
communication.
76
fEP's
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Transition Planning
The transition IEP is closely monitored for compliance by aSP) and the requirements are referred to as
"Indicator 13". Note: aSPI provides links to several websites concerning transition issues including the
Center for Change in Transition Services, http://www.seattleu.edu/ccts/index.asp .Within the Center for
Change website is a document called indicator 13. The website gives additional guidelines on transition
planning hnp:llwww.seattleu.edulccts/indicatorI3.asp
Indicator 13 includes the following requirements:
The transition plan of the IEP needs to be filled out completely during the fEP meeting when the
student is 15. It requires:
• Identification of the student's multi-year course of study and transition services necessary to help
the student achieve the post-school goals. A course of study is not a listing of courses the
student has already taken. It should include a description or list of the courses (or types of
courses) and instruction that the student will receive from the date of that IEP through hislher
anticipated year of exit from high school. At a minimum, the course of study should identify the
courses that the student will take, whether special education or general education, and instruction
that the student will receive that relate directly to helping the student meet hislher specific
postsecondary goals. This could include a description of vocational courses , elective courses,
specially designed instruction, community experiences, job shadowing/work placement
opportunities, etc. that will help the student meet his/her postsecondary goals. (aSPI Training
Module 8/2009).
• Evidence of age-appropriate transition assessments used to identify student strengths and

interests.
• Appropriate measurable postsecondary goals based on age appropriate transition assessments.
Postsecondary goals are required to be reviewed annually, and updated as appropriate, to
ensure that they reflect the student's current needs, strengths, preferences, and interests.
• These post secondary goals do not need to be written like IEP goals however a narrative needs to
be included on the IEP explaining what the student is planning on doing after graduation from
high school. A measurable postsecondary goal is one that can be clearly identified as "met" or
"not met". In other words, is it possible to determine if the goal was achieved or not? For
example. did the student go to a community college?
77
fEP's
Definitions:
Education/Training - Enrollment in one or more of the following:
(a) Community or technical college (2-year program), (b) college/university (4-year program),
(e) College preparatory program,
(d) A high school completion document or certificate class (e.g., Adult Basic Education. GED).
(e) Short-term education or employment training program (e.g., Job Corps, Vocational
Rehabilitation, military), and/or
(f) Vocational technical school, which is less than a two year program.
Employment -
Competitive emplovment means work:
(a) In the competitive labor market that is performed on a full-time or part-time basis in an
integrated setting; and
(b) For which an individual is compensated at or above the minimum wage, but not less than the
customary wage and level of benefits paid by the employer for the same or similar work
performed by individuals who are not disabled.
Supported emplovment is competitive work in integrated work settings, consistent with the
strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the
individuals, for individuals with the most significant disabilities for whom competitive employment
has not traditionally occurred; and who, because of the nature and severity of their disability, need
(' intensive supported employment services.
Independent Living Skills: are "those skills or tasks that contribute to the successful independent
functioning of an individual in adulthood" (Cronin, 1996) in the following domains: leisure /
recreation, home maintenance and personal care, and community participation.
Source of definitions: (as cited by NSTTAC): Rehabilitation Act, Section 7(35) (a), retrieved from
the Office of Special Education and Rehabilitation Services website:
http://www.ed.eov/oolicv/speced/reg/narrative.htmlon February 2,2007.
Source (as cited by NSTTAC): Cronin, M. E. (1996). Life skills curricula for students with learning
disabilities: A review of the literature. Journal 0.(Learning Disabilities, 29, 53-68.
78
IEP's
IEP's Participants at Transition IEP Meetings
When a meeting is held to consider the postsecondary goals and transition services, representatives from
transition service agencies can be important participants. With the consent of the parent or adult student.
the school must invite a representative of any other agency that is likely to be responsible for providing
or paying for transition services. This individual can help the team plan any transition services the
student needs, or can commit the resources of the agency to pay for or provide needed transition
services. If he/she does not participate, the school
• Must attempt to take alternative steps to obtain the agency's participation in the planning of the
student's transition services.
• Student must be invited to attend the transition IEP
Transition Services
On the bottom of the Secondary Transition page of the Transition IEP, transition services related to
education and training must be listed. Transition services should be based on the individual student's
individual needs, taking into account the student's strengths, preferences, and interests, and may include
instruction, related services, community experiences. the development of employment and other
post-school adult living objectives, and if appropriate, the acquisition of daily livin~ skills and provision
of a functional vocational evaluation. See the following examples provided by OSPI:
t. Instruction related to word processing/keyboarding skills

2. Tutoring in reading comprehension strategies
3. Self-monitoring instruction related to on-task behavior
4. Social skiJls training
5. Self-advocacy training
6. Instruction related to on the job safety
7. Instruction in accessing public transportation
8. Occupational therapy to improve handwriting
9. Speech Therapy to improve expressive language
10. Making a vocational rehabilitation referral
11. Applying for college and disability support services
12. Completing a career preference inventory
For more examples you can download OSPI's Evaluation and IEP Technical Assistance Module at:
http://www.kI2.wa.us/SpecialEd/pro£!Tamreview/Monitori muM odule .aspx
79
fEP's
Use of Related Services for OT/PT Everett Public Schools
IDEA 2004 (300.34) defines related services as transportation and such developmental, corrective, and
other supportive services as are required to assist a child with a disability to benefit from special
education and includes speech-language pathology and audiology. interpreting services. psychological
services, physical and occupational therapy, recreation. including therapeutic recreation , early
identification and assessment of disabilities in children, counseling services, etc.
Under this statue occupational services are defined as services provided by a qualified occupational
therapist , and include:
(A) Improving, developing, or restoring functions impaired or lost through illness, injury or
deprivation;
(B) Improving ability to perform tasks for independent functioning if functions are impaired or loss;
and
(e) Preventing through early intervention initial or further impairment or loss of function .
Under IDEA 2004, OT/PT is a related service that is provided to help the child benefit from special
education (specially designed instruction). As a related service, OT supports the child's "occupation" of
learning and their ability to participate in the educational environment. However services are only
provided if the child needs them to help them meet their annual goals as identified in the IEP.
In determining whether a child qualifies for any specially designed instruction, the three prong test
( ' applies. Is there a disability, does it create an adverse educational impact and is the child in need ofSDI
or other services?
A variety of tests can be used to make this determination. Our state regulations have outlined fine motor
and gross motor as areas of eligibility. Sensory needs can be a part of a child's profile however you
cannot qualify a child on sensory needs alone.
OT/PT services cannot stand alone on an fEP unless the child has a disability category of
orthopedically impaired or DO. If a child is health impaired they must have another area of SOl
to get OT/PT services.
Per WAC 392-172A-0 1155, Occupational means services provided for improving, developing. or
restoring functions impaired or loss through illness, injury, or deprivation, or improving the ability to
perform tasks for independent function if functions are impaired or loss, and preventing through early
intervention, initial or further impairment or loss of function."
"Services are considered related services if they are required to assist a special education student to
benefit from special education, and not provided as specially designed instruction."
Supplemental aids and services are defined as "aids, services. and other support services, that are
provided in general education classes or other education related settings to enable special education
students to be educated with non disabled students to the maximum extend appropriate in accordance
( ' with least restrictive environment."
80
rEP's
Here are questions to answer when thinking about related services for OTIPT.
I. What are you planning to do as a related service?

2. What evidence do you have that without this service the student will not benefit from specially
designed instruction?
3. How is it related to the goals and objectives in the IEP?
You cannot be speculative in your thinking. You cannot predetermine that a child will need a service.
So language like ("'may need" or "we think will need") cannot be on an evaluation.
Questions and answers from the DT/PT group:
Can I IIIOl'e students from SDI ill DriPT to related service as a way ofphasing out services?
OSPI has informed us that a student either qualifies or they don't, there is no such thing as "phasing out"
a student. The IEP team needs to determine if the related service is required to benefit from SDI. If the
student is exited from OT/PT sot a reevaluation must be completed.
What do YOII do when an IEP comes to YOII with related services for issues relating to tire general ed.
classroom such as handwriting or sensory needs, can this be a related service?
Related service can only be used for students who are in special education. It is a support service to the
special education program so you can't use it to support general education.
Can related service student be flexible Oil time, can you sa)' Oil the IEP between 30-60 MPW?
Yes
Can a team use professional judgment to determine eligibility for DTIPT services as SDI or related
services?
Professional judgment should be used sparingly. Language is noted in the evaluation procedures
section, WAC 392-1 72A-03020, "if properly validated tests are unavailable, each member of the
group shall use professional judgment to determine eligibility based on other evidence of the existence
of a disability and need for special education." This must be documented in the evaluation report.
So if the tests are determined to be invalid then professional judgment can be used. Again, this should be
used sparingly.
81
IEP's
r'.What to do if a student is not making progress: Guiding Questions for Team

1. Analyze the problem.
a. What are the issues?

b. What can I do as a teacher or therapist to change my instructional strategies?
c. Whom can I consult for ideas?
d. What can I do to change the structure of my classroom, change student groupings or the
classroom environment?
e. Are my IEP goals and objectives on target?
f. Are the minutes on the IEP reasonable? How many minutes does this student need for me to
implement the current IEP?
2. If minimal minutes are currently on the IEP, should I increase my service time? Look at this as
an option to be considered as a reasonable intervention. Then an IEP revision is needed for this
with the IEP team.
3. After trying the interventions, collect data over time (4-6 weeks) on how the student is
progressing. Record the data on data sheets.
4. If there are still concerns, assemble the IEP team to discuss the needs of the child. fEP team per
WAC language must include:
• The parent
• One general education teacher
• One special education teacher
• A district representative
• A person who can interpret evaluation results
• Anyone the parent wants to invite
• The student at transition age
5. The IEP team brainstorms ideas, reviews interventions.
6. If team decides that further assessment is needed, an evaluation plan and consent form is signed
by the parent. You cannot use a verbal OK to assess.
7. Assessment is completed by team members and results shared with the IEP Team
8. If a change in the IEP goals and objectives is needed, an IEP team meeting is held.
9. Finally, ask where this IEP can best be served according to the minutes we have determined. The
placement decision is the final decision. A Special Services representative must have been
involved if a change in LRE is anticipated.
82
r:
-,
Interpreters
83
Interpreters
Purpose of the Interpreter: The interpreter is to be a partner in facilitating understanding in

communication between staff and families who speak different languages.
The Four Roles of the Interpreter:
I. Conduit: they relay the information with any alterations

2. Clarifier: they clarify meaning in the home language
3. Cultural Broker: they help parents and staff understand the cultural differences
4. Advocate: Link to staff resolutions
Pre-session: Prior to the initiation of the meeting, the interpreter should:
1. Introduction
2. Confidentiality Pledge: Nothing stated will be shared
3. Thoroughness: Will interpret all information and concepts
4. Hand Signal: Will use sign for "stop" to carve time for interpretation
5. Transparency
~ Tips for the Professional Interpreter:
1. Have them arrive prior to the scheduled appointment.

2. interpret everything exactly as it is said - add nothing, omit nothing and change nothing
3. Use language that is readily understood by the listener
4. Study important vocabulary before going into the interpretation session
5. If the parent asks a question, interpret it, don"t answer it yourself
6. Let parents make their own decisions. Don't give advice, even if they request it
7. If the staff person or parent talks too fast or too long, use a hand signal to ask them to pause. If
they do not see the signal, you may have to interrupt and ask them to speak in smaller segments.
8. Be transparent. No side conversations should be left without interpretation. Everybody must
have an understanding of what is going on at all times.
9. Alert the staff if cultural differences may be creating a barrier to clear communication
10. Remember that the primary relationship is between the staff person and the parent. Your job as
an interpreter is to facilitate their communication and partnership
84
Medicaid Procedures
85
MEDICAID PROCEDURES
r: Sample Therapy Log:
Student Name: D.G.S. Medicaid number: School District:
Service MonthlYear: School: Provider: MPW:
Service Time Time Total CPT Progress Treatment notes D See Attached
Date in out time treatment notes
Providers signature: _ Title: Date:

Supervisor's Signature: _ Title:
---------- Date:
-----------
No treatment Codes SU-student unavailable SA-student absent

TU-Therapist unavailable T A-Therapist Absent
Progress Codes: I=Same 2=Requires assistance when working toward objective(s) 3=ls
r progressing toward objective(s) 4=Mastery ofobjectives(s)
86
MEDICAID PROCEDURES
MEDICAID PROCEDURE
CODES
Physical Therapy
Services
-: .
• Proc_edureiC~de · .. ': ';Modifier : :
- x.~rief:D ~scJiption
97001 PT evaluation
97002 PT reevaluation
97110 Therapeutic exercises
97112 Neuromuscular reeducation
97116 Gait training therapy
97124 Massage therapy
97139 Physical medicine procedure
97150 Group therapeutic procedures
97530 Therapeutic activities
97535 Self care mngment training
97537 Community/work reintegration
97542 Wheelchair mngment training
97750 Physical performance test
97755 Assistive technology assess
97760 Orthotic mgmt and training
97761 Prosthetic training
97762 Clo for orthotic/prosth use
Occupational Therapy Services
·,·". . P roce(Jur e Code

.' ,. ' . :_
' .~ ' ,
. '
.. _.
-. . "
.
";-.- .
____~_~ _ ~ _ . _
',--~'-.' -- :' : : - ~ '-. "
_
'. ,
,:;. .Modifier
. ' ' "'...~ -:;,t. ' ..
-' ;; -
. ~. ', ", ' .- ~
",
r
'. ·, ··· ·'.brjeO)e§~J.;jp1i~lf/~ " . " .>:::;:::> " :1
c -: -~ .
~ ·· ·,
95851 Range of motion measurements

95852 Range of motion measurements
97003 at evaluation
97004 at re-evaluation
97110 Therapeutic exercises
97112 Neuromuscular reeducation
97150 Group therapeutic procedures
r:
87
97530 Therapeutic activities
97532 Cognitive skills development
97533 Sensory integration
97535 Self care rnngrnent training
97537 Community/work reintegration
97542 Wheelchair mngrnent training
97750 Physical performance test
97755 Assistive technology assess
97760 Orthotic mgmt and training
97761 Prosthetic training
97762 C/o for orthotic/prosth use
Speech!Audiology Services
,
,,'-." p.r.ocedure:Co(Je, ;, ,'<: i ·:M6difiel<
... :;. ".': •.- -. '..- '. "" :';.:" . -'::,:' ·-·Y;" ',' · ,;.' " .• ),:!:"d';, ',' ', ' :ot~~r)),~~gpti~~f _
.. ".'-"'.-I l,;,
::.,.. ~ :(i'-~: -,:: ~:'
"
.:-- - , ~.[~,; ;:';
92506 Speech/hearing evaluation
92507 Speech/hearing therapy
92508 Speech/hearing therapy
~±331 tHfE lane hE~ring {8§{; air
92630 Aud rehab pre-ling hear Joss
92633 Aud rehab postling hear Joss
97532 Cognitive skills development
97533 Sensory integration
Speech-Pathology Services (for speech-pathologists only)
--' Procedll.retCode;~;·t :,~-:, .,M:odifier

", - .( . -.:";-: - - ~ .: ,",", . .: ' -',j",,- ;" .T: , < ;~~j~~n,~.~cr.~~t1oJt ' . ~/: ' ~ !:,' ':~~:':"
j ' ,fs, i f ,'", ',
" :-- ; ~-. _-_: -~' ~ : - -,._ ~:;" ; . ~; < ~ ": ,~ ~ .. --"
92607 Ex for speech device rx, lhr

92608 Ex for speech device rx addl
92609 Use of speech device service
92610 Evaluate swallowing function
Audiology Services (for audielogists only)
<., "
PrecedureCede.
' ",''' .. .
" . . ,,' '
Modifier "
."
:
l :. ,
T ' ) , \\~h~.ef Description
....:... ,". ,," . .: -.- -.::/c---__ -__-- _ _ <:::.--- ;• ..':
,~ ':'
,' j"
:
"
..
92552 Pure tone audiometry, air
88
92553 Audiometry, air & bone
92555 Speech threshold audiometry
92556 Speech audiometry, complete
92557 Comprehensive hearing test
92567 Tympanometry
92568 Acoustic refl threshold tst
92569 Acoustic reflex decay test
92579 Visual audiometry (vra)
92582 Conditioning play audiometry
92587 26 Evoked auditory test, professional
component
92587 TC Evoked auditory test, technical component
92588 26 Evoked auditory test, professional
component
92588 TC Evoked auditory test, technical component
92620 Auditory function, 60 min
92621 Auditory function, + 15 min
r Psychology Sen'ices
·· p rocedure 'C ode;;,' \.; ,:MoClifier ' ....

