1. What is the student’s name, age, grade, school, does child have an IEP or 504? Where was child educated last school year (i.e., in district – get name of teacher; out of district – ask any relevant questions – did family move? Did child return from a specialized program, etc.)
2. Who raised the concerns? (if needed, ask what their role is with the student – i.e., general education teacher, resource teacher, PE teacher, etc.)
3. What are the concerns? (encourage the reporter to describe what they are worried about; allow this to be a free narrative and use reflective listening to summarize their concerns)
4. Assess potential severity/interference with child’s educational performance — ask how much these issues are getting in the way of: (Consider asking them to rate the impact from 1-5 with 5 being the strongest negative impact.)
- student’s learning or the learning of others
- student’s ability to independently meet responsibilities at school (i.e., handing in assignments, following classroom rules and routines)
- student’s ability to handle frustration, adapt to changing circumstances
- student’s ability to work cooperatively with peers
- student’s access to learning opportunities – within the school or in community
5. Assess safety issues. If this is an urgent situation or concerns suggest the student or others may not be safe, then enact an emergency plan as appropriate. (Need a differential referral process here; for example, when does the referral go to another team – such as the positive behavior support team – instead?)
6. Assess duration and persistence of concerns (if relevant).
- How long have people had these concerns?
- Do these concerns impact the student on an hourly, daily, weekly, or ongoing basis?
- Are these concerns evident across situations the student is in? (i.e., structured and unstructured, or different educational settings)
7. What’s been discussed about the educational identification process so far (with the family, within the school team)
- who has said what to whom
- is everyone on the same page or do some folks see child differently than others (include both parents, and all members of this student’s school team in this question)
- have the parents given permission to assess
- is it okay if ed id leader contacts parents to discuss screening
