1. Students with IEPs and the One-to-One Aide
Office of Special Programs
West Virginia Department of Education
Professional Development Workshop
February 2013
We have added this very short presentation to today’s agenda as Dr. Phares has been receiving some questions from superintendents regarding the technical assistance the OSP has provided to districts regarding 1:1 aides for students with disabilities. Therefore, for most of you, this will simply be an overview of the legal requirements of the IDEA and Policy However, the presentation will also provide a summary of the research with regard to the benefits and disadvantages of 1:1 aides, and finally, emphasize the IEP Team’s responsibilities with regard to considering a request for 1:1 support, making the final determinations and documenting it on the IEP.

2. Today’s Reality
Increasing numbers of students with high-intensity needs (i.e., students with autism spectrum disorders, emotional/behavioral disorders, and multiple disabilities)
Increasing responsibilities of general education teachers with little or no support in the general education environment
Districts hiring aides in lieu of professional staff
Limited resources available to serve students in general education classrooms
Lack of availability of the continuum of service delivery options
Parent requests for 1:1 aides
Nationally, as the trend has been for more students to receive their education in general education classrooms, a common service delivery model has been to hire and assign more support personnel directly to students in a one-to-one fashion.
In some schools, assigning aides to support students with disabilities in the general education environment, has become the primary service delivery mechanism to operationalize the term “inclusive education” or “full inclusion” for students with more significant needs.
Some teachers and administrators may feel that an “easy” solution may be to add an aide to a student’s IEP when the need is fueled by one or more of the following factors: Summarize the bulleted items.

3. Who Needs What?
Some students need individual assistance for all or part of the day for academic, behavioral, social-emotional or physical support
General education teachers need support and assistance to implement specially designed instruction for some students
Parents need to be assured their children are safe in the school environment and are making progress toward IEP goals and objectives
All students need to become independent learners
The reality is that some students need individual assistance for all or part of the day. In order to determine how much support, the IEP Team must base the decision on current evaluative data; and the amount and intensity of the support would be described in the supplementary aides, services section of the IEP.
Depending on the number of students in a general education classroom and the requirements of the student’s IEP, the general education teacher may need support to meet the goals set forth in the IEP.
More intensive support may be required initially when a student is transitioning from one school to the next school level (e.g., elementary to middle) or when the student is transitioning from the special education environment to the general education environment.
We find that some students may need more intensive support initially in order to become independent in certain skills (e.g., feeding, toileting, accessing AT). This may be done intensely at first, then gradually fade as the student becomes more independent.
Of course, the primary goal is to fade that assistance & strive for the student to become more independent.

4. However . . .
for some students, individual support is critical for their educational progress!
The educational benefits for some students with disabilities in inclusive settings are enhanced by the 1:1 aide and those benefits would be minimal without that support.
The next few slides will provide an overview of the procedures that IEP Teams must follow to make the decisions regarding the type of support the student will need and when necessary, how the support should be documented on the IEP.

5. Entitlements to Students with Disabilities
Each student’s IEP must describe the special education and related services, supplementary aids and services, and program modifications or supports for school personnel that will be provided to or on behalf of the student to enable the student to:
advance appropriately toward attaining the annual goals;
be involved in and make progress in the general education curriculum;
have an equitable opportunity to participate in extracurricular and other nonacademic activities; and
be educated and participate with other students with and without disabilities in the least restrictive environment (LRE).
Policy 2419, Chapter 5 requires the IEP to describe the special education and related services that will be provided to or on behalf of the student to enable the student to:

