If however, there IS a change in the type of support or type of service, the student MUST stay put pending due process.

Manifestation Determination

• Instructions •

• A Manifestation Determination is only for a student with a disability who has an IEP, and the school proposes any form of discipline that will result in a change in placement.

Actions which count towards the 5 and 15 day rule:

1. The suspension of even one school day for a student with mental retardation without a NOREP or permission from PDE

2. Suspension of more than 5 consecutive schools days 3. Suspension of 15 cumulative school days in one school year 4. Expulsion

A change in placement occurs when the following occurs: 1. In school suspension if the IEP cannot be implemented 2. Suspension from transportation listed on the student’s IEP 3. Interruption of any related service listed on the student’s IEP

4. Exclusion from any extracurricular activity listed on the student’s IEP

• The Manifestation Determination process MUST be completed within three school days following an incident that requires a disciplinary action, as defined in the Code of Student Conduct.

• The Manifestation Determination is to be completed by a fully constituted IEP Team that includes the parent(s).

• Use the Invitation to Participate form to notify the parent(s). Include the Procedural Safeguards Notice. • The parent(s) MUST be invited, but DO NOT wait if the parent does not respond. You MUST document

your attempts at parental contact.

• A change in placement consists of any one of the following:

NOTE: You must issue a NOREP following the Manifestation Determination. The purpose of the NOREP is to provide the results to the parents while protecting the students due process procedural safeguards.

• If it is determined that the behavior IS a manifestation of the disability, the school MAY NOT implement the proposed discipline.

- The IEP Team is to meet immediately to complete a Functional Behavioral Assessment and then develop a Behavior Support Plan to address the behavior in question.

- The approved District Behavior Support Plan, on page 8 of the IEP, must be used. • If it is determined that the behavior IS NOT a manifestation of the student’s disability:

- Issue a NOREP indicating only the results of the Manifestation Determination. - Include a copy of the IEP that was reviewed.

- Include a copy of the Manifestation Determination. - Include a copy of the Procedural Safeguards Notice.

- If the parent(s) approve the NOREP, proceed with the approved form of discipline. - If the parent(s) disapprove the NOREP, initiate due process procedures immediately.

NOTE: If there is NO change in the type of support or type of service to be offered at the alternative setting, the student MAY be moved to the alternative setting pending due process.

If however, there IS a change in the type of support or type of service, the student MUST stay put pending due process.

Student Name:

ID#: DOB: Age: Grade:

School: Regional Academic Office (RAO):

IEP Coordinator: Phone:

Name and Address of Parent/Guardian:

Phone: (H) (W)

Email: Fax:

Native/Home Language: Interpreter: q Yes q No

Additional Information:

Procedural Safeguards Notice • Interpreter Services

q

I/we have received a copy of the Procedural Safeguards Notice. I understand that I can contact my school if I need assistance or more information. The school has informed me whom to contact if I need assistance or more information.

q

I/we have received the services of an interpreter at this IEP Team meeting.

q

I/we have declined the services of an interpreter at this IEP Team meeting.

Parent Signature: Date:

Documentation of Parent Contact

Type of Contact Date Response Signature

Letter: 1st class mail Phone call

Letter: Certified mail Home visit

Other:

NOTE: The following form must be sent along with Invitation to Participate:

q

Procedural Safeguards Notice

Student Name: ID#: Date:

NOTE: This information can be used for completing a Functional Behavioral Assessment and Positive Behavioral Support Plan.

A. Student Information:

1. Describe the student’s behavioral characteristics. Be specific as they relate to this incident:

2. Describe how the student’s disability affects his/her academic performance, behavior and social interactions:

B. Description of the Behavior Related to the Proposed Disciplinary Action:

1. Describe the setting events (those parts of the student’s life that he/she has no control over, but that may affect his/her behavior in school):

2. Describe the antecedents (what was happening or what happened just prior to the behavior in question):

3. Describe the behavioral incident in detail:

4. Describe the immediate consequences:

5. Provide any other details related to this incident:

C. Description of Proposed Disciplinary Action:

1. Indicate the cumulative record of disciplinary actions for this student for the current school year:

2. Indicate the total number of days this student has been suspended (change in placement) this school year: (If the total days equal or exceed 15 school days, you may not proceed with any suspension.)

D. Questions for the IEP Team Decision Making Process (You must answer all 5 questions): 1. The student’s IEP is current? q Yes q No

If the answer is FALSE, you MAY NOT proceed. The IEP team must meet and immediately take steps to develop an appropriate IEP for the student that includes a Behavior Support Plan designedto deal with the behavior in question. This must be developed using a current Evaluation Report.

2. In relationship to the behavior subject to disciplinary action, the student’s IEP and placement were appropriate? q Yes q No

This decision is based on the following considerations by the IEP Team in relationship to the behavior subject to the disciplinary action:

• The student was deriving reasonable educational benefit from his/her program.

• The student’s needs were being addressed through the IEP (including instruction, communication, behavior, etc.).

• There were appropriate related services, accommodations, adaptations and supports in place for the student.

• A Behavior Support Plan is present (if needed) and is appropriate.

• Review progress monitoring data (academic and behavioral), evaluations and diagnostic information, classroom/student observations, and teacher/staff/parent/student interviews.

3. In relationship to the behavior subject to disciplinary action, special education programs and services, supplementary aids and services and behavior intervention strategies were provided consistent with the IEP and placement? q Yes q No

This decision is based on the following considerations by the IEP Team in relationship to the behavior subject to the disciplinary action:

• The student’s IEP (including a Behavior Support Plan if needed) was implemented as designed. • Review the academic and behavioral progress monitoring data.

• Assess by reviewing the IEP sections of specifically designed instruction, related services and supports for school personnel.

• All the related services indicated on the IEP were being provided. • Necessary resources are available as part of the student’s program.

4. The student’s disability did not impair his/her ability to understand the impact and consequences of his/her behavior subject to the disciplinary action? q Yes q No

This decision is based on the following considerations by the IEP Team:

• The student, prior to this behavioral incident, demonstrated an understanding of the consequences of his/her behavior to him/herself and others.

• The student demonstrates an understanding that the behavioral incident under review was inappropriate. 5. The student’s disability did not impair his her ability to control his/her behavior? q Yes q No

This decision is based on the following considerations by the IEP Team: • The student demonstrated adequate self control prior to the incident.

• The student has demonstrated (review prior behavior) socially acceptable behavioral choices when faced with similar circumstances.

Student Name: ID#: Date: E. IEP Team Conclusions (select Option 1 or Option 2):

q

(Option 1) The IEP Team has determined that the behavior IS NOT a manifestation of the student’s disability.

NOTE: If ALL of the answers to the five questions are TRUE, the IEP Team has documented that the behavior IS NOT A MANIFESTATION of the student’s disability.

• The school MUST proceed with the approved disciplinary action as defined in the Code of Student Conduct.

• The school MUST continue to ensure a Free Appropriate Public Education (FAPE) during any disciplinary action.

• The student’s IEP MUST be reviewed and revised as necessary.

• The IEP Team MUST ensure that the student’s current IEP can be implemented at the recommended alternative setting.

OR

q

(Option 2) The IEP Team has determined that the behavior IS a manifestation of the student’s disability.

NOTE: If ANY answer to the five questions are FALSE, the IEP Team has documented that the behavior IS A MANIFESTATION of the student’s disability.

•

The proposed disciplinary action MUST NOT be implemented.

•

The IEP Team MUST do a Functional Behavioral Assessment.

•

The IEP Team MUST immediately review and revise the student’s IEP to include appropriate Positive Behavior Support goals and objectives, based on the Functional Behavioral Assessment, to meet the student’s behavior needs.

F. IEP Team Signatures and Agreement/Disagreement with the Manifestation Determination Process: Directions to the IEP team members:

Indicate if you agree or disagree with the team’s decision.

PRINTED NAME SIGNATURE ROLE

LEA Rep q Agree q Disagree

Parent q Agree q Disagree

Parent q Agree q Disagree

Special Education Teacher q Agree q Disagree Regular Education Teacher q Agree q Disagree q Agree q Disagree q Agree q Disagree q Agree q Disagree Note: If the team does not reach agreement, an expedited due process hearing may be requested by the parents or the school district.