Use of this IEP form, or any other form, will not, in and of itself, ensure
compliance with IDEA's Part B requirements. 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 Part B 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 [ Space to write ]
Date of Meeting to Develop or Review IEP [ Space to write ]
Note: For each student with a disability beginning at age 14 (or younger,
if appropriate), a statement of the student's
transition service needs must be included under the applicable parts of
the IEP. The statement must focus on the courses
the student needs to take to reach his or her post-school goals.
**********
From the Regulations:
Statement of Transition Service Needs--34 CFR §300.347(b)(1)
"The IEP must include...[f]or each student with a disability beginning
at age 14 (or younger, if determined appropriate by the
IEP team), and updated annually, a statement of the transition service
needs of the student under the applicable components
of the student's IEP that focuses on the student's courses of study (such
as participation in advanced- placement courses or a
vocational education program);"
**********
Present Levels of Educational Performance
[ Space to write ]
**********
From the Regulations:
Statement of Present Levels of Educational Performance--34 CFR §300.347(a)(1)
"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;"
**********
[ Page 1 of 5 ]
Measurable Annual Goals (Including Benchmarks or Short-Term Objectives)
[ space to write ]
**********
From the Regulations:
Statement of Measurable Annual Goals, Including Benchmarks or Short-Term Objectives--34 CFR §300.347(a)(2)
"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 [ space to write ]
Start Date[ space to write ]
Location[ space to write ]
Frequency[ space to write ]
Duration[ space to write ]
Supplementary Aids and Services [ space to write ]
Start Date[ space to write ]
Location[ space to write ]
Frequency[ space to write ]
Duration[ space to write ]
Program Modifications or Supports for School Personnel [ space to write ]
Start Date[ space to write ]
Location[ space to write ]
Frequency[ space to write ]
Duration[ space to write ]
**********
From the Regulations:
Statement of the Special Education and Related Services,
Supplementary Aids and Services, Program Modifications, and
Supports For School Personnel--34 CFR §300.347(a)(3)
"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;"
--ALSO--
Beginning Date, Frequency, Location, and Duration of Services and Modifications--34 CFR §300.347(a)(6)
"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;"
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[ Page 2 of 5 ]
Explanation of Extent, if Any, to Which Child Will Not Participate with Nondisabled Children
[ space to write ]
**********
From the Regulations:
Explanation of Extent, if Any, to Which Child Will Not Participate with Nondisabled Children 34 CFR §300.347(a)(4)
"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)
[ space to write ]
**********
From the Regulations:
Statement Of Any Individual Modifications in Administration of State or District-wide Assessments 34--CFR §300.347(a)(5)(i)
"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?[ space to write ]
How will the child be assessed?[ space to write ]
**********
From the Regulations:
If Child Will Not Participate in State or District-wide Assessment--34 CFR §300.347(a)(5)(ii)
"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;"
**********
[ Page 3 of 5 ]
How Child's Progress Toward Annual Goals Will Be Measured
[space to write ]
**********
From the Regulations:
How Child's Progress Will Be Measured--34 CFR §300.347(a)(7)(i)
"The IEP for each child with a disability must include . . .
a statement of how the child's progress toward the annual goals described in 34 CFR §300.347(a)(2) will be measured;"
**********
How Child's Parents Will Be Regularly Informed Of Child's Progress Toward
Annual Goals And Extent To Which
Child's Progress Is Sufficient To Meet Goals By End of Year
[ space to write ]
**********
From the Regulations:
How Parents Will Be Informed of Their Child's Progress--34 CFR §300.347(a)(7)(ii)
"The IEP for each child with a disability must include . . . a statement
of how the child's parents will be regularly informed
(through such means as periodic report cards), at least as often as parents
are informed of their nondisabled children's
progress, of
"(A) Their child's progress toward the annual goals; and
"(B) The extent to which that progress is sufficient to enable the child to achieve the goals by the end of the year."
**********
[ Page 4 of 5 ]
(Beginning at age 16 or younger if determined appropriate by IEP team)
Statement of Needed Transition Services, Including, If Appropriate, Statement
Of Interagency Responsibilities Or Any
Needed Linkages
[ space to write ]
**********
From the Regulations:
Statement of Needed Transition Services--34 CFR §300.347(b)(2)
"The IEP must include . . . for each student with a disability beginning
at age 16 (or younger, if determined appropriate by the
IEP team), a statement of needed transition services for the student, including,
if appropriate, a statement of the interagency
responsibilities or any needed linkages."
Definition of "Transition Services"--34 CFR §300.29
"(a) As used in [Part B], "transition services" means a coordinated set of activities for a student with a disability that:
"(1) Is designed within an outcome-oriented process, that promotes movement
from school to post-school activities, including
post-secondary education, vocational training, integrated employment (including
supported employment), continuing and adult
education, adult services, independent living, or community participation;
"(2) Is based on the individual student's needs, taking into account the student's preferences and interests; and
"(3) Includes: (i) Instruction; (ii) Related services; (iii) Community
experiences; (iv) The development of employment and other
post-school adult living objectives; and (v) If appropriate, acquisition
of daily living skills and functional vocational evaluation.
"(b) Transition services for students with disabilities may be special
education, if provided as specially designed instruction or
related services, if required to assist a student with a disability to
benefit from special education."
**********
(In a state that transfers rights to the student at the age of majority,
the following information must be included
beginning at least one year before the student reaches the age of majority)
The student has been informed of the rights under Part B of IDEA, if any,
that will transfer to the student on reaching
the age of majority. Yes [box to check]
**********
From the Regulations:
Age of Majority--34 CFR §300.347(c)
"In a State that transfers rights at the age majority, beginning at least
one year before a student reaches the age of majority
under State law, the student's IEP must include a statement that the student
has been informed of his or her rights under Part
B of the Act, if any, that will transfer to the student on reaching the
age of majority, consistent with 34 CFR §300.517."
**********
[ Page 5 of 5 ]