Fo rm 1040 Department of the Treasury—Internal Revenue Service OMB No. 1545-0074(99) IRS Use Only—Do not write or staple in this space. U.S. Individual Income Tax Return 2012 For the year Jan. 1–Dec. 31, 2012, or other tax year beginning , 2012, ending , 20 See separate instructions. Your first name and initial Last name Your social security number If a joint return, spouse’s first name and initial Last name Spouse’s social security number ▲ Make sure the SSN(s) above and on line 6c are correct. Home address (number and street). If you have a P.O. box, see instructions. Apt. no. City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Foreign country name Foreign province/state/county Foreign postal code Presidential Election Campaign Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse Filing Status Check only one box. 1 Single 2 Married filing jointly (even if only one had income) 3 Married filing separately. Enter spouse’s SSN above and full name here. ▶ 4 Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this child’s name here. ▶ 5 Qualifying widow(er) with dependent child Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a . . . . . b Spouse . . . . . . . . . . . . . . . . . . . . . . . . } c Dependents: (1) First name Last name (2) Dependent’s social security number (3) Dependent’s relationship to you (4) ✓ if child under age 17 qualifying for child tax credit (see instructions) If more than four dependents, see instructions and check here ▶ d Total number of exemptions claimed . . . . . . . . . . . . . . . . . Boxes checked on 6a and 6b No. of children on 6c who: • lived with you • did not live with you due to divorce or separation (see instructions) Dependents on 6c not entered above Add numbers on lines above ▶ Income Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1040-V. 7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . . 7 8a Taxable interest. Attach Schedule B if required . . . . . . . . . . . . 8a b Tax-exempt interest. Do not include on line 8a . . . 8b 9 a Ordinary dividends. Attach Schedule B if required . . . . . . . . . . . 9a b Qualified dividends . . . . . . . . . . . 9b 10 Taxable refunds, credits, or offsets of state and local income taxes . . . . . . 10 11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11 12 Business income or (loss). Attach Schedule C or C-EZ ..

1. Fo
rm 1040 Department of the Treasury—Internal Revenue Service
OMB No. 1545-0074(99) IRS Use Only—Do not write or staple
in this space. U.S. Individual Income Tax Return 2012
For the year Jan. 1–Dec. 31, 2012, or other tax year beginning ,
2012, ending , 20 See separate instructions.
Your first name and initial Last name Your social security
number
If a joint return, spouse’s first name and initial Last name
Spouse’s social security number
▲ Make sure the SSN(s) above
and on line 6c are correct.
Home address (number and street). If you have a P.O. box, see
instructions. Apt. no.
City, town or post office, state, and ZIP code. If you have a
foreign address, also complete spaces below (see instructions).
Foreign country name Foreign
province/state/county Foreign postal code
Presidential Election Campaign
Check here if you, or your spouse if filing
jointly, want $3 to go to this fund. Checking
a box below will not change your tax or
refund. You Spouse

2. Filing Status
Check only one
box.
1 Single
2 Married filing jointly (even if only one had income)
3 Married filing separately. Enter spouse’s SSN above
and full name here. ▶
4 Head of household (with qualifying person). (See
instructions.) If
the qualifying person is a child but not your dependent, enter
this
child’s name here. ▶
5 Qualifying widow(er) with dependent child
Exemptions 6a Yourself. If someone can claim you as a
dependent, do not check box 6a . . . . .
b Spouse . . . . . . . . . . . . . . . . . . . . . . . . }
c Dependents:
(1) First name Last name
(2) Dependent’s
social security number
(3) Dependent’s
relationship to you
(4) ✓ if child under age 17
qualifying for child tax credit

3. (see instructions)
If more than four
dependents, see
instructions and
check here ▶
d Total number of exemptions claimed . . . . . . . . . . . . . . . . .
Boxes checked
on 6a and 6b
No. of children
on 6c who:
• lived with you
• did not live with
you due to divorce
or separation
(see instructions)
Dependents on 6c
not entered above
Add numbers on
lines above ▶
Income
Attach Form(s)
W-2 here. Also
attach Forms
W-2G and
1099-R if tax
was withheld.
If you did not

4. get a W-2,
see instructions.
Enclose, but do
not attach, any
payment. Also,
please use
Form 1040-V.
7 Wages, salaries, tips, etc. Attach Form(s) W-2 . . . . . . . . . . . .
7
8a Taxable interest. Attach Schedule B if required . . . . . . . . . .
. . 8a
b Tax-exempt interest. Do not include on line 8a . . . 8b
9 a Ordinary dividends. Attach Schedule B if required . . . . . . .
. . . . 9a
b Qualified dividends . . . . . . . . . . . 9b
10 Taxable refunds, credits, or offsets of state and local income
taxes . . . . . . 10
11 Alimony received . . . . . . . . . . . . . . . . . . . . . 11
12 Business income or (loss). Attach Schedule C or C-EZ . . . . .
. . . . . 12
13 Capital gain or (loss). Attach Schedule D if required. If not
required, check here ▶ 13
14 Other gains or (losses). Attach Form 4797 . . . . . . . . . . . . . .
14

5. 15 a IRA distributions . 15a b Taxable amount . . . 15b
16 a Pensions and annuities 16a b Taxable amount . . . 16b
17 Rental real estate, royalties, partnerships, S corporations,
trusts, etc. Attach Schedule E 17
18 Farm income or (loss). Attach Schedule F . . . . . . . . . . . . . .
18
19 Unemployment compensation . . . . . . . . . . . . . . . . . 19
20 a Social security benefits 20a b Taxable amount . . . 20b
21 Other income. List type and amount 21
22 Combine the amounts in the far right column for lines 7
through 21. This is your total income ▶ 22
Adjusted
Gross
Income
23 Educator expenses . . . . . . . . . . 23
24 Certain business expenses of reservists, performing artists,
and
fee-basis government officials. Attach Form 2106 or 2106-EZ
24
25 Health savings account deduction. Attach Form 8889 . 25
26 Moving expenses. Attach Form 3903 . . . . . . 26
27 Deductible part of self-employment tax. Attach Schedule SE
. 27

6. 28 Self-employed SEP, SIMPLE, and qualified plans . . 28
29 Self-employed health insurance deduction . . . . 29
30 Penalty on early withdrawal of savings . . . . . . 30
31 a Alimony paid b Recipient’s SSN ▶ 31a
32 IRA deduction . . . . . . . . . . . . . 32
33 Student loan interest deduction . . . . . . . . 33
34 Tuition and fees. Attach Form 8917 . . . . . . . 34
35 Domestic production activities deduction. Attach Form 8903
35
36 Add lines 23 through 35 . . . . . . . . . . . . . . . . . . . 36
37 Subtract line 36 from line 22. This is your adjusted gross
income . . . . . ▶ 37
For Disclosure, Privacy Act, and Paperwork Reduction Act
Notice, see separate instructions. Cat. No. 11320B Form 1040
(2012)
Form 1040 (2012) Page 2
Tax and
Credits
38 Amount from line 37 (adjusted gross income) . . . . . . . . . . .
. . . 38
39a Check

7. if:
{ You were born before January 2, 1948, Blind.
Spouse was born before January 2, 1948, Blind.
} Total boxes
checked ▶ 39a
b If your spouse itemizes on a separate return or you were a
dual-status alien, check here ▶ 39b Standard
Deduction
for—
• People who
check any
box on line
39a or 39b or
who can be
claimed as a
dependent,
see
instructions.
• All others:
Single or
Married filing
separately,
$5,950
Married filing
jointly or
Qualifying
widow(er),
$11,900
Head of
household,
$8,700
40 Itemized deductions (from Schedule A) or your standard

8. deduction (see left margin) . . 40
41 Subtract line 40 from line 38 . . . . . . . . . . . . . . . . . . . 41
42 Exemptions. Multiply $3,800 by the number on line 6d . . . .
. . . . . . . . 42
43 Taxable income. Subtract line 42 from line 41. If line 42 is
more than line 41, enter -0- . . 43
44 Tax (see instructions). Check if any from: a Form(s) 8814 b
Form 4972 c 962 election 44
45 Alternative minimum tax (see instructions). Attach Form
6251 . . . . . . . . . 45
46 Add lines 44 and 45 . . . . . . . . . . . . . . . . . . . . . ▶ 46
47 Foreign tax credit. Attach Form 1116 if required . . . . 47
48 Credit for child and dependent care expenses. Attach Form
2441 48
49 Education credits from Form 8863, line 19 . . . . . 49
50 Retirement savings contributions credit. Attach Form 8880
50
51 Child tax credit. Attach Schedule 8812, if required . . . 51
52 Residential energy credits. Attach Form 5695 . . . . 52
53 Other credits from Form: a 3800 b 8801 c 53
54 Add lines 47 through 53. These are your total credits . . . . . .
. . . . . . 54

9. 55 Subtract line 54 from line 46. If line 54 is more than line 46,
enter -0- . . . . . . ▶ 55
Other
Taxes
56 Self-employment tax. Attach Schedule SE . . . . . . . . . . . . . .
. 56
57 Unreported social security and Medicare tax from Form: a
4137 b 8919 . . 57
58 Additional tax on IRAs, other qualified retirement plans, etc.
Attach Form 5329 if required . . 58
59a 59a
b 59b
Household employment taxes from Schedule H . . . . . . . . . . . . .
.
First-time homebuyer credit repayment. Attach Form 5405 if
required . . . . . . . .
60 Other taxes. Enter code(s) from instructions 60
61 Add lines 55 through 60. This is your total tax . . . . . . . . . . .
. . ▶ 61
Payments 62 Federal income tax withheld from Forms W-2 and
1099 . . 62
63 2012 estimated tax payments and amount applied from 2011
return 63
If you have a
qualifying

10. child, attach
Schedule EIC.
64a Earned income credit (EIC) . . . . . . . . . . 64a
b Nontaxable combat pay election 64b
65 Additional child tax credit. Attach Schedule 8812 . . . . . 65
66 American opportunity credit from Form 8863, line 8 . . . . 66
67 Reserved . . . . . . . . . . . . . . . . 67
68 Amount paid with request for extension to file . . . . . 68
69 Excess social security and tier 1 RRTA tax withheld . . . . 69
70 Credit for federal tax on fuels. Attach Form 4136 . . . . 70
71 Credits from Form: a 2439 b Reserved c 8801 d 8885 71
72 Add lines 62, 63, 64a, and 65 through 71. These are your
total payments . . . . . ▶ 72
Refund
Direct deposit?
See
instructions.
73 If line 72 is more than line 61, subtract line 61 from line 72.
This is the amount you overpaid 73
74a Amount of line 73 you want refunded to you. If Form 8888
is attached, check here . ▶ 74a
▶

11. ▶
b Routing number ▶ c Type: Checking Savings
d Account number
75 Amount of line 73 you want applied to your 2013 estimated
tax ▶ 75
Amount
You Owe
76 Amount you owe. Subtract line 72 from line 61. For details
on how to pay, see instructions ▶ 76
77 Estimated tax penalty (see instructions) . . . . . . . 77
Third Party
Designee
Do you want to allow another person to discuss this return with
the IRS (see instructions)? Yes. Complete below. No
Designee’s
name ▶
Phone
no. ▶
Personal identification
number (PIN) ▶
Sign
Here
Joint return? See
instructions.
Keep a copy for

12. your records.
Under penalties of perjury, I declare that I have examined this
return and accompanying schedules and statements, and to the
best of my knowledge and belief,
they are true, correct, and complete. Declaration of preparer
(other than taxpayer) is based on all information of which
preparer has any knowledge.
Your signature Date Your occupation Daytime phone number
Spouse’s signature. If a joint return, both must sign.
▲
Date Spouse’s occupation If the IRS sent you an Identity
Protection
PIN, enter it
here (see inst.)
Paid
Preparer
Use Only
Print/Type preparer’s name Preparer’s signature Date
Check if
self-employed
PTIN
Firm’s name ▶
Firm’s address ▶
Firm's EIN ▶

13. Phone no.
Form 1040 (2012)
Version A, Cycle 8
Internal Use Only
DRAFT AS OF
January 5, 2013
Version A, Cycle 8
Internal Use Only
DRAFT AS OF
January 5, 2013
2012 Form 1040
SE:W:CAR:MP
U.S. Individual Income Tax Return
Form
1040
Department of the Treasury—Internal Revenue Service
OMB No. 1545-0074
O M B number 1545-0074. For Disclosure, Privacy Act, and
Paperwork Reduction Act Notice, see separate instructions.
(99)
IRS Use Only—Do not write or staple in this space.
U.S. Individual Income Tax Return
2012
2012. Catalog Number 11320B.
See separate instructions.
▲
Make sure the SSN(s) above and on line 6c are correct.
Presidential Election Campaign
Check here if you, or your spouse if filing jointly, want $3 to go
to this fund. Checking a box below will not change your tax or
refund.
Filing Status
Check only one box.

14. 1
Single
2
Married filing jointly (even if only one had income)
3
Married filing separately. Enter spouse’s SSN above and full
name here. ▶
4
Head of household (with qualifying person). (See instructions.)
If the qualifying person is a child but not your dependent, enter
this child’s name here. ▶
5
Qualifying widow(er) with dependent child
Exemptions
6
a
Yourself. If someone can claim you as a dependent, do
not check box 6a
b
Spouse
}
c
Dependents:
(1) First name Last name
(2) Dependent’s
social security number
(3) Dependent’s relationship to you
(4) ✓ if child under age 17 qualifying for child tax credit
(see instructions)
(4) Check if qualifying child for child tax credit (see page 17).
If more than four dependents, see instructions and check
here ▶
d
Total number of exemptions claimed
Boxes checked on 6a and 6b
No. of children on 6c who:

15. • lived with you
• did not live with you due to divorce or separation
(see instructions)
Dependents on 6c not entered above
Add numbers on lines above ▶
Income
Attach Form(s) W-2 here. Also attach Forms W-2G and
1099-R if tax was withheld.
If you did not
get a W-2,
see instructions.
Enclose, but do not attach, any payment. Also, please use
Form 1040-V.
7
Wages, salaries, tips, etc. Attach Form(s) W-2
7
8
a
Taxable interest. Attach Schedule B if required
8a
b
Tax-exempt interest. Do not include on line 8a
8b
9
a
Ordinary dividends. Attach Schedule B if required
9a
b
Qualified dividends
9b
10
Taxable refunds, credits, or offsets of state and local income
taxes
10
11
Alimony received

16. 11
12
Business income or (loss). Attach Schedule C or C-EZ
12
13
Capital gain or (loss). Attach Schedule D if required. If not
required, check here ▶
13
14
Other gains or (losses). Attach Form 4797
14
15
a
IRA distributions
15a
b Taxable amount
15b
16
a
Pensions and annuities
16a
b Taxable amount
16b
17
Rental real estate, royalties, partnerships, S corporations, trusts,
etc. Attach Schedule E
17
18
Farm income or (loss). Attach Schedule F
18
19
Unemployment compensation
19
20
a
Social security benefits

17. 20a
b Taxable amount
20b
21
Other income. List type and amount
21
22
Combine the amounts in the far right column for lines 7 through
21. This is your total income ▶
22
Adjusted Gross Income
23
Educator expenses
23
24
Certain business expenses of reservists, performing artists, and
fee-basis government officials. Attach Form 2106 or 2106-EZ
24
25
Health savings account deduction. Attach Form 8889
25
26
Moving expenses. Attach Form 3903
26
27
Deductible part of self-employment tax. Attach Schedule SE
27
28
Self-employed SEP, SIMPLE, and qualified plans
28
29
Self-employed health insurance deduction
29
30
Penalty on early withdrawal of savings

18. 30
31
a
Alimony paid
b Recipient’s SSN ▶
31a
32
IRA deduction
32
33
Student loan interest deduction
33
34
Tuition and fees. Attach Form 8917
34
35
Domestic production activities deduction. Attach Form 8903
35
36
Add lines 23 through 35
36
37
Subtract line 36 from line 22. This is your adjusted gross
income ▶
37
For Disclosure, Privacy Act, and Paperwork Reduction Act
Notice, see separate instructions.
Cat. No. 11320B
Form 1040 (2012)
Form 1040 (2012)
Page 2
Tax and Credits
38
Amount from line 37 (adjusted gross income)
38
39

19. a
Check if:
{
}
Total boxes checked ▶
39a
b
If your spouse itemizes on a separate return or you were a dual-
status alien, check here ▶
Standard Deduction for—
• People who check any box on line 39a or 39b or who can be
claimed as a dependent, see instructions.
• All others:
Single or Married filing separately, $5,950
Married filing jointly or Qualifying widow(er), $11,900
Head of household, $8,700
40
Itemized deductions (from Schedule A) or your standard
deduction (see left margin)
40
41
Subtract line 40 from line 38
41
42
Exemptions. Multiply $3,800 by the number on line 6d
42
43
Taxable income. Subtract line 42 from line 41. If line 42 is
more than line 41, enter -0-
43
44
Tax (see instructions). Check if any from:
a
b
c
44

20. 45
Alternative minimum tax (see instructions). Attach Form 6251
45
46
Add lines 44 and 45 ▶
46
47
Foreign tax credit. Attach Form 1116 if required
47
48
Credit for child and dependent care expenses. Attach Form 2441
48
49
Education credits from Form 8863, line 19
49
50
Retirement savings contributions credit. Attach Form 8880
50
51
Child tax credit. Attach Schedule 8812, if required
51
52
Residential energy credits. Attach Form 5695
52
53
Other credits from Form:
a
b
c
53
54
Add lines 47 through 53. These are your total credits
54
55
Subtract line 54 from line 46. If line 54 is more than line 46,

