Instructions Sheet

Instructions for Completing the Deafblind Census Form

 The Texas Education Agency, Division of Special Education, is required to report annually on individuals, 0-21 years of age, who are deafblind in Texas.  Enclosed are census forms for the district special education director to copy and use to report those individuals in the district who are deafblind.

 ·         This count will not effect any other counts or funding associated with the IDEA or other reporting and funding efforts.

 ·         All information provided to the Texas Education Agency is held in accordance with the requirements for confidentiality as specified in the regulations for the Privacy Rights of Parents and Students [34 CFR § 99.31].

 ·         The Texas Education Agency is an eligible agency to view and maintain confidential and identifying information regarding individuals with exceptional needs [34 CFR § 99.31].

 ·         In order for the Texas Education Agency to release confidential information to related agencies for programming and fiscal purposes, parents must have provided consent on the 1997 Sample Form, Consent for Release of Confidential Information: Student with Visual Impairment.  The district must indicate on the Census Form whether or not this consent was obtained.

 ·         Intervener – A person who has training in specialized skills related to deafblindness and who works consistently with a child.

 To determine if a student should be reported on the Deafblind Census:

 ·         Review the Federal definition

 ·         Complete the 3-column Checklist for Deafblind Census of Texas

 Students for whom vision and hearing loss are suspected but who have not been tested may be reported on the Deafblind Census and remain for one year.  During that year, assessment of their sensory functioning should be completed.  Technical assistance related to appropriate assessment techniques is available from the Deafblind Outreach Program at the Texas School for the Blind and Visually Impaired (512 206-9242).

 Enclosed you will find green Census Forms filled out on students from your school(s) who were reported to the Deafblind Census in previous years.  Please review each student’s folder and make any necessary corrections on the green forms in red ink and return them.  Complete the Checklist for Deafblind Census of Texas attached to each Census Form.  Also included are white Census Forms you may reproduce to report additional students to the Deafblind Census.  These may include students who are:

 ·         new to the district, but previously reported on the Deafblind Census in other districts; or

 ·        newly identified as being an appropriate registrant on the Deafblind Census.

 Please keep a copy of each student's form for your records.