IEP Form 5A – Services

Offer of FAPE

Special education and related services are determined at the IEP meeting only after goals and if appropriate objectives/benchmarks have been finalized. Placement decisions must be made in conformity with the least restrictive environment (LRE) provisions. These provisions direct that to the maximum extent appropriate, students with disabilities be educated with typically developing peers, and that special classes, separate schooling or other removal of students from the general education environment occurs only if the nature or severity of the disability is such that education in general education classes with the use of supplementary aids and services cannot be achieved satisfactorily. The placement must be made in the school that the student would attend if the student did not have a disability unless unique circumstances prevent this placement. Special education and related services and supplementary aids and services, should be based on peer-reviewed research to the extent practicable.

1.      Service Delivery Options Considered: Discuss and document service delivery options considered. The team must first consider placement in the general education classroom with supports prior to recommending a more restrictive setting all or part of the day. 

Note: In determining the LRE, consideration must be given to any harmful effect on the child or quality of services that the child needs. 

Follow the continuum of services below as a guide to determining LRE:

á      General Education Class

á      General Education Class – Supplemental aids or services

á      General Education Class – Some direct instruction by special education staff. Less than 21% of time out of the classroom for special education services.

á      General Education Class – 21% to 60% of instructional day in a separate classroom.

á      Some/or no instruction in General Education Class – 60% or more of the instructional day in a separate classroom (intensive services).

á      Special day school – Separate facility (public or nonpublic) with no general education students on campus.

á      Residential School.

á      Hospital Program.

á      Home Instruction.

 

2.      Supplementary Aids, Services and Other Supports for School Personnel, or for the Student, or On Behalf of the Student: Note supplementary aids and services and/or supports for the student, school personnel (consultation to teachers, preferential seating, enlarged text, etc.). Indicate if the supports are for the student or for school personnel by checking the appropriate box in the grid.

 

Team must also document modifications and/or accommodations that will be needed in order for the student to progress toward annual goals while participating in the general curriculum. Accommodations do not fundamentally alter or lower expectations or standards in instructional level, content, or performance criteria (extended time on a timed task, enlarged text, etc.). Modifications fundamentally alter or lower expectations or standards in instructional level, content, or performance criteria (alternate math assignment, etc.). Indicate who will be responsible for the supplementary aids and services, the start and end date, duration, frequency, and location.

 

3.      Special Education and Related Services: The team needs to determine the special education and related services that will provide educational benefit and facilitate progress on the goals for the student (e.g. specialized academic instruction, health and nursing, language and speech, etc).  Identify the type of service. Indicate if the service will be individual or group. If the service is to support secondary transition, check the secondary transition box.  See CASEMIS codes below:

Specialized InstructioN

330

Specialized academic instruction

Adapting, as appropriate to the needs of the child with a disability the content, methodology, or delivery of instruction to ensure access of the child to the general curriculum, so that he or she can meet the educational standards within the jurisdiction of the public agency that apply to all children. (RSP- school based, RSP, SDC inclusion services, SDC-public integrated, SDC-public segregated, SDC-non-public school.)

340

Intensive individual instruction

IEP Team determination that student requires additional support for all or part of the day to meet his or her IEP goals. (1-1 instructional assistant)

350

Individual & small group instruction

Instruction delivered one-to-one or in a small group as specified in an IEP enabling the individual(s) to participate effectively in the total school program. (For preschool only)

Related Services

415

Language and Speech

Includes receptive and expressive language, articulation, voice, and fluency.

425

Adapted physical education

Direct physical education services provided by an APE.

435

Health & nursing –specialized physical health care services

Specialized physical health care services means those health services prescribed by the childŐs licensed physician and surgeon requiring medically related training of the individual who performs the services and which are necessary during the school day to enable the child to attend school. SPHCS include but are not limited to suctioning, oxygen administration, catheterization, nebulizer treatments, insulin administration, and glucose testing.

 

 

436

Health & nursing – other services

This includes services that are provided to students by qualified personnel pursuant to an IEP when a student has health problems which require nursing intervention beyond basic school health services.  Services include managing the health problem, consulting with staff, group & individual counseling, making appropriate referrals and maintaining communication with agencies and health care providers.

