S.C. Code Regs. § 43-243.1

Current through Register Vol. 48, No. 5, May 24, 2024

Section 43-243.1 - The Criteria for Entry into Programs of Special Education for Students with Disabilities

A. General Requirements

These criteria for entry into programs of special education for students with disabilities will be used by all members of the multidisciplinary team, who may include school psychologists, speech-language therapists, and other persons responsible for the identification and evaluation of students with disabilities.

The federal definitions for all categories of disabilities have been used, as included in the Individuals with Disabilities Act (IDEA). All examiners, however, must be appropriately credentialed or licensed and should have completed training that is directly relevant to the assessment procedure being conducted. Examiners may administer supplementary measures such as curriculum-based assessments to gain additional information.

All evaluation procedures must ensure that the following minimal requirements are met:

1. Tests and other evaluation materials used to assess a student suspected of having a disability are selected and administered so as not to be discriminatory on a racial or cultural basis and are provided and administered in the student's native language or other mode of communication unless it is clearly unfeasible to use that language or any mode of communication.

2. Materials and procedures used to assess a student with limited English proficiency are selected and administered to ensure that they measure the extent to which the student has a disability and needs special education, rather than measuring the student's English language skills.

3. A variety of assessment tools and strategies are used to gather relevant functional and developmental information about the student, including information provided by the parent and information related to enabling the student to be involved in and progress in the general curriculum (or for a preschool child to participate in appropriate activities) that may assist in determining whether the student is one with a disability and what the content of the student's IEP should be.

4. Any standardized tests that are given to a student have been validated for the specific purpose for which they are used and are administered by trained and knowledgeable personnel in accordance with any instructions provided by the producer of the tests. If an assessment is not conducted under standard conditions, a description of the extent to which it varied from standard conditions, such as the qualifications of the person administering the test or the method of test administration, must be included in the evaluation report.

5. Tests and other evaluation materials include those tailored to assess specific areas of educational need and not merely those that are designed to provide a single general intelligence quotient.

6. Tests are selected and administered so as best to ensure that if a test is administered to a student with impaired sensory, manual, or speaking skills, the test results accurately reflect the student's aptitude or achievement level, or whatever other factors the test purports to measure, rather than reflecting the student's impaired sensory, manual, or speaking skills (unless those skills are the factors that the test purports to measure).

7. No single procedure is used as the sole criterion for determining whether a student has a disability and for determining an appropriate educational program for the student.

8. The student is assessed in all areas related to the suspected disability, including, if appropriate, his or her health, vision, hearing, social and emotional status, general intelligence, academic performance, communicative status, and motor abilities.

9. In the assessment of each student with a disability, the methods of evaluation are sufficiently comprehensive to identify all of the student's special education and related-service needs, whether or not they are commonly linked to the category in which the student is suspected of having a disability.

10. Each school district/agency uses technically sound instruments that may assess the relative contribution of cognitive and behavioral factors in addition to physical or developmental factors.

11. Each school district/agency uses assessment tools and strategies that provide relevant information that directly assists persons in determining the educational needs of the student.

B. Autism Spectrum Disorder

1. Definition

Autism is a developmental disability characterized by significant deficits in social communication and interaction as well as significant restricted interests and repetitive behaviors that are not primarily caused by an emotional disability and are typically, though not always, evident before age three.

2. Eligibility Criteria

There is evidence that the child meets educational criteria for autism spectrum disorder (ASD) indicated by:

a. persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following (currently or by history):

(1) deficits in social-emotional reciprocity, ranging, for example from abnormal social approach and failure of normal back and forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions;

(2) deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication; and

(3) deficits in developing, maintaining, and understanding relationships, ranging for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers;

b. restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following (currently or by history):

(1) stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping plates, echolalia, idiosyncratic phrases);

(2) highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or pervasive interests);

(3) insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transition, rigid thinking patterns, greeting rituals, needing to take the same routine or eat the same food every day);

(4) hyper or hypo-activity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement);

c. these characteristics cannot be accounted for by an emotional disability. In cases where autism spectrum disorder and emotional disability may be comorbid, the above characteristics are in excess of what can be explained by an emotional disability alone;

d. these characteristics adversely impact educational performance as indicated by one or more of the following:

(1) difficulties maintaining appropriate social behaviors across multiple environments;

(2) difficulties initiating or maintaining positive interactions with peers and/or adults;

(3) difficulties communicating ideas, wants, or needs verbally and/or in writing;

(4) decreased ability to participate in age-appropriate activities;

(5) difficulties with social functioning skills such as planning, organizing, self-monitoring, and/or self-regulation; and/or

(6) for school age students: significantly sub-average academic achievement or notable difficulties with abstract learning tasks;

e. the adverse impact on the child's educational performance requires the provision of specialized instruction and, if necessary, related services in one or more of the following areas:

(1) academic performance;

(2) social skills;

(3) emotional regulation/coping skills;

(4) classroom behavior;

(5) adaptive skills (e.g., daily living, functional communication, work ethic, study skills, etc.); or

(6) vocational skills.

C. Deaf-blindness

1. Definition

Deaf-blindness means concomitant hearing loss and visual impairment, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education programs solely for children who are deaf or hard of hearing or children who are blind or visually impaired.

2. Eligibility Criteria

a. There is evidence that the child meets the criteria for both the Deaf/Hard of Hearing category and the Visual Impairment category.

b. There is an adverse effect of the disability on the child's educational performance.

c. The impact of this disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities requires specialized instruction and, if necessary, related services.

D. Deaf/Hard of Hearing

1. Definition

Deaf/Hard of Hearing means a diminished sensitivity to sound or hearing loss, permanent or fluctuating, with or without amplification, that that impacts the processing of linguistic information through hearing and adversely affects the child's educational performance, speech perception and production, social skills, and/or language and communication.

2. Eligibility Criteria

a. There is evidence that the child has a documented hearing loss of 20dB or greater at any frequency including a permanent conductive, sensorineural, or mixed hearing loss, either unilaterally or bilaterally; or

b. there is a fluctuating hearing loss, either unilaterally or bilaterally; or

c. there is documentation of Auditory Neuropathy Spectrum Disorder (ANSD), unilaterally or bilaterally; and

d. there is an adverse effect of the disability on the child's educational performance; and

e. the impact of the disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction and, if necessary, related services.

E. Developmental Delay

1. Definition

A delay in one or more of the following areas: physical development; cognitive development; communication; social or emotional development; or adaptive behavioral development that adversely affects a child's educational performance. The term does not apply to children who are experiencing a slight or temporary lag in one or more areas of development, or a delay which is primarily due to environmental, cultural, or economic disadvantage or lack of experience in age-appropriate activities. The developmental delay classification may be used for children three through eight.

2. Eligibility Criteria

a. There is evidence that the child's performance is significantly below average in one or more developmental areas. A general guideline is 2.0 or more standard deviations below the mean in one area or at least 1.5 standard deviations below the mean in two or more areas (+/- standard error of measurement) and/or a 40% delay in one area or 25% or greater delay in 2 or more areas:

(1) physical development;

(2) cognitive development;

(3) communication development;

(4) social or emotional development;

(5) adaptive behavior development.

b. There is evidence that the delay is not due to:

(1) environmental, cultural, economic disadvantage, or lack of experience in appropriate activities;

(2) limited English proficiency; or

(3) being Deaf/Hard of Hearing, and/or Visually Impaired.

c. There is an adverse effect of the disability on the child's educational performance; and

d. The impact of the disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction, and if necessary, related services.

F. Emotional Disability

1. Definition

Emotional Disability means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects the child's educational performance:

a. an inability to learn that cannot be explained by intellectual, sensory, or health factors;

b. an inability to build or maintain satisfactory interpersonal relationships with peers and teachers;

c. inappropriate types of behavior or feelings in 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.

The term includes schizophrenia. The term does not apply to children who are socially maladjusted unless it is determined that they have a serious emotional disability.

