New Category of Disability |
New Line No. |
Old Category of Disability |
||
A. Neurodevelopmental |
|
|
||
a. ADHD |
01 |
Included in Line 1 Learning Disabilities |
||
b. Autism Spectrum Disorder |
02 |
Included in Line 12 Mental Health |
||
c. Communication/Speech |
03 |
Line 13 Speech Disabilities |
||
d. Learning Disability |
04 |
Line 1 Learning Disabilities |
||
e. Motor |
05 |
Included in Line 17 Other |
||
Subtotal (sum lines 01-05) |
06 |
New Line please total as indicated |
||
B. Sensory |
|
|
||
a. Blind |
07 |
Line 6 Legally Blind |
||
b. Low Vision |
08 |
Line 7 Other Visual Disability |
||
c. Deaf |
09 |
Line 9 Legally Deaf |
||
d. Hard of Hearing |
10 |
Line 10 Other acoustical disability |
||
Subtotal (sum lines 07-10) |
11 |
Line 8 plus Line 11 |
||
|
|
|
||
C. Mental Health |
12 |
Line 12 Mental health disabilities |
||
D. Physical |
|
|
||
a. Basic Chronic Medical Condition |
13 |
Included in Line 17 Other |
||
b. Mobility |
14 |
Line 5 Subtotal (Lines 2+3+4) |
||
c. Orthopedic |
15 |
Line 15 Orthopedic disabilities |
||
Subtotal (sum lines 13-15) |
16 |
New Line please total as indicated |
||
E. Intersystem |
|
|
||
a. Alcohol/Substance Abuse Recovery |
17 |
Line 16 Alcohol/substance addiction & recovery |
||
b. Complex Chronic Medical Condition |
18 |
Included in Line 17 Other |
||
c. Traumatic Brain Injury |
19 |
Line 14 Traumatic brain injury |
||
Subtotal (sum lines 17-19) |
20 |
New Line please total as indicated |
||
|
|
|
||
F. Temporary Disabilities |
21 |
Included in Line 17 Other |
||
|
|
|
||
GRAND TOTAL (Total of lines 6, 11, 12, 16, 20, 21) |
22 |
New Line please total as indicated |
||
UNDUPLICATED TOTAL |
23 |
Line 21 |
||
G. Students with Multiple Disabilities |
24 |
Line 19 Multiple Disabilities |
||
Count students with multiple disabilities in every category in which they fit. Include students on line 24 if they had two or more of the disabilities in lines 1-5, 7-10, 12, 13-15, 17-19, 21. |