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ADE SPEDREQUIRED FORMAPRIL 2020Individualized Education Program(IEP)Name:ID#:Date of Birth:Age:Grade:School/Site:Duration of Services:From:To:(Excluding summer months and school holidays unless otherwise indicated)IEP Type: SCHOOL AGE - Postsecondary TransitionPurpose of te:Most Recent Evaluation Date (Date of most recent EPC or EDR with no testing):Parent Rights Under IDEA:Parent rules regs arkansas.gov/rules regs 20IDEA%20-%20Spanish.pdfParent Method of Participation:In PersonThrough alternate meansParent did not participateE-Mail(Spanish version)Excusal(s):YesNoIf yes, Name(s) of Team Member(s) nt Agreement to Excusal:YesNoIf yes, specify:Parent InitialsIs excused member's area of curriculum being discussed?Yes, written input wasprovided.NoParent/guardian input regarding enhancing the education of the child was considered.Parent/guardian input:Form: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:Present Level of Academic Achievement and Functional PerformanceA statement of the child's present levels of academic achievement and functional performance including:- Child's strengths and needs (include data used to determine strengths and needs)- Consider the academic, developmental, and functional needs resulting from the child's disability, which mayrequire special education, related services, supplementary aids, supports for personnel, or modifications.- Consider how the child's strengths relate to the child's postsecondary goals.- Effect of the child's disability on his/her involvement in the general education curriculum- Consider how the child's disability will affect the child's ability to reach his/her postsecondary goals (what thechild will do after high school).- Achievement of annual goals, performance in related service areas, and a description of any significant lack of progress.Transfer of Rights: In Arkansas, beginning not later than one year before a child reaches the age of majority under Statelaw, age eighteen (18), except for a child with a disability who has been determined to be incompetent under state law, thechild's IEP must include a statement that the child has been informed of his or her rights under Part B of the Act, if any, thatwill transfer to the child on reaching the age of majority, consistent with 34 CFR 300.520 and §9.00 of these regulations.N/A for this IEPDate notification was given to the child and parent:Initial Date of Transition PlanDevelopment:Student's Disability:Dates Plan was Reviewed (must bereviewed at least annually):Post-Secondary Transition Goals and ServicesThese goals and services are to be in place beginning not later than the first IEP to be in effect when the child turns 16, or younger ifdetermined appropriate by the IEP Team, and are to be reviewed at least annually and revised as needed.List age appropriate transition assessments used annually in determining postsecondarygoals and include year administered. For each year, multiple assessments may be listed.ASSESSMENTForm: IEP Type - SCHOOL AGE - Postsecondary TransitionYear(s) Provided

Name:1) REQUIRED - Postsecondary Career/Employment Goal(s) (After high school, what kind of work will you do?):After high school(student's name/I) will:Transition Activities/Services that will help student move towardCareer/Employment Goal Indicated Above:Responsible Party's TitleSemester/Year to beImplemented (e.g., Fall/15)2) REQUIRED - Postsecondary Education/Training Goal(s) (After high school, what additional education and training will you receive? Thiseducation/training will be correlated to career/employment goals or independent living skill goals.):After high school(student's name/I) will:Transition Activities/Services that will help student move towardEducation/Training Goal Indicated Above:Responsible Party's TitleSemester/Year to beImplemented (e.g., Fall/15)3) Postsecondary Independent Living Skills (ILS)/Community Participation Goal(s): Before establishing a goal, make sure a variety of ILS areconsidered. Remember, the activities you include under the goal should be specific to supporting the student's moving toward living independently.After high school(student's name/I) will:Transition Activities/Services that will help student move towardIndependent Living Skills/Community Participation Goal IndicatedResponsible Party's TitleAbove:Semester/Year to beImplemented (e.g., Fall/15)If there are no areas of deficit, include a statement indicating the student will maintain his or her current skills (as indicated in assessment results)to live independently.Consider the need for outside agency participation, as well as the need to invite the agency to the IEP meeting. If agencies are providing services tostudents to promote movement toward goals, include those appropriate activities in the IEP.Form: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:Courses of StudyBased on the current goals, provide specific and individualized course of study. Courses must reasonably enable the child to meethis/her postsecondary goals and be projected through their anticipated exit year. The description may be an individualized list ofcourses and/or a narrative focusing on specific skills/knowledge to be acquired in a class.Choose one option below:Narrative DescriptionList of Courses DescriptionList of Courses (Complete table below):SubjectSchool Year:School Year:School Year:School Year:EnglishSocial StudiesOral CommunicationsMathematicsSciencePhysical EducationHealth and SafetyEconomicsFine ArtsCareer FocusElectiveElectiveElectiveElectiveNarrative of Course Description:Summary of Performance is an additional piece mandated by IDEA but not part of the IEP. It must be completed during the final yearof the child's high school education and a copy given to the child.Form: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:Consideration of Special FactorsCheck yes or no whether the IEP team considers each special factor to be relevant to this child.For factors checked yes, explain any services and supports that are needed in the IEP.YesIf yes, explainNoLanguage needs as related to the IEP for achild who is an English LearnerYesInstruction in Braille if the child is blind orvisually impaired, unless determinedinappropriate based on evaluationNoCommunication needs, and for the child whois deaf or hard of hearing, the language andcommunication needs and opportunities forcommunication and instruction in the child'snative language and communication modeYesIf yes, explainIf yes, explainNoYesIf yes, explainNoAssistive technology devices and servicesYesPositive behavioral interventions andsupports and other strategies to addressbehaviorSupplementary aids and services, programmodifications and accommodations, and/orsupports for personnel in general educationor other education-related settingsNoYesIf yes, explainNoYesAre there other factors that needconsideration?If yes, explainNoForm: IEP Type - SCHOOL AGE - Postsecondary TransitionIf yes, explain

