INSTRUCTIONS FOR COMPLETING IEP FORM

Shared by: sgdy7777

Tags

special education, iep team, general education, related services, special education services, school year, school district, transition services, alternate assessment, iep goals and objectives, iep goals, education forms, iep meetings, education curriculum, esy services

Stats

views:: 6
posted:: 12/15/2009
language:: English
pages:: 8

Public Domain

Document Sample

INSTRUCTIONS FOR COMPLETING IEP FORM

Student's Legal Name The student's full name.

Student’s State ID # The student's State ID number.

School District The name of the Alaska School District.

Site The school or other setting in which the student receives services.

Grade The student's grade in school (e.g., first, fifth). Do not use
“special education."

Primary Language The language normally used by the student in the home/learning
environment. For individuals with deafness/blindness/no written
language, it is the mode of communication normally used, e.g.,
sign language, Braille, or oral communication.

Age The age of the student.

Birth Date The month, day and year the student was born.

Gender Indicate whether the student is female or male.

IEP Type Indicate whether it is an initial IEP, interim, or an annual review.
The initial IEP is the first IEP a student receives when he or she
entered special education. Choose only one.

IEP Meeting Date The date the IEP meeting is held. date the IEP meeting is held
The

Eligibility Category The disability area (e.g., Learning Disabled, Emotional Disorder,
Deaf) through which the student was certified for special
education and related services. List only one primary category.

IEP Expiration Date The date of the next planned IEP meeting cannot be more than one
year from the date of the present IEP meeting.

Eligibility Report Date Date of most recent eligibility report.

Transfer of Rights Letter Check box if Transfer of Rights letter has been sent to the student
and his/her parents.

I. - IEP Participants Signatures only indicate the persons present; they do not indicate
Present approval of the IEP. Signatures should be obtained before the IEP
meeting begins. Only participants that attended (in person or
telephonically) sign the IEP.

September 2007 EED Format – Instructions for Completing IEP Form
Page 1 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

II. - Student's Strengths Describe/list the areas in which the student shows his/her strengths
(e.g., academic, behavioral, sports). This is a great place to elicit
parent input.

III. - Student and Parent List information provided by the student and parents regarding
Comments, Needs, concerns and priorities, as well as other relevant information.
or Concerns

IV. - Other Agency Relevant or important comments, concerns, or additional
Comments information that does not logically fit in other sections.

V. - Present Levels of Concise written descriptions of the affect of the student's disability
Academic Achieve- on the student's performance in any area of education that is
ment and Functional affected. The following guidelines should be followed in
Performance developing the present levels of academic achievement and
functional performance:
 A narrative description of the student’s current functioning.
 Statements should be written in easy to understand language
that is free of educational jargon.
 Information must be current.
 Statements should reflect the results of the assessment data.
Test scores should be accompanied by statements that relate
scores to the student's level of functioning.
 There should be a direct relation between the present levels of
academic achievement and functional performance and the
other components of the IEP. If the statement describes a
problem with a child's reading, this problem should be
addressed under both the goals and objectives or benchmarks
and the specific special education and related services to be
provided.
 Transition must be addressed beginning at age 16, but can be
addressed earlier.
Note:
* Labels such as mental retardation or deafness may not be
used as a substitute for describing functioning levels.
* An explanation is required when presenting standard scores
as a result of an assessment.

VI. - Post-School Goals Identify for each area the student's desired goals based on age
for Students Age appropriate transition assessments. This information should then
16-21 / Secondary be used to help create IEP goals and objectives that support
Transition Domains attaining these goals. Describe the student's current progress or
functioning for each of the secondary transition domains listed, as
well as how the information was obtained.

September 2007 EED Format – Instructions for Completing IEP Form
Page 2 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

VII. - Statement of For students age 16-21, or younger if appropriate, provide a
Transition Service statement of the student's transition service needs that focuses on
Needs for Students the student's course of study (required, elective, modified, or
Age 16-21 specially-designed courses) and activities needed to assist the
student (e.g. on the job training, career fair, mentoring, etc.) in
reaching his/her post-secondary goals.