-,.:; " . ", . . > - ~_: .-;_<r. -.- :"._-": . , ~: .
96101 Psycho testing by psych/phys
Counseling Services
, -.
'Procedure:cCode .' ,..
" ~j.
·:Modifier ·
~ ,~; , :,", " ' f ,~ . -~~ " ::', t BrlefDescnJ.lti().. ~· \: ·· ,\ .
-'. , ,' ," ' Y( ' . ..
59445 Pt education, NOe, individual
59446 Pt education, NOe, group
Nursing Services
.
. .
. ProeedureCede... . Modifier ' . -, .. ,
.Brlef'Deserfprion
'
TIOOI Nursing assessment/evaluation

TIOO2*
RN services up to 15 minutes
TI003* LPN/LVN services up to 15min
r:
89
r ' * Use this code when billing for the following services: TI002 or TI003
C Blood glucose _.
' ,
Nebulizer treatment
testing and analysis
0 -
.~
Nurse delegation
Catheterization
[ Chest wall :J Stoma care
manipu lation/postural
drainage
0 ;] Testing oxygen saturation levels
Dressing/wound care and adjusting oxygen levels
[J Intravenous
care/feedings
C Medication 0 Tracheotomy care/suctioning
administration: oral,
enteral, parenteral,
inhaled, rectal, sub
Q,IM
0 Tube feedings
r
90
Placement
Procedures
91
rI"!""., .....,
PLACEMENT PROCEDURES
School Assignments and Program Placements
Please remember: When a team is considering making a change of placement to a more restrictive
setting, the assigned Special Service Specialist for that school must be consulted prior to initiating
an evaluation.
Remember that evaluations should not determine the program placement in the recommendation
section. The IEP drives placement.
The Ninth Circuit courts have established a four point test to determine whether a student's placement
represents the least restrictive environment.
1. The academic benefit of placement, including any supplemental aides and services which
may be available;
2. The non-academic benefits of placement. such as the linguistic and behavioral models
provided by non - disabled students; or the level of behavioral support provided by a Positive
Behavioral Supports Program;
3. The potential impact the student's presence may have on the teacher and other students; and
4. *The cost of educating the student.
r '" Do not discuss costs with a family at an rEP meeting.
Establishing Educational Placement
Evaluations make recommendations regarding educational placement, however the IEP is truly what
drives the placement.
Selection ofeducational placement is made annually at the IEP meeting and must be based on:
• The student's lEP;
1. Where the student can receive the minutes of service in the IEP.
2. Academic curricula are at an appropriate instructional level for the student.
3. The level of adult support is adequate to the student's needs.
4. The program is appropriate for the student 's adaptive and social needs.
• The least restrictive environment requirements of the WAC 392-172A-02050 through 02070;
92
• The placement option that provides a reasonably high probability of enabling the student to
attain his or her annual goals.
• Consideration of any harmful effect on the student or on the quality of services which he or
she needs.
• Unless the IEP requires some other arrangement, the student must be educated in the school
that s/he would attend if non-disabled; if other arrangements are necessary, placement must
be as close as possible to the student's horne.
Helpful things for teams to think about....
When determining placement, look at the goals and think about how many minutes of service are needed
to implement these goals. Placement options must then match student need.
Program options are school district decisions, there is no WAC telling us what kind of options to
provide.
Reminders:
• IEP teams recommend program models, but do not make school assignments. For students in
general education with resource room services, the home school is the placement. The District,
through the special education department, may assign students to any school that has the
program described in the student's IEP.
• School assignment is not an IEP or parent decision.
• Special services needs to be consulted if teams are looking at a more restrictive placement
including moving a student from drop in preschool to full program.
93
CHECKLIST FOR REFERRING A STUDENT

FOR A SELF-CONTAINED PROGRAM
Special Services does not make program placement decisions, rather, we support a teams' decision or
identify what additional data needs to be collected to make a case for a change of program.
_ _ Discussion about services needed for student to make appropriate progress. The team should use
the Guiding Questions for Placement in Self Contained Program documents. Service providers
and school psychologist review current evaluation, current lEP, progress of student,
documentation of interventions, etc. IEP Team meets and may decide to:
1. initiate the process for consideration of a self-contained placement because the current
evaluation supports a more restrictive environment and team has current levels
documented
2. initiate a reevaluation to consider self-contained program
_ _ Sending school contacts special services, who will review the file and become familiar with the
case.
(" _ _ Comprehensive Evaluation Report completed as needed.
_ _ If student needs placement in a different program, Special Services Director contacts both teams,
including principals.
_ _ The sending school psychologist contacts the receiving school psychologist to schedule a
meeting date for the IEP meeting to be held at the receiving school and sets up transportation.
_ _ The sending school notifies the parent(s) and appropriate school staff of the meeting date, time
and location.
_ _ Transition meeting may take place with sending school (may be a representative and not the
whole team), parent (must be present) and receiving team.
_ _ IEP is revised as needed and Prior Written Notice (previously known as Notice of Action) is
completed reflecting the decisions and discussion made at the IEP meeting.
94
EVERETT SCHOOL DISTRICT

Speeiill Services
202 Alder Ave, Everett WA 98203
Phone: (425) 385-5250 F:u:: (425) 252-7769
GUIDING QUESTIONS FOR

PLACEMENT IN A SELF-CONTAINED PROGRAM
For pl:u:ement of a student in a self-contained program, please consider, discuss and document the
following:
STUDENT INFORMATION
\. 0 Yes 0 No Is, there cognitive information on previous 01' current evaluation report?
DYes 0 No If, it is difficult to measure the student's cognitiveskills, do you have documentation
relatedto cognitiveindicators?
2. If consideringfor self-containedplacement,do you have current functioning for adaptlve? NOTE::

Slue/ent maynot qualify in adaplil't b"t currentlullctiolli"g IlI!Cds to be docllmellted
3. for the DIU of academics have you considered the following?

• 0 y~ 0 No Current work samples
• 0 Yes 0 No Current test lnfcrmatlon (ORA,SRI , JMS reports, standardized tests)
• 0 Yes 0 No ClassroomAssessments (or curriculum based assessment)
• 0 Yes D No Standardizedassessment
4. 0 Yes 0 No Jf, behavior is n concern or 11 reason for plocemenl in aless restrictiveenvironment,

do you have documentation of current levels for behnviorllllsocinllemotional development?
o Yes 0 No
5. Haveyou documented the strengths of student?
o YesD No
6. Have you documented interventionsattempted- successful and unsuccessful?
D Yes 0 No
Listed belcw are OTHER factors tbal may Impact decisions. PIClIse review-and note what was
applicllble when malting tbis decision:
I. How manysehecls has the student attended? _
2. Whenand where did student quolilY? _
3. Is this an ELL· student? DYes DNo
4. Could the delays be due to a late birthdny? 0 Yes DNa
j . What arethe previous Special Education services?
6. Whatwas the outcome of previous mainstreaming experiences?
7. What accommodations arc needed for the studenlto be successful?
8. Does the child requireassistive technology? DYes D No

9. Are thereany HcnlthJMedical issues? 0 Yes 0 No
If relevant, be sure 10 consider:
Outside Evnlualions: DYes DNo
Outside Diagnosis: DYes ONo
Medications taken :u home nne at school: 0 Yes 0 No
10. Are there issues with auendanee? DYes ONo
I J. Is there II need for physical intervention for unsafe behaviors? DYes DNo
12. Are there hearing or vision issues lind if so, when identified? DYes 0 No Ollte: _
13. Are Iherefamily issues that may possibly impact the child at school?
95
14. Is there hornelessness or transience? DYes DNo

15. 15 the child receiving outside ecunseling/ other supponsl resources (menial health, parole
officer, DOD. DVR, etc.)? 0 Yes 0 No
16. Docs the child hove an autism diagnosis and/or mauifestations? 0 Yes DNa
PLACEMENT CONSIDERATIONS
1. What SOl lind additional support does the student need that cannot be proviced by Resource Room
services?
2. In what areas CDn student receive instruction in general education classroom?

o Academic/Pre-Academie Functioning 0 Communication Skills
o Rellding 0 Physical
o Wriucn Expression 0 Pre-Vocarionul/Vocationul Skills
o Mathemnties 0 Sensory/Health
o Personal/Social Behavioral Skills D Self Help Skills (adaptive skills)
o Other:
J. What s(lecific needs docs the student have for typicolly developing peers! LRE?
4. Is the student ELL and has the impact or the language difference been thoroughly exnmined?
DYes ONo
S. Whnt were the results of the nonverbal cognitive Indicator?
6. Describe the history of the child related to language, school experience and ELL interventions?
7. Does parent understand disabllrty IUId the implications of the restricted plnccments proposed?
DYes DNa
• Student will poss ibly not be in neighborhood school 0 Yes ONo
• Student will be in a multiage group - 2 or more grade levels in same classroorn 0 Yes 0 No
• Student will be with the same teacher for 2 or more yeors DYes D No
• Students in classroom wi II hove significant needs 0 Yes D No
R. Can this student be served by flexible programming? 0 Yes 0 No

9. Considering lRE, what compilation ofserviees would be best for the student']
10. Whllt Is specifically needed?
II. Have all other interventions within II general education setting been exhausted? DYes 0 No
E.,<plnin:
This form is available on SEAS
96
Preschool
97
PRESCHOOL
c.. . DETERMINING CHILD OUTCOMES SUMMARY RATING SCORES FOR

CHILDREN WHO QUALIFY IN ONLY ONE AREA
I. Districts will be required to report scores for all three child outcomes for all children with IEPs.
2. If a child is eligible in only one area, it is our expectation that the child will maintain typical
developmental functioning across other domains.
3. Since the Child Outcomes are integrated and functional, it is possible that even if a child is
eligible for services in only one domain, delays or deficits in that developmental domain may
influence performance on more than one of the Child Outcomes.
4. For an individual child,
a. Gather the available assessment information.

b. If you do not have current assessment information in "other" developmental domains,
assess the child's performance using a developmental screener.
i. For example, if you have speech and language information for a SLP-only child,
you will administer a screener to obtain information on the other developmental
domains such as motor, cognition, social , etc.
11. Or, if you have motor information for a motor-only child. you will administer a
screener to obtain information on the other developmental domains such as
communication, social, etc. .
c. A screener should be quick and have adequate reliability and validity. Results should tell
you whether or not the child is maintaining typical development in areas other than the
single area of concern.
d. Score the child on all Child Outcomes using the Decision Tree and other guidance. Since
a CD-only or motor-only child may not be served by a team of professionals, the single
provider and the family can serve as the team to complete the Child Outcomes Summary
Form .
98
PRESCHOOL
r DEVELOPMENTAL SCREENERS
When selecting a screener, check to be certain that it will give you information about the child's
performance in the outcome areas: positive social-emotional skills, acquiring and using knowledge and
skills, taking appropriate actions to meet needs.
Ages and Stages Questionnaire *

Ages and Stages Questionnaire: Social-Emotional**
Battelle Developmental Inventory Screening Test*

(Birth to eight)
Brigance
Infant and Toddler Screen
Early Preschool Screen
Preschool Screen
Kindergarten and First Screen
Child Development Review Parent Questionnaire
Denver II
t":
, (Birth to six)
DIAL-3
(Three to seven)
Early Screening Inventory
Early Screening Profiles
First STEP Preschool Screening Tool
Infant Development Inventory
Parents' Evaluation of Developmental Status (PEDS)
"This instrument has been cross walked by the ECO Center.

**This instrument will he cross walked by the ECO Center.
99
PRESCHOOL
FREQUENTLY ASKED QUESTIONS (FAQ) ABOUT

EARLY CHILDHOOD OUTCOMES REPORTING FOR CHILDREN
IN PRESCHOOL SPECIAL EDUCATION PROGRAMS
OFFICE OF SUPERINTENDENT OF PUBLIC INSTRUCTION

This FAQ is intended to provide information and respond to questions from the field. Continued updates
will be provided throughout the year as needed.
STATE DATA COLLECTION REQUIREMENTS

Why is OSPI collecting outcomes data?
The federal Office of Special Education Programs (OSEP) mandates that all states develop a
process for reporting reliable performance outcomes data for an children three to five years of
age who have received special education services.
Each state is required to set a performance target to maximize the outcomes for young children
with disabilities, in three federally required focus areas. These areas are:
Indicator 7: Percentage of preschoolers with lEPs who demonstrate improved:

• Positive social-emotional skills (including social relationships)
t A£Qyj§itign ilnQ y§~ gfknmvl~Qg~ £!m! §kiH§ (!ilngYilg~ iln9 !it~nl£Y)
• Use of appropriate behaviors to meet needs
States set performance targets for the State Performance Plan (SPP), based on the reported data
from local districts.
What is OSPI's reporting timeline to OSEP?

OSPI will report exit outcome data to OSEP on the Annual Performance Report (APR) in
February 2009 and 2010. aSPI will have an opportunity to adjust the performance target level in
2009 and again for the final time in 20 I0 based on the data reported on the APR. If aSPI does
not set an appropriate performance target level based on sufficient data, OSEP will set the target
for the state.
LEA DATA COLLECTION PROCEDURES
When will data be reported to OSPI? NEW

Starting with the 2008-2009 school year, entry and exit data will be reported to OSPI only once
a year, on July 15. This is a change from previous years, when data was reported in December
and in June.
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Are preschool children required to have a student specific identification number (SSID)?
If districts are counting preschool children for federal funding, these children must have a SSID
(CSRS system) number. Therefore. it is advantageous to districts to have the children in the
CSRS system. In addition, since the number is portable, it will greatly assist districts in tracking
information from one district to another when a child transfers within the state. Sometimes there
is a delay between the time the child is registered and the time the registrar puts registration into
the CSRS system. This will cause a delay in a number assignment.
How should districts gather information about children?

Districts may gather information in a number of ways. Examples of information sources include,
but are not limited to:
• Observations and reports by family members, care providers, school and other service
providers;
• Early intervention outcome reports;
• Developmental screenings (e.g., Ages and Stages);
• Curriculum-based assessments (e.g., AEPS);
• Norm-referenced assessments (e.g., 801-2);
• Progress monitoring;
• Classroom or other environment observations; and
• Relevant information identified during assessment, planning, or lEP meetings.
( ' How long should a child be in special education preschool services before s/he is rated the first time
(at entry)?
The Child Outcome Summary' Form (COSF) should be used between three (minimum) to six
weeks (maximum) after the development of the fEP and the student's participation in the
preschool program. This timeframe will allow the preschool staff an opportunity to get
acquainted with the child and to provide special education services.
How will exit data be collected on children who transfer from one district to another district?
For the child with entry data who moves to another district, the district who is counting the child
(receiving district) and from which the child is exiting the preschool program is responsible for
completing the exit data. The child may enter several programs; however, the last program that
the child exits will be responsible for the exit data.
One exception could be children who have entry data and transfer to a new district three or fewer
weeks before the end of the program year (child has been in program for six months and is
exiting the preschool program) the former program should complete the exit data. The reason for
this is that in order for the receiving district to be able to make rating decisions it would need to
have some time to observe the child in the program. Entry at the end of the school year may not
allow for that observation time. Therefore, it would be more appropriate for the sending district
to report the data, but it should be done in collaboration/coordination with the sending district so
accurate information is available for making rating decisions. (If there is an SSID number this
should help to facilitate the exit discussion and reporting.)
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f How are data collected and reported on children whose families are highly mobile and the
~ children do not stay ill program for 6 months after entry data is collected?
Highly mobile children will make it difficult to collect data. Having a SSID number win help
somewhat in that the information about the child can be shared between districts and help
determine if indeed the child has or has not received six months of services. The SSID number
can also assist in determining whether entry data must be taken several times with the possibility
of there never being any exit data. OSEP has acknowledged there will be children the state will
never be able to report on.
If a child has entry data, has been ill program for at least six months, and does not return to school
for twenty calendar days, should the child be considered as having exited the program?
Yes. The child is considered as having exited the program for apportionment purposes after
twenty consecutive days, and should therefore be considered as having exited the program for
data collection purposes as well [WAC 392-12 I- 108 (i)]. Note: Some children may not be in
program long enough for the staff to gather entry/exit data.
What is the requirementfor parent participation ill making tire rating decision?
There is no requirement for parental involvement in making rating decisions; however OSPI
strongly urges districts to collect information and input from parents prior to making a rating
decision. The rating process should be a team responsibility involving family members, other
individuals familiar with the child in various settings and situations, and school personnel.'
Parents should be advised of the rating requirement and the process the district uses to make
rating decisions. Parents should be informed that the rating will be part of the child's file which
they can review at any time. A parent may choose to not participate in the rating process.
However, the district is still required to report entry and exit data on all children. Parental
consent is not required for the rating process. Because families are also interested in their child 's
progress , OSPI urges districts to share rating information with families. '
CHILD OUTCOME SUMMARY FORM (COSF)
How do we know a child's true potential, wltat s/he could be expected to achieve?
Each outcome rating compares a child to a typically developing child -
not to the child's individual potential. The child's initial rating on his/her functioning in relation
to typically developing children of the same age will be used to look at progress achieved during
participation in the special education preschool program. The ECO Center provides a training
module which can be found at http://www.fpg.unc.edu/-ECO/pdfs/ECO_COSF_Training2-1-
07.pdf
For children born prematurely, do we compare her/him to a typical child ofthe same chronological
age, or ofthe same corrected age?
Children born prematurely are compared to a typical child of the same chronological age. Do
not adjust for prematurity.
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( ' Are data collected on children who tlua/if)' in only one area such as communication disorder or
. orthopedically impaired?
Yes. Children who only qualify in one area for special education services are subject to the same
entry/exit reporting expectations as all other preschool children receiving special education
services.
Can the COSF be modified?

No. the initial cadre of users and ECa Center staff made what they felt were necessary
modifications for use by all early childhood staff in Washington. In order to gather meaningful
data that will allow for comparison, the CaSF must be used as is.
Tile COSF and process seem subjective, so data may not be valid, reliable, or meaningful.
The CaSF process provides a scaffold for discussion by members of the IEP team. Discussion
of the functional outcomes for each child receiving special education services will guide IEP
teams in making rating decisions.
The box for describing progress on the COSF form is 1I0t large enough to include all the child has
learned to do since the initial rating.
There is no requirement to enter extended examples ofthe child's progress towards IEP goals. The
progress description box allows the child's team to acknowledge and document progress the child
is making, and again assist in the discussion for determining the appropriate rating.
What documentation needs to be maintained - when and where?

A child's completed Child Outcome Summary Form (COSF) will remain in his/her special
education file. A copy of the form must be submitted to the individual designated by the district to
input data in reporting to aSPl only once a year, on July 15. Ifa district did not provide
preschool services to any children durine the vear. it is still required to report this on the COSF
spreadsheet. A new check box, "no entry or exit data to report for the 2008-2009 school year", has
been provided on the spreadsheet for this purpose.
The Data Management Coordinator for the Special Education Program at aSPI has developed a
spreadsheet for recording preschool district data. A link to the aSPI CaSF reporting template is
provided to districts at www.kI2.wa.us/SpecEdlEC.aspx under COSF to OSEP Analytic form. The
template automatically computes the required reporting information once entry and exit data are
entered. The template accepts SSID child identification numbers and facilitates tracking should
children change districts. Additional information is provided by the Special Education Data
Manager via monthly bulletins and CSRS trainings.
Will training and technical assistance be provided to preschool personnel on tile use ofthe COSF and
data collection process?
The aSPI Early Childhood Program Supervisor works with the ESD Early Childhood
Coordinators to identify the need for trainings. Technical assistance is available via K20, e-mail
and telephone from the Early Childhood Program Supervisor at OSPI. In addition, districts may
request technical assistance from the ESD Early Childhood Coordinators located in the nine
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ESDs. For training requests or technical assistance, please contact the OSPI Early Childhood
Program Supervisor at (360) 725-6075.
ADDITIONAL RESOURCES
www.kI2.wa.us/SpeciaIEd/links
www.kI2.wa.us/SpeciaIEd/presentiECE Outcomes.ppt
www.12.wa.us/SpeciaIEdlWACOSF Decision Tree
*The following additional resources are intended for informational purposes only.
ECO Center website www.the-eco-center.org Puget Sound ESD website
www .psesd.orf!./speciaIservices/ECOutcome
OSPI OCTOBER, 2008
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COSFFAQ
I. Do we need to do a COSF on a child who has transferred in from another local district (i.e..
Arlington, Edmonds)???
a. YES - we must complete a COSF on transfer students, even if we see they had one
completed. If there was an exit and the information is the same, you may use that info
but you must complete a new form. ***The only exception to this is if they transferred
IN DISTRICT - then, no COSF is needed pending they have one on file.
2. If a child started in early June and we did NOT complete a COSF last spring, when should we do
it? Do we count last spring in the 6 weeks?
a. The easiest way to answer this question is to remember the purpose of the COSF. You
are measuring the child's skill level and performance near their entry into preschool,
rather than the effect of a new environment on their behavior. 6 weeks is a rule, but a
flexible one. If they were in school last year, you should not need another 6 weeks to
determine their skill level at entry into preschool, but you may need more than a day or
two. COMPLETE THE COSF when you believe you have a good picture of their skill
level and performance in the classroom. This should not take more than 6 weeks.
3. Do we complete on tuition children?
a. At the time, NO. This is currently ONLY for students receiving special education
services.
_ 4 ..-.,-...,..,,-.-,.. • <f. • n
4. Do we do COSF for new students only?

a. YES. This is a tough question and I called about it. Initially, they assume some kids will
fall through the cracks (except here in Everett, where I know EVERYONE did their's).
lfthey are new to )'OU and new to the district, you do a COSF. Ifthey've been in the
district prior to now, don't do one. The only exception is #2 above.
5. Can we use B-3 exit COSF for our entry?
a. Yes and no. We need an ENTRY COSF for preschool. If the b-3 exit info is recent, we
can use information from it. If it is not recent (more than 6 weeks has passed, you should
not use that info, but instead, complete a completely new ENTRY COSF based on their
current functioning.
6. Do I need to complete a COSF on kids from last year?
a. If they have been in program and have an ENTRY COSF, no. One is completed at
ENTRY into school, not entry into the school year. ONE exit is done at the time they
are kindergarten eligible.
7. Where should typically developing or therapy only student's fall on the 7 point scale?
a. Children who are typically developing or are therapy only students in one area should be
assumed to have typical development or near typical development (score a 6 or 7). If
they do not, please meet with your team to discuss the possible need for further
evaluation of this child.
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C 8. Who is responsible for completing the COSF?
. a. The COSF was designed by the Office of Special Education Programs (federal) and is
meant to he completed by TEAMS of professionals working with students along with
families, as appropriate. Even if you are not a direct service provider, if you have
knowledge of the child. information from you is essential in completing the COSF.
b. COSF teams can consist of: teachers. parents. community members. health care
providers, daycare providers. grandparents. siblings etc.
9. Do I need to do an Exit COSF when a student moves out of district? Yes. if a student moves at
anytime during the school year or during the summer and has been in the district for 6 months an
Exit COSF is required to be completed within a week of withdrawal.
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Important things to remember for COSF
1. Entry COSF is completed within 6 wks for entry to the program. Your team can start taking
data using the developmental milestone crosswalks over the course of 6 weeks. This saves
time when filling out the forms.
.., Have the decision tree handy when filling out the forms.
3. Team members can collect data separately but the rating has to be a group decision. One rating
per outcome per child.
4. This is a global view of the child. How are they functioning in a variety of settings? If you
don't know call the parent to heJp gather the information.
5. COSF entry and exit forms are on SEAS.
6. If a child is entering preschool and it is Jess than 6 months until kindergarten you do not need to
do a COSF.
7. All students going to kindergarten with an entry COSF need an exit COSF before the end of the
school year. Exit COSF's are due by the second week of June.
8. Penny Bravo still needs a hard copy of Entry and Exit COSF.
9. Penny Bravo tracks due dates and will request a COSF if not received.
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Decision Tree for Summarv Rating Discussion
• Use this tool for evaluation the rating of each outcome.
• Optimal: Preschool teams should decide the rating together.
• Remember the question is: " Does the child ever function in a way that would be considered
age-appropriate?"
• It is really important to know your developmental milestones of the child 's age in order give
the child an accurate rating.
• Use the crosswalk tool to assist you! the team.
r:
108
Decision Tree for Summary Rating Discussions
Does the child ever function in ways that
would be considered age-appropriate with
regard to this outcome?
~
<,
r No [consider rating 1-3) f Yes (consider rating 4-7)
.> 1
<,
Does the child usc any immediate foundational skills related 10
this outcome upon which to build age-appropriate functioning Is the child's functioning age-appropriateacross
across settings and situations? all or almost all settings and situations'?
I I T
f No 1 [ Yes No
1 rYes 1
T T T
To what extent is the child using immediate To what extent is the child using Does anyone have
foundationll1 skills across settings IIDd situations? age-appropriate skills across concerns about the
settings and situations? child IS functioning
I I -....., I I
with regard to the
outcome area?
/"
........
Child uses Child uses ""I
Child rarely uses
some
immediate
foundational
immediate
foundational
skills across
age-appropriate
skills. There is
Child uses age-
appropriate skills
some of the time
J
T
much more across settings and rYes
skills across settings and
behavior that is situations. There is n
settings and situations most or not age- mix of appropriate
situations all of the time
appropriate Ulan and not appropriate
age-appropriate. behaviors and skills.
I I "-. ~ Completely
Child does
I I
- child uses
Child uses Emcrglng-
not yet use some child uses Cltild rarel,- Somewb:l'- child Child uses age
immediate immediate uses age uses age expected age expected expected
immediate
foundational foundational foundational expected skills some of the skills but skills in all
skills skiUs lime there are settings and
skills skills
J
.- . .
I he Barly Childhood Outcomes Center Revised 5-30-07
concerns situations
E'"rre\'1in~ AIfTll,lst ~mt ~h>-+

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Developmental Milestones and Skill Crosswalk Tool
These tools assist you with knowing how the developmental milestones crosswalk to each Outcome .
Remember
• Outcomes are a "global look" at a child's functioning across settings (school, daycare, home,
community places)
• When assessing a child's level of function , you are always asking yourself: "Does the child ever
function in way that would be considered age appropriate with regard to the outcome?" (This
question will be asked when determining the outcome rating using the Decision Tree.)
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Tool for On-going Data Collection (Levell)
Outcome 1: Positive social-emotional Outcome 2: Acquisition and use of Outcome 3: Appropriate behavior to
skills knowledge and skills meet needs
Fine Motor
Cognitive Fine Motor :..; Grasp s hand-size object with either
( Reproduces pan of interactive game [ : Orients picture book correctly and hand using
and/or turns pages one by ends of thumb. index, and second
action in order to continue game and/or one fingers
action =~ Copies simple written shapes after ~ Rotates either wrist on horizontal
:::; Solves common problems demonstration plane
Social-Communication Cognitive Gross Motor

