Every Child a Graduate. Every Graduate Prepared.

ALSDE: Special Education - Documents




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File NameDocument DescriptionContent TypeFile SizeDate AddedLast Updated
SLI - Voice Physician form - web (2).pdfThis form must be completed by a physician, preferably an otorhinolaryngologist (ENT), when a student is referred for a voice disability. The form is a required form. If the student is not covered by a method to pay for an examination by a physician, the public agency is responsible for the cost.PDF11 KB10/3/20076/24/2013
SLI Checklist-Preschool A1.pdfThis is one of three forms that are designed for use with preschool children to obtain information from preschool teachers or caregivers. Only one form is required as part of the referral or reevaluation process. Select one version of the form, according to your preference. The form is designed to provide required documentation that the child's communication disabilities impair participation and/or progress in the natural environment. The use of one of these specific forms is not mandatory, however information must be obtained from the teacher and recorded on one of these forms or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF12 KB10/3/20076/24/2013
SLI - ARTICULATION CHECKLIST Version 5 - web (2).pdfThis form is designed to obtain information from teachers as part of the referral or reevaluation process to provide required documentation that the child's articulation disabilities impair participation and/or progress in the general education curriculum and/or environment. The use of this specific form is not mandatory, however information must be obtained from the teacher and recorded on this form or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF12 KB10/3/20076/24/2013
SLI CHECKLIST preschool A2 (3).pdfThis is one of three forms that are designed for use with preschool children to obtain information from preschool teachers or caregivers. Only one form is required as part of the referral or reevaluation process. Select one version of the form, according to your preference. The form is designed to provide required documentation that the child's communication disabilities impair participation and/or progress in the natural environment. The use of one of these specific forms is not mandatory, however information must be obtained from the teacher and recorded on one of these forms or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF12 KB10/3/20076/24/2013
SLI - STUTTERING CHECKLIST VERSION 5 (2).pdfThis form is designed to obtain information from teachers as part of the referral or reevaluation process to provide required documentation that the child's fluency disabilities impair participation and/or progress in the general education curriculum and/or environment. The use of this specific form is not mandatory, however information must be obtained from the teacher and recorded on this form or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF13 KB10/3/20076/24/2013
SLI - VOICE DISORDER CHECKLIST version 5 (2).pdfThis form is designed to obtain information from teachers as part of the referral or reevaluation process to provide required documentation that the child's voice disabilities impair participation and/or progress in the general education curriculum and/or environment. The use of this specific form is not mandatory, however information must be obtained from the teacher and recorded on this form or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF13 KB10/3/20076/24/2013
SLI PRESCHOOL CHECKLIST A3 (2).pdfThis is one of three forms that are designed for use with preschool children to obtain information from preschool teachers or caregivers. Only one form is required as part of the referral or reevaluation process. Select one version of the form, according to your preference. The form is designed to provide required documentation that the child's communication disabilities impair participation and/or progress in the natural environment. The use of one of these specific forms is not mandatory, however information must be obtained from the teacher and recorded on one of these forms or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.PDF14 KB10/3/20076/24/2013
SLI-Language eligibility chart.pdfThis chart describes the criteria that must be used in determining eligibility for students with language disabilities. A comprehensive language assessment must be administered as the first step in the process. Additional tests may be administered as indicated on the chart.
Contact: Jan Enstrom at jane@alsde.edu
PDF15 KB2/20/20086/24/2013
SLI-Documentation of Appropriate Instruction.rtfThese three forms are suggested forms to rule out the lack of appropriate instruction in children suspected of a speech or language impairment.Rich Text Format20 KB9/29/20086/24/2013
SLI Language Checklist 2013.docxThis form is designed to obtain information from teachers as part of the referral or reevaluation process to provide required documentation that the child's language disabilities impair participation and/or progress in the general education curriculum and/or environment. The use of this specific form is not mandatory, however information must be obtained from the teacher and recorded on this form or a similar form and maintained in the student’s special education file. Relevant information from the completed form should be recorded on the eligibility report.Microsoft Word22 KB10/17/201310/17/2013
SLI-Intelligibility Rating.pdfUse this form to document intelligibility rating if using an articulation test that contains a stimulability section.PDF29 KB2/26/20086/24/2013
Screening Forms-5 Speech or Language Permission.doc Microsoft Word29 KB8/18/20106/24/2013
Screening Forms-6 Speech or Language Screening Results.doc Microsoft Word34 KB11/9/20106/24/2013
Screening Forms-4 Speech or Language Instructions.pdf PDF71 KB8/18/20106/24/2013
SLI Oral Peripheral Form.rtfThis form is a sample of the oral examination form required for eligibility for articulation. Other forms will meet the requirement as long as the document is thorough in content and is placed with the other evaluation documents. The results/relevant information should be recorded on the eligibility report.
Contact Jan Enstrom, jane@alsde.edu
Rich Text Format99 KB9/16/20139/16/2013
SLI-ARTICULATION STIMULABILITY PROBExby age.pdfThis form is to be used to assess stimulability when an articulation test does not contain a probe section.PDF218 KB2/20/20086/24/2013