Present Levels of Performance: What Box?
It’s a common misconception that students with ADHD solely have 504 plans. While a 504 plan can offer sufficient support for some with ADHD, others, especially those with co-occurring conditions, might have needs that better align with an IEP. ADHD is categorized under Other Health Impairment in IDEA.
As a school-based OT managing a significant caseload of students affected by ADHD, I I found myself confused on where in the IEP to document the impact of ADHD . The question that often arose was “Which box do I write in?”
This post, the first in our IEP series, aims to guide school-based therapists with guidance for effectively documenting ADHD’s impact while completing the Present Levels of Performance section within the IEP.
Plops, PLEPS, PL’s, Present Levels of Performance
Present Levels of Performance provide a comprehensive overview of a student’s academic, social/emotional, and physical strengths and needs. Anchored in data and formative assessment, the Present Level is the foundation of an IEP, guiding the development of all other components within the IEP.
This essential section informs the creation of goals, determines necessary supports, and outlines services tailored to address the unique requirements of the student
Depending on your state, these may be referred to as PLEPS, PLAAFP or Plops, or PL’s. According to the IDEA Sec. 300.320 Definition of individualized education program, present levels are :
“A statement of the child’s present levels of academic achievement and functional performance, How the child’s disability affects the child’s involvement and progress in the general education curriculum (i.e., the same curriculum as for nondisabled children)”
The way Present Levels are written differ by State. In NY, we have three distinct sections for present levels:
- Academic/Functional Development
- Social Development
- Physical Development
Many school-based OTs, including myself, often find themselves using a variation of the “physical development” section to document the fine motor and sensory aspects of our students’ development and needs.
Many of us are stuck in this box.
Devon Breithart, the Dynamic School OT , in her article You’re Probably Filling Out IEPs Incorrectly warns against confining OT data to the fine motor box.
” If you’re reporting on every area you address with a student in the fine motor box on Present Levels, this is not best practice”.
Devon Braveheart
In IEP writing, limiting ourselves to this box can lead to confusion and misconceptions about the scope of our profession. Devon explains that “Not everything we do in the schools is based on fine motor skills, and the more we put ourselves into that box – literally – the more our coworkers and teams think that’s all we do. “.
There is no better example than out of the box IEP writing than a student whose needs are driven by ADHD.
So what box do you write in? I had to ask, assuming that you can not just go running around the IEP draft writing in any box, and still have a job.
Where does ADHD fit in the IEP?
For a students with needs driven by ADHD, the challenge is finding the right box. The answer depends on the individual child. ADHD , a neurodevelopmental difference in the development of self-regulation and executive function, can influence all domains of development, excluding ( now abundantly obvious) physical development.
Academic Achievement/ Functional Performance and ADHD
The “Academic Achievement, Functional Performance and Learning Characteristics” section of an IEP covers a wide variation of aspects, including academic development, intellectual functioning, adaptive behavior, daily living skills, expected rate of progress, and learning style.
It includes present levels, strengths and needs related to:
- Academic development/ academic achievement: areas like reading, math and writing
- Intellectual Functioning- general intelligence, attention, memory, problem-solving ability, organization, language functioning.
- Adaptive Behavior: coping skills, judgments and decisions in reaction to natural and social demands of their environment
- Daily Living Skills- personal care, preparing meals, household activities, managing resources, travel to and from school.
- Expected Rate of Progress- the pace at which the student learns new information and skills, levels of cognitive skills, interests, age and history of rate of progress.
- Learning Style: how the student learns best (i.e. visual, auditory, hands-on approach, cooperative learning, repetition, etc
For students with ADHD who have correlated executive function and self regulatory difficulties we would include PLEPs in the Intellectual Functioning and Adaptive Behavior sections respectively.
Executive Functions
Intellectual functioning includes memory, problem-solving ability, attention, and organization. If you have a student who requires support for executive functions including working memory ,organization and problem solving, you would address the present level and need in this section.
Take Joe for example:
PLEP: According to classroom observations, when presented with teacher support, Joe organizes material and submits completed assignments 70% of the time. Joe struggles to independently initiate, organize, and complete assignments without continual support. Joe is currently submitting 30% of daily assignments independently.
NEED: Joe’s difficulty with executive function impacts his ability to stay organized and complete assignments on-time. In order to progress in the general education curriculum, Joe needs to learn methods for organizing and completing assignments within an assigned time frame.
GOAL: When given a task/assignment, Joe will demonstrate the skills of independent task completion by using a checklist completing 80% of daily task/assignments, as measured by daily tracker and observation, over one week.
Adaptive Behavior Skills and ADHD
Students with ADHD may require support for adaptive behavior, particularly with impulsivity or difficulties in emotional self regulation impacting classroom performance. Coping with the demands of an environment that was not built for them will often lead to problems with meeting classroom expectations.
