Evaluation Summary Report (ESR)

1. Reason for Referral:  

Clearly states the reason for referral and includes both teacher and parent concerns. 

Sample language:  Based on general education classroom performance or learning experiences, there is a suspicion of a disability because (Student) is not achieving adequately in the educational environment.  The following are the specific area(s) of concern....

2. Educationally Relevant Information:  

Summarize information that is directly related to the reason the student was referred.  Do NOT include information that is unrelated to the student's educational issues.  Information may be medical, social, developmental, etc.  

If there are no relevant findings, a statement is still included.

Sample Language:  The team did not receive any educationally relevant information about Student that might have a relationship to his/her functioning at school.

3. Evidence of Appropriate Instruction:  

This statement clarifies that the student had access to instruction.  The statements will vary based on the age of the student. 

Preschool - Include information that the student played with other children, and had exposure to books, environmental signs, songs, nursery rhymes, counting activities, etc.

Sample Language:  Before (Student) was referred for special education, opportunities to participate in developmentally appropriate activities were provided.  This was evidenced by...

School Age - Include information that the student had access to and received regular instruction in reading and mathematics.  Consideration of attendance is important. 

Sample Language:  Before (Student) was referred for special education, appropriate instruction in reading and mathematics was provided in the general education setting.  This was evidenced by...

4. Interventions Tried:  

Describe the interventions tried and the results of the interventions attempted.  Include the progress monitoring tool used, baseline data, frequency and duration of the interventions, and the results of the intervention (describe progress). 

Sample Language:  Interventions to address areas of concern were provided.  A description of the assessment and the results of the interventions are as follows...

5. Summary of Student Performance:  

Include a listing of pertinent test scores/data and an explanation of scores.  Example types of data:  Standardized Scores, Curriculum Based Measurements (CBM),  Diagnostic Assessments, Systematic Observation Assessments that include numerical summaries, etc.  

Sample Language:  The team conducted a review of existing data, observations, and/or additional assessments 

Following a listing of the data, SUMMARIZE the team's integration and interpretation of all the data.  

Sample Language:  The following is a summary of all relevant functional, developmental, and academic information related to the area(s) of concern...

6. Evidence of a Disability:  

Identify the eligibility category.

Sample Language:  Based on all the information, (Student) meets the eligibility criteria for...

7. Adverse Effect (NOT included in SLD):  

Explain the adverse effect of the disability on education.  This informs every one of the unique challenges that the student is experiencing because of the disability.  It must be directly related to the need for special education.  

Considerations for determining Adverse Effect:

•  There is evidence that the disability is preventing the student from accessing and progressing in general education (consider the frequency and intensity of the behaviors).

• Exposure or increased practice did not alleviate limitations in adaptive skill areas.

• Skills/behaviors were resistant to accommodations of instruction, curriculum, and/or environment.

• When interventions were provided (over a reasonable amount of time), there was no change in skill level(s) or no positive trend in the rate of skill(s) development.

• Generalization of skills to other situations/tasks did not occur with intervention.

• Despite interventions, instructional and/or curricular accommodations did not sufficiently alleviate educational or behavioral concerns.

Sample Language:  The adverse effect this disability has on (Student)’s education is inattention, impulsivity, and hyperactivity.  (Student) continues to have severe difficulty sustaining attention, staying in a seat, and constantly fidgeting during instruction.

8. Exclusionary Factors:  

A student cannot be identified as having a disability if the student's lack of progress is due to other factors.  See each Data Analysis Sheet for specific exclusionary factors for each category.  

Sample Language:  The following are NOT the primary reason for Student's academic difficulties (these will vary based on the category being considered):

• Lack of appropriate academic instruction

• Limited English proficiency

• A visual, hearing, or motor disability

• Intellectual disability

• Emotional disability

• Cultural Factors

• Environmental or economic factors
  
  

9. Need for Special Education and Related Services:  

The focus of the need for special education and related services is on instruction.  There must be a connection between the student's lack of progress and educational needs.  Describe the nature and extent of the student's need for specially designed instruction to progress in the general curriculum.  What instructional strategies (EBPs), accommodations and modifications does the student need to progress in the general curriculum?

Sample Language:  (Student) needs specially designed instruction, accommodations and/or modifications in the following areas to be involved and progress in the general education curriculum:  

See HAR Chapter 60, Appendix B, Referral, Evaluation, and Eligibility Guide (pg 96-105) for more information.