2. Eligibility Criteria

There must be evidence of all of the following:

a. the child exhibits characteristics of a social-emotional, behavioral, or mental health condition (examples include anxiety disorders, disruptive behavior disorders, schizophrenia, etc.) that:

(1) fall outside of expected age, ethnic, and cultural expectations with regard to frequency, duration, and/or severity; and

(2) have persisted for at least 6 weeks within the school setting despite the provision of appropriate intervention except in the most extreme cases when there is clear evidence of a suspected disability (e.g., student's functioning poses a danger to self or others, concerns have required hospitalization or emergency services, etc.). These interventions may include but are not limited to functional behavior assessment/behavior intervention plans, counseling, social-emotional or behavioral interventions delivered through a multi-tiered system of supports, or other therapeutic interventions received outside of the school environment (e.g., intensive outpatient services, hospitalization, etc.);

b. these characteristics adversely impact the child's educational performance, as evidenced by one or more of the following:

(1) an inability to learn that cannot be explained by intellectual, sensory, or health factors;

(2) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers;

(3) inappropriate types of behaviors or feelings under normal circumstances;

(4) a general pervasive mood of unhappiness or depression; and/or

(5) a tendency to develop physical symptoms or fears associated with personal or school problems;

c. there is an adverse effect of the disability on the child's educational performance;

d. the impact on the child's educational performance requires the provision of specialized instruction and, if necessary, related services in one or more of the following areas:

(1) academic performance;

(2) social skills;

(3) emotional regulation/coping skills;

(4) classroom behavior;

(5) adaptive skills (e.g., daily living, functional communication, work ethic, study skills, etc.); or

(6) vocational skills.

G. Intellectual Disabilities

1. Definitions

Intellectual Disability means a condition characterized by significant deficits in adaptive behavior and cognitive functioning that manifest in the developmental period (i.e., childhood) and adversely affects a child's educational performance.

2. Eligibility Criteria

There must be evidence of all of the following:

a. A significant impairment in adaptive functioning that is at least two standard deviations below the mean (+/- the standard error of measurement) in at least two of the following adaptive skill domains:

(1) Communication - The ability to convey information from one person to another through words and actions. This involves the ability to understand others and to express oneself through words or actions.

(2) Social skills - This refers to the ability to interact effectively with others. These skills include the ability to understand and comply with social rules, customs, and standards of public behavior. This requires the ability to process figurative language and detect unspoken cues such as body language.

(3) Personal independence at home and/or in community settings - This refers to the ability to take care of oneself. Some examples are bathing, dressing, and feeding. It also involves the ability to safely complete day-to-day tasks without guidance. Some examples are cooking, cleaning, and laundry. This also includes routine acts performed in the community such as shopping for groceries and accessing public transportation.

(4) School or work functioning - This refers to the ability to conform to the social standards at school or work. It includes the ability to learn new knowledge, skills, and abilities and apply this information in a practical, adaptive manner without excessive direction or guidance.

b. A significant limitation in intellectual functioning such as reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning by experience as indicated by a Full-Scale Intelligence Quotient (FSIQ), General Abilities Index (GAI), or equivalent that are at least two standard deviations below the mean (+/- the standard error of measurement) on a current, individually administered, norm-referenced measure of intelligence.

c. There is an adverse effect of the disability on the child's educational performance.

d. The impact on the child's educational performance requires the provision of specialized instruction and, if necessary, related services in one or more of the following areas:

(1) pre-academic/cognitive readiness;

(2) academic performance;

(3) classroom behavior;

(4) adaptive skills (e.g., daily living, functional communication, social skills, etc.); or

(5) vocational skills.

H. Multiple Disabilities

1. Definition

Multiple Disabilities means concomitant impairments (such as intellectual disabilities-blindness or intellectual disabilities-orthopedic impairment), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments. Multiple disabilities do not include deaf blindness.

2. Eligibility Criteria

a. There is evidence that the child meets all eligibility requirements for two or more of the following disability categories:

(1) autism;

(2) intellectual disability;

(3) traumatic brain injury;

(4) emotional disability;

(5) specific learning disability;

(6) orthopedic impairment;

(7) other health impairment;

(8) vision impairment (not to be combined with deaf/hard of hearing);

(9) deaf/hard of hearing (not to be combined with vision impairment);

(10) speech language impairment.

b. The adverse effects of the multiple disabilities on the child's educational performance cannot be accommodated in special education programs solely for one of the disabilities and require specialized instruction and if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction and, if necessary, related services. The simple presence of eligibility under two disability categories does not qualify a child under the category of Multiple Disabilities. There must be evidence to document that the interaction of the disabilities creates the need for distinctly different programming and instruction than either of the two categories alone.

I. Other Health Impairment

1. Definition

Other Health Impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems and adversely affects a student's educational performance.

This chronic or acute health problem may include, but is not limited to asthma, attention deficit hyperactivity disorder (inattentive/hyperactive/impulsive/combined type), diabetes, epilepsy, heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, Tourette syndrome, or anxiety and depression that does not rise to the level of an Emotional Disability. According to the Office of Special Education and Rehabilitative Services, Department of Education, "the list of acute or chronic health conditions in the definition of other health impaired is not exhaustive, but rather provides examples of problems that children have that could make them eligible for special education and related services under the category of other health impairment".

2. Eligibility Criteria

a. There is evidence that the child has a chronic or acute health problem (persistent or long lasting in its effects or worsens over time).

b. The diagnosed chronic or acute health problem results in at least one of the following:

(1) limited strength -the inability to perform typical or routine tasks at school;

(2) limited vitality - the inability to sustain effort or endure throughout an activity;

(3) limited alertness - The inability to manage and maintain attention, to organize or attend, to prioritize environmental stimuli, including a heightened alertness;

c. The chronic or acute health problem adversely affects a child's educational performance in one or more of the following areas:

(1) academic achievement;

(2) behavior;

(3) communication;

(4) social/emotional functioning;

(5) adaptive behavior;

(6) classroom performance;

(7) motor skills;

(8) vocational skills;

(9) executive functioning.

d. There is an adverse effect of the disability on the child's educational performance.

e. The impact of the disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction and, if necessary, related services.

J. Orthopedic Impairment

1. Definition

Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

2. Eligibility Criteria

a. A comprehensive written report from a licensed medical provider (i.e., licensed physician, physician's assistant, or licensed nurse practitioner) documenting a diagnosis of an orthopedic impairment:

(1) caused by a congenital anomaly (e.g., clubfoot, absence of a member, etc.);

(2) caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.); or

(3) resulting from conditions such as cerebral palsy, amputations, fractures, or burns that cause contractions, etc.

b. There is an adverse effect of the disability on the child's educational performance.

c. The impact of the disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction and, if necessary, related services.

K. Specific Learning Disabilities

1. Definition

Specific Learning disability means a disorder in one of more of the basic psychological processes involved in understanding or in using language, spoken, or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. Specific Learning Disability does not include learning problems that are primarily the result of: visual impairment, including blindness; hearing impairment, including deafness; orthopedic impairment; intellectual disability; serious emotional disability; cultural factors; environmental or economic disadvantage; or limited English proficiency.

2. Eligibility Criteria

a. There is evidence of significantly subaverage academic skills: The child does not achieve adequately for the child's age or to meet State-approved grade level standards in one or more of the following areas:

(1) basic reading skills;

(2) reading fluency;

(3) reading comprehension;

(4) math calculation;

(5) math problem-solving;

(6) written expression;

(7) oral expression;

(8) listening comprehension.

b. Learning experiences: The child has been provided with learning experiences and instruction appropriate for the child's age or State-approved grade level standards in the area(s) of concern.

c. Exclusionary factors: The underachievement must not be the primary result of:

(1) limited English proficiency;

(2) visual, hearing or motor disability;

(3) intellectual disabilities;

(4) emotional disabilities;

(5) cultural factors;

(6) environmental or economic disadvantage;

(7) atypical educational history such as irregular attendance or attendance at multiple schools;

(8) lack of appropriate evidence-based instruction in writing; spelling accuracy, grammar and punctuation accuracy, clarity, or organization of written expression;

(9) lack of appropriate evidence-based instruction in math; number sense, memorization of arithmetic facts, accurate or fluent calculation, accurate math reasoning; or

(10) lack of appropriate evidence-based instruction in reading; explicit and systematic instruction in the essential components of reading instruction, phonemic awareness, phonics, reading fluency, vocabulary and reading comprehension.

d. There is an adverse effect of the disability on the child's educational performance.

e. The impact of the disability requires specialized instruction and, if necessary, related services.

L. Speech-Language Impairment

1. Definition

Speech-Language Impairment means a communication disorder, such as stuttering, impaired articulation (speech sound), language impairment, or a voice impairment, that adversely affects a child's educational performance. A speech or language impairment includes demonstration of impairments in one or more of the following areas: speech sound, language, fluency, or voice as indicated in the following respective definitions.

Voice - Interruption in one or more processes of pitch, quality, intensity, resonance, or a disruption in vocal cord function that significantly reduces the child's ability to communicate effectively. The term voice impairment does not refer to:

a. differences that are the direct result of regional, dialectic, and/or cultural differences;

b. differences related to medical issues not directly related to the vocal mechanism (e.g., allergies, asthma, laryngitis, laryngopharyngeal reflux);

c. anxiety disorders (e.g., selective mutism); and

d. differences due to temporary factors such as short-term vocal abuse or puberty.

Speech sound - Atypical production of phonemes characterized by substitutions, omissions, additions, or distortions that impairs intelligibility in conversational speech and adversely affects academic achievement and/or functional performance in the educational setting. Intelligibility levels and/or speech patterns that are below the performance of typically developing peers and interfere with successful verbal communication. The atypical production of speech sounds may also result from phonology, motor, or other issues and/or disorders. The term phonological or articulation impairment does not include:

a. inconsistent or situational errors that do not have an impact on the child's ability to functionally communicate;

b. communication problems or speech sounds primarily from regional, dialectic, and/or cultural differences; and

c. speech sound errors at or above age level according to established research-based developmental norms, without documented evidence of adverse effects on educational or functional performance.

Language - Impaired comprehension and/or use of spoken language that adversely affects the child's ability to participate in the primary learning environment. The language impairment may involve an impairment in one or more of the following areas of language, in any combination to include the form of language (phonology, morphology, and syntax), the content of language (semantics) which affects the child's educational or functional performance. The term language impairment does not include:

a. anxiety disorders (e.g., selective mutism);

b. children who have regional, dialectic, and/or cultural differences (no dialectal variety of English is to be considered a disorder);

c. children who are learning English as a second language who do not exhibit difficulties in both languages;

d. children who have auditory processing disorders not accompanied by language impairment; and

e. children who have an isolated pragmatic language or phonemic awareness concern without an impairment of comprehension and/or spoken language.

Fluency - Interruption in the flow of speech characterized by an atypical rate, or rhythm in sounds, syllables, words, and phrases that significantly reduces the child's ability to participate within the learning environment with or without his or her awareness of the disfluencies or stuttering. Excessive tension, avoidance behaviors, struggling behaviors and secondary characteristics (ritualistic behaviors or movements) may accompany fluency impairments.

2. Eligibility Criteria

Voice

a. There is evidence that the child meets all of the following:

(1) An interruption in one or more processes of pitch, quality, intensity, resonance, or a disruption in vocal cord function that significantly reduces the student's ability to communicate effectively within the learning environment in addition to scores of 59 to 81 on the Pediatric Voice Index (Parent/Caregiver and/or Teacher version);

(2) There is an adverse effect of the disability on the child's educational performance requiring specially designed instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specially designed instruction, and if necessary, related services.

(3) The child has received medical clearance from a doctor prior to determination of the need for specially designed instruction to ensure the source of the voice impairment is not an organic problem for which therapy is contraindicated (e.g., paralyzed vocal cords).

Physician's orders for speech therapy may not be used as the sole criterion for determining eligibility. There must be evidence that the vocal impairment adversely affects the student's educational performance.

Speech sound

There is evidence that the child meets all of the following:

a. there is documentation of a delayed speech or speech sound production (at least two out of three must be met:

(1) three or more consonant speech sound errors when 90 percent of typically developing peers produce sound correctly according to current norms; and/or presence of one or more disordered (developmental and non-developmental) phonological processes occurring at least 40 percent of the time;

(2) stimulability less than 59 percent;

(3) percent of consonants correct less than 84 percent;

b. the speech sound impairment must have an adverse effect impacting the child's ability to perform and/or function in the child's typical learning environment, thereby demonstrating the need for specialized instruction and, if necessary, related services.

