You are on page 1of 13

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:
DOB

4/20/2004

Carrie Smith
SCHOOL YEAR

IEP INITIATION/DURATION DATES

FROM

2014

10/31/2014

2015

GRADE
TO

10/30/2015

THIS IEP WILL BE IMPLEMENTED DURING THE REGULAR SCHOOL TERM UNLESS NOTED IN EXTENDED SCHOOL YEAR SERVICES.

STUDENT PROFILE WILL INCLUDE GENERAL STATEMENTS REGARDING:

Strengths of the student:


Carrie Smith is a very attentive child and is diligent to try her best inside and outside the classroom. Carrie is eager to
learn and will usually participate in class discussions. She makes friends easily and actively participates in playing
academic games in the classroom with her fellow peers. Carries behavior is excellent in the classroom. Carrie is
respectful to her peers, elders, and any other staff within the school.
In math, Carrie has mastered number identification and rote counting. Carrie can complete basic addition and subtraction
problems (not regrouping) with accuracy and consistency. Carrie also can complete some simple multiplication problems
independently. Carrie works best with manipulatives used in the math curriculum and her work has been noted to improve
when given the opportunity to use such resources.
In reading, Carrie can identify all 26 letters of the alphabet and can discriminate between vowels and consonants. Carrie is
able to answer standardized comprehension questions from a third grade level passage with 80% accuracy. Carries
specific strengths in reading include comprehension and vocabulary. Carrie does enjoy when the teacher reads aloud to the
class and especially pays close attention to the pictures if illustrations are provided. Carrie averages at 85% for all of the
class vocabulary assessments completed thus far. Carrie does verbally sound out letter combinations that she is unfamiliar
with and will ask for help when incorrect.
Carries writing skills are average and have given no reason for concern.
Carrie is extremely artistic. She excels during visualization exercises when the class is given an assignment from a reading
passage. Her illustrations are usually very expressive and intricately detailed. She is most cheerful during these times and
during any type of spelling exercises.
Parental concerns:
Carries mother states that her greatest concern for her child is that Carrie would be on the same level as her peers.
Carries mothers has witnessed a few instances at home when Carrie and her friends are working on homework and Carrie
cannot keep up with them. Carries mother has also noticed that when assignments become difficult for Carrie at home,
she begins to doodle and will waste time drawing rather than working on homework. Carries mom stays at home with
Carries two younger siblings during the day and is concerned that she is not able to help Carrie because she has to attend
to Carries siblings.
Carries father is concerned for Carries academic progress and future academic plans. He would like to see Carrie excel in
all subjects and desires for her love of reading to be fostered and grown. Carries father is considering pulling Carrie out
of dance and gymnastics after school because of her lack of academic progress.
Student Preferences and/or Interests:
Carrie is most interested in art activities. Most of her work that is turned in usually has a doodle or two on it. Carrie is
able to express herself most freely and clearly through an art activity. Carrie also enjoys spelling games played at school
such as Letter Buzz and Spelling Bees. Carrie loves gymnastics and dance. After school she attends either gymnastics
or dance and also enjoys talking about what she does in those programs in school to her peers. Carrie is also very
interested in building things with any type of manipulative. Carrie especially likes working with Legos and has made
friends with a few boys in her class because of her interesting Lego constructions. Carrie also responds well to teacher
praise and is motivated when she is being constantly encouraged.

Page

of

ALSDE Approved Feb. 2012

Results of the most recent evaluations:


