Kentucky Department of Education

 

KY Eligibility for Speech/Language Forms

Last Updated on Wednesday, February 15, 2012 at 5:13 AM

These forms will be included in the state's student information system (SIS) Summer 2012.  The forms below exist in two formats: a Microsoft Word file and an Adobe Acrobat (PDF) file.  The Word version is an electronic form that can be downloaded and completed directly from the Word program electronically.  The Adobe Acrobat version is intended to be printed out and completed manually.

The advantage to the Word version is that once completed it can be saved as a file and uploaded to the SIS at the child level.  This option is not available in the Adobe Acrobat version unless the manually completed form is scanned and an electronic file created by that scan.

If you have questions about the content of these forms, please contact either Gwen Buffington at (502) 564-4970.

Teacher/Parent Interview: Speech Sound Production and Use

February 2012

Teacher Parent Interview Speech Sound Production.doc Teacher Parent Interview Speech Sound Production.pdf

Speech and Sound Production and Use Assessment Summary

February 2012

Speech Sound Production and Use Assessment Summary.doc Speech Sound Production and Use Assessment Summary.pdf

Communication Rating Scale: Speech and Sound Production and Use

February 2012

Communication Rating Scale - Speech Sound Production and Use.doc Communication Rating Scale - Speech Sound Production and Use.pdf

Teacher/Parent Interview: Language

February 2012

Teacher Parent Interview Language.doc Teacher Parent Interview Language.pdf

Language Assessment Summary

February 2012

Language Assessment Summary.doc Language Assessment Summary.pdf

Communication Rating Scale: Language

February 2012

Communication Rating Scale - Language.doc Communication Rating Scale - Language.pdf

Teacher/Parent Interview: Fluency

February 2012

Teacher Parent Interview Fluency.doc Teacher Parent Interview Fluency.pdf

Fluency Assessment Summary

February 2012

Fluency Assessment Summary.doc Fluency Assessment Summary.pdf

Communication Rating Scale: Fluency

February 2012

Communication Rating Scale - Fluency.doc Communication Rating Scale - Fluency.pdf

Teacher/Parent Interview: Voice

February 2012

Teacher Parent Interview Voice.doc Teacher Parent Interview Voice.pdf

Voice Assessment Summary

February 2012

Voice Assessment Summary.doc Voice Assessment Summary.pdf

Communication Rating Scale: Voice

February 2012

Communication Rating Scale - Voice.doc Communication Rating Scale - Voice.pdf

Teacher/Parent Interview: Preschool

February 2012

Teacher Parent Interview Preschool.doc Teacher Parent Interview Preschool.pdf

Communication Behavior Observation Form

February 2012

Communication Behavior Observation.doc Communication Behavior Observation.pdf

Communication Written Report

February 2012

Communication Written Report.doc Communication Written Report.pdf
For more information contact:

Gwen Buffington
500 Mero Street, 18th Floor CPT
Frankfort, KY 40601
Phone: 502-564-4970 x4135
gwen.buffington@education.ky.gov