Emotional Disturbance Evaluation Checklist
Document the characteristics, duration, degree and educational impact an ED decision requires. A free, fillable checklist for school psychologists and evaluation teams.
What’s inside
- The federal eligibility requirements, each with space to note where the evidence is documented
- 19 commonly used measures to check off, with date tested, examiner and results
- Records, interviews, observations and screenings
- Interventions tried and duration
- Evaluation timeline and a team summary box
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What IDEA requires for Emotional Disturbance
The checklist walks your team through each part of the federal definition so nothing is missed at the eligibility meeting:
- (A) An inability to learn that cannot be explained by intellectual, sensory or health factors
- (B) An inability to build or maintain satisfactory relationships with peers and teachers
- (C) Inappropriate types of behavior or feelings under normal circumstances
- (D) A general pervasive mood of unhappiness or depression
- (E) A tendency to develop physical symptoms or fears associated with personal or school problems
- One or more of the above over a long period of time and to a marked degree
- Adversely affects educational performance
- Social maladjustment alone ruled out as the explanation
- Student needs specially designed instruction
Summary of federal IDEA regulations (34 CFR §300.8(c)(4)). Your state may add criteria or use different terms. Follow state and district procedures.
Measures included in the checklist
No single test determines eligibility. The checklist lists measures school psychologists commonly use so you can document what was given, when and by whom:
- Broad rating scales: BASC-3 TRS (teacher 1), BASC-3 TRS (teacher 2), BASC-3 PRS, BASC-3 SRP, ASEBA CBCL / TRF / YSR
- Targeted measures: CDI 2 (depression), RCMAS-2 (anxiety), MASC 2 (anxiety), RADS-2 (adolescent depression), BYI-2, SSIS SEL Rating Forms
- Behavior: Functional behavior assessment (FBA), Observation: setting 1, Observation: setting 2, Observation: across time (to show duration), Discipline and attendance records
- Rule-out data: Cognitive measure or screen, Achievement measure or screen, Outside mental health records (with consent)
Blank rows let you add any other measures your team uses.
Interventions tried and duration
- Tier 2 behavior / social-emotional supports
- School counseling or group support
- Behavior intervention plan
- Community mental health services
- Home-school communication plan
- Dates showing how long concerns have lasted
Frequently asked questions
Is the checklist fillable?
Yes. You can type into it on a computer or print it. Check boxes are printed, and every date, examiner and notes field can be filled in digitally.
Does this replace my state or district forms?
No. It is a working checklist to organize data. Your state may add criteria or use different terms, so always follow state and district procedures and use their required forms.
Can I share it with my evaluation team?
Yes. Share it with colleagues on your team. If others want their own copy, send them to this page.