From: Special Education Rights and Responsibilities by Protection and Advocacy and Community Alliance for Special Education.
City, state, zip
Name of Director
Director of Special Services
Local Unified school district
City, State, Zip
Re: Your child
I am writing to refer my son/daughter for assessment to determine if he/she is eligible for special education services and support. He/She is not progressing in school. He is seven years old and attends _______ School.
(If you know which areas you think need assessed or know specific tests, you might add)–
- A psychological evaluation to determine his/her learning potential, using instruments designed for non-oral children such as the Leiter International Performance Scale Revised or the Hiskey Nebraska Test of Learning Aptitude;
- An evaluation by a non-oral communication specialist. To my knowledge, the district does not have on staff any experts in this field. I have been recommended to Barbara Brown, PhD., and unless the district has a comparable expert, I am requesting that you contract with Dr. Brown to do the non-oral communication evaluation of my son/daughter.
We are also requesting that my child be assessed under Section 504 of the Rehabilitation Act of 1973 for the presence of any educational service need which may require any accommodation or program modification not available under special education. We also request that the Section 504 Coordinator for the school district be present at the IEP meeting that will be scheduled to discuss and implement her/his findings.
We are also requesting that we be given an opportunity to observe ______ in his classroom setting including all activities that he may take part in during the day. Please have the program specialist contact me if it is necessary to be accompanied into the classroom for such an observation.
We look forward to receiving an assessment plan in 15 days. We would like to be given copies of these assessment reports prior to any scheduled IEP as well as any other written information that will be presented.
We will look forward to meeting with the school team to create an IEP that recognizes more specifically, ______’s individual and unique challenges and what must be done in order to remediate or minimize them.
Please contact me should you require further information.