6. Legal Requirements Aides should never be assigned to students based
Students with IEPs are entitled to all services that are required for access to the general education curriculum and to receive educational benefit
IEP Teams must consider current data and document the student’s relevant academic, behavioral, developmental, or functional needs in the present levels of performance
IEP Teams must consider the supplementary aids, services and supports required to meet the student’s identified needs prior to removing a student from the general education environment
The district must determine and provide the staff required to implement the services designated on the IEP
Aides should never be assigned to students based
on a particular category of exceptionality
The IDEA and Policy 2419 require the IEP Team to describe the services needed by an eligible exceptional student to access the general education curriculum based on the most current evaluative data. The student’s needs must be documented in the present levels of performance statements. The present levels must describe the type and amount of support the student will require to access the content. (i.e., does the student need physical support in PE, curricular/ instructional modifications to the presentation of the content , verbal review or practice, physical guidance or prompts to participate in activities?)
Supplementary aids and services means aids, services, and other supports that are provided in general education classes or other education-related settings to enable students to be educated with students without exceptionalities to the maximum extent appropriate in accordance with LRE requirements. These services must be considered prior to removing a student from the general education classroom.
Neither law requires the IEP Team to state the specific personnel who will deliver those services. Rather, the IEP should describe the supports necessary for the student to receive educational benefit.
According to Policy 2419, Chapter 6, Section 4, it is the responsibility of the district to provide adequate staff to implement the IEP of each student. The number of students served in an instructional period and the assignment of paraprofessionals/aides must be determined based on the intensity of services required by the students. Teachers’ class lists and student schedules must be developed and monitored to ensure the implementation of IEP services. While highly qualified teachers and licensed therapists must design and provide initial or original instruction, support personnel can provide reinforcement and practice of previously taught skills or content.
Additionally, support personnel may be required to provide assistance to students in response to specific needs related to: 
Significant cognitive and/or sensory impairments;
Communication;
Safety;
Mobility;
Personal care;
Behavior;
Medical/health; or
Other unique circumstances.
Aides are never assigned to students based on a category of exceptionality (e.g., if the student

7. Benefits of One-to-One Support Personnel
May assist in the provision of special education and related services under the supervision of a qualified teacher or a related service provider
May provide supervision for small group instruction
May implement positive behavior interventions, supports and strategies
May facilitate social interaction between peers with and without disabilities
This slide summarizes some of the obvious benefits of utilizing support personnel in the general education environment. Summarize the bulleted items.
The next few slides summarize some of the possible negative effects of defining one-to-one support aides on IEPs according to research.

8. Effects on Student Independence
Aides maintain too close proximity with student
physical contact
sitting immediately next to student
accompanying students everywhere
Such proximity of aides can be detrimental
students learns to rely on the aide
minimizes the frequency and types of peer interactions
decreases student’s opportunity to become an independent learner
Giangreco, Edelman, Luiselli, & McFarland, 1997; Marks, Shrader & Levine, 1999
Frequently, the assignment of a 1:1 aide can have a harmful effect on a student’s performance & progress toward mastery of the general education curriculum. IEP Team members must take the assignment of 1:1 support very seriously and consider the impact of that direct support on not only the student, but the other professional and service personnel who work with the student, and on the parent/teacher relationship.
Research indicates that very often one-to-one aides provide too much support, either through too much physical contact or by being in too close proximity to the student. Often they appear to be the student’s constant companion.
This may become detrimental to the student’s social development in that the student tends to rely on the aide more than he/she needs to and peers tend to avoid the student. Ultimately, it may decrease the chances that the student will ever become an independent learner.

9. Effects on the Teacher’s Role
Experienced, skilled teachers defer important curricular, instructional and management decisions to the aide
Curriculum modification and adaptation may be left up to the aide
The aide may be viewed as the “expert” in understanding the student’s needs
Responsibility for the student’s educational progress transfers to the aide
Marks, Shrader, & Levine, 1999; Giangreco, Broer, & Edelman, 2001
The assignment of 1:1 aides can also have a negative effect on the general educator’s role with the student.
Sometimes you find very experienced, highly skilled teachers turning over important decisions to the aide. Many times, teachers begin to allow the aide to make the modifications to the content and assignments for the student, rather than the skilled and knowledgeable teacher making those curricular or material modifications and accommodations.
Often the aide is relied upon as the expert on the student. Other professional staff tend to rely on the aide for information regarding the student’s instructional supports and modifications, and many times, information regarding the student’s physical or medical needs.
Many times the responsibility for the student’s educational progress transfers to the aide. Busy teachers often tend to work with other students when they know the SWD is already being provided individual attention.

10. Effects on Students’ Social/Emotional Development
Aides may separate the student from his/her classmates
Hovering aides interfere with natural peer supports
Aide’s interaction with the student may interfere with the general education students’ attention and concentration
Students may feel a loss of privacy
1. 1:1 aides can have a detrimental effect on the student’s social/emotional development in that the aide may separate the student from his/her classmates.
2-3. Read the next 2 bullets.
4. And finally, the student who is being provided the support, as well as the other students in the classroom or group, may begin to feel a loss of privacy.
Giangreco, Edelman, Luiselli, & McFarland, 1999

11. Effects on Student Academic Performance
Aides may do too much for the student
Aides are often unfamiliar with student’s IEP
Aides perceive their jobs as helping the student to not be a “problem” for the teacher
Aides may have little or no planning time with the teacher
Aides often lack the training and expertise to make the necessary curricular modifications or provide the specially designed instruction
Aides may lack skills required to fade prompts
Marks, Shrader, & Levine, 1999
Aides may provide the student too much assistance sometimes making the student prompt-dependent or create learned helplessness.
Aides may not be familiar with or understand all of the requirements of the student’s IEP.
Aides often perceive their jobs as helping the student not to be a bother or a problem for the teacher.
The aide usually does not have an opportunity to plan with the general educator. He/she may not be familiar with the lesson or activity and therefore, does not know the teacher’s expectations for the type or amount of support the student may need on a particular assignment or activity.
I think one of the most important issues is that the aide does not have the educational training to know how to make the instructional and environmental modifications and accommodations necessary to provide the student what he/she needs to participate and to make progress academically.
Also, the aide may not possess the training or skills to know when and how to fade the cues and prompts.

12. Effects on the Parent/Teacher Relationship
Parent may approach the aide for ongoing information
Parent may rely on the aide to make educational suggestions and decisions
Teacher may rely on the aide to communicate with the parent, sometimes in writing or by phone
Aide may view his/her job as dependent on parent support
Parent may communicate with the aide rather than the teacher
Giangreco, Edelman, Luiselli, & McFarland, 1997; Marks, Shrader & Levine, 1999
Research indicates the assignment of a 1:1 aide may compromise the parent/teacher relationship. For example, the parent may rely on the aide to get information about the student’s daily activities or provide the student’s teachers important information regarding the student’s medication or other health information.
The parent may rely on the aide to make accommodations or modifications the parent feels are necessary without consulting the teacher first.
The teacher may rely on the aide to relay information to the parent regarding assignments, concerns of the teacher, behavior of the student, and suggestions for change. This may be done in the form of written communication such as a daily home/school communication notebook.
There are times when the aide may view his/her job as dependent on the parent’s persistence.

13. Responsibilities of the IEP Team
Convene an IEP Team to consider a parent’s request for a 1:1 Aide
Review student’s current IEP and behavior intervention plan (BIP)
Ensure the implementation of the instructional/behavioral strategies with fidelity prior to considering if additional assistance is needed
Focus on the needs of the student to develop independence
First consider supplementary aids and supports in the general education environment
Provide prior written notice (PWN) of the team’s final decisions
It is important to know that any time a parent requests a one-to-one aide, the IEP Team is required to consider the request. In order to do so, the IEP Team must review the student’s progress toward the IEP goals and assess the benefit of this support to the student’s participation in the GEE.
The following are the steps the IEP Team must take when considering direct 1:1 support for a student. Summarize the bullets on the slide.
It is important to remember when considering supplementary aids, services for a student, the law requires the determination of which ones are appropriate for a student must be made on an individual basis. Supplementary aids and services are any material/curricular/human resource or assistance, beyond what is normally afforded students without exceptionalities, provided to support a student with an exceptionality’s in the general education classes or other education related settings to enable students in need of special education services to be educated with students without exceptionalities to the maximum extent appropriate.