445

Assistive technology services

Any specialized training or technical support for the incorporation of assistive devices, adapted computer technology or specialized media with the educational programs to improve access for students. 

450

Occupational therapy

OT includes services to improve studentŐs educational performance, postural stability, self-help abilities, sensory processing and organization, environmental adaptation and use of assistive devices, motor planning and coordination, visual perception and integration, social play abilities and fine motor.

460

Physical therapy

Services provided by a register PT pursuant to an IEP when assessment shows discrepancy between gross motor performance and other educational skills.

Mental Health Services

510

Individual counseling

One-to-one counseling, provided by a qualified individual pursuant to an IEP. 

515

Counseling & guidance

Counseling in a group setting, provided by a qualified individual pursuant to an IEP. 

520

Parent counseling

Individual or group counseling provided by a qualified individual pursuant to an IEP to assist the parent(s) of special education students in better understanding and meeting their childŐs needs.

525

Social work services

Includes services provided pursuant to an IEP by a qualified individual.

530

Psychological services

These services provided by a credentialed or licensed psychologist pursuant to an IEP.

535

Behavior intervention services

A systematic implementation of procedures designed to promote lasting, positive changes in the studentŐs behavior resulting in greater access to a variety of community settings, social contacts, public events, and placement in the LRE.

540

Day treatment services

Structured education, training and support services to address the studentŐs mental health needs.

545

Residential treatment services

A 24 hour out-of-home placement that provides intensive therapeutic services to support the educational program.

 


Low Incidence Services

610

Specialized services for low incidence disabilities

 Low incidence services are defined as those provided to the student population of orthopedic impairment (OI), visual impairment (VI), deaf, hard of hearing (HH), or deaf-blind (DB). Typically, services are provided in education settings by an itinerant teacher or the itinerant teacher/specialist. Consultation is provided to the teacher, staff and parents as needed.

 

710

Specialized deaf and hard of hearing services

These services include speech therapy, speech reading, auditory training, and/or instruction in the student's mode of communication. Rehabilitative and educational services; adapting curricula, methods, and the learning environment; and special consultation to students, parents, teachers, and other school personnel may also be included.

715

Interpreter services

Sign language interpretation of spoken language to individuals, whose communication is normally sign language, by a qualified sign language interpreter.

720

Audiological services

These services include measurements of acuity, monitoring amplification, and Frequency Modulation system use.

725

Specialized vision services

This is a broad category of services provided to students with visual impairments. It includes assessment of functional vision; curriculum modifications necessary to meet the student's educational needs -- including Braille, large type, aural media; instruction in areas of need; concept development and academic skills; communication skills (including alternative modes of reading and writing); social, emotional, career, vocational, and independent living skills. It may include coordination of other personnel providing services to the students (such as transcribers, readers, counselors, orientation & mobility specialists, career/vocational staff, and others) and collaboration with the student's classroom teacher.

730

Orientation and mobility

Students with identified visual impairments are trained in body awareness and to understand how to move. Students are trained to develop skills to enable them to travel safely and independently around the school and in the community. It may include consultation services to parents regarding their children requiring such services according to an IEP.

735

Braille transcription

Any transcription services to convert materials from print to Braille. It may include textbooks, tests, worksheets, or anything necessary for instruction. The transcriber should be qualified in English Braille as well as Nemeth Code (mathematics) and be certified by appropriate agency.

740

Specialized orthopedic services

Specially designed instruction related to the unique needs of students with orthopedic disabilities, including specialized materials and equipment.

745

Reading Services

 

750

Note taking services

Any specialized assistance given to the student for the purpose of taking notes when the student is unable to do so independently. This may include, but is not limited to, copies of notes taken by another student, transcription of tape-recorded information from a class, or aide designated to take notes.

755

Transcription Services

Any transcription service to convert materials from print to a mode of communication suitable for the student. This may also include dictation services as it may pertain to textbooks, tests, worksheets, or anything necessary for instruction.

760

Recreation Services

Therapeutic recreation and specialized instructional programs designed to assist pupils to become as independent as possible in leisure activities, and when possible and appropriate, facilitate the pupilŐs integration into general education programs.

