Special Factors (3A)
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  Incomplete Incomplete
 
Name   IEP Date
 

 
  Does student require assistive technology devices and/or services? Does student require assistive technology devices and/or services? Does student require assistive technology devices and/or services?
      If yes, specify:
 
 
 
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  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? Does student require low incidence services, equipment and/or materials to meet educational goals?
    If yes, specify:
 
 
 
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  Considerations if the student is blind or visually impaired Considerations if the student is blind or visually impaired Considerations if the student is blind or visually impaired
 
 
 
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  Considerations if the student is deaf or hard of hearing Considerations if the student is deaf or hard of hearing Considerations if the student is deaf or hard of hearing
 
 
 
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  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 If the child is an English Learner, consider the language needs of the child as those needs relate to the IEP
 
 
 
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  Does student's behavior impede learning of self or others? Does student's behavior impede learning of self or others? Does student's behavior impede learning of self or others?
    (If yes, describe)
 
 
 
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  If yes, specify positive behavior interventions, strategies, and supports If yes, specify positive behavior interventions, strategies, and supports If yes, specify positive behavior interventions, strategies, and supports
 
 
 
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  Behavior Support Plan
(BSP) attached
Behavior Intervention Plan
(BIP) attached
Behavior Goal is part
of this IEP
 

 
  For student to receive educational benefit, goals will be written to address the following areas of need: For student to receive educational benefit, goals will be written to address the following areas of need: For student to receive educational benefit, goals will be written to address the following areas of need:
 
 
 
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