Many students will need support to complete the 40 plus classroom procedures they are expected to complete. See this article on “Classroom Behavior Management for Students with Attention Deficit/Hyperactivity Disorder (ADHD) ” to learn more about how procedure completion is often confused as non-compliance. The present level, need and goal would be best documented in this section.
Take Ethan for example:
PLEP: Based on behavioral checklists, Ethan exhibits impulsivity in various situations, requiring frequent redirection to maintain appropriate behavior. While responding well to adult guidance, Ethan struggles to curb impulsive behaviors independently, with approximately 60% of instances resulting in impulsivity without continual support.
NEED: Ethan’s challenges with impulsivity significantly impact his ability to regulate behavior independently. To progress in the general education setting, Ethan needs to develop strategies to manage and reduce impulsive behaviors, fostering improved self-control and decision-making.
GOAL: When faced with situations requiring impulse-control, Ethan will demonstrate reduced impulsivity by utilizing pre-selected strategies ( not limited to taking a moment to pause, counting to 5 before responding and seeking guidance when needed) with a 75% reduction in impulsive behaviors, as measured by self monitoring tracking , over one school term.
Social Development and ADHD
The Social Development section considers how a student engages with peers and adults, including feelings about self and adjustment to the school and community environment.
Developmental delays or uneven development of the executive function and attentional domains are responsible for the social difficulties seen in ADHD.
Social skill difficulties evoke highly negative responses from peers, which leads to high levels of peer rejection which causes a downward spiral. Peer rejection leads to missed opportunities to practice and learn social skills, which leads to poor self-esteem and self-efficacy.
Read more about social skills in this article, ADHD- Social Skills and Perspective Taking .
ADHD often impacts social development, and IEP’s do not have to be ONLY academic goals. If you are working with a student with ADHD driven needs in social skills, documenting the present level, impact statement and need in the social development section is appropriate .
Take Logan , for example:
PLAAFP: Through classroom observations, Logan exhibits challenges in social skills, particularly in perspective-taking. When engaged in structured social interactions, Logan displays an average of 60% accuracy in understanding others’ perspectives. However, during less structured social situations, Logan’s accuracy in perspective-taking drops to an average of 30%.
NEED: Logan’s difficulties in perspective-taking significantly impact his social interactions, particularly in less structured settings. To flourish in social situations within the general education environment, Logan requires targeted interventions to enhance his perspective-taking skills, fostering improved social understanding and communication.
Goal: When engaged in social interactions, Logan will demonstrate improved perspective-taking skills by accurately understanding others’ viewpoints for at least 50% of observed time. This involves considering others’ feelings, thoughts, and perspectives. Progress will be measured through three weekly observations over a 6-week period.
Physical Development Gets Tricky
The Physical Development section describes the motor and sensory development, health, vitality, and physical skills relevant to the learning process.
We are all very familiar with this section however… this is where it gets tricky.
Casey is a student whose ADHD is impacting her ability to write in class , but there are no fine motor concerns outside of the legibility of written output.
Does this PLEP belong in physical development.
NO. While handwriting is a fine motor skill, the CAUSE of illegibility in this case is not a fine motor problem.
If a student requires support to demonstrate legible handwriting in the classroom context due to difficulties with working memory and impulsivity, we would NOT list a need in the physical section as the goal would not be to improve physical development.
The present level, impact statement, needs statement and correlated goal to improve the student legibility of written output would be better described in the Academic/Functional Section to address executive functions needed in the writing process.
When we confine handwriting legibility to the physical needs section then we contribute to the misconception that handwriting is purely a motor skill.
Casey’s Example
PLEP: Through classroom observations and written assessments, Casey exhibits challenges in working memory , impacting the legibility of written output. With adult support, Casey achieves legibility in approximately 50% of written assignments. However, independently, Casey struggles to maintain legibility, resulting in a lower rate of approximately 30% legibility of written output.
NEED: Casey’s difficulties in working memory significantly hinder the legibility of independently completed written assignments. To succeed in written tasks within the general education curriculum, Casey requires targeted intervention strategies to decrease working memory overload, promoting improved legibility in written output.
Goal: When given a written task, Casey will use a self monitoring checklist and spelling bank to demonstrate improved independent ability to produce legible written output for at least 40% of assignments. This includes organizing thoughts coherently and maintaining neatness. Progress will be measured through written assessments and observations, over a 6-week period.
PLEP Help
The Present Levels of Performance is arguably the most important starting point to the students entire IEP. School based practitioners need to clearly illustrate the present level of our students with ADHD in the correct areas of development with objective proof, a clear need and impact statement so we can create meaningful goals that the child requires to access their curriculum.
If you find creating Present levels challenging, you’re not alone. Stay tuned for more on writing IEPs with an understanding of ADHD. Next week, we will be releasing the tool I use to write compliant PLEPS and goals and a reviewing how to write PLEPs in 5 Steps.