Annual Review/Addendum
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
Based on updated present levels of performance, goals in the area(s) of . . . were
developed.
Due to weaknesses in . . . the accommodation of . . . was (added, continued).
The team determined that a . . . placement was required in order for ___ to make
progress on his/her IEP goals. Service delivery will be provided in (pull out, coteaching) because . . .
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
The team decided a goal in the area of . . . was no longer needed since . . .
The team decided the classroom accommodation of . . . was not need because . . .
____ placement (reg, resource, separate, etc) was determined inappropriate because
Initial Referral (DEC 1) with testing
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
Based on a review of classroom performance, intervention data, parent and teacher
concerns, the team decided assessments in the area(s) of . . . are needed because . . .
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
Because current data, as reflected on the DEC 1, is available in the area(s) of . . ., the
team determined updated information in that area is not required.
Initial Referral, (DEC 1 )
no evaluations
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because::
The data reviewed on the initial referral shows a student who . . . therefore the team
decided no evaluations are necessary. The special education process ceases.
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
The team discussed gathering additional data, but determined it was not necessary
because . . .
Initial Referral, (DEC 1)
determine eligibility based on information in hand
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
Based on the data reflected on the initial referral, all data needed to determine
eligibility is available, therefore the team decided (student) is eligible as . . . because . . .
Address topics related to the IEP
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
Additional formal and/or informal data is not required because ,. . . .
Address topics related to IEP
DEC 7 no Testing
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
The team determined no additional assessments are needed because daily classroom
performance continues to be reflective of a student with (area of eligibility) as
evidenced by (identify characteristics the student exhibits are associated with the area
of eligibility)
The team determined the student is no longer in need of (related services) in order to
access his/her special education services because . . .
Address IEP (goals, accommodation, service delivery/placement)
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
The team discussed collecting additional data, but decided . . .
Address topics rejected in review of the IEP
DEC 7 with Testing
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
The team decided additional assessment is required in the area(s) of . . . because . . .
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
The team determined assessment in the area of . . . was not needed due to . . .
The team discussed reviewing the IEP, but decided it would be most appropriate to
complete this task when . . .
Eligibility Meeting (is eligible after testing)
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
Based on a review of formal and informal assessments, the student is eligible as (area)
due to . . .
Due to weaknesses in . . . , the team determined . . . is needed as a related service in
order for (student) to access his/her special education services.
Address topics decided upon for IEP
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
(If more than one area of eligibility was considered) The team considered (area) as an
area of eligibility but determined this was not appropriate because . . .
Address topics decided against during the development/review of the IEP
Eligibility Meeting (DNQ)
I. The IEP Team or other group of appropriate individuals decided the action(s)
stated on previous pages because:
Based on a review of formal and informal assessments, the team determined the
student is not eligible as (area) due to . . .
II. The IEP Team or other group of appropriate people also considered the following
option(s), including the continuum of alternative educational placements if
applicable, and rejected these options because:
(only if the team discusses) The team determined the test results were a valid
reflection of (student) and therefore did not . . . .