Oregon Standard Individualized Education Program (Page 2 of 7) in pdf

 If a required participant participates through written input or is excused from all or part of the IEP meeting, attach documentation of

parents’ and district agreement to participation by written input or excuse.

Student’s Name:

Date:

School District:

The IEP team must consider these factors as part of IEP development

A. Does the student need assistive technology devices or services?

__ Yes, services/devices addressed in IEP

__ No

B. Does the student have communication needs?

__ Yes, addressed in IEP

__ No

C. Does the student exhibit behavior that impedes his/her learning or the learning of others?

__ Yes

__ No

(if yes, the IEP Team must consider the use of strategies, positive behavioral interventions, and supports to address the behavior(s)

D. Does the student have limited English proficiency?

__ Yes

__ No

(If yes, the IEP Team must consider the language needs of the student as those needs relate to the IEP)

E. Is the student blind or visually impaired?

__ Yes

__ No

(if yes, Braille needs are addressed in the IEP, or evaluation of reading/writing needs is completed and a determination is made that Braille

not appropriate)

F. Is the student deaf or hard of hearing?

__ Yes

__ No

(if yes, the IEP addresses the student’s language and communication needs, opportunities for direct communication with peers and

professional personnel in the child’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).

Present Levels of Academic Achievement and Functional Performance

The Present Levels of Academic Achievement and Functional Performance must include specific information addressing:



The strengths of the student;



The concerns of the parents for enhancing the education of their child;



The present level of academic performance, including the student’s most recent performance on State or districtwide assessments;



The present level of developmental and functional performance (including the results of the initial or most recent evaluation); and,



How the student’s disability affects involvement and progress in the general education curriculum.

___________________________________________________________________________________________________________________________________________________________

Form 581-5138a-P

Page 2 of 7

1/2011: Oregon Standard IEP for students age 15 and younger when IEP is in effect

Oregon Standard Individualized Education Program Page 2

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