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DyslexiaGuidelines

DENTON INDEPENDENT SCHOOL DISTRICTDenton, Texas

2008-2009

Denton Independent School District

Dyslexia ProgramTable of Contents

Philosophy..........................................................................................................................3Identification of Students with Dyslexia.............................................................................4Flow Chart for Assessment, Identification, and Instruction................................................5

Instructional Program Description..................................................................................6

Criteria for Admittance....................................................................................................7

Dyslexia Program Referral Process.................................................................................8

Dyslexia Grading Policy..................................................................................................10Directions for Grade Folders.............................................................................................11Accommodation/Modification Sheet.................................................................................12Modifications for the Dyslexic Student Checklist.............................................................13Suggested Modifications for Classroom Teachers............................................................14Dyslexia Education Plan....................................................................................................15

Criteria for Dismissal......................................................................................................16

Forms.............................................................................................................................17Referral Letter to Schools..................................................................................................18Referral to Dyslexia Program Form..................................................................................19Student Information Form.................................................................................................20Parent Response Form.......................................................................................................23Entrevista Con Padres........................................................................................................26Dyslexia Evaluation Summary..........................................................................................28Placement Form.................................................................................................................29Letter of Acceptance to Parents.........................................................................................30Do Not Qualify Letter to Parents.......................................................................................31Parent Consent for Placement Form..................................................................................32Appeals Process.................................................................................................................33Request to Reconvene the Dyslexia Selection Committee................................................34Request to Convene the District Appeals Committee.......................................................35Dyslexia Accommodations for TAKS Reading................................................................36Review of Student Progress...............................................................................................37

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Dyslexia ProgramDismissal Letter to Parents................................................................................................38

Appendix......................................................................................................................39504 Parent Rights...............................................................................................................40Texas Education Agency “The Dyslexia Handbook”.......................................................43

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Dyslexia Program

Philosophy

Children learn to read, write and spell in different ways. A balanced reading program should meet the needs of most students. Students who do not learn to read, write and spell when presented with a broad, balanced reading program should be offered a variety of alternative strategies to meet this goal. If these alternative strategies are not successful, the student may have a reading disorder, sometimes known as dyslexia. Students who exhibit signs of dyslexia may need intervention treatment in order to be successful in school. Denton Independent School District offers a dyslexia program to students who meet the eligibility criteria. The Alphabetic Phonics and Take Flight Programs are used as the intervention model. Students identified as being dyslexic will be given support and appropriate modifications in order to be successful in their academic programs.

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Dyslexia ProgramIdentification of Students with Dyslexia

Key Information

Three decision points related to the identification of students with dyslexia (need to be able to say “yes” to all three):

1. Evidence of a deficit in one or more of the primary characteristics of dyslexia: Reading real words in isolation Decoding nonsense words Reading fluency (both rate and accuracy) Written spelling (an isolated difficulty in spelling would not be sufficient to identify

dyslexia)

2. Evidence of a deficit in phonological processing, including the following: Phonological awareness Rapid naming Phonological memory

3. Evidence that the above deficits are unexpected in relation to: the student’s age, educational level, or cognitive abilities the provision of effective classroom instruction

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Dyslexia ProgramFlow Chart for Assessment, Identification, and Instruction

for Students with DyslexiaThis flow chart illustrates a process for determining the instructional support needed by students

with dyslexia.

Student exhibits poor performance on early reading assessment. 1OR

Student fails to respond to scientifically based reading instruction at any grade.

Classroom teacher intensifies reading instruction and provides classroom accommodations.

Teacher monitors reading progress.

Student makes adequate reading progress. Student does not make adequate reading progress.

Tier I------------------------------------------------------------------------------------------------------------------------------------------------------------------

Student is provided more intensive intervention in addition to the core reading instruction.

Teacher monitors reading progress. 2

Student makes adequate reading progress. Student does not make adequate reading progress. AND

The student exhibits characteristics of dyslexia. (Campus committee of knowledgeable persons should consider all collected

information.)

Student is reintegrated into traditional reading instruction in the classroom.

Tier II------------------------------------------------------------------------------------------------------------------------------------------------------------------

Student recommended for dyslexia assessment. Section 504 procedures must be followed (Notification of evaluation, parent informed of rights under §504, and permission to assess).

Student has characteristics of Student does not have dyslexia. Direct, systematic, and characteristics of dyslexiaintensive reading instruction isprovided.

Need for §504 accommodations is considered,including TAKS accommodations for studentswith dyslexia.

Tier III

1 Parents (or guardians) of students in K–2 will be notified if the student is determined to be at risk for dyslexia or other reading difficulties (TEC §28.006).

2 Parents (or guardians) may request dyslexia assessment or special education evaluation at any time.

Special education evaluation

should be conducted whenever it

appears to be appropriate. Some

students will NOT proceed

through all steps before being

referred for a Full Individual

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Dyslexia Program

Instructional Program Description

Alphabetic Phonics and Take Flight are research-based programs modeled after the Orton-Gillingham method. These interventions use multisensory techniques to teach the structure of the English language. The small-group instruction is intensive, systematic, sequential, and cumulative.

Program instructional components include, but are not limited to: Phonological Awareness History of the English Language Alphabet/Dictionary Automaticity of grapheme and phoneme recognition Discovery of new graphemes/concepts Reading/Reading Comprehension/Fluency Spelling Handwriting Verbal/Written Expression Listening

Students unable to make progress with this curriculum should be considered for a special education referral.

