National Assessment of Educational Progress (NAEP) 2012 Wave II (Grade 4/8/12 Pilots, Grade 12 Economics, SD, ELL, and Special Studies)

NATIONAL ASSESSMENT OF
EDUCATIONAL PROGRESS
WAVE 2 SUBMITTAL FOR 2012
VOLUME II
Part 7
FOR 2012 ASSESSMENT
Students with Disabilities (SD)
English Language Learners (ELL)
Worksheets

Part 7 contains:
Students with Disabilities (SD) and English Language Learners (ELL) Materials:
a.
b.
c.
d.

SD Worksheet (Economics, LTT Math, LTT Reading, Writing)
SD Worksheet (Pilot Mathematics and Reading))
ELL Worksheet (Economics, LTT Math, LTT Reading, Writing)
ELL Worksheet (Pilot Mathematics and Reading))

June 1, 2011
2012 OMB Wave 2
Part 4 of 4

THE NATIONAL ASSESSMENT OF
EDUCATIONAL PROGRESS

Wave 2 Submittal for 2012
VOLUME II
Part 7a
SD Worksheet

(Economics, LTT Mathematics & Reading, Writing-CBA)

FOR 2012 ASSESSMENT

Part 7a contains:
SD Worksheet (Economics, LTT Mathematics & Reading, Writing-CBA)
The amount of time estimated to complete the corresponding SD form is 10 minutes per student.

Inv. #NA000?????

This form must be completed in No. 2 pencil.

Please complete both sides of this
worksheet for each student.

NAEP 2012
Students with Disabilities (SD) Worksheet

perf

NAEP 2012
Students with Disabilities (SD)
Worksheet

SCHOOL COPY

Pearson Use Only
Sheet ____ of ____

SCHOOL #:
School Name:

Sheet ____ of ____

Please complete the back of this worksheet for each student.

REFER TO COLUMN B TO COMPLETE THESE QUESTIONS

Session # /
Line #

D

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

E

F

G

LOOK AT COLUMN B
What accommodations does this
student receive on your state test for the NAEP subject
listed in column B?
Refer to the enclosed State-Specific SD Guidelines
Summary for information on the accommodations allowed
by your state. Record the number of each required
accommodation from the guidelines in the space below for
each student.

H
How should this student be tested on NAEP?
1 = Without accommodations
2 = With accommodations allowed by NAEP
3 = Do not test

C

Record the student's current SD classification
using one of the codes below:
1 = Has an IEP for a disability
2 = Has a Section 504 Plan and needs
accommodation to be tested
3 = Does not have an IEP or Section 504 Plan
(Do not complete the rest of the worksheet
for this student)
How is this student included in your state
test for the NAEP subject listed in column B?
1 = Without accommodations
(Go to column H)
2 = With accommodations (Go to column G)
3 = With alternate assessment/modified
achievement standards (Go to column G)
4 = With alternate assessment/alternate
achievement standards (Go to column G)

Student Name

B
NAEP Subject
E = Economics, M/MC = Mathematics/
Mathematics with calculator block(s), R = Reading,
W = Writing

A

I

For
NAEP
Use Only

NAEP 2012
Students with Disabilities (SD)
Worksheet
School Copy

Student Name
Session # /
Line #

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

Sheet ____ of ____

N

Which of the following IDEA categories best describes this student's identified disability(ies)?
(Fill in all ovals that apply)

Other health impairment (specify)

NAEP 2012 SD Worksheet OP School
183158-001:321

What is the degree of this student's disability(ies)?
1 = Profound/Severe
2 = Moderate
3 = Mild
At what grade level does this student perform in the NAEP
subject listed in column K?
1 = At or above grade level
2 = One year below grade level
3 = Two or more years below grade level
4 = Not receiving instruction in this subject
5 = Don't know

M

Other health impairment
(Record the other health impairment in the space to
the right)

Developmental delay (age 9 or younger)

Autism

Traumatic brain injury

of

Orthopedic impairment

Emotional disturbance

Intellectual disability

Speech or language impairment

Visual impairment/blindness

L

Hearing impairment/deafness

K

Specific learning disability

J

NAEP Subject
E = Economics, M/MC = Mathematics/
Mathematics with calculator block(s), R = Reading,
W = Writing

Sheet

SCHOOL #:
Refer to the NAEP
subject listed in
column K to answer
this question.

O

Printed in the USA by Pearson

P

ISD8962

THE NATIONAL ASSESSMENT OF
EDUCATIONAL PROGRESS

Wave 2 Submittal for 2012
VOLUME II
Part 7b
SD Worksheet

(Pilot Mathematics & Reading)

FOR 2012 ASSESSMENT

Part 7b contains:
SD Worksheet (Pilot-Mathematics & Reading)
The amount of time estimated to complete the corresponding SD form is 10 minutes per student.

A

Student Name
Pearson Use Only

SCHOOL COPY

Sheet ____ of ____

B
C

Session # /
Line #

D

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

E
F

P

Sheet ____ of ____

G

Look AT COLUMN B

What accommodations does this
student receive on your state test for the
NAEP subject listed in column B?

