IADAS - Child Study Team Referral - SY20-21
This form should be used to make a referral to the IADAS Child Study Team (CST).  CST referrals can be made by individual teachers or teams.  

Please remember that Special Education Students are not referred to the Child Study Team.  Concerns about Special Education Students should be shared with the child's case manager and administration.

Referrals will only be reviewed after the child's team has already met about that child during a strategy meeting during collaborative time in order to determine and apply tier 1 interventions.  CST referrals can be made after strategy meeting interventions have been applied or when the situation seems extreme.  

Remember, if you think that a child would benefit from speaking with a  social worker,, check and connect mentor, or trauma counselor, please email Ann.  Referrals for a trauma counselor or social worker do not require a CST referral.

Please contact any members of the Child Study Team if you have questions.

The Child Study Team meets on Wednesdays From 7.45-8.45 via zoom.  If a child you referred is being reviewed, we will invite you or a member of your team to present concerns and other information if coverage is available.

IADAS Child Study Team Members:

Ann Brillante - Administrator
Alan Gibbons - Lead Teacher
Gerald McClease - Student Intervention Specialist
Ebony McClease - Special Education Consultant
Melvin Crespo - Truancy Officer
Lissette Agosto - Social Worker
Liz Demsky - School Counselor
Mia Breuler - School Counselor
Scott Anderson - Classroom Teacher
Anthony Gomez - Classroom Teacher
Katirya Lopez - Social Work Intern
Ricardo Arocha - Social Work Intern
Laura Goldblum - Supervisor

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Last, First (as listed in PowerSchool)
Child's ID Number
Does this child have an IEP?
If yes, please relay concerns to case manager instead of using this form.
Does this child have a 504 Plan?
Total Excused Absences (AE)
Total Unexcused Absences (AU)
Reasons for Referral - Please give as much information as possible.
Behavior, Academic, Other Info
Your referral will be reviewed if the child's team has already met about that child during a strategy meeting to determine and apply tier 1 interventions.
Copy Links to Strategy Meeting Protocol and other Documentation
 (Strategy Meeting Outcomes, Attendance Meeting Outcomes, Failure Intervention Documentation, etc.)
Your referral will be reviewed by the team if a conversation has been had with the child, the parent, and you have ascertained whether or not an SLC was completed for that child.
Yes, I spoke directly to the child, and the following information was gathered:  
Yes, I spoke directly to the parent / guardian and the following information was gathered:
Has a Student Led Conference been completed for this child?
Other Relevant Information
Submitted by ___________________ in discussion with ____________.
Please include your name and other members of your team where this was discussed.
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