Plattsburgh City School District Special Education Office 49 Broad Street Plattsburgh, NY 12901

STUDENT INFORMATION SUMMARY Student: Alec Hemm Address: 14 Summit Drive Peru, NY 12972 Contacts: Mrs. Brigit Hemm, Mother Mr. Curtiss Hemm, Father School Year: 2012-2013 Diploma Type Expected: Not Applicable Special Alerts: IESP INFORMATION Projected IESP Start Date: Projected IESP End Date: Projected Date of Annual Review: Projected Date for Reevaluation: Extended School Year: Behavior Intervention Plan: Supplementary Aids and Services: Assistive Technology: Supports for School Personnel: Testing Accommodations: Participate State/District Assessments: Special Transportation: MEETING INFORMATION Decision/Status: Classified PP NR Within District Dual Enrollment Reason: Annual Review Classification: Other Health Impairment Participants: Claudine Selzer, Director of Special Education/CSE/CPSE Chairperson; Linda Haubner, School Nurse Practitioner; Sister Helen Hermann, Principal; Sheldon Cullen, School Psychologist; Sue Hurd, Speech/Language Therapist; Joanne Scott, General Education Teacher; Kathy Toner, General Education Teacher; Lisa Frechette, Special Education Teacher; Suzanne Beaumont, General Education Teacher; Brigit Hemm, Mother; Curtiss Hemm, Father Date: 5/22/2012 Committee: Subcommittee on Special Education 09/04/2012 06/21/2013 05/22/2013 03/15/2013 No No Yes No Yes Yes Yes No Date of Birth: 06/30/2001 Gender: Male ID #: 25008 Age: 10:10 Native Language: English County: Clinton Interpreter Required: No Home/Mobile #: H: 643-0476 Work #: Email: Home/Mobile #: H: 643-0476 Work #: Email: Placement: Student is Parentally Placed in a School: Student is Parentally Placed in Grade: 05 Nonpublic School a Nonpublic School Parent has unilaterally placed the student at: Seton Academy

SUMMARY-SPECIAL EDUCATION PROGRAMS AND RELATED SERVICES Counseling: Individual 09/04/2012 - 06/21/2013 1 x Weekly, 30min.

Plattsburgh City School District Special Education Office 49 Broad Street Plattsburgh, NY 12901 518-563-6262
INDIVIDUALIZED EDUCATION SERVICES PROGRAM (IESP) STUDENT NAME: Alec Hemm DISABILITY CLASSIFICATION: Other Health Impairment DATE OF BIRTH: 06/30/2001 LOCAL ID #: 25008 PROJECTED DATE IESP IS TO BE IMPLEMENTED September 04, 2012 PROJECTED DATE OF ANNUAL REVIEW : May 22, 2013 DOCUMENTATION OF STUDENT'S CURRENT PERFORMANCE AND ACADEMIC, DEVELOPMENTAL AND FUNCTIONAL NEEDS Evaluations/Reports: Teacher Progress Summary (05/01/2012) Test Results: - None State and District-wide Assessments: - None ACADEMIC ACHIEVEMENT, FUNCTIONAL PERFORMANCE AND LEARNING CHARACTERISTICS LEVELS OF KNOWLEDGE AND DEVELOPMENT IN SUBJECT AND SKILL AREAS INCLUDING ACTIVITIES OF DAILY LIVING, LEVEL OF INTELLECTUAL FUNCTIONING,
ADAPTIVE BEHAVIOR, EXPECTED RATE OF PROGRESS IN ACQUIRING SKILLS AND INFORMATION, AND LEARNING STYLE:

PRESENT LEVELS OF PERFORMANCE AND INDIVIDUAL NEEDS

EVALUATION RESULTS (INCLUDING FOR SCHOOL-AGE STUDENTS, PERFORMANCE ON STATE AND DISTRICT-WIDE ASSESSMENTS)

Mathematics: - Alec has had quite a bit of difficulty with the fourth grade math curriculum this year. While he has developed some of the basic foundation skills necessary to be successful, he continues to need more practice with these skills in isolation before he can begin to correctly and confidently apply them to higher level skills including long division and multi-step word problems. Alec is a very visual, kinesthetic, and concrete learner. He requires the use of models and additional examples during his instruction, and benefits from being able to use manipulatives, to draw pictures, and to use graphic organizers to solve problems when appropriate. One accommodation that has worked well for him this year is being able to do his multiplication and division on graph paper which helps him to keep his numbers aligned. He also benefits from being able to talk out a problem as he solves it. Problem solving strategies that work well for other students, may not be those that best serve Alec. Therefore, he should be provided with the opportunity and the flexibility to be able to use those strategies that will allow him to best demonstrate what he knows.

