Low-incidence disabilities in the IEP: vision, hearing, deaf-blindness and physical needs

High-incidence disabilities, such as learning disabilities and speech or language impairments, are common enough that most schools have the staff on site. Low-incidence disabilities are the opposite. Few students in any one building have them, and the specialists who serve them often travel between schools or work for a regional program.

That difference shapes the whole IEP. The evaluation includes assessments a general team cannot give. Specific sections, the special factors, must be addressed. And parts of the plan belong to a specialist who may be at the meeting by phone. This guide compares the main low-incidence areas side by side, names who owns each IEP section, and gives one goal for each area of the expanded core curriculum.

What counts as a low-incidence disability

There is no eligibility category called low-incidence. The term describes conditions that few students have and that need staff with highly specialized training to serve well.

In IEP practice, low-incidence usually means these eligibility categories from the federal definitions in 34 CFR 300.8:^[1]

• Visual impairment, including blindness.
• Deafness and hearing impairment, which are two separate categories.
• Deaf-blindness, which is its own category and is not counted under multiple disabilities.
• Orthopedic impairment.
• Multiple disabilities, such as an intellectual disability with an orthopedic impairment.

Traumatic brain injury and significant cognitive disabilities are often grouped here too, because they need specialized staff. Each state and region draws the line a little differently, and many run regional low-incidence programs or consultants.

The deciding test: low-incidence or high-incidence planning

Ask one question: does this IEP need a specialist the school does not employ full time? If yes, plan it as low-incidence. That means scheduling the specialist's evaluation early, checking the special factors, and writing the specialist's service time and consultation into the IEP.

A student with a mild hearing loss who uses hearing aids may still need a teacher of the deaf to consult monthly and an audiologist to check equipment. That is low-incidence planning, even if the student spends the whole day in general education.

Low-incidence disabilities side by side

The table compares the main areas across the parts of the IEP that change. Rules on certification and evaluation tools vary by state.

The special factors come from 34 CFR 300.324(a)(2).^[2] For a student who is blind or visually impaired, the team must provide braille instruction unless it decides, after evaluating reading and writing skills, needs and future needs, that braille is not appropriate. For a student who is deaf or hard of hearing, the team must consider language and communication needs, including chances for direct communication with peers and staff in the student's language and mode. For every student, the team considers assistive technology.

Orientation and mobility, audiology and interpreting are named related services in the federal definitions.^[3] Schools must also make sure hearing aids and the external parts of cochlear implants are working, under 34 CFR 300.113.^[4]

Who owns which IEP section

Low-incidence IEPs have more authors than most. Confusion about who writes what is the most common reason a section is thin. This table names the specialist and the part each one usually writes.

The case manager pulls these sections into one plan. A practical habit: send each specialist the draft present levels two weeks before the meeting, with their section highlighted, and ask for goals back a week ahead.

The expanded core curriculum, with one goal each

Students who are blind or visually impaired need instruction in skills sighted peers pick up by watching. That set of skills is called the expanded core curriculum, and it has nine areas.^[5] Many teachers of the deaf use a similar list for students who are deaf or hard of hearing. The goals below are examples; baselines and criteria are illustrations.

For students who are deaf or hard of hearing, add listening and communication access. Two examples:

• Auditory skills: In a quiet room, the student will identify 6 of 6 Ling sounds at 3 feet with hearing aids on, on 5 consecutive mornings. See auditory skills goals.
• Visual communication: Given a signed story at their language level, the student will retell 4 of 5 key events in ASL on 3 consecutive probes. See visual communication goals.

Keyboarding is often the bridge between braille, typing and assistive technology. See keyboarding goals. All eight access skill pages sit under access skills IEP goals.

Three scenarios

These are fictional students, written to show how the deciding test works.

A first grader with low vision

Ella has low vision and reads large print slowly, with her face close to the page. The team asks the deciding question: she needs a TVI, whom the district shares with three other schools. That makes it low-incidence planning. The TVI completes a learning media assessment before the meeting. Because Ella's vision is expected to decline, the team considers braille under the special factor and decides to start pre-braille instruction alongside print. The O&M specialist screens her travel and finds she trips on curbs at dusk, so O&M goes in the IEP too.

