Inclusion and Resource Education

County Forms
These templates are filled in with general Sevier County information, but otherwise blank. They are in Microsoft Word, version 6.0 (except for the blank IEP). If you have this version or later on the computer you are connecting with, you can save the template to your hard drive, then modify it from there. If you are using MS Works instead, you'll need to save to a disk or just download from a computer that does have MS Word.

Parent Survey, for guardians to rate the evaluation and Special Education planning process

Problem Solving Team Forms

PS Team Instructions

PS Team Refferal Form

Intervention Documentation

Exclusionary Factors

Team Notes and Decisions

New Re-Eval Forms

Parent Input for ReEval

Adaptive Behavior Data

Intellectual/Cognitive Data

Summary Report Sections I & II

Summary Report Section IV

Summary Report Section V

Link to all Section III's

1. Parent Permission for Comprehensive Screening, for the guardians to indicate permission (or not) for the school to screen their child
2. Assessment Report, a cover sheet for the test administrator to indicate results, recommendations, and comments from the assessment testing sessions
3. Specific Learning Disabilities Eligibility Documentation, notice boxes 4a and 4b especially.  Sevier County's interpretation of an appropriate time period for an intervention is 6 to 12 weeks.
4. Documentation of Medical Diagnosis Form, for doctors to indicate a diagnosis/prognosis for students with health/orthopedic impairments, attention deficits, or traumatic brain injury (PDF file.)
5. Eligibility Report, to document eligibility for Special Education services and the instructions for completing it. Save it to your own hard drive because depending on your default printer's setup, you may have to reset a few tabs to get the check boxes to line up. Or here is the PDF file.
6. Release of Information, the letter guardians sign so Sevier County can either send or get a student's Special Education records; the same file in PDF format
7. Physical/Health Impaired Evaluation Summary in Word, as a PDF file
8. Request for Special Transportation, complete and fax to Rebecca Campbell
9. Continuation of Educational Services as a PDF File, so guardians can indicate previous Special Education enrollment when their child moves around or out of Sevier County
10. Special Education Exit Form, for a student reaching 18 years old and choosing to terminate Special Education services.  The same form as a PDF file.

Less Frequently Used Forms

1. Initial Evaluation Timeline Waiver. Also notice that the instruction for completing it( PDF file) require coordination with Nashville.
2. Medication Administration Form, for parents to allow their child to be given or take a prescription or over-the-counter medication at school. Please see Use of Medicines by Students, BP 627 for the complete procedure.
3. Report of Accidents and Injuries (to Students); original to Central Office, copy kept at school
4. Package for Requesting Homebound Services
   These are in Adobe PDF file format.
   1. Cover Letter to Parents and Students Requesting Homebound Services, from the Director of Special Education
   2. Request for Homebound Services, the form to complete
   3. Homebound Medical Form, the doctor's medical evaluation (for use with other-than pregnancy-related requests)
   4. Homebound for Pregnancy Form, the physician's verification
   5. Homebound for Pregnancy Information, two pages of questions, answers, and advice
   6. Release of Information, permission for the school system to get information to and from the physician
   7. Parent Acknowledgement, consent for the teacher to come to the home
5. SCS Anecdotal Record, for documenting day-to-day incidental reports to students' records. You may want to print this one on green paper to match what is currently in the files.
6. Request for Special Transportation, complete and fax to Rebecca Campbell
7. Field Trip Permission to Parents one fill-in-the-blanks model to send home. Also see Field Trips and Excursions, Sevier County School Board Policy 515.
8. Tracking Calls Home one way, or a second way to record talks with parents
9. Note to Home, a progress update to send home with the student each day
10. CDC/SDC Meeting Record, a table-structured conference form, for keeping all staff working with the same students informed of the same highlights or actions needed
11. Class Listing of Accommodation/Modifications, for the caseload manager to share with the students' general education teacher(s) (same file as above, but as a PDF)
12. Assessment Summary, 1-page tracking of a single student's assessment progress over her or his school career
13. Inclusion Schedule, for weekly tracking of rooms students are to be in for certain periods
14. Four Year Educational Plan, a worksheet to plan credits for grades 9 through 12
15. Review of Progress Toward IEP Goals, for use in drafting six week progress reports
16. Lesson Plan Form, an  MS Word template covering what is required in lesson plans for nontenured teachers
17. Student's Skill Summary, another way of reporting progress on IEP goals
18. IEP Progress Report Cover Sheet, for the parent and teacher to send and receive comments each grading period
    

