Introduction

This document contains the Individualized Family Service Plan (IFSP) forms used in the Oregon Early Intervention (EI) and Early Childhood Special Education (ECSE) programs (finalized in 2006 - 2007). The forms include requirements of Part C (birth to three), Part B (three to twenty-one) and requirements for the IFSP in Oregon Revised Statute (ORS 343.521)  and Oregon Administrative Rules (OARs 581-015-27 00-2860.)

For further information about this document, please call or write the Office of Special Education

Oregon Department of Education
255 Capitol Street, NE
Salem, Oregon 97310-0203
(503) 947-5600

INDIVIDUALIZED FAMILY SERVICE PLAN (IFSP) PAGE (EI/ECSE Services)

Demographic information and a summary of early intervention, early childhood special education and/or other services for the child are documented on this page. This is a summary of services so the bulk of this page (EI/ECSE Services) is completed after the IFSP team has formulated the child’s goals and objectives.

Directions:

1.	Enter the child’s complete legal name, gender, date of birth, including month, day and year and the child’s student identification number assigned by Oregon Department of Education.

2.	Enter the parent(s) or guardian’s name, home phone, work phone and home address.

3.	Enter the name of the Service Coordinator and the resident school district. All children birth to three must have an assigned Service Coordinator. Service Coordinators may be assigned for children three to school age.

4.	List all pertinent dates, including the IFSP meeting date, the date when the child’s eligibility for EI/ECSE services was established, and projected dates for reviews. IDEA 2004 permits changes to an IFSP for children age 3 to age 5 (ECSE) between annual IFSP meetings without an IFSP meeting if the parent and the authorized EI/ECSE program representative agree. Instead the parent and the authorized EI/ECSE program representative may develop a written document to amend or modify the IFSP. IDEA 2004, Sec 614(d)(3)(D)(new). See EI/ECSE form: Written Agreements between the Parent and the EI/ECSE Program.

5.	List the specific EI/ECSE services necessary to meet the unique needs of the child and family to achieve the identified goals in the child’s IFSP. Specify the service, such as, physical therapy, speech therapy, social skills training, mobility training, concept development, sensory development activities, etc. Sometimes a child is placed in a preschool classroom to receive instruction on specific skills. The service is the specialized instruction the child will receive, not the preschool.
•	Method – Describe how the service will be provided (e.g., individual instruction, small group instruction (usually 3 to 4 children), total group instruction, consultation with family).
•	How often? – Specify the frequency and duration of the services (amount should clearly indicate when services will be delivered).
•	Location – Specify the place(s) where services will be provided. The natural environment (settings that are natural for the child’s typical age peers) is required for early intervention. If the child’s services are not provided in the natural environment, explain why not at the bottom of the page. The least restrictive environment with typical peers to the maximum extent appropriate is required for children receiving ECSE services. If services are not provided with typical peers, explain (at the bottom of the page) the extent to which services are not provided with typical peers and the reason why.
•	Who will do this? – Specify the agency and role of the person who will provide the service.
•	Who will pay? – Specify the agency with financial responsibility for each service.
•	Start date – Specify the date (month, day and year) that each service will begin.
•	Stop date – Specify the anticipated duration (month, day and year) of each service.
•	Other (non EI/ECSE) Services – Specify other services the child and family may need but are not early intervention or early childhood special education services. These may be medical services, health services, Oregon Head Start Prekindergarten services, child care, etc. Indicate the method, location, who will do it, who will pay, start date and stop date for the service(s). If the source of funding is undetermined list the steps that will be taken to secure those services through public or private sources.

6.	Are EI services in the child’s natural environment?  If not, please explain why EI services could not be achieved in the natural environment. This item applies to children under the age of three. If the child is over age three, indicate that the item is not applicable. For children under the age of three, “home” or the place where the child’s typical peers are (e.g., the babysitter’s house) is the natural environment. If the child will receive services in a setting other than the natural environment, explain the reason(s) for not providing services in such a setting.

Note:  Federal placement (educational environments) codes for the Special Education Child Count (SECC) changed in August 2006. The codes are no longer limited to only when ECSE services are provided to the child but encompass all early childhood environments the child accesses. To capture this information EI/ECSE programs must determine the amount of time each child accesses any early childhood environment, including those environments not funded by IDEA (e.g. child care).

