Checklist for Culturally Responsive Practices: III

The Checklist to Address Culturally Responsive Practices

Section III: Culturally Responsive IEP Team Decision Making – Evaluation and Eligibility Determination

Student: ______

Student #:______

School: ______

Grade:______

Completed by:

 IEP Team Date completed______

 CCIES Coordinator Date completed______

Revised September 23, 2008 2 A. Culturally Responsive IEP Team Decision-Making –Evaluation

Indicators of Quality: For each question, indicators are provided to demonstrate what should be discussed and documented during the evaluation process.

Evidence Documenting Interventions: Indicate where on the IEP the information is documented.

Rubric: This will be completed by the Special Education Coordinator who is reviewing the case. Scores of 3 or better are needed.

Critical Questions Indicators of Quality included in IEP Evidence & Rubric completed by Special Education Coordinator evaluation Documentation completed by PST 1. Were multiple □ Evaluation included standardized tests that □ Information from 1. The evaluation included minimal or no standardized tests and no measures/modalitie were normed based on culturally Assessment and informal evaluations such as curriculum-based measures, social s of evaluation representative population. Other Sources history, classroom observations, etc. Information obtained from a single conducted across □ Evaluation included other informal □ Other: source. settings and time assessments such as curriculum-based ______2. The evaluation included some standardized tests and minimal or no which were measures, social history, classroom informal evaluations such as curriculum-based measures, social appropriate for the observations, etc. from multiple sources in history, classroom observations, etc. Information obtained from a student? multiple environments. couple sources. □ Multiple perspectives were gathered from 3. The evaluation primarily included standardized tests, and some parent/family, classroom teacher, and informal evaluations such as curriculum-based measures, social student (if appropriate). history, classroom observations, etc. Information obtained from multiple sources. 4. The comprehensive evaluation included multiple standardized tests, informal evaluations such as curriculum-based measures, social history, classroom observations, etc. Information obtained from multiples sources in multiple environments. 2. Did observations □ Observation report provided numeric data, □ Review of 1. Fewer than 3 observations were completed in a variety of settings. of the student such as % of time on task and # of Existing Data Observations were only conducted by one individual. The observation include measurable interruptions form report included a narrative report but no numeric data. and observable □ Narrative report took into consideration the □ Information from 2. Fewer than 3 observations were completed in a variety of settings. data? student’s background when interpreting Assessment and Observations were conducted by more than one individual. The results. Other Sources observation report included a narrative report and minimal numeric □ Multiple observations occurred in a variety of □ Other: data, such as % of time on task and # of interruptions. settings with multiple individuals. ______3. Multiple observations were completed in a variety of settings with more than one individual. The observation report included a narrative report and some numeric data, such as % of time on task and # of interruptions. 4. Multiple observations were completed in a variety of settings with more than one individual. The observation report included a narrative report and extensive use of numeric data, such as % of time on task and # of interruptions. The student’s background was taken into consideration when interpreting the observation results. Revised September 23, 2008 3 Critical Questions Indicators of Quality included in IEP Evidence & Rubric completed by Special Education Coordinator evaluation Documentation completed by PST 3. Did the □ Evaluation included a social history with □ Review of 1. Evaluation included no social history with no information gathered evaluation team information gathered from a home visit(s) Existing Data from student, parent, or other family members. No home visit or non- gather and and/or non-school observation(s). form school observation. consider □ Multiple perspectives were gathered from □ Information from 2. Evaluation included a social history with minimal information information about parent(s), caretakers and/or extended family Assessment and gathered from student, parent, or other family members. Minimal the student’s home members, and student (if appropriate. Other Sources information regarding home visit or non-school observation. and parent/family □ Other: 3. Evaluation included a social history with some information gathered culture? ______from student, parent, or other family members. Some information regarding home visit or non-school observation. 4. Evaluation included a comprehensive social history with information gathered from student, parent, or other family members. Extensive information regarding home visit or non-school observation.

4. When social, □ IEP team included pupil services staff such □ IEP Referral 1. When social/emotional/behavioral or medical concerns were emotional, as school psychologist, social worker, nurse, □ Invitation Cover expressed in the referral, IEP team did not include appropriate pupil behavioral or counselor as appropriate who engaged in Sheet services staff. medical concerns assessment activities. □ Information from 2. When social/emotional/behavioral or medical concerns were were expressed in Assessment and expressed in the referral, IEP team consulted with a school the referral, were Other Sources psychologist or social worker. appropriate pupil □ Other: 3. When social/emotional/behavioral or medical concerns were services personnel ______expressed in the referral, IEP team included a school psychologist involved in the and/or school social worker. evaluation 4. When social/emotional/behavioral or medical concerns were activities? expressed in the referral, IEP team included school psychologist, social worker and/or or nurse as appropriate to ensure a comprehensive evaluation. 5. It is documentated that there are no social, emotional, behavioral or medical concerns at this time.

