Guidelines for Completion of
Special Education Documentation
Guidelines for Completion of the At-Risk Intervention
Documentation
Complete Demographic Information
•Parents should be notified of concerns previous to this form
being submitted to the LEA.
• Students with English as a second language need to be tested
for English proficiency. (Example of tests that may be used or information
on how to get it done)
Identify all the Areas of Concern within the subcategories
of: academic, communication, social/emotional, and sensory/motor.
Other information should give some indication as to whether
the areas of concern might be due to a disability or some other
factor that may be corrected without special educational services.
It is very important that this section is filled out with a view
to helping the student, regardless of meeting special education
referral criteria. Additionally later decisions (e.g., the definition
of a "learning disability") require this documentation.
• Other testing (standardized or other) which may or may not
show a deficiency in one or more of the areas of concerns should
be listed.
• Previously received special education services
• Student retention
• Health issues: vision, hearing or general. If the student
has not received vision or hearing screening within the last year,
arrange with the school nurse to have it done.
• Attendance record. If the student is frequently absent, what
is the reason? Can it be corrected?
At least two Interventions must have been attempted.
• A list of possible interventions is provided. The teacher
may try other interventions.
• A starting date and ending date (or ongoing) must be provided,
along with and indication of whether the intervention was effective
or not.
• Data must be documented and attached to the form.
After the form is completed it should be given to the LEA, after
reviewing the information on the form will decided the next appropriate
step to take as listed on the form. The LEA then signs and dates
the form.
Guidelines for Completion of the Referral for Evaluation for
Special Education Services
Complete the Demographic Information
• Person making referral must be included.
• If the person is a parent/guardian, the Parent Concerns
needed to be listed.
• If the person is a teacher, the At-Risk Documentation
must be attached.
The At-Risk documentation includes the form filled out by
the regular education teacher along with the back-up documentation
Parent Concerns. If the parent made the referral, their specific
concerns should be listed in the space provided.
The LEA will determine the Action Taken, whether the student
should be evaluated or not.
• This form must be signed and dated by the LEA. The date must
be before the date on the evaluation forms.
Guidelines for Completion of the Prior Notice and Consent for
Evaluation/Reevaluation
Complete the Demographic Information
All the areas that will be tested must be checked on this form.
The tests and purposes of each area are listed on the back of this
form. The areas included are:
• Intellectual/Cognitive
• Academic
• Communication
• Psychomotor
• Motor
• Adaptive
• Social/Behavioral
• Hearing
• Vision
• Vocational/Transition
The parent may or may not give permission for the evaluation of
their student. In either case, a signature and date is required.
A copy of the Procedural Safeguards is to be sent with this
form to the parents.
• This pamphlet is provided to the parents to make them aware
of the rights of their student with disabilities.
Guidelines for Distribution and Discussion of the Procedural
Safeguards
The Procedural Safeguards Parent Pamphlet (more
info) provides parents with a full explanation of their
rights and the rights of their student with a disability. These
rights are protected under law the Individuals with Disabilities
Education Act (IDEA) 97. The Procedural Safeguards are designed
to protect the rights of students as well as give families and schools
a procedure for resolving disputes. (Legal
Ref) (more
info)
Parents must know what the Procedural Safeguards are.
Schools, as a public agency, must be distributed a copy of the Procedural
Safeguards to parents of students with disabilities with the
following forms:
• Prior Notice and Consent for Evaluation/Reevaluation
• Notice of Meeting
• Re-Evaluation Data Review
Parents must be given an explanation of the Procedural Safeguards
and/or be told where to get assistance in understanding the safeguards.
During every IEP meeting the main points of the Procedural
Safeguards must be reviewed in detail.
The main points of the safeguards are: (print these main points)
• Parents may inspect and review all of their student's educational
records.
• Parents must be given the opportunity to participate in meetings
regarding identification, evaluation, or educational placement of
their student.
• Parents may obtain an independent educational evaluation
of their student.