6


Dyslexia Program

Criteria for Admittance

The working definition of the International Dyslexia Association states:Dyslexia is a specific learning disability that is neurological in origin. It is characterized

by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge (Adopted by the International Dyslexia Association Board of Directors, November 12, 2002).

1. Students considered for the program should have at least average intelligence. (90 ± or above)

2. The student’s achievement is unexpected according to his/her cognitive functioning.

3. There should be evidence of a deficit in phonological processing.

4. Denton ISD Dyslexia Program starts in second grade. Students may be referred after one semester of 1st grade. (Repeating first graders may be served in Literacy Groups as appropriate.)

5. The student may have an indication of reading problems in his/her family history.

6. The Dyslexia Selection Committee, composed of dyslexia therapists, dyslexia diagnostician, and program supervisors will make final decisions for admittance into the Denton ISD Dyslexia Program.

CRITERIA FOR ADMITTANCE OF LIMITED ENGLISH PROFICIENT (LEP) STUDENTS and ENGLISH AS A SECOND LANGUAGE (ESL) STUDENTS

In addition to the above criteria, the students with limited English must also meet the following criteria:

1. The LEP student must have an adequate foundation of the English language asdetermined by the LPAC.

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Dyslexia Program

Dyslexia Program Referral Process

Pre-referral Screening Criteria:1. The school pre-referral committee will gather data to determine if a referral should be

made to the Dyslexia Selection Committee. Data to be gathered are typically found in the student’s cumulative folder:

vision and hearing screening · academic progress reports teacher reports · parent reports results of any standardized testing/TAKS test results of modifications /intervention previously provided samples of student’s work

2. The school pre-referral committee should determine that the student has at least average intelligence quotient (IQ) or school ability. The screening assessments should indicate discrepancies between ability and reading achievement using any of, but not limited to, the following tests:

School Ability (IQ) Slosson Intelligence Test Kaufman Brief Intelligence Test (K-BIT-II)

Current Achievement Data Kaufman Test of Educational Achievement (K-TEA-II) Wide Range of Achievement Test (WRAT-3)

3. Evidence of a deficit in reading.

4. Documentation of other remedial strategies (minimum 10 weeks) used which have not been successful.

5. Student must be in his/her second semester of 1st grade or higher to make a referral.

Intervention OptionsAt this point of the identification process, a decision should be made about referring the student to the most appropriate service delivery system (considering the least restrictive environment) immediately following the data gathering. These interventions may include remedial strategies in the classroom, referral to a dyslexia program for assessment OR referral for special education services.

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Dyslexia ProgramReferral process to the Dyslexia Program:1. Teachers or parents can initiate the referral process after consulting with the counselor.

Parent referrals must go through the same process as referrals initiated by the school.

2. The counselor or teacher will have collected and reviewed referral data.

3. The referral cut-off date is February 27, 2009.

4. The campus referral committee will review the data to determine whether the referral should proceed.

5. If it is determined that a referral is appropriate, a referral packet should be completed.

6. The referral packet should contain:a. Referral to Dyslexia Program form signed by counselor and administratorb. Student Information form completed and signed by the classroom teacher or the

language arts instructor, counselor, administrator and dyslexia therapistc. Parent Response form with signature for consent for testingd. Copies of all available screening and assessment data (most can be found in

cumulative folder)e. Samples of student’s work

7. After gathering ALL necessary information and signatures, the referral packet should be sent to Tanya McGlothlin, Dyslexia Supervisor, at the Professional Development Center.

8. The testing should be completed within 60 calendar days after the referral packet is received by the Dyslexia Office.

9. The Dyslexia Selection Committee, composed of the dyslexia therapists, dyslexia diagnostician, and the program supervisors, will determine eligibility and admittance into the Denton ISD Dyslexia Program.

10. A letter and a parent consent form will be sent to the parents informing them of the committee’s recommendations. Copies of the letter and assessment will be sent to the principal to be placed in the cumulative folder. A copy of the letter will be sent to the counselor.

NOTE: Careful consideration must be made before referring a student receiving Special Education Services to the Dyslexia Program. Denton ISD uses the Alphabetic Phonics and Literacy program which is a multisensory approach to teaching phonological awareness leading to sound/symbol correspondences for reading and spelling. It is a systematic, sequential, fast-paced program and may not meet the needs of all students with learning disabilities.

9


Dyslexia Program

Dyslexia Grading Policy

Texas Scottish-Rite Hospital developed the program Denton ISD uses as the basis for our Dyslexia Program. This program is based on the Orton-Gillingham method of therapy. It includes strategies and techniques to be used in word attack, including coding, recognizing suffixes and prefixes, and the knowledge of sounds that letters make individually and when joined with other letters. This information is presented to the students using a very systematic, cumulative, multisensory (visual, auditory, kinesthetic) method of instruction, which is heuristic or “discovery” based learning. Procedures are taught which include sky-writing, and how to syllabicate specific words. Judging progress in the program is very subjective, and includes areas such as following directions and actually performing the procedures correctly, and as such, it is extremely difficult to try to attach a numerical grade to achievement or progress. It is the recommendation of Scottish-Rite that no grade be given to indicate student progress in the program.

Six week student reports in Dyslexia should reflect what the student is learning, and their progress in attaining and applying the newly acquired techniques and strategies. To achieve that goal, the six weeks reports will be used at the end of each grading cycle in the elementary school. Information on this report includes the exact components presented during each six weeks, and will indicate where that student is in obtaining the information and applying it to a level of automaticity. This type of report better reflects student progress in the program and is also more consistent with the other therapy programs in our district. It gives parents a much clearer and more concise understanding of what their child is learning while attending the dyslexia program, what they have mastered, and which skills are still being developed.

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Dyslexia ProgramDirections for Grade Folders

1.) Make a copy of the Alphabetic Phonics Report card. Please include with your grades in their report card.

2.) Fill out the Accommodation/Modification page inside of the folder.

3.) Sign and date the bottom portion of Accommodation/Modification page.

4.) Return entire folder along with a copy of your report card. Return no later than the date indicated on the bottom of the page.

If you have any questions, please do not hesitate to call me (2983).

Regards,

, C.A.L.T. ElementaryAlphabetic Phonics Therapist(940) 369-

Return folder by:

1st Six-Weeks:_________________________________________________________

2nd Six-Weeks:________________________________________________________

3rd Six-Weeks:_________________________________________________________

4th Six-Weeks:_________________________________________________________

5th Six-Weeks:_________________________________________________________

6th Six-Weeks:_________________________________________________________

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Dyslexia ProgramAccommodation/Modification Sheet

Name: ______________________ School Year: ____________________

D.O.B. ______________________ Teacher: ________________________

Indicate answers below by placing “Y” or “N” in the correct six-week box.1 2 3 4 5 6

Is this student 504 or Special Education?

Is the student receiving accommodations/modifications in the classroom?

Do we need to add or delete and accommodations/modifications?

Do we need to meet and discuss this student?

Please place a copy of the student’s report card in this folder. Return folder signed, with report card copy placed inside folder.

1st Six-Weeks- __________________________________________________________________________

(Teacher’s signature with date)

2nd Six-Weeks- _________________________________________________________________________


3rd Six-Weeks- _________________________________________________________________________


4th Six-Weeks- _________________________________________________________________________


5th Six-Weeks- _________________________________________________________________________


6th Six-Weeks- _________________________________________________________________________


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Dyslexia ProgramStrategies for Success:

Modifications for the Dyslexic Student Checklist

Name of student: __________________________________ Date __________________

Teacher:__________________________________________

Put a check mark by the modification recommended.

Allow the student to copy from paper rather than the chalkboard or overhead. Modification or assistance for copying/note taking Tape lectures. Avoid penalizing for handwriting errors. Give directions in small distinct steps. Have student repeat the instructions orally. Demonstrate the procedures before beginning independent work. Read proper nouns. Read all questions and answers to student. Peer/Buddy reading Use taped texts Avoid penalizing for spelling errors. Code unknown words in textbooks. Allow student to sub-vocalize while reading “silently”. Provide study aids/manipulatives. Change pace of instruction. Keep an assignment journal. Provide preferential seating Allow frequent breaks. Reduce written tasks. Adapt reports to projects. Allow use of computer for word processing. Allow use of cursive in classroom. Modify tests/oral administration/shortened test/change in format. Read all questions and answers to student for testing purposes. Extended time for assignments or tests Other:

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Dyslexia ProgramSuggested Modifications for Classroom Teachers

Intelligent students who have unusual difficulty with written language skills often perform very well in the areas of verbal or experiential learning. Whenever possible, the curriculum and school work requirements need to be adapted to their unique learning abilities. The following suggestions will help students who have less talent for written language skills learn more successfully.

FIND A WAY FOR STUDENTS TO USE THEIR SPECIAL TALENTSBuilding three-dimensional models or projectsDemonstrating and/or discussing hobbiesCompleting art or visual projects rather than written

STRESS VERBAL PARTICIPATIONReduce reading requirementsProvide tapes of content area textbooksDo not require student to read aloudReduce written work assignmentsSubstitute oral reports for written reportsAccept work dictated by student and written by parent or tutor

MAKE DIRECTIONS BRIEF AND SIMPLEGive only one step at a timeAsk student to repeat; make sure he/she understandsGive examples; allow student time to rehearse each stepEncourage student to ask questions; treat each question patiently

TEACH STUDENT HOW TO ORGANIZEBreak assignments into small stepsAllow a “buddy” to write down assignmentsHelp schedule long term assignmentsAllow student more time to think

PROVIDE MEMORY AIDSPost visual reminders or examplesProvide matrix chartsAllow student to tape record lectures and test reviews

GRADE ABILITIES, NOT DISABILITIESGrade verbal performance more than written performanceGive credit for effort and time spentTest student orally whenever possible

REQUEST PARENTS’ COOPERATION AND HELPEncourage parents to read student’s homework to him/herMake parents become aware of the need for structure in student’s daily lifeHelp parents to structure student’s study timeEncourage parents to designate a regularly scheduled time and place for homeworkEncourage parents to provide opportunities for student to discover and develop his/her unique abilitiesHelp parents to develop a positive attitude and understanding of their child’s worth

Copyright 1984, Margaret T. Smith and Edith A. Hogan. All rights reserved. Schools may duplicate this list of suggestions for their teachers. All copies must contain the copyright information.

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Dyslexia ProgramDyslexia Education Plan

Grade Forms:Schedule 1Schedule 2ASchedule 2BSchedule 2CSchedule 3A – Concepts, Prefixes and SuffixesSchedule 3A – Multi-sensory LessonsSchedule 3BBook 1 – TSRH New CurriculumBook 2 – TSRH New CurriculumBook 3 – TSRH New CurriculumBook 4 – TSRH New Curriculum

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Dyslexia Program

Criteria for Dismissal

A campus dyslexia committee review should be held to determine if the student should be dismissed from the dyslexia program.

It is recommended that the committee include at least 3, but not limited to, the following: dyslexia therapist classroom teacher campus administration/counselor parent others as appropriate.

The student may also be dismissed by an ARD or 504 committee.

Criteria for dismissal: The student may have successfully completed the Alphabetic Phonics/Take Flight

program. The student demonstrates improved classroom performance. The student could also be dismissed because of excessive absenteeism, limited progress,

inappropriate placement, non-participation in the classes, receiving other services, and/or exhibits poor motivation toward the Dyslexia Program.

Notification of the dismissal (Review of Student Progress) should be placed in the student’s cumulative folder and a copy placed in the dyslexia folder.

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Dyslexia Program

Forms

17


Dyslexia ProgramReferral Letter to Schools

TO: Elementary and Middle School TeachersElementary and Middle School CounselorsElementary and Middle School Principals

FROM: Tanya McGlothlin, Elementary SupervisorDian Molinar, Secondary Supervisor

DATE: August 27, 2008

SUBJECT: Dyslexia Program

The school counselor will coordinate the pre-referral/referral process, collect the necessary data and send the completed referral to Tanya McGlothlin, Dyslexia Supervisor, at the Professional Development Center. (The deadline for submitting a referral is February 27, 2009) The screening assessments should indicate discrepancies between ability and reading achievement using any of, but not limited to, the following:

Student AbilitySlosson Intelligence Test-RKaufman Brief Intelligence Test (K-BIT II)

Current Achievement Data Test of Educational Achievement (K-TEA brief form)Wide Range of Achievement Test-III (WRAT-III)

The school pre-referral committee should determine that the student’s difficulties are unexpected in relation to age and other cognitive abilities.

The dyslexia diagnostician and/or contracted diagnostician will conduct the formal assessments. When the assessments are complete, the Dyslexia Selection Committee will meet periodically to review the assessment information to determine placement in the Dyslexia Program.

Careful consideration must be made before referring a special education student to the Dyslexia Program. The Dyslexia Program uses a multisensory approach to teaching phonological awareness, sound/symbol correspondences, reading and spelling. It is a systematic, sequential, fast-paced program and may not meet the needs of all students with learning disabilities.

The Referral packet is available on the O: Drive at: O:\Curriculum and Instruction\Dyslexia\Dyslexia 08-09\Forms.

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Dyslexia ProgramReferral to Dyslexia Program Form

Name _______________________________ D.O.B. ____________ Age _______ Sex ______

ID#___________School_________________Grade________Teacher____________________ (Print first and last name)

Parents______________________________Address__________________________________

City__________________________ZipCode______________Phone_____________________

Referred By _________________________________Position _____________________

Reason for Referral______________________________________________________

Home Language survey:Date: _____________________ Results: ____________________________________________Vision testing: _________ Date: __________ Results: _______________________________Hearing testing: _________ Date: __________ Results: _______________________________CALP Score: __________________________TELPAS Score: ________________________Attendance:This student has been absent ___________days out of __________ school days this year to date.Screening Assessment Information:Screening assessments administered by _______________________________Date___________Intellectual Assessment _________________________________ Verbal Score ______________ Nonverbal Score ______________ Composite Score ______________SAI’s (current and previous) Grade _____ Grade _____ Grade _____ T _____ T _____ T _____ V _____ V _____ V _____ N _____ N _____ N _____Achievement Assessment ______________________________ Reading Score ______________ Math Score ______________ If age appropriate, has the student passed the reading portion of TAKS? ___________________

Counselor’s Signature Date

Administrator’s Signature Date

Yes ______ No ______Has this student been referred to special education?Yes ______ No ______Did student qualify?Yes ______ No ______Is student currently receiving special education services? Yes ______ No______ If so, what services?______________________

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Dyslexia ProgramStudent Information Form

Family Data:Parent’s Name:___________________________________________________________Telephone Number: Home:___________________Work:_________________________Mailing Address:____________________________City:_____________Zip:_________E-mail Address:__________________________________________________________

School History:* When did reading problems begin?_____________________________________________* What remediation has student received? (Attach documentation)

Title I SOAR Reading Recovery Literacy groups Modifications At Risk Special Education Other_________________

* Is the student currently receiving Special Education Services? Yes No (If so, please attach a copy of the ARD minutes which reflect the decision for this referral.)* Is this student currently being referred to special education? Yes No * Has parent been contacted about the referral? Yes No Date of Contact___________

Teaching information:* Attach a copy of all test profile sheets. Include as many as available. (Ex. TAKS, OLSAT

and All pre-referral screenings, ELI (K-2), IRI (3-5), SRI)

Information from Classroom Teacher:

Indicate the student’s level:

Academic Characteristics* 1. Fountas & Pinnell Reading Level ______________* 2. Comprehends material read to them (est. grade level) ______________* 3. Comprehends material independently (est. grade level) ______________* 4. Performs Math reasoning (est. grade level) ______________* 5. Spelling (est. grade level) ______________* 6. Writes legibly (est. grade level) ______________

* Required Fields

Name_________________________________________________Age________Sex_______

I.D.#__________________________D.O.B.____________School______________________

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Dyslexia Program* Student services and special programs that have been provided in response to the student’s

problem(s):

How Long Effective IneffectiveSpecial Education Including Speech, Resource, CM, ________ SAC, OTDyslexia Program ________ESL/Bilingual Program ________ Intervention Programs: Grade 1 Reading Recovery ________ Grades 3-5 STAR/READ 180 ________ Grades K-2 Literacy Group ________

Other: (list) __________________________

* Instructional modification, which have been attempted, include:

How Long Effective IneffectiveAlternate methods of presentation/material _______Ability grouping _______Changed seat class _______Behavior management plan _______Adapted methods of testing (oral) _______ Peer tutoring Individual tutoring _______School tutorials _______Modified or shortened assignments _______Extra time for completion of work _______Taping written materials _______Other_______________________ _______

* Does the student exhibit any signs of a health or medical problem in the classroom? Yes No If Yes, cite specific observations:_____________________________________

* Does the student exhibit any behaviors in the classroom that might indicate vision or hearing problems? Yes No If Yes, cite specific observations: ___________________________

* Required Fields

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Dyslexia ProgramTeacher(s) Must Complete:* Discuss student’s reading behaviors (including the exact nature of the difficulties). Include

samples of student written work.

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_________________________________________________________________* Teacher

_____________________________________________ Date ___________________

* Dyslexia Therapist ____________________________________ Date ___________________

* Counselor ___________________________________________ Date ___________________

* Principal ____________________________________________ Date ___________________

* Required Fields

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Dyslexia ProgramParent Response Form

To aid in assessing the problems your child is experiencing in school and to detect the possibility of dyslexia, please answer each of the following questions.

Yes No Family History

Have any other members of the family had reading problems?FatherMotherSiblingOther: ______________________________________________________

Did your child attend Kindergarten?

Has your child repeated a grade? If so, which one:_______________

Has your child received any type of special instruction? (Ex: Title 1, Resource, Speech, Content Mastery)Explain:

Has your child received instruction for dyslexia in any other school district? If yes, explain:

Name of Student___________________________________________Date_________

School_______________________________Grade___________D.O.B____________

Parent’s Name__________________________________________________________

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Dyslexia ProgramYes No Physical History

Has your child ever been critically or chronically ill?Explain:

Does your child seem to have trouble hearing?

Does your child seem to have trouble seeing?

Does your child have any other physical problems which you feel may cause difficulty in learning?____________________________________

_________________________________________________________

Does your child have allergies?Does your child have asthma?Has your child been diagnosed with ADD/ADHD??Other Explain:______________________________________________

Is your child currently taking medication? If yes, explain:_____________

____________________________________________________________

Yes No Behavior QuestionsDo you often repeat instructions to your child?

Does your child seem to have difficulty following directions?

Does your child seem to spend more time than is appropriate on homework?

Does your child seem to have more difficulty in reading, writing, and spelling than in most other subjects?

Does your child’s grades in reading, writing and spelling seem low compared to his ability to think and understand?

Do you spend time reading to your child?

Does your child seem to enjoy being read to?

Does your child talk favorably about school?

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Dyslexia ProgramYes No Previous Testing

Has your child had any previous testing by a private agency?If so, please attach copies of the testing information.

Has your child had any previous testing by the Denton ISD SpecialEducation Program?

If yes, I give permission for the Dyslexia Program to review the SpecialEducation assessment data.

_____________________________________ _____________________Parent’s signature Date

Participation

I give my permission for ____________________________________ to participate in the screening and assessment necessary to determine his/her eligibility for the Dyslexia Program.

If eligible for the Dyslexia Program, I understand that my support, cooperation, and commitment to the program is essential for my child’s success.

Please discuss the concerns you have for your child._______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

___________________________________________________________________

________________________________________________________ _____________________Parent/s Signature Date

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Dyslexia ProgramDistrito Escolar Independiente de Denton

PROGRAMA DE DISLEXIAEntrevista Con Padres

Para ayudarnos a evaluar las dificultades que está presentando su hijo/a en la escuela, y detectar la posibilidad de la dislexia, favor de responder a cada una de las siguientes preguntas:

Sí No Antecedentes Familiares

¿Algún familiar ha presentado dificultades con la lectura? Padre Madre Hermano o hermana Otro

¿Asistió su hijo/a al Kinder?

¿Ha repetido su hijo/a algún año? En caso afirmativo, especifique cual:___________________________

¿Ha recibido su hijo/a algún tipo de instrucción especial en la escuela? (Ej.: Título I, Resource, Terapia de Lenguaje, Clases integradas –Content Mastery) Especifique:

¿Ha recibido su hijo/a instrucción para dislexia en algún otro distrito escolar? En caso afirmativo, explique:

Antecedentes físicos ¿Ha padecido su hijo/a algún tipo de enfermedad grave o crónica? Explique:

¿Sospecha usted que su hijo/a tiene dificultades con la audición?

¿Sospecha usted que su hijo/ atiene dificultades con la vista?

¿Considera usted que su hijo/a tiene cualquier otra dificultad física que afecta su rendimiento escolar?

