🗓

ARD Committee Meeting Information

TEA Model IEP §Header · Meeting logistics, participants, and procedural safeguards

Yes-TEA

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Meeting Details

Meeting Type * TEA Model IEP §Header

ARD Meeting Date *

Meeting Location *

Start Time *

End Time *

District of Responsibility

Required ARD Committee Members

LEA Representative (Name) *

LEA Representative (Title) *

Special Education Teacher *

General Education Teacher *

Evaluation Personnel / Interpreter of Results *

Parent / Guardian 1 *

Parent / Guardian 2

Student Participation

Additional / Conditional Participants

Speech-Language Pathologist

Occupational Therapist

BCBA / Behavior Specialist

LPAC Representative (if EL applicable)

CTE Representative (if applicable)

Transition Agency Rep. (if applicable)

VI Teacher (if applicable)

AI/DHH Teacher (if applicable)

Other Participants (Name, Title, Role)

Procedural Safeguards — Required by IDEA 20 U.S.C. §1415(d)

Procedural Safeguards Notice Date *

Prior Written Notice (PWN) Date *

Meeting Invitation Sent Date *

Parent Consent Date (Initial IEP)

Interpreter Services Provided?

Meeting Conducted via Teleconference?

👤

Student Information

TEA Model IEP §I · Demographics, case management, and contacts

Yes-TEAPEIMS

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Demographics

Student Legal Name (First, Middle, Last) * TEA Must match PEIMS/TSDS records exactly. Read-only after SIS sync.

Date of Birth * TEA Age: 6 yr 10 mo · Age of majority: 2037

Gender * E0004

Local Student ID * TEA

State ID (PEIMS) * E0001 10-digit TEA unique ID

Current Grade * TEA

Expected Grad. Year

Current Campus * TEA

Campus PEIMS ID * PEIMS Auto-derived from SIS

Home Language * E0030

Race / Ethnicity * E0348

EL / LEP Status E0841

Economically Disadvantaged E0785

Home Address & Contact

Street Address

City

State

ZIP

Parent / Guardian Contacts

Parent 1 Name *

Parent 1 Phone

Parent 1 Email

Parent 2 Name

Parent 2 Phone

Parent 2 Email

Case Management & Special Ed. Status

Case Manager / SPED Teacher of Record

Date Entered Special Education * PEIMS

SPED Effective Date E1632 Syncs to PEIMS E1632

Record Type / Status *

Most Recent FIE Date

Next Reevaluation Due AUTO Auto-calculated: FIE date + 3 years

♿

Disability Information

TEA Model IEP §I/PEIMS · Classification, PEIMS codes, and administrative indicators

Yes-TEAPEIMS C053

▼

Primary Disability * C053

Secondary Disability C053

Tertiary Disability C053

Multiply Disabled Indicator * PEIMS

Instructional Arrangement * C035

PEIMS Instructional Setting Code C035 AUTO Auto-derived from instructional arrangement selection

Medically Fragile

Child Count Funding Type

PPCD Indicator (Ages 3–5)

DSM-5 / Evaluation Diagnosis

Clinical Diagnosis

Diagnosing Clinician

Date of Clinical Diagnosis

Additional Diagnoses / Comorbidities

⚖️

Consideration of Special Factors

34 CFR §300.324(a)(2) · ARD committee must consider all 6 factors for every student

FEDYes-TEA

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Factor 1 — Behavior

Does behavior impede learning (self or others)? *

FBA Completion Date

Behavior Intervention Plan Description

Factor 2 — Limited English Proficiency

LEP / Language Needs Status *

Factor 3 — Blind or Visually Impaired

Blind / Visually Impaired Consideration *

Factor 4 — Communication Needs

Communication Needs Present? *

AAC Device / Communication System

Communication Supports Provided

Factor 5 — Deaf or Hard of Hearing

Deaf / Hard of Hearing Consideration *

Factor 6 — Assistive Technology

AT Devices / Services Needed? *

Assistive Technology Devices & Services

📊

Present Levels of Academic Achievement & Functional Performance (PLAAFP)

