Special Factors

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Name   IEP Date

Does student require assistive technology devices and/or services? Does student require assistive technology devices and/or services?
    If yes, specify:
 
Does student require low incidence services, equipment and/or materials to meet educational goals? Does student require low incidence services, equipment and/or materials to meet educational goals?
    If yes, specify:
 
Considerations if the student is blind or visually impaired Considerations if the student is blind or visually impaired
 
 
Considerations if the student is deaf or hard of hearing Considerations if the student is deaf or hard of hearing
 
 
If the child is an English Learner, consider the language needs of the child as those needs relate to the IEP If the child is an English Learner, consider the language needs of the child as those needs relate to the IEP
 
Does student's behavior impede learning of self or others? Does student's behavior impede learning of self or others?
    (If yes, describe)
  If yes, specify positive behavior interventions, strategies, and supports If yes, specify positive behavior interventions, strategies, and supports
 
Areas of need to be addressed in goals for the student to receive educational benefit Areas of need to be addressed in goals for the student to receive educational benefit

Participation in State/Districtwide Assessments (STAR)
CAT-6/California Standards Tests CAT-6/California Standards Tests
 
- Level
(CASEMIS)   

 
Participation in the CAPA is appropriate because Participation in the CAPA is appropriate because
 
Other Statewide/Districtwide Assessments - Accommodations/Alternate Other Statewide/Districtwide Assessments - Accommodations/Alternate
 
Alternate assessment(s) appropriate because Alternate assessment(s) appropriate because

For Preschoolers: