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Student Info & IEP Date
Student Name / Birthdate / IEP Date — Auto-populated from SEIS/SIS. Verify all fields before the meeting.
Special Factors must be completed at every annual IEP. These are not optional — each section requires a documented team discussion and decision, even when the answer is No.
⚠ Leaving sections blank is not compliant. Every Yes/No must be checked and every rationale must reflect the team's actual consideration of the student's current needs.
Assistive Technology (AT)
Indicate Yes or No to reflect whether the student requires assistive technology (AT). While many students use technology as an accommodation or instructional tool, AT should only be identified as a Special Factor when the device and/or service is determined to be necessary for the student to access FAPE, typically based on the results of an assistive technology assessment.
AT ranges from low-tech (pencil grips, highlighters, graphic organizers) to high-tech (AAC devices, text-to-speech, screen readers).
If Yes: Specify the device/service in the Rationale and include it in the IEP Services section with frequency and responsible provider.
If No: The Rationale must still explain WHY AT is not needed. "Student does not use AT" is not a rationale — document what the team considered and why no AT is required at this time.
⚠ A "No" with no rationale is a compliance gap. IDEA requires documented consideration, not just a checkbox.
Low Incidence Services, Equipment & Materials
Low incidence disabilities include blindness/visual impairment, deafness/hearing impairment, deafblindness, and severe orthopedic impairments.
If Yes: Specify equipment or materials needed (Braille materials, FM system, specialized seating, communication device). These must be provided at no cost to the family.
Low Incidence Funding (LIF) — Charter SELPAs receive separate CDE funding for low incidence students. Contact your SELPA coordinator to access equipment and materials through the LIF process. Do not deny necessary equipment due to cost.
⚠ For initial low incidence placements, assessment by a credentialed specialist (TVI, DHH, OT/PT) may be required before services can be determined.
Considerations: Blind or Visually Impaired
If the student is blind or visually impaired, the IEP team must specifically address:
• Braille instruction — California law (EC 56352) creates a presumption that Braille should be provided. Document team reasoning if not providing.
• Visual efficiency skills — Use of remaining vision, optical devices
• Orientation and Mobility (O&M) — Safe and independent travel; O&M specialist must be involved
• Assistive technology — Screen readers, magnification, tactile materials
• Access to visual information — How will the student access curriculum?
A credentialed Teacher of the Visually Impaired (TVI) must be involved in assessment and service delivery.
Considerations: Deaf or Hard of Hearing
If the student is deaf or hard of hearing, the IEP team must address:
• Language and communication needs — Spoken language, ASL, a combination, or AAC?
• Direct communication opportunities with peers and staff in the student's language/mode
• FM system or amplification — Consider classroom acoustics and equipment needs
• Interpreting services — If ASL is the primary language, a qualified interpreter is required
• Full range of communication options — The team must inform the parent of all options
A credentialed DHH specialist must be involved in assessment and service planning.
English Learner Section — Complete If EL
Complete this entire section if the student is identified as an English Learner in SIS.
If the student is NOT an EL, this section may be left blank — but verify EL status in SIS. A reclassified (FEP) student still requires 4-year monitoring.
EL Item 1 — Comprehensive ELD Requirement
All EL students must receive both Designated AND Integrated ELD as part of their core instructional program.
Designated ELD (D-ELD) — A dedicated time period focused specifically on developing English language skills. Must be in addition to content instruction — not instead of it.
Integrated ELD (I-ELD) — English language development woven throughout all content areas. ALL teachers of EL students are responsible for I-ELD.
⚠ Special education services are not a substitute for ELD. Document how both Designated and Integrated ELD will be provided within or alongside the special education program.
EL 1a — Primary Language Supports & 1b Designated ELD Setting
1a: "Does the student need primary language supports during integrated ELD?"
If Yes, check all applicable supports from the list:
• Oral clarification in primary language
• Illustrated glossaries / bilingual dictionary
• Graphic organizers with key concepts translated
• Frontloading in primary language to bridge prior knowledge
• Frequent comprehension checks with student response in primary language
Selected supports must be implemented consistently across ALL content areas — not just in the special education setting. Document who is responsible.
1b: Where will the student receive Designated ELD? • General Education — Standard setting; student receives D-ELD with general education EL peers
• Special Education — D-ELD delivered within the special ed setting; must be justified and include qualified ELD instruction
EL Item 2 — Language Acquisition Program
The student is currently participating in:
Structured English Immersion (SEI) — The default program for most EL students. Academic instruction is delivered in English using techniques designed to develop English proficiency.
Other: Parent-selected multilingual/language acquisition program — Parent has exercised their right under Proposition 58 (2016) to enroll the student in a bilingual, dual-language, or other multilingual program. This is a parent right and cannot be denied.
⚠ Document the parent's program choice and ensure IEP services are compatible with the chosen program.
Comments: Note any relevant information about the student's language acquisition progress or coordination between special education and ELD staff.
Behavior Impeding Learning
"Does the student's behavior impede the learning of self or others?"
⚠ The IEP team MUST consider positive behavioral interventions and supports when behavior impedes learning — this is a federal IDEA requirement (34 CFR 300.324(a)(2)(i)).
If Yes: • Describe the specific behavior(s) in observable, measurable terms
• Document positive behavior interventions below
• Consider whether an FBA is needed
• Determine if a BIP is needed or should be updated
If No: The team still must have considered it. A student whose behavior is managed effectively through existing supports may be No — document what supports are in place that make No appropriate.
Behavior Interventions, Strategies & Supports
If behavior impedes learning, document ALL positive behavioral supports being implemented:
• Environmental modifications (seating, sensory breaks, transition warnings)
• Antecedent strategies (prevent the behavior before it occurs)
• Reinforcement systems currently in use
• De-escalation strategies and staff protocols
• Crisis response plan if applicable
Behavior Goal is part of this IEP — Check if an annual goal specifically targeting the behavior is included.
Behavior Intervention Plan (BIP) Attached — Check if a BIP exists.
⚠ A BIP should not be developed without a completed FBA. If the student has a pattern of behavior impeding learning and no BIP exists, the team should discuss conducting an FBA first.
El Dorado County Charter SELPASpecial FactorsSpecial Education Local Plan Area