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 2 of 10

Reading: - Alec has participated in the Scott Foresman fourth grade reading program this year. He has a strong grasp of the vocabulary and spelling words that each unit has presented and has done fairly well with the grammar skills taught in the series as well. Given the weekly selection tests, Alec generally does a nice job with the literal level questions, but is not always willing to go back into the text to find the information needed to answer these questions correctly. He is now better able to decipher between facts and opinions and has made some improvements with determining causes and effects. He is not always able to pick out the main idea of a passage or story and continues to have difficulty with making predictions, generalizations, and inferences about what he is reading. With teacher prompting and scaffolding, Alec is better able to arrive at more appropriate responses, but is not yet able to perform these higher order thinking skills on his own. Study Skills: - Alec has made some good gains with his study skills in the classroom during this school year. However, since many aspects of the curriculum have become more difficult for him, his level of distractability has increased and his ability to self-modulate has declined. His classroom teacher reports that he has become increasingly more frustrated when unable to receive her immediate attention, and requires frequent prompting and redirection throughout the day in order to maintain his focus. Next year, it will be beneficial to have Alec sit in the front row in close proximity to the teacher so that she can monitor his attention. Also, a visual, nonverbal cue decided upon between she and Alec would help to refocus him when needed. Alec has continued to work on using various test taking strategies to ensure that he is thorough and accurate in his responses. He has recognized that using these strategies can help him to get better grades on his tests, but does not yet do so independently. Alec has difficulties with organizationwhich carries over into many aspects of his day including keeping his desk clean, completing multi-step directions and tasks, making sure he has the appropriate materials to complete his homework, and completing his classwork in the time alloted. Activities, assignments, and transitions should be broken down into short, manageable steps with ongoing checks for Alec's understanding of what he is being asked to do. Having him repeat directions in the appropriate sequence is helpful and models, pictures, and/or checklists provide visual references for him as well. Within the classroom, Alec and his teacher will need to devise a plan for helping him keep his workspace and materials organized and properly managing his time to get his work completed. Writing: - Alec is creative and has a good imagination, but has had difficulty with many fourth grade writing tasks. Basic writing activities have sometimes been difficult for him, even when they require simply searching for facts within the text, such as with cloze procedures. On the written response portions of his weekly selection tests, Alec frequently has difficulty understanding what the questions are asking of him. His answers often include facts and/or details from the story that are not at all applicable or appropriate to the questions. Given writing prompts, he often has difficulty developing original ideas and formulating responses that are related to the topic. He requires verbal and visual scaffolding from an adult to help him initiate the activity and to start to get his ideas down on paper. Brainstorming and using graphic organizers do help Alec organize his thoughts before he writes, but he does not yet use these strategies independently. STUDENT STRENGTHS, PREFERENCES, INTERESTS: - -Alec has a strong vocabulary and excellent background knowledge. -Alec enjoys reading and does so with good fluency. -Alec's written expression improve with verbal and visual teacher prompting and scaffolding. -Alec has made some good gains with his math foundational skills. ACADEMIC, DEVELOPMENTAL AND FUNCTIONAL NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE
PARENT:

- -Alec needs to improve his higher order comprehension skills, wirtten expression skills, and math skills. -Alec needs to improve his organization and time management skills SOCIAL DEVELOPMENT THE DEGREE (EXTENT) AND QUALITY OF THE STUDENT'S RELATIONSHIPS WITH PEERS AND ADULTS; FEELINGS ABOUT SELF; AND SOCIAL ADJUSTMENT TO SCHOOL
AND COMMUNITY ENVIRONMENTS:

- Alec is a very kind, gentle, and polite boy. He has a good sense of humor and works easily with adults once he trusts them and becomes comfortable with them. He has developed a nice friendship with one of the boys in his class and enjoys spending time with him both in and out of school. While he has made

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 3 of 10

improvements this year in becoming more adaptable and flexible within social situations, he does still struggle when play or social interactions do not follow his rules or parameters. He often has difficulty when his favored peers do not want to participate in the same activity that he does, and has quite a bit of trouble verbalizing and expressing why this upsets him. At this point, he still requires adult intervention to help him talk about and solve the problem. Once he is taught appropriate replacement or alternative behaviors, he is inconsistent with using and applying them if the same situation arises again. Alec is generally very interactive within small group or one-on-one instruction and has become a more active participant in large group discussions and conversations within the classroom. STUDENT STRENGTHS: - -Alec is friendly, polite, and generally very enjoyable to work with. SOCIAL DEVELOPMENT NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE PARENT: - -Alec needs to improve his ability to verbalize and express his feelings in age-appropriate ways. -Alec needs to demonstrate appropriate reactions to social situations that may not follow his parameters. PHYSICAL DEVELOPMENT THE DEGREE (EXTENT) AND QUALITY OF THE STUDENTS MOTOR AND SENSORY DEVELOPMENT, HEALTH, VITALITY AND PHYSICAL SKILLS OR LIMITATIONS WHICH
PERTAIN TO THE LEARNING PROCESS:

- Alec scores within the average range in the areas of visual motor, visual perceptual and fine motor (speed) skills. His handwriting is legible and his overall fine motor performance is adequate for classroom tasks. Using the Sensory Processing Measure, Alec continues to score in the below average range in the sensory areas of social participation, visual processing, reactions to to tactile experiences, and planning/ideas. More specifically, he has difficulty maintaining the appropriate personal space of others, is distracted by visual stimuli, shows distress touching certain textures or when he is unexpectedly touched by his peers, slaps his feet when walking, fidgets at his desk, leans on his desk, has difficulty organizing his materials, and is unable to complete classroom tasks without assistance. Alec is able to communicate self regulation concepts, but is inconsistent in applying these techniques when in a situation that he perceives as challenging or stressful. Alec places his hands into his arm pits and squeezes when excited, thinking, or upset. This appears to be an alternative , more subtle form of self stimulation that fulfills his sensory seeking needs. He enjoys activities of deep pressure such as vibration, massage and therapy ball activities. - Alec has a difficult time with keyboarding due to poor isolated motor control and kinesthetic feedback. He relies on his stronger visual sense and lacks positional awareness of his fingers when typing.

STUDENT STRENGTHS: - Alec is a charming and cooperative boy who has a wonderful sense of humor. Alec does well in 1 to 1 therapy sessions and appears motivated to perform to the best of his ability in these sessions. Alec is proud of his accomplishments. PHYSICAL DEVELOPMENT NEEDS OF THE STUDENT, INCLUDING CONSIDERATION OF STUDENT NEEDS THAT ARE OF CONCERN TO THE PARENT: - Alec needs to improve his sensory self regulation skills in his natural settings. MANAGEMENT NEEDS THE NATURE (TYPE) AND DEGREE (EXTENT) TO WHICH ENVIRONMENTAL AND HUMAN OR MATERIAL RESOURCES ARE NEEDED TO ADDRESS NEEDS IDENTIFIED
ABOVE:

- Alec continues to benefit from a predictable classroom routine. He likes structure within his day and presetting him for transitions and/or changes is always helpful. He has enjoyed having a daily schedule which has also reinforces positive behaviors in the classroom; this is something that his fifth grade teacher may want to continue to use. An area of significant need for Alec within all settings is the ability to initiate and stay engaged in activities. He is often unsure of how to approach a task in order to begin working at it, even when it may be something that is very easy for him. When it is an activity that is difficult for Alec, this raises his level of anxiety which makes it even harder for him to think the process through. This is a skill that Alec needs direct instruction, modeling, and continued practice with as it impacts his ability to learn and function at school. Within past years, he has responded well to having a visual checklist on his desk to aid him in solving various problems that arise in the classroom (i.e. using appropriate ways to ask for help). As the expectations rise and the content continues to becomes more difficult in fifth grade, it will be necessary for Alec and his teacher to develop a strategy for learning how to attack these types of

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 4 of 10

tasks with independence. A self-monitoring checklist will help Alec and his teacher learn to recognize when and where he is having the most success during his day, as well as those times and/or areas that are more difficult for him. It should include positive reinforcement to motivate Alec to use his strategies when necessary and must also incorporate a discussion of evaluation between Alec and his teacher. Social stories will continue to be useful in introducing Alec to new situations and/or to address particular behaviors or difficulties that may arise. When problems do occur, Alec frequently needs someone to help him to verbalize and work through his emotions. It is beneficial to address issues with Alec as close to when they occur as possible so that it does not disrupt his ability to cotinue on with his day. When he does become upset about something that has happened, using humor and jokes can generally pull him out of it to relieve his anxiety. EFFECT OF STUDENT NEEDS ON INVOLVEMENT AND PROGRESS IN THE GENERAL EDUCATION CURRICULUM OR, FOR A PRESCHOOL STUDENT, EFFECT
OF STUDENT NEEDS ON PARTICIPATION IN APPROPRIATE ACTIVITIES

- Alec demonstrates delays in social problem solving and attentional skills which adversely affects his academic performance and interfere with participation in age appropriate activities.

STUDENT NEEDS RELATING TO SPECIAL FACTORS BASED ON THE IDENTIFICATION OF THE STUDENT'S NEEDS, THE COMMITTEE MUST CONSIDER WHETHER THE STUDENT NEEDS A PARTICULAR DEVICE OR SERVICE
TO ADDRESS THE SPECIAL FACTORS AS INDICATED BELOW, AND IF SO, THE APPROPRIATE SECTION OF THE IESP MUST IDENTIFY THE PARTICULAR DEVICE OR SERVICE(S) NEEDED.

Does the student need strategies, including positive behavioral interventions, supports and other strategies to address behaviors that impede the student's learning or that of others? S Yes No Does the student need a behavioral intervention plan? S No monitor and evaluate specifically targeted behaviors.

Yes:

Alec should have a daily schedule/checklist which allows both he and his teacher to

For a student with limited English proficiency, does he/she need a special education service to address his/her language needs as they relate to the IESP? Yes No S Not Applicable For a student who is blind or visually impaired, does he/she need instruction in Braille and the use of Braille? Does the student need a particular device or service to address his/her communication needs?

Yes No S Not Applicable

Yes S No

In the case of a student who is deaf or hard of hearing, does the student need a particular device or service in consideration of the student's language and communication needs, opportunities for direct communications with peers and professional personnel in the student's language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the student's language and communication mode? Yes No S Not Applicable Does the student need an assistive technology device and/or service? Yes S No If yes, does the Committee recommend that the device(s) be used in the student's home?

Yes No

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012 MEASURABLE ANNUAL GOALS

Individualized Education Services Program

Page 5 of 10

THE FOLLOWING GOALS ARE RECOMMENDED TO ENABLE THE STUDENT TO BE INVOLVED IN AND PROGRESS IN THE GENERAL EDUCATION CURRICULUM, ADDRESS
OTHER EDUCATIONAL NEEDS THAT RESULT FROM THE STUDENT'S DISABILITY, AND PREPARE THE STUDENT TO MEET HIS/HER POSTSECONDARY GOALS.

ANNUAL GOAL

CRITERIA

METHOD

SCHEDULE

WHAT THE STUDENT WILL BE EXPECTED TO ACHIEVE BY THE

END OF THE YEAR IN WHICH THE IESP IS IN EFFECT

MEASURE TO DETERMINE IF
GOAL HAS BEEN ACHIEVED

HOW PROGRESS WILL BE

MEASURED

WHEN PROGRESS WILL

BE MEASURED

SOCIAL / EMOTIONAL / BEHAVIORAL

1. Alec will learn multiple strategies on how to navigate social interactions (i.e. perspective taking, problems solving with peers, and initiating social interactions with peers).

90% success over 10 months

Recorded observations

Every marking period

2. Alec will build a relationship with the counselor to discuss his 100% success over 10 months problems.

Recorded observations

Every marking period

REPORTING PROGRESS TO PARENTS Identify when periodic reports on the student's progress toward meeting the annual goals will be provided to the student's parents: There will be 4 written progress reports during the school year. RECOMMENDED SPECIAL EDUCATION PROGRAMS AND SERVICES FREQUENCY HOW OFTEN
PROVIDED

SPECIAL EDUCATION PROGRAM/SERVICES SPECIAL EDUCATION PROGRAM: - None RELATED SERVICES: Counseling SUPPLEMENTARY AIDS AND SERVICES/PROGRAM MODIFICATIONS/ACCOMMODATIONS: Special Seating Arrangements

SERVICE DELIVERY RECOMMENDATIONS*

DURATION LENGTH OF
SESSION

LOCATION WHERE SERVICE WILL BE

PROVIDED

PROJECTED BEGINNING/ SERVICE DATE(S)

Individual

1 x Weekly

30min.

Therapy Room

09/04/2012

It is recommended that Alec sit in the front of the classroom in close proximity to the teacher so that his attention can be closely monitored and he is more easily accessible for assistance if needed.

/Daily

Throughout the School Day

Classroom

09/04/2012

Student Name: Alec Hemm Positive Reinforcement Plan

DOB: 06/30/2001

Meeting Date: 5/22/2012 /Daily

Individualized Education Services Program Throughout the School Day all academic classes, including special areas

Page 6 of 10 09/04/2012

Check for Understanding

Breakdown of multiple step directions

Use of Visual Aids

Alec benefits from a daily schedule/chart which provides both he and his teacher the ability to monitor and evaluate target behaviors. It is important the this plan provides reinforcement that is positive and motivating in nature for Alec. Alec has difficulty with abstract concepts that require higher levels of thinking and application of skills. He needs ongoing checks for his understanding of information and tasks provided. Alec's lack of organizational skills makes make multi-step directions and tasks difficult for him. He needs assignments broken down into short, sequential, manageable steps to assist with accurate completion, and to prevent him from getting anxious or overwhelmed by the task. Alec is a very concrete learner. His instruction should incorporate visual aides, models, and examples whenever possible. He also benefits from having a visual list of strategies or

/Daily

During Instructional Time

all academic classes, including special areas

09/04/2012

/Daily

During Instructional Time

all academic classes, including special areas

09/04/2012

/Daily

Throughout the School Day

all academic classes, including special areas

09/04/2012

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 7 of 10

Refocusing and Redirection

Support for Organizational Skills

a checklist to remind him of how to solve problems within the classroom if they arise. This list might include strategies such as, how to appropriately ask for help when needed or how to initiate or begin a task even when it appears to be difficult. Alec requires teacher prompting to ensure that he is focused and attentive to instruction. A visual, nonverbal method or cue decided upon by Alec and his teacher, would help to provide Alec with redirection while not drawing further attention to him. If Alec's time-on-task can be monitored through recorded observations, it will help him begin to monitor his own levels of attention and focus. Alec's difficulties with planning and organizing influence many aspects of his day, including his ability to mange his time appropriately. He needs time built into his day to do things such as cleaning and organizing his desk and workspace. It would also be very helpful to have him complete a checklist or planner at the end of the

/Daily

Throughout the School Day

all academic classes, including special areas

09/04/2012

/Daily

Throughout the School Day

classroom

09/04/2012

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 8 of 10

Other Additional Set of Books

day to ensure that he has the appropriate materials to complete his homework. Positive reinforcement for completing these activities should be built into a self-monitoring checklist or targeted behavior chart. team meeting with parents If available, Alec's parents should be provided with additional copies of textbooks for the purposes of preteaching, review, and practice of skills.

1/Monthly 1/Yearly

1 hour Through out the School Year

Classroom Home

09/04/2012 09/04/2012

ASSISTIVE TECHNOLOGY DEVICES AND/OR SERVICES: - Not applicable SUPPORTS FOR SCHOOL PERSONNEL ON BEHALF OF THE STUDENT: Occupational Therapy Consultation

Through out Seton Academy 09/04/2012 the School Year * Identify, if applicable, class size (maximum student-to-staff ratio), language if other than English, group or individual services, direct and/or indirect consultant teacher services or other service delivery recommendations.