Refer to the enclosed State-Specific SD
Guidelines Summary for information on
the accommodations allowed by your
state. Record the number of each required
accommodation from the guidelines in the
space below for each student.

H
I

How should this student be tested on NAEP?
Review columns G and H and the SD Decision
Tree on page 2 of the Worksheet Instructions for
how to answer this question.
1 = Without accommodations
2 = With accommodations allowed by NAEP
3 = Do not test

P

NAEP 2012
Students with Disabilities (SD) Worksheet

Are all of the student's accommodations listed
in column G allowed in the NAEP subject?
Refer to the enclosed State-Specific SD Guidelines
Summary for information on the accommodations
allowed by NAEP.
1 = Yes, all accommodations are allowed
2 = No, some/all accommodations are not
allowed

perf

NAEP 2012
Students with Disabilities (SD)
Worksheet

Record the student's current SD classification
using one of the codes below:
1 = Has an IEP for a disability
2 = Has a Section 504 Plan and needs
accommodation to be tested
3 = Does not have an IEP or Section 504 Plan
(Do not complete the rest of the worksheet
for this student)
According to the student's IEP or Section
504 Plan, how is this student assessed on the
state assessment in the NAEP subject listed
in column B?
1 = Without accommodations
(Go to column I)
2 = With accommodations (Go to column G)
3 = With alternate assessment/modified
achievement standards (Go to column G)
4 = With alternate assessment/alternate
achievement standards (Go to column G)

NAEP Subject
M = Mathematics, R = Reading

Inv. #NA000?????

This form must be completed in No. 2 pencil.

Please complete both sides of this
worksheet for each student.

SCHOOL #:

School Name:
Please complete the back of this worksheet for each student.

REFER TO COLUMN B TO COMPLETE THESE QUESTIONS
J

For
NAEP
Use Only

NAEP 2012
Students with Disabilities (SD)
Worksheet
School Copy

P

Student Name
Session # /
Line #

(Column O on Admin. Schedule)

Autism

Traumatic brain injury

Orthopedic impairment

Emotional disturbance

Intellectual disability

Speech or language impairment

Sheet ____ of ____

O

Other health impairment (specify)

NAEP 2012 SD Worksheet Pilot School
183158-001:321

What is the degree of this student's disability(ies)?
1 = Profound/Severe
2 = Moderate
3 = Mild
At what grade level does this student perform in the
NAEP subject listed in column L?
1 = At or above grade level
2 = One year below grade level
3 = Two or more years below grade level
4 = Not receiving instruction in this subject
5 = Don't know

N

Other health impairment
(Record the other health impairment in the space to
the right)

of

Developmental delay (age 9 or younger)

NAEP Student Booklet ID #
Visual impairment/blindness

M

Hearing impairment/deafness

L

Specific learning disability

K

NAEP Subject
M = Mathematics, R = Reading

Sheet

P
SCHOOL #:
Refer to the NAEP
subject listed in
column L to answer
this question.

P

Printed in the USA by Pearson

Q

Which of the following IDEA categories best describes this student's identified disability(ies)?
(Fill in all ovals that apply)

ISD8962

THE NATIONAL ASSESSMENT OF
EDUCATIONAL PROGRESS

Wave 2 Submittal for 2012
VOLUME II
Part 7c
ELL Worksheet

(Economics, LTT Mathematics & Reading, Writing-CBA)

FOR 2012 ASSESSMENT

Part 7c contains:
ELL Worksheet (Economics, LTT Mathematics & Reading, Writing-CBA)
The amount of time estimated to complete the corresponding ELL form is 10 minutes per student.

Inv. #NA000?????

This form must be completed in No. 2 pencil.

Please complete both sides of this
worksheet for each student.

NAEP 2012
English Language Learner (ELL) Worksheet

perf

NAEP 2012
English Language Learner (ELL)
Worksheet

SCHOOL COPY

Pearson Use Only
Sheet ____ of ____

SCHOOL #:
School Name:

Sheet ____ of ____

Please complete the back of this worksheet for each student.

REFER TO COLUMN B TO COMPLETE THESE QUESTIONS

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

E

F

G

Look AT COLUMN B
What accommodations does this
student receive on your state test for the
NAEP subject listed in column B?
Refer to the enclosed State-Specific ELL
Guidelines Summary for information on
the accommodations allowed by your
state. Record the number of each required
accommodation from the guidelines in the
space below for each student.

