FORM 9A SPECIFIC LEARNING DISABILITY –
DETERMINATION
OF
ELIGIBILITY
This form
documents the requirements for identifying a student as having a
“specific learning disability” (SLD).
A draft of this form
is
typically completed prior to the IEP meeting with a discussion and final decision reached by the IEP team
during the meeting.
The Case Manager completes the form with input from the appropriate IEP team members
(School Psychologist, Special
Education Teacher, General
Education Teacher, etc.)
• Fill out the appropriate information based on the evaluations indicating the area of achievement that is severely discrepant
from
the
level of intellectual ability and the processing disorder associated with this discrepancy.
• Indicate whether the discrepancy is or
is
not caused by poor attendance, environmental,
emotional,
sensory or the other reasons listed in Section III.
• Include any medical findings that are educationally relevant and the other information required
on this form.
• If there is a team decision that is not
based on the standard measures indicated,
support that decision.
• Obtain signatures from all
participants in the IEP meeting on this form.
[Excerpted from the State SELPA IEP Manual, July, 2013]