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THE STATE EDUCATION
DEPARTMENT /
THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 _____________________________________________________________________________________________________ MANAGER, STRATEGIC EVALUATION DATA COLLECTION, ANALYSIS AND REPORTING 1613 ONE COMMERCE PLAZA ALBANY, NEW YORK 12234 Tel. (518) 474-7965 Fax (518) 408-3363 E-mail: dataquest@nysed.gov |
To: |
Special Education Data Managers of Public Schools
Districts |
November 2005 |
From: | Inni Barone | |
Subject: |
PD-1/4 – Public School District Report of Number of Students with Disabilities Provided Special Education on December 1, 2005 and Number of Students with Disabilities Provided Special Education in Regular School-Based Programs and in Separate Settings. Important: Due Date is Between December 1, 2005 and January 2, 2006. |
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Attached is the PD-1/4 form for your use in recording child count and
placement information for all students with disabilities (ages 3-21) who
are the responsibility of your Committee on Preschool Special Education
(CPSE) or Committee on Special Education (CSE) and receive special
education programs and/or services on December 1, 2005. This form also
requests the numbers of students with disabilities who are parentally
placed in nonpublic elementary and secondary schools located in your
school district. This count will be used by school districts to
determine the minimum proportionate per-pupil amount of IDEA funds to be
used for services for parentally placed students with disabilities in
elementary and secondary nonpublic schools located in the school
district during the 2006-07 school year. Beginning in the 2006-07 school
year, the Department will request data on the numbers of parentally
placed students in elementary and secondary nonpublic schools, located
in your school district, who are referred for special education
services, the numbers of such students who are determined to be eligible
for special education services and the numbers of such students who are
provided special education services during the entire school year. These
data are required pursuant to sections 612 and 618 of Public Law
108-446. The PD-1/4 data are to be submitted by all school districts by entering the data through the website at http://pd.nysed.gov or by using the File Transfer Protocol (FTP) process. Paper copies of this report are not accepted. The web-based PD data system provides immediate feedback on any data reporting errors and allows school districts to make any necessary corrections. A User ID and password to access the web-based system has been mailed to the latest contact person identified on the PD website. If your school district has a new contact person, or did not get this information, please contact my office. Please note: if your school district has the capability of submitting PD-1/4 data through the FTP process, the User Name and password for that process are different from the User ID and password that has been assigned to the contact person to submit PD data through the PD website. If your school district needs a User Name and password to submit data through the FTP process, please contact this office. The due date for this report is between December 1, 2005 and January 2, 2006. Only the Certification and Assurance Form (page 1 of the PD-1/4 form), with an original ink signature, must be submitted through regular mail. Paper copies of this report will not be accepted. Your timely and accurate completion of this report is required in order to ensure full compliance with federal reporting requirements. The data entered on the PD-1/4 form will provide the December 1, 2005 count of students with disabilities and will indicate the extent to which students with disabilities are removed from regular education and are placed in separate educational settings outside of regular school facilities. This report requests data regarding the settings in which students receive regular and special education services and will not affect your State aid allocations in any way. (In contrast, the SA-100 form collects data for State aid purposes regarding the cumulative extent to which students receive special education programs and/or services.) Data from the PD-1/4 form, child count data from Charter Schools on the PD-1C/4C form, program expansion information from Charter Schools, and information provided on the SEDCAR-1 forms, which will be sent to school districts by approved special education programs (ASEP), will establish the number of school-age and preschool-age students with disabilities to be included in local level calculations to determine the school district’s 2006-2007 federal fund allocation under IDEA sections 611 and 619. These data will also be useful in determining:
To be counted in this report, each student with a disability, must meet the following criteria as of December 1, 2005:
OR
AND
Federal law and regulations require that State and local education
agencies ensure an unduplicated count of students with disabilities.
