TEACHER GUIDE FOR FILLING OUT AN IEP COVER PAGE- PAGE 1

Enter the date of the Annual Review Conference

Select the disability classification (Learning Disability, Emotional Disability, etc.) from the drop down menu.

To get to the drop down menu, check “yes”, “yes”, “n o” in the consecutively lower placed boxes on this page; when you

check “no” in the third box, then you access the drop down menu. (See sample page 1 below)

Double check that the correct disability classification shows up on the page

PRESENT LEVELS OF PERFORMANCE AND INDIVIDUAL NEEDS- PAGE 2

A) In the PRESENT LEVELS OF PERFORMANCE AND INDIVIDUAL NEEDS include: 1) Student's post high school plans ex. Work, College, Field of Study/Work 2) Student's learning modality (visual, hearing, kinesthetic) 3) Rate of attendance 4) Grades 5) Credits 6) General background from student-Level One Interview Information

B) Fill out SOCIAL DEVELOPMENT NEEDS only if they do not have counseling, if they have couseling, the counselor fills this o ut.

C) Under PHYSICAL DEVELOPMENT, if you think they are in good health, always best to enter, “appears to be in good health”

D) Under MANAGEMENT NEEDS, put any type of teaching techniques that you may think would benefit the student, including 1:1 encouragement, use of graphic organizers, checklists, study guides, pre-reading strategies, etc. :

Sample Page 2

PRESENT LEVELS OF PERFORMANCE AND INDIVIDUAL NEEDS

DOCUMENTATION OF STUDENT'S CURRENT PERFORMANCE AND ACADEMIC, DEVELOPMENTAL AND FUNCTIONAL NEEDS

EVALUATION RESULTS (INCLUDING FOR SCHOOL-AGE STUDENTS, PERFORMANCE ON STATE AND DISTRICT-WIDE ASSESSMENTS) NYS 8th Grade Tests: English, Math, and Social Studies are all Level 2. The Science NYS 8th Grade Test was scored as a Level 3. Regents Exam Scores: English Language Arts 62%, Living Environment 61%, Earth Science 57%, Integrated Algebra 56%, Global History

69%, US History/Gov't 65%

ACADEMIC ACHIEVEMENT, FUNCTIONAL PERFORMANCE AND LEARNING CHARACTERISTICS LEVELS OF KNOWLEDGE AND DEVELOPMENT IN SUBJECT AND SKILL AREAS INCLUDING ACTIVITIES OF DAILY LIVING, LEVEL OF INTELLECTUAL FUNCTIONING, ADAPTIVE BEHAVIOR, EXPECTED RATE OF PROGRESS IN ACQUIRING SKILLS AND INFORMATION, AND LEARNING STYLE: Tiffany is a polite and friendly student. Tiffany is a senior and is on her way to graduating with a Local diploma. Her attendance for the year has been good. Tiffany plays on the New Utrecht High School Softball team, Bowling team and Basketball team. Tiffany passed all 5 of her classes during the first marking period of the Spring Term, with an average of approximately 74%. She makes good use of the Resource Room. She can sit and focus on completing her work independently. Tiffany is a visual and hands-on learner and benefits when lesson material is presented using both learning modalities. She prefers independent learning compared to group work, unless group work is being utilized in Math and/or Economic classes. Currently, she would like to further her studies into being a Physical Education teacher, and in time she would like to get into Culinary Arts. She will continue to discuss her after school plans with her Resource Room staff and transition coordinator. STUDENT STRENGTHS, PREFERENCES, INTERESTS: Tiffany is a sociable and mature student, she shows a good deal of school spirit as she plays on the school's Softball, Bowling and Basketball teams. ACADEMIC, DEVELOPMENTAL AND FUNCTIONAL NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE PARENT: Tiffany has SETSS 5x per week and benefits from the extra help she receives.

SOCIAL DEVELOPMENT THE DEGREE (EXTENT) AND QUALITY OF THE STUDENT’S RELATIONSHIPS WITH PEERS AND ADULTS; FEELINGS ABOUT SELF; AND SOCIAL ADJUSTMENT TO SCHOOL AND COMMUNITY ENVIRONMENTS: COUNSELING 1x40 1:5 - Tiffany is a sweet and mature young lady who has developed good rapport with the writer; she attends counseling on a regular basis and knows she can depend on writer to guide and advise her in the any matter she needs help with. She is very capable of expressing herself in mature and appropriate methods, and is also capable of understanding the other person's side to any issue she might be involved in; she usually displays good insight in various subjects. Tiffany is slated to graduate this June and is hoping to go to college. Tiffany can get distracted from her path when

