Initial IAT Referral - Elementary
The Purpose of the IAT Process

-It's Ohio Law

-Districts must provide interventions within the context of general education to resolve problems for any child who is struggling academically.

-Interventions must be provided that address student concerns prior to conducting a full and individual evaluation for students suspected of having a disability.

-Results of such interventions must be included in the Multi-factored Evaluation. Those found to be effective will be used to write the IEP.

Email address *
Your Name (First and Last): *
Your answer
Today's Date *
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Student's Name: (First and Last) *
Your answer
Student Date of Birth *
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YYYY
Grade Level: *
Educational History
Was this student retained? *
Previous district attendance? *
Describe the student's attendance: *
Regular (comes almost every day), Irregular (misses days frequently all the time), Inconsistent (attendance fluctuates)
Current Concerns
What are your concerns regarding this student? *
Your answer
Were parents made aware of the concerns listed prior to this IAT referral?
Please list all attempted interventions: *
Please provide as much information as possible about interventions you have attempted in your classroom.
Your answer
Please list all accommodations this student is currently receiving: *
Your answer
Student's academic/behavioral/social strengths: *
Please describe
Your answer
Student's academic/behavioral/social weaknesses: *
Please describe
Your answer
Does the student exhibit behavioral concerns? *
If yes, please respond to the next question.
Behaviorally, does the student need to work on any of the following?
Do any of the following areas need to be considered?
Medical Information
Please indicate any relevant medical concerns:
Your answer
Academic Information
Student's Current Reading Level: *
Your answer
Student's Current Math Level: *
Student's statewide test scores (if applicable):
Your answer
Student's iReady Scores in Reading (if applicable):
Your answer
Student's iReady Scores in Mathematics (if applicable):
Your answer
What is the student's English grade?
What is the student's math grade?
What is the student's spelling/writing grade (if applicable)?
What is the student's Reading grade (if applicable)?
What is the student's social studies grade (if applicable)?
What is the student's science grade (if applicable)?
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