Wechsler Intelligence Scale for Children-Third Edition (WISC-III)- measures a childs verbal and performance
intelligence.
Full Scale: 96 (average)
Verbal IQ: 89 (low average)
Performance IQ: 102 (average)
Woodcock Johnson Tests of Achievement- Third Edition-measures a childs achievement test scores in reading, oral
language, math, and writing.
Composite Score: 80
Reading: Letter-word identification-76 (low range); passage comprehension-99 (average); word attack-82 (low average)
Oral Language: Understanding directions-100 (average); picture vocabulary-98 (average)
Math: Calculation-84 (low average); applied problems-92 (low range)
Written Language: Spelling-84 (low average); writing samples-89 (low average)
Subject Grades (1st 9-Weeks Report Card):
Reading- 56
English Language Arts- 57
Social Studies- 59
Math-66
Science-75
Behavioral Observations:
Carrie is a fairly confident young lady and is willing to answer any questions about herself with an enthusiastic
personality. She pays close attention in the classroom and can follow one-step directions with ease. Carrie works well with
her peers and enjoys working in a group. Carrie sometimes will not complete her assignments and can become easily
distracted through doodling on her assignments. Her off task behavior results from frustration with nor being able to
complete the assignment independently.
Hearing screening: Passed
Vision screening: Passed
The academic, developmental, and functional needs of the student:
Carries largest deficits are in math and reading. According to her classroom teacher, in reading, Carrie struggles with
reading stories of her grade level text. Carrie reads on a second grade level but is able to answer comprehension questions
from a third grade level text read aloud to her. Carrie has most difficulty reading words with more than one syllable
[RF.3.3c]andcannotdecodewordswithsilentletters [RF.2.3].Carrie also is unable to identify homonyms independently
[L.4.1]. Because Carrie struggles with decoding words on their own and within a text, she also struggles with other
subjects such as social studies. Carrie needs to receive reading intervention that will reinforce phonics and phonemic
awareness and prepare her for grade level assessments and build her confidence as she continues to read independently.
Carrie also struggles in math with the concept of regrouping in some basic and all multi-digit addition and subtraction
problems [2-OA1]. Although she enjoys working with the manipulatives used in class, she cannot connect the meaning of
grouping and regrouping the objects to numbers on an assignment. Carrie also only has a third of her multiplication
facts memorized (1s, 2s, and 5s, and 10s) [3-OA7]. Because Carrie struggles with knowing all of her multiplication facts,
she is struggling to grasp the concept of division (especially long division) as well [4-NBT6]. Carrie needs to receive
intervention that will specifically address regrouping and the basics of multiplication and division in order to build up to
long division and more complex multiplication problems on grade level.
Although Carrie is an enthusiastic and positive individual, she will shut down and become frustrated when she cannot
complete an assignment on her own. The interventions that Carrie receives should address these insecurities and help her
establish a greater confidence and foundation for a greater self-esteem concerning schoolwork.

Page

of

ALSDE Approved Feb. 2012

Other:

For the child transitioning from EI to Preschool, justify if IEP will not be implemented on the childs 3 rd birthday:

Page

of

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM


STUDENTS NAME:

Carrie Smith

SPECIAL INSTRUCTIONAL FACTORS


Items checked YES will be addressed in this IEP:

Does the student have behavior which impedes his/her learning or the learning of others?
Does the student have limited English proficiency?
Does the student need instruction in Braille and the use of Braille?
Does the student have communication needs (deaf or hearing impaired only)?
Does the student need assistive technology devices and/or services?
Does the student require specially designed P.E.?
Is the student working toward alternate achievement standards and participating in the
Alabama Alternate Assessment?
Are transition services addressed in this IEP with an annual goal(s)?

YES
[x]
[ ]
[ ]
[ ]
[ ]
[ ]

NO
[ ]
[x]
[ x]
[x]
[x]
[x]

[ ]
[ ]

[ x]
[x]

TRANSPORTATION AS A RELATED SERVICE


Students mode of transportation:
[ x] Regular bus
[ ] Bus for special needs
[ ] Parent contract
[ ] YES
Does the student require transportation as a related service?
If yes, check any transportation needs:
[
[
[
[
[

]
]
]
]
]

Bus assistance:
[ ] Adult support
Preferential seating
Behavioral Intervention Plan
Wheelchair lift and securement system
Restraint system
Specify type:

[ x ] Other:
[ x] NO

Nanny pick-up
school)

(after

[ ] Medical support

[ ]

Other. Specify:

[x ]

Bus driver and support personnel are aware of the students behavioral and/or medical concerns.
NONACADEMIC and EXTRACURRICULAR ACTIVITIES

Will the student have the opportunity to participate in nonacademic/extracurricular activities with his/her nondisabled
peers?
[ x ] YES.
[ ] YES, with supports. Describe:
[ ]

NO. Explanation must be provided:


METHOD/FREQUENCY FOR REPORTING PROGRESS OF ATTAINING GOALS TO PARENTS

Annual Goal Progress reports will be sent to parents each time report cards are issued (every
Page

of

weeks).

ALSDE Approved Feb. 2012

Page

of

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM


STUDENTS NAME:
[ ]
[ ]
[ ]

Carrie Smith

This student is in a middle school course of study that will help prepare him/her for transition.
This student was invited to the IEP Team meeting.
After prior consent of the parent or student (Age 19) was obtained, other agency representatives were invited to the
IEP Team meeting.
EXIT OPTIONS (Complete for students in Grades 9-12)

[ ]
[ ]
[ ]

Alabama High School Diploma


Alabama Occupational Diploma
Graduation Certificate

Anticipated Date of Exit:

Month:

Year :

PROGRAM CREDIT TO BE EARNED (Complete for students in grades 9-12)


For each course taken, indicate
program credit to be earned.

ENGLISH

MATH

SCIENCE

SOCIAL
STUDIES

Alabama High School Diploma


Alabama Occupational Diploma
Graduation Certificate
TRANSITION: (Beginning not later than the first IEP to be in effect when the student is 16, or earlier if appropriate, and
updated annually thereafter)
Transition Assessments (Check the assessment(s) used to determine the students measurable transition goals):
[ ]

Transition Planning Assessments

[ ] Interest Inventory

[ ]

Other

Goals for Postsecondary Transition:


Postsecondary Education/Training Goal
If Other is selected, specify
Employment/Occupation/Career Goal
If Other is selected, specify
Community/Independent Living Goal
If Other is selected, specify
Transition Services: Based on the student's strengths, preferences, and interests, the following coordinated transition
services will reasonably enable the student to meet the postsecondary goals. Consider these service areas: Vocational
Evaluations (VE), Community Experiences (CE), Personal Management (PM), Transportation (T), Employment Development (ED),
Medical (M), Postsecondary Education (PE), Living Arrangements (LA), Linkages to Agencies (LTA), Advocacy/Guardianship (AG),
Financial Management (FM), and if appropriate Functional Vocational Evaluation (FVE).

Transition Strands
Academics/Post Secondary
Education/Training

Employment/Occupations/
Careers

Personal/ Social

Daily Living

Service(s)

Page

of

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM


STUDENTS NAME:

Carrie Smith

[ ] This goal is related to the students transition services needs.


AREA:

Reading

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:


Carrie can identify all 26 letters of the alphabet and can discriminate between vowels and consonants [RF.K.2]. Carrie can
decode words of one syllable with 90% accuracy [RF.K.3]. Carrie is able to answer standardized comprehension questions
from a third grade level passage with 80% accuracy [RI.3.1].
Carrie struggles with decoding multisyllabic words [RF.3.3c]and understanding letters that are silent [RF.2.3]. Carrie also
has difficulty spelling words that are multisyllabic [L.3.2] due to her trouble with decoding. Carrie cannot differentiate
between homonyms [L.4.1] due to her trouble with decoding multisyllabic words as well. Carries inability to decode
multisyllabic words [RF.3.3c] has caused for her to have difficulty in the current reading program and progression in the
reading curriculum. Carrie requires specialized instruction and modification in the area of reading if she is to continue
making progress.
MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By September 2015, Carrie will be able to decode 25 multisyllabic words independently using at least one decoding
strategy with at least 80% accuracy.
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ x ] Curriculum Based Assessment [ ] Teacher/Text Test
[ ] Teacher Observation
[ ] Data Collection
[ ] State Assessment(s) [ x ] Work Samples
[ ] Other:

[ ]

[ ]

Grades

Other:

BENCHMARKS:
1. By December 2014, Carrie will be able to decode 5 multisyllabic words with teacher
prompting with 80% accuracy. [RF.3.3c]
2. By March 2015, Carrie will be able to independently decode 10 multisyllabic words
using at least one decoding strategy with 80% accuracy. [RF.3.3c]
3. By May 2015, Carrie will be able to independently decode 15 multisyllabic words
using at least one decoding strategy with 80% accuracy. [RF.3.3c]
4. By August 2015, Carrie will be able to independently decode 20 multisyllabic words
using at least one decoding strategy with 80% accuracy. [RF.3.3c]

Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

[ ] This goal is related to the students transition services needs.


Page

of

ALSDE Approved Feb. 2012

AREA:

Math

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:


In math, Carrie has mastered number identification and rote counting. Carrie can complete basic addition and subtraction
problems with 85% accuracy [2-OA1].Carriecanidentifythefunctionsigns(i.e.xformultiplication).Carrie has one-third of
her multiplication facts memorized (1s, 2s, 5s, and 10s) [3-OA7].Carrie can complete single-digit multiplication problems
independently with 80% accuracy [3-OA7].
Carrie struggles with regrouping in some basic and all multi-digit addition and subtraction problems [2-OA1]. Although
Carrie can work with manipulatives for regrouping, she fails to connect the object to the number form of the concept.
Carries cognitive deficits impact her ability to continue making progress in the area of math without specialized
instruction and modification.

MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By May 2015, Carrie will be able to complete addition and subtraction problems involving regrouping independently with
at least 80% accuracy 3/3 trials.
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ x ] Curriculum Based Assessment [ ] Teacher/Text Test
[ ] Teacher Observation
[ ] Data Collection
[ ] State Assessment(s) [ x ] Work Samples
[ ] Other:
[ ] Other:
BENCHMARKS:
1. By November 2014, Carrie will be able to complete basic addition problems
involving regrouping with at least 80% accuracy 3/3 trials. [2-OA1]
2. By February 2015, Carrie will be able to complete basic multiplication problems
involving grouping with at least 80% accuracy 3/3 trials. [2-OA1]
3. By April 2015, Carrie will be able to complete multi-digit addition and subtraction
problems involving regrouping with at least 70% accuracy 3/3 trials. [2-OA1]
4. By May 2015, Carrie will able to complete multi-digit addition and subtraction
problems involving regrouping with at least 80% accuracy 3/3 trials. [2-OA1]

Page

of

[ ]

Grades

Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

ALSDE Approved Feb. 2012

AREA:

Math

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:


In math, Carrie has mastered number identification and rote counting. Carrie can complete basic addition and subtraction
problems with 85% accuracy [2-OA1].Carriecanidentifythefunctionsigns(i.e.xformultiplication).Carrie has one-third of
her multiplication facts memorized (1s, 2s, 5s, and 10s) [3-OA7].Carrie can complete single-digit multiplication problems
independently with 80% accuracy [3-OA7].
Carrie struggles with memorizing all of her multiplication facts and cannot complete multiplication problems that are
double digit independently [4-NBT5]. Carrie also does not comprehend the concept long division because of her deficits
in multiplication understanding [4-NBT6]. Carries cognitive deficits impact her ability to continue making progress in the
area of math without specialized instruction and modification.

MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By September 2015, Carrie will be able to complete double digit multiplication problems using memorization skills with
75% accuracy 2/2 trials.
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ x ] Curriculum Based Assessment [ ] Teacher/Text Test
[ x ] Teacher Observation
[ x ] Data Collection
[ ] State Assessment(s) [ x ] Work Samples
[ ] Other:
[ ] Other:
BENCHMARKS:
1. By December 2014, Carrie will be able to recall all basic multiplication facts from
memory (0-10) with 80% accuracy 2/2 trials. [3-OA7]
2. By March 2015, Carrie will be able to use multiplication memorization skills to
complete single-digit multiplication problems with 80% accuracy 2/2 trials. [3-OA7]
3. By May 2015, Carrie will be able to use multiplication memorization skills to
complete double-digit multiplication problems with 75% accuracy 2/2 trials. [3-OA7]
4. By August 2015, Carrie will be able to use multiplication memorization skills to
complete multi-digit multiplication problems with 75% accuracy 2/2 trials. [3-OA7]

Page

of

[ ]

Grades

Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM


Students Name:

Carrie Smith

SPECIAL EDUCATION AND RELATED SERVICE(S): (Special Education, Supplementary Aids and Services,
Program Modifications, Accommodations Needed for Assessments, Related Services, Assistive Technology, and Support
for Personnel.)

