Exhibit 1 - Learning Disabilities- NASET Coding System and Guide IEP Format WITHOUT Explanations
[EXHIBIT 1]
Learning Disabilities
NASET Coding System and Guide IEP Format WITHOUT Explanations
INDIVIDUAL EDUCATIONAL PROGRAM
School District/Agency: Barlow School District
Name and Address: Edison Township, Va.
Section 1- Background Information
Student Name: Julian Danna
Date of Birth:2/5/2002 Age: 14
Street: 13 Benson Ave.
City: EdisonZip: 19876
Date of Referral for Committee Review: March 17, 2016
Telephone: 999-675–8976 County of Residence: Edison Township
Male _X_ Female __ Student ID#: 3467H Current Grade: 9
Dominant Language of Student: English Interpreter Needed: Yes___ No _X__
Medical Alerts: none
Mother’s Name/Guardian’s Name: Leona
Street Address: same
City: same Zip: same
Telephone: same County of Residence:
Dominant Language of Parent/Guardian: English Interpreter Needed: Yes__ No _X_
Father's Name/Guardian's Name: Malcolm
Street Address: same
City: same Zip: same
Telephone: same County of Residence: same
Dominant Language of Parent/Guardian: English Interpreter Needed: Yes__ No __X_
Section II-Type of Meeting:
A-Initial Evaluation
1. Date of Initial Evaluation Meeting: March 2, 2016
2. Area of Suspected Disability - (NASET Coding System and Guide Level I Diagnosis)-Learning Disabilities
3. Origin of Evaluation used in determining classification:
- In-school ___X____ Non-school Personnel Evaluation_____
4. Components of Present Evaluation:
- Individual Standardized Testing ___X____
- Informal Assessment Measures ____X___ (i.e. Portfolio Assessment)
- Observation ___X___
- Social History ___X___
- Teacher Reports ___X___
- Interviews with Child ___X___
- Review of Medical Records ___X____
5. Specific Areas Covered in Evaluation:
- Intelligence Testing ___X____
- Academic Testing ___X___
- Medical Evaluation ____X____
- Speech Language Evaluation_______
- Occupational Evaluation ___X____
- Other (Be Specific) _________
- Audiometric Evaluation _______
- Psychiatric Evaluation _______
- Psychological Evaluation ____X___
- Portfolio Assessment ___X____
- Curriculum Based Assessment_______
- Authentic Assessment ___X_____
- Task Analysis ____X____
- Outcome Based Assessment ________
- Learning Styles Assessment ____X____
6. Committee Recommendations:
Classification (NASET Coding System and Guide Coding)
Level I-Learning Disabilities LD
Level II- Dyslexia LD 4.00
Level III- Dysphonesia Dyslexia LD 4.07
Level IV Not Applicable
Level V Mild
Level I-Learning Disabilities LD
Level II- Dyscalculia LD 2.00
Level III-Temporal Dyscalculia LD 2.12
Level IV Not Applicable
Level V Moderate
Level I-Learning Disabilities LD
Level II-Organizational Disorder LD 9.00
Level III-External disorganization Disorder LD 9.04
Level IV Not Applicable
Level V- Moderate
Level I-Learning Disabilities Code: LD
Level II-Visual Processing Disorder LD 12.00
Level III-Visual Motor Processing Disorder LD 12.09
Level IV Not Applicable
Level V Mild
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