7.	How many hours per week does the child attend an early childhood program?  This applies to children age three and older. For a child under age three, indicate that the item is not applicable. Record the number of hours per week the child attends a regular early childhood program (for example, enter 30 hours for a child attending child care 5 times a week for 6 hours per day). A regular early childhood program is defined as a program that contains at least 50% nondisabled children. Early childhood programs include, but are not limited to Head Start; kindergarten; reverse mainstream classrooms; private preschools; Oregon Prekindergarten; Migrant Seasonal Head Start; and group child care.

•	How many hours per week will ECSE services be provided with typical peers in an early childhood program?  Record the number of hours (or fractions of an hour) per week the child will receive ECSE services with typical peers in an early childhood program. For example an IFSP team that plans for a child to receive the 6 hours per week of his ECSE services in the Head Start classroom he attends records 6 hours per week in this section of the IFSP.
•	How many hours per week will ECSE services not be provided with typical peers in an early childhood program?  Record the number of hours (or fractions of an hour) per week the child will not receive ECSE services with typical peers in an early childhood program. For example an IFSP team that plans for a child to receive the majority of his ECSE services in the Head Start classroom he attends and 30 minutes per week of ECSE services outside the classroom records 1/2 hour per week in this section of the IFSP.

•	If ECSE services will not be provided with typical peers in an early childhood program, explain the reason(s) for not providing services with typical peers. This item applies to children age three to school age. If the child is under age three, indicate that the item is not applicable. For children age three and older, explain why the services cannot be provided in such a setting.

•	If you have questions on the SECC or federal placement codes, please see: http://www.ode.state.or.us/search/page/?id=2964 

8.	Parents will be informed of the child’s progress toward annual goals. Children birth to age three must have progress reviewed at least every 6 months and annually. Children age three to school age must have progress reviewed periodically. Review schedules are indicated on the IFSP services page. The team also indicates how progress will be reported to parents. For children under age three this will happen in a meeting with the child’s parents. Children age three and older may have their progress reviewed in a meeting or a progress report may be sent home to the child’s parents. The IFSP goal and objective pages of the IFSP with completed progress reporting information are sufficient for meeting this requirement.

 Parents will be provided with information about their child’s results on the Assessment, Evaluation, and Programming System (AEPS) or Ages and Stages Questionnaire (ASQ) at the annual IFSP. Explain the AEPS or ASQ to the parents and their child’s assessment results.

9.	Parents or any IFSP member may request an IFSP meeting at anytime, regardless of when the most recent IFSP occurred. Make sure that everyone on the team understands that any member of the team may request an IFSP review at anytime.

Early Childhood Special Education Page

IFSPs for preschool children (three to five) require the consideration of and documentation of some specific services and special factors. These are described below.

Directions:

1.	Enter the child’s name, date of birth and the date the form is completed.

2.	Specify any supplementary services, adaptations and/or accommodations necessary for the child to advance appropriately toward annual goals; progress in appropriate activities; participate in nonacademic activities and to be educated and participate with other children. Include how often the services will occur, where it will occur, who will provide the service and the anticipated dates of initiation and duration.

3.	Specify any modifications or supports for program personnel that are necessary for the child to advance appropriately toward annual goals; progress in appropriate activities; participate in nonacademic activities and to be educated and participate with other children. Include how often the services will occur, where it will occur, who will provide the service and the anticipated dates of initiation and duration. Supports for program personnel could include special training for a teacher but should address specific skills targeted for the child and not simply general information on educating young children with disabilities.

4.	Consideration of Special Factors. The IFSP must reflect consideration of communication needs and assistive technology services and/or devices for all children. The other special factor considerations are required in those circumstances for which children show a specific need, such as children for whom behavior is an issue, children with limited English proficiency, children who are blind/visually impaired and children who are deaf/hard of hearing.

Children who demonstrate behaviors which impede learning: When a child’s behavior impedes learning (his/her own or others), the IFSP must reflect strategies and supports, including positive behavioral interventions, to address those behaviors. A functional behavior analysis should be conducted for all such children to provide information on why a child engages in a behavior, when the child is most likely to demonstrate the behavior and situations in which the behavior is least likely to occur.

Children and/or families with limited English proficiency: For children and/or families who speak limited English, the IFSP must reflect how the child’s language needs relate to the IFSP. The IFSP team may want to consider: whether the child has been assessed in his/her native language; what language will be used for instruction; and what language or mode of communication will be used to address and report information to the child’s parents and/or family members.

Children who are blind or visually impaired: For children who are blind or visually impaired, the IFSP must reflect instruction in pre-Braille or Braille, unless the team determines, after an evaluation of the child’s pre-reading and writing skills, that Braille is not appropriate for the child. Consideration of future needs for instruction in Braille or the use of Braille must be considered and documented annually.

