IEP Help for the teacher

Sample Form
Use of this IEP form, or any other form, will not, in and of itself, ensure compliance with IDEA's. Whether or not a state or local education agency chooses to require or recommend that teams use this form for IEPs, all IEP team participants including parents need to receive clear guidance and training regarding requirements and to understand the importance of the IEP in focusing instruction to meet the unique needs of each child with a disability.

Individualized Education Program (IEP)

Student Name ___________________________

Date of Meeting to Develop or Review IEP _________________________

Transition service needs

The statement must focus on the courses the student needs to take to reach his or her post-school goals.

Statement of Transition Service Needs--(if student is 14 or under)

_________________________________________________________

Present Levels of Educational Performance

_________________________________________________________

Statement of Present Levels of Educational Performance

"The IEP for each child with a disability must include . . . a statement of the child's present levels of educational performance, including

"(i) How the child's disability affects the child's involvement and progress in the general curriculum (i.e., the same curriculum as for nondisabled children); or

"(ii) For preschool children, as appropriate, how the disability affects the child's participation in appropriate activities;"

_________________________________________________________

Measurable Annual Goals (Including Benchmarks or Short-Term Objectives)

_________________________________________________________

Statement of Measurable Annual Goals, Including Benchmarks or Short-Term Objectives"The IEP for each child with a disability must include . . . a statement of measurable annual goals, including benchmarks or short-term objectives, related to

"(i) Meeting the child's needs that result from the child's disability to enable the child to be involved in and progress in the general curriculum (i.e., the same curriculum as for nondisabled children), or for preschool children, as appropriate, to participate in appropriate activities; and

"(ii) Meeting each of the child's other educational needs that result from the child's disability;"

_________________________________________________________

Special Education and Related Services _____________________________

Start Date__________________________
Location ___________________________
Frequency _________________________
Duration ___________________________
Supplementary Aids and Services ___________________________
Start Date ________________________
Location __________________________
Frequency ________________________
Duration __________________________
Program Modifications or Supports for School Personnel ____________________
Start Date ________________________
Location __________________________
Frequency ________________________
Duration __________________________

Statement of the Special Education and Related Services, Supplementary Aids and Services, Program Modifications, and Supports For School Personnel

"The IEP for each child with a disability must include... a statement of the special education and related services and supplementary aids and services to be provided to the child, or on behalf of the child, and a statement of the program modifications or supports for school personnel that will be provided for the child

"(i) To advance appropriately toward attaining the annual goals;

"(ii) To be involved and progress in the general curriculum in accordance with 34 CFR §300.347(a)(1) and to participate in extracurricular and other nonacademic activities; and

" (iii) To be educated and participate with other children with disabilities and nondisabled children in the activities described in this section;"

_________________________________________________________

Beginning Date, Frequency, Location, and Duration of Services and Modifications

"The IEP for each child with a disability must include . . . the projected date for the beginning of the services and modifications described in 34 CFR §300.347(a)(3), and the anticipated frequency, location, and duration of those services and modifications;"

_________________________________________________________

Explanation of Extent, if Any, to Which Child Will Not Participate with Nondisabled Children

_________________________________________________________

Explanation of Extent, if Any, to Which Child Will Not Participate with Nondisabled Children "The IEP for each child with a disability must include . . . an explanation of the extent, if any, to which the child will not participate with nondisabled children in the regular class and in the activities described in 34 CFR §300.347(a)(3);"

_________________________________________________________

Administration of State and District-wide Assessments of Student Achievement

Any Individual Modifications In Administration Needed For Child To Participate In State Or District-wide Assessment(s)

_________________________________________________________

Statement Of Any Individual Modifications in Administration of State or District-wide Assessments

"The IEP for each child with a disability must include . . . a statement of any individual modifications in the administration of State or district-wide assessments of student achievement that are needed in order for the child to participate in the assessment;"

_________________________________________________________

If IEP Team Determines That Child Will Not Participate In A Particular State Or District-Wide Assessment

Why isn't the assessment appropriate for the child?_____________________________
How will the child be assessed?_________________________

If Child Will Not Participate in State or District-wide Assessment

"If the IEP team determines that a child with a disability will not participate in a particular State or district-wide assessment of student achievement (or part of an assessment), the IEP must include a statement of

"(A) Why that assessment is not appropriate for the child; and

"(B) How the child will be assessed;"

_________________________________________________________

How Child's Progress Toward Annual Goals Will Be Measured

_________________________________________________________

How Child's Progress Will Be Measured