Version May 2024
| Diagnosis and tests listed in the Social Security Administration's childhood "Listing of Impairments" for children (Part B) |
| Medical history of the child for the previous 12 months |
| Complete, detailed, clinical findings (eg, results of physical, intelligence, developmental, and mental status examinations) |
| Complete, detailed laboratory findings (eg, blood pressure, radiographs) |
| Specific diagnosis (statement of disease or injury based upon signs and symptoms) |
| Review of treatment(s) prescribed and description of response and prognosis |
| The probable duration of the impairment |
| An assessment of the child's physical or mental abilities to function independently, appropriately, and effectively in an age-appropriate manner and to perform age-appropriate daily activities |
| The nature and limiting effects of the impairment(s) on the child's ability to function independently, appropriately, and effectively in an age-appropriate manner and to perform age-appropriate daily activities |
| School documents, reports, or information indicating the child's need for special education services and deviations from age-appropriate performance in the school setting |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