VIII. - Statement of For students age 16-21, or younger if appropriate, list the student's
Needed Transition needed services in the areas of:
Services for Ages
16-21  Instruction
Course of study and/or other training needed to prepare student
to achieve postsecondary goals.
 Related Services
Support services required in order to assist a child with a
disability to benefit from special education.
 Community Experiences
Skills, training, and practices necessary to assist student in
societal adaptation.
 Job Training / Employment
Training/assistance needed to aid student in seeking and
securing employment and/or a vocational skill.
 Adult Living and Post-school Activities
Postsecondary education, vocational training/education,
integrated employment, supported employment, continuing and
adult education services, independent living and community
participation.
 Daily Living Skills (when appropriate)
Skills for self-care, social skills, domestic maintenance,
employment, vocation and recreation.
 Functional Vocational Assessment
Services, assessment required to assist student in determination
of appropriate vocational possibilities.

There should be a direct relationship between the statement of
needed transition services, the present level of academic
achievement and functional performance, and the IEP goals and
objectives or benchmarks.

Transition Needs & Agency(s) & Contact / Date Provider &
Services Activities Responsibilities Payer

Name of Service What is needed and What agency will Who will be Who is the
what is planned to be providing the contacting the provider of this
provide this service service and what agency and date service and who
agencies are of contact is responsible
responsible for payment of
service

September 2007 EED Format – Instructions for Completing IEP Form
Page 3 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

(continued)
VIII. - Statement of Also, provide documentation of the student's preferences/interests
Needed Transition if the student did not attend the IEP meeting. Document the
Services for Ages participation of other agency personnel if they did not attend the
16-21 IEP meeting.

IX. - Special Factors Indicate whether the IEP team found the following to be
concerns/needs of the student:
 Behavioral interventions
 Limited English proficiency
 Instruction in Braille and the use of Braille
 Communication needs for Deaf and Hard of Hearing
 Assistive Technology needs
Indicate that the IEP team reviewed each of the special
considerations and determined whether it was a concern to be
addressed in the IEP.

X. - Progress / Progress Progress to be measured in percentages or ratios. Example: 80%
Reports accuracy or 4-5 tries or 8-10 days. Person responsible should
initial with date and notations.

Part XI of the IEP may be used as a progress report. If the student
is not making sufficient progress, the IEP Team must revise the
student's IEP. Reports must be provided at least as often as
progress reports are given to parents of students without
disabilities. Indicate whether the reports will be provided
quarterly, at the trimester, or other time schedule.

XI. - Measurable Goals should focus on addressing the specialized instructions and
Academic and related service needs resulting from the child's disability. They
Functional Annual should address the needs summarized in the child's present level of
Goal(s) academic achievement and functional performance, including
secondary transition needs, if appropriate. The goals are written
statements that describe what a child is expected to learn from
his/her educational program within the IEP time period, usually
one year. The following guidelines should be followed when
developing goals:
 Goals should be written in measurable terms.

 Goals should be general statements yet focus on different skill
areas.

September 2007 EED Format – Instructions for Completing IEP Form
Page 4 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

(continued)
XI. - Measurable  Goals should be designed to correct the weaknesses indicated
Academic and in the present level of academic achievement and functional
Functional Annual performance.
Goal
 Goals should reflect reasonable expectations for student
accomplishments.
The language of the goals should be easily understood by all
members of the IEP committee.
Copy Part XI as necessary for additional goals. Refer to the
Secondary Transition Sample IEP in Appendix G for assistance in
completing this part of the IEP.

 Standard Addressed IEP goals should be based on the Alaska State Performance
Standards / Grade Level Expectations (GLE). Indicate which
standard the specific goal relates to on the IEP.

 Short-Term Instruc- Short-term objectives or benchmarks are derived from the annual
tional Objectives or goals but represent smaller, more manageable learning tasks a
Benchmarks student must master on the way to achieving the annual goals. At
least two objectives or benchmarks should be written for each
annual goal. Objectives or benchmarks must be measurable and
must include the following three components:
 Objective criteria that enable progress to be monitored and
allow for determination of when the objective or benchmark
has been accomplished.

 Evaluation procedures to be used. For example, teacher
observation, written performance, oral performance, criterion
referenced test, parent report, observation, time sample,
teacher-made tests.

 Review Dates to determine how often the objective or
benchmark will be measured. For example, one to two weeks,
one month, six weeks, nine weeks, each semester, annually.

XII. - State & District- Students will participate in state and district-wide assessments,
Wide Assessments with or without accommodations. Indicate how the student will
participate:

 Without accommodations;
 With accommodations;
 Alternative Assessments - Modified HSGQE or
Nonstandardized HSGQE (diploma track; requires application
and Department approval);

September 2007 EED Format – Instructions for Completing IEP Form
Page 5 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

(continued)
XII. - State & District-  Alternate Assessment (non-diploma track; requires parental
Wide Assessments acknowledgement, and a statement of why regular assessment
is not appropriate and why the Alternate Assessment is
appropriate).