Name:Extended School Year (ESY):ESY will be considered at a later date.ESY is not necessaryESY is necessary. (Document services below).GoalDescription ofServicesTime/AmountFrequencyLocationBegin DateEnd DateParticipation in Program Options, Nonacademic, and Extracurricular ActivitiesThe district assures that this child will have an equal opportunity to participate in program options, nonacademic and/orextracurricular activities and services offered by the district.Form: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:IEP GoalsIEP Goals without ObjectivesIEP Goals with ObjectivesAnnual Goals: provide measurable annual goals, including academic and functional goals to enable the child to beinvolved in and make progress in the general education curriculum and to meet other educational needs that result fromthe disability.Goal #:Goal Area:Curriculum-Based AssessmentProgress towards the Goal will be measured by :Student ConferencesGradesPortfoliosChecklistsScoring RubricsTeacher/Text TestObservation ChartsWork SamplesOther (specify):Progress Reports Completed Each Grading/Progress Period, as Scheduled by the St.DateProgressSt.DateProgressSt.Key for Status of Goals C Continued D Discontinued M Mastered N Not InitiatedAnnual Goals: provide measurable annual goals, including academic and functional goals to enable the child to beinvolved in and make progress in the general education curriculum and to meet other educational needs that result fromthe disability.Goal #:Goal Area:Curriculum-Based AssessmentProgress towards the Goal will be measured by :Student ConferencesPortfoliosChecklistsGradesScoring RubricsTeacher/Text TestObservation ChartsWork SamplesOther (specify):Progress Reports Completed Each Grading/Progress Period, as Scheduled by the St.DateKey for Status of Goals C Continued D Discontinued M Mastered N Not InitiatedForm: IEP Type - SCHOOL AGE - Postsecondary TransitionProgressSt.DateProgressSt.

Name:IEP Goals with ObjectivesAnnual Goals: provide measurable annual goals, including academic and functional goals to enable the child to beinvolved in and make progress in the general education curriculum and to meet other educational needs that result fromthe disability.Goal #:Goal Area:Date Annual Goal Mastered:Objectives: Required for students who take alternate assessments; optional for all other students1.2.3.4.5.Curriculum-Based AssessmentProgress towards the Goal will be measured by :Student ConferencesGradesPortfoliosChecklistsScoring RubricsTeacher/Text TestObservation ChartsWork SamplesOther (specify):Goal mberObjective Progress ssSt.DateProgressSt.

Key for Status of Goals C Continued D Discontinued M Mastered N Not InitiatedForm: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:Services(Schedule of Services)Special Education ServicesCo-taught services inIndirect Services inDirect instruction inSpeech/Language servicesinTime/AmountFrequencySettingNumber of1XDayRegular ClassroomMinutes:2XWeekSpecial Ed Classroom3XMonthTherapy Room4XQuarterOther o-taught services inIndirect Services inDirect instruction inSpeech/Language services inNumber of1XDayRegular ClassroomMinutes:2XWeekSpecial Ed Classroom3XMonthTherapy Room4XQuarterOther o-taught services inIndirect Services inDirect instruction inSpeech/Language services inNumber of1XDayRegular ClassroomMinutes:2XWeekSpecial Ed Classroom3XMonthTherapy Room4XQuarterOther o-taught services inIndirect Services inDirect instruction inSpeech/Language services inNumber of1XDayRegular ClassroomMinutes:2XWeekSpecial Ed Classroom3XMonthTherapy Room4XQuarterOther orm: IEP Type - SCHOOL AGE - Postsecondary Transition

Name:Services SummaryRelated ServicesNone NeededRelated Service(s):(Please type if a service is not listed)Time/AmountFrequencySettingNumber of1XDayRegular ClassroomMinutes:2XWeekSpecial Ed Classroom3XMonthTherapy Room4XQuarterOther (specify):Hours:Periods:5X6XSessions:7X8X9XRelated Service(s):(Please type if a service is not listed)Number of1XDayMinutes:2XWeek3XMonthRegular ClassroomSpecial EdClassroomTherapy Room4XQuarterOther (specify):Hours:Periods:5X6XSessions:7X8X9XRelated Service(s):(Please type if a service is not listed)Number of1XDayMinutes:2XWeek3XMonthRegular ClassroomSpecial EdClassroomTherapy Room4XQuarterOther (specify):Hours:Periods:5X6XSessions:7X8X9XForm: IEP Type - SCHOOL AGE - Postsecondary Transition