item(s) need revision.
(For missing evaluations, you may be able to save this form as is, by first checking the incomplete box.)
Desired Results Developmental Profile
access
Rating Record
Incomplete
Child's information
1. Student ID
(Issued by district for reporting to CASEMIS)
2. Statewide Student Identifier
(10-digit SSID)
3. First Name (Legal)
4. Last Name (Legal)
5. Gender
6. Birth date
Child's language information
(NOTE: As of October, 2012, the language information is no longer required, and does not appear on the printed information form)
Is this child an English Learner?
Yes
No
Yes
No
Yes No
If Yes, what is/are the child's home language(s)?
If Yes, what is/are the child's home language(s)?
(select/specify up to three)
1.
2.
3.
Other languages / legacy entries
(used only if nothing appears above)
Was the child assessed by someone knowledgeable of his/her home language?
Yes
No
Yes
No
Child's ethnicity/race information
7a. Is this child Hispanic or Latino?
(select one)
7b. What is the race of this child?
7b. What is the race of this child?
(the DRDP report can use up to the first three specified)
1.
1.
-
2.
2.
-
3.
3.
-
4.
4.
-
5.
5.
-
6.
6.
-
Child's disability information
8. Primary Disability.
8. Primary Disability.
-
Child's adaptation information
9. Adaptations
(Note: These selections affect all DRDP rating records for this student.) Check all that apply.
Augmentative or alternate communication system
Alternative mode for written language
Visual support
Assistive equipment or device
Functional positioning
Sensory support
Alternative response mode
Program information
10. SELPA
11. District of service
12. Name of person completing the assessment
12. Name of person completing the assessment
13. Role of person completing the assessment
13. Role of person completing the assessment
(specify if other:)
Assessment information
14. Special Education Enrollment
14. Special Education Enrollment
15. Date DRDP
access
was completed
15. Date DRDP
access
was completed
Note:
The Rating Record is not meant to be used independent of the DRDP access Manual or Booklet. You will need to refer to the DRDP access Manual or Booklet to complete this Rating Record. This record plus an Information Page must be completed for all children birth to five who receive special education services from LEAs.
Instructions:
Write the child’s name, student identification number (issued by the district for reporting to CASEMIS), and the date this Rating Record was completed. Record the numerical rating for each Measure the number that corresponds to the Descriptor for the highest developmental level the child has mastered. Check EM (emerging) if the child is “emerging” to the next level (optional). In the rare circumstance that you are unable to rate a particular Measure, check UR (unable to rate) and circle the reason why you are unable to rate this Measure (absence or other).
Measure
Description
Rating
EM
UR
UR Reason
1. SELF1
1. SELF1
Identity of Self
2. SELF2
2. SELF2
Recognition of Own Skills and Accomplishments
3. SELF3
3. SELF3
Self-Expression
Measure
Description
Rating
EM
UR
UR Reason
4. SOC1
4. SOC1
Expressions of Empathy
5. SOC2
5. SOC2
Interactions with Adults
6. SOC3
6. SOC3
Relationships with Familiar Adults
7. SOC4
7. SOC4
Developing Friendships
8. SOC5
8. SOC5
Building Cooperative Play with Other Children
9. SOC6
9. SOC6
Conflict Negotiation
10. SOC7
10. SOC7
Awareness of Diversity
Measure
Description
Rating
EM
UR
UR Reason
11. REG1
11. REG1
Impulse Control
12. REG2
12. REG2
Seeking Other’s Help to Regulate Self
13. REG3
13. REG3
Responsiveness to Other’s Support
14. REG4
14. REG4
Self-Comforting
15. REG5
15. REG5
Taking Turns
Measure
Description
Rating
EM
UR
UR Reason
16. LANG1
16. LANG1
Language Comprehension
17. LANG2
17. LANG2
Responsiveness to Language
18. LANG3
18. LANG3
Expresses Self Through Language
19. LANG4
19. LANG4
Uses Language in Conversation
Measure
Description
Rating
EM
UR
UR Reason
20. LRN1
20. LRN1
Curiosity and Initiative
21. LRN2
21. LRN2
Attention Maintenance and Persistence
Measure
Description
Rating
EM
UR
UR Reason
22. COG1
22. COG1
Memory
23. COG2
23. COG2
Cause and Effect
24. COG3
24. COG3
Engages in Problem-Solving
25. COG4
25. COG4
Object and Pretend Play
Measure
Description
Rating
EM
UR
UR Reason
26. MATH1
26. MATH1
Number Sense: Understands Quantity and Counting
27. MATH2
27. MATH2
Number Sense: Math Operations
28. MATH3
28. MATH3
Number Sense: Comparison of Quantity
29. MATH4
29. MATH4
Shapes
30. MATH5
30. MATH5
Time
31. MATH6
31. MATH6
Classification and Matching
32. MATH7
32. MATH7
Measurement
33. MATH8
33. MATH8
Patterning
Measure
Description
Rating
EM
UR
UR Reason
34. LIT1
34. LIT1
Interest in Literacy
35. LIT2
35. LIT2
Concepts of Print
36. LIT3
36. LIT3
Letter and Word Knowledge
37. LIT4
37. LIT4
Phonological Awareness
38. LIT5
38. LIT5
Emerging Writing
39. LIT6
39. LIT6
Comprehension of Text
Measure
Description
Rating
EM
UR
UR Reason
40. MOT1
40. MOT1
Movement
41. MOT2
41. MOT2
Balance
42. MOT3
42. MOT3
Grasp/Release and Manipulation
43. MOT4
43. MOT4
Eye-Hand Coordination
Measure
Description
Rating
EM
UR
UR Reason
44. SH1
44. SH1
Personal Care Routines: Toileting and Hygiene
45. SH2
45. SH2
Personal Care Routines: Dressing
46. SH3
46. SH3
Personal Care Routines: Self-Feeding
47. SH4
47. SH4
Personal Safety
48. SH5
48. SH5
Understanding Healthy Lifestyle: Eating and Nutrition
Comment / note to administrator