Tool Search: Special Ed Documents
The Referral form is used to record the reason for referral to evaluate the student for special education services.
The current format of this document is the KY Referral 2023 print format. Formats are selected in Eval Types.
Editor Home
Editor Home
The Editor Home lists the editors available, their status, and Modification and Completion information.
Header | Description |
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Name | The name of the editor. |
Status | The state of the editor. Statuses can be: - In Progress indicates a user has entered and saved data in that editor.
- Not Started is the default status for all editors.
- Complete indicates a user has clicked the Complete button on the editor, and the editor is read-only. This does not lock the editor from further editing but indicates the user considers the editor finished.
- Not Needed indicates a user has clicked the Not Needed button on the editor. This is usually done for editors that do not apply to the student.
The following statuses are only available for certain state-specific documents: |
Modified By | The date and the user by whom the editor was last edited. |
Completed By | The date and the user who clicked the Complete button for that editor. |
General Information
The following table lists the actions available for the editors. When resizing the window, certain buttons are condensed into a single Action button.
Button | Description |
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Save | Different editors have different save options. Click the arrow next to the Save & Stay button to view all saving options for any given editor. - Save captures progress and navigates the user to the Editor Home or to the List Screen for List editors. See the Editor Types section for additional information.
- Save & Stay captures progress and keeps the user on the current editor. This save button is the default save option and is usually found within the detail screen or list editors, such as Goals and Objectives.
- Save & Next captures progress and navigates the user to the next editor.
- Save & New captures progress and creates a new record. This save button is usually found within the detail screen of a list editor, such as Goals and Objectives. See the Editor Type section for additional information.
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Refresh | Retrieves a new copy of data from the student's record. This includes enrollment, student, parent/guardian, and team member information. This also returns any accidentally deleted records. Manually entered fields do not change when the refresh button is clicked. The user must Save after clicking Refresh to capture changes.
A side panel displays a listing of all the student's applicable enrollment records. See the Enrollments tool documentation for additional information. |
Cancel | Navigates the user to the Editor Home screen or the List Screen for List editors. |
Status | Changes the status of the editor. - Complete indicates the editor is finished. This makes the editor read-only. However, this does not lock the editor from further editing. The user must click In Progress to further edit after an editor is marked Complete.
- Not Needed indicates the editor does not apply to the student's plan or evaluation. This makes the editor read-only. However, this does not lock the editor from further editing. Click the In Progress button to further edit after an editor is marked Not Needed.
- In Progress only displays when the editor is in the Complete or Not Needed status and allows additional edits to be made.
The following status is only available for the Nevada IEP: |
Print | Prints the entire document. |
Editors | Opens a side panel listing all the available editors and their status. Select an editor from this list to navigate to that editor or click Close to collapse the side panel. |
Previous | Navigates the user to the previous editor. |
Next | Navigates the user to the next editor. |
Editor Types
There are two types of editors available: List or Basic editors. When navigating to a Basic editor, the list of fields within the editor is displayed. List editors display a list of all records within that editor. Clicking an existing record or the New button opens the detail view for an individual record.
Editor Lock Out and Release Logic
Only one user at a time can actively work on an editor. A person with a padlock icon () displays in the Editors side panel, Editor Home, and List Screen of list editors indicating which editors currently have users working on them. Hovering over the icon displays the name of the user who has checked out the editor, including the current user (you).
Editors that are currently being edited are read-only for all other users. The name of the person working on the editor displays in the header.
To release an editor, the user must:
- navigate to the next editor by clicking Save and Next or the Editors button and selecting the next editor from the side panel.
- click the Cancel button to return to the Editor Home screen.
- log out of the Campus application.
- navigate to a different tool in the Campus application.
Editors are automatically released when the in-application timeout limit has been exceeded. This is a back-end process and is usually around 30-60 minutes.
Template Banks
Certain fields within several editors have an Add Template icon that displays next to their name. Clicking this button displays a side panel with the available library of predetermined text for that field. Template Banks are managed in System Administration.
Template Bank Side PanelClick the plus (+) icons next to the category to view the available template values.
