INSTRUCTIONS
IDEA, PART B DECEMBER 1, 2001 CHILD COUNT
The attached forms are for reporting your December 1, 2001, unduplicated count of children with disabilities who are receiving special education and related services under Part B of the Individuals with Disabilities Education Act (IDEA). PLEASE NOTE THAT DECEMBER 1 FALLS ON A SATURDAY THIS YEAR. AS A RESULT, THE ACTUAL COUNT DATE IS DECEMBER 3, 2001. The forms include necessary information regarding age, sex, ethnic designation, primary disability category and educational placement. The final section of this form is to be used to provide by disability category the number of children and youth with disabilities eligible under Part B of IDEA who are served in correctional facilities and the total number of children and youth with disabilities enrolled in private schools who receive special education and related services at public expense.
Sections I-IV: IDEA, Part B December 1, 2001 Child Count - The deadline for returning the report is December 15, 2001. Accuracy is important. If errors are discovered after the report has been mailed, revised reports increasing or decreasing the count will be accepted until December 31, 2001. Thereafter, only downward revisions will be accepted. Revisions must be made by filling out the form in full, signing and dating it and marking it REVISED REPORT in the upper right hand corner.
This is to be an unduplicated count of all children and youth with disabilities by age, race, sex and primary disability category according to their educational placements. Since this is intended to be a count of the children and youth receiving services under Part B of IDEA on December 1, 2001, all children counted must be enrolled in a special education program that is provided in accordance with an individualized education program (IEP) on the count date. A temporary placement qualifies if it is being provided in accordance with a temporary IEP. All counts should represent the setting in which children and youth with disabilities eligible under Part B of IDEA have been placed for educational services according to federal placement guidelines.
Each eligible child should be counted on the form where the child’s education placement, primary disability category, age, sex and ethnic designation intersect. The ages are the child’s age on December 1, 2001. In order to have sufficient room for logging data, the disability categories have been abbreviated as follows:
DisabilityAbbreviation / Disability Category / Disability
Abbreviation / Disability Category
MR / Mental Retardation / OHI / Other Health Impairments
HI / Hearing Impairments / SLD / Specific Learning Disability
SI / Speech/Language Impairments / DB / Deaf-Blindness
VI / Visual Impairments / MD / Multiple Disabilities
SED / Serious Emotional Disturbance / AU / Autism
OI / Orthopedic Impairments / TBI / Traumatic Brain Injury
Should there be need for interpretation, please refer to Section 300.7 of the IDEA, Part B regulations. Please note that Deaf-Blindness means “concomitant hearing and visual impairment, the combination of which causes such severe communication and other developmental and educational problems that they cannot be accommodated in special education programs solely for children with deafness or children with blindness.”
Each district must complete its own count and keep a list of all students counted on December 1. The Special Education Office will be auditing child counts, and it will be necessary for the local education agency (LEA) to provide a LIST of those students claimed on the December 1 count.
IMPORTANT REMINDER: Do not count children who are served by two or more teachers more than one time on this count.
NOTE: To calculate the percentage of time outside the regular classroom, divide the number of hours the student receives special education and related services outside the regular classroom by the total number of hours in the school day.