TEA Model IEP §III · Baseline data, strengths, functional skills, and disability impact

Yes-TEAFED

▼

Academic Performance

Reading Performance *

Mathematics Performance *

Written Language Performance

Other Academic Areas

Functional Performance

Social / Emotional / Behavioral Functioning *

Communication Skills

Motor Skills (Fine / Gross)

Daily Living / Self-Help Skills

Strengths, Concerns & Disability Impact

Student Strengths *

Parent Concerns for Enhancing Education *

General Education Teacher Concerns

How Disability Affects Involvement in General Ed Curriculum *

Nathaniel's Autism Spectrum Disorder significantly affects educational performance across multiple domains. ACADEMIC IMPACT: Social communication deficits and concrete thinking patterns affect reading comprehension (particularly inferential comprehension requiring social-emotional understanding), mathematical word problem solving (language processing rather than math reasoning), and written expression (working memory deficits, fine motor delays, and difficulty organizing thoughts). SOCIAL/BEHAVIORAL IMPACT: Minimal spontaneous peer interaction, difficulty with perspective-taking and social cues, and challenges with behavioral flexibility affect participation in collaborative learning and adaptation to daily routines. SENSORY IMPACT: Sensory processing differences affect attention, behavior regulation, and ability to function in typical school environments without modifications. WITHOUT specialized instruction, accommodations, and autism-specific programming, Nathaniel would not make adequate progress in the general education curriculum or develop critical social communication and adaptive skills. WITH appropriate supports — intensive autism programming, visual supports, sensory accommodations, social skills instruction, and behavioral flexibility training — Nathaniel can participate meaningfully in general education and make progress toward grade-level standards.

How Disability Affects Participation in Age-Appropriate Activities (Preschool — Conditional) 34 CFR §300.320(a)(1)(ii) — Required for preschool-age students only

🔬

Comprehensive Evaluation Results

Assessment instruments, scores, and clinical interpretation — referenced in PLAAFP

ENHANCED

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Cognitive Assessment — WPPSI-IV (with Autism Accommodations)

Scale	Score (SS)	Percentile	Range	Interpretation
Full Scale IQ (FSIQ)	87	19th	Low Average	Underestimate — autism accommodations
Verbal Comprehension Index (VCI)	82	12th	Low Average	Language-based tasks affected by autism
Visual Spatial Index (VSI)	95	37th	Average	STRENGTH AREA
Fluid Reasoning Index (FRI)	88	21st	Low Average
Working Memory Index (WMI)	78	7th	Below Average	SIGNIFICANT WEAKNESS
Processing Speed Index (PSI)	92	30th	Average

Academic Achievement

Test / Subtest	Score (SS)	Percentile	Grade Equiv.	Interpretation
WJ-IV: Letter-Word Identification	95	37th	1.5	STRENGTH
WJ-IV: Reading Fluency	88	21st	1.0	Average Range
WJ-IV: Passage Comprehension	82	12th	K.8	PRIMARY DEFICIT
WJ-IV: Math Calculation	90	25th	1.2	STRENGTH
WJ-IV: Applied Problems	78	7th	K.5	PRIMARY DEFICIT
WJ-IV: Written Expression	79	8th	Late K/1st	PRIMARY DEFICIT
KTEA-3: Phonological Processing	92	30th	—
KTEA-3: Reading Comprehension	80	9th	—	Deficit
KTEA-3: Math Concepts & Applications	79	8th	—

Speech-Language & Related Services Assessments

Instrument	Score	Percentile	Domain	Interpretation
CELF-5: Core Language Score	79	8th	Language	Below Average
CELF-5: Pragmatic Language (PLSI)	—	15th–25th	Pragmatics	PRIMARY DEFICIT
Beery VMI-6: Visual-Motor Integration	88	21st	Fine Motor
Beery VMI-6: Motor Coordination	85	16th	Fine Motor	Mild Delay
Beery VMI-6: Visual Perception	98	45th	Visual	STRENGTH
Vineland-3: Communication (Teacher)	75	5th	Adaptive
Vineland-3: Daily Living (Teacher)	82	12th	Adaptive
Vineland-3: Socialization (Parent)	71	3rd	Social	Significant Deficit
ADOS-2 (Module 3): Total Score	15	—	Autism	Autism Range (≥10)
SRS-2: Total Score (Parent)	75T	—	Social Respond.	Severe Range
BRIEF-2: Shift (Parent)	75T	—	Exec. Function	Clinically Significant
BASC-3: Adaptability (Parent)	33T	—	Behavior	Clinically Significant

Diagnostician / LSSP Name

FIE Complete Date

🎯

Annual Goals, Objectives & Progress Monitoring

TEA Model IEP §IV–VIII · Measurable goals, benchmarks, and progress reporting

Yes-TEAFED

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1

Reading Comprehension — Inferential / Social-Emotional ELA · Autism-Specific

Goal Start Date *

Goal End Date * AUTO Auto-calculated: start date + 1 year

Measurable Annual Goal *

How Progress Will Be Measured *

Progress Reporting Frequency

Method of Reporting to Parents

Benchmarks / Short-Term Objectives

1.1 Nathaniel will identify characters and their emotions in first-grade narrative texts using emotion charts and visual supports with 70% accuracy across 3 consecutive sessions, by April 2026.

1.2 Nathaniel will answer "why" questions about character actions using character analysis graphic organizers with 60% accuracy across 3 consecutive sessions, by July 2026.

1.3 Nathaniel will make simple inferences about social situations in stories using explicit comprehension strategies and visual cues with 65% accuracy across 3 consecutive sessions, by October 2026.

2

Mathematics — Word Problem Solving Mathematics

Goal Start Date

Goal End Date AUTO

Measurable Annual Goal

Benchmarks / Short-Term Objectives

2.1 Nathaniel will identify key information in first-grade word problems (numbers, operation words, question) using visual highlighting and graphic organizers with 70% accuracy across 3 consecutive trials, by April 2026.

2.2 Nathaniel will select the correct operation (add/subtract) for word problems involving familiar vocabulary with 75% accuracy across 3 consecutive sessions, by July 2026.

3

Social Communication — Peer Interaction Behavior/Social Skills · Autism-Specific

Goal Start Date

Goal End Date AUTO

Measurable Annual Goal

Benchmarks / Short-Term Objectives

3.1Nathaniel will greet familiar peers by name using rehearsed greeting scripts in 4/5 structured opportunities per week, by April 2026.

3.2Nathaniel will use learned conversation initiation scripts to ask a peer to join an activity in 3/5 daily opportunities during recess, by July 2026.

3.3Nathaniel will maintain a reciprocal social interaction with a peer for 3+ minutes using Social Thinking strategies in 3/5 observed opportunities, by October 2026.

Progress Monitoring Schedule

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Special Education & Related Services

TEA Model IEP §VII · Service grid with PEIMS auto-coding, SHARS billing, and school day fields

Yes-TEAPEIMS AUTOSHARS

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🖥 PEIMS Service Indicator Codes — Auto-Generated from Service Grid

Speech Therapy

SI = 1 (Yes)

Occupational Therapy

OT = 1 (Yes)

Physical Therapy

PT = 0 (No)

Counseling

COUN = 0 (No)

Medical/Diagnostic

MED = 0 (No)

School Health

SH = 0 (No)

Interpreting Type

N/A (Not DHH)

Transportation

See §XII

ESY Contact Hrs

102 hrs (See §X)

Special Education Instruction

Service Type	Setting	Min/Session	Freq./Week	Start Date	End Date	Provider
SPED — Autism Programming / Social Skills Social Thinking, Zones of Regulation, behavioral flexibility	SPED Resource Room	30 min	5x/week (daily)	01/15/2026	01/15/2027	Ms. Sandra Okafor
SPED — Reading Comprehension (SDI) Inferential comprehension, social-emotional inference, autism-specific strategies	SPED Resource Room (1:3 ratio)	45 min	5x/week (daily)	01/15/2026	01/15/2027	Ms. Sandra Okafor
SPED Co-Teaching — Reading Block Collaborative co-instruction in general education setting	General Education Classroom	60 min	5x/week (daily)	01/15/2026	01/15/2027	Ms. Sandra Okafor + Mr. Novak

Length of Student's School Day * TEA

Shortened School Day? TEA

Shortened Day Justification (if applicable)

Related Services

Service	Delivery	Min/Session	Freq.	Start	End	PEIMS Code
Speech-Language Therapy Pragmatic language, social communication, conversational skills	Direct (Pull-out)	45 min	2x/week	01/15/2026	01/15/2027	SI=1
Occupational Therapy Fine motor, sensory processing, handwriting, AT support	Consultation + Direct (2x/month)	30 min	2x/month	01/15/2026	01/15/2027	OT=1
BCBA Behavioral Consultation BIP implementation, data review, staff coaching	Indirect/Consultation	30 min	2x/month	01/15/2026	01/15/2027	N/A-PEIMS

Supplementary Aids & Services

Program Modifications & Supports for School Personnel

Program Modifications for Student * TEA

Supports for School Personnel * TEA

Peer-Reviewed Research Basis — Best Practice Documentation

SHARS Billing & Consent — School Health and Related Services · Texas Medicaid Revenue Recovery

SHARS Medicaid Eligible? NEW

SHARS Parental Consent Date

SHARS Notification Date

Parent Refused SHARS Consent?

Telehealth Services Authorized?

🏫

Least Restrictive Environment (LRE) Determination

TEA Model IEP §XI · 34 CFR §§300.114–300.120 · Placement decision and justification

Yes-TEAFEDPEIMS

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% Time in General Education * Calculated from service minutes (1,980 gen ed / 2,700 total)

% Time in Special Education * Must total 100% with gen ed

LRE Placement Code PEIMS AUTO

Justification for Removal from General Education *

Nathaniel requires specialized autism-specific programming for 375 minutes per week (23% of school day) that cannot be delivered effectively in the general education setting. Specialized instruction includes: (1) Intensive social skills instruction using Social Thinking® curriculum — 30 min daily in small group (1:3); (2) Behavioral flexibility training using Zones of Regulation framework — integrated into autism programming time; (3) Specialized academic SDI for reading comprehension with social-emotional inference support — 45 min daily in resource setting; (4) Small-group instruction (1:3–1:4 ratio) to address autism-specific learning patterns requiring individualized pacing and immediate feedback. The ARD committee determined that the intensity, frequency, and autism-specific nature of these services require a specialized setting. Nathaniel participates in general education for 77% of school day including all core instruction with accommodations, all specials (PE, art, music), lunch, and recess.

Supplementary Aids & Services Considered Before Placement

Educational Benefits Analysis

Potentially Harmful Effects Considered

📋

State Assessments & Instructional Accommodations

TEA Model IEP §IX · STAAR participation, accommodations, and instructional supports

Yes-TEA

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STAAR Assessment Participation

