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1342.12 Companion
July 12, 2017
Page 122
IEP CONTENT AND PLACEMENT APPROPRIATENESS
IEP team agreed this was the correct placement prior to incident?
☐
Yes
☐
No
☐
No Team Consensus
Comments:
Is the IEP team in agreement now as to correctness of placement?
☐
Yes
☐
No
☐
No Team Consensus
Comments:
Was there a behavior plan in effect for similar behavior prior to incident?
☐
Yes
☐
No
If No, would one probably have prevented this behavior?
☐
Yes
☐
No
☐
No Team Consensus
Does this behavior suggest the presence of a suspected disability or service need?
☐
Yes
☐
No
CONCLUSION 1
Conclusion 1: Was the behavior caused by, or did it have a direct and substantial relationship to, the
student’s disability?
☐
Yes
☐
No
Rationale:
Discussion
: What are the observable behavioral manifestations of this disability for this student as
reported by individuals knowledgeable of both this disability and this student’s prior associated
behavior?
☐
Yes
☐
No
☐
No Team Consensus
Comments: