【正文】 up da te: ______ __________________ P e r son s At t e n d in g the M e e ting Na me:_______________ ________________ Na me:___________________________________ Na me:_______________ ________________ Na me:___________________________________ Na me:_______________ ________________ Na me:___________________________________ P e r son (s) w h o r e f e r r e d : __________________________________________________________ S p e c if ic C on c e r n s : _______________________________________________________________ ________________________________________________________________________________ Re view of P e r tinen t Inf or m at ion ________________________________________________________________________________ ________________________________________________________________________________ Curre nt A c c ommoda tions a nd M odific a tio ns P rogre s s a nd Re s ults Time F ra m e Hyp ot h e sis of P r ob lem : ___________________________________________________________ ________________________________________________________________________________ ________________________________________________________________ ________________ Ne w E a rl y I nt e r v e ning P la n W ho is R e s ponsi bl e Time Fra m e Res ponse to Interv e nt ion P ar e n t N ot if icat ion an d /or Si gn at u r e : __________________________________Da te:_________ Re c o m m e n d at ion s : __________ _____________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Articulation Language Voice Fluency Learning Disabilities MSHA Staskowski 2022 21 Language Assessment MSHA Staskowski 2022 22 Michigan Rule 1710 Rule of the Michigan Special Education code provides the following definition of a speech and language impairment: Subrule (1) A “speech and language impairment” means a munication disorder that adversely affects educational performance, such as a language impairment, articulation impairment, fluency impairment, or voice impairment. MSHA Staskowski 2022 23 L AN G UA G E E L IG IB I L IT Y G UID E /T E AM S UM M AR Y Stu d e n t B ir th d ate Date Sp ee ch L a n g u a g e P ath o lo g i s t T ea m Me m b er s El i g i b i l i t y D e t e r mi n a t i o n P h a se * Co ll e c ted in p a rt d u ri n g p re re f e rra l p h a se D o e s n o t su p p o r t e l i g i b i l i t y S u p p o r t s e l i g i b i l i t y T ea cher ( s ) □ i n ter v ie w /o b s er v atio n s * P a re nt □ n o tif icatio n ( p r e r ef er r al) □ in ter v ie w /o b s er v atio n s * Student i n t erv i e w / co mm ents * In p u t Rev iew o f P er t inent I nfo r m a t io n E d u ca tio n al ac h i ev e m e n t a n d o th er r ec o r d s s u ch as: M L P P , DI B E L S, s tu d e n t p er m an e n t r ec o r d ( C A 6 0 ) * Co ns idera t io n o f cult ura l / lin g uis t ic dif f er ence s * C o m p lete t h e p r o ce s s in t h e C u lt u r all y a n d L i n g u is tical l y Di v er s e L a n g u a g e Sectio n if in d icate d Co ns idera t io n o f env iro n m e nta l o r ec o no m ic diff er ence s * P r o v id e d o cu m e n tatio n f r o m t ea m r ep o r ts , teac h er , an d p ar en t Re v ie w s if n ee d ed . Curric ul u m B a s ed L a ng ua g e Ass es s m ent * W a t c h t h e st u d e n t a t t e mp t a c u r r i c u l a r t a s k r e p o r t e d t o b e d i f f i c u l t e i t h e r w i t h y o u o r i n t h e c l a ssr o o m. D e t e r mi n e w h e t h e r t h e st u d e n t ’ s l a n g u a g e i s a d e q u a t e f o r su c c e ssf u l p a r t i c i p a t i o n i n t h a t c u r r i c u l a r t a s k o r w h e t h e r t h e st u d e n t l a c k s t h e l a n g u a g e sk i l l s a n d st r a t e g i e s n e e d e d . Wo rd lev el: P h o n o lo g y , m o r p h o lo g y , s e m a n tics , r ea d in g d ec o d in g , s p ellin g , w o r d r e tr iev al, an d p r ag m atics Sente nce lev el: Mo r p h o lo g y , s y n ta x , s e m a n tic s , f o r m u la tio n , an d p r ag m atic s L a n g ua g e Sa m ples / Na rr a t iv e T a s k s / P o rt f o lio Ass ess m ent C o l l e c t o r a l a n d w r i t t e n l a n g u a g e samp l e s t o f u r t h e r i n v e st i g a t e t h e st u d e n t ’ s l a n g u a g e f u n c t i o n w i t h i n t h e c u r r i c u l u m . Dis co urs e lev el : O r g an iza tio n , s e m a n tics , s y n ta x , f o r m u latio n , co h esio n , a n d p r ag m atic s Resul t s o f Stude nt’ s Respo n s e t o I nte rv ent io n * Do c u m e n t th e re su lt s o f th e e a rly in terv e n in g p r o c e ss . No te t h e lev e l o f a c c o m m o d a ti o n o r i n terv e n ti o n stra teg ies th a t th e stu d e n t re q u ires to b e su c c e ss f u l in th e c u rr icu lu m . Co u ld t h e stu d e n t b e su c c e ss fu l if th e c las sro o m tea c h e r u se d th e se stra teg ies o r a