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Forms to Implement IEP

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Click the title to get a description of a form and citation, or click the PDF/Word icon to directly download the file:

Form Title PDF Word
Instructional Schedule Matrix: Blank PDF icon Word icon
Instructional Schedule Matrix: Sample PDF icon  
Related Services Received PDF icon Word icon
Task Analysis Data Sheet PDF icon Word icon
Data Collection Sheet PDF icon Word icon
Data Collection Sheet ~ Rating Scale ~ PDF icon Word icon
Behavior Intervention Program: Blank PDF icon Word icon
Behavior Intervention Program: Sample PDF icon  
Daily Schedule PDF icon  

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Instructional Schedule Matrix (PDF icon Word icon Blank / PDF icon Sample)


Bates, J. (1997). Developing, implementing, and monitoring the IFSP/IEP. In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


This matrix may be used as a data collection form for a child’s IEP objectives/goals within a daily routine and ongoing activities in the classroom. It also visually summarizes which IEP objectives/goals may be embedded into which daily activities in the classroom.

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Related Services Received PDF icon Word icon


Bates, J. (1997). What is my role? In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


A form for related service providers to share a brief description of services they provided a child with other team members at an inclusive early childhood program.

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Task Analysis Data Sheet PDF icon Word icon


Bates, J. (1997). Developing, implementing, and monitoring the IFSP/IEP. In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


A data collection rating scale. A target behavior may be analyzed and divided into small steps. Data codes can be determined in a convenient way for users to indicate the child’s performance level or the level of support needed.

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Data Collection Sheet PDF icon Word icon


Bates, J. (1997). Developing, implementing, and monitoring the IFSP/IEP. In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


A data collection sheet to rate the level of support a child may need to accomplish a specific objective.

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Data Collection Sheet ~ Rating Scale ~ PDF icon Word icon


Bates, J. (1997). Developing, implementing, and monitoring the IFSP/IEP. In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


A data collection sheet to record the performance of multiple children.

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Behavior Intervention Program (PDF icon Word icon Blank / PDF icon Sample)


Keating, J. (1997). Supporting children with challenging behaviors. In J. Bates, & J. Keating; The Preschool Inclusion Manual. Unpublished master’s thesis, University of Kansas, Lawrence, KS.


An example of an intervention program for a child’s challenging behaviors. It contains a definition of the behavior and the criteria of desired outcomes, as well as a description of specific procedures to be used.

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Daily Schedule PDF icon


Developed by Kids FIRST Early Intervention Program


The daily schedule includes a child's goals and objectives into their daily schedule. A blank form and sample form are included.

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Copyright © 2002, University of Kansas, Circle of Inclusion Project. Permission for reproduction of these materials for non-profit use with proper citation is granted. Please send your comments and questions to questions@circleofinclusion.org