PRESENT LEVELS OF PERFORMANCE AND INDIVIDUAL NEEDS

DOCUMENTATION OF STUDENT'S CURRENT PERFORMANCE AND ACADEMIC, DEVELOPMENTAL AND FUNCTIONAL NEEDS

she is emotionally upset, but can usually get back on her path after talking through whatever the problem might be; Tiffany is always looking for ways to negotiate matters that are not only beneficial for her, but she is also caring enough to think about the benefit of anyone else she might be involved with. STUDENT STRENGTHS: Tiffany is a good and loyal friend; sometimes, she gives too much credit to people who might end up coming forth as less-than- perfect friends; but she always looks for ways for 'fix' a problem, and she usually does. She can be very resourceful and is not afraid to work for something she wants. SOCIAL DEVELOPMENT NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE PARENT: Tiffany can be sensitive and can have her feelings easily hurt. Tiffany needs to realize that she should not take things personally, because the problem might not necessarily lie with her, but with other people; it might be their life lesson - not hers. She should not be discouraged from making friendships where ever she goes.

PHYSICAL DEVELOPMENT THE DEGREE (EXTENT) AND QUALITY OF THE STUDENT’S MOTOR AND SENSORY DEVELOPMENT, HEALTH, VITALITY AND PHYSICAL SKILLS OR LIMITATIONS WHICH PERTAIN TO THE LEARNING PROCESS: Tiffany appears to be in good physical health. STUDENT STRENGTHS: Tiffany plays on the school's Softball, Bowling and Basketball teams. PHYSICAL DEVELOPMENT NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE PARENT: Student appears to be of age appropriate physical development.

MANAGEMENT NEEDS THE NATURE (TYPE) AND DEGREE (EXTENT) TO WHICH ENVIRONMENTAL AND HUMAN OR MATERIAL RESOURCES ARE NEEDED TO ADDRESS NEEDS IDENTIFIED ABOVE: Tiffany benefits from 1:1 encouragement and academic assistance that she receives in her SETSS class.

EFFECT OF STUDENT NEEDS ON INVOLVEMENT AND PROGRESS IN THE GENERAL EDUCATION CURRICULUM OR, FOR A PRESCHOOL STUDENT, EFFECT OF STUDENT NEEDS ON PARTICIPATION IN APPROPRIATE ACTIVITES Tiffany has all general education classes with the addition of a SETSS class. Tiffany is presently passing all of her general education classes, and is on her way to graduating with a Local Diploma.

STUDENT NEEDS RELATING TO SPECIAL FACTORS-PAGE 3

A) For the section below, go to the student's PROFILE page and see if they are in need of ELLS (English Language Learner Service)

or not; if they are a student in need of ELLS services, then it is very important the “YES” box is checked on this page; if they do not

need the services, then check the “NO. Scroll down to the sample page below and you will see the red highlighted section where you

must check either the appropriate yes or no box.

;

See sample page #3 below :

STUDENT NEEDS RELATING TO SPECIAL FACTORS BASED ON THE IDENTIFICATION OF THE STUDENT'S NEEDS, THE COMMITTEE MUST CONSIDER WHETHER THE STUDENT NEEDS A PARTICULAR DEVICE OR SERVICE TO ADDRESS THE SPECIAL FACTORS AS INDICATED BELOW, AND IF SO, THE APPROPRIATE SECTION OF THE IEP MUST IDENTIFY THE PARTICULAR DEVICE OR SERVICE(S) NEEDED:

Does the student need strategies, including positive behavioral interventions, supports and other strategies to address behaviors that impede the student's learning or that of others? Yes No Does the student need a behavioral intervention plan? No Yes

For a student with limited English proficiency, does she need a special education service to address her language needs as they relate to the IEP? Yes No Not Applicable

For a student who is blind or visually impaired, does she need instruction in Braille and the use of Braille? Yes No Not Applicable

Does the student need a particular device or service to address her communication needs? Yes No In the case of a student who is deaf or hard of hearing, does the student need a particular device or service in consideration of the student's language and communication needs, opportunities for direct communications with peers and professional) personnel in the student's language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the student's language and communication mode? Yes No Not Applicable

Does the student need an assistive technology device and/or service? Yes No If yes, does the Committee recommend that the device(s) be used in the student's home? Yes No

MEASUREABLE SECONDARY POSTSECONDARY GOALS-PAGE 4 See example below:

This section is filled out by Teachers ( Related Service providers, ex. Counseling, Speech, etc. will enter on line 2, otherwise

teachers do this too.) :

MEASUREABLE ANNUAL GOALS-PAGE 5

Fill in at least three goals in ELA (Reading), Math (Algebra), and Study Skills (These must be Common Core

based, take from the goals bank/create one, student must have a Reading Goal if they have a Reading Test

Accommodations, ex. Revised Test Directions)

Just choose one method of How Progress Will Be Measured and under Schedule, list once per month.

