Sheridan AllPrep Academy

Section 504 Handbook

Section 504 of the Rehabilitation Act of 1973

And

The 1990 Americans with Disabilities Act

As Amended by the ADA Amendments Act of 2008

Contact

Jesse Eisenschmidt, Executive Director

jeisenschmidt@sheridanallprep.org

503-890-8938

Updated May 2016

Acknowledgment: Various documents from school schools, state agencies, organizations and individuals throughout the United States have been used in the development of this reference document.

NOTICE OF NONDISCRIMINATION

Sheridan AllPrep Academy does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, marital status, pregnancy, sexual orientation, gender identity or veteran status in admission or access to, or treatment or employment in, its programs, services and activities. Applicants, students, parents/guardians, employees, referral agencies and all unions or professional organizations holding collective bargaining or professional agreements with the Sheridan AllPrep Academy are hereby notified. Any person with concerns regarding Sheridan AllPrep Academy’s compliance with the regulations implementing Title VI, Title IX, Section 504 or the Americans with Disabilities Act (ADA) is directed to contact:

Jesse Eisenschmidt, Executive Director

jeisenschmidt@sheridanallprep.org

503-890-8938


TABLE OF CONTENTS

BACKGROUND

PURPOSE

DISCRIMINATION

NONACADEMIC SERVICES

DEFINITION OF DISABILITY

PHYSICAL OR MENTAL IMPAIRMENTS

SUBSTANTIAL LIMITATION

MAJOR LIFE ACTIVITIES/MAJOR BODILY FUNCTIONS

MITIGATING MEASURES

FREE APPROPRIATE PUBLIC EDUCATION

EDUCATIONAL SETTING

THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT (FERPA)

THE 504 TEAM CASE MANAGERS

TEAM MEMBERSHIP

STEP BY STEP OUTLINE

PARENT REQUEST FOR EVALUATION

NOTICE OF PARENT/STUDENT RIGHTS

PRE-REFERRAL INTERVENTIONS/TIERED INTERVENTIONS

REFERRAL

EVALUATION

SOURCES OF EVALUATION INFORMATION

ELIGIBILITY

ACCOMMODATION PLAN DEVELOPMENT

PLAN AND SERVICES IMPLEMENTATION

ANNUAL REVIEW

REEVALUATION

TRANSFER STUDENT SECTION 504 ACCOMMODATION PLAN

STUDENT DISCIPLINE

ENFORCEMENT

SECTION 504 TERMS AND ACRONYMS

DEFINITION OF TERMS

APPENDIX

LIST OF FORMS

ADDITIONAL RESOURCES

Form 504 A   Section 504 Referral

Form 504 B    Section 504 Meeting Notice

Form 504 C    Notice of Consent to Evaluate Under Section 504

Form 504 D   Parent/Student Rights in Identification, Evaluation, and Placement: Section 504 of the Rehabilitation Act of 1973

Form 504 E    Consent for Release of Information

Form 504 F    Request for Medical Information for Section 504 Evaluation

Form 504 G   Section 504 Evaluation and Eligibility Determination

Form 504 H   Section 504 Accommodation Plan

Form 504 I     Section 504 Manifestation Determination

Form 504 J     Title VI, Title IX and Section 504 Compliance Grievance

Procedure

Form 504 K   Title VI, Title IX and Section 504 Compliance Grievance

Section 504 Checklist (for case managers to track the process)

Rubric to Assist in Determining Level of Impact of Disability on School Functioning

        


BACKGROUND

Three federal laws regulate provision of educational services to children and adolescents with disabilities: Individuals with Disabilities Act (IDEA); Section 504 of the Rehabilitation Act of 1973 (§504); and the Americans with Disabilities Act (ADA). These laws fundamentally mandate that each child with a disability be provided a free education that is appropriate to the child’s educational needs in light of his or her particular disability. The definition of what constitutes a disability, however, is not identical under each of these laws. The information contained in this document focuses mainly on Section 504 and the ADA Amendments Act of 2008. The school has specific responsibilities under the Act, which include the responsibility to identify, evaluate, and if the child is determined to be eligible under Section 504 and has needs, to afford access to appropriate educational services through a written accommodation plan. The substantive standard is commensurate opportunity.

PURPOSE

This handbook provides guidelines to uniformly implement student-related requirements for Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (as amended in 2008) in the Sheridan AllPrep Academy. Its focus is the application of Section 504 to students with disabilities in elementary and secondary programs and services. As such, this handbook is a guide, not a regulatory document; hence it does not provide legal advice, nor should it serve in lieu of the entirety of Section 504 of the Rehabilitation Act of 1973 (§504) or the Americans with Disabilities Amendments Act of 2008.

Personnel in each school should be aware of Section 504s general requirements. Teachers should understand the general requirements for IDEA and Section 504. This includes the requirement to implement instructional and behavioral accommodations for students who are IDEA and Section 504 disabled.

DISCRIMINATION

Section 504 is a nondiscrimination statute, not a funding statute. It operates as a rider attached to every grant of federal funds. It is not a special education statute, although it addresses the provision of education to qualified individuals with disabilities. The school receives no separate funding to educate or accommodate students qualified as disabled under Section 504.

In general, Section 504 prohibits discrimination against persons with disabilities in all programs and activities conducted by recipients of federal financial assistance.

Programs or activities include all programs and activities of the school, including extracurricular, non-academic, transportation, field trips, recreational athletics, employment opportunities, counseling referrals, and recreational activities.

It is important to note that the protections required by Section 504 are not limited to students with disabilities. Protection against discrimination is also extended to adults with disabilities, including parents, applicants, and school employees with disabilities.

Discrimination under Section 504 occurs when a recipient of federal funds:

NONACADEMIC SERVICES

Qualified disabled students shall be provided an equal opportunity to engage in counseling services, physical recreational athletics, transportation, special interest clubs, etc. Qualified disabled students:

DEFINITION OF DISABILITY

Under Section 504, a student with a disability has a physical or mental impairment that results in a substantial limitation in one or more major life activities/major bodily functions. (34 CFR §104.3 (j) (1)). In addition, students who have a record of a disability or who are regarded as impaired are protected from discrimination based on disability but do not receive a Section 504 plan.

