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AREA OF ELIGIBILITY Hearing Impaired _Deaf or Hard of Hearing_

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					                                     Pajaro Valley Unified School District
                                      Special Education Local Plan Area
                                    REVIEW OF DATA FOR ELIGIBILITY



Student:                                         Date of Birth:                   C. A.:
Date of Review:                                  School:                          Grade:

The following information is based upon the current assessment data and is provided for the IEP
team’s consideration in determining eligibility.

AREA OF POSSIBLE ELIGIBILITY
     Hard of Hearing
     Deaf

CRITERIA (All Three Must Apply)

Y       N       There is a current audiological evaluation documenting that the student has a
                hearing impairment, either permanent or fluctuating.

Y       N       The hearing impairment is so severe that it impairs the processing of linguistic
                information (including speech and language reception and speech and language
                discrimination) through hearing even with amplification.

Y       N       These impairments adversely affect the student's educational performance, and the
                student's needs cannot be solely met within the general education classroom
                setting.

COMMENTS




RPT 01-RDE (1/07)              Student’s Name:                                  DOB:

				
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