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Hart County Special Education Department

Donna LeFevre
Director of Special Education

25 Quality Street
Munfordville, KY 42765
PHONE: 270-524-9345
FAX: 270-524-2634
donna.lefevre@hart.kyschools.us
 
SCHOOL PSYCHOLOGISTS

LeAnn Pinson, EdS, NCSP
leann.pinson@hart.kyschools.us

Kristina Sidebottom, EdS, NCSP
kristina.sidebottom@hart.kyschools.us

Jane Ann Gibson, Psychologist Assistant
janeann.gibson@hart.kyschools.us
 
 

25 Quality Street
Munfordville, KY 42765
PHONE: 270-524-9345
FAX: 270-524-2634



SCHOOL PSYCHOLOGY RESOURCES

National Association of School Psychologists: www.nasponline.org
Kentucky Association for Psychology in Schools: www.kapsonline.org



Additional parent resources found at www.parentinvolvementmatters.org

 

click HERE for Special Education Department Schedule
 
Contact information for the Special Education Department and
personnel schedules are Included in the link:
Jane Ann Gibson - Special Education Assistant
LeAnn Pinson - School Psychologist
Kristina Sidebottom - School Psychologist
Dana Brown - Speech/Language Pathologist
Lessa Croley - Speech/Language Pathologist
Beth Huff - Speech/Language Pathologist
Jana Prichard - Occupational Therapist
Michelle Higdon - Physical Therapist
Lucindy Atwell - Teacher for the Visually Impaired

 

Click HERE for Online Resources for Psychologists, Parents, & Educators
which address the following topics:

Anxiety Disorders
Attention Deficit/Hyperactivity Disorder (ADHD)
Autism Spectrum Disorder (ASD)
Behavior and Conduct Disorders
Deaf and Hard of Hearing
Dissociative Disorders
Eating Disorders
Fetal Alcohol Syndrome
Gifted and Talented
Learning Disabilities
Nonverbal Learning Disabilities
Medical Conditions
Mental Disabilities
Mood Disorders
Selective Mutism
Speech and Language
Substance Abuse
SuicideTourette's Disorder
Traumatic Brain Injury (TBI)


Click HERE for Online Resources for Psychologists, Parents, & Educators
which address the following topics:

Adolescence
Assessment and Evaluation
Brochures, Pamphlets, and other Documents
ERIC Clearinghouses
Functional Behavioral Assessment
Behavioral Intervention
Journals
Law and Education
Mental Health
Social and Emotional Development
Parenting and Family
Peer Resources
Professional Organizations
Research
School Psychology
Special Education
Violence & Terrorism
Other Reference Lists and Resources




Hotline Numbers Every Youth Should Have


The National Runaway Switchboard: 1-800-RUNAWAY

National Safe Place: text the word SAFE and your current location
to the number 69866 to get the address of the nearest
"Safe Place" site and a phone number for the local youth shelter

 