ANNUAL GOALS-PAGE 5: Filling out Progress notes using pull down menus for each annual goal: Done Once Per Month

1x per month

REPORTING PROGRESS TO PARENTS-PAGE 6

Enter “at the same time school report cards are issued” on the drop down menu.

RECOMMENDED SPECIAL EDUCTION PROGRARM/SERVICES- PAGE 7:

See below for several different scenarios:

The following entry is for a student receiving SETSS only:

The following entry is a CORRECTION in how we have been filling out this section. We have to go back to

listing specific classes, according to the student’s present schedule. Be careful to look to see if the classes are

Special Classes (self-contained) 15:1, or co-teaching classes and list accordingly

SEE THE SAMPLE IEP BELOW:

TWELVE MONTH SERVICE AND/OR PROGRAM- PAGE 8:

l

On the first line, check “No” There is a pull down menu where you indicate the student's school environment: Select “NYC DOE

Community School”

TESTING ACCOMODATIONS-PAGE 9:

************New testing Accommodations can only be added on a Triennial!****************** We have new testing accommodations-see below:

For Annual Reviews, only fill in Testing Accommodations that were on the student’s last IEP. Check below for the

latest way to fill out this section:

Extended Time State and Local Assessments Time and One Half or Double Time

Use of Calculator State and Local Assessments Scientific/Graphic

Revised Test Directions- State and Local Assessments Directions read to student 2x

Use of Assistant Technology/Device State and Local Assessments that do

not measure reading comprehension-

Text passages, questions, items and

multiple choice responses read to student

Location with Minimal Distractions State and Local Assessments Minimal Auditory and Visual Distractions

TESTING ACCOMODATIONS-PAGE 9:

A List of Most Testing Modifications

Enter the Testing Accommodations found for each student. A Code for Testing Accommodations: 1-Time Limit Extended

2- Location with Minimal Distractions

3- (Now: Text passages, questions, items and multiple choice responses read to student)

4-Answers recorded in any Manner (Scribe)

5-Calculator

6-Exam in Braille or Large Type

7-Directions Read to Student 2x

8-Visual Magnification and Auditory Amplification

9-Masks, or Markers to maintain place

0-Use of Arithmetic Tables

M-more than 7 modifications

COORDINATED SET OF TRANSTION ACTIVITIES-PAGE 10

This page is filled out by the Transition Coordinators, not by special education teachers. PARTICIPATION IN STATE AND DISTRICT-WIDE ASSESSMENTS-PAGE 11

Check “No” box for all students who will be taking Regents exams; Check “Yes” box for all alternate assessment students.

Continue down for Page 12

PARTICIPATION WITH STUDENTS WITHOUT DISABILITIES-PAGE 12

On ly fill ou t th e f ield , “FOR T HE S CHOO L -AGE S T UDE NT”, i n this case the student is taking S ETS S classes.

Also, check on student's previou s IEP to see if they are exempted from the “L ANGUAGE

OTHER THAN ENGLISH REQUIREMENT”. Usually they are not exempted and you check the

“No” box.

SPECIAL TRANSPORTATION/PLACEMENT RECOMMENDATIONS-PAGE 13

Check th e “None” box.

Under “ PLACEME NT RECOMMENDATION”, select, “N YC DOE C ommunity School ” from

the drop down menu.

SUMMARY PAGE-PAGE 14

The top half of this sample summary page, which is NOT on view here, is automatically filled in by the SESIS

software program and summarizes a lot of the information already entered.

The bottom half of the page has to be filled in. First, check the box indicating whether the IEP has been modified

from the last Annual Review. Second, the promotion criteria has to be checked off for the CURRENT YEAR and

NEXT YEAR. Usually the “Standard ” box is checked f or both , unless you know that they have

“Modified” promotion criteria.

Make sure that you enter an educational program that was considered and rejected [just check off the box(es)].

And make sure you enter a “ Reason for Rejection ” Use the pull down menu

ALL THE FIELDS HAVE TO BE FILLED OUT ON THIS PAGE OR IT CAUSES DIFFICULTIES WHEN THE

DOCUMENT IS “FINALI ZE D”. WHAT HAPPENS IS T HAT THE OTHE R STUDENT ACCOUNT IN G

S YS T E MS WIL L REJE CT T HE IE P AN D T HE N T HE IE P HAS TO B E “REO PE NED” A ND

DONE OVE R!

ATTENDANCE PAGE 15

Special Education teachers DO NOT have to fill out this page, this page is filled out by the IEP

Coordinators,

All questions, please address the IEP coordinator,

Thank you for consulting this document!