21. enter -0- ▶
55
Other Taxes
56
Self-employment tax. Attach Schedule SE
56
57
Unreported social security and Medicare tax from Form:
a
b
57
58
Additional tax on IRAs, other qualified retirement plans, etc.
Attach Form 5329 if required
58
59
a
59a
b
59b
Household employment taxes from Schedule H
First-time homebuyer credit repayment. Attach Form 5405 if
required
60
Other taxes. Enter code(s) from instructions
60
61
Add lines 55 through 60. This is your total tax ▶
61
Payments
62
Federal income tax withheld from Forms W-2 and 1099
62
63
2012 estimated tax payments and amount applied from 2011
return

22. 63
If you have a qualifying child, attach Schedule EIC.
64
a
Earned income credit (EIC)
64a
b
Nontaxable combat pay election
64b
65
Additional child tax credit. Attach Schedule 8812 .
65
66
American opportunity credit from Form 8863, line 8
66
67
Reserved
67
68
Amount paid with request for extension to file
68
69
Excess social security and tier 1 RRTA tax withheld
69
70
Credit for federal tax on fuels. Attach Form 4136
70
71
Credits from Form:
a
b
c
d
71
72
Add lines 62, 63, 64a, and 65 through 71. These are your total

23. payments ▶
72
Refund
Direct deposit? See instructions.
73
If line 72 is more than line 61, subtract line 61 from line 72.
This is the amount you overpaid
73
74
a
Amount of line 73 you want refunded to you. If Form 8888 is
attached, check here ▶
74a
▶
▶
b
Routing number
▶ c Type:
d
Account number
75
Amount of line 73 you want applied to your 2013 estimated
tax ▶
75
Amount You Owe
76
Amount you owe. Subtract line 72 from line 61. For details on
how to pay, see instructions ▶
76
77
Estimated tax penalty (see instructions)
77
Third Party Designee
Do you want to allow another person to discuss this return with
the IRS (see instructions)?
Designee’s name ▶

24. Phone
no. ▶
Personal identification number (PIN) ▶
Sign Here
Joint return? See instructions. Keep a copy for your records.
Under penalties of perjury, I declare that I have examined this
return and accompanying schedules and statements, and to the
best of my knowledge and belief, they are true, correct, and
complete. Declaration of preparer (other than taxpayer) is based
on all information of which preparer has any knowledge.
Your signature
Date
Spouse’s signature. If a joint return, both must sign.
▲
Date
If the IRS sent you an Identity Protection PIN, enter it
here (see inst.)
Paid Preparer Use Only
Preparer’s signature
Date
Check if
self-employed
Form 1040 (2012)
p1-t1: p1-t2: p1-t3: p1-t4: Phillipsp1-t5: Dumpyp1-t11:
321445766p1-t6: Clairep1-t7: Dumpyp1-t14: 567771258p1-t8:
p1-t9: p1-t10: f1_011: f1_012: f1_013: c1_02_0_: c1_03:
c1_04: MJp1-t17: p1-t18: c1_05: 1c1_06: 1p1-t20: HaleyDum
p1-t21: 621187592p1-t24: sonc1_07: 1p1-t25: Alex Dumpyp1-
t26: 621928751p1-t30: daughterc1_08: 1p1-t31: Luke
Dumpyp1-t32: 626219999p1-t35: sonc1_09: 1p1-t36: p1-t37:
p1-t40: c1_10: c1_01_0_: p1-t19: 2p1-t42: 3p1-t43: p1-t44: p1-
t45: 5p1-t46: 57,000p1-t47: p1-t48: 300p1-t49: p1-t50: p1-t51:
p1-t52: 395p1-53: p1-t54: p1-t55: p1-t56: p1-t57: p1-t58: p1-
t59: p1-t60: 665,320p1-t61: c1_11: p1-t62: 104,304p1-t63: p1-
t64: p1-t65: p1-t66: p1-t67: p1-t68: p1-t69: p1-t70: p1-t71: p1-
t72: p1-t73: p1-t74: p1-t75: p1-t76: p1-t77: p1-t78: p1-t79: p1-