Record of a disability means having a history of an impairment, i.e., former placement in special education program, diagnosed as ADD or with a mental illness, having had cancer, or being a student in recovery. Misclassified students are also included, i.e., a limited English proficient student mistakenly determined to have a mental disability. Regarded as impaired means a doctor or parent/guardian regards the student as impaired and therefore limited.

PHYSICAL OR MENTAL IMPAIRMENTS

Under Section 504, the term "physical or mental impairments" means (a) any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs;  cardiovascular; reproductive; digestive; genito-urinary; hemic and lymphatic; skin and endocrine. This definition includes such diseases and conditions as orthopedic, visual, speech and hearing impairments; cerebral palsy; epilepsy; muscular dystrophy; multiple sclerosis; cancer; heart disease; diabetes; attention deficit disorder (ADD); attention deficit hyperactivity disorder (ADHD); acquired immune deficiency syndrome (AIDS); and human immune deficiency virus (HIV+); or (b) any mental or psychological disorder, such as cognitive impairment, organic brain syndrome, specific learning disabilities, major depression, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and schizophrenia.

Certain conditions are not considered impairments under Section 504 and the ADA: substance abuse disorders resulting from the current use of illegal drugs, kleptomania, pyromania, exhibitionism, voyeurism, gender identity issues not resulting from physical impairment, and other sexual disorders. (29 CFR §1630.3(d)).

An episodic impairment or impairment in remission may be a disability if it substantially limits a major life activity when active. (ADA Amendments Act
2008).

The definition of a disabled person specifies that only physical and mental disabilities are included. Thus, environmental, cultural, and economic disadvantage are not themselves covered. (34 CFR §104 Appendix A, Analysis of Final Regulation). Examples of environmental, cultural or economic factors include divorce, transience, death of a family member, military deployments, lack of motivation, homelessness, poverty, attendance problems, and ESL or ELL (learning English as a second language) status.

SUBSTANTIAL LIMITATION

A substantial limitation is a restriction as to the condition, manner, or duration under which an individual can perform a major life activity as compared to an average person in the general population. (29 CFR §1630.2(J) (2)). It would be an error to measure substantial limitation in reference to the child’s potential and/or the student’s immediate classmates. Instead, the reference should be to the performance of children at the same age or grade in the general population.

Temporary and non-chronic impairments of short duration with little or no residual effects are not typically substantially limiting. Conditions such as the common cold, seasonal influenza, a sprained joint, minor and non-chronic gastrointestinal disorder, and broken bones that are expected to heal completely are examples of conditions that are not impairments under Section 504. (29 CFR §1630.2(j) (8)).

MAJOR LIFE ACTIVITIES/MAJOR BODILY FUNCTIONS

Major Life Activities/Major Bodily Functions (MLA/MBF) include, but are not limited to: seeing, hearing, breathing, walking, learning, communicating, thinking, concentrating, reading, or the operation of a major bodily function such as the digestive or immune system. (34 CFR §104.3(j) (2) (ii) as amended by the ADA Amendments Act 2008).

MITIGATING MEASURES

Schools must make Section 504 eligibility determinations based upon the student’s disability as it would present itself without mitigating measures. Determining that a student is not Section 504-eligible because of the corrective effects of mitigating measures is prohibited, except for the use of corrective lenses or ordinary contact lenses. Mitigating measures include:

In other words, impairment may be a disability within the meaning of Section 504/ADAAA08 even if there is no current substantial limitation of a MLA/MBF because of the use of mitigating measures. (ADA Amendments Act 2008 and proposed regulations (29 CFR §1630.2(I)).

FREE APPROPRIATE PUBLIC EDUCATION

Section 504 requires school schools to provide a free appropriate public education (FAPE) to eligible students with disabilities within the school school's jurisdiction, who have a physical or mental impairment that substantially limits one or more major life activities. This means the school is required to provide appropriate regular education or special education and related aids and services designed to meet the individual education needs of disabled persons as adequately as the needs of nondisabled students are met.  The FAPE requirements for services mean that evaluations, accommodations, and educational and related services are to be provided without cost to the student with disabilities and their parents or guardian.

EDUCATIONAL SETTING

The school must educate each student with disabilities with nondisabled students to the maximum extent appropriate to the needs of the students with disabilities. In order to remove a student from the regular educational environment, the school must demonstrate that educating the student in the regular environment with the use of supplementary aids and services cannot be achieved satisfactorily (34 CFR §104.34). This requirement parallels a similar IDEA requirement known as the Least Restrictive Environment requirement.

THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT (FERPA)

FERPA specifies rights related to educational records. This act gives the parent/guardian the right to:

THE 504 TEAM CASE MANAGERS

The Section 504 case manager is the individual in the school designated by the principal to manage the schools Section 504 caseload. The case manager’s responsibilities should not be assigned to special education personnel. The role of the Section 504 case manager is to facilitate the process in order to comply with requirements and to manage services for eligible students. The Section 504 case manager should:

TEAM MEMBERSHIP

A group of individuals, known as the Section 504 team, conducts the evaluation and makes the eligibility and placement decisions for the student. The Section 504 team is responsible for receiving the Section 504 referral, securing evaluation information, determining eligibility, and developing appropriate accommodations, related aids, or services for eligible students. The team shall be composed of a group of persons who are (1) knowledgeable about the student, (2) understand the meaning of evaluation data, and (3) are familiar with placement options. (34 CFR §104.35(c)). Typically this means the child's teacher(s), building administrator, and other relevant members make up the team. For example, if a psycho-educational assessment or behavioral assessment is being considered, a school psychologist should be included on the team. When medical or health related issues are of concern, a school nurse should be in attendance. Parents of the student being referred will be afforded the opportunity to participate in Section 504 Team meetings.

STEP BY STEP OUTLINE

In order for the school to comply with the regulations implementing the federal law, the school must document that it followed the required process. This page provides an outline of the steps followed from initial identification of a student to the completed written plan. The sections following go into more depth explaining the required steps.

  1. When a concern is raised about a student due to a documented or suspected medical condition that does not impact academic, social or emotional skills, proceed as follows:
  1. Refer to the Section 504 team for an evaluation. Complete referral (Form 504 A), send meeting notice (Form 504 B), and obtain consent (Form 504 C). Provide copy of parent/student rights (Form 504 D). If necessary, have parent sign a request for release of information (Form 504 E) and/or a request for medical information (Form 504 F).
  2. Determine whether student is eligible for a Section 504 Accommodation Plan (complete Form 504 G to document eligibility).
  3. If eligible and there is a need, develop an accommodation plan (Form 504 H).
  4. If eligible but there is no need for an accommodation plan, the student must still be protected from discrimination.
  1. If a concern is raised about a student that impacts academic, social or emotional skills, proceed as follows:
  1. The Professional Learning Community (PLC) team, or equivalent team if not referred to as a PLC, will design, implement, and monitor interventions. If successful, student returns to Tier I instruction.
  2. If interventions are not successful, refer to Student Support Team (SST) using current school-specific referral/meeting request form.
  3. SST will determine need for special education evaluation. If decision is not to evaluate, continue tiered interventions.
  4. If student is evaluated and is eligible for special education services, an IEP will be developed.
  5. If student is not eligible for special education services, IEP team determines if referral for a Section 504 evaluation is necessary. If so, complete a referral form (Form 504 A), send meeting notice (Form 504 B), and obtain consent (Form 504 C). Provide copy of parent/student rights (Form 504 D). If necessary, have parent sign a request for release of information (Form 504 E) and/or a request for medical information (Form 504 F).
  6. Section 504 team determines if additional evaluation data is needed. If so, data is collected. Determine whether student is eligible for a Section 504 Accommodation Plan (complete Form 504 G to document eligibility).
  7. If eligible and there is a need, develop an accommodation plan (Form 504 H). h)  If eligible but there is no need for an accommodation plan, student must still be protected against discrimination.

PARENT REQUEST FOR EVALUATION

Under Section 504, schools are not required to provide evaluations of children based solely upon parental request. Only when school personnel have reason to believe that the child has a disability and may need special instruction, accommodations, or related services, must an evaluation be conducted. If a parent disagrees with the schools decision not to evaluate a student for Section 504, school personnel will seek assistance from the Section 504 compliance coordinator who will attempt to resolve the issue.

NOTICE OF PARENT/STUDENT RIGHTS

It is the intent of Section 504 and the ADA to keep parents/guardians fully informed concerning decisions about their child. With respect to the identification, evaluation, or educational placement of students who, because of a disability, need or are believed to need special instruction or related services, the Sheridan AllPrep Academy provides notice of Parent/Student Rights. These Parent/Student Rights include the right to a written notice and the opportunity for parents to examine relevant records, as well as the right to an impartial hearing which includes the right to be represented by counsel. (34 CFR §104.36). Parents should be provided the Parent/Student Rights in Identification, Evaluation, and Placement (see appendix for Form 504 D) at the initial meeting to discuss possible referral, evaluation, eligibility or placement under Section 504.

PRE-REFERRAL INTERVENTIONS/TIERED INTERVENTIONS

When concerns about a students academic, social, or emotional skills are raised, the student’s teacher will discuss those concerns with their Professional Learning Community (PLC) team, or the equivalent team if not referred to as a PLC. The team will design, implement and monitor interventions. If it is determined that these interventions have not been successful a referral to the Student Support Team (SST) should be initiated.

Certain situations or circumstances may trigger a referral to the building team (e.g., PLC) for development of interventions. The following circumstances are occasions or events that may trigger such a referral:

Parents, teachers, or school professionals may refer some students with medical or health conditions that do not negatively affect learning or behavior directly to the Section 504 team without going through the intervention process.

REFERRAL

If implementation of interventions designed by the building team has not been successful, the team may make a referral to the Student Support Team (SST). When the student is thought to have a disability adversely affecting his or her educational performance, the SST refers the student to the IEP team for an evaluation for possible IDEA eligibility.  If it is determined that a child is not eligible under the IDEA, the IEP team may consider referring the student to the Section 504 team. The team must complete the Section 504 Referral Form (see appendix for Form 504 A) and submit it to the 504 case manager. The Section 504 team then considers eligibility. There may be occasions when the student is referred directly to the Section 504 team. For example, some students with medical/health needs that do not negatively affect learning or behavior may be referred directly to the team. Under these circumstances, the Section 504 team will be responsible for meeting the evaluation requirements prior to determining eligibility.

EVALUATION

An evaluation must be conducted prior to a student's initial placement into regular or special education programs and prior to any subsequent significant change in services. (34 CFR §104.35). The parents consent is required prior to the conduct of the initial evaluation for identification, diagnosis and prescription for educational services. Before conducting an evaluation, parents must provide written consent for the evaluation. (See appendix for Form 504 C, Notice and Consent to Evaluate Under Section 504).

If the student recently underwent an evaluation under IDEA, it is not likely that additional information will be required. If this is the case, indicate on the Notice and Consent to Evaluate Under Section 504 form (Form 504 C) that eligibility will be determined after reviewing existing data. Obtain parental consent before reviewing existing data or when conducting an evaluation. Parents must also be provided a Parent/Student Rights notice.

An evaluation should be sufficiently comprehensive to enable the Section 504 team to determine the existence of a physical or mental impairment and whether or not the impairment results in a substantial limitation in one or more major life activities/major bodily functions.

SOURCES OF EVALUATION INFORMATION

Prior to making Section 504 eligibility and placement decisions, information from a variety of sources must be considered. An evaluation may include cognitive and achievement tests, teacher recommendations, social or cultural background information, adaptive behavior data, etc. Formal evaluations are required when necessary to determine eligibility and accommodations. Much of the evaluation data considered by the 504 team will come from "informal" sources. Examples of both formal and informal evaluation information include:

The Consent for Release of Information form (See appendix for Form 504 E) and the Request for Medical Information form (See appendix for Form 504 F) must be completed and signed, as appropriate, before information is sought from outside service providers or physicians.

ELIGIBILITY

The Section 504 team will consider evaluation data, both formal and informal, from a variety of sources to determine if the student has a mental or physical impairment that substantially impairs a Major Life Activity/Major Bodily Function (MLA/MBF).

The student has a substantial limitation if he/she is limited in the performance of one or more MLA/MBF's that the average student at the same age or grade in the general population can perform. The Rubric to Assist in Determining Level of Impact of Disability on School Functioning is provided in the appendix to assist teams.

The Section 504 Evaluation Eligibility and Eligibility Determination form (See appendix for Form 504 G) is used to guide the team in making Section 504 eligibility decisions. A copy of the completed eligibility paperwork and the Parent/Student Rights notice is given to the parents.

ACCOMMODATION PLAN DEVELOPMENT

Section 504 requires an appropriate educational program be designed to meet the individual educational needs of qualified disabled students. The 504 team, consisting of members knowledgeable of the student, the evaluation data, and the placement options is responsible for the development of an accommodation plan.  Accommodations, services, and related aids must focus on the identified substantial limitation(s) in a MLA/MBF. For example if a student's impairment results in a substantial limitation in the major life activity of reading, then accommodations that address motor limitations, etc., would not be appropriate. Accommodations must be designed to meet individual educational needs of students with disabilities as adequately as the needs of non-disabled students are met.

PLAN AND SERVICES IMPLEMENTATION

The Section 504 Accommodation Plan form (See appendix for Form 504 H) is used to record accommodations and services. The Section 504 case manager must provide teachers and other staff responsible for implementing the plan with a copy of the student’s accommodations and services. Assure that teacher(s) and staff are trained on special accommodations and services, such as the use and administration of EpiPen, etc., when necessary. The Section 504 case manager monitors the implementation of the plan and the progress of the student.

ANNUAL REVIEW

Each student with accommodations and/or services shall have their plan reviewed annually. The review may occur more often if the student’s rate of progress changes significantly, if there is a noticeable change in behavior, or upon parental request.

Attendees at annual reviews are generally the student's teachers and other Section 504 team members. Recognizing that some teachers may not be able to attend due to schedule conflicts, teachers should provide the team with information about the student's classroom performance.

The review should address the need for additional evaluation information, whether the student continues to have a qualified disability, and the effectiveness of the accommodations.

REEVALUATION

A reevaluation shall be conducted every three years. The reevaluation may occur sooner, though no more than one time each year, when requested by parents or school personnel. In addition, the Section 504 team will conduct a reevaluation prior to any significant change of placement, e.g., changing from a regular education setting to a special education setting, or facing a long-term suspension/expulsion. Keep in mind that the discontinuation of services is a significant change of placement. (34 CFR §104.35(d)).

TRANSFER STUDENT SECTION 504 ACCOMMODATION PLAN

When a student transfers into Sheridan AllPrep Academy from another school with an existing Section 504 Plan, the team must meet to review the plan. If there are no concerns about the transfer student’s eligibility or the accommodation plan, the transfer plan should be implemented without delay. On the other hand, if the Section 504 team does not agree with the decision and/or plan from the previous school, the student should be promptly evaluated to determine eligibility and the need for accommodations. In this case, the existing plan will be followed until the reevaluation and eligibility determination are completed.

STUDENT DISCIPLINE

When a student commits a violation of the schools code of conduct for which a suspension, e.g. in-school, out-of-school, bus suspension, expulsion, etc., is considered which could result in more than 10 cumulative days for the school year, the Section 504 team must meet first to determine if the behavior is directly caused by the student's disability or the failure of the school to provide FAPE. The Section 504 Manifestation Determination form (See appendix for Form 504 I) must be completed at this meeting.

If it is determined that the behavior is caused by the disability, the 504 team shall modify the current educational placement or provide, if appropriate, an alternative educational placement.

On the other hand, if the team determines that the violation of the school code of conduct is not caused by the disability, the relevant disciplinary procedures applicable to students without disabilities may be applied. This means that Section 504 eligible students may be suspended without educational services if non- disabled students would not receive services during the same suspension. If non- disabled students are offered enrollment in an alternative school during the suspension, the same offer must be made to Section 504 eligible students.

ENFORCEMENT

The school has specific responsibilities under the Act, which include the responsibility to identify, evaluate, and if the child is determined to be eligible under Section 504, to afford access to appropriate educational services through a written accommodation plan. The substantive standard is commensurate opportunity. The school must also provide notice and due process. If the parent/guardian disagrees with the determination made by the professional staff of the school, he/she has a right to a hearing with an impartial hearing officer.

The United States Department of Educations Office of Civil Rights (OCR) is charged with the responsibility of ensuring compliance with Section 504 in order to: 1) protect qualified disabled students from denials or exclusions from educational opportunities based on a disability; 2) prohibit unequal treatment of qualified disabled students based on their disability; and, 3) protect qualified disabled students when IDEA protection is not applicable or available.

Regulations grant OCR the authority to investigate individual complaints of discrimination. It has virtually no discretionary power not to investigate complaints. Unlike IDEA, where the federal government’s impact on local schools is mediated through the state department of education, OCRs regulatory authority to investigate complaints places the federal government face-to-face with local administrators.

Enforcement of Section 504 is the responsibility of the Office for Civil Rights. The Headquarters is located at:

U.S. Department of Education Office for Civil Rights

Customer Service Team

400 Maryland Avenue, SW

Washington, D.C. 20202-1100

OCR National Office Contact Information:

Telephone: 800-421-3481

TDD: 877-521-2172

FAX: 202-245-6840 Email: OCR@ed.gov

The regional OCR office serving Oregon is located at:

Seattle Office

Office for Civil Rights

U.S. Department of Education

915 Second Avenue Room 3310

Seattle, WA 98174-1099

Telephone: 206-607-1600

FAX: 206-607-1601; TDD: 800-877-8339 Email:  OCR.Seattle@ed.gov


SECTION 504 TERMS AND ACRONYMS

The following list is common terms and acronyms used in Section 504, the Americans with Disabilities Amendments Act and the IDEA:

ADA - Americans with Disabilities Act

ADAAA08 - Americans with Disabilities Amendments Act of 2008

ADD - Attention Deficit Disorder

ADHD - Attention Deficit Hyperactivity Disorder

CEE - Cultural, Environmental and Economic Factors

CFR - Code of Federal Regulations

DD - Developmental Disabilities

DNR - Do Not Resuscitate

EEOP - Equal Education Opportunity Plan (§504 plan)

ED - Emotionally Disturbed

ESY - Extended School Year

FAPE - Free Appropriate Public Education

FERPA - Family Educational Rights and Privacy Act

HI - Hearing Impaired

IDEA - Individuals with Disabilities Education Act-Special Education (2004)

IEP - Individualized Education Program

LEA - Local Education Agency

PT - Physical Therapy

RTI - Response to Intervention

SEA - State Education Agency

Section 504 - Section 504 of the 1973 Rehabilitation Act

TTY - A Telecommunication Device for the Deaf (Teletypewriter)


DEFINITION OF TERMS

Accommodations -Adaptations and services made by classroom teachers and other school staff to enable the students with disabilities to benefit from their educational program. Changes “how” services are delivered, e.g., shortening assignments, allowing extra time, reading tests aloud, etc.

Americans With Disabilities Act (ADA)-A civil rights law that prohibits discrimination against persons with disabilities in the areas of accessibility, employment, public services, public accommodations, transportation, and communication.

Barrier-Free Environment - A barrier free environment is a school/work environment free of obstacles preventing access and use by individuals with disabilities.

Consent - 504 - OCR policy interpretation requires parental consent prior to conducting the initial Section 504 evaluation. Although the OCR on-line Q & As imply consent is required prior to a Section 504 placement, neither Section 504 nor its regulations require consent prior to Section 504 placement.

Cultural, Environmental, And Economic Factors (CEE) - Cultural, Environmental, and Economic Factors (CEE) include conditions such as transience, divorce, death of a close family member, military deployment. CEE may be may be the cause of student learning and/or behavioral problems. (CEE) disadvantages such as limited English proficiency, transience, and divorce. Because CEE factors are not mental or physical impairments, resulting learning problems or behavior problems are not disabilities under Section 504. (Appendix A to Part 104 - analysis of Final Regulation: Subpart A).

Equal Access - Equal opportunity of a qualified person with a disability to participate in or benefit from educational aide, benefits, or services.

Family Educational Rights and Privacy Act (FERPA) - The federal law and accompanying regulations that address student’s educational records and confidentiality.

Free Appropriate Public Education (FAPE)-Related aids and services that are designed to meet individual, educational needs of students with disabilities as adequately as the needs of nondisabled persons are met.

Individuals With Disabilities - Under Section 504, an individual with a disability is anyone (1) who has a physical or mental impairment which substantially limits one or more major life activities, (2) who has a record of such an impairment, or (3) who is regarded as having such an impairment. (34 CFR §104.3(j)).

Major Life Activities/Major Bodily Functions - Functions such as caring for ones self, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating and working. Also, included are major bodily functions including, but not limited to, functions of the immune system, bowel, brain, endocrine, normal cell growth, respiratory, reproductive, digestive, neurological and circulatory systems. The list of examples is not exhaustive; other functions may be considered major life activities. In addition, the ADAAA08 makes it clear that one need have a substantial limitation in but one major life activity for eligibility purposes. (29 CFR 1630.2(i)).

Maximum Extent Appropriate - The maximum integration of children with and without disabilities in the instructional and non-instructional setting consistent with the avoidance of harmful effects.

Mitigating Measures - Mitigating measures are measures that eliminate or reduce the symptoms or impact of impairment. Examples of mitigating measures include, but are not limited to, such things as medication, medical equipment and devices, prosthetic limbs, low vision devices, reasonable accommodations and behavioral modifications. The corrective effect of mitigating measures may not be used to rule out Section 504 eligibility. (ADAAA08).

Modification - Changes that alter what is measured or the validity of the results. Changes what is taught.

Office for Civil Rights (OCR) -This federal agency has three, primary responsibilities: (1) investigating complaints, (2) conducting compliance reviews, and (3) providing technical assistance. In addition to its national office, 10 regional OCR offices are located throughout the United States.

Physical Or Mental Impairment - (1) any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genitourinary; hemic and lymphatic; skin; and endocrine; or (2) any mental or physical disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities.

The term physical or mental impairment includes, but is not limited to, such diseases and conditions as orthopedic, visual, speech, and hearing impairments; cerebral palsy; epilepsy; muscular dystrophy; multiple sclerosis; cancer; heart disease; diabetes; mental retardation; emotional illness; drug addiction; and alcoholism.

The following are not impairments: current drug use, pyromania, voyeurism, kleptomania, compulsive gambling, transvestitism, incarceration, pedophilia, sexual disorders, age, and sick building syndrome. Other conditions that are not impairments include pregnancy, lactose intolerance, homosexuality, bisexuality, gender identity, etc. (29 CFR §1630.3(d)(1-2)).

Impairments generally not considered substantially limiting are temporary and non- chronic impairments of short duration with little or no residual effects. These are usually not considered disabilities and include, but are not limited to, the common cold, seasonal or common influenza, a sprained joint, minor and non- chronic gastrointestinal disorders, or a broken bone that is expected to heal completely. Whether or not impairment substantially limits a MLA/MBF must be determined on a case-by-case basis.

Placement -“ A term used in the elementary and secondary school context that refers to a regular and/or special education program in which a student receives educational and/or related services.

Program Accessibility - The school will ensure programs and activities are accessible to and usable by persons with disabilities. In many instances, programs and activities may be made accessible through slight modifications and adjustments in procedures, practices, and policies. In others, building renovation or construction may be required. Structural change is required only where program accessibility cannot be achieved effectively through other means.

Public Notice - School schools and post-secondary institutions are required to provide public and internal notices (i.e., to staff, individuals with disabilities, and students) stating they do not discriminate on the basis of a disability.

Qualified Student - Qualified disabled person means an elementary or secondary student with a disability is (1) of an age during which non-disabled persons are provided services, (2) or any age during which it is mandatory under state law to provide such services, or (3) to whom a state is required to provide FAPE under the IDEA.

Related Services -- Transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. The term also includes school health services, social work services on schools, and parent/guardian counseling and training.

Section 504 - Section 504 of the Rehabilitation Act of 1973 is the federal law prohibiting discrimination on the basis of disability.

Section 504 Coordinator - Section 504 regulations require, a recipient, i.e., school or post-secondary institution employing 15 or more persons, must assign a person to coordinate compliance with Section 504 regulations.

School 504 Liaison - A School 504 liaison is generally a student services or general education staff member appointed by the principal to coordinate school- based 504 efforts including convening the 504 team, ensuring accommodations are implemented and providing outreach to parents of 504 students with disabilities.

Substantial Limitation - A substantial limitation means an individual is substantially limited in the performance of a major life activity as compared to most people in the general population (34 CFR§1630.2(j)).

