An important part of a special education teachers job is to write effective IEPs for their students. There are many different components involved in the IEP. The special e

Present Levels of Academic Achievement and Functional Performance (PLAAFP) Example

Summarize Special Education Services the Student is Receiving:

Lesley was receiving special education services in math calculation, math problem solving, and written expression under the specific learning disability eligibility.

Section 2: Evaluation Information

This information loads from the Most Recent MET. Lesley's strengths are in Reading. She also has good attendance.

This information loads from the Most Recent MET. Lesley has needs in the areas of math computation, math problem solving, and written expression.

This information loads from the Most Recent MET. Other conclusions here may include information related to language proficiency.

The general review of all data would be presented here by the psychologist. The general review of all data would be presented here by the special education teacher.

This information loads from the Most Recent MET. The areas of math and writing will affect Lesley's progress in the general curriculum.

Areas of Eligibility:

Special Education Primary Category: Specific learning disability

For students with SLD only, the following area(s) of eligibility was previously determined:

Written expression, mathematics calculation, mathematics problem solving

Section 3: Present Level of Academic Achievement

READING

Lesley enjoys reading and is always reading a book for a leisure activity.

Specific scores from reading assessments or AIMS results can be entered here as well.

Lesley needs to improve her reading out loud in a group setting.

Lesley does not need any accommodations in reading.

WRITING

Lesley's handwriting is very legible, but she does not enjoy writing. She does very well with organizing how an assignment should be set up with graphic organizers and outlines.

Specific scores from writing assessments or AIMS results can be entered here as well.

Lesley needs to improve her writing in the areas of answering questions in complete sentences and completing the required amount (words or pages) for written assignments.

Specific scores from writing assessments or AIMS results can be entered here as well.

Lesley's only accommodation is that she receives some extra time for completing written assignments/assessments.

MATH

Lesley does very well with basic math skills and algebra.

Specific scores from math assessments or AIMS results can be entered here as well.

Lesley has a hard time comprehending geometry and the postulates required.

Specific scores from math assessments or AIMS results can be entered here as well.

Lesley has completed her math class in geometry, so this year in algebra, she should do well and not require any accommodations or modifications.

Parent's Input on Student's Current Academic Achievement:

Lesley's parents are very satisfied with her current academic achievement. They are happy that she is getting good grades in all her subjects with little support.

Current Classroom-Based Data:

All of Lesley's teachers enjoy having her in class, she does complete assignments in a timely manner and never overextends her allowed extra time.

Math teacher reports, "Lesley should do just fine in algebra this year, after reviewing her pre-test."

English teacher reports, "Lesley completes all assignments in a timely manner and is currently receiving a B+."

Science teacher reports, "If Lesley needs any assistance in class this year, I will be available and notify her service coordinator of any issues, so far this year, she is doing well and receiving a B."

World history teacher reports, "Lesley currently has an A- in my class."

Child development teacher reports, "Lesley loves this class and is always wanting to do extra things for the class, she currently has an A."

Study skills teacher reports, "Lesley shows up on time and is ready to complete her homework for her other classes. Other students in the classroom sometimes distract Lesley, but she has been able to keep her behavior in check so far this year."

State and District Assessments:

Lesley is approaching the standard in reading. In math and writing, she is falling far below the standard on the AIMS Assessment.

Section 4: Functional Performance

Social Emotional and Behavior:

Lesley follows direction well from teachers and adults.

Lesley exhibits inappropriate behavior with friends and classmates at times. She can be easily distracted and then she becomes upset when she misses information, resulting in a conflict with either the teacher or a classmate.

Lesley is able to recognize when she gets anxious and upset, so per her Behavior Intervention Plan (BIP), Lesley is able to leave the classroom to "cool down." She may either go to the hall, after telling the teacher and getting a pass (pre-made), or go to her service coordinator, counselor, or principal.

Since the BIP has been set up, her attendance to classes where conflict existed has increased. She does not have any tardies at this time. Her time outs are self-monitored.

Behavior does significantly and adversely affect the progress in the general curriculum.

Counselor Notes:

Lesley has come to see me on two occasions this past year to "cool down." Each time she was able to explain the situation that upset her and together we talked through solutions that she then carried out.

Physical Development:

Lesley's only health concern is her asthma, which can, at times, limit her ability to participate in physical activity. She takes medication for both asthma and depression. The depression medication can sometimes make her feel drowsy. Lesley should have no needs in this area.

Communications:

Lesley can communicate well verbally, she struggles with oral presentations in front of a group.

Parent's Input on Student's Current Functional Achievement:

Lesley's parents are impressed with Lesley's functional achievement as it relates to behavior. Since the BIP has been established, understood by Lesley and her teachers, her days at school have been a lot better.

Transition:

Student expressed an interest in the following career areas:

Lesley is interested in either teaching or counseling as a profession.

Student's job preference at this time is:

Lesley currently works in the district based preschool program as an assistant to the teacher.

Independent Living Skills:

Lesley is able to take care of herself and others. She has her driver’s license and has her own car for transportation. She has a bank account where she deposits her checks. She currently monitors her own medications for depression/anxiety.

Environmental Access/Mobility:

Lesley has adequate access to her community. She is involved in her church and helping out in the Sunday school classes with preschool aged children.

Self-Determination/Self-Advocacy Skills:

Lesley is fairly assertive, she seems to say "yes" to every request, and then overwhelms herself at times. She needs to work on communication with adults and employers.

Sources of information regarding transition:

Student Interview; Work Experience

Summary of Work Habits:

Lesley attends a study skills class daily that allows her the opportunity to complete homework, organize her agenda and ask the teacher questions related to homework and her goals. She also can work on the computer in this class and research careers and interests.

Lesley learns best in a classroom environment with activities that she can see and work on independently or in a group setting.

She can use a computer well and uses her agenda daily to help her organize school and work.

Test taking can require a little extra time for Lesley.

Section 5: Summary of Educational Needs

Based on the information from the current multidisciplinary evaluation, academic achievement, functional performance, and transition based data (if applicable), the IEP team has determined that the student has educational needs in the following areas:

Math calculation, math problem solving, written expression, counseling

Clarification: Math calculation and math reasoning services will not be provided for Lesley this year, as the team has agreed that she has completed the math class and that she struggles with geometry. If any needs arise, an IEP addendum can be prepared to accommodate her with these areas.

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Special Education Department

Individualized Education Program (IEP)

Student Name: Student Data/Cover Sheet (Form A-1) IEP Meeting Date:

Student ID: DOB:

Demographic Information
Student Number:	Student Name:	Birthdate:	Gender:	Grade:
Student Address:	Home Phone:
City, State, Zip:
Parent 1 Name:	Parent 1 Relationship:
Parent 1 Address:	Home Phone:
City, State, Zip:	Work Phone:
Parent 1 Email:
Parent 2 Name:	Parent 2 Relationship:
Parent 2 Address:	Home Phone:
City, State, Zip:	Work Phone:
Parent 2 Email:
Primary Language of Home:	Primary Language Survey Date: Primary Language Survey Results:	Language of Instruction:
Home District: Attendance District:	Service Coordinator:
Home School:	Attending School:
Vision Screened On:	Results:	Hearing Screened On:	Results:
Meeting Date:	Anticipated Duration of IEP: To	Re-evaluation Due: Current Evaluation:
Special Education Primary Category #1:
Special Education Eligibility Category #2:
Special Education Eligibility Category #3:
For Students with SLD only, the following area(s) of eligibility was/were previously determined:
Level of Services: (A)
Type: of Meeting:
Date Meeting Notice Sent to the Parent(s):	Date Procedural Safeguards given to the Parent(s):

Special Education Department

Individualized Education Program (IEP)

The following persons participated in the conference and/or the development of the IEP. Additionally, parents have been given a copy of their rights regarding the student’s placement in special education and understand that they have the right to request a review of their child’s IEP at any time.

Position/Relation to Student Participant Date (MM/DD/YY)

*If during the IEP year the student turns 16, if the student is not present at the IEP meeting, the service coordinator must review the IEP with the student and obtain the student’s signature and the date of this review.

Special Education Department

Individualized Education Program (IEP)

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Section 1: Current IEP Information

Goal Number Written:

Summarize special education services the student is receiving:

Section 2: Evaluation Information

Areas of Eligibility

Special Education Primary Category:

Special Education Eligibility Category #2:

Special Education Eligibility Category #3:

For students with SLD only, the following area(s) of eligibility was previously determined:

Section 3: Present Level of Academic Achievement

READING

WRITING

MATH

Parent’s Input on Student’s Current Academic Achievement:

Current Classroom-Based Data:

State and District Assessments:

Section 4: Functional Performance

Social Emotional and Behavior:

Parent’s Input and Student’s Current Functional Achievement:

Summary of Work Habits:

Section 5: Summary of Educational Needs

Special Education Department

Individualized Education Program (IEP)

ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS

Considered Not Included

Needed

Individual Transition Plan

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Statement of Transfer of Parental Rights at Age of Majority

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For a student whose behavior impedes his/her learning, or that of

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others, positive behavior interventions, strategies, and supports have

been considered.

Statement of Language Needs in the Case of a Child with Limited English

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Proficiency

Statement of Provisions of Instruction in Braille & User of Braille for a

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Visually Impaired Child

Statement of the Language of Needs, Opportunities for Direct Communication

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with Peers in the Child’s Language and Communication Mode

Statement of Required Assistive Technology Devices and Services

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Statement of Communication Needs for a Child with a Disability

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Statement of Health Concerns

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Special Education Department

Individualized Education Program (IEP)

Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:

Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:

Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:

Special Education Department

Individualized Education Program (IEP)

ACCOMODATIONS

Date given to Genera Ed. Teacher: Service Coordinator:

Accommodations do not change now much of the curriculum the student is expected to learn. It only changes how students access and express knowledge on a daily basis. Accommodations are changes in how a student accesses information and demonstrates learning. Accommodations do not substantially change the instructional level, content, or performance criteria. The changes are made in order to provide a student with equal access to learning and equal opportunity to show what he or she knows and can do. Students with disabilities who qualify in one academic area are eligible for accommodations in other areas to the extent that their disability would affect performance in those areas.

Accommodations	Type	Location

Legend for Type and Location Fields

Type: 1 = Class work / assignments 2 = Assessments / tests 3 = Both class work / assignments / assessments.

Location: A = All Subjects B = Language Arts / English C = Reading D = Spelling E = Math F = Science G = Social Studies H = Health I = Electives J = Physical Ed. K = Lunch L = Transition / Vocation M = Library N = Title 1 Special / Exploratory

Parental Communication

How will the parent be informed of their child’s academic progress and the extent to which that profess is sufficient to enable the child to achieve annual goals by the end of the year?

IEP Team Consideration for Extended School Year

Consideration for eligibility: IEP team considered ESY eligibility in the areas of regression and recoupment factors and essential skills at a critical stage of development.

Eligible for ESY:

Written explanation as to why ESY is or is not needed:

Special Education Department

Individualized Education Program (IEP)

ASSESSMENT

Rationale: Students with disabilities will participate in usual district assessments unless indicated by this form. Only those accommodations that are provided for instruction and are required by the IEP should be provided for assessment. All students will be assessed at grade level, other than the few who must be provided alternative assessments.

State Assessments

Standard Accommodation(s):

District Assessments

Standard Accommodation(s):

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS

Testing Area	Test Results	Grade	Semester	Year
Reading
Writing
Math
Science

Special Education Department

Individualized Education Program (IEP)

SPECIAL EDUCATION SERVICES TO BE PROVIDED Special Education Program(s) Necessary to Meet Special Education Goals and Objectives during the school calendar year.
**The child is in need of specially designed instruction in the following areas:
Special Education Services	Instructional Setting / Location	Start Date	Frequency	Provider	Duration / End Date
RELATED SERVICES Educationally Relevant Related Services Are Listed Below
Special Education Services	Instructional Setting / Location	Start Date	Frequency	Provider	Duration / End Date
Clarification:
SUPPLEMENTARY AIDS / ASSISTIVE TECHNOLOGY AND SERVICE FOR STUDENTS Educationally Relevant Supplementary Aides / Assistive Technology and Services Are Listed Below.
SUPPORTS FOR SCHOOL PERSONNEL Supports For School Personnel Are Listed Below
Clarification:

LEAST RESTRICTIVE ENVIRONMENT

Provide an explanation of the extent, if any, to which the student will NOT participate with non-disabled students in the general curricular, extracurricular and nonacademic activities, and program options. §300.347(a)(4):

Consider any potential harmful effects of this placement for the child or on the quality of services that he or she needs §300.552 (a-b):

Reason for Different Services School:

Rationale

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