Re-Evaluation ñ Areas of Concern & Intervention Summary for use ...

Union County Public Schools
PROGRAMS FOR EXCEPTIONAL CHILDREN
Local Procedures
Re­Evaluation – Areas of Concern & Intervention Summary
For use in conducting a comprehensive evaluation for student classified as Speech­Language Impaired
When the school’s IEP Team determines a need to conduct a comprehensive evaluation (e.g.,
learning, behavior, etc.) for a student classified as Speech­Language Impaired (SI), state and federal
regulations consider this to be a re­evaluation. Therefore, the DEC 7, Reevaluation form must be
completed by the IEP Team.
In addition, local procedures require the IEP Team to complete the DEC 1, Special Education Referral
(in EasyIEP) in order to discuss and document topics not indicated on the DEC 7.
A new local procedure now allows the team to complete the Re­evaluation – Areas of Concern &
Intervention Summary form, which can be found on­line in the UCPS Local Forms & Procedures
Manual on the UCPS EC Department Website. This form should be completed by the IEP Team in
lieu of completing a DEC 1 in EasyIEP if a comprehensive re­evaluation is to be conducted on a SI
student.
Although the Re­Evaluation – Areas of Concern & Intervention Summary form is not currently listed
on the Paperwork Coversheet that is sent to the Secretary to Psychologists (along with the Re­
Evaluation Packet), the form should be included in the Re­Evaluation Packet so that the psychologist
receiving the packet can review the form along with the DEC 7 and plan for a comprehensive
assessment.

Union County Public Schools
PROGRAMS FOR EXCEPTIONAL CHILDREN
Local Procedures
Re­Evaluation – Areas of Concern & Intervention Summary
Student:
School:
DOB: Grade: Gender: Ethnicity:
Parent/Guardian:
Student’s Teacher:
SCREENING INFORMATION
Vision Screening Date: Pass Fail
Far R 20/ L 20/ Near R 20/ L 20/
Hearing Screening Date: Pass Fail
dB (Intensity Level)
Hz (Frequencies)
I. DISCUSSION OF STUDENT’S STRENGTHS
a. Describe student’s academic and functional skill strengths (reading, math, written
language, daily living activities, etc.).
b. Describe student’s behavioral/social skill strengths.
c. Describe student’ study/work skill strengths.
d. Describe student’s communication skill strengths.
e. Describe student’s motor skill strengths (gross/fine motor).

II. REASONS FOR REFERRAL / AREAS OF CONCERN
Language Arts
Mathematics
Phonemic Awareness
Basic Math Facts
Word Identification
Computation
Alphabetic Knowledge
Problem­Solving
Reading Comprehension
Word Problems
Reading Fluency
Geometry
Written Expression
Measurement
Writing Mechanics
Probability / Data
Writing Conventions
Analysis
Vocabulary (Reading/Oral)
Math Reasoning
Other:
Other:
Behavior / Social
Noncompliance
Motivation
Lack of Motivation
Self­Concept/Esteem
Peer or Adult Relationships
Withdrawn/Moody
Overactive
Verbally/Physically Aggressive
Fearful / Anxious
Ritualistic Behaviors
Self­Destructive
Overly Sensitive / Cries Easily
Poor Social Boundaries
Other:
Health / Medical
Visual Acuity
Hearing
Seizures
Overweight / Underweight
Tired / Listless
Frequently Gets Hurt
Diagnosed Medical Condition
Medication
Physical Complaints
Diagnosed Mental Health
Condition
Other:
Communication
Expressive Language
Receptive Language
Non­Verbal
Articulation
Voice Problems
Fluency
Vocabulary
Other:
Motor
Copying
Handwriting
Walking/Running
Throwing/Catching
Fine Motor Coordination
Gross Motor Coordination
Moving from sitting to standing
Moving from standing to sitting
Transitioning from class to class
Frequent Falls
Concerns with child’s safety
Commode Transfer
Overall Coordination
Other:
Study / Work Skills
Disorganized
Making Transitions
Avoids Difficult Tasks
Following Directions
Completing Tasks
Does not work independently
Remaining in seat
Attention Span/Concentration
Excessive Daydreaming
Turning in Assignments
Difficulty with Memory
Other:
Daily Living Skills
Toileting
Dressing Self
Feeding Self
Drinking From Cup
Communicating Wants/Needs
Safety (to self or others)
Understanding/Responding to
Social Cues
Gullible/Naïve
Understanding/Responding to
Environmental Cues
Other:
Other Concerns:

III.
REVIEW OF ADDITIONAL DATA BY IEP TEAM MEMBERS
a. Describe the instructional practices/interventions implemented to address area(s) of
noted concern and state the outcomes.