 

New Functional Behavior Assessment

Parent Permission to Assess

FBA Referral

ABC Observation Form

FBA Form

FBA Worksheet

FBA Hypothesis

Teacher Interview

Parent Interview

Student Interview

 

1. Behavior Plan in Word, as commonly used in Sevier County when necessary; also as a PDF file
2. Therapeutic Crisis Intervention Restraint Incident Form in PDF format, for documenting student restraints that last more than a couple minutes
3. FBA Behavior Support Plan in Word, as a PDF, and in MS Works. Similar to the one directly above.
4. Manifestation Determination Form, the documentation of review needed for determining if a student's behavior was or was not a manifestation of the disability (in MS Word, and as a PDF file.)
5. Report of Suspension Form to be used for all Sevier County student suspensions.  (Here is the same file as a PDF.)
6. Educational Status of Detainees in Sevier County, an MS Word form for tracking students who are incarcerated. (Also see
7. Educating Incarcerated Youth with Disabilities in Sevier County for questions and answers on the education rights of special education students who are in jail.)
   

   Accomodations, Modifications, and Adaptations

1. Accommodations, Modifications, and Adaptations practical summary from a California educator's presentation
2. Instructional methods and accommodations to try for 15 different disability areas:
   These are MS Word 6.0/95 files; most in table format.
   1. Attention/Behavior Difficulties
   2. Attention Deficit
   3. Autism
   4. Deafblindness
   5. Deaf, Hard of Hearing
   6. Emotional Behaviors
   7. Mild Intellectual Disability
   8. Nonreader
   9. Sensory Impairments (Vision and Hearing)
   10. Significant Developmental Delay
   11. Specific Learning Disabilities
   12. Speech and Language Impairment
   13. Tourette's Syndrome
   14. Traumatic Brain Injury
   15. Visual Impairments

Teaching Students in Inclusive Settings

1. Behavior Management and Inclusion Ideas for All Students, practical advice for the K-12 classroom
2. From Isolation to Collaboration, thorough information on inclusion
3. All About Inclusion, from the University of Northern Iowa's Special Education Department
4. Inclusive Programming for All Students, from the Sevier County Director of Special Education
5. Inclusion for General Education Teachers, some good information and checklists
6. Inclusion, has good legal requirements and teaching strategies sections
7. Serving Students with Special Needs in Mainstreamed Classes, 100+ page PDF file developed by North Carolina Central University for that state's Department of Education. Good coverage of everything from laws to implementation.
8. Using Best Practices to Build Inclusive Schools for Students with Diverse Learning Abilities, intro to a six-module series from the U.S. and Georgia Departments of Education. The modules are all downloadable as PDF files for schoolings wanting to
9. Special Education for Inclusive Classrooms, an online text by Price, Mayfield, McFadden, and Marsh
10. 5 Inclusion Sites to start with, an annotated list
11. Inclusion, a very short history
12. 4 Models of Inclusion explained
13. Overview of Inclusion in Sevier County
14. Exceptional Learner in Regular Education, suggestions for accommodating exceptional students in general education
15. Inclusion in Science Education research from the University of West Virginia
16. Adapting Learning for students with disabilities in general education settings Inclusion, Behavior Management, Assessment, Evaluation, etc. from the Utah Education System
17. Special Education Interventions for general education classes
18. Social Plus of inclusion
19. Syracuse University's View of what's inclusion (and what isn't)
20. Summary of Inclusion, the positive and negative
21. Circles of Friends, an inclusion activity
22. Social Skills for students in elementary and secondary inclusive settings
23. Curriculum Modifications, a thorough summary of modification to try in inclusive education settings