A seventh grader with a cochlear implant

Marcus has a cochlear implant and does well in class, with a remote microphone system. His grades are average. The team almost writes the hearing section as "no needs." The deciding test says otherwise. He still needs a teacher of the deaf to consult, and someone must check his equipment daily. The DHH teacher's data show he misses most of what classmates say in group discussion. The IEP adds a self-advocacy goal for asking speakers to use the microphone and a daily equipment check by a trained adult.

A high school student who is deaf-blind

Priya is deaf-blind and uses tactile sign. She needs both vision and communication special factors addressed, a TVI and a DHH teacher who plan together, an intervener during the school day, and O&M. Her IEP names her communication mode in the present levels, so every adult knows how to talk with her. Her goals include requesting a break with a tactile sign, traveling a familiar route with a cane, and choosing between two activities using object cues.

When a student needs more than one specialist

Many low-incidence students need several specialists at once. A student with cerebral palsy and a visual impairment may need a TVI, PT, OT and SLP. The risk is four plans stapled together. Three habits help:

• One set of present levels. Each specialist writes a section, and the case manager joins them into one statement of what the student does now.
• Shared goals where skills overlap. A goal for using a switch to request a break can be written once, with the OT, SLP and TVI each supporting it.
• A consultation line for each specialist. Write how often each one meets with the classroom team, not only direct minutes.

For students with multiple and significant support needs, the goals for students with severe and profound disabilities cover communication, choice-making and participation goals that fit alongside the access skills here. The hubs for multiple disabilities and cerebral palsy have more templates.

Measuring access skill goals

Many access skills are routines, so task analysis fits travel, technology and daily living goals. Score each step every session on the task analysis data sheet and graph the percent of steps done independently. Braille reading fits oral reading fluency, scored the same way as print. Listening checks and requests fit opportunity data.

Itinerant specialists see a student once or twice a week, so the classroom team often collects the daily data. Agree on the definition and the data sheet at the meeting, and have the specialist check the data at each visit.

Frequently asked questions

Use it in IEP Atlas

• Access skills IEP goals
• IEP goals for deaf blindness
• IEP goals for hearing loss
• IEP goals for visual impairment
• Goals for the DHH teacher role
• Deaf blindness in the IEP glossary

Related guides

• IEP goals for students with severe and profound disabilities
• Transition planning in the IEP: what is required and when
• Deafblind IEP goals for communication
• IEP goals for deaf and hard of hearing students
• Accommodations for deaf and hard of hearing students
• Communication plans for deaf and hard of hearing students
• Abacus for blind students: instruction and IEP goals
• Accommodations for visual impairment, written for the IEP
• Auditory skills hierarchy for IEP goals
• Braille IEP goals from pre-braille to contracted braille
• Braille reading rate: how to measure it
• Cane skills progression for O&M goals
• CVI IEP goals
• Expanded core curriculum goals by area
• Hearing impairment and deafness: the IEP categories explained
• How to measure listening checks and hearing technology goals
• How to measure O&M route goals with an orientation and mobility data sheet
• IEP goals for sighted guide (human guide)
• IEP goals for students with cerebral palsy: 12 examples
• IEP goals for students with visual impairments
• IEP goals for understanding your audiogram
• Low vision IEP goals for magnifiers, telescopes and screen tools
• Remote microphone systems: student goals and teacher use
• Self-advocacy goals for deaf and hard of hearing students
• Speechreading IEP goals
• Traumatic brain injury at school: eligibility and accommodations
• Visual impairment eligibility and the learning media assessment
• Working with an educational interpreter: student IEP goals

Sources

1. 34 CFR §300.8: Child with a disability, Legal Information Institute, Cornell Law School
2. 34 CFR §300.324: Development, review, and revision of IEP, Legal Information Institute, Cornell Law School
3. 34 CFR §300.34: Related services, Legal Information Institute, Cornell Law School
4. 34 CFR Part 300: Assistance to States for the Education of Children with Disabilities, eCFR (National Archives)
5. American Foundation for the Blind, American Foundation for the Blind

Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.