Language

a. There is documentation of impaired language development (at least three of the following must be met):

(1) composite standard score of two deviations or more below the mean on a global assessment of language with consideration for the cut score for that specific assessment, sensitivity and specificity at that cut score, and confidence intervals;

(2) two or more phonological awareness skills that do not meet age/grade appropriate norms;

(3) narrative abilities that are greater than one year or more below the chronological age;

(4) language sample(s) with three or more skills in the areas of morphology, syntax, relational semantics, and/or pragmatics that do not meet age-appropriate norms;

(5) dynamic assessment results that reveal a student is unable to complete any or only up to three steps of dynamic assessment for targeted skill(s), there is no, or limited improvement noted, and/or requires moderate to substantial support;

b. There is an adverse effect of the disability on the child's educational performance.

c. The impact of the disability requires specially designed instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specially designed instruction, and if necessary, related services.

Fluency

a. There is documentation of dysfluent speech (at least two of the following must be met):

(1) frequency of dysfluency that is six to ten percent vocal dysfluencies per speaking minute, ten to fifteen percent of syllables stuttered or six to ten dysfluencies per minute;

(2) the dysfluency is described as frequent to habitual repetitions, prolongations, blocks, hesitations, interjections vocal tension, pauses of two seconds or greater, or five or more reiterations in a repetition;

(3) presence of associated non-vocal behaviors that include at least one associated behavior that is noticeable and distracting;

(4) avoidance of some speaking situations;

b. There is evidence of an adverse effect of the disability on the child's educational performance.

(1) evidence of educational struggles in most or all areas when compared to peers;

(2) two observations revealing ability to verbally communicate is dissimilar to peers across half or more contexts, settings, environments, and/or circumstances;

(3) score of 45-100 on the Overall Assessment of the Speaker's Experience of Stuttering (OASES).

M. Traumatic Brain Injury

1. Definition

Traumatic Brain Injury (TBI) means an acquired injury to the brain resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a student's educational performance. The term applies to open or closed head injuries, deceleration injuries, chemical/toxic, hypoxia, tumors, infections, and stroke resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.

2. Eligibility Criteria

a. The child must have an acquired injury to the brain that occurred following a period of normal development. The acquired injury may not be due to congenital causes such as Down Syndrome, Phenylketonuria, or degenerative causes such as Multiple Sclerosis or Muscular Dystrophy or induced by birth trauma such as a perinatal stroke.

b. The child's brain injury was caused by an acquired brain injury in one of the following ways:

(1) Open head injury (also called penetrating) - This results when the scalp/skull is broken, fractured, or penetrated. This may occur when a foreign object (e.g., a bullet) goes through the skull, enters the brain, and damages specific parts of the brain. This focal, or localized, brain damage occurs along the route the object has traveled. Symptoms following an open TBI vary depending on the part(s) of the brain that is (are) damaged.

(2) Closed head injury - This results when an outside force impacts the head, but the skull is not broken, fractured, or penetrated. This may occur, for example, when the head strikes the windshield or dashboard in a car accident. Damage is typically widespread or diffuse. Symptoms following a closed TBI vary depending on the extent of the damage to the brain.

(3) Deceleration injuries (also known as diffuse axonal injury) - This typically happens when a rapidly moving skull is abruptly stopped (e.g., an auto accident, shaken baby syndrome), while the brain continues forward and impacts directly below the site where the skull stops.

(4) Chemical/Toxic (also known as metabolic disorders) - This happens when harmful chemicals damage the neurons. Chemicals and toxins can include insecticides, solvents, carbon monoxide poisoning, lead poisoning, etc.

(5) Hypoxia (also called lack of oxygen) - This happens if the blood flow is depleted of oxygen, which can cause irreversible brain injury from anoxia (no oxygen) or hypoxia (reduced oxygen). It may take only a few minutes for this to occur. This condition may be caused by heart attacks, respiratory failure, drops in blood pressure and a low oxygen environment. It may also be caused by a near drowning incident or strangling.

(6) Tumors - Tumors caused by cancer as well as benign tumors can grow on or over the brain. Tumors can cause brain injury by invading the spaces of the brain and causing direct damage. Damage can also result from pressure effects around an enlarged tumor. Surgical procedures to remove the tumor may also contribute to brain injury.

(7) Infections - The brain and surrounding membranes are very prone to infections if the special blood-brain protective system is breached. Viruses and bacteria can cause serious and life-threatening diseases of the brain such as encephalitis, meningitis, staph infections and post-covid syndrome.

(8) Stroke - If blood flow is blocked through a cerebral vascular accident (stroke), cell death in the area deprived of blood will result. If there is bleeding in or over the brain (hemorrhage or hematoma) because of a tear in an artery or vein, loss of blood flow and injury to the brain tissue by the blood will also result in brain damage.

c. The child's educational performance is adversely affected due to total or partial functional disability or psychosocial impairment, or both, in one or more of the following areas: (When examining the child's educational performance, consider both academic and nonacademic skills and progress.)

(1) cognition;

(2) memory;

(3) reasoning;

(4) communication;

(5) problem solving;

(6) speech and language;

(7) attention;

(8) abstract thinking;

(9) judgement/decision making;

(10) sensory, perceptual, and motor skills;

(11) information processing;

(12) physical functions (muscle movement, sleep, fatigue, weakness, balance, seizures, etc.);

(13) psychological or social functioning (emotional control and mood swings, appropriateness of behaviors, depression, anxiety, frustration, irritability, agitation, etc.);

(14) executive functions (organizing, planning, evaluating, and goal directed activities).

d. There is an adverse effect of the disability on the child's educational performance.

N. Visual Impairment

1. Definition

Visual impairment, including blindness, means impairment in vision that, even with correction, adversely affects a student's educational performance. The term includes both partial sight and blindness.

2. Eligibility Criteria

Visual Impairment includes at least one of the following:

a. visual acuity in the better or both eyes with the best possible correction;

(1) legal blindness - 20/200 or less at distance and/or near;

(2) low vision - visual acuity between 20/70 and the definition of legal blindness at distance and/or near; or

(3) medical and educational documentation of progressive loss of vision, which may in the future affect the child's ability to learn visually;

b. visual field restriction with both eyes; or

(1) legal blindness - remaining visual field of 20 degrees or less;

(2) low vision - remaining visual field of 40 degrees or less; or

(3) medical and educational documentation of progressive loss of vision, which may in the future affect the child's ability to learn visually;

c. other visual impairment, not visual processing in nature, resulting from a medically documented condition; or

d. cortical visual or cerebral visual impairment; and

e. there is an adverse effect of the disability on the child's educational and functional performance.

f. The impact of the disability requires specialized instruction and, if necessary, related services. For a child who is not yet in kindergarten, the adverse effects of the disability on the child's ability to participate in age-appropriate activities require specialized instruction and, if necessary, related services.

O. Reevaluation

Reevaluations for all categories of disability must be conducted at least once every three years and must be conducted more frequently if conditions warrant, if the parents or school personnel request such reevaluations, or if the student's dismissal from special education is being considered.

1. This reevaluation must be planned and conducted by an IEP team and other qualified professionals as appropriate.

2. The IEP team must review existing evaluation data on the student, including evaluations and information provided by his or her parents, current classroom-based assessments, and observations of teachers and related service providers.

3. On the basis of that review and input from the student's parents, the IEP team must identify what additional data, if any, are needed to determine the following:

a. whether the student continues to have a disability;

b. what the present levels of performance and the educational needs of the student are;

c. whether the student continues to need special education and related services; and

d. whether any additions or modifications to the special education and related services are needed to enable the student to meet the measurable annual goals set forth in his or her IEP and to participate, as appropriate, in the general curriculum.

4. Appropriate, qualified professionals must administer such tests and/or collect other evaluation information to produce the data identified by the IEP team.

5. If the IEP team and other qualified professionals, as appropriate, determine that no additional data are needed, the team must document the justification for this determination.

S.C. Code Regs. 43-243.1

Amended by State Register Volume 23, Issue No. 5, eff May 28, 1999; State Register Volume 25, Issue No. 4, eff April 27, 2001; State Register Volume 26, Issue No. 12, eff December 27, 2002; State Register Volume 31, Issue No. 8, eff August 24, 2007; State Register Volume 48, Issue No. 05, eff. 5/24/2024.