A 5-item rating scale was developed for the New York City schools to determine eligibility for English as a Second Language instruction in Category C exceptional students exempted from testing. Most students follow a curriculum of daily living skills, and many are nonverbal. The test was piloted with 163 students including severely, trainable, and profoundly mentally handicapped and autistic children. Meaningful responses, whether verbal or nonverbal, indicated English proficiency. Both English-speaking and bilingual samples were included in order to test the Language Proficiency Questionnaires ability to discriminate between the two groups. Results indicated that in most cases the form discriminated well between the bilingual and English-only groups. This difference was less clear with nonverbal students because of the difficulty in assessing language proficiency. It was, therefore, recommended that the form be modified for autistic and severely and profoundly mentally handicapped populations; the two categories of "always" and "frequently" should be combined, since there is no way to define a qualitative difference. This pilot study suggested that the form was both reliable and valid. Different cutting scores were recommended for verbal and nonverbal students. The test and testing instructions are appended. (GDC)