Academic
Sources
If applicable, identify the sources of the data used to assess the student’s academic achievement and functional performance. Sources may include, but are not limited to current classroom-based assessments, district and/or state assessments, and classroom-based observations, parent information, student and general education teacher input in all relevant areas.
Instructional Grade Level Performance
If applicable, identify the student’s instructional grade level.
NOTE:
The student’s instructional performance may not be on grade level. If not, this may be an indicator that the student’s IEP team needs to consider supplementary aids, services, program modifications, and supports needed. Although a student’s performance may not be at grade level, the student is to receive instruction in grade level content.
Summary of Assessment Findings
If applicable, summarize the assessment findings, including the date(s) of administration. Assessment findings include data and information from, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Impact on Academic Achievement and Functional Performance
If applicable, indicate YES or NO if the student's disability impacts the student's academic achievement or functional performance in the identified area that requires the provision of special education and related services.
Health
Identify, as applicable, any strength, concern/needs, parental concerns regarding the student’s health, including vision, hearing, allergies, medical conditions that adversely affects the student’s ability to access or participate in the general curriculum that may require the provision of special education and related services. Include sources of information, summary of assessment findings, including the dates of administration. Assessment findings include, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Sources
If applicable, identify the sources of the data used to assess the student’s academic achievement and functional performance. Sources may include, but are not limited to current classroom-based assessments, district and/or state assessments, and classroom-based observations, parent information, student and general education teacher input in all relevant areas.
Level of Performance
If applicable, identify the student’s level of performance.
Summary of Assessment Findings
If applicable, summarize the assessment findings, including the date(s) of administration. Assessment findings include data and information from, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Impact on Academic Achievement and Functional Performance
If applicable, indicate YES or NO if the student's disability impacts the student's academic achievement or functional performance in the identified area that requires the provision of special education and related services.
Physical
Identify, as applicable, any strength, concerns/needs, and/or parental concerns regarding the student’s fine or gross motor abilities that may adversely affects the student’s ability to access or participate in the general curriculum that may require the provision of special education and related services. Include sources of information, summary of assessment findings, including the dates of administration. Assessment findings include, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Sources
If applicable, identify the sources of the data used to assess the student’s academic achievement and functional performance. Sources may include, but are not limited to current classroom-based assessments, district and/or state assessments, and classroom-based observations, parent information, student and general education teacher input in all relevant areas.
Level of Performance
If applicable, identify the student’s level of performance.
Summary of Assessment Findings
If applicable, summarize the assessment findings, including the date(s) of administration. Assessment findings include data and information from, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Impact on Academic Achievement and Functional Performance
If applicable, indicate YES or NO if the student's disability impacts the student's academic achievement or functional performance in the identified area that requires the provision of special education and related services.
Behavioral
Identify, as applicable, any strength, concerns/needs, parental concerns regarding the student’s social, emotional, and behavioral performance that may adversely affects the student’s ability to access or participate in the general curriculum and/or impedes the student’s learning or the learning of others that may require the provision of special education and related services, including a functional behavioral assessment and behavioral intervention plan to address misconduct to reduce inappropriate behavior through the use of positive intervention strategies. Include sources of information, summary of assessment findings, including the dates of administration.
Sources
If applicable, identify the sources of the data used to assess the student’s academic achievement and functional performance. Sources may include, but are not limited to current classroom-based assessments, district and/or state assessments, and classroom-based observations, parent information, student and general education teacher input in all relevant areas.
Level of Performance
If applicable, identify the student’s level of performance.
Summary of Assessment Findings
If applicable, summarize the assessment findings, including the date(s) of administration. Assessment findings include data and information from, but not limited to: current classroom-based assessments, district and/or state assessments, classroom-based observations, parent information, and student and general education teacher input in all relevant areas.
Impact on Academic Achievement and Functional Performance
If applicable, indicate YES or NO if the student's disability impacts the student's academic achievement or functional performance in the identified area that requires the provision of special education and related services.