STAAR Participation Determination *

Alternate Assessment Justification

STAAR Testing Accommodations

Extended TimeTime and a half on all sections

Oral AdministrationHuman reader for all passages and questions

Small Group Administration1–5 students; familiar test administrator

Scheduled BreaksEvery 30 min; movement allowed

ScribeFor written response sections

Graphic OrganizersProvided for reading/writing tasks

CalculatorPermitted sections only

Alternate SettingSeparate room, reduced distractions

TELPAS AccommodationsConditional: EL students only

Local Assessment Accommodations

☀️

Extended School Year (ESY) Services

TEA Model IEP §XXI · Regression-recoupment analysis and ESY service grid

Yes-TEAESY Contact Hrs

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ESY Services Needed? *

ESY Start Date

ESY End Date

ESY Justification — Regression / Recoupment Data *

1. REGRESSION/RECOUPMENT DATA: Summer 2024 data indicates Nathaniel regressed 4 months in reading level over 10-week summer break (2.2 GE → 1.8 GE); required 6 weeks of intensive instruction in Fall 2024 to recoup lost skills. Social communication skills showed significant regression with increased social withdrawal after breaks; lost conversational turn-taking and peer interaction gains requiring extensive reteaching.
2. SEVERITY OF DISABILITY: Autism significantly impacts social communication and behavioral flexibility, requiring continuous programming to maintain acquired skills. Breaks in structured social communication programming result in demonstrable skill loss.
3. CRITICAL DEVELOPMENTAL PERIOD: Ages 6–7 are crucial for social skill development in children with autism. Currently at critical juncture in literacy development (learning-to-read → reading-to-learn transition). Loss of reading skills during summer would significantly impact 2nd grade curriculum access.
4. ESY services will prevent significant regression in critical autism-specific skills and maintain academic progress essential for 2nd grade readiness.

ESY Service Grid

Service	Minutes/Session	Frequency	Total Hours	Provider	Location
Social Skills Instruction Social Thinking® curriculum, peer interaction, turn-taking	60 min	4x/week	24 hr	SPED Teacher w/ Autism Endorsement	Sunrise Elementary Summer Program
Reading Comprehension Maintenance Inferential comprehension, visual supports	60 min	4x/week	24 hr	SPED Teacher	Sunrise Elementary Summer Program
Structured Social Activities with Peers Naturalistic social opportunities with trained typical peers	60 min	4x/week	24 hr	SPED Teacher + Paraprofessional	Sunrise Elementary Summer Program
Speech-Language Therapy (Pragmatics)	30 min	2x/week	6 hr	Ms. Lauren Beckett, CCC-SLP	Sunrise Elementary
BCBA Behavioral Consultation	30 min	1x/week	3 hr	Mr. Kevin Adler, BCBA	Sunrise Elementary

ESY Contact Hours (Total) PEIMS AUTO

ESY Goals (Selected from Annual Goals)

⚽

Nonacademic & Extracurricular Activities

TEA Model IEP §X · Participation with nondisabled peers in all school settings

Yes-TEA

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Lunch Participation *

Physical Education (PE) *

Recess Participation *

Statement of Services/Supports for Extracurricular and Nonacademic Activities *

🚌

Transportation Services

TEA Model IEP §XX · Transportation as related service and PEIMS indicator

Yes-TEAPEIMS

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Special Transportation Required? *

Transportation PEIMS Indicator AUTO Auto-set from determination above

Transportation Notes / Special Considerations

🎓

Transition Services & Transfer of Rights

TEA Model IEP §XVII–XVIII · TEC §29.011 + 34 CFR §300.320(b) + Age of Majority

Yes-TEA (Age 14+)FED (Age 16+)

▼

Student Age / Transition Status *

Transfer of Rights — Age of Majority — TEC §29.0122 · Required beginning at age 17 (one year before 18th birthday)

Student Informed of Rights Transferring at Age 18? * TEA

Date Student Informed of Transfer of Rights

Guardianship / Alternatives Information Provided? * TEA

Date Guardianship Information Provided

✍️

ARD Committee Participants & Signatures

TEA Model IEP §XIII · All required and conditional participant signature blocks

CRITICAL — TEA

▼

Parent / Guardian 1 ★ Required

Date: 01/15/2026

Agreed Disagreed N/A

Parent / Guardian 2

Date: 01/15/2026

Agreed Disagreed N/A

District Representative ★ Required

Date: 01/15/2026

Agreed Disagreed

Special Education Teacher / Provider ★ Required

Date: 01/15/2026

General Education Teacher ★ Required

Date: 01/15/2026

Interpreter of Evaluation Results ★ Required

Date: 01/15/2026

Student (if appropriate) — Age 6, Not Required

N/A

CTE Representative (if applicable)

N/A

LPAC Representative (if applicable — EL students)

N/A

VI Teacher (if applicable)

N/A

AI / DHH Teacher (if applicable)

N/A

Transition Agency Representative (Age 16+)

N/A (Age 6)

Other Participant — Speech-Language Pathologist

Date: 01/15/2026

Other Participant — BCBA / Behavior Specialist

Date: 01/15/2026

📋

ARD Member Excusal

34 CFR §300.321(e) · Federal requirement for excused member documentation

FED — Yes

▼

Any ARD Member Excused?