Forms
GENERAL FORMS
Formal Records Request
SECTION I. BEHAVIORAL INTERVENTIONS (FBA/BIP)
Behavioral Goals/Chores
BIP - IC version (print & complete)
may elect to complete online by going through IC
Daily Point Sheet
Daily Point Sheet - Sample 1
Daily Point Sheet - Sample 2
Daily Point Sheet - Sample 3
Daily Point Sheet - Sample 4
FBA - IC version (print & complete)
may elect to complete online by going through IC
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SECTION II. CORE CONTENT & EDUCATIONAL GUIDES
Character Education Guide
Collaborative Teaching Practices - Q&A
ELA Standards by Grade Level
Math Progressions Table
Math Standards by Grade Level
Special Education Data Standards Update (01-17-14)
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SECTION III. DUE PROCESS
Appointment of Representative for Educational Decisions
ARC Meeting Invitation Notice - Annotated Version
Conference Summary - Annotated Version
Decline of Services
Determination of Student Representative
Excusal of ARC Member
Justification for Placement (LRE)
Parent Rights
Parent Rights - SUMMARY
Participation Guidelines for the KY Alternate Assessment
Record of Access
Release of Information - HIPAA
TEMPLATE: Conference Summary Minutes - Annual Review
TEMPLATE: Conference Summary Minutes - Initial Eval & Eligibility
TEMPLATE: Conference Summary Minutes - Referral
Verification of Previous Services
Verification Form (Temporary Placement)
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SECTION IV. EVALUATION/REEVALUATION/SCREENERS
ADHD Screener Permission
Behavior Observation Form (General)
Behavior Observation Form - Interval Recording Sample
Behavior Observation Form - Interval Recording
Behavior Observation Form - Mass Trials
Behavior Observation Form - Repeated Trials
Behavior Observation Form - Repeated Trials Sample
Behavior Screener Consent (General)
Cognitive/Academic Screening Permission
Motor Screener Form
Physician's Medical Questionnaire - ADHD
Physician's Medical Questionnaire - General
Reevaluation Checklist for DoSE
Reevaluation Request for Information
Referral - Annotated Version
Referral Checklist
Social-Developmental History
Teacher Input Form
Triangulation of Data (Guide)
Vision/Hearing/Communication/Observation Screener Consent
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SECTION V. HART COUNTY EXCEPTIONAL EDUCATION POLICIES & PROCEDURES
Policies & Procedures 2008
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SECTION VI. IEP DOCUMENTS
ESY Form
ESY Guidelines
Health Service Log
I have read and understand....
IEP Addendum Process (Directions)
IEP - Annotated Version
IEP - Development Tool
IEP - Lesson Plan Handbook
IEP - Progress Data Collection
IEP - Progress Monitoring Directions
IEP - Progress Monitoring & Summary: Objectives #1-4
IEP - Progress Monitoring & Summary: Objectives #5-8
Justification for Placement
LRE-Guide for Determining Placement
LRE-Guide for Determining Placement (Preschool)
Measurable Goal Template
Monitoring Document - Sample 1
Progress Monitoring
SAMPLE IEP - HI
SAMPLE IEP - MMD
SAMPLE IEP - VI
SAMPLE PLEP - Middle School Student
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SECTION VII. KDE RECORD REVIEW
2013-14 KDE Record Review Compliance Document
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SECTION VIII. MEDICAID
Annual Notice of Medicaid
Medicaid Release for Billing
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SECTION IX. RELATED SERVICES (OT,PT,SLT)
Guide to Normal Speech Development
Guidance for OT, PT, & S/L in the School
Speech & Language Screener Referral
Speech Sound Production Cues
Speech Therapy Monitoring
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SECTION X. RESOURCES
K-12 Teacher Time Sheet
New Student & Exiting Student Form
Tasks for the Ages
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SECTION XI. RESPONSE TO INTERVENTION (RTI)
Checklist: Writing Observations for Progress Monitoring
Reading Recovery Progress Monitoring - 1st Grade
Reading Recovery Progress Monitoring - 2nd Grade
Reading Recovery Progress Monitoring - 3rd Grade
Research Based Intervention Resources
RTI Progress Monitoring & Summary: Objectives #1-4
RTI Progress Monitoring & Summary: Objectives #5-8
RTI Student Intervention Documentation
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SECTION XII. SAFE PHYSICAL CRISIS MANAGEMENT (SPCM)
Physical Restraint & Seclusion Forms
(2 pages)
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SECTION XIII. SCHOOL PSYCHOLOGIST
Assessment Results Profile
EBD Evaluation Worksheet
EBD Evaluation Worksheet - SAMPLE
GAI Worksheet
LD Discrepancy Form
OHI Guide
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SECTION XIV. SPANISH FORMS
Consent for Evaluation/Reevaluation
Consent for Special Education & Related Services
Evaluation Planning
Notification of ARC Meeting
Parent Questionnaire for Attention & Behavioral Concerns
Referral for Initial Multidisciplinary Evaluation
Social & Developmental History Questionnaire
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SECTION XV. TEACHER ASSISTANCE TEAM (TAT)
Documentation of Interventions
TAT Checklist
TAT Meeting Record Form
TAT Request Form
Teacher Input Form for TAT
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SECTION XVI. TRANSITION & ILP
Age Appropriate Transition
Assessment Checklist
Destruction of Records Letter
Dropout FAPE Letter
Dropout Prevention Form
KY Transition News - Summer 2012
Multi-Year Course of Study
My Goals...(post-secondary)
04/04/14 update
Release of Student Records to Third Party
SAMPLE ILP
Summary of Performance
Summary of Performance-Live Form
Transfer of Parental Rights/Guardianship
Transition Checklist: Age 14 to Graduation
Transition Services
10/2013 update
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