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 |
September 2004 | ||
From: | Inni Barone | |||
Subject: |
PD-1/4 – Public School District Report of Number of Students with Disabilities Provided Special Education on December 1, 2004 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, 2004 and January 2, 2005. All school districts must submit this report electronically through the PD web-based system at http://pd.nysed.gov or through the File Transfer Protocol (FTP) process. Paper copies of this report will not be accepted. 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. |
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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 or services on December 1, 2004. This form also requests data for students with disabilities who are also limited English proficient; data for students with disabilities receiving testing accommodations; and data for students not classified as students with disabilities by the CSE, but receiving accommodations pursuant to Section 504 of the Rehabilitation Act. Pursuant to Section 618 of Public Law 101-476 and Section 300.754 of Federal Regulations, the New York State Education Department
(SED) is required to report these data to the U.S. Department of Education.
Federal law and
regulation 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 or services.
During 2004-2005, 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. Attachment
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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 the address at the top of this page will be directed to the contact person reported in the PD web-based system at http://pd.nysed.gov. You may update the contact person at any time through the PD web-based system located at http://pd.nysed.gov.
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 services on December 1, 2004 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, 2004. I further certify that the students reported were the responsibility of this school district’s CSE or CPSE, had a current Individualized Education Program and received special education programs 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. |
__________________________ |
___________________ |
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Superintendent Must Sign and Date on or after December 1, 2004 |
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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 3 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 your CPSE. These students must be receiving preschool special education programs or services, pursuant to Sections 4201 or 4410 of the Education Law, on December 1, 2004. The total number of preschool students, ages 3-4, reported in each of these two tables must be identical. Table 2 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, 2004. Table 4 is to be completed by public school districts which operate an approved preschool special education program. The count of children to be reported in Table 4 is the total enrollment of preschool students with disabilities in the district’s approved preschool special education program, who are receiving special education services pursuant to Section 4410, disaggregated by students who are residents of the school district and those who are not. 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 or services at public expense. Students reported in Table 5 are also reported in Tables 1 and 3. Table 6 is to report the number of preschool students with disabilities who are reported in Tables 1 and 3, 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 Committee on Special Education (CSE) responsibility to provide special education services, and is providing such services on December 1, 2004. 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 services on
December 1, 2004.
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 which 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, 2004. 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, 2004. Counts reported in Tables 1 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 suballocated 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: 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, 2004, and were receiving preschool special education programs or services on December 1, 2004. 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, 2004 (who will turn 3 years of age by December 31, 2004) and are receiving preschool special education services, pursuant to Section 4410 of the Education Law, should be included in this column. |
______________________
1The order of these settings does not
reflect a continuum from least to most restrictive. These settings are
alphabetized.
Table
3:
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 Table 3.
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.
If
this district operates an approved preschool special education program, report
the number of preschool students with disabilities provided special
education programs or services, pursuant to Section 4410 of the
Education Law, on December 1, 2004.
Report students in Line 1 if they are residents of your school
district, or in Line 2, if they are residents of other school districts. |
Line No. |
Preschool Students in District-Operated Approved Programs | Ages 3-4 |
Age 2* |
1 |
Report the number of preschool students with disabilities who are residents of your school district, and are enrolled in your district-operated preschool program on December 1, 2004. | ||
2 |
Report the number of preschool students with disabilities who are residents of other school districts, and are enrolled in your district-operated preschool program on December 1, 2004. Please note that your district must submit a SEDCAR-1 form to each school district of residence, in order to receive a sub-allocation of IDEA funds under Sections 611 and 619 for students reported in this line. |
*Students
who are 2 years old on December 1, 2004 (who will turn 3 years of age by
December 31, 2004) and are receiving preschool special education services,
pursuant to Section 4410 of the Education Law, should be included in the column
for students age 2.
Such students will not be used to calculate a suballocation of federal
funds under IDEA, Sections 611 and 619, but may be served with Section 611
funds.
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 3 above) whose basic education is paid through private resources and who receive special education programs 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 2 (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, 2004 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:
Type
of Programs in Which Special Education Services are Provided to
School-age Students with Disabilities
Provide an unduplicated
count of all school-age students with disabilities for whom this
school district has Committee on Special Education (CSE) responsibility
to provide special education services, and is providing such services on
December 1, 2004, in accordance with Individualized Education Programs
(IEPs) at a school, home, hospital or other non-school facility,
directly or through a contract with another service provider. Please
determine age as of December 1, 2004. The counts reported in this
section, child count data from Charter Schools on the PD-1C/4C forms,
any enrollment expansion information received from Charter Schools, and
information reported in the SEDCAR-1 forms received from the approved
special education programs are to be used by school districts to
determine the amount of federal IDEA funds under Sections 611 and 619 to
be sub-allocated to approved special education programs, charter schools
and the amount to be retained by school districts, for school-age
students with disabilities.
