Disabilities Data Tracking Instrument (DDTI) Instructions
(05.02.05/01-2011)
Child's information is added when IEP/IFSP is received, or when parent signs the permission for evaluation/referral.
PART A - General Information
Child's Name: Joe Smith
Enrollment Date: 04/20/92
Departure Date: 10/03/92
DOB: Date of Birth12/10/04
Date of developmental screening: Date Denver was done (and re-done if needed) or N/A if the child has IEP/IFSP
Date of Parental Consent for Evaluation/Referral signed
All bi-weekly staffing dates and an "X" under "yes" or "no" for follow up needs.
Date of Referral and to whom (name of school district, CFC number, doctor's name, DSCC, etc.)
PART B - Diagnosis
D is Diagnosis and S is Services - under the H.S. categories.
Diagnosis Needed - Box with capital D, draw a diagonal line through it.
Services Needed - Box with capital S, draw a diagonal line through it.
Diagnosis Began - Box with capital D, draw a diagonal line through it, and shade the bottom half of box.
Services Began - Box with capital S, draw a diagonal line through it, and shade the bottom half of box.
Diagnosis Completed - Box with capital D, shade entire box.
Services Completed - Box with capital S, shade entire box.
PART C - Services
Date of the latest IEP/IFSP (the copy you have in your files)
An "X" under who provides the services (most of the time it will be "both")
An "X" under type of services the child is receiving, as per IEP or IFSP
- Physical Therapy (PT)
- Occupational Therapy (OT)
- Speech Therapy (ST)
- Psychological Services (PS)
- Developmental Therapy (DT)
- Service Coordinator (SC)
Use the "Comments" section to explain special circumstances, date of your mailings, request for copies, etc.