10 hours/year

10 x Yearly

12-MONTH SERVICE AND/OR PROGRAM - Student is eligible to receive special education services and/or program during July/August: If yes:

S No Yes

Student will receive the same special education program/services as recommended above. Student will receive the following special education program/services:
SPECIAL EDUCATION PROGRAM/SERVICES - None SERVICE DELIVERY RECOMMENDATIONS FREQUENCY DURATION LOCATION PROJECTED BEGINNING/ SERVICE DATE(S) OR

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 9 of 10

Name of school/agency provider of services during July and August: For a preschool student, reason(s) the child requires services during July and August: Not Applicable TESTING ACCOMMODATIONS (TO BE COMPLETED FOR PRESCHOOL CHILDREN ONLY IF THERE IS AN ASSESSMENT PROGRAM FOR NONDISABLED PRESCHOOL CHILDREN): INDIVIDUAL TESTING ACCOMMODATIONS, SPECIFIC TO THE STUDENTS DISABILITY AND NEEDS, TO BE USED CONSISTENTLY BY THE STUDENT IN THE
RECOMMENDED EDUCATIONAL PROGRAM AND IN THE ADMINISTRATION OF DISTRICT-WIDE ASSESSMENTS OF STUDENT ACHIEVEMENT AND, IN ACCORDANCE WITH DEPARTMENT POLICY, STATE ASSESSMENTS OF STUDENT ACHIEVEMENT

TESTING ACCOMMODATION

CONDITIONS*

IMPLEMENTATION RECOMMENDATIONS**

NONE
- Administer Individually - Tests Administered in a Separate Location/Room - Extended Time (1.5) - Reread directions for each page of questions - Answers Recorded in Test Booklet - On-task Focusing Prompts - Use of Masks or Markers to Maintain Place - Have student read test aloud to teacher to ensure focus/attention - Administer test in several sessions (45 minutes on task, 10 minute break) - For Directions-Additional Examples Provided - Repeat oral comprehension items more than specified in standard administration - 1 extra time. *Conditions - Test Characteristics: Describe the type, length, purpose of the test upon which the use of testing accommodations is conditioned, if applicable. **Implementation Recommendations: Identify the amount of extended time, type of setting, etc., specific to the testing accommodations, if applicable.

PARTICIPATION IN STATE AND DISTRICT-WIDE ASSESSMENTS

(TO BE COMPLETED FOR PRESCHOOL STUDENTS ONLY IF THERE IS AN ASSESSMENT PROGRAM FOR NONDISABLED PRESCHOOL STUDENTS)

S The student will participate in the same State and district-wide assessments of student achievement that are administered to general education students. The student will participate in an alternate assessment on a particular State or district-wide assessment of student achievement.
Identify the alternate assessment: Statement of why the student cannot participate in the regular assessment and why the particular alternate assessment selected is appropriate for the student:

Student Name: Alec Hemm

DOB: 06/30/2001

Meeting Date: 5/22/2012

Individualized Education Services Program

Page 10 of 10

PARTICIPATION WITH STUDENTS WITHOUT DISABILITIES REMOVAL FROM THE GENERAL EDUCATION ENVIRONMENT OCCURS ONLY WHEN THE NATURE OR SEVERITY OF THE DISABILITY IS SUCH THAT, EVEN WITH THE
USE OF SUPPLEMENTARY AIDS AND SERVICES, EDUCATION CANNOT BE SATISFACTORILY ACHIEVED.

FOR THE PRESCHOOL STUDENT: Explain the extent, if any, to which the student will not participate in appropriate activities with age-appropriate nondisabled peers (e.g., percent of the school day and/or specify particular activities): - Not Applicable FOR THE SCHOOL-AGE STUDENT: Explain the extent, if any, to which the student will not participate in regular class, extracurricular and other nonacademic activities (e.g., percent of the school day and/or specify particular activities): - Not Applicable If the student is not participating in a regular physical education program, identify the extent to which the student will participate in specially-designed instruction in physical education, including adapted physical education: - The student will participate in the general education physical education program. EXEMPTION FROM LANGUAGE OTHER THAN ENGLISH DIPLOMA REQUIREMENT: S No Yes - The Committee has determined that the student's disability adversely affects his/her ability to learn a language and recommends the student be exempt from the language other than English requirement. SPECIAL TRANSPORTATION TRANSPORTATION RECOMMENDATION TO ADDRESS NEEDS OF THE STUDENT RELATING TO HIS /HER DISABILITY

S None. Student needs special transportation accommodations/services as follows: Student needs transportation to and from special classes or programs at another site:
PLACEMENT RECOMMENDATION Student is Parentally Placed in a Nonpublic School