Special Education Resource Package

PRE-REFERRAL

A teacher who has concerns about a student may make a request at any time to the administration either for support or to have the case studied by an ad hoc committee.  When additional strategies or alternative teaching approaches are required, the Teachers’ Resource Guide – (Hawthorne Books), is used as a guide for making suggestions.  The request for an ad hoc committee meeting must be made in writing.  The REPORT ON INTERVIEW FORM which included the following information, can be used as the request with a memo attached:

ü      Student I.D.

ü      Reason for Referral

ü      Description of problem

ü      Measures taken to date as well as duration.  The success or not of these measures must be shown, as well.

The teacher making the request, as well as the principal, should initial the report on interview.  (The resource teacher, who is taking down the information from the teacher who is experiencing difficulty with a student, ensures that this is done).  A copy is given to the teacher and to anyone who will eventually do follow-up.  This ensures that everyone is accountable for follow-up and is an excellent reminder.  A copy is often provided to the parent at the end of the meeting that they attend, as well.  The resource teacher should have parents initial the report on interview as well, so no misunderstanding occurs.  The original report remains in the student’s confidential file.  Support services that could be requested are listed on the Report on interview.  These include resource teacher, social worker, speech and language therapist, and psychologist.  The request for services must take into account the distribution of support services determined by the school level committee.  The teacher may make written comments to the school level committee concerning the services received.  In serious case or where the problem persists, even after support is given, the teacher may request that the ad hoc committee study the case.  When such a request is made the current procedure and operation of such a committee shall apply.

Teacher identifies student in difficulty.

Problem Solved or teacher takes steps to solve problem.  This means that the resource teacher fills in the report on interview with the teacher, that the parents are informed of the situation and that a plan of action that all participants feel will be helpful, is put into place.

Problem persists   ………………. Ad hoc requested.

Teacher requests services …… From school administration.

Problem solved………………… Services delivered.

Problem persists ………………… Ad hoc requested.

Services continue:

Reviewing the confidential file in order to check what strategies have already been tried will save time in the long run.

Using the Resource Guide (Hawthorne) suggestions are made and strategies identified as to how the student might be helped.  In the event of behavioral difficulties the behaviour contract should be established.  The teacher is asked to try some of the suggestions, and to document the changes.  In the event of escalating difficulties the school social worker should be consulted.

FORM 1:      Report on Interview

This form is used to document what took place during the meeting.  It is possible that the student’s situation is such that a  Request for Complementary services should be made immediately.  (See form No. 3A)  Inter-Office Memo, if necessary.

FORM  2:     Tracking Form

This form should be attached to a file folder and a file is then opened concerning the student. Whatever takes place from this time on regarding student services for this student will be recorded on this form.  It is clear to any one needing to check the status of the student.

FORM 3:      Request for Individual Testing

This form is to be filled out and signed by the parent(s).  In the list of professionals, located at the lower part of the sheet, the word psychologist is omitted, as there is a specific sheet for this request.  (As well, it has been found that parents are often wary of signing the form if this is included.) 

In most schools a telephone call is made to the home before the request for testing is sent.

OR

FORM 3-A:  Authorization for making a request for complementary services

When a student requires complementary services such as a social worker, this form is filled out by the resource teacher in collaboration with the principal, and sent home for signing.

FORM 3-B:  Request for CLSC Services

This form comes from the CLSC and is a request for a service that can be obtained through the CLSC.  (Nurse, social worker).

FORM 4:      Referral Form

This form is filled out once permission to test has been obtained from the parent(s).  This should be filled out as completely as possible so that the examiner is then more able to observe the student from the perspective of the teacher.  As well, it is difficult, when writing the final report, to be of help to the teacher when the problem is not clarified.

FORM 5-A    Authorization to release confidential information

FORM 5-B    Authorization to obtain confidential information

These forms are required in order that information, such as testing information, can be sent to a psychologist, doctor, pediatrician, pediatric psychologist, CLSC, CJGIM, C.R., and so that information may be sent back to the school.

FORM 6:      Request for Psychological Services                  

FORM 7:      Fiche de reference if needed 

FORM 8:      Connors’ Rating Scale Teacher and Parent
                       (available at the board office)

These forms are filled in both by the teacher and parent in order to confirm findings on the testing that suggest ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY or ATTENTION DEFICIT DISORDER WITHOUT HYPERACTIVITY.  This is a medical condition and needs further documentation, depending on the scores on the Connors’, by the psychologist, (as required by the MEQ) before the doctor is contacted.  One teacher fills in the teacher form, although collaboration between teachers is fine.  The teacher or resource frequently meets with parents to fill in the parent form, rather than sending it home to be filled in. 

FORM 9:      Authorization for the Administration of Prescribed Medication

Parents must authorize the administration of all medication.  In the case of neuro-stimulants, the time of administration must be clearly indicated.  Children who have an attention deficit disorder with hyperactivity usually require medication prior to going outdoors for the noon break.  For those requiring medication that helps them to focus, this is not necessary.  As well, as neuro-stimulants often cut appetite, this must be a consideration when setting the time for medication.  An alternative method used by some schools, in order to lessen the amount of paperwork asked of teachers, in which the principal notifies staff through a memo, that documentation regarding certain behaviors is required.    

FORM 10:    Medicational Watch  

Annexes     I        Roadsheet

                   II       Collaborative Intervention Meeting