=l Turns and looks toward person q Imitates words not frequently used ::::1Creeps forward using alternating arm
speaking C: Uses an object to obtain another and leg
q Follows person's gaze to establish object movements
joint Q Solves common problems =l Assumes balanced sitting position
attention C; Uses imaginary objects in play 1:": Walks avoiding obstacles
C: Engages in vocal exctnnges by q Categorizes like objects q Stoops and regains balanced standing
babbling c; Demonstrates functional use of one- position
:l Gains person's attention and refers to to-one without support
an correspondence
object , person, and/or event =; Recognizes environment symbols Adaptive
q Recognizes own name (signs, logos, labels) C: Uses tongue and lips to take in and
c.; Quiets to familiar voice Q Demonstrates functional use of swallow
c: Carries out two-step direction without reading materials solid foods and liquids
contextual cues =; Demonstrates use ofcommon =1 Bites and chews hard and chewy
opposite concepts foods
Social Q Repeats simple nursery rhymes ;=1 Drinks from cup and/or glass
C1 Responds appropriately to familiar C"; Eatswith fork and/or spoon
adult's Social-Communication :::1Initiates toileting
affect [{ Gains person 's att ention and refers to ~ Washes and dries hands
q Initiates and maintains interaction an =1 Brushes teeth
with object, person. and/or event q Undresses self
familiar adult q Uses consistent word approximations
Q Initiates and maintains q Uses 50 single words Cognitive
communicative q Uses two-word utterances c; Navigates large object around barriers
exchange with familiar adult q Uses three-word utterances
=1 Panicipates in established social Social-Communication
routines C; Gains person's attention and refers to
~ Initiates and maintains interaction an object,
with peer* person, and/or event
:, Initiates and maintains : 1Uscsconsistent word approximations
communicative Q Uses 50 single words
exchange with peer =; Uses two-word utterances
.:::] Uses three-word utterances
Social
[ ! Meets observable physical needs in
socially
appropriate ways
L; Participates in established social
routines
11 1
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Tool for On-going Data Collection (Level II)
Outcome I: Positive social emotional Outcome 2: Acquisition and use of Outcome 3: Appropriate behavior to
skills knowledge and skills meet needs
Cognitive Fine Motor Fine Motor
0 Evaluates solutions to problems 0 Prints pseudo-letters 0 Uses two hands to manipulate
C Makes statements and 0 Prints first name objects. each hand performing
appropriately answers questions Cognitive different movements
that require reasoning about 0 Demonstrates understanding of Adaptive
objects. situations, or people color. shape. and size concepts 0 Eats and drinks a variety of foods
0 Engages in games with rules 0 Demonstrates understanding of using appropriate utensils with little
Social-Communication qualitative and quantitative or no spilling
0 Uses words. phrases. or sentences concepts 0 Prepares and serves food
to inform. direct. ask questions, 0 Demonstrates understanding of 0 Carries out all toileting functions
and express anticipation. spatial and temporal relations 0 Washes and grooms self
imagination, affect. and emotions eoncepts 0 Unfastens fasteners on garments
0 Uses conversational rules 0 Groups objects, people, or events 0 Selects appropriate clothing and
0 Establishes and varies social- on the basis of specified criteria dresses self at designated times
communicative roles 0 Follows directions of three or more 0 Fastens fasteners on garments
Social related steps that are not routinely Social-Commu nication
0 Interacts with others as play given 0 Uses words, phrases, or sentences
partners 0 Places objects in series according to inform, direct. ask questions, and
0 Initiates cooperative activity to length or size express
0 Resolves conflicts by selecting 0 Retells event in sequence 0 anticipation. imagination, affect.
effective strategy 0 Recalls events that occurred on and emotions
::J Initiates and completes age- same day, without contextual cues 0 Asks questions
appropriate activities 0 Evaluates solutions to problems Social
::J Watches, listens. and participates 0 Makes statements and 0 Meets physical needs in socially
during small group activities appropriately answers questions appropriate ways
0 Watches, listens, and participates that require reasoning about 0 Follows context-specific rules
during large group activities objects. situations, or people outside home and classroom
0 Follows context-specific rules 0 Engages in cooperative, imaginary 0 Communicates personal likes and
outside home and classroom play dislikes
0 Understands how own behaviors, 0 Counts at least 20 objects
thoughts, feelings relate to 0 Demonstrates understanding of
consequences for others printed numerals
0 Demonstrates phonological
awareness skills
0 Uses letter-sound associations to
sound out and write words
C Reads words by sight
Social-Communication
0 Uses words. phrases. or sentences
to inform. direct, ask questions.
and express anticipation,
imagination, affect. and emotions
0 Uses conversational rules
0 Establishes and varies social-
communicative roles
0 Uses verbs
0 Uses noun inflections
0 Asks questions
0 Uses pronouns
0 Uses descriptive words
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Phvsical Age 2 to 3 Can use for Outcome 3

Children become more comfortable with motion, increasing speed, and coordination. Most begin to:
• Run forward
• Jump in place with both feet together
• Stand on one foot, with aid
• Walk on tiptoe
• Kick ball forward
Children are able to manipulate small objects with increased control. Most can:
• String large beads
• Tum pages one by one
• Hold crayon with thumb and fingers instead of fist
• Draw a circle
• Paint with wrist action, making dots and lines
• Roll, pound, squeeze, and pull clay
Physical Age 3 to 4 Can use for Outcome 3

Movement and balance improve. Most children can:
• Run around obstacles
• Walk on a line
• Balance on one foot
• Push, pull, and steer toys
• Ride a tricycle
• Use a slide without help
• Throw and catch a ball
Children's precision of motion improves significantly. Most are able to:

• Build a tall tower of blocks
• Drive pegs into holes
• Draw crosses and circles
• Manipulate clay by making balls, snakes, etc.
Phvsical Age 4 to 5 Can use for Outcome 3

Children are now more confident, and most are able to:
• Walk backwards
• Jump forward many times without falling
• Jump on one foot
• Walk up and down stairs without assistance, alternating feet
• Tum somersaults
Children develop skills that will help them as they enter school and begin writing. Most can:
• Use safety scissors
("' • Cut on a line continuously
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~ • Copy squares and crosses
'. • Print a few capital letters
For ages 2 to 3 Can usc for Outcomes 1 and 2

Children begin to experience themselves as more powerful, creative "doers." They explore everything,
show a stronger sense of self and expand their range of self-help skills. Self-regulation is a big
challenge. Two-year-olds are likely to:
• Show awareness of gender identity
• Indicate toileting needs
• Help to dress and undress themselves
• Be assertive about their preferences and say no to adult requests
• Begin self-evaluation and develop notions of themselves as good, bad, attractive, etc.
• Show awareness of their own feelings and those of others, and talk about feelings
• Experience rapid mood shifts and show increased fearfulness (for example, fear of the dark, or certain
objects)
• Display aggressive feelings and behaviors
Children enjoy parallel play, engaging in solitary activities near other children. They are likely to:
• Watch other children and briefly join in play
• Defend their possessions
• Begin to play house
r" · Use objects symbolically in play
. • Participate in simple group activities, such as singing clapping or dancing
• Know gender identity
For ages 3 to 4 Can use for Outcomes 1 and 2 and 3

As their dexterity and self-help skills improve, 3-year-olds become more independent. Most can:
• Follow a series of simple directions
• Complete simple tasks with food without assistance, such as spreading soft butter with a dull knife
and pouring from a small pitcher
• Wash hands unassisted and blow nose when reminded
Children become more interested in other children. They are now more likely to:
• Share toys, taking turns with assistance
• Initiate or join in play with other children and make up games
• Begin dramatic play, acting out whole scenes (such as traveling, pretending to be animals)
For ages 4 to 5 Can use for Outcomes I and 2 and 3

At this age, children are more aware of themselves as individuals. They:
• Show some understanding of moral reasoning (exploring ideas about fairness and good or bad
behavior)
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~ • Compare themselves with others
4-year-olds are very interested in relationships with other children. They:

• Develop friendships
• Express more awareness of other people's feelings
• Show interest in exploring sex differences
• Enjoy imaginative play with other children, like dress up or house
• Bring dramatic play closer to reality by paying attention to detail, time, and space.
For Children Ages 2-3 Outcomes I and 2

A lot of learning is done through a child's own exploration, and this really takes off at this age. Most
children can:
• Respond to simple directions
• Choose picture books, name pictured objects, and identify several objects within one picture
• Group objects by category
• Stack rings on peg in order of size
• Identify themselves in the mirror, saying "baby" or their own name
• Relate what they are doing to others
• Observe and imitate more complex adult actions (for example, housekeeping play)
For Children Ages 3-4 Outcomes 1 and 2

As children have more exoeriences in the world. their analytic Dowers {!fOW. For some time. thev have
A.S cnuoren nave more expenences In me worm, tneir ana ync powers grow. For some time, they have
been observing and mentally "sorting" objects according to their physical propenies. Now most children
can:
• Understand concepts like grouping and matching (for example, recognizing and matching colors)
• Organize materials on their own, for example by stacking blocks or rings in order of size
• Identify parts of a whole, like a slice of pie
• Draw, name, and briefly explain somewhat recognizable pictures that are meaningful to them
• Actively seek information through why and how questions
• Tell you their full name and age
• Attend to an activity for a longer stretch of time (between 5 and 15 minutes)
• Learn both by observing and listening to adults' explanations
• Show awareness of past and present
For Children Ages 4-5 Outcomes I and 2

At this age, children actively seek information and new experiences from the people in their
environment. Most can:
• Play with words. mimicking and creating sounds, and make rhymes
• Point to and name many colors
• Understand order and process
• Draw a person with detail
• Draw, name, and describe pictures
• Count to 5
• Tell you their street and town
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r For Children ages 2-3 Outcome J and 2
Both understanding of language and speaking develop more rapidly at this stage. Most 2-year-olds can:
• Join familiar words into phrases
• Begin to use modifiers (adverbs and adjectives)
• Point to common objects when they are named
• Name objects based on their description
• Respond to "what?" and "where?" questions
• Enjoy listening to stories and asking for favorite stories
• Recount events that happened that day
For Children ages 3-4 Outcome J and 2

Language usage becomes more complex. Most 3-year-oJds can:
• Make themselves understood to strangers, despite some sound errors
• Use and understand sentences
• Use more complex grammar, such as plurals and past tense
• Understand sentences involving time concepts (for example, "Grandma is coming tomorrow") and
narrate past experiences
• Understand size comparisons such as big and bigger
• Understand relationships expressed by "if. .. then" or "because" sentences
("" • Follow a series of two to four related directions
• Sing a song and repeat at least one nursery rhyme
For Children ages 4-5 Outcome J and 2

4-year-oJds use language not only to converse, but also to exchange information. Most can:
• Retell a story (but may confuse facts)
• Combine thoughts into one sentence
• Ask "when?" "how?" and "why?" questions
• Use words like "can," "will," "shall," "should," and "might"
• Combine thoughts into one sentence
• Refer to causality by using "because" and "so"
• Follow three unrelated commands appropriately
• Understand comparatives like loud, louder, loudest
• Listen to long stories (but may misinterpret the facts)
• Understand sequencing of events when clearly explained (for example, "First we plug the drain, then
we run the water, and finally we take a bath")
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Physical Development/Outcome 3
Runs well, marchea.stands on one foot
briefly, rides tricycle, imitates cross, feeds
self well, puts on shoes and stockings,
unbuttons and buttons, build tower of 10
cubes. Pours from pitcher.
Age 3
Emotional Development/Outcome 1
likes to conform; easy going attitude. not so
resistive to .change, more secure. greater
sense .of-persone!identity,beginningbbe
adventuresorne, enjoys music;
Physical Development/Outcome 3
Skips on one foot, draws "ManA, cuts with
scissors (not well), can wash and dry face,
dress self except ties, standing broad jump,
throws ball overhand, high motor drive.
Emotional Development/Outcome 1 Age 4 Intellectual Development!

Seems sure of himself, out-of bounds Outcome 2
behavior, often negative, may be defiant, Uses complete sentences, 1540 words, asks
seems to be testing himself out, needs endless questions, learning to generalize,
controlled freedom. highly imaginative, dramatic, can draw
recognizable simple objects.
PhyslcaI'DevelopmentrOutcome '3 . ., ' Social Development! Outcome 1&2
Hops ,~nd"skips,dresses'withouthelp.~:good HighIY90opera.tive play, 'has special ,
balanceandsmoothermusclesction. ' ,; ,"fr,iencfs~;Jlighly organized. :enjoys ,sim'ple
~kates/rii:fesYiagon ,andscooter" p'nnts ta~legames:reqLiitlngtumSand observil1g
simple :/etters,.handednessestablished;"ties niles, ,lIschool". feels pride clothes and '. .. '
shoe!>,girls,sm~lIl11uscl~ :develo.pment ' acc0!11plis~meJits"eager to carry out some
about1i,yearahead of.b~ys. ' ' responsil;ii1ity. . ".
Em~tiJn~1 De\t~lopmel1t/outcome 1 Inteliectual Develcip'ment/

Self,.assured,stable; 'well-adjusted, horne-r: "c< 'Outcome 2 • .' , . '.
centered,'likesto 'associate ,'with 'mother; .'2,072 words , tells long tales, carries out
capable,of sofr.teself-eriticism~enjoys ' direction well, reads own name. counts to
responsibility: Likes to 'follow therules. 10,. asks meaning ofwords,know5 colors,
,;ll9sinnlng toknow difference betWeen fact
:and fiction~lyh,g, interested in environment,
cRy, stores, 'etc.
117
PRESCHOOL
COSF Forms
CHILD OUTCOMES SUMMARY FORM-ENTRY
Date of Entry: Date of 1". Rating:
Child Information:
Legal Name : Date of birth:
District 10: State 10:
Program: 0 School Preschool
o Therapy Only o Other:

Persons involved in decidin~ the summary ratinus:
Name (First, Middle Initial, Last) Role
Family information on child functioning (Check all that apply):

o Received in team meeting
o Collected separately
D Incorporated into assessment(s)
o Not included
118
PRESCHOOL
r:
\
1. POSITIVE SOCIO·EMOTIONAL SKILLS (INCLUDING SOCIAL RELATIONSHIPS)
To answer the questions below, think about the child's functioning in these and closely related areas (as indicated by
assessments and based on observations from individuals in close contact with the child):
• Relating with adults
• Relating with other children
• Following rules related to groups or interacting with others (if older than 18 months)
1a. To what extend does this child show behaviors and skills related to this outcome appropriate for his or
Overall Not Age Appropriate Overall Age Appropriate
her age across a variety of settings and situations? (check one)
Not Vet -Emerging Emerging -Somewhat Somewhat -Completely Completely
0-1 0-2 0-3 0-4 0 -5 0-6 0-7