Children who are deaf/hard of hearing: For children who are deaf or hard of hearing, the IFSP must explain the communication and language needs and the opportunities for interaction with peers and educational personnel in the child’s own language and communication mode. Opportunities for direct interaction in the child’s own language and communication mode must be described.

Children with communication needs: The IFSP must reflect the teams’ consideration of the child’s communication needs. If the child has communication needs, indicate whether these needs are addressed in the IFSP.

Children who need assistive technology (AT) services or devices: AT devices are items, equipment or product system(s) that are used to increase, maintain, or improve the functional capabilities of a child. These devices may be either “low-tech” (e.g., colored overlays, specialized eating utensils) or “high-tech” (e.g., computers). AT service is any service that assists the child in the selection, acquisition or use of such devices.

Extended Year Service: EYS is special education and related services for maintaining a child’s acquired skills and to reduce regression during periods of time ECSE is not in session. Most children lose skills during breaks from instruction but regain the lost skills in a short amount of time. The purpose of EYS is to prevent significant regression and to facilitate recoupment (regaining) of skills after an interruption of instruction (e.g., summer vacation). If the Team determines that EYS services are to be considered at a later date, indicate the date by which the Team will meet again to discuss the need for EYS services.

Individualized Family Service Plan Participants

IFSPs require the participation of certain individuals. While the team requirements for early intervention and early childhood special education are closely aligned, there are some minor differences.

Directions:
1.	Enter the child’s name, date of birth and the date the form is completed.

2.	Enter the date of the meeting.

3.	List all of the IFSP team members participating in the IFSP meeting.
IFSP team membership for children birth to three (EI) includes:
•	The child’s parents;
•	The EI specialist who works most frequently with the child.  This could be a licensed or authorized EI specialist or other appropriately licensed or certified EI service provider such as an Occupational Therapist or Physical Therapist.
•	The child’s service coordinator, who may be the child’s specialist;
•	A representative of the contractor or subcontractor who may be another member of the team and who is:
•	Qualified to provide or supervise the provision of EI/ECSE services to meet the unique needs of children with disabilities;
•	Knowledgeable of typical child development and appropriate activities for infants and young children; and
•	Knowledgeable about the availability of resources.
•	An individual, who may be another member of the team who:
•	Was involved in conducting the evaluation of the child;
•	Is knowledgeable about the child’s disability; and 
•	Can interpret the developmental or instructional implications of the evaluation. 
•	There are several options for meeting this requirement. The evaluator can participate in the meeting via telephone conference call, or a knowledgeable representative can attend the meeting or the evaluation records can be made available to the IFSP team;
•	Advocate(s) and/or other family members as requested by the parents; and 
•	Other individuals, including related services personnel as appropriate, invited by the parent, contractor or subcontractor, who have knowledge or special expertise regarding the child.

IFSP team membership for children three to five (ECSE) includes:
•	The child’s parents;
•	The ECSE specialist who works most frequently with the child.  This could be a licensed or authorized EI/ECSE specialist or other appropriately licensed or certified EI/ECSE service provider such as an Occupational Therapist or Physical Therapist.
•	A representative of the contractor or subcontractor who may be another member of the team and who is:
•	Qualified to provide or supervise the provision of EI/ECSE services to meet the unique needs of children with disabilities;
•	Knowledgeable of typical child development and appropriate activities for infants and young children; and
•	Knowledgeable about the availability of resources.
•	The child’s preschool teacher if the child is or will be participating in a regular preschool program;
•	An individual, who may be another member of the team who:
•	Was involved in conducting the evaluation of the child;
•	Is knowledgeable about the child’s disability; and
•	Can interpret the developmental or instructional implications of the evaluation. 
•	There are several options for meeting this requirement. The evaluator can participate in the meeting via telephone conference call or a knowledgeable representative can attend the meeting or the evaluation records can be made available to the IFSP team;
•	A representative of the school district in which the child resides during the year before the child enters school; and
•	Other individuals, including related services personnel as appropriate, invited by the parent, contractor or subcontractor who have knowledge or special expertise regarding the child.
•	If a required participant is excused from all or part of the IFSP meeting (ECSE only), attach documentation of parents’ and district agreement to participation by written input or excusal.

4.	If an IFSP participant is filling more than one role at the meeting (e.g., the service coordinator also is the evaluator attending the meeting) then record their name in both places on the form.