Note: Consult the Participation Guidelines.

XIII. - Program Describe the program modifications/accommodations to enable the
Modifications / child to:
Accommodations
 Advance appropriately toward meeting his/her annual goals.
 Be involved in the general education curriculum (include
modifications/accommodations for students participating in
state and district-wide assessments).
 Participate with other children (those with disabilities and
those without) in extracurricular and other activities.

Note: Address all areas.

 Supports for School List the supports and/or training required for school personnel to
Personnel enable the child to:
 Advance appropriately toward meeting his/her annual goals.

 Be involved in the general education curriculum.

 Participate with other children (those with disabilities and those
without) in extracurricular and other nonacademic activities.

Note: Address all areas.

 Extended School Year Indicate if extended school year services are anticipated for the
student. The information used to support this need should be
noted. If the need for ESY services has not been determined,
indicate the date the IEP team will meet to consider the need.

XIV. - Special Education Refer to the following subsections for this part of the IEP form.
and Related
Services

 Number of Hours in Note the total number of hours in the student’s school day
Student’s School Day (including lunch, recess and study periods).

September 2007 EED Format – Instructions for Completing IEP Form
Page 6 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

 Special Education Identify the areas for which special education services will be
provided. If any services will be provided by special education
providers who are not certified, then supervision by a certified
special education provider must be listed. Insert rows as necessary
for additional services not listed.
Note: Do not count supervision or transportation in the total
number of hours of special education and related service time
received by the student.

 Related Services List the areas for which related services will be provided. If any
services will be provided by individuals other than a certified
related service provider, then supervision by a certified related
services provider must be listed. Insert rows as necessary for
additional services not listed.
Note: Do not count supervision or transportation in the total
number of hours of special education and related service time
received by the student.

 Supervision Supervision must be noted for both Special Education and/or
Related Services when those services are not provided by a
certified/licensed provider. Supervision must be on-site at least
once a month, unless the IEP Team determines otherwise.

 Location The location where the services will be delivered (e.g., the
student's regular classroom, resource room).

 Projected Start Date The date the service will begin.

 Projected End Date The date the anticipated service will end. Generally the duration
of service date and the expiration date of the IEP are the same.
However, the expected duration of one service may be less than
the expected duration of another service.

 Provider The title of the person responsible (e.g., speech therapist, speech
pathologist, special education teacher, regular teacher, aide).
Do not name an individual!

 Frequency The amount of time per session, and the frequency (e.g., 30 minutes
per day, 5 days per week.) The frequency of on-site program review
by each itemized service provided.

September 2007 EED Format – Instructions for Completing IEP Form
Page 7 of 8
INSTRUCTIONS FOR COMPLETING IEP FORM

 Time List the amount of time per week that the student receives special
education, related services, or regular education services.
Note: Do not count supervision or transportation in the total
number of hours of special education and related service time
received by the student.

 Regular Education Regular education participation means there are no special
Participation education services being provided (no specially-designed
instruction, such as modifications) and no special education
support (aide) being provided.

XV. - Federal Reporting Determine the category that best describes the student's program
Requirement for and check the appropriate box.
Educational
Environment To calculate the percentage of time INSIDE the regular classroom,
divide the number of hours INSIDE the regular classroom by the
total number of hours in a school day, then multiply the answer by
100.
Note: Do not leave this section blank.

XVI. - Justification for A justification for placement must be provided to ensure that the
Placement child is placed in the least restrictive environment. An explanation
of the extent to which the student will not be participating with
children without disabilities must be provided.
Note: Only one placement may be selected. Be certain to justify
why lesser restrictive placements were not selected (see Part V,
Section 5).

SUPPLEMENTAL IEP FORMS
Alternate Assessment These pages should be used for students who are participating in
Goals and Objectives the Alternate Assessment. Separate pages representing the
Pages student's grade level and the specific Alternate Performance
Standards are available on the Assessment website at
http://www.eed.state.ak.us/tls/assessment/alternate_optional.html

IEP Amendment Form This form can be used for indicating small changes to a current
IEP. It may not be used to extend the review date on an IEP.

September 2007 EED Format – Instructions for Completing IEP Form
Page 8 of 8