Transition Services

820

College Awareness

 

830

Vocational assessment, counseling, guidance, and career assessment

Organized educational programs that are directly related to the preparation of individuals for paid or unpaid employment and may include provision for work experience, job coaching, development and/or placement, and situational assessment. This includes career counseling to assist student in assessing his/her aptitudes, abilities, and interests in order to make realistic career decisions.

840

Career awareness

Transition services include a provision for in self-advocacy, career planning, and career guidance.

850

Work experience education

Work experience education means organized educational programs that are directly related to the preparation of individuals for paid or unpaid employment, or for additional preparation for a career requiring other than a baccalaureate or advanced degree.

855

Job Coaching

Job coaching is a service that provides assistance and guidance to an employee who may be experiencing difficulty with one or more aspects of the daily job tasks and functions.  The service is provided by a job coach who is highly successful, skilled and trained on the job who can determine how the employee that is experiencing difficulty learns best and formulate a training plan to improve job performance.

860

Mentoring

Mentoring is a sustained coaching relationship between a student and teacher through on-going involvement and offers support, guidance, encouragement and assistance as the learner encounters challenges with respect to a particular area such as acquisition of job skills.  Mentoring can be either formal as in planned, structured instruction of informal that occurs naturally through friendship, counseling and collegiality in a casual, unplanned way.

865

Agency linkages (referral and placement)

Service coordination and case management that facilitates the linkage of individualized education programs.

870

Travel Training (includes mobility training)

 

890

Other transition services

These services may include program coordination, case management and meetings, and crafting linkages between schools and between schools and post-secondary agencies.

900

Other Special Education/Related Services

Any other specialized service required for a student with a disability to receive educational benefit.

 

4.      Start and End Date: This will often be the same start/end dates for the primary service on the IEP. 

 

5.      Provider: Note the title of the provider of the service (do not put the personŐs name).

 

6.      Frequency: Indicate the frequency of the service being provided, such as daily, weekly, monthly, yearly, or any other frequency.

 

7.      Duration: Indicate number of times per frequency (see CASEMIS for examples).

 

8.      Location:  Select the location of where the service is provided to the student from the following:

210      Home instruction based on IEP team determination (not medical)

220      Hospital

310      HeadStart center

320      Child development or childcare facility

330      Public preschool

340      Private preschool

350      Extended day care

360      Residential facility

510    Regular classroom/public day school

           Includes students who are fully included in general education classrooms..  Also includes students who are seen under a Ňpush inÓ model in the general education classroom and students who receive DIS services in the general education classroom. Additionally, students who receive services in a setting that includes other students with special needs are included here if there are general education students who are Ňreverse mainstreamÓ students in that class for that portion of the day.

520    Separate class in public integrated facility

           Includes students receiving special education Ňpull-outÓ services, including RSP and DIS, or in a Ňspecial day classÓ model,Ó etc.

530    State Special School

540    Separate school or special education center or facility

550    Public residential school

560    Other public school or facility

570    Charter school operated by an LEA/district

580    Charter school operated as an LEA/district

610      Continuation school

620      Alternative work education center/work study facility

630      Juvenile court school

640      Community school

650      Correctional institution or facility

710      Community college

720      Adult education facility

810      Nonpublic day school

820      Nonpublic residential school-in California

830      Nonpublic residential school-outside California

840    Private day school (not certified by CDE Special Education Division)

850    Private residential school (not certified by CDE Special Education Division)

860      Parochial school

890      Service provider location

           This would include CMH Outpatient Services provided at a clinic or other outside medical/therapeutic setting.

900      Any other location or setting

 

9.      Extended School Year (ESY): Discuss if the student needs ESY to receive FAPE. Check yes or no. If yes, specify in the grid the services the student will receive, the start and end date, provider, frequency, duration, and location.

Note: ESY shall be provided to a student with a disability who the IEP deems requires special education and related services in excess of the regular academic year. Such students shall have disabilities which are likely to continue indefinitely or for a prolonged period of time, and interruption of the studentŐs educational programming may cause regression, when coupled with limited recoupment capacity, rendering it impossible or unlikely that the student will attain the level of self-sufficiency and independence that would otherwise be expected in view of his or her disability.  (5 CCR 3043)

 

[Source: State SELPA IEP Manual (draft), July 2008]