5.	Have the parents of the child sign when the IFSP meeting is completed. Explain to parents of children birth to three that their signature indicates their understanding and consent to the IFSP plan and services. Parents of children birth to three have the right to consent for some of the services in the IFSP and refuse consent for other services. Have the parent initial and date, on the IFSP services page, the services they consent to and indicate (e.g., cross out and initial) the ones they decline.

6.	The signature of parents of children three to five indicates that they have participated in the development of the plan; parental approval or consent to the plan and services for children in ECSE is not required.

7.	Additional meeting participation options for children receiving ECSE services
•	IFSP team attendance – not necessary. A member of the IFSP team is not required to attend the IFSP meeting, in whole or in part, if the parent of a child with a disability and the EI/ECSE program agree that the attendance of such a member is not necessary because the member’s area of expertise or related service is not being modified or discussed at the meeting. The EI/ECSE program must separately document this agreement in writing, retain the written submission in the child’s educational records and the child’s IFSP should reflect no changes to that area of expertise or related service. IDEA 2004, Sec. 614(d)(1)(C)(i)(new). See EI/ECSE form:  Written Agreements between the Parent and the EI/ECSE Program.

•	IFSP team attendance – written input. A member of the IFSP team may be excused from attending the IFSP meeting, in whole or in part, when the meeting involves a modification to or discussion of the members’ area of expertise or related services if the parent and the EI/ECSE program consent to the excusal, and the member submits in writing to the parent and to the IFSP team input into the development of the IFSP before the meeting. The EI/ECSE program must separately document this agreement, and retain the written submission in the child’s educational records. IDEA 2004, Sec. 614(d)(1)(C)(ii)(new). See EI/ECSE form:  Written Agreements between the Parent and the EI/ECSE Program.

Present Level of Development

Present level of development information guides the IFSP team in developing goals, objectives and services for the child. The child’s present level of development is based on relevant, functional and developmental evaluation information, including information provided by the parents. In addressing the child’s present level of development, the IFSP must reflect the child’s disability, discuss how the disability affects the child’s involvement in appropriate activities (activities engaged in by typical children of the same age), and address the child’s pre-literacy, language and numeracy skills if the child has needs in these areas. Information from the child’s curriculum based assessment should provide sufficient information to inform the team if the child has needs in these areas.

The present level of development is a summary of information discussed by the IFSP team in considering the following:
•	The strengths of the child;
•	The concerns of the parents for enhancing the development of their child; and
•	The results of the initial or most recent evaluation.

Present levels of development give a summary sketch of what the child can do and the skills the child needs to learn as a result of his/her disability. These present level statements lay the foundation for the succeeding components of the IFSP. There must be a direct relationship between the present levels of development, the annual goals, short-term objectives and the specific EI/ECSE services to be provided to the child. Whenever there is a developmental area identified in “needs to learn” there must be corresponding goals and objectives in the IFSP. If the child is at “age level” in a particular area the team should indicate that the child is functioning within normal limits and that there are no “needs to learn” to target for early intervention or early childhood special education. The present level of development page also includes the child’s needed skills in the areas of pre-literacy, language, and numeracy.

Directions:

1.	Enter the child’s name, date of birth and the date the form is completed.

2.	Identify the child’s strengths and interests. These are supportive comments made by parents and other team members and are used by the team as a starting point upon which to build new skills.

3.	Describe how the child’s disability affects his/her participation in appropriate activities. Appropriate activities are activities that children of the same age engage in such as banging objects together, babbling and cooing to a caregiver, coloring, sharing, playing and listening to stories told or read by a parent or caregiver.

4.	Indicate the information considered in developing the IFSP. Include the date of the most recent evaluation.

5.	Enter information on the child’s health, vision and hearing. Screening instruments developed by the EI/ECSE program are available to provide this information. 

6.	Summarize the child’s present levels of development. For children in early intervention information is required in all areas: cognitive, communication, social, physical (including health, vision and hearing) and adaptive. For children in early childhood special education information may be reported in all areas but is required in the areas of suspected disability.

7.	For Early Intervention (EI) indicate whether the child has communication needs. EI programs must ensure that each preschool child with a disability has access to a comprehensive plan for communication that allow the child, by the age of three years, to engage in expressive and receptive communicaton across all learning, home and community settings.  The communication plan is composed of IFSP goals, objectives, and services.  Select one or more of the following areas that will be addressed by the communication plan:
•	Spoken language
•	Sign language
•	Assistive technology
•	Augmentative communication

If the child is functioning at age level in expressive and  receptive communication, make the appropriate notation in the “Needs to Learn” column and select “Spoken Language” in this section.