Expanded Category and Values SelectedTemplate Bank Categories display on the left and the selected text displays on the right. Click the Add button to add the template value. This adds the template to the queue of values on the right. The red X removes selected templates while the sequence field can be used to reorder the templates. Another option is to use the up and down arrows next to the sequence field to reorder values.
Click Cancel to go back to the document. The Clear Selected Template(s) button removes all selected template values from the right selection screen.
Once selections are finalized, click the Insert Selected Template(s) button to add the values to the field within the document in the selected order. Template values are separated by carriage returns.
Example Template Bank Selections in the Document
Text Editors
Images should not be inserted into text fields.
Editors
The following section lists each editor and describes each field on the editor.
Referral Header
The Referral Header editor includes the dates associated with evaluation of the student, including the date the student was referred and the student's suspected disability.
Referral Header
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Field | Description | Validation |
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ARC Decision Date Required | The day the Admissions and Release Committee made the decision. | N/A |
Referred Date | The referral date. | N/A |
Referring Person/Title | The person who referred the student and their title or position. | N/A |
Suspected Disability | The potential disability of the student. Options include: - Autism
- Deaf-Blindness
- Developmental Delay
- Emotional-Behavioral Disability
- Functional Mental Disability
- Hearing Impairment
- Mild Mental Disability
- Multiple Disabilities
- Orthopedic Impairment
- Other Health Impairment
- Specific Learning Disability
- Speech or Language Impairment
- Traumatic Brain Injury
- Visual Impairment
- No Disability Suspected
| Multiple options can be selected. Options available are found in a locked Attribute Dictionary, Evaluation > Consent to Evaluate/Revaluate > Suspected Disability. |
Select disability area(s) for 'Developmental Delay' | The disability areas associated with the student's developmental delay, when applicable. Options include: - Cognition
- Motor Development
- Self-help/adaptive behavior
- Communication
- Social-emotional development
| This field is available when Developmental Delay is selected as the Suspected Disability.
Multiple options can be selected. Options available are found in a locked Attribute Dictionary, Evaluation > Consent to Evaluate/Revaluate> Developmental Delay. |
Select disability area(s) for 'Specific Learning Disability' | The disability areas associated with the student's specific learning disability, when applicable. Options include: - Oral Expression
- Written Expression
- Reading Fluency Skills
- Mathematics Calculation
- Listening Comprehension
- Basic Reading Skills
- Reading Comprehension
- Mathematics Reasoning
| This field displays when Specific Learning Disability is selected as the Suspected Disability.
Multiple options can be selected. Options available are found in a locked Attribute Dictionary, Evaluation > Consent to Evaluate/Revaluate > Specific Learning Disability Field Name = SLD. |
Select disability area(s) for 'Speech or Language Impairment' | The disability areas associated with the student's speech or language impairment, when applicable. Options include: - Speech Sound Production and Use
- Language
- Fluency
- Voice
| This field displays when Speech or Language Impairment is selected as the Suspected Disability.
Multiple options can be selected. Options available are found in a locked Attribute Dictionary, Evaluation > Consent to Evaluate/Revaluate > Speech Language. |
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Enrollment Information
The Enrollment Information editor reports Special Education information from the student's Enrollment record. This editor is read only.
The Refresh button retrieves a fresh copy of data from the student's record. The Refresh button must be clicked before the editor can be placed in a Complete status.
See the General Information section for additional information.
Enrollment Information Editor
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Field | Description | Database Name/Location (when Refresh is clicked) | Validation |
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Primary Disability, if currently identified | The student's primary disability. | Enrollment > Primary Disability
Enrollment.disability1 | This field is read-only and is pulled from the student's Enrollment record upon Refresh.
Displays None when a disability is not identified. |
Grade | The student's current grade. | Enrollment > Grade
enrollment.grade | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
General Education Teacher | The student's general education teacher's name. | N/A | This field is limited to 150 characters. |
School Name | The student's school of attendance. | Learner Planning > Learning Plans > Enrollments > residentSchool
enrollment.residentSchool | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
School Phone | The student's school of attendance phone number. | Learner Planning > Learning Plans > School > Phone
v_SchoolCurrent.phone | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District Information |
District Number | The district number associated with the Enrolled school. | System Administration > Resources > District Information > State District Number | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District Name | The district name associated with the Enrolled school. | System Administration > Resources > District Information > Name | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District Address | The district address associated with the Enrolled school. | System Administration > Resources > District Information > Address | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District Phone | The district phone number associated with the Enrolled school. | System Administration > Resources > District Information > Phone | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District SPED Address | The district special education address associated with the Enrolled school. | System Administration > Resources > District Information > SPED Address | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
District SPED Phone | The district special ed phone number associated with the Enrolled school. | System Administration > Resources > District Information > SPED Phone | This field is read-only and is pulled from the student's Enrollment record upon Refresh. |
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Student Information
The Student Information editor displays basic information about the student such as demographic information. This is a read-only editor.
The Refresh button retrieves a fresh copy of data from the student's record. See the General Information section for additional information.
Student Information Editor
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Field | Description | Database/UI Location (when Refresh is clicked) |
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Last Name | The student's last name. | Census > People > Demographics > Last Name
identity.lastName |
First Name | The student's first name. | Census > People > Demographics > First Name
identity.firstName |
Middle Name | The student's middle name. | Census > People > Demographics > Middle Name
identity.middleName |
Suffix | The student's suffix. | Census > People > Demographics > Suffix Name
identity.suffix |
Gender | The student's gender. | Census > People > Demographics > Gender
identity.gender |
Birthdate | The student's birthdate. | Census > People > Demographics > Birth Date
identity.birthDate |
Race, Ethnicity | The student's race/ethnicity. | Census > People > Demographics > Race/Ethnicity
identity.raceEthnicity |
Primary Mode of Communication of Student | The student's language they speak at home.
Values available are found in the locked Attribute Dictionary, LanguageList. | Census > People > Demographics > Home Primary Language
identity.homePrimaryLanguage |
Address | The student's address.
This field becomes a dropdown when more than one address exists for the student. The primary household displays by default. | Census > Households > Address Info
address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip |
Student Number | The student's identification number. | Census > People > Demographics > Student Number |
State ID | The student's state identification number. | Census > People > Demographics > State ID |
Case Manager Information These fields are read-only. |
Name | The first and last name of the team member. | Student Information > Special Ed > General > Team Members > Case Manager Name |
Title | The role of the team member. | Student Information > Special Ed > General > Team Members > Case Manager Title |
Phone | The phone number of the team member. | Student Information > Special Ed > General > Team Members > Case Manager Work Phone |
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Parent/Guardian Information
The Parent/Guardian Information editor populates based on the guardian checkbox on the student's Relationships tool. The editor includes Demographics information for the student's guardian.
The Delete button next to each parent/guardian can be used to remove a parent/guardian from the Evaluation.
The Refresh button retrieves a new copy of parent/guardians' data. This also returns any accidentally deleted people. Manually entered fields do not change when the refresh button is clicked. The user must Save after clicking Refresh to capture changes.
Parent/Guardian Information Editor
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Field | Description | Database/UI Location (when Refresh is clicked) | Validation |
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Last Name | The last name of the parent/guardian. | Census > People > Demographics > Last Name
identity.lastName | This field populates from Census. This is part of the header for the parent/guardian. |
First Name | The first name of the parent/guardian. | Census > People > Demographics > First Name
identity.firstName | This field populates from Census. This is part of the header for the parent/guardian. |
Middle Name | The suffix of the parent/guardian. | Census > People > Demographics > Suffix Name
identity.suffix | This field populates from Census. This is part of the header for the parent/guardian. |
Suffix | The suffix of the parent/guardian. | Census > People > Demographics > Suffix Name
identity.suffix | This field populates from Census. This is part of the header for the parent/guardian. |
Relationship | The relation of the parent/guardian to the student. | Census > People > Relationships | This field populates from Census. This is part of the header for the parent/guardian. |
Print Sequence | The print order of the parent/guardian(s) on the IEP. | N/A | When no Sequence is selected, parent/guardian(s) print in the order displayed in the UI. When any Sequences are selected, parent/guardian(s) with a sequence number print in the order defined. Un-sequenced parent/guardians display at the bottom. |
Address | The parent/guardians' address. | Census > Households > Address Info
address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip | This field populates from Census.
When there are multiple addresses for a person, a drop down with an option to select which address displays. When there is only one address, the drop down has one option. The populated address is the one marked Primary. |
Home Phone | The home phone number of the parent/guardian. | Census > People > Demographics > Household Phone | This field populates from Census. |
Work Phone | The work phone of the parent/guardian. | Census > People > Demographics > Work Phone | This field populates from Census. |
Cell Phone | The cell phone of the parent/guardian. | Census > People > Demographics > Cell Phone | This field populates from Census. |
E-mail | The primary email address for the parent/guardian. | Census > People > Demographics > Email | This field populates from Census. |
Primary Mode of Communication in the Home | The language spoken at home.
Values available are found in the locked Attribute Dictionary, LanguageList. | Census > People > Demographics > Home Primary Language
identity.homePrimaryLanguage | This field populates from Census. |
Student Representation |
Student Represented By
| The person representing the student. Options include: - Parent
- Guardian
- Self
- Surrogate
| N/A | N/A |
Does Student Live with Parents?
| Indicates the student live with their parent/guardian(s). | N/A | N/A |
If No, With Whom Does the Student Live? *Required
| The person the student lives with. | N/A | *This field becomes available and is required when No is selected for the question, Does Student Live with Parents? |
Relationship *Required
| The relationship of the student to the person they are living with. | N/A | *This field becomes available and is required when No is selected for the question, Does Student Live with Parents? |
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Summary of Interventions
The Summary of Interventions editor includes text editors for providing information regarding the interventions.
Summary of Interventions Editor
Field | Description |
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1. Describe the area being targeted for intervention and means of identifying the need. | A text field used to describe the area targeted for intervention and how the need is identified. |
2. Indicate the area(s) of suspected disability. | A text field used to describe the area(s) of suspected disability. |
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Summary of Interventions Data
The Summary of Interventions Data editor provides the ability to add New Intervention Data. From the Summary of Intervention Data List, data can be selected, edited, and deleted.
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Summary of Interventions Data List Screen
Summary of Interventions Data List Screen
Column Name | Description |
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Padlock Icon | The user currently editing the Summary of Interventions Data record. |
Tier Intervention | The level of intervention. |
Begin Date | The first day of the intervention. |
End Date | The last day of the intervention. |
Summary of Interventions Data Detail Screen
Select an existing record or New to view the detail screen.
Summary of Interventions Data Detail Screen
Field | Description | Validation |
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Summary of Interventions Data |
Interventions Required | The level of intervention. Options include: - Tier I Interventions
- Tier II Interventions
- Tier III Interventions
| N/A |
Describe the intervention(s) implemented in the general education classroom to address the area being targeted and the name of the interventionist. | A description of the intervention. | N/A |
Impact | The final result of the intervention. | This field is limited to 8000 characters. |
Expected Progress | The expected result of the intervention. | This field is limited to 8000 characters. |
Duration and Frequency |
Begin Date Required | The first day of the intervention. | N/A |
End Date | The last day of the intervention. | N/A |
Frequency of Service | The frequency of the service sessions. | This field is limited to 25 characters. |
Amount of Time | The amount of time per sessions. | This field is limited to 25 characters. |
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Major Areas of Concern
The Major Areas of Concern editor provides the ability to add New Area of Concern data. From the Major Area(s) of Concern List, data can be selected, edited, and deleted.
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Major Areas of Concern List Screen
Major Areas of Concern List Screen
Column Name | Description |
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Padlock Icon | The user currently editing the Summary of Interventions Data record. |
Area | The area of concern. |
Reasons for Referring | The reason for referral. |
Major Areas of Concern Detail Screen
Select an existing record or New to view the detail screen.
Major Areas of Concern Detail Screen
Field | Description | Validation |
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Area(s) Required | The area of concern. - Communication
- Academic Performance
- Health, Vision, Hearing and Motor Abilities
- Social and Emotional Status
- General Intelligence
- Work Skills / Technical / Vocational Functioning
| This field is required.
Only one entry for each area is allowed. Once an option is selected, it is removed from the drop down.
|
Reasons for Referring Required | The reason for the referral . The options available depend on the Area selected above.
