Frederick County, Maryland, Public Schools



Frederick County, Maryland, Public Schools

Confidential Educational Assessment Report

Name:

Date of Birth:

Grade/Teacher:

Age:

School:

Primary Language:

Date(s) of Evaluation:

Parents/Guardian:

Address:

Examiner:

Background:

Assessments Given: Brigance Diagnostic Inventory of Early Development III. This battery determines the developmental or performance level of the child. The child’s strengths and needs are expressed in years and months.

Educationally Relevant Medical Findings:

Summary of Learning Profile based on educational test data, observations, and teacher judgment:

RELATIVE STRENGTHS RELATIVE NEEDS

Conclusions from the Assessment:

Documentation of assessment validity. (Indicate as appropriate. If the response to either question is No, the evaluator must explain.)

Yes No In the opinion of the evaluator, this assessment is an accurate reflection of

the student’s performance at this time.

Yes No This assessment is felt to be culturally and linguistically valid for its

intended purpose and for this student.

Relevant test behavior:

Description of student’s overall performance in comparison to developmental milestones, achievement levels and/or behavior patterns of typical peers:

Information regarding ______’s skills and abilities on the Brigance Diagnostic Inventory of Early Development III was obtained through test administration, teacher/instructional assistant report, and parent report.

In the area of Fine-Motor Skills and Behaviors, _____’s overall performance ranged from _______ to _______ years. On the General Eye/Finger/Hand Manipulation subtest, ______. On the Block Tower Building subtest, _____. On the Early Handwriting Skills subtest, ______. On the Copies Forms subtest, _____. On the Draws a Person subtest, _____. On the Cuts with Scissors subtest, ______. .

In the area of Daily Living skills, ______’s overall performance ranged from ____ to ___ years. Some of this information was obtained by a checklist that was rated by _____. On the Feeding/Eating subtest, _____. On the Dressing and Undressing subtests, ______. On the Fastening and Unfastening subtests, ______. On the Toileting subtest, _____. On the Bathing subtest, ______. On the Grooming subtest, ______. Additional information was obtained through direct test administration. On the Knows What to Do in Different Situations subtest, ______. When asked if ____ Knows the Function of Community Helpers, _______. On Knows Where to Go for Services, _________.

In the area of Language Development, ______’s overall performance ranged from ___ up to ___ years. On the Identifies Parts of the Body subtest, ______. On the Colors subtest, _______. On Understands Directional/Positional Concepts, _________. On Understands Qualitative Concepts, ______. On the Classifying subtest, ____________. When asked the Use of Objects, _______.

In the area of Academic/Cognitive: Literacy, ______’s overall performance ranged from ___ up to ___ years. On the Response to and Experience with Books subtest,_______. On the Identifies Common Signs subtest, ________. On Blends Word Parts Into One Word, ______. On Identifies Blended Word Parts as Words, ______. On a subtest measuring Auditory Discrimination, _______. On the Visual Discrimination subtest, ________. During the Recites Alphabet subtest, _____. On the Uppercase Letters and Lowercase Letters subtests, ______. When asked to Print Personal Data, _______. On the Identifies Rhymes subtest, _________. When assessed to determine how well ___ Segments Words Into Word Parts, ______. When tested to see how ____ Identifies Beginning Sounds, _______. On Matches Beginning Sounds and Letters with Pictures, _______. On the Identifies Blended Phonemes as Words subtest, ________. When assessed on Word Recognition, __________.

In the area of Academic/Cognitive: Mathematics and Science, ______’s overall performance ranged from ___ up to ___ years. On the Understands Number Concepts subtest, ______ . On Counts by Rote, ______. On Compares Different Amounts, _______. On the Identifies Shapes test, _______. When checked to see how ___ Sorts Objects, _______. On the Recognizes Quantities section, ______. On Matches Quantities with Numerals, ________. When asked to point to the Ordinal Position on a picture, _______. On the Reads Numerals subtest, _______. On Knows Missing Numerals in Sequence, _______. On Solves Word Problems, ________. On Determines Total of Two Sets, ________. On Understands Weather Concepts, ________.

In the area of Social and Emotional Development, ______’s overall performance ranged from ____ to ___ years, as rated by _____. On the Relationships with Adults subtest, ______. On the Play and Relationships with Peers subtest, ______. On the Motivation and Self-confidence subtest, ________. On Prosocial Skills and Behaviors, ___________.

Recommendations:

1. The IEP team should review this information in comparison to other evaluation information to determine the absence or presence of an educational disability.

Examiner’s Signature: _____________________________

Certified Special Education Teacher

Date: _______________

Test Results on the Brigance Inventory of Early Development III - 2013 (Birth to Eight Years)

|Subtest Name |Description |Developmental Age Range |

|Physical Development: |Measures skills requiring the use of hands and fingers in |Approx. |

|Fine Motor Skills |grasping and manipulating. | |

| |General eye, finger, hand skills | |

| |Block tower building | |

| |Early Handwriting Skills | |

| |Copies forms | |

| |Draws a person | |

| |Cuts with scissors | |

|Language Development |Measures the development of the student’s receptive and | |

| |expressive language skills. | |

| |Identifies Parts of the Body | |

| |Colors | |

| |Understands Directional/Positional Concepts | |

| |Understands Qualitative Concepts | |

| |Classifying | |

| |Use of Objects (“Why”) | |

|Academic/Cognitive: |Measures student’s knowledge and appreciation for books, |Approx. |

|Literacy |knowledge of the alphabet, phonological awareness, early | |

| |writing skills, and early reading skills. | |

| |Response to and Experience with books | |

| |Identifies common signs | |

| |Blends word parts into one word | |

| |Identifies blended word parts as words | |

| |Auditory discrimination | |

| |Visual Discrimination | |

| |Recites alphabet | |

| |Uppercase letters | |

| |Lowercase letters | |

| |Prints personal data | |

| |Identifies rhymes | |

| |Segments words into word parts | |

| |Identifies beginning sounds | |

| |Matches beginning letters and sounds to pictures | |

| |Identifies blended phonemes as words | |

| |Word recognition | |

|Academic/Cognitive: |This assessment measures the student’s understanding of numbers| |

|Mathematics and Science |and one-to-one correspondence. | |

| |Understands number concepts | |

| |Counts by rote | |

| |Compares different amounts | |

| |Identifies shapes | |

| |Sorts objects | |

| |Recognizes quantities | |

| |Matches quantities with numerals | |

| |Ordinal position | |

| |Reads numerals | |

| |Knows missing numerals in sequence | |

| |Solves word problems | |

| |Determines total of two sets | |

| |Understands weather concepts | |

|Daily Living |Measures skills the child can perform in order to function with|Teacher Parent |

| |the greatest possible degree of independence. |Approx. Approx. |

| |Feeding/eating | |

| |Undressing/dressing | |

| |Unfastening/fastening | |

| |Toileting | |

| |Bathing/Grooming | |

| |“What” to do in situations | |

| |“Why” do we have community helpers | |

| |“Where” to go for services | |

|Social and Emotional |Measures level of development in social, play, and work |Teacher Parent |

|Development |situations. |Approx. Approx. |

| |Relationships with adults | |

| |Play and relationships with peers | |

| |Motivation and self-confidence | |

| |Prosocial skills and behaviors | |

*Indicates that the test’s ceiling was reached.

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