MULTIDISCIPLINARY EVALUATION TEAM (MET) REPORT AND ELIGIBLIITY RECOMMENDATION
Cognitive Impairment (CI)
Oakland County School Districts
Student Name
MET Report Date
Birthdate
Grade
School District
Attending Building
Parent/Guardian
PURPOSE
This form is being used by the Multidisciplinary Evaluation Team (MET) to recommend: (Choose one)
q Initial eligibility for special education.
q Change of eligibility for special education.
q Reevaluation of eligibility for special education.
EVALUATION REQUIREMENTS
The MET must use a variety of assessment tools and strategies to determine eligibility for special
education: §300.304(b)
Review
§ *Parent input
§ Educationally relevant medical information
§ School records (i.e., teacher reports, report cards, discipline, attendance, academic work samples,
Evaluator(s)
Date(s)
previous assessments, history of, and response to, supplemental interventions)
Interview
§ Student, parents, and teachers regarding concerns related to the area(s) of suspected disability
Observe
§ *Direct observation of the student in general education (including relevant behavior and its relationship to academic
functioning in the area(s) of suspected disability)
Test
§ *Academic achievement level in reading and math using multiple assessment tools within the last 12 months
§ *Intellectual assessment/description of cognitive development
§ *Description of adaptive behavior
DIAGNOSTIC ASSURANCE STATEMENTS
The MET must consider the following assurance statements before making a recommendation regarding this student’s eligibility:
Yes
No
q
q
R 340.1705 CI shall be manifested during the developmental period and be determined through the demonstration of all of the
following behavioral characteristics:
(a) Development at a rate at or below approximately 2 standard deviations below the mean as determined through intellectual assessment.
q
q
(b) Scores approximately within the lowest 6 percentiles on a standardized test in reading and arithmetic.
q
q
(c) Lack of development primarily in the cognitive domain.
q
q
(d) Impairment of adaptive behavior.
q
q
§300.306(b)(1) The determinant factor for eligibility determination is not primarily the result of:
(i) Lack of appropriate instruction in reading, including the essential components of reading instruction
q
q
(ii) Lack of appropriate instruction in math
q
q
(iii) Limited English Proficiency
q
q
R 340.1705(1)(e) Adverse Educational Impact:
The suspected disability interferes with access to and progress in general education to the degree that the student requires special
education programs/services.
If any of the diagnostic assurance statements are checked no, then the student is not eligible for special education programs/services.
* Mandated
Revised December 2016
ELIGIBILITY RECOMMENDATION
The Multidisciplinary Evaluation Team:
1. Has checked “Yes” to all of the diagnostic assurance statements
2. Has based conclusions on a variety of sources of information §300.306(c )(1)(i); and
3. Recommends, based on the evaluation findings, that this student is eligible for special education programs/services under R340.1705.
q Yes (Complete all remaining sections)
q No (Proceed to the Participant Signatures section)
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE
With enough detail to determine a starting point for instruction, describe this student’s present level of academic achievement and functional performance, including a
description of how the disability affects his/her progress in the general curriculum: (For preschool age children, describe how the disability affects involvement in agelevel activities)
PARTICIPANT SIGNATURES
As a member of the Multidisciplinary Evaluation Team, my input is included in writing and I agree with the eligibility recommendation: (Sign and check below)
* Psychologist
Yes No
q q
Other / Role
Yes No
q q
* Other / Role
q
q
Other / Role
q
q
Other / Role
q
q
Other / Role
q
q
* Mandated
Revised December 2016