When Communication is selected, options include: - Communicates Basic Needs and Wants
- Articulation
- Knowledge of Sound/Letter Association
- Expressive Language
- Voice Quality
- Receptive Language
- Other Specify
When Academic Performance is selected, options include: - Oral Expression
- Written Expression
- Reading Comprehension
- Mathematics Calculation
- Listening Comprehension
- Basic Reading Skills
- Reading Fluency
- Mathematics Reasoning and Application
- Other Specify
When Health, Vision, Hearing and Motor Abilities is selected, options include: - Gross Motor Skills-Body Control
- Gross Motor Skills-Locomotion
- Vision
- Developmental History
- Fine Motor Skills-Perceptual Motor
- Fine Motor Skills-Sensory
- Hearing
- Other Specify
When Social and Emotional Status is selected, options include: - Interaction with Peers
- Interaction with Adults
- Acceptance of Rules
- Acceptance of Correction
- Acceptance of Disappointment
- Self Help Skills/Play Skills
- Team/Membership
- Mood Swings
- Repetitive Behaviors
- Self Concept
- Inactivity or Withdrawal
- Cooperation
- Self Control
- Expression of Feelings/Affect
- Lack of focus
- Inattention
- Easily distractible
- Impulsive
- Other Specify
When General Intelligence is selected, options include: - Understanding New Concepts
- Interpreting Data to Make Decisions
- Comparing/Contrasting Ideas of Objects
- Perceptual Discrimination
- Predicting Events/Results
- Problem Solving
- Applying Knowledge
- Memory
- Other Specify
When Work Skills/Technical/Vocational Functioning is selected, options include: - Attending to Task
- Following Directions
- Independent Work Habits
- Seeking Assistance When Needed
- Using Research Tools Effectively
- Maintaining Physical Stamina
- Having Realist Vocational Goals
- Punctuality
- Completing Work
- Organizing Materials/Belongings
- Using Technology to Gather/Organize Info
- Identifying Preferences/Interests
- Recognizing Personal Limitations
- Other Specify
| N/A |
Specify Other *Required | A specific other area. | *This field is available and required when Other Specify is selected from Reasons for Referring for any Area.
This field is limited to 1000 characters. |
Specialized Equipment Used by Student | Any specialized equipment the student uses. | This field is limited to 8000 characters. |
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School Information
The School Information editor summarizes data related to the student's school records.
School Information Editor
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Field | Description | Validation |
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School Information |
Number of Schools Attended to Date | The number of schools the student has attended. | This field is limited to 3 characters. |
Column Name: - Year
- Grade
- Days Enrolled
- #of Absences Excused
- #of Absences Unexcused
- #of Tardies Excused
- #of Tardies Unexcused
|
Years in School Including Current Year | The number of years the student has been in school. | This field is limited to 5 characters. |
Years in Primary Program Including Current Year | The number of years the student has been in a primary program. | This field is limited to 5 characters. |
Repeated Grades | The number of repeated grades. | This field is limited to 5 characters. |
Summary of Most Recent Grades (Provide Current or Most Recent Grades the Student Received by Content) |
Reading | The grade the student received in reading. | This field is limited to 5 characters. |
Math | The grade the student received in math. | This field is limited to 5 characters. |
Science | The grade the student received in science. | This field is limited to 5 characters. |
Spelling | The grade the student received in spelling. | This field is limited to 5 characters. |
English | The grade the student received in English. | This field is limited to 5 characters. |
Social Studies | The grade the student received in social studies. | This field is limited to 5 characters. |
Additional Content 1 | The name of first additional content. | This field is limited to 25 characters. |
Content Grade 1 | The grade the student received in the additional first content area. | This field is limited to 5 characters. |
Additional Content 2 | The name of second additional content. | This field is limited to 25 characters. |
Content Grade 2 | The grade the student received in the additional second content area. | This field is limited to 5 characters. |
Additional Content 3 | The name of third additional content. | This field is limited to 25 characters. |
Content Grade 3 | The grade the student received in the additional third content area. | This field is limited to 5 characters. |
Summary of Standardized Group Test Data (Attach copies) Columns Headers: - Test Name
- Date
- Reading
- Math
- Language
- Spelling
Only 5 rows/tests can display. All fields are limited to 50 characters, except the Date field. |
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Physical Functioning and Summary of Support
The Physical Functioning and Summary of Support Editor summarizes screening and past and present support information.