Goals and Objectives

Goals and objectives are used to develop and implement the IFSP for the child. Once the team develops goals for the child they can develop strategies for teaching the goals and formulate short-term objectives to help the team monitor the child’s progress throughout the year. Accomplishment of short-term objectives also should help the team to revise the IFSP as needed. Annual goals and short-term objectives must relate to:
•	Meeting the child’s needs that result from her/his disability;
•	Meeting the child’s needs to enable his/her involvement in and progress in appropriate activities (the same or similar activities as typical peers);
•	Meeting the child’s pre-literacy, language and numeracy skills, if needed (use the child’s curriculum based assessment results to determine needs); and
•	Meeting other educational needs that result from the child’s disability.

Directions:

1.	Enter the child’s name, date of birth, the date the form is completed and the area of development the goal addresses.

2.	Long-term goals are statements, written in measurable terms that are related to meeting the child’s needs that result from her/his disability. An example of an annual goal is:
“Seth will eat and drink independently (use a spoon, fork and cup) at home and at child-care.”

3.	Each annual goal must include:
•	Criteria: the standard by which the skill is judged as successful. For example, the criteria for the above is that Seth will independently use a spoon, fork and cup at home and at child-care.
•	Evaluation Procedures: the process or procedures used to evaluate the child’s performance. For example, the goal above will be evaluated by completing an observation checklist and a rating scale for each item. The rating scale indicates that the skill is completed independently, with help, with total help (full physical assistance) or was not attempted.

Item	Home	Childcare	
Spoon	Independently	With Help	
Fork	With total help	Did not attempt	
Cup	With help	With help	

4.	Short-term objectives are measurable intermediate steps that provide the team with guidance for teaching the annual goal. Short-term objectives for Seth could include:
•	Drink from cup ¼ filled; return to surface with no spilling;
•	Drink from cup ½ filled; return to surface with no spilling;
•	Drink from cup ¾ filled; return to surface with no spilling;
•	Eat with spoon with help to scoop;
•	Eat with spoon; no spilling;
•	Eat with fork with help to spear food;
•	Eat with fork; no spilling.

5.	Review date. IFSP progress for children birth to age three is reviewed at least every six months and annually. IFSP progress for children age three to age five is reviewed periodically according to the review schedule on the IFSP services page.

6.	Progress made toward goal (based on the criteria and evaluation). At the review date indicate, using the criteria and evaluation procedures prescribed, the progress the child has made toward reaching the goal.

7.	Is the progress sufficient for the child to meet the goal?  Indicate whether or not the child’s progress is sufficient for meeting the goal by the annual review date.

8.	If not, what changes are planned?  If the child’s progress is not sufficient to meet the goal by the annual review date, indicate changes planned by the IFSP team. Remember, if the team changes the goal, types of service or frequency of service (anything but teaching strategies) the IFSP team must have a meeting or an agreement with the parent to make a change without a meeting (allowed between annual IFSP meetings). A written document amending or modifying the IFSP is developed and a special education action form, describing the changes, is completed and given to the parents.

9.	Annual review date. This is the date of the annual review.

10.	Progress made toward goal (based on the criteria and evaluation). At the annual review indicate, using the criteria and evaluation procedures prescribed, the progress the child has made toward reaching the goal and whether or not the goal was met.

Family Outcomes/Transition

This page of the IFSP is used to address Family Outcomes, Early Intervention Transition and Early Childhood Special Education Transition.

Family Outcomes: Plan to Enhance the Child’s Development

The IFSP must include a statement of Family Outcomes addressing needs identified by the family for enhancing the development of their child. Needs identified by families can range from learning more about their child’s disability, getting trained baby-sitters to stay with their child, obtaining child care so parents can work, working with community agencies to include their child with disabilities, etc. There is no end to the list because each child and family is different and come with different strengths and needs. It is important to identify, with the family, their strengths and assets when completing this part of the IFSP. Family strengths and assets are used as building blocks for establishing other supports the family indicates it needs.

Directions:

1.	Enter the child’s name, date of birth, and date the form is completed.

2.	Families have the choice of completing the family outcomes. If a family indicates that a plan is not needed at this time, request that they initial and date the line at the top of the left-hand side of the page. This documents that the provider gave this option to the family. All families should be encouraged to participate in completing the family outcomes section. The service coordinator could ask the family to think about their priorities and concerns prior to the meeting (even suggest writing them down) so they are prepared for this section of the IFSP. Family outcomes should be completed toward the beginning of the meeting since this section of the IFSP may relate to goals, objectives and services.

3.	List the family priorities and concerns. This could include the family’s concerns about their child’s disability, how to enhance their child’s development, how to include the child in family activities, etc. Priorities and concerns are identified by the family and not by other team members. A priority or concern exists only if the family perceives it as important. Information from the family assessment will be included here.  IDEA 303.321(c)(2) requires that a family assessment be conducted by qualified personnel to identify the families resources, priorities, and concerns and the supports and services necessary to enhance the family’s capacity to meet their child’s needs. The information from this assessment The assessment must:  
•	be voluntary; 
•	based on information obtained through the assessment tool and also through an interview with family members that participated in the assessment; and
•	include the family’s description of its resources, priorities, and concerns related to enhancing the child’s development.

4.	Document family resources that are available or that are needed. Resources, strengths and abilities that can be mobilized to meet family priorities and concerns are listed here. Resources needed by the family also are documented in this space. Needs may include material, monetary and/or additional services needed by the family to enhance their child’s development.

5.	Document the steps for addressing the family’s priorities and concerns, including who will do what and timelines for accomplishing the activities.

Transition (right-hand side of the page)

Transition planning is required for children leaving early intervention services at age three and leaving early childhood special education services when eligible for school. Steps to support both of these transitions must be included in the child’s IFSP during the year prior to the transition.

Directions:

1.	Describe the steps to support the child’s transition from EI to ECSE or other services. Teams for all children transitioning out of EI must determine if the child is eligible for ECSE, provide families with information about the child’s transition, prepare the child and parent for changes in service delivery including helping the child adjust to the new setting, and prepare the child and family to exit the program. Include steps that are individual to the child and family.

2.	Describe the steps to support the child’s transition from ECSE to school. There are many common “transition steps” for children transitioning from ECSE to school. It is acceptable to use a checklist that includes individualized information for the child and is attached to the IFSP.

Placement Decision

Documentation for placement is required for children receiving ECSE services. It is not required for children receiving EI services. The setting where the child receives services (i.e., placement determination) is made by a group of people, including the parents, who are knowledgeable about the child, the child’s special education needs, and the various placement options. The placement decision is based on the child’s IFSP by determining where the goals and objectives in the IFSP can most appropriately be taught. According to OAR 581-015-2845, EI/ECSE programs must ensure that unless the child’s (IFSP) requires some other arrangement, the child is educated in the public school or public program, if any, that he or she would attend if not disabled. Federal and State law and regulation (34 CFR 300.115, OAR 581-015-2845) require that a continuum of alternative placements be available to meet the needs of children with disabilities. There are a variety of placement options that can meet these requirements and the needs of preschool children with IFSPs.

In selecting the placement, consideration is given to any harmful effects on the child or on the quality of services that the child needs for any of the options considered. Also, this documentation must identify any modifications/services that were considered to reduce any of the identified harmful effects noted for a placement option.

An appropriate setting for a particular child may be child care, community preschool, an ECSE operated preschool, a Head Start classroom, a clinic or skill group targeting specific skills for children, or a home-based program. Integrated placement options such as community-based settings with typically developing peers, must be available to preschool children with disabilities who require those settings to implement their goals and objectives. An integrated setting is not required if a child’s IFSP goals and objectives do not require it  The overriding requirement is that placement decisions for children with disabilities are made on an individual basis.

Directions:

1.	Enter the child’s name, birth date, date of placement decision, and date of the IFSP.

2.	Enter the placement option(s) considered.

3.	Document consideration of each option, including the setting or school the child would attend if not disabled.

4.	Document the benefits, possible harmful effects on the child or on the quality of services which he or she needs, and the modifications, aids or services for each placement consideration.

5.	Indicate the evaluation reports upon which the placement decision is based.

6.	Indicate the selection or rejection of each option.

7.	Provide an explanation why an option was selected. The explanation should clearly indicate why the option did or did not meet the child’s educational needs. Statements to avoid:
•	Statements that merely name or describe the child's disability category.
•	Statements that are too general and that do not adequately explain the team’s decision based on each child's unique needs.
•	Justification statements that simply state "1:1 instruction."

8.	List the individuals who participated in the meeting. The placement decision is made by a group of persons, including the parents, and other persons knowledgeable about the child, the meaning of the evaluation data and the placement options.