Excused Member Name & Role

Reason for Excusal

Written Parental Consent Date * (required for all excusals)

Written Input from Excused Member

✅

Agreement / Disagreement with ARD Decisions

TEA Model IEP §XIV · Per-member agreement status — critical compliance documentation

CRITICAL — TEA

▼

Parent / Guardian 1 — Carol Chin — AGREED with ARD decisions All ARD decisions accepted as documented

Parent / Guardian 2 — Robert Chin — AGREED with ARD decisions All ARD decisions accepted as documented

District Representative — Dr. Holloway — AGREED with ARD decisions

Adult Student Agreement — N/A (Age 6) Required when student is age 18+

Written Statement of Basis for Disagreement (if any member disagreed) TEA §XIV–XV

📝

Documented Decisions of the ARD Committee

TEA Model IEP §XVI · Official record of all decisions made during this ARD meeting

CRITICAL — TEA

▼

Documented Decisions of ARD Committee * TEA §XVI

The ARD committee met on January 15, 2026 at Sunrise Elementary School and made the following decisions:

1. ELIGIBILITY: Nathaniel J. Chin continues to be a student with a disability under the Individuals with Disabilities Education Act (IDEA). Primary disability: Autism Spectrum Disorder. Secondary disability: Speech or Language Impairment.

2. INITIAL IEP: The committee developed and approved an initial Individualized Education Program for Nathaniel, effective January 15, 2026, through January 15, 2027.

3. PLAAFP: The committee reviewed and accepted the Present Levels of Academic Achievement and Functional Performance as documented, including evaluation results from the FIE completed November 20, 2025.

4. ANNUAL GOALS: The committee approved 3 measurable annual goals addressing (1) Reading Comprehension/Inferential Skills, (2) Mathematics Word Problem Solving, and (3) Social Communication/Peer Interaction.

5. SERVICES: The committee determined Nathaniel requires 375 minutes per week of specialized autism programming (special education instruction), speech-language therapy (2x/week, 45 min), OT consultation (2x/month, 30 min), and BCBA behavioral consultation (2x/month, 30 min).

6. LRE PLACEMENT: The committee determined Nathaniel's placement in a resource setting for 23% of his school day (375 min/week) with 77% participation in general education, constituting LRE Code 02 (Inside regular class 40–79%).

7. STATE ASSESSMENTS: Nathaniel will participate in STAAR standard administration with documented accommodations.

8. ESY: The committee determined Nathaniel qualifies for Extended School Year services based on documented regression-recoupment data. ESY services approved for 6 weeks (June 8 – July 17, 2026).

9. AUTISM SUPPLEMENT: The committee completed the Autism Supplement (TAC §89.1055(f)) with all 11 strategy determinations documented.

10. BIP: The Behavior Intervention Plan (developed following FBA dated November 15, 2025) was reviewed and incorporated into the IEP.

11. PROCEDURAL SAFEGUARDS: A copy of the Procedural Safeguards Notice was provided to the parent(s) on January 8, 2026.

12. PARENTAL CONSENT: Parents/guardians provided written consent for the initial provision of special education services.

All committee members present agreed with the decisions as documented. No disagreements were expressed.

🧩

Autism Supplement — All 11 Required Strategies

TAC §89.1055(f) · Required for ALL students with primary disability of Autism — Nathaniel qualifies

CRITICAL — TEA

▼

1

Extended Educational Programming

Description of Strategy Implementation

2

Daily Schedules Reflecting Minimal Unstructured Time

Description

3

In-Home and Community-Based Training or Viable Alternatives

Description

4

Positive Behavior Support Strategies

Description

5

Futures Planning

Description

6

Parent/Family Training and Support

Description

7

Suitable Staff-to-Student Ratio

Description

8

Communication Interventions (Including Pragmatic / Social Language)