• Parents must receive written prior notice on matters regarding
the identification, evaluation, or educational placement of their
student.
• Parents may give or refuse consent before their child is
initially evaluated or placed in a special education program for
the first time.
• Parents must notify the school/district in writing if they
intend to remove their student from public school and place him/her
in a private school at public expense.
• Parents may request a due process hearing to be conducted
by an impartial hearing officer.
• Parents must notify the school/district in writing if they
intend to request a due process hearing.
• Parents may appeal the initial hearing decision to the Utah
State Office of Education (USOE).
• Parents may bring civil action in an appropriate state or
federal court to appeal a final hearing decision.
• Parents may request reasonable attorney's fees (under certain
circumstances) from a court for actions or proceedings brought under
IDEA 97.
• Students will remain in his/her current educational placement,
unless the parents and school agree otherwise, while administrative
or judicial proceedings are in process.
• All evaluation information regarding the student will be
kept strictly confidential.
Guidelines for Completion of the Prior Notice for Identification
and Determination of Eligibility (all classifications except Specific
Learning Disability)
Complete the Demographic Information
Based on the evaluation results, the IEP Team makes a determination
if the student has a disability and is eligible to receive special
education services (Legal Ref)
(more
info)
• If the student does have a disability and is eligible, the
first box should be marked and one of the following classifications
(full descriptions of the classifications are in the State Regulations)
written on the line provided:
• Autism
• Communication disorder
• Deaf/blindness
• Developmental delay
• Emotional disturbance
• Hearing impairment/deafness
• Intellectual disability
• Multiple disabilities
• Orthopedic impairment
• Other health impairment
• Traumatic brain injury
• Visual impairment
• If the student does not have a disability and therefore is
not eligible to receive special education services, the second box
should be marked.
Be sure to check that parents have received and understand the Procedural
Safeguards.
All IEP Team participants sign this form.
• IEP Team participants include: Parent, Student (over age
14), School Principal (LEA), School Psychologist, Regular Education
teacher, Special Education teacher, Speech & Language Pathologist
(if applicable), Behavior Specialist (if applicable), Occupational
Therapist (if applicable), (other agency representatives, if applicable)
Guidelines for Completion of the Prior Notice for Identification
and Determination of Eligibility for Learning Disability
Complete the Demographic Information
Based on the evaluation results, the IEP Team makes a determination
if the student has a learning disability and is eligible to receive
special education services. (Legal Ref)
(more
info)
All Achievement Tests that were administered should be checked
and dated.
All Ability Tests that were administered should be checked
and dated.
The student must be observed within the regular classroom setting
and the behavioral observation form must be attached.
Using the information from the tests, the Area
of Severe discrepancy can be identified. The process for
determining a severe discrepancy requires:
• 1) administering an IQ test that is appropriate for the student
and choosing the score that best measures the intelligence of the
student
• 2) determining the achievement area where the student is
having the most difficulty based on grade, teacher reports, classroom
observations and criterion-referenced test data
• 3) Administering an achievement test appropriate for the
student, and choosing the score that is the best measure of achievement
in the achievement area where the student is having the most difficulty
• 4) Entering only these scores in the Utah severe discrepancy
formula and making the appropriate calculation. USEO supplies districts
with the Estimator: 7.0 version (copyright
1999) software for making the necessary calculations.
A severe discrepancy is demonstrated when one can be 93% confident
that a student's obtained achievement is substantially bower than
his/her expected achievement (as determined by the IQ score).
The discrepancy formula contained in the estimator program assumes
the user is comparing one aptitude (IQ) test score with one achievement
test score and that there is prior reason to believe the student
is having difficulty in the achievement area. The program does not
adjust for the increased probability of finding a severe discrepancy
by chance when multiple comparisons are made.
Areas where a discrepancy may be determined are:
• Oral Expression
• Written Expression
• Listening Comprehension
• Basic Reading Skills
• Reading Comprehension
• Math Calculations
• Math Reasoning
The following questions are found on the form and should be answered
yes or no.
• Is the student primarily identified as manifesting any
other disabling conditions described in the USOE Special Education
Rules? This question is to make sure that the student is correctly
classified. Many students may have the necessary discrepancy between
their ability and achievement to be classified as having a learning
disability, but may have an other disability that contributes to
their learning difficulties. For example, a student who had a brain
tumor removed during preschool years may show a severe discrepancy
between ability and achievement, but the classification would be
"Traumatic Brain Injury". Or perhaps another student after
3-4 years of schooling has the severe discrepancy, but the student's
behavior is the real cause of the lack of learning and so the student
should be evaluated for behavior and if necessary classified as
"Behavior Disorder".
• Does the severity of this deficiency warrant special education
placement?
Many students will have a discrepancy when evaluated. But whether
or not that discrepancy is severe is determined by the general
rule of using 93% confidence that the obtained achievement is substantially
below the expected achievement as defined by the Utah severe discrepancy
formula. Where confidence that a discrepancy is severe is less
than 93%, students should probablly not be placed. Of
course, this ultimately is an IEP team decision.
• Can this student's educational needs be addressed without
special education services? There are other educational alternatives
that would be just as or more effective than special education placement.
These alternatives should be considered before placement in special
education. Some examples of alternative services might be special
counseling, Chapter One reading program or other at-risk programs.
• Are there educationally relevant medical findings?
For some students the learning disability is compounded by physiological
issues such as ADD or ADHD, which must be address and treated in
order for special education services to be effective.
• The relevant behavior noted during the observation of
the student and the relationship of that behavior to the student's
academic functioning. This may be important because it could
bring to the observer's attention other issues that may be involved
such as behavioral or physiological issues.
Based on the evaluation results, the team makes a determination
if the student has a learning disability and is eligible to receive
special education services under that classification.
• If the student does have a learning disability and is eligible,
the first box should be marked.
• If the student does not have a learning disability and therefore
is not eligible, the second box is marked.
Be sure to check that parents have received and understand the Procedural
Safeguards.
All Team participants sign this form.
• Team participants include: Parent, Student (over age 14),
School Principal (LEA), School Psychologist, Regular Education teacher,
Special Education teacher, Speech & Language Pathologist (if
applicable), Behavior Specialist (if applicable), (other agency
representatives, if applicable)
Guidelines for Completion of the Notice of Meeting
Fill in the student's name and the date of the notice.
Check the box next to the purpose of meeting. More than one box
may be appropriate.
Fill in the date, time and place of meeting. Try to contact all
team members to insure their availability to attend the meeting
on a particular date and time before sending out the notice of the
meeting.
Fill in the list of participants invited to attend. The people in
attendance will be the IEP team.
Be sure to list your name and phone number at the bottom so that
you may be contacted if the parent needs to cancel the appointment.
A copy of the Procedural Safeguards is to be sent with this
form to the parents.
• This pamphlet is provided to the parents to make them aware
of the rights of their student with disabilities.
Guidelines for Completion of the Individualized Education Program
(IEP) (5a)
(Legal Ref)
Complete the Demographic Information
Services needed to achieve annual goals and advance in general
curriculum
(Fed Reg) (Legal
Ref)
• Special education services include any time that the
special educator spends providing specialized instruction for the
student.
• Related services are services that help student benefit
from instruction, ie. speech & language services, occupational
therapy etc. (Legal Ref)
• If the student needs special transportation due to behavior
or physical issues, this box needs to be checked and the appropriate
arrangements made for the transportation.
• Program modifications, supports, or supplementary aids
and services in regular education programs are extra aids that
the student receives in order to progress in the regular education
curriculum. For example, teacher training programs for regular education
teachers on how to support the student. Or aide time within the
regular classroom to provide support for regular curriculum. (Legal
Ref)
• Projected date of initiation the day the special education
services will start.
