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As appropriate to the disability, documentation (SAR form) should include the following information:

 

• Eligibility/Diagnostic Statement
• Formal Diagnosis and Date
• Basis of Determination
• Current Functional Impact
• Response to Instructional Intervention
• Description of the expected progression or stability of the impact of the disability over time
• History of Accommodations
• Suggested Accommodations
• Signature
• Authorization of Release
• Student Written Response

 

ELIGIBILITY/DIAGNOSTIC STATEMENT

 

The diagnostic systems used by the Department of Education, the Area Education Agencies, the State Department of Rehabilitative Services or other State agencies and/or the current editions of either the Diagnostic Statistical Manual of the American Psychiatric Association (DSM-IV-TR) or the International Statistical Classification of Diseases and Related Health Problems of the World Health Organization (ICD) are the recommended diagnostic taxonomies.

 

An eligibility/diagnostic statement includes the nature of the disability and the:

 

• Date of original eligibility into the system

• Most recent reevaluation date, and

• Current area(s) of concern

 

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FORMAL DIAGNOSIS AND DATE

 

When available include the formal diagnosis, the name of the professional evaluator with credentials (certification, licensure, and/or the professional training of individual(s) conducting the evaluation should be provided), and the date of the evaluation.  Please indicate if there is no formal diagnosis available. 

 

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BASIS OF DETERMINATION

 

List the diagnostic test(s), criteria and/or process(es) used for the determination of the disability. Include specific results from the diagnostic procedures and/or tests that are relevant to the disability and when they were administered.  Diagnostic methods used should be congruent with the disability and current professional practices within the field. Informal or non-standardized evaluations should be described in enough detail that a professional colleague could understand their role and significance in the diagnostic process.  Useful and relevant information includes:

 

• Formal/informal diagnostic assessments,

• Recent reevaluation results, and/or

• Performance levels with/without accommodations

 

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CURRENT FUNCTIONAL IMPACT

 

The current functional impact of the disability is most helpful in describing either explicitly or through provision of specific diagnostic results how the student functions within the academic setting.  Include current levels of function, goals, rate of progress, modifications, and accommodations.  In addition, provide any information that describes the typical progression of the disability, its interaction with development across the life span, the presence or absence of significant events (since the date of the evaluation) that would impact academic performance, and the applicability of the information to the current context of the request for accommodations at the post secondary level.  Current functional impact focuses on:

 

• Perceptual,

• Cognitive,

• Behavioral and/or

• Physical abilities

 

Include current treatments and medications.  A brief review or history of treatments and medications noting significant and/or potential side effects that may impact perceptual, cognitive, behavioral and/or physical performance should also be included.

 

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RESPONSE TO INSTRUCTIONAL INTERVENTION

 

A description of instructional interventions, assistive devices, accommodations and/or assistive services should be provided.   Include statements about their effectiveness in managing and/or minimizing the impact of the disability for the individual.

 

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DESCRIPTION OF THE EXPECTED PROGRESSION OR STABILITY OF THE IMPACT OF THE DISABILITY OVER TIME

 

This description should provide an estimate of the change in the functional limitations of the disability over time and/or recommendations concerning the predictable needs for reevaluation.

 

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HISTORY OF ACCOMMODATIONS

 

Depending on the impact of the condition on the individual, a history of accommodations implemented and perceived effectiveness in managing and/or minimizing the impact of the disability should be provided.  For individuals graduating from high school, a record of accommodations used during eighth through twelfth grade provides a more complete picture of the student’s experiences.  It also provides an opportunity for the student to engage in reflection and self-determination.

 

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SUGGESTED ACCOMMODATIONS

 

Depending on the functional impact of the condition on the individual, include a listing of suggestions for accommodations and supports that may be beneficial in providing full access as the student transitions.  Recommendations may include:

 

• Accommodations,

• Adaptive devices,

• Assistive services,

• Compensatory strategies, and/or

• Collateral support services

 

As appropriate, recommendations for collateral medical, psychological, and/or educational support services or training that would be beneficial may also be included.

 

Recommendations from professionals with a history of working with the individual provide valuable information for the review process. They will be included in the evaluation of requests for accommodation and/or auxiliary aids. Where such recommendations are congruent with the programs, services, and benefits offered by the (College/University) they will be given deference. When recommendations go beyond services and benefits that can be provided by the College they may be used to suggest potential referrals to area service providers beyond the (College/University).

 

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SIGNATURE

 

The signature of the professional (i.e. secondary special education teacher, transition coordinator) completing this form along with the person’s title/role, and contact information is included for reference.  

 

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AUTHORIZATION OF RELEASE

 

The student should be involved in this process and document his/her authorization for the release of the information for the purpose of evaluating eligibility and accommodation requests by signing and dating the release. 

 

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STUDENT WRITTEN RESPONSE

 

The purpose of the student written response is to engage the student in the process of his/her transition and self-determination. The response may be handwritten or word processed.

 

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