IEP Suggestions

1. Seven Steps, explains the steps of the IEP process
2. IEP Process Overview, from assessment to implementation
3. IEP Development, Tracy Collier and Melinda Dunlap's PowerPoint from the March 9, 2006 inservice session
4. IEP Roles, Multidisciplinary Team member roles for each step of the IEP process
5. Rights of Children with Disabilities and Parent Responsibilities, a Tennessee focus, commonly given to parents/guardian during multidisciplinary team meetings
6. Rights Brochure, the state's document mentioned immediately above, in a 4-page version
7. Instructions for Completing IEP Paperwork; the same 16-page instruction booklet in Spanish
8. Tennessee's IEP Manual, with 54 pages of detail; the same manual in Spanish
9. TCAP Testing Allowable Accommodations Table as revised for the new school year
10. English Language Learner Accommodations for TCAP achievement, competency, writing, and Gateway testing
11. TCAP Testing Accommodations Instructions for the IEP as revised for 2006-2007 
12. Modifications Checklist, a 2-page expanded listing for modifications to make for students in general education settings
13. Accommodations Checklist, a 2-page table of accommodations to make by subject content
14. IEP Objectives by Topic and Subject, from Nebraska
15. Suggestions for Tracking IEP Progress from the Alief Independent School District
16. Limits on Holding IEP Meetings without the parents attending
17. Summary of Special Education Timelines for disciplinary and IEP development actions
18. Guidelines for Determining the Need for Paraprofessional Support, for use during Sevier County IEP meetings
19. High School IEPs, the quick and easy of it for Sevier County
20. IEPs vs. Section 504, explains the difference between IEPs and 504 plans
21. IEP Technical Assistance Guide from Nebraska's Department of Education
22. Woodcock-Johnson III Frequently Asked Questions, by test section, with answers and a link to submit questions
23. Support Teams for Special Education in Sevier County
24. Related Services, descriptions of related services, with two-digit codes for all and examples for some
25. Justifications for Restricted Placements, samples of some Least Restrictive Environment IEP wording, borrowed from an Alaskan school system
26. Suggested IEP Content for a Student with Autism, more than a good start for drafting an autism IEP
27. Suggested IEP Goals and Objectives for the Bipolar Student from the Papolos' book The Bipolar Child
28. Checklist for Multidisciplinary Team Meeting/IEP Creation, steps to keep in mind and their IDEA '97 and 34 CFR 300 regulatory references

 

Professional Forms

1. Flexible Inservice Credit for Noncertified Staff, for paraprofessional staff to document the 6 hours of inservice time required each year. The same form as an Acrobat PDF file
2. Flexible Inservice Credits, for professional staff to document the 6 (or more) hours of inservice time required each year. The same form as an Acrobat PDF file.
3.   Request for Professional Leave, must be signed by the principal and director of curriculum and instruction before the date(s) requested
4. Claim for Conference Travel Reimbursement, for covered employees to be reimbursed for hotel, dining, and travel after returning from official business trips for which Sevier County Schools agreed to pay
5. Claim for Traveling Expenses, for covered employees to be reimbursed for driving their own vehicles on official business
6. Dental or Vision Direct Reimbursement Claim Form, for covered employees to receive back part of their payments for covered dental work or eye exams, glasses, contacts, etc. (form was revised to add vision in January 2004)
7. Application for Tennessee Teaching License or Amendment to Licensure, the form for adding education credits, additional endorsements, or Praxis scores
8. Table of Endorsement Titles and Corresponding Codes, includes most (but not all) Tennessee Teaching License add-on endorsement codes. Link to the full list. This also lists disability codes.

    

Bus Driver Information

1. Bus Conduct Report, the driver's form for reporting student behavior and corrective action taken
2. Bus Emergency Card, for quick contact of the guardians and medical information on the students
3. Bus Cell Phone Policy, concerning students' phones on special education buses
4. Special Education Bus Driver Absentee Form, the driver's form to self-report mornings or afternoons missed.  The same form as an MS Works file
5. Special Education Bus Attendant Absentee Form, the bus attendant's form to self-report mornings or afternoons missed.  The same form as an MS Works file
6. Weekly Special Education Bus Transportation Log, to document days that students rode a Sevier County school bus.  The same form as an PDF file
7. Bus Maintenance/Completion Reporting Form, Sevier County Schools Form 620, for the driver to indicate a problem and the garage staff to report how they fixed the vehicle