DRDP (2015) Infant/Toddler View Information Page & Rating Record

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DRDP (2015) – A Developmental Continuum from Early Infancy to Kindergarten Entry

Special Education Information Page

For Use with Early Intervention and Early Childhood Special Education Programs

1. Child’s first name (Legal) __________________________

2. Child’s last name (Legal) __________________________

3. Date DRDP (2015) was completed (e.g., 09/07/2015) _______ / _______ / _______

4. Assessment period (e.g., Fall 2015) __________________________

Child Information

5. Student ID (Issued by distric for reporting to CASEMIS) __________________________

6. Statewide Student Identifier (10-digit SSID) __________________________

7. Gender □ Male □ Female

8. Birth date (e.g., 03/05/2012) ______ / ______ / ________

9. Special education enrollment. Check one.
   □ Individualized Family Service Plan (IFSP)   □ Individualized Education Program (IEP)

Child’s Language Information

10. Child’s home language(s):
   □ English   □ Spanish
   □ Vietnamese   □ Cantonese
   □ Hmong   □ Tagalog/Pilipino
   □ Other (specify) ____________________

11. Language(s) used with this child:
   □ English   □ Spanish
   □ Vietnamese   □ Cantonese
   □ Hmong   □ Tagalog/Pilipino
   □ Other (specify) _____________________

12. Is a language other than English spoken in the child’s home? □ Yes □ No
   If yes, complete the ELD measures for a preschool-age child.
   If the child is Deaf or Hard of Hearing and not learning a spoken language, mark “No” and do not complete the ELD measures.

Child’s Ethnicity

13a. Is this child Hispanic or Latino? Check one.
 □ Yes, Hispanic or Latino □ No, not Hispanic or Latino
 □ Intentionally left blank

13b. What is the race of this child? Check up to three.
   □ Asian Indian   □ Hmong   □ Samoan
   □ Black or African-American   □ Japanese   □ Tahitian
   □ Cambodian   □ Korean   □ Vietnamese
   □ Chinese   □ Laotian    □ White
   □ Filipino   □ Native American   □ Intentionally left blank
   □ Guamanian   □ Other Asian
   □ Hawaiian   □ Other Pacific Islander

Special Education Information

14. Special education eligibility. Check one.
   □ Autism   □ Intellectual Disability   □ Specific Learning Disability
   □ Deaf-Blindness   □ Hard of Hearing
   □ Deafness   □ Multiple Disability   □ Speech or Language Impairment
   □ Emotional Disturbance   □ Orthopedic Impairment
   □ Established Medical Disability   □ Other Health Impairment   □ Traumatic Brain Injury
   □ Visual Impairment

15. Adaptations used in the assessment. Check all that apply.
   □ Augmentative or alternative communication system   □ Functional positioning
   □ Alternative mode for written language   □ Sensory support
   □ Visual support   □ Alternative response mode
   □ Assistive equipment or device   □ None

Program Information

16. SELPA __________________________

17. District of service __________________________

Assessment Information

18. Name of person completing the assessment __________________________

19. Role of person completing the assessment:
   □ Early Intervention Specialist   □ Speech/Language Pathologist
   □ Occupational/Physical Therapist   □ Teacher of the Deaf/Hard of Hearing
   □ Program Specialist or Administrator   □ Teacher of the Visually Impaired
   □ Special Education Teacher □ Other

20. Assistance completing the assessment? □ Yes □ No
   If yes, what is that person’s relationship to the child? __________________________


DRDP (2015) – A Developmental Continuum from Early Infancy to Kindergarten Entry

Infant/Toddler View Rating Record

For use with infants and toddlers in both Early Education and Special Education Programs

Child’s Name (First and Last): ________________________

Student ID (Issued by district for reporting to CASEMIS): ________________________

Assessment Period (e.g., Fall 2015): ________________________

Date DRDP (2015) was completed (e.g., 09/07/2015): ________ / ________ / ________

 

Note: The Rating Record is meant to be used together with the DRDP (2015) Instrument for keeping track of each child’s developmental levels as you complete the assessment.

Instructions: Write the child’s name, student identification number, and the date this Rating Record was completed. Mark the developmental level the child has mastered for each Measure. Check EM (emerging) if the child is “emerging” to the next level (optional). In the rare circumstance that you are unable to rate a Measure, mark UR.

Measure

Measure Name

Responding

Exploring

Building

Integrating

EM

UR

Earlier

Later

Earlier

Middle

Later

Earlier

Middle

Later

Earlier

ATL-REG 1

Attention Maintenance

 

 

 

 

ATL-REG 2

Self-Comforting

 

 

 

 

ATL-REG 3

Imitation

 

 

 

 

ATL-REG 4

Curiosity and Initiative in Learning

 

 

 

 

ATL-REG 5

Self-Control of Feelings and Behavior

 

 

 

 

SED 1

Identity of Self in Relation to Others

 

 

 

 

SED 2

Social and Emotional Understanding

 

 

 

 

SED 3

Relationships and Social Interactions with Familiar Adults

 

 

 

 

SED 4

Relationships and Social Interactions with Peers

 

 

 

 

SED 5

Symbolic and Sociodramatic Play

 

 

 

 

LLD 1

Understanding of Language (Receptive)

 

 

 

LLD 2

Responsiveness to Language

 

 

 

 

LLD 3

Communication and Use of Language (Expressive)

 

 

 

LLD 4

Reciprocal Communication and Conversation

 

 

 

LLD 5

Interest in Literacy

 

 

 

 

COG 1

Spatial Relationships

 

 

 

 

COG 2

Classification

 

 

 

 

COG 3

Number Sense of Quantity

 

 

 

 

Note: COG 4 - COG 7 and COG 10 are only for use for preschool age children

 

 

 

 

 

 

 

 

 

 

 

COG 8

Cause and Effect

 

 

 

 

COG 9

Inquiry Through Observation and Investigation

 

 

 

 

COG 11

Knowledge of the Natural World

 

 

 

 

PD-HLTH 1

Perceptual-Motor Skills and Movement Concepts

 

 

 

 

PD-HLTH 2

Gross Locomotor Movement Skills

 

 

 

PD-HLTH 3

Gross Motor Manipulative Skills

 

 

 

PD-HLTH 4

Fine Motor Manipulative Skills

 

 

 

PD-HLTH 5

Safety

 

 

 

 

PD-HLTH 6

Personal Care Routines: Hygiene

 

 

 

 

PD-HLTH 7

Personal Care Routines: Feeding

 

 

 

 

PD-HLTH 8

Personal Care Routines: Dressing