Revised September 23, 2008 4 B. Culturally Responsive IEP Team Decision-Making – Eligibility Determination

Critical Questions Indicators of Quality included in IEP Evidence & Rubric evaluation Documentation completed by PST 1. Were adequate attempts to  Alternative means for participation □ IEP referral 1. Minimal to no efforts were made to involve involve parents /family were offered (i.e. transportation was □ Invitation parents/family members in the evaluation process. members made throughout arranged to encourage attendance by □ Review of existing 2. Three good faith attempts were made to involve the evaluation process? parents/family members, data parents/family members. teleconference, meeting outside of □ Information from 3. Three good faith attempts were made to involve school setting). assessment and parents/family members and an alternative for participation □ IEP participants routinely made phone other sources was offered (i.e. transportation was arranged to encourage calls or home visits to gather □ Other: attendance by parents/family members, teleconference, parent/family member input. ______meeting outside of school setting etc.). There was some  Parents were actively involved in the documentation that conversations occurred between the process from early intervening student’s family and staff regarding family values, interests services through the evaluation and experiences. process. 4. Three good faith attempts were made to involve  Information was obtained regarding parents/family members and an alternative for participation the family values and the student’s was offered (i.e. transportation was arranged to encourage interests and experiences. attendance by parents/family members, teleconference, meeting outside of school setting). The documentation included a comprehensive description of the family’s values, interests and experiences. 2. Were race and culture or  IEP records document discussion □ Review of Existing 1. No documentation was provided to indicate that racial, the student’s unique about cultural or language differences Data linguistic, cultural, ethnic differences were discussed. background and experiences and the effect on student’s □ Information from 2. Minimal documentation was provided regarding the a primary explanation for the learning/behavioral difficulties. Assessment and student’s racial, linguistic, cultural, or unique background student’s learning or  The student has had behavioral Other Sources experiences. There was no description of the impact behavioral difficulties? and/or academic support in their □ Eligibility Criteria these factors had on the student’s learning or behavior. primary language at appropriate level Checklist(s) 3. Some documentation was provided regarding the and duration. □ Eligibility impact that racial, linguistic, cultural, ethnic differences had  Evidence of the student’s culture was Determination on the student’s learning or behavior. General statements present in the classroom setting. page. were included in the report.  Evidence that the student had □ Other: 4. The documentation provided a clear understanding of opportunities to experience varied ______the impact that race, linguistic cultural, ethnic differences learning style activities and had on the students learning or behavior. A summary interactions included a discussion regarding the curriculum taught,  Evidence that the rules and behavioral expectations in the classroom, early expectations are reviewed explicitly interventions and parental input. and regularly with the student 5. It was documented that race, culture and unique background experiences werenot primary factors in the student’s learning or behavioral difficulties in school. Revised September 23, 2008 5 Critical Questions Indicators of Quality included in IEP Evidence & Rubric evaluation Documentation completed by PST 3. Was mobility or excessive □ IEP records document discussion □ Review of Existing 1. No documentation was provided to indicate the absences the primary about the number of excused, Data student’s mobility or attendance history was discussed. explanation for the student’s unexcused absences, truancies, and □ Information from 2. Minimal documentation was provided regarding the learning and behavior tardiness and its effect on student’s Assessment and student’s mobility or attendance history. There was no difficulties? learning/behavioral difficulties. Other Sources description of the impact these factors had on the □ IEP records document the □ Eligibility Criteria student’s learning or behavior. interventions tried to reduce the root Checklist(s) 3. Some documentation was provided regarding the cause of poor attendance. □ Eligibility impact that the student’s mobility or attendance had on the Determination student’s learning or behavior. General statements were page. included in the report. □ Other: 4. The documentation provided a clear understanding of ______the impact that attendance or mobility had on the students learning or behavior. A summary included a discussion regarding the root cause of the observed patterns, early interventions and parental input. 5. It was documented that mobility or attendance was not primary factors in the student’s learning or behavioral difficulties in school.

4. Were life stressors (i.e.,  IEP records document discussion □ Review of Existing 1. No documentation was provided to indicate that life divorce, death of a family about stressors in home situation, Data stressors were discussed. member) the primary violence/abuse, and the effect on □ Information from 2. Minimal documentation was provided regarding life explanation for the student’s student’s learning/behavioral Assessment and stressors. There was no description of the impact these learning and behavior difficulties. Other Sources factors had on the student’s learning or behavior. difficulties?  IEP records document discussion □ Eligibility Criteria 3. Some documentation was provided regarding the about stressors such as death of Checklist(s) impact that the life stressors had on the student’s learning parent/family member, witness to □ Eligibility or behavior. General statements were included in the violence and the effect on student’s Determination report. learning/behavioral difficulties. page. 4. The documentation provided a clear understanding of  IEP records document discussion □ Other: the impact that life stressors had on the students learning about home, school, and community ______or behavior. A summary included the communication environments and the effect on between home, school and/or community, early student’s learning/behavioral interventions and parental input. difficulties. 5. It was documented that life stressors were not primary  IEP records document the factors in the student’s learning or behavioral difficulties in interventions tried to reduce the school. impact of life stressors on the student’s learning or behavior

Revised September 23, 2008 6 Critical Questions Indicators of Quality included in IEP Evidence & Rubric evaluation Documentation completed by PST 5. Was insufficient instruction □ IEP records document discussion □ Review of Existing 1. No documentation was provided to indicate there was a in reading and or math about curriculum, differentiation and Data discussion regarding the student’s instruction in reading or the primary explanation for insufficient instruction and the effects □ Information from math. the student’s learning and on student’ learning and behavioral Assessment and 2. Minimal documentation was provided regarding the behavior difficulties? difficulties. Other Sources student’s instruction in reading or math. There was no □ IEP records document the □ Eligibility Criteria description of the impact these factors had on the interventions tried in the areas of Checklist(s) student’s learning or behavior. reading and/or math □ Eligibility 3. Some documentation was provided regarding the Determination impact that the student’s instruction in reading or math had page. on the student’s learning or behavior. General statements □ Other: were included in the report. ______4. The documentation provided a clear understanding of the impact that the student’s instruction in math or reading had on the students learning or behavior. A summary included a discussion regarding whether the curriculum took into consideration the student’s background, culture and learning style, there were regular opportunities to build on prior knowledge and participate in varied learning styles and interactions. 5. It was documented that insufficient instruction in reading and/or math was not primary factors in the student’s learning or behavioral difficulties in school.

Revised September 23, 2008 7