Child does not Child shows Child shows Child shows Child shows Child generally Child shows age- appropriate
yet show any some immediate some but not age- appropriate shows age- functioning in all or almost all
immediate immediate foundational much age- functioning some appropriate everyday situations
r: foundational
skills in any
situation.
foundational
skills
skills most or
all of the time .
appropriate
functioning.
ofthetime
and/or in some
situations.
functioning but
there are some
significant
concerns
S upporfmg eVI·dence f or answer to Q uestion 1a
Supporting Date(s) of
Summary of Relevant Results
Evidence Used Evidence
119
PRESCHOOL
r 2. ACQUIRING AND USING KNOWLEDGE AND SKILLS
To answer the questions below, think about the child's functioning in these and closely related areas (as indicated by
assessments and based on ooservetions from individuals in close contact with the child):
• Thinking, reasoning, remembering, and problem solving
• Understanding symbols
• Understanding the physical and social worlds
2a. To what extent does this child show behaviors and skills related to this outcome appropriate for his or

her age across a variety of settings and situations? (check one number)
Not Yet -Emerging Emerging -Somewhat Somewhat -Completely Completely
0-1 0-2 0-3 0-4 0-5 0-6 0-7

('I foundational
skills in any
situation.
foundational
skills
skills most or
all of the time .
appropriate
functioning .
of the time
and/or in some
situations.
functioning but
there are some
significant
=-----:~-_:_'_:__--=--- .... concerns
~~=_-7___:::__---"--------L-=.:..:.::::=~--.....L-----------l
Supporting evidence for answer to QuestIon 2a
Summary of Relevant Results
Evidence Used Evidence
(P"
\
120
PRESCHOOL
r-
'. 3. TAKING APPROPRIATE ACTION TO MEET NEEDS
To answer the questions below, think about the child's functioning in these and closely related areas (as indicated
by assessments and based on observations from individuals in close contact with the child):
• Taking care of basic needs (e.g., showing hunger, dressing, feeding, toileting, etc.)
• Contributing to own health and safety (e.g., follows rules, assists with hand washing, avoids inedible objects)
(if older than 24 months)
• Getting from place to place (mobility) and using tools (e.g., forks, pencils, strings attached to objects)
3a. To what extent does this child show behaviors and skills related to this outcome appropriate for his or
her age across a variety of settings and situations? (Check one number)
Not Yet -Emerging Emerging -Somewhat Somewhat -Completely Completely
0-1 0-2 0-3 0-4 0-5 0-6 0-7

foundational foundational skills most or appropriate of the time functioning but
skills in any skills all of the time . functioning. and/or in some there are some
situation. situations. significant
I concems
Supporting evidence for answer to Question 3a
Summary ofRelevant Results
EvidenceUsed -. Evidence .
121
PRESCHOOL
[ Entry Outcome Example 1 - Therapy Only Student
~
Date of Ently: 9124108 Date of fl'. Rating: 1117/08
Child Information:
, .. . .' ~ . :
Legal Nam - ' . " • • I : ~ • ' ,' I \ Date of birth: 3118/05
DislrlcllO_ Sta1e 10:
Program: 0 School Preschool

181 Therapy Only o other:
~ . ~ - . ~
-' r : . ' • •. ,
Mother
Family information on child functioning (Check all that opply):

[8J Ret:elved In learn maeUng
181 Collected separately
o Incorporated into assessment(s)
o Not Included
@2005 SRllnlamaUoneL Version: 4.20.06. Permission Is granted 10 reproduce this form for stale 1
and local program usn. Developed by the Early ChDdhood Oulcomes CentorwUh Support from the Office
of Spet:IaI EducsUon Programs, U.S. Oapartmanl of Education.
122
PRESCHOOL
r:
, ~ . POSITIVE SOCIO·EMOTIONAL SKILLS (INCLUDING SOCIALRELATIONSHIPS)
To answer tile questions below, thinlc abou//he ch'ld's func:/icning in these end closely m/aled amas (as
indica led by assessments and based on observa/lons fromIndividuals in close contact wflh the chfJd):
RelaUng wllh adults
Relating wllh otherchildren
FoUowlng rules related tD groups or Inleractlngwith others (If older than 1B months)
1a. 'Towhat extend does this chUd show behavIors and skIns related to this outcome uppropriatc for
his or her age across a variety of settings and situations? (checJr one)
Not Yel -Emerging EmergIng -Somowhat Somowhat -Complolely Completely
[}.1 . [}2 0-3

.Child shews 0-4 0.5 ~-6 0-1
QIIld dlms na\ Chltdshows ChlldshDws Child sIuIw:i ChIlD gsnsrally CI1Iid shtl'l/sage. 8llPJtlllrlale
yet sIlgwany soma lmrnedl81e StmlD bulnot tl!J!'- appmprfilll shaw; aga- fun:lfonlngln all Dr almost 1I1
Immedlale tmmedlalo loorulaUl1OaI mUd1age- rundlonlng some appraprtala everyday sllu;Uans
IoUnda6onal laundaUonal sklIIs meal or llpptCI;IrlalD oJlhe8me funcIlcnIng but
skl\ls In any skllJ!i ali arlin! Urne. funcUonlng. and/Dr In same ltlareareSomB
siluolllcn. s1Lual/ans. 81~IIi~nl
concerns
upporting evldenclt for answer to Question 18
" ,: : v-, .'" -,..-, ,C"', ' " ' ' , ,,.. ,c',". , ..,. ',W' «,..".,,,.,,, .~~,_ ~;, i\'~.,<"•.' ...",", ','"
..':S'
. t1.~Q, , g'.........'. ...~~....
~.~....\..fitij1~~ . .. r,n·tJa1:···~(~Jm
e . I .s·":tt.,j ." "~'J'-
Ir~.t .:..:.& " :=:'_: .~" I . :....i ~ ~ " ",-· '
. ....... .. _ .~ ..
~ ~:;t'=-
...~ . '..I ~t~ :·::"i:..t;·-:.. :: ~::;
• . ,....:::1..1-..... -.-: •·· C ·" "
; ....
' •• '. • " '. :' , .. . .... ;-, : .. i·.':. ·•• '.. ' : ·d ......,;i·.;;;.tr;.-:-;·:i5 .' 1~.Res rts';;.,:,·~ ,~!, ··~; ·
Eviience I.m-.
r.:. · .. ......
.... ...·tJsed.: ··iliv.itJl!ljlJJ;e.··.~;~~:
....... ". .:..-, ... .- ..... ...... ;':i'i;;:~.:;:·~~·<; ..
~:i ~.Zt;:
-~ .,
~' . \ . .... ,it!tii~~
....~.... . ~~:.~:.: j ;~...l
'.. •: " -~ • . :. . .!--..." ... . .t ~ . :,.:.:,:. ~1 ·. ':' .. ~": :;" .":i4; • ."".; •.•-....... ~'''Il ~-~~:~._'• _" ' .~ _ . " ~::!~.:J!
Infcnnation from 10/1, 10'6, played appropriately with his brother and with
speech sessions 10/15 the SLP. followed directions, took turns. Some
Interactions are dffflcult due to articulation Issues.
Information from 1117/08 initiates conversations with adults andother

mother children, but continued conversatfon Is difficult due
to articulation.
r: DevelDped by \he Early ChDdhood Oulcomes (EeD) Cenlfr.wIth SUppDri fl'Dm the Office of Special Edu::slion 2
Programs. U.S. Department or Educ:aUon. 123
PRESCHOOL
~ 2. ACQUIRING AND USING KNOWLEDGE AND SKll.LS
To answer the questfons below, think about the child's funcllonfngln these and closelyrelated areas (as
Indicsled by assessmenls andbasad on ObSBfVstfons (rom individuals In closecontact with the chi/d):
Thin/ring, reasDnlng, romemberfng, endproblem selving
• Understanding the physical and social wOIids
2li. io what oxtllnt daDS this child show behaviors and skills relnted to this outcome appropriate for
his or her age across a variety of settings and situations? (check one number)
WotYot -=-I11Drglng Emef9ing -Somewhat Somowhllt -Completely Completely
0-1 0-2 0-3 D-4 0-5 [}.6 ~-7
QIId doesnot ChllO sl:ll\\'S Child al\DWlI Ch~ lIt\lIVJI Qllld generally CbII:I stto\llS 2Q!I-lIpJll'lJJToiale
)II!ls11:lwony imine some but nol age.. oppraprtata sh:Im age- 11111d1on11l1l1n aU llI' iIImtlst 1111
~te Immlll!lllle mur:hsDI!- runctlonlng BOrne apPl'cprillla lM!I}Iday sllualltll'5
Jcundallmal lbulldalklnal 8PllfOprla18 Dflhll!tne fUncllml!nll bill
&kIJs In any skllls funcIlanIng. mIlarInsoma lhen= Bill &OmS
sltuallara. s1l11a11llns. s1gnllll;an1
can::ems
... ~ J
...., . ... ..:~.: .~.:
~- ,,,.
Learned correct producQon of newsounds,
understood games with cause--effecl
InfDrmation from 11n/OB Is able to understand and express things Uks

molhar "Daddy's home because It's Salurday".
Develo;1ed by Ihe Early Chfldhood OutcomElS {ECO) COnl!!rwllh SuppDrt from 1118 Office of Spada! Education 3
Programs, U.S. Department of Educsllcn.
124
PRESCHOOL
3. TAKING APPROPRIATE ACTION TO MEET NEEDS
To answer the quesUons below, think about the chUd's fUnctIoning in these and closely related areas (as
indica1ed by assessments andbased on observations from Individuals In c/Dse contact with tile chlld):
• Ta/rfng care orbasic needs (e.g., showing hunger, dressing, hisdlng, toiJat1ng, etc.)
• Contributing 10 own hElSlth and safety (e.g., fallow:. rules, assists with handwashing, avoidsInedible
objects) (N olderthan 24 months)
• Gatting from pIece toplace (mobifiiy) and usIng tools(e.g., forks, pen=ils, strings atlDched to Objects)
Sa.To what extent does this chlld show bohaviors and skills rulated to this outcome appropriate
.
for his or her age across a variety of settings and situations? {Chec
Not Yet -emerging emerging -Somewhat Somewhat -Completely Comple1ely
0-1 0-2 0·3 0-4 0·5 ®-6 0.7

CIItl daas nal Chillisnows ChDdahowo ChUa rmllWll CI1ld sIlaw9 Child gllner.lDy ChIld !:II llWS 1Ige- appraprlalll
yelsh;many scm! immediate samsbUlnat ltge-apprcprlaltl shllWll agrr funcUonIng In BIt oratnClSl all
Imml!lllele 1mm8111a1e foundalJo:iD! mIlCh uae· IuncGonlng soms appnlpr'.a1D GVl!rydsy s!luaIlcns
lllllllllalt:ml (auIllla!llllBl ekllSm:l5t or appfO;lllatD of ltutlImB fum;!lQn!llg bul
&11113 III aqy skIlt all Dflhl! time. funcllo.1lnD- andJorln li1llTIe Ihere are !Qmll
slluOIllan. slluaUans. slgnilicanl
concerns
information from 11/7/08 Sometimes exhibits tantrum behavior Ifhe Isn't abJe
mother to make himself understood dueto articulaUon
dlfficulUes.
DBvI!IapM by !heEarlyChildhood OUtcomes (ECO) Cenlerwlth Support fromtho Officeof SpedaJ EducaUon 4
PnIgmms, u.s. Department of Educatlon.
125
PRESCHOOL
~ Early Outcome Example 2 - Preschool Student
Date of Entry: 09129/06 Date of 111• Rating: 11/03106
Child Infonnatlon:
Legal Nam '. ' : .i:> Date of birth: 08/31/05
District IIIIIIf StErle 10:
Program: XO School Preschool [j LittleRed 0 Providence
o Therapy Only 0 Other.
Developmental Preschool teacher
Speech-langtJage pathologist
Family information on child functioning (ChBC/( sf/that apply):

