HAYSVILLE U.S.D. 261
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Regression Worksheet for Learning Disabilities
Student:
___________________________________________________________________________________
Age: ____________ Grade: ________________ School: _____________________________
Ability/Intelligence Test:
WISC-IV
DAS-II
WJ-III
SB-V
WPPSI-II
CTONI
WAIS-III
Other:__________________
Achievement Test:
WJ-III
WIAT-II
PIAT-R
KTEA-II
YCAT
Other: _________________
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ABILITY SCORE: _______________
FSIQ
VIQ
PIQ
GCA
Other: _____________________
Significant Discrepancy
WJ-III /or Other Score Critical Value Table
Yes No
Basic Reading Skills ___________ ___________ ___________
Reading Comprehension ___________ ___________ ___________
Basic Math Skills ___________ ___________ ___________
Math Reasoning ___________ ___________ ___________
Basic Writing Skills ___________ ___________ ___________
Written Expression ___________ ___________ ___________
______________________ ___________ ___________ ___________
______________________ ___________ ___________ ___________
WIAT-II/or Other
Yes No
Basic Reading ___________ ___________ ___________
Listening Comprehension ___________ ___________ ___________
Mathematics Reasoning ___________ ___________ ___________
Numerical Operations ___________ ___________ ___________
Oral Expression ___________ ___________ ___________
Reading Comprehension ___________ ___________ ___________
Written Expression ___________ ___________ ___________
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SE-106