The Oklahoma Individualized Education Program (IEP) form is a crucial document designed to outline the educational needs of children with disabilities. It serves as a roadmap for educators, parents, and specialists, ensuring that each child receives the support necessary for their success in school. This article will explore the key components of the IEP form and its significance in fostering an inclusive educational environment.
The Oklahoma Individualized Education Program (IEP) form plays a crucial role in ensuring that children with disabilities receive the support they need to thrive in their educational environments. This comprehensive document gathers essential information about the child, including their name, birthdate, grade, and the names of their parents or guardians. It outlines the child's current academic and functional performance, detailing how their disability affects their participation in the general education curriculum. The form also highlights the child's strengths and needs, allowing educators and parents to work together effectively. Special factors are considered, such as behavioral interventions, language needs, and assistive technology requirements. The IEP includes measurable annual goals tailored to the child's unique needs, along with short-term objectives to track progress. Additionally, it addresses transition services for older students, preparing them for postsecondary goals related to education, employment, and independent living. By capturing this information, the Oklahoma IEP form serves as a roadmap for the child's educational journey, fostering collaboration between families and schools.
INDIVIDUALIZED EDUCATION PROGRAM (IEP)
NAME OF CHILD: ____________________________________________________STUDENT ID: ____________________________
FIRST MIDDLELAST
BIRTHDATE: ___________________________
GRADE: ____________________
AGE: ___________________________
MONTH/DAY/YEAR
PARENT(S):_______________________________________________________________________________________________
PHONE: (WORK) _______________________ (HOME) ________________________
(OTHER) __________________________
HOME ADDRESS: _______________________________________________________ DISTRICT/AGENCY: ________________
STREET ADDRESS/P.O. BOX
CITY
STATE
ZIP
BUILDING:________________
SITE CODE: __________
IEP TEACHER OF RECORD:______________________________
INITIAL IEP:___________
INTERIM IEP:__________
SUBSEQUENT IEP:__________
DATE
AMENDED or MODIFIED:__________
Present Levels of Academic Achievement and Functional Performance: Document current evaluation data and write objective statements, (may include most recent statewide and districtwide assessments) to demonstrate how the child’s disability affects the child’s involvement, functional performance, and progress in the general education curriculum and postsecondary transition, as appropriate. For students of transition age, document transition assessment results as they relate to the postsecondary goal(s). For preschool children, describe how the disability affects the child’s participation in age appropriate activities.
Current Assessment Data
Objective Statements
OSDE Form 7
Page __ of __
Initial IEP Date__________ Interim IEP Date____________ Subsequent IEP Date____________
IEP – Strengths/Needs, Special Factors, and Parent Concerns Page
List strengths of the child and a statement of the anticipated
List the educational needs resulting from the child’s disability,
effects on the child’s participation in the general education
which may require special education, related services,
curriculum or appropriate activities.
supplementary aids, supports for personnel, or modifications.
Strengths:
Anticipated Effects:
Consideration of special factors: Check yes or no whether the IEP team considers each special factor to be relevant to this child. Yes No
Strategies, positive behavior interventions and supports, as appropriate, if behavior impedes learning of self or others
Language needs as related to the IEP for a child with limited English proficiency (LEP)
Instruction and use of Braille if child is blind or visually impaired, unless determined inappropriate based on evaluation.
Communication needs, and for child who is deaf or hard of hearing, the language and communication needs and opportunities for communication and instruction in the child’s native language and communication mode
Whether this child requires assistive technology devices and service
For special factors checked yes, explain determinations of the team as to whether services are required in the IEP.
Parent Concerns for Enhancing the Child’s Education:
IEP – Goals Page
NAME OF CHILD:
STUDENT ID:_________________________
FIRST
MIDDLE
LAST
Annual Goals:
Provide measurable annual goals, including academic and functional goals to enable the child to be involved in and make progress in the general education curriculum (for a preschool child in the appropriate activities), and to meet other educational needs that result from the disability.
GOAL # _______
Parents are to be informed of progress in annual goals, in addition to general education academic performance reports. Describe how often this will occur and what methods will be utilized.
Record the extent of progress toward achieving the annual goals by the end of the year (i.e., one-half, two-thirds, fifty percent, passing grades in general curriculum).
DATE (ESY)
How will the extent of progress toward annual goals be measured?
COMMENTS:
IEP – Goals and Short-Term Objective/Benchmark Page
Short-term Objectives or Benchmarks: In addition to Annual Goals, provide at least two short-term objectives or benchmarks per goal for children who take alternate assessments aligned to alternate achievement of the standards.
SHORT-TERM OBJECTIVE/BENCHMARK #________
IEP – Transition Services Plan – Goals and Activities Page
(Beginning not later than the first IEP developed during the student’s ninth grade year, or upon turning 16 years of age, whichever occurs first)
STUDENT ID: ________________________
Postsecondary Goal(s): _________________________________________________________________________________________
___________________________________________________________________________________________
Annual Transition Goals
Provide measurable annual transition goals to assist the young adult in working toward their postsecondary goal(s). The annual transition goal(s) must include academic and functional goals to enable the young adult to be involved in and make progress in the general education curriculum and in community experiences. For a young adult beginning with the first IEP developed during the student’s ninth grade year or upon turning 16 years of age, whichever occurs first, postsecondary goal(s) based upon age appropriate transition assessments related to education/training, employment, and where appropriate, independent living skills, and to meet other educational needs that result from the disability. For young adults being taught to alternate achievement of the standards, include a minimum of two (2) short-term objectives or benchmarks for each annual goal.
Education/Training Goal(s)
Short-Term Objectives/Benchmarks (as needed)
Coordinated Activities
Responsible Party(ies)
Parents are to be informed of progress in annual goals, in addition to general
Extent of progress toward achieving the annual transition goals by
education academic performance reports. Describe how often this will occur
the end of the year (i.e., one-half, two-thirds, fifty percent, passing
and what methods will be utilized.
grades in general curriculum).
Employment Goal(s)
IEP – Transition Services Plan – Transition Goals/Course of Study
(Beginning not later than the first IEP developed during the student’s ninth grade year or upon turning 16 years of age, whichever occurs first.)
Independent Living Goal(s) (if appropriate)
Build a course of study, to be updated annually, to assist the young adult in achieving their postsecondary goal(s):
Grade __________
Grade ___________
Projected date of graduation/program completion and type:
______________________________________
Standard Diploma
General Education Development (GED) Other _____________________________
In planning the course of study, is information needed regarding opportunities for vocational education (e.g., high school vocational education courses, school-based training, work study programs, technology education, or area career technology center programs)?
Yes No
If yes, document date(s) when information was provided to young adult and parent(s). Date: ______________________
By age 16, the young adult has been referred to the vocational rehabilitation counselor in the young adult’s school district.
Person responsible for the referral: __________________________________________Date:__________________________________
Name of the Vocational Rehabilitation Counselor: ____________________________________________________________________
Have the young adult and parent(s) been provided a copy of the referral form? Yes No
If no, explain why. _____________________________________________________________________________________________
If yes, explain how. ____________________________________________________________________________________________
By age 17, have young adult and parent(s) been informed of any transfer of rights at age of majority? Yes No
If no explain why: _____________________________________________________________________________________________
Comments: __________________________________________________________________________________
IEP – Services Page
Special Education Services: List each special education service.
Type of Service(s)
Amount of Services (Time
Starting Date
Ending Date
Person Responsible
and Frequency)
(Title)
Related Services: List each related service necessary for the child to benefit from special education.
Location of
Services
Provide an explanation of the extent, if any, to which the child will not participate with nondisabled children in the general education curriculum or age-appropriate activities:
The continuum of placements for the least restrictive environment (LRE) includes regular classes full-time, special classes part-time or full-time, public/private separate day school facility, public/private residential facility, home instruction/hospital environment, correctional facility, or parentally placed in private schools. For preschool children (aged 3 through 5), the continuum includes early childhood program, special education program, residential facilities, home, service provider location.
Continuum of Placement:
Amount of time in general education setting: _____ of _____ periods per day OR __________ % of instructional day.
If block schedule, describe:
Is this child’s instructional day the same length as nondisabled peers? Yes No
If no, describe the reason(s) for a shortened school day:
Regular PE Adapted PE NA
List modifications necessary for this child to participate in regular PE
If not applicable provide justification:
(specially designed adapted PE, if needed, must be addressed on the IEP):
Supplementary aids and services, program modifications and/or supports for personnel in general education or other education-related settings not otherwise addressed as special education or related services:
Supplementary aids and services:
Location/Class/Settings
Program modifications:
Supports for personnel:
IEP – Signature Page
State and Districtwide Assessment Programs
Child will participate in:
Oklahoma Core Curriculum Tests (OCCT)
Alternate Assessment (OAAP or OMAAP)
If the child is participating in alternate assessment, has the IEP team considered the guidelines for participation in alternate assessment?
Yes No If no, explain why:
If the child is participating in an alternate assessment, how will the child be assessed?
OAAP Portfolio
OMAAP
If the child is participating in OMAAP, list each subject for which the child will participate.
Specify state approved accommodations used in each test administration.
Extended School Year (ESY) Services
ESY Services: Requires further data; will reconvene by ___/____/___
are necessary
are not necessary
If necessary, describe services provided:
Documentation of LRE Placement Considerations
Describe continuum of placements considered and reasons determined not appropriate:
Is this placement in the school the child would normally attend if nondisabled? Yes No
If no, is the placement as close as possible to the child’s home? Yes No
If no, explain why the IEP requires other arrangements:
Explain considerations of potential harmful effects on the child or the quality of services needed:
When special classes, separate schools/facilities, or other removal from the general education environment occurs, describe how the nature and severity of the disability is such that education in general education classes, with the use of supplementary aids and services, cannot be achieved satisfactorily:
Date of next IEP _______________________________________________________________Date of next 3 year reevaluation ______________
FROM INITIAL
FROM INTERIM
FROM SUBSEQUENT
Team Participant Signatures:
Parent(s)________________________________________________
Date _________________
Agree
*Disagree
Special Education Teacher__________________________________
Regular Education Teacher _________________________________
Administrative Representative_______________________________
Student _________________________________________________
Other___________________________________________________
*Team members who disagree may submit separate statements presenting their conclusions. (Complete Comment Form as necessary.)
If parent(s) did not attend the IEP meeting, explain other methods to ensure parent participation (and/or child as appropriate): (e.g., conference call, videoconference, home visit)
Parent(s) have protection under the procedural safeguards.
Translation/Interpretation needed:
Yes No
Parent(s) received Parents Rights in Special Education:
If yes, specify how provided: ______________________
Notice of Procedural Safeguards
Yes
No
Parent(s) received Parent Survey form and business reply envelope:
Parent Initial: _____________________
Parent consent for initial placement (consent is voluntary and may be revoked at any time)
Parent Signature: _______________________________________________________ Date: _________________________________
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