Special Education Resources for Staff

  • Conference Report Form - Revise 12/2009

    This document is to be used to supplement all MDE and IEP meetings. The team should use the checklist to document all parts that were discussed at a meeting. If anything is discussed at the meeting that is not on the checklist, document in the "other" section. List at the bottom of the conference report all those who participated in the meeting. This form also serves as the cover sheet for documents to be placed in the school guidance file as well as the documents forwarded to the special education office.
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  • ESY Checklist

    The ESY checklist is to be used by the IEP Team to consider and discuss eligibility for ESY services.

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  • Functional Behavior Assessment (FBA)

    The Functional Behavior Assessment (FBA) is used when a student's behavior interferes significantly with his or her learning or that of peers. A functional behavioral assessment consists of indirect and direct information-gathering that result in identifying a hypothesis about the function of the behavior, the environmental events, and the consequences that are serving to maintain the behavior.
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  • IEP Sample

    This document is a sample resource that provides information concerning the sections of the IEP. The IEP must be reviewed at least one time annually.
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  • Level of Intervention Form

    The Level of Intervention Worksheet is to be used to calculate the amount of time a student receives special education services. This should be calculated carefully so that the Penn Data is recorded correctly with the Department of Education.
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  • Medical Assistance Letter

    This letter provides the school district with permission from the student's parent to bill Medical Assistance for medically related services that are required in the student's IEP. Examples of related services would be speech and language services, physical therapy services, etc. This form must be signed by the parent annually and should be completed at the annual review of the student's IEP.

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  • Parent Re-Evaluation Form

    The parent form should be sent home to the student's parent or guardian as part of the two or three year reevaluation process. The information returned by the parent should then be incorporated into the Reevaluation Report.
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  • Positive Behavior Support Plan (PBSP)

    Information gathered from the FBA is used to develop the Positive Behavior Support Plan (PBSP). This is an individualized plan to target specific behaviors.
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  • Reevaluation Sample

    This document is an sample resource that provides information concerning the sections of the reevaluation report. A reevaluation report must be completed for all students at least one time every three years with the exception of students identified as mentally retarded (MR). Students who are MR must be reevaluated every two years.
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  • Reevaluation Teacher Report

    Regular education teachers who have a student participating in their class should complete the teacher reevaluation form as part of the two or three year reevaluation process. The information should be returned by the regular education teacher and incorporated into the Reevaluation Report.
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  • Structured Observation Report

    Use this form to complete an observation of a student. It will assist in determining time on task.
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