Please see additional directions and definitions for Section B, Table 1 on page 4 of 24 for information regarding CSE responsibility. If you have specific questions about which students are the responsibility of your CSE, 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 provided special education services in programs operated by another school district (not a Special Act School District). | ||
3 | Count of school-age students provided special education services full-time in programs operated by a Board of Cooperative Educational Services (BOCES). | ||
4 | Count of school-age students provided special education services while enrolled in a Charter School. | ||
5 | 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 your 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. | ||
6 | Subtotal (Sum of Lines 1, 2, 3, 4 and 5): This number and information received by districts on the SEDCAR-1 forms will assist school districts to determine a per pupil amount of IDEA funds to be sub-allocated to approved special education programs and Charter Schools during the 2005-2006 year. | ||
7 | 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. | ||
8 | Total (Sum of Lines 6 and 7): 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 or services on December 1, 2004. (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
or Who are Home Schooled.
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Table
3:
Students
Placed in Home School Buildings.
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Table
4:
Test
Accommodations for Students with Disabilities
Of the school-age students reported in Section B-Table 1, enter the number of students whose individualized education programs (IEPs) include one or more testing accommodations, by the appropriate age interval in Line 1. Students should be reported once, regardless of the number of testing accommodations listed in their IEPs. Also, all students should be reported regardless of whether they will be administered a State assessment during the 2004-2005 school year.
Line No. |
Description | Students
Ages 4 - 12 |
Students
Ages 13 - 15 |
Students
Ages 16 - 21 |
1 |
Total number of students provided any type(s) of testing accommodations. |
Table
5:
School-age Students with Disabilities who are also Students with Limited English
Proficiency (also referred to as English language learners.)
Of
the school-age students with disabilities reported in Section B-Table 1,
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. Students determined to have a disability pursuant to Section 504 only, and do not have an IEP developed by a Committee on Special Education, should not be reported in this section, regardless of LEP status
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Table
6:
Students Provided Section 504 Accommodations
Number of school-age students provided “reasonable accommodations”
pursuant to Section 504 of the Rehabilitation Act of 1973. Students should
be reported if they were the responsibility of this school district’s
Section 504 Multidisciplinary Team and provided services/accommodations
specified in a Section 504 Accommodation Plan on December 1, 2004. Please
note that students reported in the table below, should not be included in
Section B-Table 1 of this report, and students included in Section B-Table
1 of this report are not to be counted in this Section, even if they
qualify to be counted for both.
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Table
7:
School-Age Students with Disabilities by Grade or Age
For all students with disabilities reported in Section B, Table 1, Line 8 (Ages 4-21) report the number of students by grade level in Part 1 below. For students with disabilities who are not enrolled in a grade, report them by age in Part 2 below. Each student with a disability is to be reported in only one line of either Part 1 or Part 2. Assignment of students with disabilities should be reported by grade if students attend classes with a particular grade. If students with disabilities attend classes with more than one grade, report them in the grade that they attend for majority of their classes, or the grade with which they identify. Please note the total number of students with disabilities in Line 14 of Part 1 plus the total number of students with disabilities in Line 16 of Part 2 must equal the total number of students with disabilities reported in Section B, Table 1, Line 8 (Ages 4-21). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Directions: Please review directions and definitions for
completing reports 1-18 beginning on page 4.
Report 1: Report of Students with Autism Placed as of December 1, 2004
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 2: Report of Students with Emotional Disturbance Placed as of December 1, 2004
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, 2004
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, 2004
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, 2004
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, 2004
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, 2004
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, 2004
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, 2004
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, 2004
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, 2004
pd-1-4_13Table 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, 2004
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, 2004
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, 2004
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 8 (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, 2004,
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, 2004, 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,
2004 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, 2004, 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, 2004. 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 3, 4, 5 and 7 of this PD-1/4 form. Furthermore, Line 1 below should equal Section B, Table 1, Line 4; Line 2 below should equal Section B, Table 1, Line 3; Line 3 plus Line 6 below should equal the number of students reported in Section B, Table 1, Line 5; Line 4 plus Line 5 below should equal the number of students reported in Section B, Table 1, Line 7.
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 |