Supplementary Aids and Services €“ Aids, services, and other supports that are provided in regular education classes or other education-related settings to enable children with disabilities to be education with children without disabilities to the maximum extent appropriate.

Student Support Team - Among other things, the Student Support Team is responsible for developing intervention plans for referred students and is comprised of the principal (or designee) and at least two, certified regular education teachers.

Temporary - Transitory Impairments - A temporary impairment is an impairment of short duration with limited or no residual effect that does not result in substantial limitation of one or more major life activities/major bodily functions for an extended period of time. Whether or not a temporary impairment is substantial enough to be a disability under Section 504 must be determined on a case-by-case basis, taking into consideration both the duration (or expected duration) of the impairment and the extent to which it actually limits a major life activity of the affected individual.

Transportation €“ A related service that includes travel to and from school and between schools; travel in and around school buildings; and specialized equipment (such as special or adapted buses, lifts, and ramps), if required to provide special transportation for a child with a disability.


APPENDIX

LIST OF FORMS

Form 504 A   Section 504 Referral

Form 504 B    Section 504 Meeting Notice

Form 504 C    Notice of Consent to Evaluate Under Section 504

Form 504 D   Parent/Student Rights in Identification, Evaluation, and Placement: Section 504 of the Rehabilitation Act of 1973

Form 504 E    Consent for Release of Information

Form 504 F    Request for Medical Information for Section 504 Evaluation

Form 504 G   Section 504 Evaluation and Eligibility Determination

Form 504 H   Section 504 Accommodation Plan

Form 504 I     Section 504 Manifestation Determination

Form 504 J     Title VI, Title IX and Section 504 Compliance Grievance

Procedure

Form 504 K   Title VI, Title IX and Section 504 Compliance Grievance

ADDITIONAL RESOURCES

Section 504 Checklist (for case managers to track the process).

Section 504 Process/Form Checklist (provides explanation of forms and when to use them.

Rubric to Assist in Determining Level of Impact of Disability on School Functioning.


Sheridan AllPrep Academy

Section 504 Referral - Form 504 A

Referred By:_________________________________ Referral Date: ________________

Student Name: __________________________ Age: ___ Date of Birth: _____________

 Grade: _____________Teacher:_____________________________________________

Parent(s): __________________________Address_______________________________

Home Phone: ____________________________Cell: ____________________________

For a student to be eligible for Section 504 services, the student must have a physical or mental impairment that substantially limits one or more major life activities.

1.   Reason for Referral:

2.   What major life activity(ies) do you believe is/are substantially limited?

3.   Indicate specifically how the major life activity is being limited (e.g., what is the student not able to do or benefit from?):

4.   What interventions have been attempted and what were the results?

5.   Briefly summarize the student’s classroom performance (e.g., grades, attendance, behavioral concerns, health care needs, etc.):

*Attach any supporting documents and return this form to the school.


Sheridan AllPrep Academy

Section 504 Meeting Notice - Form 504 B

To Parent/Guardian: _____________________________________Date: _____________

This is to confirm our arrangement for a Section 504 meeting for the following student:

____________________________________         ___________                 ___________

Student’s Name                                        Grade                        Date of Birth

The meeting with you has been scheduled for:

____________        ____________        ____________________________________
Date                        Time                        Place

The meeting is scheduled for the following reason(s):

The following people will be included in the meeting:

If you are unable to attend this meeting, please contact me at __________________as soon as possible.

__________________________________________________        __________________

Name                                                                         Date

______________________________________________

Title


Sheridan AllPrep Academy

Notice and Consent to Evaluate Under Section 504 - Form 504 C

Date: _______________

To: __________________________________

From: _______________________________

This letter is to provide notice that the school proposes to evaluate __________________________________ and determine if he/she is eligible for services under Section 504 of the Rehabilitation Act of 1973.

The team has concluded that the following assessments are necessary to determine if your child has a disability under Section 504 and needs a Section 504 Accommodation Plan:

Your written consent is necessary because this is a(n):

You will be invited to participate in a meeting to review the evaluation results and to determine if your child is eligible for a Section 504 Accommodation Plan.

PARENT CONSENT

I understand that the granting of consent for evaluation is voluntary.

______________________________________        _______________        ____________

Parent/Guardian Signature                                Date                        Phone

For questions, please contact: __________________________at:___________________

Thank you for working with the school to provide appropriate services for your child.

For Staff Use:

Date Received: _________________

Received By: (initial) ____________

Sheridan AllPrep Academy

Parent/Student Rights in Identification, Evaluation, and Placement

Form 504 D

(Section 504 of the Rehabilitation Act of 1973)

Please Keep This Explanation for Future Reference

This document describes the rights granted by federal law to students with disabilities. The intent of the law is to keep you fully informed concerning decisions about your child and inform you of your rights if you disagree with any of these decisions.

You have the right to:

  1. Have your child take part in, and receive benefits from, public education programs without discrimination based on disability.
  2. Have the school advise you of your rights under federal law.
  3. Receive notice with respect to identification, evaluation, or placement of you child.
  4. Refuse consent for the initial evaluation and initial placement of your child.
  5. Have your child receive a free appropriate education.  This includes the right to be educated with non-disabled students to the maximum extent appropriate.  It also includes the provision of regular education or special education and related aids and services that are designed to meet the individual needs of students with disabilities as adequately as the needs of non-disabled students are met.
  6. Have your child educated in facilities and receive services comparable to those provided to non-disabled students.
  7. Have evaluation, educational, and placement decisions made based upon a variety of information sources, and by persons who know the student, the evaluation data, and placement options.
  8. Have education and related aids and services provided to your child without cost except for those fees imposed on the parents/guardians of non-disabled students.
  9. Have your child be given an equal opportunity to participate in non-academic and extracurricular activities offered by the school.
  10. Examine all relevant records related to decisions regarding your child’s identification, evaluation, educational program, and placement.
  11. Obtain copies of educational records at a reasonable cost unless the fee would effectively deny you access to the records.
  12. A response from the school to reasonable requests for explanations and interpretations of your child’s records.
  13. Request amendment of your child’s educational records if you believe they are inaccurate, misleading, or otherwise in violation of the privacy rights of your child. If the school refuses this request for amendment, you have the right to a hearing to challenge this refusal.
  14. Request an impartial due process hearing related to decisions or actions regarding your child’s identification, evaluation, educational program, or placement. To initiate an impartial hearing, you must file a written Notice of Request for a Due Process Hearing with the Oregon Department of Education 255 Capitol St NE, Salem, OR 97310.  You and your student may participate in the hearing.  You may have an attorney to represent you.
  15. File a written grievance following the schools grievance or compliance procedures.
  16. File a complaint with the U.S. Department of Education Office for Civil Rights, 915 Second Avenue, Room 301, Seattle, WA 98174-1099.  Telephone (206) 607-1600. Facsimile (206) 607-1601.

The person in the school who is responsible for assuring that the school complies with Section 504 is:

Ms. Jesse Eisenschmidt, Executive Director

Sheridan AllPrep Academy

339 NW Sherman Street

Sheridan, Oregon 97378

Phone: (503) 890-8938

Fax: (866) 758-1982

Email:  jeisenschmidt@sheridanallprep.org

This document is your notice of rights under Section 504

Sheridan AllPrep Academy

Consent for Release of Information - Form 504 E

I, the undersigned, give my consent and authorize the health care provider or agency identified on the Request for Medical Information for Section 504 Evaluation Form to release information responding to the inquiries made on behalf of ____________________________________(student) by the Sheridan AllPrep Academy.

I also consent and authorize, but do not necessarily request, you to discuss medical records and health care information pertaining to the above named student with a representative of the Sheridan AllPrep Academy.

A photocopy of this authorization to release information is to be as effective and valid as the original signed by me.

This consent for release of information and all authority to disclose information pertaining to the above named student shall expire one year from the date of the signature below.

______________________________________        _______________        ____________

Parent/Guardian Signature                                Date                        Phone

______________________________________

Parent/Guardian Printed Name


Sheridan AllPrep Academy

Request for Medical Information for Section 504 Evaluation –

Form 504 F

Date:______________________

Health Care Provider/Facility: _____________________________

Address: __________________________________________________________

           __________________________________________________________

Student’s Full Name: ____________________________ Date of Birth:______________

Dear Health Care Provider:

The above named student has been referred for evaluation and consideration of eligibility for Section 504 accommodations due to physical or mental impairment. Please provide the following information and return to the person indicated below. If the person indicated is not the student’s parent, a Consent for Release of Information - Form 504 E is attached. Thank you for your timely provision of this information.

  1. Students medical diagnosis ___________________________________________
  1. Is the disability/impairment temporary?  yes  no
  2. If temporary, what is the anticipated duration? ______________________
  1. Please check which major life activities, or identify which other bodily functions are affected:

Please explain how the disability or impairment affects the major life activity or bodily function:

  1. Medical treatment plan (include medications and/or assistive devices): *Attach pages as necessary.

  1. Recommendations or additional comments: *Attach pages as necessary.

_____________________________________________________                ____________

Signature of Physician/Health Care Provider                                        Date

_____________________________________________________

Printed Name

Please return to:

_____________________________________        ______________________________

Name                                                        Title

________________________________________________________________________

Address

_______________________________        _______________________________

Telephone Number                                Fax number

Directions for Case Manager: While a medical diagnosis is not required to support the existence of a Section 504 disability, information about an existing medical diagnosis may be helpful to the evaluation and eligibility process. You may use this form to seek information from the health care provider with the parents consent (see Consent for Release of Information - Form 504 E). Seeking the medical information does not prevent the evaluation process from continuing.

Sheridan AllPrep Academy

Section 504 Evaluation and Eligibility Determination - Form 504 G

Student Information

Name:

Date of Birth:

Grade:

Teacher:

Parent/Guardian Name:

Address:

Phone:

Email:

Date of Meeting:

Eligibility Team Participants

Name

Signature

Position/Title

Evaluation Data Considered

The team has reviewed and carefully considered data gathered from a variety of sources. (Check all that apply and attach copies of data).

Parent Input

Student Work Portfolio

Grade Reports

Special Education Records

Standardized Test Scores

Disciplinary Records/Referrals

Intervention Data

Mitigating Measures

Teacher/Administrator/Staff Input

Other

School Health Information

Other

Medical Evaluations/Diagnoses

Other

Section 504 Eligibility Determination (Check appropriate boxes)

  1. Does the student have a physical or mental impairment (including impairments that are episodic or in remission)? Note: This is an educational determination only, and not a medical diagnosis for purposes of treatment.

Yes                No

If Yes, identify the impairment here:

  1. Does the physical or mental impairment affect one or more major life activities (including major bodily functions)?

Yes                No

If Yes, identify the major life activity(ies) here:

  1. Does the physical or mental impairment substantially limit a major life activity (not considering the ameliorative effects of mitigating measures)? See the Appendix of the Section 504 Handbook for the Rubric to Assist in Determining Level of Impact of Disability on School Functioning.

Note: If the substantial limitation is primarily the result of cultural, economic, or environmental factors rather than the students impairment, answer No

Yes                No

If No, explain:

  1. Does the student need Section 504 accommodations in order for his/her educational needs to be met as adequately as those of non-disabled peers?

Note: If the student’s impairment is in remission, or the student’s needs are currently addressed by mitigating measures, the student is not in need of an accommodation plan.

Yes                No

Interpretation

  1. If all four questions are answered Yes, the student is eligible for both nondiscrimination protection and a Section 504 accommodation plan.
  2. If only the first three questions are answered Yes, the student is eligible for the nondiscrimination protections of Section 504. The Section 504 team will not create a Section 504 plan at this time as the students needs are currently being met as adequately as his/her nondisabled peers.
  3. If any of the first three questions are answered No, the student is not eligible under Section 504

Section 504 Team Decision (Check appropriate box)

Team Notes


Sheridan AllPrep Academy

Section 504 Accommodation Plan - Form 504 H

Student Information

Name:

Date of Birth:

Grade:

Teacher:

Parent/Guardian Name:

Address:

Phone:

Email:

Date of Meeting:

Eligibility Team Participants

Name

Signature

Position/Title

Information Relating to Nature of the Disability


Section 504 Accommodation Plan Development

Section 504 requires an appropriate educational program be designed to meet the individual educational needs of a qualified disabled student. Accommodations, services, and related aids must focus on the identified substantial limitation(s) in a major life activity or major bodily function. Accommodations must be designed to meet individual educational needs of students with disabilities as adequately as the needs of non-disabled students are met.

Accommodations for ________________________________ include:

Describe the student’s educational placement and the student’s least restrictive environment:

Yes                No

If Yes, describe the related services to be provided, including the amount, duration, frequency, and location of these services. If relevant, include any transportation that the student requires as a necessary related service.


Team Notes:

(In addition to anecdotal notes, this section should be used to explain or provide further detail for any area where the Accommodation Plan may be unclear or subject to confusion.)

I, the parent/legal guardian of the student named above, was given the opportunity to participate in the development of this Section 504 Accommodation Plan and agree with the plan as developed. I also have been given a copy of the Parent/Student Rights in Identification, Evaluation, and Placement €“ Form 504 D.

__________________________________________________        __________________

Parent/Guardian Signature                                                Date


Sheridan AllPrep Academy

Section 504 Manifestation Determination - Form 504 I

Student Information

Name:

Date of Birth:

Grade:

Teacher:

Parent/Guardian Name:

Address:

Phone:

Email:

Date of Meeting:

Eligibility Team Participants

Name

Signature

Position/Title

Sources of Information for Completing Manifestation Determination (attach copies)

Behavior subject to disciplinary action:

Has the student been removed from school for disciplinary reasons in the past? Describe:

List the student’s disability(ies) and summarize current accommodations and services, including any current behavior management plan:

Based upon the above information, the parent and relevant members of the Section 504 team have determined that:

  1. The conduct in question was the direct result of the school not implementing the students Section 504 Accommodation Plan

Yes                No

  1. The conduct in question was caused by or had a direct and substantial relationship to the
    students disability

Yes                No

Determination:

If the answer is Yes to either question above, the behavior must be considered a manifestation of the student’s disability.

Team Notes:

_________________________________        _____________________        ____________

504 Case Manager                                Title                                Date

___________________________________________

Telephone Number


Sheridan AllPrep Academy

Title VI, Title IX AND Section 504 Grievance Procedure - Form 504 J

Students, their parents/guardians and employees have the right to file a formal complaint alleging noncompliance with regulations implementing Title VI of the 1964 Civil Rights Act, Title IX of the Educational Amendments of 1972 and Section 504 of the Rehabilitation Act of 1973. A Grievant alleging discrimination on the basis of sex, race, national origin or disability may act according to the following grievance procedure.

Level One: Grievant has the option to formally discuss the complaint with the school Executive Director. A student grievant may discuss the complaint with a teacher or counselor. Grievant may formalize the complaint by submitting the grievance in writing. The Grievant shall state the nature of the grievance and the remedy requested. The filing of the Level One grievance must occur within fifteen (15) working days from the date of the event- giving rise to the grievance or from the date which Grievant could reasonably become aware of such occurrence. The Grievant may request a meeting with the Title IX and Section 504 Compliance Officer. A minor student may be accompanied at the meeting by a parent/guardian. The Title IX and Section 504 Compliance Officer shall investigate the complaint and attempt to resolve it. The Title IX and Section 504 Compliance Officer will send Grievant a written report regarding the investigation and action taken within fifteen (15) working days after receipt of the written grievance..

Level Two: Grievant may appeal the Level One response to the Board of Education. Grievant shall present the appeal in writing to the President of the Board of Education within ten (10) working days after receipt of the decision from the Executive Director or his or her designee. Grievant may request a public or private meeting with the Board of Education to discuss the appeal. The Board of Education will render a decision at their next regularly scheduled meeting. Grievant will receive written notice of the Boards decision within ten (10) working days.

This grievance procedure does not deny or limit the right of Grievant to file formal complaints with the Oregon Department of Education or the U.S. Department of Education Office for Civil Rights (Region X); to contact other agencies available for mediation or recertification of rights; or to seek private counsel.

Ms. Jesse Eisenschmidt, Executive Director

Sheridan AllPrep Academy

339 NW Sherman Street

Sheridan, Oregon 97378

Phone: (503) 890-8938

Fax: (866) 758-1982

Email:  jeisenschmidt@sheridanallprep.org

Sheridan AllPrep Academy

Title VI, Title IX AND Section 504 Grievance - Form 504 K

Name of Grievant_________________________________________________________

Please Print Clearly)

Contact Information: ______________________________________________________

(Mailing Address)

______________________________________________________

______________________________________________________

(Telephone Number(s); Email Address)

State the nature of the complaint and the remedy requested. Please be specific.  (Attach additional sheets if necessary)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________        __________________

Signature of Grievant                                                        Date

Please submit completed form to:

Ms. Jesse Eisenschmidt, Executive Director

Sheridan AllPrep Academy

339 NW Sherman Street

Sheridan, Oregon 97378

Phone: (503) 890-8938

Fax: (866) 758-1982

Email:  jeisenschmidt@sheridanallprep.org

Sheridan AllPrep Academy

Section 504 Checklist

Student: _______________________________________Date______________________

Sheridan AllPrep Academy

Rubric to Assist in Determining Level of Impact of Disability on School Functioning

To determine level of impact, refer to the rubric below. Keep in mind:

Mild

Moderate

Substantial

Academic

  • Proficient on standards-based assessments
  • Grades of some concern
  • Occasionally misses school work
  • Below proficient on standards-based assessments
  • Poor grades
  • Inconsistent school work
  • Performs below or far below proficient on standards-based assessments
  • Failing or very low grades
  • Rarely turns in schoolwork

Social

  • Some friends, but would like more
  • Typical relationships with adults
  • Average self-esteem  
  • Makes but loses friends
  • Trouble interacting with  adults
  • Occasionally expresses low self-esteem
  • Has few friends
  • Expresses feelings of loneliness
  • Few relationships with adults at school
  • Poor self-esteem

Behavioral

  • Occasional behavioral concerns
  • Occasional parent contact
  • Some suspensions
  • Parent contacted monthly
  • Frequent suspensions
  • Parent contacted weekly

Participation/

Attendance

  • Occasionally excluded due to behavior or school work
  • Average attendance
  • Misses some school activities due to behavior or school work
  • Often absent
  • Frequently misses school activities due to behavior or school work
  • Frequently absent