Description

9

Social Skills Supports and Strategies

Description

10

Professional Educator and Staff Support

Description

11

Teaching Strategies Based on Peer-Reviewed Research

Description

Statement of Basis for Any Strategy Marked "Not Needed" — TAC §89.1055(f)(2)

🛡

Behavior Intervention Plan (BIP) Reference

TEA Model IEP §XXV · BIP attachment documentation and review tracking

Yes-TEA

▼

BIP Included as Part of This IEP? *

FBA Completion Date

BIP Annual Review Date

BIP Summary

📈

Supplemental Accelerated Instruction

TEA Model IEP §XXVI · Required determination per TEC §28.0211 (grades 3–8 assessment thresholds)

Yes-TEA

▼

Supplemental Accelerated Instruction Required? *

Accelerated Learning Committee (ALC) Decisions

🔒

Restraint & Confinement/Time-Out Provisions

TEA Best Practice · Proactive documentation of restraint/seclusion policies if applicable

Best Practice

▼

Use of Restraint Addressed in IEP?

Confinement / Time-Out Provisions

Restraint / Seclusion Documentation (if applicable)

🖥

PEIMS Auto-Coding Summary

All PEIMS/TSDS codes auto-generated from IEP data entries — Texas state reporting

PEIMS AUTO

▼

🔵 Student & Disability Codes

State Student ID (E0001)

8841056293

Gender (E0004)

M — Male

Race/Ethnicity (E0348)

03 — Asian

Home Language (E0030)

000 — English

EL Status (E0841)

0 — No

SPED Effective Date (E1632)

01/15/2026

🔵 Disability & Placement Codes

Primary Disability (C053)

AU — Autism

Secondary Disability (C053)

SI — Speech/Lang.

Multiple Disabilities

0 — No

Instructional Arrangement (C035)

42 — Resource Room

LRE Placement Code

02 — 40–79% gen ed

% Gen Ed

77%

🔵 Service Indicator Codes

Speech Therapy Indicator

SI = 1 (Yes)

OT Indicator

OT = 1 (Yes)

PT Indicator

PT = 0 (No)

Counseling Indicator

COUN = 0 (No)

Medical/Diagnostic

MED = 0 (No)

School Health

SH = 0 (No)

Interpreting Type (DHH)

N/A — Not DHH

Transportation Indicator

0 — No

ESY Contact Hours

102.0 hrs

PPCD Service Location

N/A (Age 6+)

RDSPD District

N/A

Medically Fragile

0 — No

PEIMS / District Student Number

District of Residence Code

District of Responsibility Code

Child Count Snapshot Date

ECSE Indicator

ECI Indicator

🏥

Health & Medical Information

Texas sample advantage — medical needs affecting educational programming

ENHANCED

▼

Current Medications

Vision Status *

Hearing Status *

Allergies

Medical Conditions Affecting Education

Emergency Procedures / Health Considerations

Nurse / Health Services Involvement

💬

Parent Communication Preferences

Texas sample advantage — language, contact preferences, and parent input documentation

ENHANCED

▼

Preferred Language for IEP Communications *

Interpreter Needed?

Best Method of Contact *

Best Time to Contact

Progress Report Delivery Preference

Home-School Communication Log?

Parent Input for IEP Development

💰

State Reporting, Compliance Tracking & IEP Dates

TEA compliance calendar, timeline monitoring, and document control

TEAPEIMS

▼

IEP Implementation Date *

IEP End Date *

Next Annual IEP Due Date * Auto: implementation date + 365 days

Days Until Annual Review AUTO

FIE Due Date (Triennial) AUTO Auto: FIE date + 3 years

Compliance Status

Outstanding Requirements / Action Items

📂

Document Version History & Amendments

Texas sample advantage — change tracking and amendment audit trail

ENHANCED

▼

Version	Date	Type	Author	Description of Change
1.0	01/15/2026	Initial IEP	Ms. Sandra Okafor	Initial IEP developed at ARD meeting. Full document created including Autism Supplement, BIP reference, and all TEA/PEIMS fields. Generated via IEP Companion AI in under 5 minutes; reviewed and finalized by ARD committee.

Amendment History (Future Amendments Documented Here)