(Fed Reg)
• Anticipated duration of the services the date that
the special education services will finish. The duration for most
IEPs is one year from the date of initiation.
(Fed Reg)
Regular Curriculum, Extra-curricular and Non-academic Activities
is to address any other areas (ie. PE, library or computer lab)
where the student may not be able to participate or where special
support may be necessary. (Fed Reg)
It will be determined at the time of the IEP meeting whether or
not the student will participate in the State and District Assessments
(more info). (Fed
Reg) Make sure that you understand your district's policy regarding
the kinds of accommodations that are allowed.
• CORE Testing. If the student is to participate
in CORE testing, will there be any accommodations or modifications
made to the testing protocol to best demonstrate the student's true
knowledge and understanding of the material? For example, a student
who has been instructed in 5th grade science and has a good understanding
of the material but reads at the 3rd grade level will be placed
at an unfair disadvantage if he is required to read the material
himself. In this situation, an appropriate accommodation would be
to have the test read to the student. But the accommodation must
be mentioned in the IEP. Also, if the student has been instructed
in 1st grade reading and language, but is a 3rd grader, it is unfair
for the student to be tested on material that he/she has not been
taught. So the student may be tested at his/her ability level, or
the level at which he/she was instructed. Again, the accommodation
must be specified in the IEP.
(more
info)
• SAT Testing. Remember that SAT testing does not
allow any changes in testing protocol (i.e., the test may not
be read to the student). (more
info)
• Other district-wide assessments. The Federal Regulations
and State Rules apply to all district-wide assessments. Assessments
that apply to nondisabled students also apply to students receiving
special education services. (more info)
Special Factors includes other special considerations that
may need to be addressed in order for the student to receive full
educational value from special educational services. Review each
one, checking whether or not it is applicable to the student's situation.
Placement Review will be checked on all IEP with the exception
of the initial IEP. Maintaining current placement means that the
student will remain in or continue the placement in which the student
was the previous year. Placement options for a student include:
• regular class (the student remains in his/her regular education
classroom with or without resource pullout)
• special class (the student is in an all day special education
classroom)
• special school (the student is in a facility separate from
the regular school)
• home instruction (a parent decides to home school the student)
• hospital/institution (the student is institutionalized because
the student's behavior may pose danger to self or others)
• graduation (the student completes school graduation requirements
and leaves the school system)
• student is not eligible for special education services (the
student can now function successfully within the regular classroom
setting without further special educational services)
Parent Prior Notice for Free Appropriate Public Education
should be discussed with the parent as a reminder to parent of the
right their student has to have a Free Appropriate Public Education
(FAPE) as outlined in the Procedural Safeguards.
All major points of the Safeguards should be discussed and any questions
answered.
IEP Team Participants. IEP Team participants sign and date
this form. The IEP Team participants include: Parent, Student (over
age 14), School Principal (LEA), Regular Education teacher, Special
Education teacher, School Psychologist, Speech & Language Pathologist
(if applicable), Behavior Specialist (if applicable), (other agency
representatives, if applicable).
Present Levels of Performance includes the student's current
grade level and classification. The statement should include the
student's current levels of academic and behavioral performance
for areas affected by disability as well as areas not affected by
disability and be written in objective measurable terms that are
understandable to the parent with all sources of data included.
Parent concerns for enhancing the education of their child need
to be addressed. (Fed Reg)
Measurable Annual Goal is written for each area of need.
The student should be able to accomplish the goal before the IEP
ending date and the goal should reflect anticipated growth within
the instructional categories. The goals should be clear and understandable
(ie. not overly vague, doesn't contain jargon, not too specific)
and stated positively. The goals must be justified on the basis
of information contained in the PLEP statements and are relevant
to the student's academic, social and vocational needs. (Fed
Reg)
Report of progress on Annual Goal provides a schedule to
ensure that the student's progress is reported to the parent as
often as a regular student's is. How the parents will be informed
must be checked. Also, methods used to measure student's progress
must be identified. (Fed Reg)
Short Term Objectives/Benchmarks are written for each annual
goal and lead to the mastery of goal skills at a functional level.
The individual needs of your student should be reflected in the
objective. An example of a format for goals and short term objectives
is as follows:
• Given (description of measure or assessment situation and/or
level of assistance and/or learning setting), (name of student)
will (observable behavior) with (performance level) on each of (number)
(daily, weekly, biweekly, monthly etc) (teacher checklist, observation,
test, worksheet, exercise etc.). (Info taken from Benjamin Lignugaris/Kraft
class presentation)
Guidelines for Completion of the Individualized Education Program
(IEP) (5b)
(Legal Ref)
Form 5b is an alternative to form 5a. Form 5b requires
multiple statements of "Present Levels of Performance".
Complete the Demographic Information
Services needed to achieve annual goals and advance in general
curriculum
(Fed Reg) (Legal
Ref)
• Special education services include any time that the
special educator spends providing specialized instruction for the
student.
• Related services are services that help student benefit
from instruction, ie. speech & language services, occupational
therapy etc. (Legal Ref)
• If the student needs special transportation due to behavior
or physical issues, this box needs to be checked and the appropriate
arrangements made for the transportation.
• Program modifications, supports, or supplementary aids
and services in regular education programs are extra aids that
the student receives in order to progress in the regular education
curriculum. For example, teacher training programs for regular education
teachers on how to support the student. Or paraeducator time within
the regular classroom to provide support for regular curriculum.
(Legal Ref)
• Projected date of initiation the day the special education
services will start. (Fed Reg)
• Anticipated duration of the services the date that
the special education services will finish. The duration for most
IEPs is one year from the date of initiation. (Fed
Reg)
Regular Curriculum, Extra-curricular and Non-academic Activities
is to address any other areas (ie. PE, library or computer lab)
where the student may not be able to participate or where special
support may be necessary. (Fed Reg)
It will be determined at the time of the IEP meeting whether or
not the student will participate in the State and District Assessment.
(Fed Reg) Make sure that you
understand your district's policy regarding the kinds of accommodations
that are allowed.
• CORE Testing. If the student is to participate
in CORE testing, will there be any accommodations or modifications
made to the testing protocol to best demonstrate the student's true
knowledge and understanding of the material? For example, a student
who has been instructed in 5th grade science and has a good understanding
of the material but reads at the 3rd grade level will be placed
at an unfair disadvantage if he is required to read the material
himself. In this situation, an appropriate accommodation would be
to have the test read to the student. But the accommodation must
be mentioned in the IEP. Also, if the student has been instructed
in 1st grade reading and language, but is a 3rd grader, it is unfair
for the student to be tested on material that he/she has not been
taught. So the student may be tested at his/her ability level, or
the level at which he/she was instructed. Again, the accommodation
must be specified in the IEP.
(more
info)
• SAT Testing. Remember that SAT testing does not allow
any changes in testing protocol (i.e., the test may not be read
to the student). (more
info)
• Other district-wide assessments. Assessments that
apply to nondisabled students also apply to students receiving special
education services. (more info)
Special Factors includes other special considerations that
may need to be addressed in order for the student to receive full
educational value from special educational services. Review each
one, checking whether or not it is applicable to the student's situation.
Placement Review will be checked on all IEP with the exception
of the initial IEP. Maintaining current placement means that the
student will remain in or continue the placement in which the student
was the previous year. Placement options for a student include:
• regular class (the student remains in his/her regular education
classroom with or without resource pullout)
• special class (the student is in an all day special education
classroom)
• special school (the student is in a facility separate from
the regular school)
• home instruction (a parent decides to home school the student)
• hospital/institution (the student is institutionalized because
the student's behavior may pose danger to self or others)
• graduation (the student completes school graduation requirements
and leaves the school system)
• student is not eligible for special education services (the
student can now function successfully within the regular classroom
setting without further special educational services)
Parent Prior Notice for Free Appropriate Public Education
should be discussed with the parent as a reminder to parent of the
right their student has to have a Free Appropriate Public Education
(FAPE) as outlined in the Procedural Safeguards. All major
points of the Safeguards should be discussed and any questions answered.
IEP Team Participants. IEP Team participants sign and date
this form. The IEP Team participants include: Parent, Student (over
age 14), School Principal (LEA), Regular Education teacher, Special
Education teacher, School Psychologist, Speech & Language Pathologist
(if applicable), Behavior Specialist (if applicable), (other agency
representatives, if applicable).
Present Levels of Performance includes the student's current
levels of academic and behavioral performance for a specific area
affected by disability (ie. reading, math etc.) and be should written
in objective measurable terms that are understandable to the parent
with all sources of data included. Parent concerns for enhancing
the education of their child need to be addressed.
(Fed Reg)
Measurable Annual Goal is written for the area effected by
the disability. The goals should reflect anticipated growth within
the categories of instructional areas and the student should be
able to accomplish the goal before the IEP ending date. The goals
should be clear and understandable (ie. not overly vague, doesn't
contain jargon, not too specific) and stated positively. The goals
must justified on the basis of information contained in the PLEP
statements and are relevant to the student's academic, social and
vocational needs. (Fed Reg)
Report of progress on Annual Goal provides a schedule to
ensure that the student's progress is reported to the parent as
often as a regular student's is. How the parents will be informed
must be checked. Also, methods used to measure student's progress
must be identified. (Fed Reg)
Short Term Objectives/Benchmarks are written for the annual
goal and lead to the mastery of goal skills at a functional level.
The individual needs of your student should be reflected in the
objective. An example of a format for goals and short term objectives
is as follows:
• Given (description of measure or assessment situation and/or
level of assistance and/or learning setting), (name of student)
will (observable behavior) with (performance level) on each of (number)
(daily, weekly, biweekly, monthly etc) (teacher checklist, observation,
test, worksheet, exercise etc.). (Info taken from Benjamin Lignugaris/Kraft
class presentation)
Guidelines for Completion of the Transition Plan
Transition services must be addressed for every
student 14 years of age and older on his/her IEP. (Fed
Reg) (more info)
Fill in the Student Name and date of IEP meeting
Step 1. Based on the student's needs, preferences and interests,
check the post school activities that apply. During the IEP
meeting, the student's interests need to be identified and possible
occupations determined. Then identify the setting in which the student
may practice and learn skills for the preferred occupations.
Step 2. Complete the IEP to address the post school activities
identified above. Determine the skills the student needs to
master for his preferred occupation. Write Measurable Annual Goals
for the mastery of those skills.
Step 3. Having completed the IEP, indicate the student's coursework/
instruction that is specifically designed to address the post school
activities identified above. Identify classes the student will
need to take that will teach skills for the preferred occupations.
Step 4. For students 16 and over, check the needed transition
services.
• Community. Identify skills that will allow the student
to function more independently in the residential/community environment
and will promote integration with non-disabled peers. Then write
an IEP goal for any deficient skills.
• Employment. Identify skills that will enable the student
to function in his/her preferred vocational environment. When possible,
develop and reinforce skills in the natural vocational environment.
Then write an IEP goal for any deficient skills.
• Adult Living Objectives. Identify skills that
will promote independent living skills. Then write an IEP goals
for any deficient skills.
• Daily Living Skills. Identify skills that will enhance
the student's ability to make choices and will improve student's
quality of life. Then write an IEP goal for any deficient skills.
• Functional Vocational Evaluation. The student is to
be given a comprehensive evaluation that will identify the student's
abilities and interests in general and specific work settings. These
types of evaluations are available through high school counselors,
university job placement offices and employment agencies.
Step 5. For students 16 years, identify the interagency linkages/
responsibilities for the student. List the agencies that need
to be involved with the transition of this student into vocational
training and independent living. These agencies should be contacted
and participate in the student's transition planning.
Step 6. On or before the student's 17t birthday, inform the student
of transfer of rights at age 18 and attach the Age of Majority form.
Read the form to the student and his/her parents and answer any
questions regarding it. Then have student parent and school representative
sign it.
Guidelines for Completion of the Prior Notice and Consent for
Initial Placement in Special Education
Complete the Demographic Information
Check the proposed placement for the student within special education.
Placement options for a student include:
• regular class (the student remains in his/her regular education
classroom with or without resource pullout)
• special class (the student is in an all day special education
classroom)
• special school (the student is in a facility separate from
the regular school)
• home instruction (a parent decides to home school the student)
• hospital/institution (the student is institutionalized because
the student's behavior may pose danger to self or others)
Check the reason(s) placement option was chosen.
• Curriculum modifications would include using materials that
are at the ability level of the student. For example, a 3rd grade
student using 2nd grade reading materials.
• Instructional modifications would include using small group
or individualized instruction methods to make it more effective
for the student.
• Behavioral interventions would include the development of
behavioral plans to be used to teach and develop appropriate behaviors
to the student.
• Other modifications, if any need to also be identified.
Be sure to check that parents have received and understand the Procedural
Safeguards.
The parents sign and date this form to give or not give their consent
to the placement of their student into special education.
Guidelines for Completion of the Prior Notice of Change of Placement
in Special Education
Complete the Demographic Information
If the placement of the student is no longer appropriate, then it
should be changed to a more appropriate placement. Placement options
for a student include:
• regular class (the student remains in his/her regular education
classroom with or without resource pullout)
• special class (the student is in an all day special education
classroom)
• special school (the student is in a facility separate from
the regular school)
• home instruction (a parent decides to home school the student)
• hospital/institution (the student is institutionalized because
the student's behavior may pose danger to self or others)
• graduation (the student completes school graduation requirements
and leaves the school system)
• student is not eligible for special education services (the
student can now function successfully within the regular classroom
setting without further special educational services)
Check the reason(s) placement option was chosen.
• Curriculum modifications would include using materials that
are at the ability level of the student. For example, a 3rd grade
student using 2nd grade reading materials.
• Instructional modifications would include using small group
or individualized instruction methods to make it more effective
for the student.
• Behavioral interventions would include the development of
behavioral plans to be used to teach and develop appropriate behaviors
to the student.
• Other modifications, if any need to also be identified.
Be sure to check that parents have received and understand the Procedural
Safeguards.
Guidelines for Completion of the Re-Evaluation Data Review
Complete the Demographic Information
Data Reviewed. The student's levels of performance using
curriculum-based assessments and classroom observations needs to
be reviewed to determine if re-evaluation testing will provide information
needed to maintain placement within special education. For example,
if a 5th grade LD student being serviced for reading only is reading
and comprehending on 5th grade level, it can be assumed that the
student is probably not eligible for special education any more.
Using the above information, the need of further assessment is then
determined.
• The existing data may be sufficient to determine the continued
need for special education services. For example, if the data shows
that the student's performance in math is considerably below grade
level, it might not be necessary to test the student again to determine
eligibility.
• If the existing data is not sufficient, then further evaluation
needs to be done and the areas of assessment need to be identified.
For example, if a LD student is decoding close to grade level, but
has some difficulty with comprehension, it would be hard to determine
whether or not the student is still eligible for special education
without further evaluation.
Parents may request further evaluation, even if existing data is
sufficient for continued special education services. In this case,
areas of assessment need to be identified.
A copy of the Procedural Safeguards is to be sent with this
form to the parents.
• This pamphlet is provided to the parents to make them aware
of the rights of their student with disabilities.
All IEP Team participants sign this form.
• IEP Team participants include: Parent, Student (over age
14), School Principal (LEA), School Psychologist, Regular Education
teacher, Special Education teacher, Speech & Language Pathologist
(if applicable), Behavior Specialist (if applicable), (other agency
representatives, if applicable)
Guidelines for Completion of the Note to Parents and Students
Regarding Age of Majority Rights (Fed
Reg)
Meet with the student and his/her parents on or before
the student's 17th birthday and read to them this form containing
the rights of the student.
Then the student, parent and school representative sign and date
the form.
Guidelines for Completion of the Private School Services Plan
(SP)
When the public school programs cannot fulfill
the needs of a student, the parents may request and receive tuition
for the placement of their student in a private school.
(Legal Ref)
Complete the Demographic Information
Services (Fed Reg) (Legal
Ref)
• Special education services include any time that the
special educator spends providing specialized instruction for the
student.
• Related services are services that help student benefit
from instruction, ie. speech & language services, occupational
therapy, etc. (Legal Ref)
• Supplementary aids and services are extra aids that
the student receives in order to progress in the private educational
curriculum. For example, teacher training programs for teachers
on how to support the student. Or aide time within the regular classroom
to provide support for the student so that he/she will succeed in
regular curriculum. (Legal Ref)
• Projected date of initiation the day the special education
services will start.
(Fed Reg)
• Anticipated duration of the services the date that
the special education services will finish. The duration for most
SPs is one year from the date of initiation.
(Fed Reg)
Parent Prior Notice for Free Appropriate Public Education
should be discussed with the parent as a reminder to parent of the
right of their student to have a Free Appropriate Public Education
(FAPE) within the district schools.
SP Team Participants. SP Team participants include: Parent,
Student (over age 14), School Principal (LEA), Regular Education
teacher, Special Education teacher, School Psychologist, Speech
& Language Pathologist (if applicable), Behavior Specialist
(if applicable), (other agency representatives, if applicable).
Parent Prior Notice for Free Appropriate Public Education
should be discussed with the parent as a reminder to parent of the
right their student has to have a Free Appropriate Public Education
(FAPE) as outlined in the Procedural Safeguards.
IEP Team Participants. IEP Team participants sign and date
this form. The IEP Team participants include: Parent, Student (over
age 14), School Principal (LEA), Regular Education teacher, Special
Education teacher, School Psychologist, Speech & Language Pathologist
(if applicable), Behavior Specialist (if applicable), (other agency
representatives, if applicable).
Present Levels of Performance includes the student's current
levels of academic and behavioral performance for a specific area
affected by disability (ie. reading, math etc.) and be should written
in objective measurable terms that are understandable to the parent
with all sources of data included. Parent concerns for enhancing
the education of their child need to be addressed. (Fed
Reg)
Measurable Annual Goal is written for the area effected by
the disability. The goals should reflect anticipated growth within
the categories of instructional areas and the student should be
able to accomplish the goal before the IEP ending date. The goals
should be clear and understandable (ie. not overly vague, doesn't
contain jargon, not too specific) and stated positively. The goals
must justified on the basis of information contained in the PLEP
statements and are relevant to the student's academic, social and
vocational needs. (Fed Reg)
Report of progress on Annual Goal provides a schedule to
ensure that the student's progress is reported to the parent as
often as a regular student's is. How the parents will be informed
must be checked. Also, methods used to measure student's progress
must be identified. (Fed Reg)
Short Term Objectives/Benchmarks are written for the annual
goal and lead to the mastery of goal skills at a functional level.
The individual needs of your student should be reflected in the
objective. An example of a format for goals and short term objectives
is as follows:
• Given (description of measure or assessment situation and/or
level of assistance and/or learning setting), (name of student)
will (observable behavior) with (performance level) on each of (number)
(daily, weekly, biweekly, monthly etc) (teacher checklist, observation,
test, worksheet, exercise etc.). (Info taken from Benjamin Lignugaris/Kraft
class presentation)
Guidelines for Completion of the Parent Contact log
Date
Who was contacted, mother, father or guardian
Identify the purpose of contact. For example, to set up IEP meeting
(write down date and time) or discuss student's absences.
Summarize content of the conversation. Be specific about important
facts.