xD Received in team meeting
x[] Coliected separately
D Incorporated into asseesrnentta)
o Not included
mD05 SRIInlemauonal. Version: 4.20.IE. Penn!sslon 15 gra."1led to reproduce this form for slate
and local programuse. Oeveloped by Ihe Early Childhood Outcomes Cenlerwllh Support frem the Office
of Spedal Edut:aUDn Programs. U.S. Department of EducaUon.
126
PRESCHOOL
1. POSITIVE SOCIO-EMOTIONAL SKILLS (INCLUDING SOCIAL RELATIONSHIPS)
To ilnSL\'fJr /he questions be/ow, think abcutlhe child's functioning Tn these andcloselyrelated areas (as
ind~tBd by assessments and based on observations from individuals in close rontact with the cl)(Id):
Relating Wlttl adulls
• Rela~ng with otherchUdren
Following rules related to groups or Interao!ing wlth others (Ifolderthen 18 months)
1a. To what exlend does this chlld show behavlars and skills related to this outcome appropriate for
NclYet -Emerging emerging -Scmewhal Somewhat -Completely Completely
0·' 0-2 D-3 D-4 0-5 0-6 XO-7
Chll:lClllB& ncI Chillist:ll'Ns Ch1klsh~ ChlId sbmus ClIIld IhmIS Child glllllll'llliy QllId sh:N$ l!;e'llpproplllllIf
yel Dbllllllll\Y SllIl1S ImlIleclltlte BlIl1IlI bUt no! IIIIll" lIPPlDplfa!e GIluwIoaso' lun:&m!ngIn IIIIIlr Qr\osl an
In1msfGlle tiuro.edlale faundsllllnlli mueh~ rlllld!Dnlng s=ma 1I1lJl1CP1lalD everydaysllwdIans
lDundallm1l11 fmmdBllDnal skills l1\DlIlor a;pra;lllate cfU1:l!Im fundlcn/ng bill
llkal5 kI sny 'kUls ;))1 crllle lima. rundlcnlng. lIl1dIar In SDIlIIl lhn ens !ICITI1l
sllua1bn. !llI\llll1llflS. sfgnllicont
c:m=rns
Su
r:
.'.
~'~t~r-;
.'Ilii~,
is a nice nttle boy who interacts well with
adults and peers. He fallows instructions and
classroom rules. He Inl\iates play with others and
wlll try to hold a conversation. He wnl share but
does notofferto s to others to share in lav,
~~~---1
As observed by 11104/08 In gross and fine motor group, follows
OTIPT staff during simple groupnorms sucb as walking to a carpet
both gross andfine squareand sitting down, waits for instructions for
motor groups as well the WIIIID up acm'ity and makes nice eye contact
as when seen for with the instructor, He can follow more than one
Individual therapy step Instructions but is inconsistentdue to limited
memory ofsequentinl steps, requiring reminders and
needs supportto focus on details. He is kind to his
peers and triesto help themwhen he CUD by verbal
cueingDr giving a helping hand.
Language group end 10/6/08- independently greets adults. he asks and

small grouptherapy 1116/08 answers questions as his language abDity allol.\'S.
He ptayscooperatively with peers.
Deveklped bVthe EarlyChildhood Outcomeli (ECO)CenlerWith SUppart fromIhe Offi::e of Special Educalion :2
Programs, U.S. Department DfEducallcn.
127
PRESCHOOL
1b. (tf Queslion 1e has, been answerad pruvlously): Has the child shown any new skills or behaviors
related to positive soclo-emotJonal skills (Including positive social relationships) since the last
o uteornas summarv? (chec/r OIIeJ
-· :.j~k.~~,\J j~;~g~ ~~rr ~
:~~}!~~'" ~:":""~~~
Describe progress:
0-' 0-2 0-0
Developed by lhe EaJ1y Chndhocd Outcomes (EeO) Centerwith Support from the Office Df Special EduC8tiorl 3
ProglilRlS, U.S. DepBrtmenl Dr Education.
128
PRESCHOOL
2... ACQUIRING AND USING KNOWLEDGEAND SKILLS
Toanswerthequestions belaW. think about the child's hmcticning in these and closely relatedareas (es
indic;aled by assessments andbased on observations from individuals in closs contact with Ihe chfld):
Thin/dng. reasoning, remembering, and problemsolving
• Understanding the physicalend soc:ial worlds
2a.To "hal extent does this child show bshaviors and skDIs related to this outcome appropriate fDr
Not Yet -Emarglng emerging -Somewhat. Somewhat -Completely Completely
0-1 0-2 .[J.4 0-6

0-3 XD-5 01
Chll:l dllS:l Ml Cl1lldSllDvJS ChBd show; Child51\DVtS Chlblsho\ll5 CbIId g9l11ltlllly Chi~ sl1a¥Ili 29&' IIlIIJllIlI:iale
yDllWIWany some 1m.'1I1U!lah= StlIll~ bul l\Q1 ll!J00 8flPmpMlU sh:lWS Ilgll- funt;llcn!ng in alillf a1ma,t an
lmmlll:Ilate Immedlalll rOllndsllllnel mucllIIgll' rum:ll:lnlng some DIIpnspr!ale 8IIlllYdiIYs!lwll!a11!l
~wuIllUoaal
fllUltd;llanal sldllc mostor opprvprlale aflhBtbuI fundllmlng but
skBmln IllY skill!; all of lhollme. fur.cllDnlng. aiId/Qr h same lho(l! 1I111 1IDm&
sllull1\on. IlBuallDsl!l. s1unllicllJ1t
CDnc:sms
As observed by 11/04108
OTIPT staff during
both gross and fine
motor groups as well
as when seenfor
Individual therapy
Developed by the Early Chlklhcod Outcomes {ECO} Centerwllh SUp;lOI1 fromUle Offrce of Special Education 4
Pmgmms. U.S. Department ciEducaUon.
129
PRESCHOOL
atypical activities to facilitate
Classroom language 10/6/08- is learning the theme vocabulary and Is

lherapyand 11/6/0B able to Iabel correctly new vocab. He Is able to .
individual/small group point to obje..'1s In books and Is also learning verbs
therapy and can point to them with some cues.
2b. (If Question 2a hasbeen answered previously): Has the child shown any new skills or behaviors
related to acqu1rine and using Icnowledge and skills since the last outcomes summary? (check one)
"- ~'o:' P~' ~ 2~J~~

'.'.Y.~::;,i ~~ ~~~,~1N:t~~:Ji~ Describe progress:
· . ' ••1 • ••• - "t..' f
0-' 0-2 0-0
.,...,
Developed by the Early Childhood Outoames (E!=O) Csnlerwllh Support from the Office of Special EducaUo., 5
Programs. U.S. Department of Education.
130
PRESCHOOL
3. TAKING APPROPRlATE ACTION TO MEET NEEDS .

To answsr/he quastlons below, think about the chHd's functioning In these and closelyre/aiea Cll'Bas (as
indicated by assessments and based on observalions from individuals in close contact .,.lith the cJtJIcJ):
Taking care of basipneeds (e.g., showing hunger. dmsslng, reading. lofleling, etc.)
Contrlb1Jling to ovm health and safely (e.g., follows rules. assists 'vith hand washing, avofdsfned1b!e
objects) (if olderthan 24 months)
Getting from place to place (mobolty) lind using toals (e.g., faries, penelis, strings attached to objects)
Ja. To whal extent does this chIld show behaviors and skills related to this outcome appropriate
Nat Yet -Em\!rglng Emerging -Somewhal Somewhat -Completely Completely
0-1 0-2 0-3 o- XO-5 D-6 0-1

Chitl dcas nat Cn!ld :;ham; Chllllllhcws Ciild IIhClWll Cl1UdslllnllS Child genllF1l&Y Chlld shDWS Bge- Ipprgpllate
yellhowany SIlIllll Immlldlalc saml! bUll1Dl 89e-appropriate sIlowaDga- fundlonln; in 8lIor almllSlall
!mmlllliala lmmadllIla lIlundaUonal mucllll!l" IuncllDnlng soma DllPTDPflale lMIryday slIUl\Um"
IIIlIlIdDIIa n;I IllUIIliIIliana ! skill' moll or IIJlJll1lprtala arl/lDdrno functlanin; but
skilllln any r.ItlIIs aU of lll& llma. runcllontng. lllIdIar In llama lIulle atl!same
llRual!lln. duatIlIRII. slgnlflCll\l
CIInlZms
~ ~.
~~-=?~~";";';'---..:-..f
is in diapel'B and does not feellhe
sen&ations of his bowel and bladder. He is a willing
child when It comes to changing him and will help
by lifting and lowering his body to help In the
changing precess. He can wash hands and throw
the paper towel in the trash. He wiD request more
snack or choose not to eat it if he doesn't mee it He
has not yet said no thank you if he doesn't warn it
He 1& mobile and can wBlkfrom place to place in 1he
room and building. He uses tools like a spoon,
era ona, & scIssors.
As observed by 11104/08 does demonstrate underslflnding of the use
OTJPT staff durlng ofbnsic classroom objects such as markers, scissors,
both gross and fine gluesticks and can physically manipulate them to
motor groups as well participate in class projects.. He is ableto walk
2S when seen for
independently (using an AFO) and follow adults or
individual therapy
peers, can imitate mnvemems as pari. of a motor nnd
is cautious about activities whichmay posea
balance hszard. Once be learns B skill, he can be
Dluch mare willin tn take risks andbe inde endem.
Developed by Ihe Earl~' ChUdhocd Oul::ames (~CO) Cantor with Support lrom the Office cl SpecialEducallon 6
Programs. U.s. Department. credu:a1lDn .
131
PRESCHOOL
Classroom language 10/6108- is learning the themevocabulary and is

therapy and 11/6/08 ableto label correctly new vocab. He is able to
individuaVsmall group poIntto objects in books and Is also learning verbs
them v and can oint to them with some cues.
3b. (If Question 3s has been anslfleredpreviously): Has the child shown any new skills Dr behaviors
related to taldng appropriate action to meet needs since tho last outcomes summary? (Chec/r one)
¥~g~.~:~ t~~~!'~*~ !~~~~i Describe progress:

'.-:~:';'"''
0·1 0-2 0-0
1 fiR. EX rr C-(j SF
Oeveltlped by the Early Chlldhoad DIJLcoms& ceco) Center withSUpport fremIhe Office of Special Erlu;;alion 7
Programs, U.S. Department of Education.
132
Private and
Home Schooled
Students
133
PRIVATE AND HOME SCHOOLED STUDENTS
SPECIAL EDUCATION SERVICES FOR PRIVATE SCHOOL and HOME-SCHOOL

STUDENTS
All students ages 3-21 residing within a school district's boundaries have a right to access special
education evaluation processes and special education services. regardless of whether the student
is enrolled in a district school. IDEA and the WACs have different rules for the provision of
services to students enrolled by their parents in private schools depending on whether:
• The student is of preschool age or at the K-12 level
• The private school attended by the student is within or outside of district
boundaries
• The student's parents agree to enroll the student in the district for services
• The private school is secular or faith-based
• The student receives home schooling
EVALUATION
For K-12 students, evaluation is the responsibility oftire district in which tireprivate school is
located, even if the student does not reside in the same district. The referral is handled by the
school the student would attend based on the address of the private school.
fOf hOJJJ~:§f/JOo[~dJrud~lIt§ ~§idiRg Witllill lll~ di§tFifr'§ houlfdafi~J ~valflatioll;I I/'~

responsibility ofthe student's neighborhood school.
For preschool students, evaluation is tire responsibility ofthe district in which tire student
resides regardless of the location ofthe student's preschool or child care center. The referral is
handled by the preschool assessment team (PAT)~
Private school and horne-school students may be referred for special education evaluation by
their parents, private school staff members, physicians, or other concerned parties. As with any
student, the WAC timelines apply and a referral does not automatically lead to an evaluation.
All regular evaluation processes must be followed.
When the evaluation is complete:

• If the student resides within Everett Public School boundaries, forward the evaluation to
the appropriate IEP team for the development of the IE? Please make sure the team at
the school is aware that an IEP will be developed for a private-school student. If the
parents explicitly state that they are not interested in an IEP. please contact your special
education director immediately so that a decision can be made about how to proceed.
• If the student resides outside of the Everett Public Schools boundaries, inform the parents
that they may take the evaluation to their resident district and request that an IEP be
developed. Without a signed Mutual Exchange of Information statement, the Everett
evaluation team may not contact the resident district or forward the evaluation.
134
Individualized Education Plan (lEP)
Dual Enrollment. Every special-education eligible private school or home-schooled student

residing within the district boundaries is entitled to IEP services. In order for parents to accept
and access special education services in the public schools, the parent must enroll the student in
the district. Parents should enroll their child(ren) at their home school. Private school students
are often referred to as "dually enrolled" students because they are enrolled in both the public
and private schools.
Students who attend private schools in Everett, but do not reside within the Everett Public
Schools boundaries, are not entitled to receive IEP services from Everett. Their parents may, as
for any other non-resident student, apply for a variance to be allowed to enroll in Everett School
District.
IEP team. For private school students a general education teacher who serves the student at the
private school should be invited to the IEP team meeting.
IEP Formulation. As with any other special education student, the lEP must be properly
formulated and address every area of student eligibility. The determination of minutes of SOl (as
reflected in the summary of service) must reflect the amount of service reasonably calculated to
result in meaningful progress on the student's goals and may not be influenced by scheduling
issues . The iEP team must ihe
make program recommendation (resource room , exienaed
resource, positive behavior support, etc) that they believe would be appropriate given the
student's level of disability and educational needs. The decision must be made as if the student
was a full time public school student. The IEP team cannot make a program recommendation
that is different than the recommendation the team would make if the student was a solely
enrolled public school student.
School Assignment. The location of IEP services for private and home schooled students will be
determined by the Special Services office and the decision will be based on capacity. While the
district does its best to place the student in the school closest to the private school or the home
address, private and home schooled students do not have an entitlement to receive services in any
particular location.
While there is no rule barring districts from providing services on site at secular schools, districts
have no obligation to provide services anywhere but at public school sites and generally provide
services at public schools for the sake of efficiency, resource availability and team programming.
School districts may not provide services or material support on the sites of faith-based private
schools.
Scheduling. Private and home schooled students will be offered SDI commensurate with the
schedule that already exists in the school to which they have been assigned. The school district
and individual schools have no obligation to alter their scheduling to avoid scheduling conflicts
with the private school or personal schedules.
135
Parent Refusal ofServices, Private school and home-schooling parents often wish to engage in
"cherry picking" - opting for some of the offered IEP services and rejecting others. In general
the district will allow private school parents to reject some IEP services. documenting this
refusal in a Prior Written Notice (previously known as Notice of Action). IEP teams may not
change the IEP to eliminate or reduce the services the parent does not wish to access.
Transportation. The district has an obligation to provide transportation as a related service to

dually-enrolled private school students and to enrolled home-school students if the service is
required for the student to access SOL Transportation is provided from or to the private school
and/or home address; depending on where the student is at the time services are offered. The
district has no obligation to transport students across district boundaries. Students who reside
in Everett but attend private schools in another district may be transported to and from their
private schools by their parents. See Transportation page, under Transportation section.
~
\
136
Psychologist
F Procedures
r:
\
137
PSYCHOLOGIST PROCEDURES
'"
( ..
School Psychologist Overload Procedures
Definition:
Overload is a condition that is caused by an unexpected number of evaluations that are due at
one time, or an unexpected influx of students that require verifications/evaluations.
Overload is not due to:

• Re-evaluations that are known at the beginning of the year, unless there is a group of re-
evaluations that were all done at the beginning of the year.
• Performing general education testing that is not specifically due to a decision to assess for
special education, i.e. it meets all the criteria for making that decision
• Performing "other tasks" for general education
o "Other tasks" are defined as: RTI, Curriculum Based Measurement, reading in a
general education classroom, or other activities that are in the general education
realm. If your principal wants the psychologist to participate in these activities
and the psychologist also wishes to do so, the principal need to speak with Special
Services about how the psychologist will be paid for the time, or the school
psychologist needs to be able to complete all primary testing duties without
asking for additional assistance.
-Parameters
•
. . ..
of Overload Request:
- - ----- - - - - - - - - - - - - - - -
Do not hand off students that are short on timelines. Hand off the ones just received.
• Do not hand off cases that are particularly difficult as these would be best served by
having the psych at the school involved; hand off easier cases.
Procedure for Requesting Overload:

• Email the School Psychologist Lead with your request at least 2 weeks in advance of
need. Include the following:
1. Why you are experiencing the overload
2. What specific relief you are seeking
3. Timelines for the relief
• School Psychologist Lead will review the request and may ask for additional information
including a list of students tested and what their needs are.
• School Psychologist Lead will make recommendation "for" or "against" overload assist
within 1 day of receiving needed information and then send this to Special Services for
review.
• Special Services will review and provide any information that needs to be considered
within 1 day.
• School Psychologist Lead wiIJ then make request of Overload Psych and provide the
information.
• School Psychologist Lead will get back to the requesting school psychologist within 3
days.
138
• Overload Psych will contact the requesting school psychologist. They will work out
specifically what needs to be done and when.
• Overload school psychologist will have a tracking sheet and will complete this sheet to
help track the needs.
Oversight Committee:
An oversight committee will be established that meets each semester to review the overall
procedure implementation and make recommendations for any changes.
Test Kit Acquisition Procedures
1. Get information from the school psychologists about which tests Special Services no
longer needs to support and recycle those kits.
2. Identify the main purposes for each test kit 's use of those we continue to support.
3. Get information from school psychologists regarding what "purposes'Yneed for testing
are not covered by current test kits .
4. Investigate tests that are on the market that address the need. Based on investigation,
make a proposal to the psychologists.
5. Psychologists vote on new test kit. If agreed, a recommendation for how many to
purchase and how to share the kit , will be made.
6. The recommendation is ~iven to the administration which includes c()st1 ~m:i ~ ITl~th9g for
C' 7.
sharing and how it will enhance the current testing and perhaps replace something else.
Administration lets the psychologists know if the test kit proposal looks feasible.
8. If the test kit proposal is bought off on by the psychologists and administration, then a
timeline of acquisition (and ifreplacing something, for replacement) is determined.
139
Test Protocol Procedures
I. School Psychologists identify which test kits are no longer needed and those protocols
and kits are discarded
2. School Psychologists will provide input to administration through a form provided by
administration, of the number of protocols they have for each test kin in their possession.
3. Based on that input, protocols will be sent to each psychologist to get them through the
151 semester. The goal would be to have 25 protocols for each core test kit for each
psychologist.
4. Additional protocols will be ordered and kept at Special Services to be sent out as
needed.
5. Prior to the end of the Isl semester or January, another query will be sent regarding
number of protocols in schools and school psychologists will be re-stocked to 25. Special
Services will continue to have a stock of most used protocols on hand to send to school
psychologists if needed.
6. Special Services will stock a pack of "on call" protocols for each kit that the
psychologists have determined they still use. This will be re-evaluated at the end of the
year.
7. Regionally based kits such as the DAS 2 will be stocked with 25 protocols in the kit.
When the psychologist using the kit sees that the protocols are down to 5 they are to let
Special Services know so the kit can be re-stocked. Extra protocols will be kept at Special
Services.
8. At the end of each year, school psychologists will discuss which test kits can be recycled
and which are still to be used. The count for number of protocols will be taken and
Special Services will continue this cycle for replenishing protocols.
140
~.
' ..
Resources
141
Revocation
of
Consent
143
REVOCATION OF CON SE'( T FO R SPEC I A L EDUCATIOl': SER V ICE S
In response to federal guidance effect ive December 3 1. 200 8 parents of students w ith IEr s may
revo ke co nsent for s pec ial education and related se rvices. In other word s, parents may now reject all
IEP serv ices and return their students to general ed ucatio n cla sses. Please IWfifY YOIlT area special
education director if this issue co mes lip in y our s chool!
DO C UMEl':TATION
• Parent revocation of conse nt for serv ices must be in writing. T he distri ct can accept a
signed and da ted handwritten or typed no te from a pare nt. or an ema il if the parent ' s nam e
is iden tifiab le in the em ai l address. T he stale also pro vides a form that the paren t can sign
in lieu or a note . Thi s form is a vai lab le o n the aSPI website (in S pec ial Education. under
Medel S tate Forms).
• Adult studen ts may revoke con sent initia lly pro vided by their pare nts. This revocation must
also be in writing, If the ad ult stude nt verba lly indi cates a desire to revoke services and is
unable to writ e a note. please co ntac t your area specia l educat ion director for guidance,
• Aft er rece iving a wr itten notificatio n of re vocat ion of consent, the d istr ict must send the
paren t or adu lt student a Prio r W ritten No tice (previously kno wn as Notice o f Action )
informing hint/her of the ram ification s of this decision , There is a copy o f this document on
SEAS"
• It is reco mme nded that. u nless the parent is insistent on immed iate effect. the
effec tive date of the change is about 5 days o ut to g ive the parent or adult
stude nt time to change his/her mind .
• Pend ing revisio n of the Notice of Procedural Safegu ards. an am endme nt to this document
is available to provide to parent s co nsidering revo cation.
SER ' "ICES
• Students for whom IEP se rvices have been revoked must be served as general education
stude nts . Stud en ts may return to their nei ghborhood schoo l at parent req uest.
• Seco ndary schoo l students for whom co nse nt has bee n revo ked must be removed fro m
special edu cati on classes and enro lled in ge neral educ at ion classes. We sho uld encourage
parents of high school stude nts to consider waiting nntil tile end of a course before
revocation so that the change ill ser vices will not impact credit accrual.
• We will no longer allow parents o f full tim e enro lled students to accept some IEP services
and reject others (a practi ce ca lled "cherry pick ing "). Parents and adu lt students ma y accept
or reject the entire IEP.
• For stude nts w ho are currently cherry picki ng, we will allow the student to
finish out the IEP cyc le un less there is a co mpelling rea son to add ress the
education plan be fore the nex t annua l meeting,
• A parent ' s (or adult stude nt ' S) revocation of consent for spec ia l ed ucation services is also
10 be treated :15 a rejectio n o f accommodations under Section 50-l. IEP se rvices. inclu ding
accomm odati ons and mo difi cation s. are not to be rolled over into a 504 plan.
144
REVOCATIO~ OF CONSENT FOR SPECIAL EDUCATION SERVICES
• Students for whom lEP services have been revoked may not have the Measurement of
Student Progress (Grades 3-R) or the High School Proficiency Test (Grade 10) or other
testing accommodations nor may they take the basic state assessment, DAPE (previously
called the DAW), LDA, or WAAS (Portfolio).
RECORDS
• Revocation of consent is not retroactive. The district or school will not amend student
records to remove references to special education eligibility or destroy or remove special
education paperwork (lEPs and evaluations) that would typically remain in a student file.
DISCIPLINE
• Disciplinary protections that are available to students under IDEA 2004 are NOT available
to students whose IEP services have been revoked. This means that disciplinary infractions
for previous special education students should be treated as they would for general
education students . Initial guidance from aSPI suggests that re-referral does not invoke
disciplinary protections during the evaluation process for students whose IEP services have
been revoked.
RE-ENTRY
• If a parent who has revoked services indicates a desire to resume special education and
related services, the parent may make a referral for a special education evaluation. This
_ .1'1.. • ... . . t.- __ ., __ . _ r ....._ ..... U'~-J .u~ .. _ .... _._....'-4 • .lUI .... ~t''¥ .... JUj .... UU"""UVll ~valuallUl1. JJJJ~
referral will be treated as an initial evaluation. A full evaluation addressing all areas of
suspected disability will be conducted within appropriate referral and evaluation timelines.
Parents may not choose to reject evaluation in any area that was previously an area of
eligibility or is now an area of concern.
Please refer to aSPI website hnp:/lwww/k 12.wa.us/S[!ccialEd/rcgulations.aspx. for the addendum explaining
revocation of consent in the Procedural Safeguards
\45
Riser
rrgt~dur~§
146
f RISER PROCEDURES
Evaluationl amend Riser Forms in

Program Needed SEAS Riser Meeting Needed**
Preschool to :
General Kindergarten yes to exit none No
General Kindergarten
with yes IEP revision No
therapy or Resource
room NOA
Self Contained DK no IEP revision no

transportation
Self Contained DK
Behavior no NOA no
Extended Resource no same as above no
Life Skills no same as above no
Self Contained OK and

PBS OK to:
F General 1st grade yes to exit none no
General 1st grade with nol yes· IEP revision no

therapy or resource room NOA
any self contained class no IE? revision no

transportation
NOA
·NOTE An evaluation or
evaluation amendment is
needed if there is a
significant change in
program minutes.
"NOTE In lieu of riser meetings. teams can do an IEP revision. transportation form and NOA at the evaluation
results meeting or March conference.
147
RISER PROCEDURES
Self Contained
Developmental
Preschool
-
Self Self-Contained General Ed General Ed
Contained Developmental with with
Primary Kindergarten Resource Therapy
Room Only
Are you adding, deleting, or Yes, a reevaluation or evaluation amendment is

changing an area of SOl? required
No, an evaluation or evaluation

amendment is not required
~
\
148
RISER PROCEDURES
Preschool
with peer
models
Self Self-Contained General Ed General Ed

Contained Developmental with with
Primary Kindergarten Resource Therapy
Room Only
, , 1
Are you adding, deleting, or changing an area of Yes, a reevaluation or evaluation
SOl? amendment is required
No, an evaluation or evaluation

149
RISER PROCEDURES
Self-Contained
Developmental
Kindergarten
Self General Ed General Ed

Contained with with
Primary Resource Therapy
Room Only
!
Are you adding, deleting, or Yes, a reevaluation or evaluation
changing an area of SOl? amendment is required
No
No, an evaluation or evaluation .

150
.ii""'"" . II ..., II
RISER PROCEDURES
( '
KINDERGARTEN PROGRAM OPTIONS FOR STUDENTS WITH AN IEP
General Education (with resource room and/or therap\' support)

Mild or no cognitive delays
Mild or no academic delays
Mild or no adaptive delays
Mild or no social delays (does not include students with significant aggression)
May have need for communication and/or motor therapies (does 110t include students who are unable to
communicate effectively in group settings)
These children will he expected to progress with the general kindergarten curriculum (with
accommodations. modifications, and/or special education support) at a pace roughly commensurate
with that oftheir typical peers.
Developmental Kindergarten
Cognitive delays
Academic delays
- Adaptive delays
May have sociallbehavioral delays
May require communication and/or motor therapies
f~ These students may access a pre-kindergarten curriculum or may progress 'with the typical kindergarten
'. curriculum but at a slower pace than that oftheir typical peers.
Positive Behavior Support Kindergarten

Mild or no cognitive delays
Mild or no academic delays
Mild or no adaptive delays
Externalizing sociallbehavioral issues that have resulted in creation of an FBA, BIP, and IEP goals
addressing aggressive behaviors
May require communication and/or motor therapies
These children will be expected to progress with the general kindergarten curriculum (with
accommodations, modifications, and/or special education support) at a pace roughly commensurate
with that oftheir typical peers.
Extended Resource
Mild-moderate cognitive delays
Mild-moderate academic delays
Mild-moderate adaptive delays
May have mild-moderate social/behavioral delays
May require communication or motor therapies
Includes students with the above profile who would be in self-contained DK but require a full day
( ' program to make meaningful progress on lEP goals.
151
RISER PROCEDURES
r:
-. These students may access a pre-kindergarten curriculum or may progress with the typical kindergarten
curriculum but at a slower pace than that oftheir typical peers.
Life Skills
Moderate-severe cognitive and pre-academic delays
Adaptive delays
May have social/behavioral delays
Will Jikely require communication and/or motor therapies
Students will likely need a life-skills or functional approach to academic instruction
Includes students with the above profile who would be in self-contained OK but require a full day
program to make meaningful progress on IEP goals
These students will likely need a pre-kindergarten curriculum.
152
Safety Net
153
SA FETY NET
SA FET Y NET
Safe ty Net is a means by which dist ricts that spend m ore on special educatio n services than they rece ive
for these se rvices can apply to the state for grant funding to reimburse them for serv ices to hiuh cost
students. Safety le t fund s arc intended to allevi ate the finan cial drain of stude nts whose edu~ational
needs cost the district substantially more than the district receives for that stude nt 's education.
• Safe ty Net funds can only be awarded to districts that have estab lished that they spend marc on
spec ial educat ion than the special education reven ues provided by the federal and state
governments.
• • Safety Net funds are availab le for students w ho cos t more than 2. 1 rimes the Average Per Pupil
Expenditure (APPE). For the 2009-20 I0 school year. Safe ly et funds will be available for
students who cost the district more than S 18.608 for school di stricts who adequately demonstra te
need for add itiona l funding .
• Everett Public Schoo ls will submit to the Safet y Net com mittee IEPs for students with ded icated
paraprofessi onals o r interpreters, contract placements or expe nsive assisrivc technolo gy, and
students in se lf-contained classrooms with high stnff to stude nt ratios.
• Ind ividual lEPs of high cos t sillden ts arc scru tinized by the Safety Net Oversight Committee.
• The legislative language establishing Sa fety Net specifies that funds can only be award ed for
students with properly fo rmulated lEPs. IEPs submi tted to Sa fety Net must show evide nce of
procedura l correctness and have all the required elements established by the WACs.
• The most common reason IEPs arc not funded by the Safet y Net committee arc :
I. lEP ' s contain goals that are not measurable (goals that do not contain basel ine and goa l
data points and/or appropriate measures),
2. LEr' s have incomp lete or vag ue transi tion plans (tra nsition plans lacking in age-
appropriate transition assess ments. po st-school o utcome goals, and/or courses of study)
and
3. lEP' s do not properly specify and qua ntify services in the Summary of Service Matrix.
• Fund s awarded to Everett Public Schools by the Sa fety Net Oversight Commit tee go into the
general fund. No department. school, or progra m has an y individual cmitle mcn t to any of these
funds.
• Everen Public Sc hool s will never ask an IEP team to put something in an IEP for Safety Net
purposes that would o therwise not be co nside red approp riate for the individual needs of a
student. A " Sa fety Ne t fEP" is essentially a well -wr itten, properly formulat ed and compliant
IEP
• It is never appropriate 10 discuss Safety Net 0 1" G il)' otherfunding orfiscal issue at all IEP
meeting.
154
State
Assessments
155
r STATE ASSESSMENTS: MSP & HSEP (PREVIOUSLY CALLED THE \\'ASL>
Special Education State Assessment Testing Options by Grade Level:
3rd thru 8th grade:

• Measurement of Student Progress (MSP) with accommodations
• MSP Basic (Measurement of Student Progress at a level 2 in qualifying areas) OSPI
recommends that the BASIC be used as an option in high school only, but remains an IEP
team decision. Buildings should be aware that the BASIC is not recognized bJ' the Federal
Government as an assessment option and therefore it is considered a zero score for A I'P at all
grade levels. The Basic is considered acceptable for graduation requirements.
• WAAS Portfolio (for those students who demonstrate significant cognitive disabilities and
require intensive instruction in multiple settings to accomplish acquisition. application and
transfer of knowledge/skills)
10th Grade:
• High School Proficiency Exam (HSPE) with accommodations
• HSPE-Basic: High School Proficiency Exam at a level 2 in qualifying areas, based on IEP team
decision.
require intensive instruction in multiple settings to accomplish acquisition, application and
trnn~f~r Qf knQ\VI~gg~/~kms)
u" Grade:
• HSPE with accommodations
• HSPE-Basic (level 2 in qualifying areas)
• DAPE (Developmentally Appropriate Proficiency Exam) must pass at Level 3 on a MSP from
grades 3-8 available/or students in grades 11 and 12 only
12th grade:
• HSPE with accommodations
• HSPE-Basic (level 2 in qualifying areas)
• DAPE (Developmentally Appropriate Proficiency Exam) must pass at Level 3 on a MSP from
grades 3-8 available/or students in grades 11 and /2 only
• Locally Determined Assessment: Twelfth-graders receiving special education services for whom
the High School Proficiency Exam (with or without accommodations), the HSPE-Basic (passing
is at Level 2) or the Developmentally Appropriate Proficiency Exam (DAPE) are not appropriate
tools to assess their skills.
156
STATE ASSESSMENTS
Continuum of Cognitive Development

& Assessment Options for Grades 3-8
Level .of Cognitive Development Assessment Option

Abstract Conceptual:
Comprenends. interprets . and
analyzes on-grade level text; Assessments with or
understands and applies on-grade
level mathema tics concepts and
without
skills: communicates in writing using accommodations
etaborauon and complex structures
Concrete Conceptual - on Grade

Level: Reads and comprehends on-
grade level text; masters a limited
number of on-grade level
mathematics concepts and skills:
communicates ideas in writing with
limited eiaboration and simple
structures
Basic Assessments
Concrete Conceptual - on or with or without
below grade level: Reads and
comprehends below-grade level or accommodations
modified on.grade level print texl;
masters below grade level or a very
limited number of or•.grade level
mathematics
_
concepts and skills;
- - _. _ - . -- -- _ .. _ - -- ..-.
communicates baSIC ideas In writing
using simple structures
Abstract Symbolic: Reads sight

words and picture symbols; writes
using sight words or picture symbols
to communicate : counts objects and
recogniZes symbolic numbers;
cemprenencs modified texts
composed of sight words and picture
symbOls
Early-symbolic: Recognizes
pictures; may also use a range of
pictureS/objects to communicate
IWAAS Portfolio
ideas
Pre-symbolic: Uses objects or

gestures 10communicate; relies on
immediate context and uses objects
to communicate
Awareness: Limited consciousness

and/or communication
157
STATE ASSESSMENTS
Continuum of Cognitive Development& Assessment Options

for Diploma (Grades 10-12) Requirements
Level of Cognitive Development Assessment Option

Abstract Conceptual:
Comprehends . interprets. and
analyzes on-grade leveltexl;
understands and applies on-grade Assessments with or without
level matnematics concepts and accommodations (Grades 10-12)
81(111s; cernmun tcates in wriling uSing
elaborat;on and complex structures
I
Concrete Conceptual on Grade
Level: Reads and comprehends on-
grade level text; masters a limited
numbe~ of on-grade level
mathematics concepts and skills;
Basic Assessments with or
communicates ideas in writing with without accommodations (Grades
limited elaboration and simple 10·12)
strUctures
Concrete Conceptual on or below

grade tevet: Reads and
comprehends below-grade level or
modified on-grade level print text; WAAS-DAA with or without
masters :>elowgrade level or a very
accommodations (Grades 11.12)
limIted number 01on-grade level
millhl!lTliltiG§ G9n(;@pt§ i1ns 6kill§; or L.DA (GI1I(jG 1~)
commun;eates basic ideas in writing
uSing simple structures
Abstract Symbolic: Reads sight

words and p icture symbols; writes
using sight words or picture symbols
to communicate; counts objects and
recognizes symbolic numbers:
comprehends modified texts
composed of sight words and picture
svmbols
Early-symbolic: Recognizes
pictures; may also use a range of
I
WAAS Portfolio (Grades 10·12)
pictures/objects to communicate
ideas
Pre-symbolic: Uses objects or I

gestures to communicate: relies on
immediate context and uses Objects
to communicate
Awareness: Limited coosccusness

and/or
L...- communication --' } Waiver through Special
Circumstances Appeals (Grades 11-12)
158
Transportation
159
TRANSPORTATION
Transportation Pick up/Drop off Information
In Everett, we work together with families to maintain a safe transportation system. To avoid confusion
and maintain consistency for students and staff, we will be implementing aI pick up, J drop off location
policy. Both locations need to be within District boundaries. If daycare is different from home, it needs
to be within a reasonable distance and must be consistent. We can no longer accommodate "as needed"
pick up or drop off stops.
160
Vision Services
r-
".
161
VISION SERVICES
Information about Vision Services
Everett Public Schools employs a Teacher of the Visually Impaired (TVI). Services include:
• Vision assessments
• Braille instruction
• Technologies for the blind
• Orientation and Mobility
• Consult and support services for students with visual impairments
Please contact Terri Lang, TVl, if:
• Vision is considered an area of concern in the evaluation process

• Prior to any IEP meeting in which vision impairment or visual issues are stated on the IEP
Visual Impairment is determined based on medical criteria. This criterion includes:
• Acuities
• Field of vision
• Retina and optic nerve health
~
t Students, whose acuities or field of vision deficits can be correct by wearing prescriptive glasses, are not
considered visually impaired.
Terri (Teresa) Lang, TVI, can be reached via e-mail or phone at ext. 5268.
162
Addendum
163
ADDENDUM
EVEREIT PUBLIC SCHOOlS DISTRICT SPECIAL ED POllCY
2210
Page 1 of5
INSTRUCTION
Special Education and Related Services for Eligible Students
The District recognizes that students whose disabilities adversely impact educational performance and
who require specially designed instruction can improve educational performance when they receive
special education and related services tailored to fit their needs.
Each eligible special education student in the District will be afforded a full education opportunity. This
goal will be met consistent with the state's goals through ensuring the provision of a free appropriate
public education, complying with state and local procedures, and improving performance goal
indicators.
The District shall comply with state and federal requirements for special education. The
Superintendent shall develop procedures consistent with state and federal laws and rules to implement
the following:
• Free appropriate public education;

r: ·
.
Con~denti.ality ojper~onaH~ i~~n.tifiable jnTormat~on;
• Identification, evaluation, eligibility and reevaluation;
• Participation in assessments;
• Development of individualized education program (lEP) and placement;
• Participation in regular education. least restrictive environment (LRE);
• Procedural safeguards;
• Parent participation;
• Transition from Part C to Part B services for preschool children;
• Private school students unilaterally placed by parents;
• Staff qualifications and personnel development; and
• Program administration and evaluation.
The Superintendent shall develop procedures to implement this policy, as directed by federal regulation
(34 CFR 300.220). This policy and procedures shall be consistent with the state's special education
regulations and filed with the Office of the Superintendent of Public Instruction.
Not all students with disabilities are eligible for special education services. The needs of each student
will be addressed individually and provided appropriate accommodations or modifications required
under § 504 of the Rehabilitation Act, Title II of the Americans with Disabilities Act, and the
Washington laws against discrimination.
164
ADDENDUM
r: 2210
Page 2 of5
Free Appropriate Public Education (FAPE)
The District shall provide all eligible students with disabilities ages three through twenty-one
with a free appropriate public education, which consists of special education,
necessary related services, and supplemental aids and services, provided:
1. at public expense, under District supervision and direction;

2. in compliance with the standards of the State Educational Public Agency;
3. to include preschool, elementary, and secondary educational opportunities: and
4. in conformity with an Individualized Education Program (IEP) which meets the
requirements of special education rules.
Such educational and support services may extend beyond the traditional 180-day
school calendar year if necessary to provide an individual eligible student with a free
appropriate public education.
Confldentlality of Personally Identifiable Information

In addition to complying with the District's policies and state and federal law on the
confidentiality of all student records, the Superintendent is directed to develop
procedures to implement confidentiality requirements that are consistent with state
~ special education rules.
This includes informing parents of students or eligible students of their right to

confidentiality, at least annually, through appropriate notice.
Identification, Evaluation, Eligibility, and Reevaluation

Childfind
The District shall develop and implement awareness and screening activities for the
purpose of locating, identifying and evaluating all resident students enrolled in school or
not who are suspected of having disabilities and are in need of receiving special
education and related services. These procedures shall encompass students ages birth
through twenty-one regardless of the severity of their disability who reside in the District,
including those attending public and private agencies and institutions, and religious
schools.
The District's procedures shall also include methods for conducting childfind activities
including methods to determine which students are/are not currently receiving needed
special education and related services. The procedures shall include methods to locate
students who are highly mobile and students suspected of being a student with a
disability and in need of services even though they are advancing from grade to grade.
Childfind procedures shall be developed in consultation with appropriate representatives
of private school students.
165
ADDENDUM
("' 2210
Page 3 of5
Evaluation and Eligibility
The District shall develop evaluation procedures that are consistent with state and
federal requirements. including: referral, evaluation methods and timeline(s), areas of
evaluation, periodic review. evaluation safeguards. reporting and documenting the
determination of eligibility and independent educational evaluation.
The District recognizes the developmentally delayed category for eligible students ages
three to nine. The Superintendent shall develop procedures for implementation of this
eligibility category.
Reevaluation
The District shall develop reevaluation procedures that are consistent with state and
federal requirements, including general requirements, purposes, notice of results,
procedures for appropriate identification and classification, and procedures for
determining continuing or additional needs for special education and related services.
Development of IEP and Placement
Development of lEP
~ The District shall develop procedures for implementing the lEi> requirements for each
. student that are consistent with state and federal regulations, including methods for
updating each IEP at least annually and appropriate inclusion of eligible students in
local and state assessment programs.
Placement
The District shall develop procedures for implementing state and federal requirements
regarding the delivery of special education services including: least restrictive
environment, nonacademic and extracurricular services, alternative service delivery
options, placement considerations and annual review, initial placement, evaluation of
IEP, preschool services, District initiated placements, transition of preschool students
from Part C to Part B services, and placements paid for at public expense.
The District shall also develop procedures to determine the services provided to
students unilaterally placed in private schools by their parents. The procedures shall
include consultation with appropriate representatives of private school students to
determine the number of unilaterally placed students. the needs of students and their
location, so that it can be decided which students will receive services. what services
will be provided, how and where services will be provided and how services will be
evaluated.
166
ADDENDUM
t": 2210
Page 4 of5
Procedural Safeguards
The District shall develop procedures for implementing safeguards for parents and
students consistent with state and federal requirements that include notice relating to:
informed parental consent, assessment (protection in evaluation procedures),
confidentiality, opportunity to examine records, prior notice, independent educational
evaluation, impartial due process hearing, surrogate parents, discipline, attorney's fees,
mediation and citizen complaints.
Personnel Development
The District recognizes the importance of a qualified staff in delivering appropriate
educational services to special education students. The Superintendent shall develop
procedures for the implementation of a District plan for hiring and staff development for
administrators, teachers and support personnel. Such a plan shall be complementary to
the statewide plan for Comprehensive System of Personnel Development, which
includes:
1. the in-service training of general and special educational administrative,

instructional and support personnel to insure that they are appropriately and
r
.
adequately prepared and trained;
2. effective procedures for acquiring and disseminating to teachers and
administrators of programs for special education students significant information
derived from educational research, demonstration. and similar projects;
3. and procedures for adopting promising practices.
Program Administration and Evaluation

Program Administration
The District shall develop procedures for implementing the administrative requirements
contained in state and federal regulations including: full educational opportunity, public
control, use of funds including excess cost, non-supplanting and maintenance of effort,
comparable services, information reports and records, public participation,
transportation, program coordination, construction and comparability of facilities,
program length, health or safety, transition to preschool, aversive interventions,
disciplinary exclusions, and citizen's complaint process.
Evaluation
The District shall develop procedures for updating, at least annually, the effectiveness of
individualized education programs in meeting the educational needs of special
education students, including parent/family involvement in the evaluation process.
Students eligible for special education and related services shall be re-evaluated every
three years in accordance with state and federal requirements.
167
ADDENDUM
r:
\ 22]0
Page 5 of5
Cross References: Board Policy 221 \ Education of Students with Disabilities Under Section 504 of the
Rehabilitation Act of 1973
Board Policy 3300 Corrective Actions or Punishment

Board Policy 3323 Long-Term Suspensions or Expulsions
Board Policy 3600 Student Records
Legal References: RCW 28A.155 Special Education WAC 392-172A Rules for the Provision of Special
Education
20 USC 1400et seq. Individuals with Disabilities Education Improvement Act of 2004
34 CFR 99.1 - 99.67 Family Education Rights and Privacy
34 CFR 104.1 - 104.61 Nondiscrimination on the basis of handicap in programs and activities receiving
or benefiting from federal financial assistance
34 CFR 300.1 - 300.754 Assistance to Education of Children with Disabilities Program. Part B
34 CFR 303.\ - 303.67 Early intervention for infants and Toddlers with disabilities, Part C
Adopted: January 22, 1996

Revised: April 13, 1998
-- _ -
Revised: July 11,2000
Revised: February 2001
Revised: March 25, 2008
168

ESD Special Education Program Implementation Guide

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·r Special Education

(V@T@tt Public Schools

Revised September 2009

r PROCEDURAL IMPLEMENTATION GUIDELINES

MISSION AND VISION 7

SPECIAL EDUCATION TOOLKIT 9

ROLES AND RESPONSIBILITIES 13

SPECIAL SERVICES CONTACT INFORMATION ]6

r: •Safe Room Monitoring Checklist 26

CHILD-SPECIFIC EOUIPMENT RECOMMENDATION 32

INDIVIDUAL EDUCATIONAL PROGRAMS 61

PRIVATE AND HOME SCHOOLED STUDENTS 133

PSYCHOLOGIST PROCEDURES 137

REVOCATION OF CONSENT FOR SPECIAL EDUCATION SERVICES 143

RISER INFORMATION 146

SAFETY NET 153

• 1 est 1'.][ i\CQUlSmOn rroceoures

VISION SERVICES 161

USEFUL INTERNET LINKS

• Reduced Due Process

1. New IEP Forms

Special Education Toolkit

Process for Reimbursement:

SPECIAL SERVICES SPECIALIST

SPECIAL EDUCATION TEACHERS

GENERAL EDUCATION TEACHERS

r DEAF AND HARD OF HEARING TEACHER

OCCUPATIONAL AND PHYSICAL THERAPISTS (OT/PT)

r Special Services X 5250

Specialist, Elementary Programs Specialist, Secondary Programs

Executive Assistant Administrative Assistant

Office Secretary Records Secretary (Record Requests)

Student Records Secretary (North) Student Records Secretary (South)

Other Important Phone Numbers

System Analyst (SEAS) Special Services Registered Nurse

Teacher of Visually Impaired Teacher for DHH

Elementary Life Skills Teachers

Elementarv PBS Teachers

Middle School Resource Room Teachers

Middle School Extended Resource Room Teachers

Middle School Life Skills Teachers

Middle School PBS Teachers

'--'''IVI L..".....·l :.u YV II\.-LJU1111

High School Extended Resource Room Teachers

~ High School Lif~ Sldll§ T~ach~n

High School PBS Teachers

Developmental Kindergarten Teachers

What are some examples aversive interventions?

Aversive interventions which are prohibited are: (WAC-172A-03125)

• Withholding of food or liquids

Use of Safe Rooms (An Aversive Intervention)

Everett Public Schools Safe Room Monitoring Checklist

Safe Room Location: _

Staff member responsible for monitoring the safe room: _

1st Review 2nd Review 3rd Review

Trained Staff (Name/Titfe): Date: _

Trained Staff (Name/Title): Date: _

Trained Staff (Name/Title): Date: _

Certifying Administrator or Designee: _

e If ......ll. .~don, ... u<t ...ndua If _aIfacadG". mull CDtldua

() 2001 DIONNE&. RORIC~ All RlOI-m; RESERVED

REQUEST FOR HOME TEACHER

Reason for requested service and needed documentation: Date Requested: _