Name of Grant Program: Early Childhood Special Education Allocation Fund Code: 262

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1 Name of Grant Program: Early Childhood Special Education Allocation Fund Code: 262 PART IV REQUIRED STATISTICAL INFORMATION please use this template as a working document and submit final numbers through the online version. The online version is similar and asks for the same information. To meet state and federal requirements as outlined in the State Performance Plan (SPP) ( please provide the following information based on the Year End child count for FY2009. All data requested in the following four sections should be based on programmatic information for the school year. Sections A and B collect data to report on SPP Indicators #12 (Transitions from Early Intervention) and #6 (Inclusion Practices in Preschool). Indicator #12 is a compliance indicator and it is the goal of the state to reach 100% compliance. Section B (Inclusion Practices in Preschool) will provide the state with consistent data for Indicator #6 on Least Restrictive Environments in Preschool. All data collected for the purposes of the SPP will be reported in aggregate, as well as by district, in order to determine progress as outlined in the performance plan. A. Transitions from Early Intervention 1. Number of children referred from Early Intervention (EI) in school year. a. Of that number, the number of children referred at least 45 school working days in advance of their third birthday. 2. Of the number provided in question 1a, indicate the number of children found: a. ineligible for special education services b. eligible for special education services c. not able to follow up due to parent refusal to consent, continue through the eligibility determination, or return a signed IEP. d. referral recently received, still in process and within the 45 day timeline e. parent delay in returning consent form, cancelling meeting dates but still in process Note: 2a +2 b +2 c = number in 1a a. 2b. 2c. 2d. 2e. 3. Of the number provided in question 2a, indicate the number of children who were determined ineligible on or before their third birthday. 4. Of the number provided in question 2b, indicate the number of children who had an IEP developed and implemented: a. Prior to their 3 rd birthday b. On their third birthday c. After their third birthday c.

2 5. Of the number provided in question 4c, indicate the number of remaining children who had their IEP developed and proposed to the parent prior to their third birthday: Number of children remaining without an IEP developed and proposed to the parent prior to the child's third birthday 6. The final number: (should be zero) Note: on the online version, if a number appears in 6, a pop-up box will appear asking for child specific reasons for each delay.

3 Name of Grant Program: Early Childhood Special Education Allocation Fund Code: 262 B. Inclusion Practices in Preschool 7. Other than EI, please estimate how many children were referred to special education by the following in school year: a. Child Care (Head Start, Child Care, and Family Child Care) b. Public School Program c. Parents d. Other: c. d. 8. Number of preschool-aged children residing in the district with IEPs Of the number provided in question 8, please indicate how many children had an IEP that called for Related Services only (should match # in code 48). 10. Of the number provided in question 8, indicate how many children served were from families experiencing homelessness 11. Of the number provided in question 8, please provide the breakdown of the placements as determined by the IEP process and based on the MA Dept. of Ed. New Data Element: Special Education Placement, ages 3-5 for the Student Information for the Management System (SIMS) categories: 00 - Not a Special Education Student 01 - Not currently a Special Education student age 3-5 but was previously a Special Education student during the current school year year old, General Education students serving as role models in Pre-K classes 30 - In the regular early childhood program at least 80% of the time 32 - In the regular early childhood program at least 40% - 79% of the time 34 - In the regular early childhood program less than 40% of the time 36 - Substantially Separate Class 38 - Public Separate Day 42 - Private Separate Day 44 - Residential Facility 45 - Public Residential Institutional Facilities 46 - Home 48 - Service provider location (private clinicians offices, clinician s office in school building, hospital facilities)

4 12. For children identified in Question 11, please indicate the number of children who received their special education services in the following settings: a. Head Start b. Child Care Center c. Family Child Care d. Public School e. Home b c. d. f. Other: e. f. 13. Number of preschool-aged children in the public school preschool without IEPs Of the number provided in Question 13, indicate the number of children who were funded partially or totally with Community Partnerships for Children funds. 15. Does the district charge tuition for preschool services for children without IEPs? If yes, please be prepared to upload the program s rate schedule into the online version Yes or No

5 C. Kindergarten 16. Total number of children enrolled in the district s kindergarten: a.) Half-day program b.) Full-day program a. b. 17. Of the number in question 17, indicate the number of kindergarten children with IEPs that call for a: a.) Half-day program b.) Full-day program 18. Of the numbers provided in questions 17a and 17b, indicate the number of kindergarten children who received services in the following kindergarten settings: 10 (all ages) Full inclusion, less than 21% outside general education classroom 20 (all ages) Partial inclusion, 21%-60% outside general education classroom 40 (all ages) Substantially separate, outside general education more than 60% 41 (all ages) Public Separate Day 50 (all ages) Private Separate Day 60 (all ages) Residential School 70 (all ages) Homebound/Hospital (Not home schooled) 90 (all ages) Public Residential Facility D. Eligibility in Early Childhood 19. At the start of the school year, how many children in the preschool program: a.) do not have IEPs and are age eligible to be in the kindergarten program? b.) have an IEP and are age eligible to be in the kindergarten program? 20. At the start of the school year, how many children in the kindergarten program: a.) do not have IEPs and are age eligible to be in the first grade? b.) have an IEP and are age eligible to be in the first grade?