Physical Functioning and Summary of Support Editor
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Field | Description | Validation |
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Vision Required for all students referred for special education |
Vision Screening Date | The date of the student's vision screening. | N/A |
Vision Screening Results | The results of the vision screening. Options include: | N/A |
Hearing Required for all students referred for special education |
Hearing Screening Date | The date of the student's hearing screening. | N/A |
Hearing Screening Results | The results of the hearing screening. Options include: | N/A |
Motor Required when Specific Learning Disability suspected and as determined by ARC |
Motor Screening Date | The date of the student's motor screening. | N/A |
Motor Screening Results | The results of the motor screening. Options include: | N/A |
Speech Required as Determined by the ARC |
Speech Screening Date | The date of the student's speech screening. | N/A |
Speech Screening Results | The results of the speech screening. Options include: | N/A |
Describe any Existing Medical Health Conditions Below | A description of any of the student's existing medical health conditions. | N/A |
Is Student Currently on Medication? | Indicates the student is currently on medication. Options are Yes or No. | N/A |
Specify Type and Dosage Below *Required | A description of the type of medication and the specific dosage. | *This field is available and required when Yes is selected for the question, Is Student Currently on Medication?
This field is limited to 8000 characters. |
Summary of Past and Present Support |
Has this student been evaluated for special education previously? | Indicates the student has been evaluated for special education previously. Options are Yes or No. | N/A |
If yes, When was the student evaluated? *Required | The date of the previous evaluation. | *This field is available and required when Yes is selected for the question, Has this student been evaluated for special education previously? |
What was the suspected area of disability? *Required | A description of the student's suspected disability. | *This field is available and required when Yes is selected for the question, Has this student been evaluated for special education previously?
This field is limited to 50 characters. |
What services is this student receiving or what services has this student received in the past? For the services below, enter [C] if currently receiving or [P] if the service was provided in the past. |
Limited English Proficient | Indicates the student has received Limited English Proficiency services currently or in the past. | This field is limited to 2 characters. |
Migrant | Indicates the student has received Migrant services currently or in the past. | This field is limited to 2 characters. |
Title 1 | Indicates the student has received Title 1 services currently or in the past. | This field is limited to 2 characters. |
Speech Language | Indicates the student has received Speech Language services currently or in the past. | This field is limited to 2 characters. |
504 | Indicates the student has received Section 504 services currently or in the past. | This field is limited to 2 characters. |
Extended School Services | Indicates the student has received Extended School services currently or in the past. | This field is limited to 2 characters. |
Gifted and Talented | Indicates the student has received Gifted and Talented services currently or in the past. | This field is limited to 2 characters. |
Involvement with Outside Agency(ies) | Indicates outside agencies have been involved in providing services. Options are Yes or No. | N/A |
Agency *Required | The name of the agency. | *This field is available and required when Yes is selected for the question, Involvement with Outside Agency(ies).
This field is limited to 50 characters. |
Describe services that are being provided to this student by the agency(ies) listed above *Required | A description of the services provided to the student by the agencies listed. | *This field is available and required when Yes is selected for the question, Involvement with Outside Agency(ies). |
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Documentation of Student Progress
The Documentation of Student Progress editor provides the ability to add New Test data. From the Documentation of Student Progress List, data can be selected, edited, and deleted.
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Documentation of Student Progress List Screen
Documentation of Student Progress List Screen
Column Name | Description |
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Padlock Icon | The user currently editing the Documentation of Student Progress record. |
Test Name | The name of the test. |
Documentation of Student Progress Detail Screen
Select an existing record or New to view the detail screen.
Documentation of Student Progress Detail Screen
Field | Description |
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Scores from District Universal Screenings |
Test Name Required | The name of the assessment. |
Reading | The name of the reading assessment. |
Date | The date of the reading assessment. |
Math | The name of the math assessment. |
Date | The date of the math assessment. |
Language | The name of the language assessment. |
Date | The date of the language assessment. |
Behavior | The name of the behavior assessment. |
Date | The date of the behavior assessment. |
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