H
How should this student be tested on NAEP?
1 = Without accommodations
2 = With accommodations allowed by NAEP
3 = Do not test

Session # /
Line #

D

How is this student included in your state test
for the NAEP subject listed in column B?
1 = Without accommodations (Go to column H)
2 = With accommodations (Go to column G)
3 = With a simplified English/native language
test (Go to column G)
4 = Does not participate (Go to column H)

C

Record the student's current ELL
classification using one of the codes below:
1 = Yes, ELL
2 = No, formerly ELL (monitored for AYP) (Do
not complete the rest of the worksheet for
this student)
3 = No, not ELL (Do not complete the rest of
the worksheet for this student)

Student Name

B

NAEP Subject
E = Economics, M/MC = Mathematics/
Mathematics with calculator block(s),
R = Reading, W = Writing

A

I

For
NAEP
Use Only

NAEP 2012
Enlgish Language Learner
(ELL)
Worksheet
School Copy

Student Name
Session # /
Line #

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

N
O

Writing English

Sheet ____ of ____

Reading English

M

Speakng English

of

Listening comprehension in English

L

At what grade level does this student perform
in the NAEP subject listed in column K?
1 = At or above grade level
2 = One year below grade level
3 = Two or more years below grade level
4 = Not receiving instruction in this subject
5 = Don't know

K

Including this school year, how long has this student been
receiving academic instruction primarily in English?
1 = Does not receive academic instruction primarily in English
2 = Less than 1 year
3 = 1 to 2 years
4 = 2 to 3 years
5 = 3 years or more
6 = Don't know

J

NAEP Subject
E = Economics, M/MC = Mathematics/
Mathematics with calculator block(s),
R = Reading, W = Writing

Sheet

SCHOOL #:

Refer to the NAEP For each item listed below, how would you
subject listed in
characterize this student's English
column K to answer
proficiency?
this question.
1 = ELL advanced

P

2 = ELL intermediate
3 = ELL beginning
4 = No proficiency
5 = Don't know

NAEP 2012 ELL Worksheet OP School
183158-001:321
Printed in the USA by Pearson
ISD8962

THE NATIONAL ASSESSMENT OF
EDUCATIONAL PROGRESS

Wave 2 Submittal for 2012
VOLUME II
Part 7d
ELL Worksheet

(Pilot Mathematics & Reading)

FOR 2012 ASSESSMENT

Part 7d contains:
ELL Worksheet (Pilot-Mathematics & Reading)
The amount of time estimated to complete the corresponding ELL form is 10 minutes per student.

Student Name
B

Pearson Use Only

SCHOOL COPY

C

Session # /
Line #

D

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

E
F

Sheet ____ of ____

Sheet ____ of ____

G
H

Look AT COLUMN B

What accommodations does this
student receive when tested in the
NAEP subject listed in column B?

Refer to the enclosed State-Specific ELL
Guidelines Summary for information on
the accommodations allowed by your
state. Record the number of each required
accommodation from the guidelines in the
space below for each student.

I
J

How should this student be tested on
NAEP? Review columns F, H and I and the
ELL Decision Tree on page 2 of the Worksheet
Instructions for how to answer this question.
1 = Without accommodations
2 = With accommodations allowed by NAEP
3 = Do not test

NAEP 2012
English Language Learner (ELL) Worksheet P

Are all of the student's accommodations listed
in column H allowed in the NAEP
subject? Refer to the enclosed State-Specific
ELL Guidelines Summary for information on the
accommodations allowed by NAEP.
1 = Yes, all accommodations are allowed
2 = No, some/all accommodations are not
allowed

P

What is the student's primary language?
1 = Spanish
2 = Other

A

perf

NAEP 2012
English Language Learner (ELL)
Worksheet

Record the student's current ELL
classification using one of the codes below:
1 = Yes, ELL
2 = No, formerly ELL (monitored for AYP) (Do
not complete the rest of the worksheet for
this student)
3 = No, not ELL (Do not complete the rest of
the worksheet for this student)
How long has this student been enrolled in
U.S. schools?
1 = 1 full academic year or more before the
NAEP assessment
2 = Less than 1 full academic year before the
NAEP assessment

NAEP Subject
M = Mathematics , R = Reading

Inv. #NA000?????

This form must be completed in No. 2 pencil.

Please complete both sides of this
worksheet for each student.

SCHOOL #:

School Name:

Please complete the back of this worksheet for each student.

REFER TO COLUMN B TO COMPLETE THESE QUESTIONS
K

For
NAEP
Use Only

NAEP 2012
Enlgish Language Learner
(ELL)
Worksheet
School Copy

P

Student Name
Session # /
Line #

NAEP Student Booklet ID #
(Column O on Admin. Schedule)

P
Q

Refer to the NAEP subject
listed in column M to answer
this question.

NAEP 2012 ELL Worksheet Pilot School

Writing English

O

Reading English

N
Sheet ____ of ____

Speakng English

P

Listening comprehension in
English

of

At what grade level does this student perform
in the NAEP subject listed in column M?
1 = At or above grade level
2 = One year below grade level
3 = Two or more years below grade level
4 = Not receiving instruction in this subject
5 = Don't know

M

Including this school year, how long has this student been
receiving academic instruction primarily in English?
1 = Does not receive academic instruction
primarily in English
2 = Less than 1 year
3 = 1 to 2 years
4 = 2 to 3 years
5 = 3 years or more
6 = Don't know

L

NAEP Subject
M = Mathematics , R = Reading

Sheet

SCHOOL #:
R

For each item listed below, how
would you characterize this student's
English proficiency?
1 = ELL advanced
2 = ELL intermediate
3 = ELL beginning
4 = No proficiency
5 = Don't know

183158-001:321
Printed in the USA by Pearson
ISD8962