Before submitting the PD-1/4 report, please complete local verification
procedures to ensure that each student is counted only once. Such
verification procedures may include visual scans, computer scans or
other methods; and are especially important for school districts having
several school buildings and for students receiving multiple special
education programs and/or services.
During 2005-2006, Strategic Evaluation Data Collection Analysis and Reporting (SEDCAR) Unit personnel may be available to conduct a limited number of regional training programs regarding the various special education data forms (i.e., the PD forms). If you feel that such training would be useful to the data managers in your area, please contact your local Special Education Training and Resource Center (SETRC). The data collected through the PD forms are used in the following reports and activities:
If you have any questions or are in need of assistance in completing
this report, please contact the SEDCAR Unit by using the contact
information provided in the letterhead. Thank you. |
The
University of the State of New York PD-1/4 – Public School District Report of: |
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Instructions: |
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School District Information |
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(Enter 12-digit SED Code Below) |
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SCHOOL
DISTRICT NAME |
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ADDRESS
(include building name, room number , or mail stop information) |
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CITY | STATE | ZIP | |||||||||||||
Contact Person Information* |
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NAME |
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TITLE |
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TELEPHONE (include Area Code) | FAX |
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E-MAIL
ADDRESS |
*All correspondence from SEDCAR will be directed to the contact person identified in the PD web based data entry system at http://pd.nysed.gov. Please keep the contact person information current, including the e-mail address as most communication will occur via e-mail.
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I have reviewed the PD-1/4 data that has been submitted
electronically to the State Education Department. I will also review any
modifications that may be made to these data and the final verification report
that will be issued to the school district by the State Education Department.
These data provide the number of students with disabilities provided special
education programs and/or services on December 1, 2005 and number of students
with disabilities provided special education in regular school-based programs
and in separate settings. I certify that this is a complete and accurate count
of students with disabilities served on December 1, 2005. I further certify that
the students reported were the responsibility of this school district’s CSE or
CPSE or were parentally placed in nonpublic schools located in this school
district, had a current Individualized Education Program, and received special
education programs and/or services that met State standards.
I assure that IDEA funds will be sub-allocated, in a manner consistent with
State and federal laws and regulations, to Charter Schools in which resident
students with disabilities are enrolled and provided special education services
directly or indirectly by Charter Schools and to approved special education
programs. I also assure that students with disabilities who are parentally
placed in nonpublic schools located in this school district will be provided a
proportionate share of special education services supported with IDEA funds.
__________________________ |
___________________ |
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Superintendent Must Sign and Date on or after December 1, 2005 |
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Instructions and Definitions for Completing the PD-1/4 Report
Directions for Section A This section contains six Tables. Tables 1 and 4 request placement information by age and by race/ethnicity category for all preschool students with disabilities, ages 3 to 4, who are the responsibility of the school district’s CPSE. These students must be receiving preschool special education programs and/or services, pursuant to Sections 4201 or 4410 of the Education Law, on December 1, 2005. The total number of preschool students, ages 3-4, reported in each of these two tables must be identical. Table 2 requests the counts of preschool students with disabilities who are provided preschool special education services by approved programs operated by Suffolk and Westchester counties. These data will be used by the Department to calculate the minimum per-pupil federal sub-allocation, which school districts must provide to the approved special education programs. Table 3 is to report the count of preschool students with disabilities, age 2, who are receiving preschool special education services, pursuant to Sections 4201 or 4410 of the Education Law, on December 1, 2005. Table 5 is to report, by race/ethnicity, the total number of preschool students with disabilities who are residents of the school district, who are enrolled in regular parochial or other private schools at parents or guardians expense, but who are provided special education programs and/or services at public expense. Students reported in Table 5 are also reported in Tables 1 and 4. Table 6 is to report the number of preschool students with disabilities who are reported in Tables 1 and 4, and who are also limited English proficient (or English language learners). Definitions
for Section A,
Tables 1 and 3
Directions and Definitions for Section B, Table 1 Section B, Table 1, requests the count of all school-age students for whom the district has CSE responsibility to provide special education services, and is providing such services on December 1, 2005. To comply with requirements of IDEA section 612(a)(10), this Table is also used to collect the numbers of students with disabilities who are parentally placed in nonpublic elementary and secondary schools, located in the school district, and provided publicly funded special education services. Additional directions to assist school districts to accurately complete this Table are provided above the Table. The school districts of residence maintain CSE responsibility for students except in the following circumstances:
Directions and Definitions for Section C, Reports 1-14 Section C,
Reports 1-14: There are two tables for each disability category-
Table 1 and Table 2. These tables request placement information for all
school-aged students with disabilities, ages 4-21, who are the
responsibility of your CSE and are provided school-age special education
programs and/or services on December 1, 2005.
In order to determine the percentage of time students receive services outside regular classrooms (i.e., in rooms/groupings attended by students with disabilities only), it is important to consider where the service is provided rather than the type of service that is provided. To calculate the percentage of time outside the regular classroom, divide the number of hours the student receives special education and related services outside the regular classroom each day or week by the total number of hours in the school day or school week. Use the length of the entire school day, including all periods and lunch. The following examples are provided for purpose of clarification:
Table 2: Report the number of
students with disabilities for whom the school district has CSE
responsibility and who are educated in separate educational settings.
These are settings which are attended by students with disabilities
only. The definition of each separate educational setting follows: Table 1: Educational Placements of Preschool Students with Disabilities (Ages 3-4*) Enter the total number of preschool students with disabilities for whom this school district has CPSE responsibility to ensure the provision of special education programs or services. Report preschool students who were 3 to 4 years of age and who received preschool special education programs or services on December 1, 2005. In Column D, report the number of students who were provided related services only. Students reported in Column D are a subset of Column C. Column D cannot be greater than Column C. Only count students who were served pursuant to Sections 4410 or 4201 of the Education Law. Please determine age as of December 1, 2005. Counts reported in Tables 1, 2 and 4 of this section and information contained on the SEDCAR-1 forms which school districts will receive from approved preschool special education programs, will assist you in determining the amount of federal IDEA funds, under Sections 611 and 619, which must be sub-allocated to other programs, and the amount to be retained by your school district, for preschool students with disabilities, ages 3-4. Important information for completing this section is included in the Directions and Definitions for Section A, beginning on page 2. *Children who are 5 years of age on December 1 are "school-age" children, and must be reported in Sections B and C of this report not in Section A. |
Table 2: Preschool Students in Specific Preschool Programs (Ages 3-4*).
Of the preschool students reported in Table 1, Line 8, enter the number of preschool students with disabilities, by age as of December 1, 2005, provided preschool special education programs and/or services in the two approved preschool special education programs listed below. The information entered in this table is a subset of data provided in Table 1 above (All students reported in this Table must also be reported in Table 1 above.) The information provided below will be used by the State to calculate the minimum per-pupil amount of federal IDEA funds to be sub-allocated by school districts to approved special education programs in the 2006-07 school year. The methodology for calculating the per-pupil amount of federal funds for sub-allocation to approved special education programs was revised for the 2006-07 and subsequent school years and is described in Chapter 437 of the Laws of 2005.
Line Number |
Specific Preschool Programs |
A | B | C | D |
Age 3 |
Age 4 |
Total Ages 3 to 4 |
Subset of Column C Students Receiving Related Services Only |
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Suffolk County Preschool Program | |||||
Westchester County Preschool Program | |||||
Total |
Table 3: Count of Preschool Students with Disabilities, Age 2.