SECTION I - Regular Class
Include an unduplicated count of children and youth with disabilities receiving special education and related services for less than 21% of the school day. Each eligible child should be reported in the appropriate age subsection where the race/sex and primary disability category intersect. This may include children and youth with disabilities placed in:
- regular class with special education/related services provided with regular class (indirect services)
- regular class with instruction within the regular class and with special education/related services provided outside regular class (itinerant and/or related services)
- regular class with special education services provided in a resource room (less than 21% of the school day in a resource room)
SECTION II - Resource
Include an unduplicated count of children and youth with disabilities receiving special education and related services for 60% or less of the school day and at least 21% of the school day. Each eligible child should be reported in the appropriate age subsection where the race/sex and primary disability category intersect. This may include children and youth with disabilities placed in:
- resource rooms with special education/related services provided within the resource room
- resource room with part-time instruction in a regular class
SECTION III - Separate Class
Include an unduplicated count of children and youth with disabilities receiving special education and related services for more than 60% of the school day. Do not include pupils who received education programs in public or private separate day or residential facilities. Each eligible child should be reported in the appropriate age subsection where the race/sex and primary disability category intersect. This may include children and youth with disabilities placed in:
- self-contained special classrooms with part-time instruction in a regular class
- self-contained special class full-time on a regular school campus
- resource rooms with special education/related services provided within the resource room
- resource room with part-time instruction in a regular class
SECTION IV - Private Special Day School, Public Special Day School, Residential and Hospital/Homebound
Include a list of all IDEA, Part B children and youth with disabilities receiving special education and related services in one of the following educational placements:
- Private Special Day School
- Public Special Day School
- Residential
- Hospital/Homebound
Record the student’s name or other identification, age, code for sex, race, primary disability category, educational placement and instruction provider’s name. The following coding system should be used for sex, ethnic, primary disability and placement:
SEXCode / Type
1 / Male
2 / Female
ETHNIC
Code / Type
1 / American Indian/Alaskan Native
2 / Asian/Pacific Islander
3 / Black, Not Hispanic
4 / White, Not Hispanic
5 / Hispanic
PRIMARY DISABILITY
Code / Type
1 / Mental Retardation
2 / Hearing Impairments
3 / Speech/Language Impairments
4 / Visual Impairments
5 / Serious Emotional Disturbance
6 / Orthopedic Impairments
7 / Other Health Impairments
8 / Specific Learning Disabilities
9 / Deaf-Blindness
10 / Multiple Disabilities
11 / Autism
12 / Traumatic Brain Injury
PLACEMENT
Code / Type
1 / Private Special Day School
2 / Public Special Day School
3 / Residential
4 / Hospital/Homebound
SECTION IV-A - Educational Placement Totals
Provide the total number of IDEA, Part B children and youth with disabilities included in each placement (Sections I - IV).
SECTION V, Part A: Children with Disabilities Served in Correctional Facilities
Indicate by disability category, gender and ethnic designation the number of children and youth reported in the IDEA, Part B child count who are receiving special education in correctional facilities. This is intended to be a count of all children and youth receiving special education in:
- short-term detention facilities (community-based or residential)
- correctional facilities
SECTION V, Part B: Children with Disabilities Enrolled in Private Schools
Enter by disability category, gender and ethnic designation the total number of children with disabilities reported in the IDEA, Part B child counts who have been enrolled by their parents in regular parochial or other private schools and whose basic education is paid through private resources and who receive special education and related services at public expense from a local education agency or intermediate educational unit.
SECTION V, Part C: Certification of Information by Superintendent, Director or Chief Administrator
The superintendent, director or chief administrator must sign this form.
Report of Children and Youth with Disabilities Receiving Special Education and Related Services Counted Under IDEA, Part B, Individuals with Disabilities Education Act
December 1, 2001
District ______LEA # ______
I. REGULAR CLASS – 5 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 6 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 5 and 6) Page 1 Count ______
IDEA, Part B, December 1, 2001 Child Count
Page 2
District ______LEA # ______
I. REGULAR CLASS – 7 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 8 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 7 and 8) Page 2 Count ______
IDEA, Part B, December 1, 2001 Child Count
Page 3
District ______LEA # ______
I. REGULAR CLASS – 9 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 10 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 9 and 10) Page 3 Count ______
IDEA, Part B, December 1, 2001 Child Count
Page 4
District ______LEA # ______
I. REGULAR CLASS – 11 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 12 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 11 and 12) Page 4 Count ______
IDEA, Part B, December 1, 2001 Child Count
Page 5
District ______LEA # ______
I. REGULAR CLASS – 13 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 14 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 13 and 14) Page 5 Count ______
IDEA, Part B, December 1, 2001 Child Count
Page 6
District ______LEA # ______
I. REGULAR CLASS – 15 YEAR OLDSDisability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
I. REGULAR CLASS – 16 YEAR OLDS
Disability
Category / Amer. Ind./
Alaskan Nat. / Asian/
Pac. Islander / Black / White / Hispanic / Total
M / F / M / F / M / F / M / F / M / F
1. MR
2. HI
3. SI
4. VI
5. SED
6. OI
7. OHI
8. SLD
9. DB
10. MD
11. AU
12. TBI
Regular Class (Ages 15 and 16) Page 6 Count ______
IDEA, Part B, December 1, 2001 Child Count