2015-2016
Nevada Department of Education
Testing Accommodations for Students in Special Education and 504 Programs
First Name:
Last Name:
MI:
DOB:
Student ID #:
Eligibility:
School:
District:
Contact Person :
Title:
Date:
Attach this form to the Individualized Education Program (IEP) or 504 Plan; what is specified on this form should be aligned with what
is described in the accommodations section of the IEP or 504 Plan, and should be used during regular classroom instruction.
Accommodations are disability related and specific for each student. Relevant information from this form must be provided to the
appropriate test administrator(s). Security procedures must be strictly adhered to in test administration for all students.
NO ACCOMMODATIONS
The IEP/504 committee has determined that no accommodations are needed for this student.
SEE PAGE 2 FOR DESIGNATED SUPPORTS.
ACCOMMODATIONS
The IEP/504 committee has determined this student will participate in state assessments except those noted below* with
the accommodations selected on this form. See the Nevada Department of Education (NDE) Testing Calendar for a
complete list of assessments. Accommodations not listed on this form require advance written approval from the NDE.
*Career and Technical Education Assessment accommodations are administered in accordance with the student’s IEP and
the specific testing vendor’s guidelines.
*College and Career Readiness accommodations must be requested in advance through the specific testing vendor.
*English Language Proficiency Assessment accommodations are administered in accordance with the student’s IEP and
the specific testing vendor’s guidelines.
*National Assessment of Educational Progress accommodations are administered in accordance with federal guidelines.
Schools selected for participation will receive written procedures.
This student will test with the following accommodations (check all that apply):
Abacus
Alternate Response Options (e.g., adapted keyboard or mouse, keyboard, touch screen)
Describe:
American Sign Language (ASL) embedded tool for grades 3 – 8 English Language Arts (ELA) listening items and online
math items; ASL word-to-signed symbol glossary for all paper/pencil math and science items
Braille
Calculator for the math High School Proficiency Examination (HSPE)—IEP students ONLY. Must be a free-standing,
basic or scientific device only. Graphing and programmable features are PROHIBITED.
Calculator with special features (e.g., Braille or talking scientific calculator) for calculator-approved math items in grades
6 – 8, End-of-Course, and HSPE (IEP ONLY). Graphing and programmable features are PROHIBITED.
Closed Captioning for online administrations
Large-Print Test Booklet for paper/pencil administrations
Multiplication Table—Paper-based single-digit (1 x 9) table for math items at grade 4 and above
Print on Demand for online administrations
Read Aloud—Grades 6 – 8 ELA Reading PASSAGES, End-of-Course Reading PASSAGES, and for blind students who
have not acquired adequate Braille skills
Nevada Department of Education
2015-2016