Line Number |
Description |
Age 2* |
1 |
Provide the count of preschool students with disabilities, who were 2 years old on December 1, 2005, and were receiving preschool special education programs or services on December 1, 2005. Report students who were the responsibility of your school district’s CPSE, and who were provided services pursuant to Sections 4410 or 4201 of the Education Law. |
*Students who are 2 years old on December 1, 2005 (who will turn 3 years of age by December 31, 2005) and are receiving preschool special education services, pursuant to Section 4410 of the Education Law, should be included in this column. |
Table
4:
Educational
Placements of Preschool Students with Disabilities
(Ages 3-4), According to Race/Ethnicity Category
In the Table below, report
race/ethnicity data for all preschool students reported in Column C of Table 1.
The Total (Column C) for each line in Table 1 must match the Total (Column F)
for each Line in this Table.
For all preschool students reported in Table 1, enter the number which appear to
belong, identify with, or are regarded in the community as belonging to each
race/ethnic group. (Each student should be counted once.) See definition of each
race/ethnic group on page 2, under Instructions and Definitions for Completing
the PD-1/4 report.
Table 5: Race/Ethnicity of Preschool Students with Disabilities Enrolled by Their Parents or Guardians in Regular Parochial or Other Private Schools.
In the Table below, report the number of preschool students with disabilities (who are also reported in Tables 1 and 4) whose basic education is paid through private resources and who receive special education programs and/or services at public expense. |
Table 6: Preschool-age Students with Disabilities who are also Students with Limited English Proficiency
Of the preschool-age students with
disabilities reported in Section A-Tables 1 and 3 (i.e., all preschool-age
students with disabilities for whom the school district has CPSE
responsibility), report the subset of such students having limited English
proficiency (LEP) in Line 1. Such students should be reported based on LEP
designation, regardless of the extent or type(s) of LEP services provided.
Preschool students with disabilities are considered to be limited in English
proficiency if the primary language spoken at home is other than English
(excluding manual methods of communication). December 1, 2005 should be used in
determining student age.
Students determined to have a disability pursuant to Section 504 only, and do
not have an IEP developed by a Committee on Preschool Special Education, should
not be reported in this section, regardless of LEP status.
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Table
1:
Provision of Special Education Services to School-age Students with Disabilities
Provide an unduplicated count of all school-age students with disabilities who are the responsibility of this school district’s CSE or are parentally placed in nonpublic elementary and secondary schools located in this school district and receiving special education programs and/or services on December 1, 2005. School districts will use the counts reported in Lines 1-7 in this section, child count data from Charter Schools on the PD-1C/4C forms, any enrollment expansion information from Charter Schools, and information in the SEDCAR-1 forms from approved special education programs to determine the per-pupil amount of 2006-07, federal IDEA funds under sections 611 and 619 to be sub-allocated to approved special education programs, charter schools, and the per-pupil amount to be available to serve students who are parentally placed in nonpublic elementary and secondary schools located in the school district and the amount to be retained by school districts for school-age students with disabilities. In addition to the description provided for each Line below, the following are additional clarifications:
Please see additional directions and definitions for Section B, Table 1 on page 4 of 24 for information regarding CSE responsibility and school district’s responsibilities related to students who are parentally placed in nonpublic elementary and secondary schools located in the school district. If you have specific questions regarding school district’s responsibilities please contact your regional associate. |
Line No. |
Report Each Student Only Once |
Ages 4-5 |
Ages 6-21 |
1 | Count of school-age students provided special education services in district-operated programs. (See above directions for additional guidance on who to include.) | ||
2 | Count of school-age students who are residents of this school district and are parentally placed in nonpublic schools located in this school district and who are provided publicly funded special education services as of December 1, 2005. | ||
3 | Count of students with disabilities who are residents of other school districts and parentally placed in nonpublic schools located in this school district and who are provided publicly funded special education services as of December 1, 2005. | ||
4 | Count of school-age students placed by the CSE in other public school district programs and provided special education programs and/or services. (Do not include in this line students placed in a Special Act School District). | ||
5 | Count of school-age students provided special education services full-time in programs operated by a Board of Cooperative Educational Services (BOCES). | ||
6 | Count of school-age students provided special education services while enrolled in a Charter School. | ||
7 | Count of school-age students provided special education services in approved private schools for students with disabilities, and State-supported schools listed in Section 4201 of the Education Law. Include students with disabilities who were resident to this district at the time they were placed in out-of-State residential schools by courts or other State agencies. Also include in this line, all other out-of-State placements. | ||
8 | Subtotal (Sum of Lines 1-7): This number and information received by school districts on the SEDCAR-1 forms and information from Charter Schools will assist school districts to determine a per pupil amount of 2006-2007IDEA funds to be sub-allocated to approved special education programs, Charter Schools and proportionate amount of IDEA funds that will be available for students with disabilities who are parentally placed in nonpublic elementary and secondary schools located in this school district. | ||
9 | Count of school-age students, provided special education services by contracting with Special Act School Districts, or in the New York State School for the Blind in Batavia or the New York State School for the Deaf in Rome. | ||
10 | Numbers of students with disabilities who are residents of this school district and are parentally placed in nonpublic schools located in other school districts and who are provided publicly funded special education services as of December 1, 2005. | ||
11 | Sum of Lines 1, 2, 4, 5, 6, 7, 9 and 10): This number represents the total number of school-age students who are the responsibility of this school district’s CSE and are provided special education programs and/or services on December 1, 2005. (The number entered for this line must match the number entered in Section C, Report 14 of this form.) |
Table
2:
School-age Students with Disabilities Whose Basic Education Costs are Paid by
Private Resources
Enter by race/ethnicity the total number of school-age students with disabilities who are reported in Section B- Table 1, Lines 2 and 10. These students are residents of the school district and are enrolled by their parents or guardians in a nonpublic elementary or secondary school and whose basic education is paid through private resources and who receive special education programs and/or services at public expense through a public school district. The total number of students reported below must be equal to the total number of students reported in Section B, Table 1, Lines 2 and 10 combined. |
Section C:
Educational Placement of School-age Students by Disability |
Directions: Please review directions and definitions for
completing reports 1-14 beginning on page 4.
Report 1: Report of Students with Autism Placed as of December 1, 2005
Table
1:
In Regular School-Based
Programs in buildings attended by disabled and nondisabled students (Consultant
Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
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01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings which are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
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01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 2: Report of Students with Emotional Disturbance Placed as of December 1, 2005
Table
1:
In Regular School-Based
Programs in buildings attended
by disabled and nondisabled students (Consultant Teacher, Resource Room,
Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings
Outside of regular school facilities, in buildings which are attended by
students with disabilities only.
In Line 5, include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 3: Report of Students with Learning Disabilities Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings which are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 4: Report of Students with Mental Retardation Placed as of December 1, 2005
Table
1: In Regular School-Based
Programs in
buildings attended by disabled and nondisabled students (Consultant Teacher,
Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 5: Report of Students with Deafness Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 6: Report of Students with Hearing Impairments Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 7: Report of Students with Speech or Language Impairments Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 8: Report of Students with Visual Impairments (including Blindness) Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 9: Report of Students with Orthopedic Impairments Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 10: Report of Students with Other Health Impairments Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 11: Report of Students with Multiple Disabilities Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 12: Report of Students with Deaf-Blindness Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 13: Report of Students with Traumatic Brain Injury Placed as of December 1, 2005
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 14: Summary Report of All Students with Disabilities Placed as of December 1, 2005
The
two sections below aggregate the data reported in Reports 1 to 13 to facilitate
State and local data verification procedures.
Completing these two tables will facilitate the reporting of
race/ethnicity data in Reports 15 and 16.
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Notes for Reviewing Data Reported in Report 14 Above:
The Report 14 total in Table 1, Line 4, Column F, plus the total in Table 2, Line 7, Column F must equal the total in Section B, Table 1, Line 11 (sum of Ages 4-5 and 6-21) of this PD-1/4 form.
The total in each cell of Tables 1 and 2 of Report 14 should be the cumulative total of the corresponding cells from Reports 1-13.