Special Education
Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Carrie will receive one-on-one instruction


in reading.
Carrie will receive small group instruction
in reading.

Twice a week

30 mins

11/1/14 to 10/30/15

Everyday

20 mins

11/1/14 to 10/30/15

Carrie will receive one-on-one instruction


in math.

Twice a week

30 mins

11/1/14 to 10/30/15

Math Intervention
Classroom

Carrie will receive small group instruction


in math.

Everyday

20 mins

11/1/14 to 10/30/15

General Education
Classroom

Related Services

[ ] Needed

[ x ] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Service(s)

Service(s)

Beginning/Ending
Duration Dates

Location of Service(s)

Reading Intervention
Classroom
General Education
Classroom

Location of Service(s)

to
to

Supplementary Aids and Services


Service(s)

[ ] Needed

[ x] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

to
to

Program Modifications
Service(s)

[ ] Needed

[ x ] Not Needed

Anticipated
Frequency of
Service(s)

Amount of
time

Beginning/Ending
Duration Dates

Location of Service(s)

to
to

Accommodations Needed for


Assessments
Service(s)

Carrie will be assessed on her average


performance of separate trials in math
reading.

[ x ] Needed

[ ] Not Needed

Anticipated
Frequency of
Service(s)

Amount of
time

Beginning/Ending
Duration Dates

When needed

Dependent
upon
task/subjec
t

11/1/14 to 10/30/15

Location of Service(s)

to
Page

of

ALSDE Approved Feb. 2012

Assistive Technology
Service(s)

[ ] Needed

[ ] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

to
to

Support for Personnel


Service(s)

[ ] Needed

[x ] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

to
to

Page

of

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM


STUDENTS NAME:

Carrie Smith
TRANSFER OF RIGHTS

(Beginning not later than the IEP that will be in effect when the student reaches 18 years of age.)
Date student was informed that the rights under the IDEA will transfer to him/her at the age of 19
The IEP Team has considered the need for extended school year services.

[ x ] Yes

[ ] No

LEAST RESTRICTIVE ENVIRONMENT


Does this student attend the school (or for a preschool-age student, participate in the environment) he/she would attend if
nondisabled?
[ x ] Yes
[ ] No
If no, explain:
Does this student receive all special education services with nondisabled peers? [ ] Yes [ x] No
If no, explain (explanation may not be solely because of needed modifications in the general curriculum):
Student receives specific math and reading instruction in an intervention room because of needed modifications.
[ X] 6-21 YEARS OF AGE

[ ] 3-5 YEARS OF AGE

Least Restricted Environment:

General Education Classroom


COPY OF IEP

COPY OF SPECIAL EDUCATION RIGHTS

Was a copy of the IEP given to parent/student (age 19) at


the IEP Team meeting?
[ x ] Yes
[ ] No

Was a copy of the Special Education Rights given to


parent/student (age 19) at the IEP Team meeting?
[ x ] Yes
[ ] No

If no, date sent:

If no, date sent:

Date copy of amended IEP provided/sent to parent/student (age 19)


THE FOLLOWING PEOPLE ATTENDED AND PARTICIPATED IN THE MEETING TO DEVELOP THIS IEP.

Position

Signature

Date

Parent
Parent
General Education Teacher
Special Education Teacher
LEA Representative
Someone Who Can Interpret The Instructional
Implications Of The Evaluation Results
Student
Career/Technical Education Representative
Other Agency Representative

INFORMATION FROM PEOPLE NOT IN ATTENDANCE

Page

of

ALSDE Approved Feb. 2012

Position

Page

of

Name

Date

ALSDE Approved Feb. 2012