______________________________________________________________________________________________

¿Tiene Alergias?¿Tiene asma?¿Ha sido diagnosticado con ADD/ADHD?Otros, explique: __________________________________________________________________________________

¿Está tomando su hijo/a actualmente algún medicamento? En caso afirmativo, explique:__________________________

Nombre del Alumno________________________________________________________________Fecha______________

Escuela_____________________________________________Grado___________Fecha Nacimiento_________________

Nombre de padres____________________________________________________________________________________

Domicilio_______________________________________________________________Teléfono____________________

Email: _____________________________________________________________________________________________

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Dyslexia Program_________________________________________________________________________________________________

Entrevista con Padres (sigue)Sí No Preguntas sobre la conducta ¿Tiene que repetir con frecuencia las instrucciones que le da a su hijo?

¿Se le hace difícil a su hijo/a seguir las instrucciones?

¿Considera usted que su hijo/a pasa más tiempo de lo apropiado haciendo su tarea?

¿Considera usted que a su hijo/a se le dificulta más la lectura, escritura, y ortografía que sus otras materias?

¿Considera usted que las calificaciones de su hijo/a en lectura, escritura y ortografía parecen estar por debajo de su capacidad para pensar y comprender?

¿Lee usted con su hijo?

¿Disfruta su hijo/a cuando alguien le lee?

¿Habla bien su hijo/a acerca de la escuela?

Evaluaciones previas ¿Ha sido evaluado su hijo/a anteriormente por alguna agencia privada?

En caso afirmativo, favor de adjuntar copias de los resultados de las evaluaciones.

¿Ha sido evaluado su hijo/a anteriormente por el Programa de Educación Especial del Denton ISD?

En caso afirmativo, doy mi permiso para que el Programa de Dislexia estudie los resultados de las evaluaciones.

______________________________________________________ ____________________________________ Firma del Padre(s) Fecha

Participación

Doy mi permiso para que _________________________________________________ participe en los diagnósticos y evaluaciones que consideren necesarios para determinar si cumple o no el criterio para participar en el programa de dislexia.

En caso de que mi hijo o hija cumpla con el criterio para participar en el programa de dislexia, entiendo que los resultados que tenga él o ella dependen muchísimo de mi apoyo, cooperación, y participación con el programa.

Por favor explique las preocupaciones que usted tiene acerca de su hijo.________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

_________________________________________________________________ ____________________________________

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Dyslexia ProgramFirma del Padre(s) Fecha

28


Dyslexia ProgramDyslexia Evaluation Summary

Name of Student: ______________________________________ Date: __________________________I.D. # __________________________ D.O.B. ______________ School: _________________________Age: _________________ Sex: _____________ Grade: ________ Teacher: ______________________

Sources of Data:Parent information date: ____________________Teacher referral information date: ____________________WISC-IV:Date administered ___________________________by ________________________________________

Verbal Comprehension ________ Retention Yes ____ No _____Perceptual Reasoning ________ Family History Yes ____ No _____ InWorking Memory ________ Sp. Ed. Yes ____ No _____ Progress ___Processing Speed ________Full Scale ________ TAKS

ALPHABET:Oral: Able ____ Unable ____ Time ____ SAI or other measures of intelligence: Interventions:Written: Able ____ Unable ____ Time ____ WOODCOCK-JOHNSON-III: Age NormsDate administered ___________________________by ________________________________________Letter Word Identification (1) SS _________ CTOPP:Reading Fluency (2) SS _________ Date administered ____________________Spelling (7) SS _________ by _________________________________Passage Comprehension (9) SS _________Writing Samples (11) SS _________ Phonological Awareness SS _______Word Attack (13) SS _________ Elision SS _______Math Calculation (5) SS _________ Blending Words SS _______

Phonological Memory SS _______NOTES: Memory for Digits SS _______

Nonword Repetition SS _______Math: _____________________________________________ Rapid Naming SS _______

Rapid Digit Naming SS _______Listening: __________________________________________ Rapid Letter Naming SS _______

Oral Language: ______________________________________ GORT-4:Date administered ____________________

Attention: _________________________________________ by _________________________________Rate SS _______

Handwriting: ________________________________________ Accuracy SS _______Comprehension Score SS _______

Behavior/Emotional Factors: ___________________________ ORQ SS _______

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Dyslexia ProgramPlacement Form

Student Name DOB ID# Campus

The dyslexia screening and assessment has been completed. The Dyslexia Selection Committee is comprised of the dyslexia therapists, dyslexia diagnostician, supervisors and any other appropriate personnel, i.e., counselor, principal.

DATE OF MEETING

DECISION OF THE DYSLEXIA COMMITTEE:Placement not recommended at this timePlacement in dyslexia programReferral to Special EducationOther

Parent letter sent for program placement or non-placement ____________________(Date sent)

Parent permission for placement received at Dyslexia office ____________________(Date sent)

Student is placed in dyslexia class and instruction begins: To be determined by campus dyslexia therapist

THIS FORM IS TO REMAIN IN THE STUDENT’S PERMANENT FOLDER.

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Dyslexia ProgramLetter of Acceptance to Parents

Date

NameAddressCity

Dear:

____________’s referral for assessment and admission to the Denton ISD Dyslexia Program is now complete, and he/she does meet the criteria for the program. Initiation of services varies depending upon campus circumstances. Contact your campus Dyslexia Therapist for further information.

Sincerely,

Tanya McGlothlinSupervisor

cc: Name, PrincipalName, CounselorCentral File

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Dyslexia ProgramDo Not Qualify Letter to Parents

Date

NameAddressCity

Dear:

Your child, __________________________, was referred for admission to the Dyslexia Program at _______________________________ Elementary School. Based on committee review of the current assessment, ___________________________ does not qualify for the program.

Please contact me if you have any questions or need additional information.

Sincerely,

Tanya McGlothlinSupervisor

cc: xx, Principalxx, CounselorCentral File

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Dyslexia ProgramParent Consent for Placement Form

Student Name: _____________________________________

Campus: __________________________________________

This consent form will allow the Dyslexia Therapist to begin working with your child as soon as classroom circumstances allow. An official parent packet will be mailed to your home address.

Please check the appropriate statement and return the form.

____ I DO give my permission for my child to be placed in the Dyslexia Program.

____ I DO NOT give my permission for my child to be placed in the Dyslexia Program.

________________________________________Parent Signature

________________________________________ ________________Printed Name Date

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Dyslexia ProgramAppeals Process

When questions arise concerning the selection committee’s decision, the following procedure should be followed:

1. The campus administrator, parent or other advocate may initiate an appeal..

2. The campus administrator discusses the individual student’s summary profile with members of the Dyslexia Selection Committee, parents or advocate.

3. The administrator, parents, or advocate may request another meeting of the Dyslexia Selection Committee. Parents/administrators are notified of the results of this meeting. When the committee reconvenes, the screening chairperson should complete the Campus Appeal Request.

4. A request for an appeal must occur no later than 30 days after the notification of the committee’s decision has been sent.

If administrator/parents still have a concern after the second meeting of the selection committee, they may complete a District Appeal Request. The campus administer submits this request to the District Appeals Committee, consisting of the Dyslexia Program Supervisors, the Dyslexia Diagnostician, the Elementary/Secondary Director of Curriculum and Staff Development, the Assistant Superintendent of Instructional Services, a campus administrator and a teacher. The District Appeals Committee reviews all information concerning the child and makes a placement decision. The committee submits a written summary of the meeting and recommendations of the committee to the Superintendent. Parents are notified of the decision of the District Appeals Committee by the office of the Superintendent.

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Dyslexia ProgramCampus Appeal

Request to Reconvene the Dyslexia Selection Committee

Student’s Name ________________________ School ____________________ Grade________Parent’s Name _________________________ Telephone ________________ Date__________The following steps have been undertaken:Date:_______________ Conference with teacher(s)_______________ Conference with counselor or specialist_______________ Conference with principal or assistant principal

I wish to appeal the Dyslexia Program placement decision to the Campus Appeals Committee for the following reason(s): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signed: ________________________________ Relation to Student ______________________

Date: __________________________________

Return this portion

The Dyslexia Selection Committee met ____________________ (Date)

The action of the committee: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Members of the committee:_____________________________________ _________________________________________________________________________ ____________________________________

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Dyslexia ProgramDistrict Appeal

Request to Convene the District Appeals Committee

Student’s Name ________________________ School ____________________ Grade________Parent’s Name _________________________ Telephone ________________ Date__________The following steps have been undertaken:Date:_______________ Conference with teacher(s)_______________ Conference with counselor or specialist_______________ Conference with principal or assistant principal_______________ Meeting of the Selection Committee

I wish to appeal the Dyslexia Program placement decision by the Dyslexia Selection Committee for the following reason(s): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Signed: ________________________________ Date: _______________________________

Return this portion

The District Appeals Committee met ____________________ (Date)

The action of the committee: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Members of the committee:____________________________________ ____________________________________

____________________________________ ____________________________________

Superintendent notification date: _______________________Parent notification date: ______________________________

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Dyslexia ProgramDyslexia Accommodations for TAKS Reading

Name of student: ______________________________________________________________

School: ______________________________________________________________________

Grade: ______________________________

Date: _______________________________

It has been decided that _____________________________________________ is eligible to receive the set of three bundled accommodations on the English and Spanish TAKS reading tests at Grade 3, 4, 5, 6, 7 or 8.

orally reading all proper nouns associated with each passage before student began individual reading

orally reading all questions and answer choices to student, and extending the testing time over a two-day period

Campus Committee of Knowledgeable Persons

1. _______________________________________ _________________________(Sign) (Date)

2. _______________________________________ _________________________(Sign) (Date)

3. _______________________________________ _________________________(Sign) (Date)

4. _______________________________________ _________________________(Sign) (Date)

5. _______________________________________ _________________________(Sign) (Date)

6. _______________________________________ _________________________(Sign) (Date)

7. _______________________________________ _________________________(Sign) (Date)

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Dyslexia Program

38


Dyslexia ProgramReview of Student Progress

Student Name ___________________________ DOB _______________ ID#_______________Campus ________________________________

Year 1. Review of student progress by the campus dyslexia committee. Date________________________Recommendations: (Check one)______ Continue placement in the dyslexia program Lesson ________________________ Return to regular reading class______ Refer to special education______ Refer to 504 committee______ Other ________________________________Reason for dismissal: ________________________________________________________________________________________________________________________________________________________________________

___________________________ ___________________________Signature Signature___________________________ ___________________________Signature Signature

Year 2. Review of student progress by the campus dyslexia committee. Date________________________Recommendations: (Check one)______ Continue placement in the dyslexia program Lesson ________________________ Return to regular reading class______ Refer to special education______ Refer to 504 committee______ Other ________________________________Reason for dismissal: ________________________________________________________________________________________________________________________________________________________________________


Year 3. Review of student progress by the campus dyslexia committee. Date________________________Recommendations: (Check one)______ Continue placement in the dyslexia program Lesson ________________________ Return to regular reading class______ Refer to special education______ Refer to 504 committee______ Other ________________________________Reason for dismissal:_________________________________________________________________________________________________________________________________________________________________________


*Place copy in student cumulative folder.

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Dyslexia ProgramDismissal Letter to Parents

__________________________ Date

Dear Parents:

Your child, _____________________________________ is being dismissed from the Denton Independent School District’s Dyslexia Program. This dismissal was recommended by the campus instructional staff, Dyslexia Selection Committee, ARD committee, or 504 committee.

Throughout your child’s school career, it may be necessary to make the teachers aware of his/her dyslexia or 504 status. Good communication between teacher and parents is essential for student success.

If you have any questions, please contact me at

____________________________________________ _______________________________. School Phone Number

Thank you,

Dyslexia Therapist

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Dyslexia Program

Appendix

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Dyslexia Program504 Parent Rights

Notice of Parent and Student RightsUnder Section 504, The Rehabilitation Act of 1973

The Rehabilitation Act of 1973, commonly referred to as “Section 504”, is a nondiscrimination statue enacted by the Untied States Congress. The purpose of the Act is to prohibit discrimination and to assure that disabled students have educational opportunities and benefits equal to those provided to nondisabled students.

An eligible student under Section 504 is a student who (a) has, (b) has a record of having, or (c) is regarded as having, a physical or mental impairment which substantially limits a major life activity such as learning, self-care, walking, seeing, hearing, speaking, breathing, working, and performing manual tasks.

Dual Eligibility: Many students will be eligible for educational services under both Section 504 and the Individuals with Disabilities Education Act (IDEA). Students who are eligible under the IDEA have many specific rights that are not available to students who are eligible solely under Section 504.

It is the purpose of the Notice form to set out the rights assured by Section 504 to those disabled students who do not qualify under IDEA. The enabling regulations for Section 504 as set out in 34 CFR Part 104 provide parents and/or students with the following rights:

1. You have a right to be informed by the school district of your rights under Section 504. (The purpose of this Notice form is to advise you of those rights.) 34 CFR 104.32

2. Your child has the right to an appropriate education designed to meet his or her individual educational needs as adequately as the needs of nondisabled students are met. 34 CFR 104.33

3. Your child has the right to free educational services except for those fees that are imposed on nondisabled students or their parents. Insurers and similar third parties are not relieved from an otherwise valid obligation to provide or pay for services provided to a disabled student. 34 CFR 104.33

4. Your child has a right to facilities, services, and activities that are comparable to those provided for nondisabled students. 34 CFR 104.34

5. Your child has a right to facilities, services, and activities that are comparable to those provided for nondisabled students. 34 CFR 104.34

6. Your child has a right to an evaluation prior to an initial Section 504 placement and any subsequent significant change in placement. 34 CFR 104.35

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Dyslexia Program

7. Testing and other evaluation procedures must confirm with the requirements of 34 CFR 104.35 as validation, administration, areas of evaluation, etc. The district shall consider information from a variety of sources, including aptitude and achievement tests, teacher recommendations, physical conditions, social cultural background, adaptive behavior, physical or medical reports, students grades, progress reports, parent observations, anecdotal reports, and TAKS scores. 34 CFR 104.35

8. Placement decisions must be made by a group of persons knowledgeable about your child, the meaning of evaluation data, the placement options, and the legal requirements for least restrictive environment and comparable facilities. 34 CFR 104.35

9. If eligible under Section 504, your child has a right to periodic reevaluations, generally at least every three years. 34 CFR 104.35

10. You have the right to notice prior to any action by your district in regard to the identification, evaluation, or placement of your child. 34 CFR 104.36

11. You have the right to examine relevant records. 34 CFR 104.36

12. You have the right to an impartial hearing with respect to the district’s actions regarding your child’s identification, evaluation, or educational placement, with opportunity for parental participation in the hearing and representation by an attorney. 34 CFR 104.36

13. If you disagree with the decision of the impartial hearing officer, you have a right to a review of that decision by a court of competent jurisdiction. 34 CFR 104.36

14. On Section 504 matters other than your child’s identification, evaluation, and placement, you have a right to file a complaint with the district’s Section 504 Coordinator (or designee), who will investigate the allegations to the extent warranted by the nature of the complaint in an effort to reach a prompt and equitable resolution.

15. You also have the right to file a complaint with the Office of Civil Rights. The address of the Regional Office which covers Texas is:

Office of Civil Rights, Region VI1200 Main Tower Building

Dallas, Texas 75202(214) 880-2459

16. If you wish to challenge the actions of the district’s Section 504 Committee in regard to your child’s identification, evaluation, or educational placement, you should file a

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Dyslexia Programwritten Notice of Appeal with the district’s Section 504 Coordinator, Dr. Roger Rutherford, Central Services, 1307 North Locust, Denton, Texas 76210, (940) 369-0134 within ten (10) calendar days from the time you received written notice of the Section 504 Committee’s action(s). A hearing will be scheduled before an impartial hearing officer and you will be notified in writing of the date, time, and place for the hearing.

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Dyslexia ProgramTexas Education Agency “The Dyslexia Handbook”

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