Section 2: Confidentiality and Teacher of Record (TOR)
2.1 Confidentiality
2.2 Authorization for Release and Exchange of Information-Form
2.2S Authorization for Release and Exchange of Information-Spanish-Form
2.3 Special Education Teacher Responsibilities
2.4 Special Education Student Information Distribution
Section 3: Enrollment
3.1 Enrollment Form
3.2a Suspected Special Education Student Enrollment Form
3.3 Transfer Procedure Flowchart
Section 4: General Education Intervention (GEI)
4.1 Procedures for General Education Intervention (GEI) Initial Evaluation
4.2 General Education Intervention (GEI) Flowchart
4.3 General Education Intervention (GEI) Team Meeting Notification
4.3S General Education Intervention (GEI) Team Meeting Notification-Spanish
4.4 Building Intervention Team Referral Form-Elementary
4.5 Building Intervention Team Referral Form-Secondary
4.6 Building Intervention Team Student Data Form-Secondary
4.7 Building Intervention Team Initial Meeting Form
4.8 Intervention Implementation Fidelity
4.9 Building Intervention Team Follow Up Form
4.10 Response to Intervention (RTI) Documentation Checklist
4.11 Response to Intervention (RTI) Checklist for SLD Identification
4.12 Tier 2 Intervention Documentation Worksheet
Section 5: Procedural Safeguards and Surrogate Parent
5.1 Distribution of Procedural Safeguards/Parent Rights
5.3 Indiana Department of Education Notice of Procedural Safeguards
5.3S Indiana Department of Education Notice of Procedural Safeguards-Spanish
5.4 Educational Surrogate Parent Procedures and Guidelines
5.5 Surrogate Parent Appointment Form
Section 6: Initial Evaluation
6.1 Identification and Evaluation Procedures
6.2 Procedures for Initial Evaluation by Parent Request
6.3 Procedures for Initial Evaluation Parent Referral Flowchart
6.4 Indiana IEP Instructions for Initial Evaluation
6.5 Teacher/Counselor Information Form
6.5P Teacher/Counselor Information Form – Preschool
6.6 Social and Developmental History-Form
6.6T Social and Developmental History-Online Template
6.6P Social and Developmental History-Preschool
6.6S Social and Developmental History-Spanish
6.7 Procedures for Initial Evaluation Language or Speech Impairment Parent Referral
6.8 Preschool Speech and Language History-Form
6.8 Preschool Speech and Language History-Online Template
6.8S Preschool Speech and Language History-Form-Spanish
6.9 Parent Notification of Completed Evaluation
6.10 Occupational Therapist (OT) and Physical Therapist (PT) Screening and Evaluation Procedures
6.11 Parent Procedures for Requesting an Initial Evaluation
6.11S Parent Procedures for Requesting an Initial Evaluation-Spanish
Section 7: Reevaluation
7.1 Reevaluation Procedure Flowchart
7.3 Social History Reevaluation-Form
7.3 Social History Reevaluation-Online Template
7.4 Parent Notification Reevaluation of Scheduled Case Conference
Section 8: Multidisciplinary Responsibilities and Evaluations
8.1 Multidisciplinary Team Process
8.2 Multidisciplinary Evaluation Plan
8.3 Autism Spectrum Disorders (ASD) Multidisciplinary Team Members and Responsibilities
8.4 Eligibility Criteria for Autism Spectrum Disorder (ASD) Multidisciplinary Team Summary
8.5 Blind Low Vision (BLV) Multidisciplinary Team Members and Responsibilities
8.6 Eligibility Criteria for Blind Low Vision (BLV) Multidisciplinary Team Summary
8.7 Cognitive Disabilities Multidisciplinary Team Members and Responsibilities
8.8 Eligibility Criteria for Cognitive Disability Multidisciplinary Team Summary
8.9 Deaf-Blind (DB) Multidisciplinary Team Members and Responsibilities
8.10 Developmental Delay (DD) Multidisciplinary Team Members and Responsibilities
8.11 Eligibility Criteria for Developmental Delay (DD)Multidisciplinary Team Summary
8.12 Emotional Disability (ED) Multidisciplinary Team Members and Responsibilities
8.13 Eligibility Criteria for Emotional Disability (ED) Multidisciplinary Team Summary
8.14 Language or Speech Impairment (LSI) Multidisciplinary Team Members and Responsibilities
8.15 Eligibility Criteria for Language or Speech Impairment (LSI) Multidisciplinary Team Summary
8.16 Multiple Disabilities Multidisciplinary Team Members and Responsibilities
8.17 Eligibility Criteria for Multiple Disabilities Multidisciplinary Team Summary
8.18 Orthopedic Impairment (OI) Multidisciplinary Team Members and Responsibilities
8.19 Eligibility Criteria for Orthopedic Impairment (OI) Multidisciplinary Team Summary
8.20 Other Health Impairment (OHI) Multidisciplinary Team Members and Responsibilities
8.21 Eligibility Criteria for Other Health Impairment (OHI) Multidisciplinary Team Summary
8.22 Specific Learning Disability (SLD) Multidisciplinary Team Members and Responsibilities
8.23 Eligibility Criteria for Specific Learning Disability (SLD) Multidisciplinary Team Summary
8.24 Traumatic Brain Injury (TBI) Multidisciplinary Team Members and Responsibilities
8.25 Eligibility Criteria for Traumatic Brain Injury (TBI) Multidisciplinary Team Summary
8.26 Determining Eligibility for a Reading Disability Resulting from Organic Dysfunction Flowchart
1 ICAM/NIMAS Form 1: Special Consideration Factor
2 ICAM/NIMAS Form 2: Determination of Specialized Formats
3A ICAM/NIMAS Form 3A: Add Update Student
3B ICAM/NIMAS Form 3B: Add Update Student
3C ICAM/NIMAS Form 3C: Add Update Student
5 ICAM/NIMAS Form 5: Student/Parent Accessible Materials Use Agreement
8.27 Print Disability Eligibility Form
8.28 Preschool Teacher Information Form Parent Referral for Individual Evaluation
8.29 Preschool Special Education Teacher Summary Report
8.30 Physician Questionnaire for Medical Concerns
Section 9: Educational Evaluation Reports
9.1 Educational Evaluation Report Procedures
9.2 Multidisciplinary Team Report Cover Page
9.3 General Education Teacher Report for Student Evaluation
9.4 Special Education Teacher Report for Student Evaluation
9.5 Written Record of Observation
9.6 Autism Observation Summary Report
9.7 Behavior Consultant Assessment Summary Report
9.8 Blind Low Vision (BLV) Teacher/Consultant’s Summary Report
9.8a Doctor Eye Report for Low Blind Vision
9.9 Occupational Therapist (OT) Assessment Summary Report
9.10 Orthopedic Impairment (OI) Assessment Summary Report
9.11 Physical Therapist Summary Report
9.12 Speech/Language Pathologist Summary Report
9.13 Procedure For Releasing Educational Evaluation Reports to Parents/Guardians
9.14 Verification of Receipt of Copy of Psychological Report
9.15 Occupational Therapy (OT)/Physical Therapy (PT) Initial Evaluation Procedures
9.16 Occupational Therapy (OT)/Physical Therapy (PT) for Students Eligible for Special Education Services
9.17 Occupational (OT)/Physical Therapist (PT) Therapy Screening Request Form
Section 10: Case Conference Process
10.1 Reevaluation Procedure Flowchart
10.2 Annual Case Conference Due Dates
10.3 Parent Notification of Scheduled Case Conference Eligible/Ineligible
10.4 Parent Notification: Completed Annual Case Conference
Section 11: Individualized Education Plan (IEP)
11.1 Indiana IEP Instructions for Teachers of Record (TOR)
11.2 Indiana IEP Instructions for Multidisciplinary Team Members
11.3 Indiana IEP Instructions for Managing Caseload
11.4 Indiana IEP Instructions for Revising an IEP
11.5 Indiana IEP Instructions for Resetting Data-Utilizing Checkbox
11.6 Indiana IEP Instructions for Initial Evaluation of Student Attending a Nonpublic School
11.7 Individualized Education Program Procedures
11.8 Present Level of Educational Performance (PLEP) Guidelines
11.9 Present Level of Educational Performance (PLEP) Narrative
11.10 Instructions for Entering PLEP Information on the IEP
11.11 Transportation Guidelines
Section 13: Extended School Year
13.1 Extended School Year (ESY) Services Guidelines
13.2 Extended School Year (ESY) Services Decision Making Form
Section 14: Termination of Special Education Services
14.1 Termination of Individualized Education Plan (IEP) due to Revocation of Consent
14.2 Notice of Discontinuation of Special Education Services-Form
14.2 Notice of Discontinuation of Special Education Services-Online Template
Section 15: Manifestation Determination
15.1 Student Suspension/Removal Guidelines
15.2 Student Suspension/Removal Flowchart
15.3 Manifestation Determination Expulsion Procedures
15.4 Manifestation Determination Expulsion Flowchart
15.5 Manifestation Determination Form
15.6 Manifestation Determination Conference Parent Notification
15.7 Documentation of Provided Services
Section 16: Functional Behavioral Assessment and Positive Behavior Intervention Plan
16.1 Functional Behavioral Assessment (FBA) & Positive Behavior Intervention Plan (PBIP) Guidelines
16.2 Steps to Conducting a Functional Behavioral Assessment (FBA) and Positive Behavior Intervention
16.4 Record Review Notes
16.5 FBA Teacher/Staff Interview
16.5(temp) FBA Teacher/Staff Interview – Online Template
16.6 FBA Behavior of Concern Questionnaire
16.6(temp) FBA Behavior of Concern Questionnaire – Online Template
16.7 FBA Functional Assessment Checklist for Teachers and Staff (FACTS A and B)
16.7(ex) FBA Functional Assessment Checklist for Teachers and Staff (FACTS A and B) Example (not available)
16.7(temp) FBA Functional Assessment Checklist for Teachers and Staff (FACTS A and B) Template
16.8(temp) FBA Student Interview-Online Template
16.9a FBA Reinforcement Survey
16.9a(temp) FBA Reinforcement Survey – Online Template
16.9b FBA Dunn Rankin Reward Preference Inventory
16.9b(temp) FBA Dunn Rankin Reward Preference Inventory Template
16.10 FBA Functional Assessment Checklist for Students (FACTS A and B)
16.10(ex) FBA Functional Assessment Checklist for Students (FACTS A and B) Example (Not available at this time)
16.10(temp) FBA Functional Assessment Checklist for Students (FACTS A and B) Template
16.11 FBA Parent Interview Form
16.11(temp) FBA Parent Interview Form – Online Template
16.12 FBA Possible Data Collection Methods
16.12a ABC Recording Form
16.12a(ex) ABC Recording Form Example
16.12b Event Recording (Frequency) Form
16.12b(ex) Event Recording (Frequency) Form Example
16.12c Scatterplot
1612c(ex) Scatterplot Example
16.12d Duration Recording Form
16.12d(ex) Duration Recording Form Example
16.12e Intensity Recording Form
16.12e(temp) Intensity Recording Form Example (Not available at this time)
16.12f Latency (Time to Respond) Recording Form
16.12f(ex) Latency (Time to Respond) Recording Form Example
16.12g Behavior Data Graphing Form
16.12g(ex) Behavior Data Graphing Form Example
16.12g(temp) Behavior Data Graphing Form Template
16.13 Functional Assessment (FBA) Data Triangulation
16.13(ex) Functional Assessment (FBA) Data Triangulation Example (Not available at this time)
16.13(temp) Functional Assessment (FBA) Data Triangulation – Online Template
16.14 FBA Function of Behavior Checklist
16.15 FBA Competing Behavior Pathway
16.15(inst) FBA Competing Behavior Pathway Instructions
16.15(ex) FBA Competing Behavior Pathway Example
16.15(temp) FBA Competing Behavior Pathway – Online Template
16.16 Positive Behavior Intervention Plan (PBIP)
16.16(ex) Positive Behavior Intervention Plan (PBIP) Example (Not available at this time)
16.16(temp) Positive Behavior Intervention Plan (PBIP) – Online Template
16.17 Individual Crisis Management Plan
16.17(ex) Individual Crisis Management Plan Example
16.17(temp) Individual Crisis Management Plan – Online Template
16.18 FBA & PBIP Additional Resources
16.18a Environmental Inventory
16.18b Classroom Environment Checklist
16.18c Possible ABC Strategies by Function
16.18d Classroom Interventions
16.18e ABC Intervention Ideas
16.19 FBA & PBIP Behavior Support Resources
Section 17 Physical Restraint and Time-Out
17.1 Physical Restraint Guidelines
17.2 Physical Restraint Reporting Form
17.3 Seclusion Timeout Procedures
17.4 Seclusion Timeout Reporting Form
17.5 Procedures for Students with Wandering Running Behavior
Section 18: Transition
18.1 Transition Individualized Education Plan (IEP) (not available)
18.2 Student Transition Assessment Planning Interview
18.4 Community Resources Information Sheet
18.5 Transition from Early Intervention Services to Early Childhood Special Education
Section 19: Medicaid
19.2 Speech/Language/Audiology/Occupational Therapy Referral
19.3 Physical Therapy Referral
19.4 Approval for Behavioral Services
Section 20: Testing Accommodations
20.1 District Assessments
20.2 Guidelines for ISTEP/GQE/ECA Accommodations
20.3 Determining Participation in the State Assessment System
Section 22: Nonpublic and Home School Services
22.1 Procedures for Nonpublic School and Home School Students
22.2 Evaluation of Nonpublic School and Home School Students Flowchart
Section 24: PACE Preschool
24.1 Parent Notification: Schedule Evaluation
24.2 Parent Notification: Missed Evaluation Appointment
24.3 Parent Notification: Schedule Therapy Sessions
24.4 Parent Notification: Missed Therapy Sessions
Section 25: Section 504
25.2 Section 504 Referral
25.3 Parent Notice Permission to Evaluate under Section 504-Form
25.3 Parent Notice Permission to Evaluate under Section 504-Online Template
25.4 Section 504 Physician Letter Regarding Medical Concerns
25.5 Section 504 Eligibility Determination Report
25.6 Section 504 Parent Meeting Notification
25.7 Section 504 Manifestation Determination Report
25.8 Section 504 Plan Termination Form