PROCEDURE TO REFER A STUDENT FOR AN INITIAL EDUCATIONAL EVALUATION

When the PARENT REQUESTS TESTING…
Inform the parent(s) of the availability and benefits of the general education intervention (GEI) process.   Following that discussion, the parents are given the option to proceed with the evaluation process or to suspend their request until the Student Assistance Team has completed GEI procedures.  

They may also choose to proceed with the evaluation process AND begin the GEI process at the same time.   The GEI process must not in any way delay the referral process.   If the parent agrees to the implementation of the GEI strategies, these will coincide with the referral process.   If, after the intervention strategies have been implemented for a period of time and the school and parent(s) agree that an educational evaluation is no longer required, they may withdraw permission.   If an educational evaluation is still deemed necessary, send any GEI documentation to Psychological Services.

511 IAC 7-25-3(b): “General education intervention shall not be a prerequisite to an educational evaluation.”

When school personnel recommends testing, GEI strategies should have already been tried first.

In any event, a meeting should be held with the parent as soon as possible at which time you should:

• Discuss the student’s learning difficulties and the reason the referral for an educational evaluation is being made.
• Describe the review process to determine what data exists and what, if any, additional data is needed.
• Describe the evaluation process, including proposed assessment techniques and what the tests or evaluation procedures will measure.
• When general education interventions have been used, discuss the attempts to remediate the learning difficulties through GEI strategies and why those attempts were unsuccessful.
• Describe the timeline for conducting the educational evaluation and convening the case conference committee meeting.
• Explain how the parent may obtain a copy of the report of the initial education evaluation prior to the case conference committee meeting, including asking if the parent wishes to have a meeting with an individual who can explain the results of the evaluation prior to the case conference meeting.
• Give the parent(s) a copy of “Notice of Procedural Safeguards and Parent Rights in Special Education” which includes a list of sources for parents to contact to obtain assistance with understanding the provisions of this section.

If you are unable to meet with the parent, this information should be shared with them in written form.

In order to facilitate our timeline, we prefer that the parent(s) to be given Form 202 – Social and Developmental History and have them return it at that first meeting, at which time they will sign Form 210 – Permission for Educational Evaluation and the 60-day timeline begins.   If the parent has already presented you with a written request, the timeline begins at that moment.

Do not hold the referral paperwork while waiting for the parent to return the Social/Developmental History or other information.   Attach documentation of your attempts to obtain the missing information and send what you have to Psychological Services.   Under no circumstances should a referral for evaluation be received in Psychological Services with less than 30 instructional days left in the 60-day limit.

FORMS REQUIRED FOR REFERRAL FOR PSYCHOEDUCATIONAL EVALUATION

For Initial evaluations and those students who may have been evaluated previously but are not currently receiving Special Educational Services:

Kindergarten through 12 th Grades:

1. Referral Form No. 209 (4 pages)
   • This form should be completed, signed and dated by the student's regular classroom teacher (even if the parent is the one requesting testing).
   • Please be sure to completely fill out all demographic information.
2. Parent Permission for Evaluation Form No. 210 (1 page)
• Be sure all items are filled out completely.   Parent must initial line stating that he/she received a copy of the Notice of Procedural Safeguards.   He/she must also sign and date the form after checking permission given or not given.
• The Public Agency Representative should be the person who has explained the referral process to the parent(s).
• Double check that both signature lines are signed and dated.
• If the parent is initiating the referral, that should be noted as the reason for the referral.   We no longer will require a separate parent request for evaluation form (No. 221).
3. Social/Development History Form No. 202 (4 pages)
• This form should be completely filled out, signed and dated by the parent or guardian.   If the parent is unable to fill out the form, the teacher or principal should assist and sign his/her own name with the notation that information was obtained in an interview with the parent.
4. Classroom Observation Form No. 212
• This form should be completed by someone other than the regular classroom teacher (for example: LD Resource teacher, school social worker, any teacher, etc.).
5. Woodcock-Johnson III Tests of Achievement - Standard Battery
   • This test should be given to the student by the LD Resource teacher or other qualified person in your building.   This must accompany the referral unless other arrangements have been made with your school psychologist (if so, please send a note to that effect with the referral)

All of the above-required forms should be sent together to Sandy Cunningham, Psychological Services, Administration Building.   Copies or carbons should be given to the parent and another set should be kept in the student's file at the building.

Please note that the 60-day limit begins the day the parent signs the permission form, so please do not hold it in your building any longer than necessary.

Please Note:   General Education Intervention strategies must not in any way delay the referral process.   If the parent agrees to the implementation of such strategies, these will coincide with the referral process.   If, after the intervention strategies have been implemented for a period of time and the school and the parent feel that a psychoeducational evaluation is no longer required, send to Psych. Services either

• Parent Permission (Form No. 210) signed and dated with the "Do not give permission" checked
• If the school and the parent agree that testing is still necessary, send copies of intervention information to Psych. Services.

REFERRAL CHECKLIST

FOR INITIAL REFERRALS - GRADES K-12
		Referral Form No. 209 (4 pages)
		Parent Permission for Evaluation Form 210 (1 page)
		Social Developmental History Form No. 202 (4 pages)
		Classroom Observation Form No. 212
		Woodcock-Johnson III (Protocols and scoresheet)

FOR ALL FORMS - double check that all information is complete and all forms are signed and dated.