14. Responsibilities of the District
Design and implement a consistent process or set of procedures to determine student need for one-to-one assistance and support
Utilize current data related to progress toward goals and BIP to make decisions
Secure parent permission and conduct additional evaluations, including observations and interviews, if needed
Review existing services and supports, student’s successes and difficulties & skills needed to increase independence.
Consider alternatives to 1:1 aide support (e.g., peers, other personnel within the building, changes to student or teacher schedule, etc.)
Provide appropriate training, support and supervision
In order to address these requests in a proactive manner, districts should have a process or set of procedures in place when a parent or a teacher requests a 1:1 aide for a student.
As this is very often an emotional subject in an IEP Team meeting, it may serve the district well if the IEP Team requests an evaluation of the student’s need for 1:1 support. Of course, you must obtain the parent’s consent before conducting any individual evaluation for the student. Aside from an evaluation, the district must first ensure there is ample documentation to support the existing supplementary aids, services and supports in the student’s current IEP are being implemented as written. The lack of evidence may be the impetus for the student’s need for additional support.
The district may want to look at the student’s daily schedule and assess each environment for any natural supports that already exist (e.g., peers, other support personnel, other professional staff) or possible changes to the student’s schedule where other supports may be more readily available.
The quality of the instructional services that aides provide is directly related to the training they receive. In fact, the training an aide receives is frequently left to the general education teacher.
So, the most critical component for success is the provision of training to the aides. It may be in the form of an initial orientation, including a review of the student’s IEP services, and then ongoing on-the-job training. It is wise to conduct follow-up activities to the training, possibly through individual monthly meetings to assess skill acquisition and provide feedback and evaluation.

15. Plan to Fade One-on-One Support
Set student goals toward independence
Train all staff on consistent implementation of student’s IEP and data collection
Prioritize data collection and consistently review student progress
Train and involve peers to provide natural supports
Start fading assistance as soon as independence increases
Communicate frequently with parents
When the IEP Team determines that 1:1 support is necessary, a plan should also be put in place to eventually fade that support. Again, this training component becomes essential so the aide will know how and when to gradually fade that support.
The aide first must be familiar with the requirements of the student’s IEP, primarily, those that are the aide’s specific responsibilities.
Fading support for a student can only be accomplished successfully if the aide understands the requirements of the IEP and the techniques and strategies to provide the support, collect data on the student’s progress and based on the data, how and when to fade the support.
It is important also, that the parents are informed of the student’s progress on a regular basis, and that the primary goal for the student is independence.

16. Documenting the Service on the IEP
Section A: Supplementary Aids, Services/Program Modifications
Location of Services
Extent/
Frequency
Initiation Date
Duration
Direct Adult Supervision
(Medicaid Eligible)
All school environments
Daily
October 26, 2012
October 2013
Continuous One to One Supervision
Adult Supervision
(Non-Medicaid)
Cafeteria, recess, transition to classes
Daily for behavioral support
October 2013
This slide provides 3 examples of how support can be written on an IEP.
When documenting support personnel on the IEP you never want to write 1:1 aide unless you mean the aide will be with the student throughout the day, in all settings, as in direct and continuous support.
When documenting for Medicaid billing - It is important that you understand the district is billing the student’s medical card for the personal care services you are providing to that child. It cannot be the services you provide to other students, only those to the student. The word continuous in not necessary in the first example as it is implied when writing all school environments and daily. In other words, the services will be provided in a continuous manner, in all school environments on a daily basis. Also, in order to bill Medicaid, the service or support must be medically necessary and so, the student must require that service in all school environments.
In the second example, the words one-to-one are used. If you don’t use one-to-one, you can say direct, but the service must be provided by one person to that student in all settings consistently in order to bill Medicaid. For additional information, you may access the School-Based Services Medicaid Operations Manual, Section 8, Personal Care, at
We also have Vicki Mohnackey on this call to clarify and answer any questions you may have at this time.
Non-Medicaid - The last example may be provided by a one-to-one support person; however, this would not be billable to Medicaid because it is not continuous, direct and does not imply that the support will be provided in a continuous one-to-one fashion as in the 2 examples above.
Additionally, a letter of findings from June has been provided for your review. This LOF is the WVDE’s interpretation of the law regarding 1:1 support aides and the IEP. In this particular complaint case, the district was cited for violating a student’s IEP that required 1:1 personnel as written above; however, the aide was supporting 2 students simultaneously. We also provided the Department’s letter of clarification from April 2000, which we refer to as the Lusk letter, and a copy of the IEP services page listing similar examples to those on the slide.

17. Success will occur when the student can function independently~
Finally, it is important when making decisions about the support students need, to focus on the same goal we have for all students, which is to make them independent learners and ultimately, independent adults who can live, work and participate in the communities in which they live.

18. Contact Information
West Virginia Department of Education
Office of Special Programs
Lorraine Ciambotti Elswick
If you need additional information regarding this topic, please don’t hesitate to call or write to . . .