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t96: p1-t97: p1-t98: p1-t99: p1-t100: p1-t101: p1-t102: p1-t103:
p1-t104: p1-t105: p1-t108: p1-t109: p1-t110: p1-t111: p1-t112:
p1-t113: p1-t116: p1-t117: p1-t118: p1-t119: p1-t120: p1-t121:
p2-t1: p2-t2: c2_01: c2_03: c2_04: c2_05: p2-t3: c2_06: p2-t4:
p2-t5: p2-t6: p2-t7: p2-t8: p2-t9: p2-t10: p2-t11: c2_08: c2_09:
c2_10: p2-t12: p2-t13: p2-t14: p2-t15: p2-t16: p2-t17: p2-t18:
p2-t19: p2-t20: 10800p2-t21: p2-t24: p2-t25: p2-t26: p2-t27: p2-
t28: p2-t29: p2-t30: p2-t31: c2_13: c2_14: c2_15: p2-t34: p2-
t32: p2-t33: p2-t37: p2-t38: p2-t39: p2-t40: p2-t41: p2-t42:
c2_16: c2_17: p2-t43: p2-t44: p2-t45: p2-t46: p2-t47: p2-t48:
p2-t49: p2-t50: p2-t53: 6,375p2-t54: p2-t55: p2-t56: p2-t57: p2-
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c2_23: p2-t71: p2-t72: p2-t73: p2-t74: p2-t75: p2-t76: c2_24:
p2-t77: p2-t78: f1_040_0_: c2_25: c2_26: p2-t105: p2-t106: p2-
t107: p2-t108: p2-t109: p2-t110: c2_27: p2-t111: p2-t113: p2-
t114: p2-t119: p2-t121: p2-t122: f2_130: p2-t130: p2-t123: p2-
t125: p2-t124: p2-t127: p2-t129:
Allen
ISSUE: Accommodations and Modifications
Read the following case study. Type each of the questions at
the end of the case and provide your response. Use your
textbook, links provided in the module and conduct research on
your own to develop your responses.
Allen is an 11-year-old boy who is currently in the fifth grade.
He has been diagnosed with AD/HD since he was in second
grade. At that time his teacher and parents had enough concerns
that Allen was taken to a pediatrician who specialized in
AD/HD. After having his parents and teachers complete several
checklists and questionnaires, the pediatrician made the
diagnosis of AD/HD, Combined Type, meaning he is both

26. inattentive and hyperactive/impulsive. The diagnosis was made
using the criteria stated in the most recent Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV). At the time
of the diagnosis, the parents decided that they did not want to
put Allen on medication.
In class, Allen rarely completed his seatwork. His parents
reported that he also would not complete his homework
assignments without considerable structuring and coaxing.
When he did complete his work he made numerous careless
mistakes. His parents were frustrated because even when he
completed his homework he often did not turn it in. Allen has
always been very active and climbs and jumps on furniture and
literally runs around the house. After trying several different
teaching strategies his second grade teacher suggested that she
meet with the parents to develop a 504 plan. She explained that
a 504 plan would allow certain modifications to Allen’s
instructional program, such as allowing more time on tests. She
also felt that a conference would be important to allow the
parents to provide their input and to coordinate efforts between
the home and school.
With the implementation of the 504 plan Allen’s performance
improved slightly. However, both his teacher and parents
reported that he still acted before he thought and got mad if he
didn’t get his way or had to do things that he didn’t like (e.g.,
schoolwork). They also mentioned that Allen was easily
frustrated. Allen also had a 504 plan in the third and the fourth
grade. These were changed somewhat from year to year but
ended with similar results. Different behavior management
programs were also tried with varying success. Essentially,
Allen was making passing grades, although it required
significant diligence on his teachers’ and particularly his
parents’ part. In the fifth grade his teacher felt that Allen

27. would experience significant problems transitioning to Middle
School unless he could get his behavior under control. At that
point, his parents consulted with Allen’s pediatrician and a
decision was made to put him on medication, receiving Ritalin
twice a day. His behavior improved and his teacher noted that
he could spend a lot more time on task. It seemed to take about
an hour before the medication took effect so timing was very
important. The pediatrician and teacher working together were
able to work out a dosage schedule and the teacher continued
with educational interventions.
Questions:
1. What accommodations or modifications would you use to
assist Allen in completing his seatwork? (8 points)
a. Provide a rationale for your decisions. (8 points)
2. What suggestions would you give to Allen’s parents to assist
him in turning in his homework? (8 points)
a. Provide a rationale for your decisions. (8 points)
3. Based on the information given, what modifications and
accommodations would be appropriate for Allen’s 504 plan?
(10 points) Remember Section 504 from Module I. Conduct
research on your own to develop your response.
a. Provide a rationale for your decisions. (8 points)