The totals on each line of Column F in Tables 1 and 2 above should be identical to the totals in Column F of each line in Tables 1 and 2 of Report 15.
The total for Table 1 plus Table 2 above should equal the total reported in Line 14 of Column F of Report 16.
Report
15: Report of All Students with Disabilities as of December 1, 2005,
According to Race/Ethnicity Category and Type of Placement
For
all students reported in Table 1 and Table 2 of Report 14, enter the number
which appear to belong, identify with, or are regarded in the community as
belonging to each race/ethnic group.
(Each student should be counted once.)
The Total (Column F) for each Line in this Report must match the Total
(Column F) for each Line in Report 14.
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students (Consultant Teacher, Resource Room, Special Class, et. al.)
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Total |
|||||||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 |
Total |
Table
2:
In Separate Settings Outside of
regular school facilities, in buildings which are attended by students with
disabilities only. In Line 5,
include students who are placed on home instruction by the CSE.
Students who are home-schooled by parent choice should be reported in
Table 1.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Total |
|||||||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Report 16: Report of All Students with Disabilities as of December 1, 2005, According to Race/Ethnicity Category and Type of Disability
In
the table below, report race/ethnicity data by disability for all students
reported in Tables 1 and 2 of Reports 1 to 13.
The
total reported below in Column F for each disability must match the sum of
totals reported in Tables 1 and 2 under the corresponding disability in Reports
1 to 13.
Racial/Ethnic Group |
|||||||
Line Number |
Disability |
A | B | C | D | E | F |
American Indian or Alaskan Native | Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic |
White (not of Hispanic origin) |
Total | ||
01 | Autism | ||||||
02 | Emotional Disturbance | ||||||
03 | Learning Disability | ||||||
04 | Mental Retardation | ||||||
05 | Deafness | ||||||
06 | Hearing Impairment | ||||||
07 | Speech or Language Impairment | ||||||
08 | Visual Impairment (includes Blindness) | ||||||
09 | Orthopedic Impairment | ||||||
10 | Other Health Impairment | ||||||
11 | Multiple Disabilities | ||||||
12 | Deaf-Blindness | ||||||
13 | Traumatic Brain Injury | ||||||
14 | Total (Lines 1-13) |
Report 17: Report
of Students with Disabilities Who are 14 to 21 Years of Age as of December 1,
2005 According to Race/Ethnicity Category.
(These
students are also reported in Reports 15 and 16 of this report.)
Line Number |
Category of Students |
A | B | C | D | E | F |
Total |
|||||||
01 | Students with Disabilities, Ages 14-21 |
Report 18: Report
of School-Age Students with Disabilities In Specific Types of Schools, as of
December 1, 2005, by Race/Ethnicity.
(These
students are also reported in Reports 15 and 16 and, if applicable, in Report
17.)
In the table below, report race/ethnicity data for school-age students with disabilities, enrolled in Charter Schools, BOCES, approved private schools, Special Act School Districts, State-Operated, and State-Supported Schools, and in out-of-State court placements and emergency interim placements as of December 1, 2005. The total reported in Line 7, Column F below must be the same as the sum of numbers reported in Section B, Table 1, Lines 5, 6, 7 and 9 of this PD-1/4 form. Furthermore, Line 1 below should equal Section B, Table 1, Line 6; Line 2 below should equal Section B, Table 1, Line 5; Line 3 plus Line 6 below should equal the number of students reported in Section B, Table 1, Line 7; Line 4 plus Line 5 below should equal the number of students reported in Section B, Table 1, Line 9.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Total |
|||||||
01 | Charter Schools | ||||||
02 | BOCES | ||||||
03 | Approved Private Schools | ||||||
04 | Special Act School Districts | ||||||
05 | State-Operated Schools (in Rome and Batavia) | ||||||
06 | State-Supported Schools (Section 4201) | ||||||
07 | Total |