Present Level of Academic Achievement and Functional Performance:
Communication Status:
Academic Performance:
Health, Vision, Hearing, Motor Abilities:
Social and Emotional Intelligence
General Intelligence:
Functional Vision/ Learning Media Assessment:
Functional Hearing, Listening, & Communication Assessment:
Transition Needs:
Transition Services Needs:
What transition assessments were used to determine the child’s preference and
interests?
Needs Related to The Course of Study: See Present Levels of Performance
Do transition service needs focus on the child’s course of study and are they addressed
in the Present Levels?
Postsecondary Goal(s)
Postsecondary Goal(s) Related to Education/Training & Employment
Transition Service:
Agency Responsible:
Postsecondary Goal(s) Related to Independent Living:
Course of Study:
Measurable Annual Goals and Benchmarks:
Annual Measurable Goal (#1):
Method(s) of Measurement:
Specially Designed Instruction:
Benchmark/Short-Term Instructional Objectives:
Annual Measurable Goal (#2):
Method(s) of Measurement:
Specially Designed Instruction: Modeling, Guided practice, Repetitive practice,
Benchmark/Short-Term Instructional Objectives:
Annual Measurable Goal (#3):
Method(s) of Measurement:
Specially Designed Instruction:
Benchmark/Short-Term Instructional Objectives:
Annual Measurable Goal (#4):
Method(s) of Measurement:
Specially Designed Instruction:
Supplementary Aids and Services:
Benchmark/Short-Term Instructional Objectives:
Supplementary Aids and Services:
Accommodations for Administration of State Assessments and Assessments in the
Classroom:
Learner Characteristics Inventory:
What is the student’s primary classroom setting?
Program Modifications/Supports for school personnel will be provided
Least Restrictive Environment (LRE) and General Education
Special Education Services:
Type of
Service:
Service
Minutes:
Extended School Year:
Service
Frequency:
Service
Period
Start Date:
End Date:
_______
_______
Service
Provider:
Location: