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IEP Assignment

IEP Assignment
Emilia Cervantes
College of Southern Nevada

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IEP Assignment

Directions: Fill in the blanks of this IEP with answers that would facilitate learning for the student. At
the end of the IEP you will find an answer sheet. Attach a cover sheet to this assignment and submit it via
canvas.

STUDENT/PARENT INFORMATION

Student: John Doe Student ID: 10684626 Sex: M Birth Date: 7/4/2006 Grade: 05

Student Primary Language: SPANISH

Address: 3481840 Main St. City/State/Zip: Towson MD 21204 Student Phone: (410) 555-4262

Parent/Guardian/Surrogate: Mariah Scott Parent Phone (Home): (410) 555-4262

Parent Phone (Work): (410) 555-4279Optional (Cell): (000) 000-0000

Primary Language Spoken at Home: ENGLISH

Interpreter or Other Accommodations Needed: Interpreter in attendance

Current School: CSN Elementary

ELIGIBILITYCATEGORY

Primary: Autism Spectrum Disorder

ELIGIBILITY DATE: 09/25/2015 ANTICIPATED 3-YR REEVALUATION: 09/24/2018

MEETING INFORMATION
DATE OF MEETING: 915/2016

PURPOSE OF MEETING:
Interim IEP Revision to IEP Dated: _________
Annual IEP Exit/Graduation IEP

Initial IEP Other: ________________

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IEP Assignment
IEP Following 3-Yr Reevaluation

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IEP Assignment
DATE OF LAST IEP MEETING: 09/25/2015 IEP SERVICES WILL BEGIN: 9/15/2016
ANTICIPATED DURATION OF SERVICES: 9/15/2017
IEP Assignment
PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

ASSESSMENTS ASSESSMENT EFFECT ON STUDENT'S


CONDUCTED RESULTS INVOLVEMENT AND
PROGRESS IN GENERAL
EDUCATION CURRICULUM
OR, FOR EARLY
CHILDHOOD STUDENTS,
INVOLVEMENT IN
DEVELOPMENTAL
ACTIVITIES
Multidisciplinary Team As noted in the MDT Report, John was below
Report (MDT) dated average in reading, both in decoding and
comprehension. He could identify all 26
XX/XX/XXXX
letters, short and long vowels. John could
answer factual questions at the middle first
grade level that were read to him. His
functional skills were within grade level
expectations.
Reading:John knows all the letters and sounds
of the alphabet. He reads CVC
(consonant/vowel/consonant) words and
Core, XX/XX/XXXX, "silent e" words with 90% accuracy. He has
AIMSweb, difficulty with dipthongs (such as: ow, ou, ie,
XX/XX/XXXX igh, oo), digraphs (such as ph, ng, rh, gh, ea, 5th grade peers can read grade
General education and ee, ie, ew), and breaking words into syllables. level text with fluency
special education He is not consistent when decoding 2 or more
(approximately 110 words per
teacher observations, syllable words. In the 5th grade basal, John
reads 15 words per minute. If material is read minute) and answer factual and
XX/XXXX, Student inferential questions. Due to John's
aloud to him, he can answer literal/factual
work samples- questions. At his instructional level, middle reading deficit in reading fluency
comprehension 2nd grade, he can read 70 words per minute. and comprehension, he cannot
questions, XX/XXXX John can answer literal comprehension read independently at a 5th grade
questions at the middle 2nd grade level
reading level.
independently. John struggles to answer
higher order questions (interpretive and
critical). John was administered the AIMsweb
Oral Reading Fluency on 3 different days. His
median score was 76 at the 2nd grade level.
On the same dates, John was given the
AIMsweb MAZE assessment. His median
score was 24 with 8 errors.

ReadingK-TEA II
Letter & Word Recognition: Standard Score
(SS): 74
Reading Comprehension: SS: 70
Overall Reading: Standard Score SS: 70
IEP Assignment
Normal range on the KTEA is 85-115; 68% of
students score within the normal range. John
is scoring below the normal range in reading. Fifthgradestandardsand
John has difficulty reading multi-syllabic curricularexpectationsrequirethat
Kaufman Test of words consistently. He has made progress
studentsbeabletousecombined
Educational with identifying some blends (cl, str, bl, br)
and digraphs (sh, th, ch). He has difficulties knowledgeofalllettersound
Achievement, Second correspondences,syllabication
with unusual blends (tch, and schwas). He can
Edition (K-TEA II) identify words such as: ocean, behind, patternsandknowledgeofroots
XX/XX/XXXX understood, point, and guess. John struggles andaffixestoreadaccurately
General and Special with identifying words such as: kneel, quiet, unfamiliarmultisyllabicwordsin
Education Teacher company, and several. He often asked several isolationandwithincontext.They
Observations, questions and had to be redirected towards
readonleveltextwithpurpose,
trying his best to independently answer. He
XX/XXXXInformal understandingandfluency.
shuts down when given more difficult
Assessments material even with assistance. John has Studentsareabletodeterminetwo
XX/XX/XXXX-XX/ difficulties with identifying key elements to aremoremainideasoftextand
XX/XXXX, text such as main idea, details, when given explainhowthosemainideasare
grade level text. He struggles with putting supportedbykeydetails.Byend
Work Samples, information into sequential order. John is able
offifthgradestudentsreadand
XX/XX/XXXX to make predictions and will orally revise
them during readings. comprehendinformationtexts
includingreadingcontentarea
material.DuetoJohn'sdeficitsin
readingfluencyand
Behavior:The general education teachers' comprehension,Johnexperiences
progress reports indicate the following: John
difficultywiththepaceandrigor
is social and friendly. John can display very
respectful behavior and has no difficulty ofgradelevelmaterials.John
speaking up or advocating for himself. cannotreadatgradelevel,
Behaviors of concern include talking during therefore,heisunabletoanswer
instruction (on the average of 10 times in a 50 comprehensionquestions
minute period, distracting others (average of 3 independently.
times per 50 minute period), being off-task (in
a 10 minute observation period, taken 3 times Typical peers are able to listen to
during the week, he was off-task, 5 of the 10
class instruction and complete
General Education minutes) and he does not hand in homework
and in-class assignments. class and homework in a timely
Teachers' Progress manner. Due to John's difficulty in
John's Level of Language Acquisition:
Reports, XX//XXXX Speaking: Level 4-Advanced Intermediate attending to instruction and
General and Special Reading: Level 3-IntermediateWriting: Level staying on task, he struggles with
Education Teacher 2- Emerging Comprehension: Level 3- completing work on time.
observations, Intermediate Overall Level 3: Intermediate
XX/XXXX Students are considered proficient when
reaching a minimum of Level 4 in Listening,
Speaking, Reading, Writing and reaching a
minimum Level 5 in Overall.John has shown
a great deal of academic improvement in his
reading and writing skills. At times, he
IEP Assignment
English Language struggles with correct subject/verb agreement
Proficiency Scores when speaking and in writing. He is
comfortable speaking with peers and shows
(ELPA) XX/XX/XXX
no hesitation in participating in class
General and Special discussions.
Education Teachers
observations,
XX/XXXX Math
Math Concepts & Appl.SS: 72
Kaufman Test of Math ComputationSS: 85 Students in the 5th grade are
Educational Overall MathSS: 77 proficient in using whole numbers,
fractions, and decimals to solve
Achievement, Second Normal range is 85-115, 68% of students problems. The standards focus on
Edition (K-TEA II) score in that range. John is able to perform multiplying and dividing decimals
XX/XX/XXXX math computations within the low average by whole numbers and generating
General and Special range of his typical peers. John requires and solving addition, subtraction,
Education Teacher extensive time to complete computations. He multiplication, and division
Observations, is performing within the representational problems using whole numbers
stage in multiplication and division; he draws and decimals in practical
documentation, work an array to solve multiplication and division situations. Due to John's
samples, informal problems. He is inconsistent with regrouping weaknesses in math concepts and
assessments within multi-digit addition & subtraction applications, he experiences
XX/XXXX problems. He has difficulty answering multi- difficulty when solving multi-step
step problems, and answering problems that and higher level math problems.
contain money, time, and basic number
concepts such as skip counting. Additionally,
he struggles with problems that require the
use of measurement, geometry, and fractions.
Math computation is John's academic
strength. He is able to apply different
strategies to solve more complex
computations. John struggles with identifying
important information from word problems.
He has difficulties with answering multi-step
problems. John will often omit important
steps or make simple errors when solving
problems that require more than one step.
John enjoys participating in math and is
comfortable with his abilities. He is willing to
attempt problems that are more difficult for
him without prompts or assistance. John
struggles with multi-step problems and
requires math assignments to be broken down
into single steps.

Writing
IEP Assignment
Written Expression SS: 64 The 5th grade content core
SpellingSS: 71 standards in the area of writing
Kaufman Test of emphasize the development of
Written expression and spelling are areas of students' writing, speaking, and
Educational
need. He was administered the K-TEA II on listening skills. The curriculum
Achievement, Second XX/XX/XXXX. 68% of students fall in the focuses on writing summaries of
Edition (K-TEA II) normal range, 85-115. During testing, John oral and written stories, and
XX/XX/XXXX was able to spell words such as: you, as, bath, writing paragraphs and
open, very, and said. He was unable to spell compositions with topic sentences,
General and Special words such as: of (uv), what (wut), went variety of sentences, logical
Education Teacher (wint), dry (drie), and phone (fone). In the sequence, and main ideas that are
observations, student general education classroom, John attempts to supported by details and a
spell words phonetically, and his written work conclusion, and using correct
work samples
is illegible. He does not consistently utilize grammar, capitalization and
XX/XXXX correct capitalization. He struggles with punctuation when writing. Due to
applying basic and complex forms of John's weakness in written
punctuation. In the special education expression, such as spelling and
classroom, John writes basic simple writing connected text, he
sentences. He has difficulty with writing experiences difficulty with writing
compound/complex forms of sentences. He essays and constructed response
has a difficult time with planning and answers.
organization of his written work and does not
consistently write in sequential order. John
will attempt to write detailed sentences. He
requires several prompts to correct his written
work. John is able to apply capitalization and
ending punctuation when directly dictated a
simple sentence in the special education
classroom. He struggles with independently
utilizing correct capitalization and
punctuation. He is consistent with applying
ending punctuation. John does not apply
complex forms of punctuation such as:
commas, apostrophes, and quotations. When
writing, John struggles with verb tense and
often leaves words out. He has made progress
with adding some details to simple sentences.
He is unable to consistently write two or three
sequential sentences.
IEP Assignment
STRENGTHS, CONCERNS, INTERESTS AND PREFERENCES

Statement of Student Strengths:

John is a very hard worker. He likes to help the teachers and gets along well with his peers. John's addition
and subtraction math computation skills are very good.

Statement of Parent Educational Concerns:

John's parent was unable to attend the meeting, but let the special education teacher know that she is
concerned about John's reading and writing ability.

Statement of Students Preferences and Interests:

John loves to play video games, talk about cars, and enjoys going on the computer to play educational games.

CONSIDERATION OF SPECIAL FACTORS


1. Does the student's behavior impede the student's learning or the learning of others?
If YES, team must provide positive behavioral strategies, supports and interventions, or other strategies,
supports and interventions to address that behavior.

Yes, addressed in IEP. No action needed.

2. Does the student have limited English proficiency? If YES, team must consider language needs of the
student as those needs relate to the student's IEP.

Yes, addressed in IEP. No action needed.

3. Is the student blind or visually impaired? If YES, team must evaluate reading and writing needs and
provide for instruction in Braille unless determined not appropriate for the student.

Yes, addressed in IEP. No action needed.

4. Is the student deaf or hard of hearing?If YES, team must consider communication needs.

Yes, addressed in IEP. No action needed.

5. Does the student require assistive technology devices and services?If YES, team must determine nature
and extent of devices and services.

Yes, addressed in IEP. No action needed.


IEP Assignment
IEP GOALS, INCLUDING ACADEMIC AND FUNCTIONAL GOALS,
AND BENCHMARKS OR SHORT-TERM OBJECTIVES

Measurable Annual Goal (including how progress toward the annual goal will be measured)
By annual review date, in a classroom setting, during instruction and seatwork, John will work independently
and quietly at his assigned location, achieving a criteria of 25 minutes in 4 out of 5 trials as measured by
documentation as implemented by Special Education Staff.
Benchmark or Short-Term Objective
#1 By end of second trimester of XXXX-XXXX school year, in a classroom setting, John will work quietly and
independently, without disturbing others, achieving a criteria of 10 minutes as implemented by Special Education
Staff.
#2 By end of third trimester of XXXX-XXXX school year, in a classroom setting, John will work quietly and
independently, without disturbing others, achieving a criteria of 15 minutes as implemented by Special Education
Staff.
#3 1. Create a benchmark for this goal.
#4 2. Create a benchmark for this goal.

Measurable Annual Goal (including how progress toward the annual goal will be measured)
By annual review date, in a classroom setting, John will demonstrate knowledge by applying phonics and
word analysis skills in decoding words (RF.5.4) at a middle 3rd grade level, 100 words per minute, achieving
a criteria of 80% in timed readings, as measured by curriculum based assessments as implemented by Special
Education Staff.
Benchmark or Short-Term Objective
#1 By end of second trimester of XXXX-XXXX school year, in a classroom setting, John will fluently decode words
with two and three letter blends (e.g., sp, spr) achieving a criteria of 80% as implemented by Special Education
Staff.
#2 By end of third trimester of XXXX-XXXX school year, in a classroom setting, John will fluently decode words
with consonant trigraphs (e.g., sch, str, spr, squ) achieving a criteria of 80% as implemented by Special Education
Staff.
#3 By end of first semester of XXXX-XXXX school year, in a classroom setting, John will fluently decode words
with digraphs (e.g., qu, ph) achieving a criteria of 80% as implemented by Special Education Staff.
#4 By annual review date, in a classroom setting, John will know and apply phonics and word analysis skills in
decoding words (RF.5.4) at a middle 3rd grade level, 100 words per minute, achieving a criteria of 80% in timed
readings, as measured by curriculum based assessments as implemented by Special Education Staff.

Measurable Annual Goal (including how progress toward the annual goal will be measured)

3. Create a goal for writing.

Benchmark or Short-Term Objective


#1 4. Create a benchmark for your goal.
# 2 5. Create a benchmark for your goal.
# 3 6. Create a benchmark for your goal.
# 4 7. Create a benchmark for your goal.
IEP Assignment
Measurable Annual Goal (including how progress toward the annual goal will be measured)
By annual review date, in a classroom setting, John will solve three step word problems, with extraneous
information, that are read aloud, involving combinations of addition, subtraction, multiplication, division,
(NV 5.5.4) achieving a criteria of 80% as measured by teacher-made tests and student work samples as
implemented by Special Education Staff.
Benchmark or Short-Term Objective
#1 8. Create a benchmark for this goal.
# 2 9. Create a benchmark for this goal.
# 3 10. Create a benchmark for this goal.
# 4 11. Create a benchmark for this goal.

SPECIAL EDUCATION SERVICES

Specially Designed Service Type Beginning and Frequency of Location of


Instruction End Dates Services Services
Behavior Direct 9-15-2016 9-15-2017 30 Min/Wk General Education
Reading Direct 9-15-2016 9-15-2017 12. Select Mins 13. Select Location
Math Direct 9-15-2016 9-15-2017 14. Select Mins 15. Select Location
16. Any additional if yes include all
services needed? columns

RELATED SERVICES

Related Service Service Type and / Beginning and Frequency of Location of


or Description End Dates Services Services

SUPPLEMENTARY AIDS AND SERIVICES

Modification, Beginning and Frequency of Location of Services


Accommodation, or Support End Dates Services
for Student or Personnel
17. Create an accommodation
or support.
18. Create an accommodation
or support.
19. Create an accommodation
or support.
20. Create an accommodation
or support.
21. Create an accommodation
or support.
IEP Assignment
PLACEMENT

Placement: 9/15/2016 9/15/2017 Total Minutes per week in school: 1855

Placement Considerations:

Regular class with supplementary aids and services (no removal)


Regular class and special education class (e.g. resource) combination
Self-contained program
Special School
Residential
Hospital
Home
Other: ____________

22. Select placement for John based on the services you selected.

JUSTIFICATION FOR PLACEMENT INVOLVING REMOVAL FROM REGULAR EDUCATION


ENVIRONMENTS*

23. In what areas does John require special instruction?

24. What supports are needed to make John successful in the general education setting? (summarize)

25. Why can Johns needs not be met in the general education setting? (summarize, consider social
emotional impact as well)

IEP IMPLEMENTATION

As the parent, I agree with the components of this IEP. I understand that its provisions will be implemented
as soon as possible after the IEP goes into effect.

As the parent, I disagree with all or part of this IEP. I understand that the school district must provide me
with written notice of any intent to implement this IEP. If I wish to prevent the implementation of this IEP, I
must submit a written request for a due process hearing to the local school district superintendent.

Parent not in attendance. Parent participated via telephone.

A copy of this IEP was provided to the student's parent on: 9/15/2016 by: Special Education Teacher
IEP Assignment
Answer Sheet: Please fill in answers here.

1. _ By end of first semester of 2016-2017 school year, in classroom setting, John will work
independently and quietly, without disturbing his peers, achieving a criteria of 20 minutes as
implemented by special education staff.
2. _ By annual review date, in classroom setting, john will know how to work independently and
quietly, achieving a criteria of 25 minutes in 4 out of 5 trials as measured by documentation as
implemented by Special Education Staff.
3. _By annual review date, in a classroom setting, John will understand how to write
complex/compound sentences by applying correct use of grammar, complex form of punctuation,
and sequential order, achieving a criteria of 80% in written responds as implemented by special
education teacher.
4. _ By end of second trimester of 2016-2017 school year, in classroom setting, John will be able to
write a two paragraph written response essay that includes correct use of commas, apostrophes,
verb tense, capitalize, and spelling, achieving a criteria of 80%as implemented by special
education staff.
5. _By end of third trimester of 2016-2017 school year, in classroom setting, John will be able to write
a three paragraph written response essay that involve use of sequential sentences, achieving
criteria of 80% as implemented by special education staff.
6. _By end of first semester of 2016-2017 school year, in classroom setting, John will able to write a
three paragraph written response essay that have correct use of grammar, punctuation, and
spelling, achieving a criteria of 80% as implemented by special education staff.
7. _ By annual review date, in classroom setting, John will apply correct use of grammar, complex
form of punctuation, and sequential order to create complex/compound sentences, achieving a
criteria of 80% in written response essay as implemented by special education staff.
8. _By end of third trimester of 2016-2017 school years, in classroom setting, John will understand
how to look for clue information in three step word problems by creating his own questions that
include additional, subtraction, multiplication, and solve it, achieving a criteria of 80% as
implemented by special education staff.
9. _By end of third trimester of 2016-2017 school years, in classroom setting, John will know how
solve three step problems that include combination of multiplication, division, and additional in a
teacher-made test, achieving a criteria of 80% as implemented by special education staff.
IEP Assignment
10. _By end of first semester of 2016-2017 school years, in classroom setting, John will work on three
step word problems where he has to highlight clue words, and fill in the blanks for step 1, step 2,
and etc to show how solve it in a teacher-made test, achieving a criteria of 80% as implemented by
special education staff.
11. _By end of annual review date, in classroom setting, John will solve three step word problems that
are read aloud, and includes addition, subtraction, multiplication, and division, (NV 5.5.4)
achieving a criteria of 80% as measured by teacher-made tests and student work samples as
implemented by Special Education Staff.
12. _30 Min/Wk
13. _ Resource because he cannot read at his grade level, and have a hard time keeping pace with
grade level materials
14. _45 min/WK
15. _General education because his is comfortable with his ability, and wants try more difficulty
problems without assistant
16. _ writing/direct
17. _Allow additional time to complete an assignments
18. _ Provide a clearly written topic sentence and an informal outline to get the student started on a
paragraph or essay
19. -Allow additional time to read
20. _Provide vocabulary lists with user-friendly definitions
21. _Oral testing
22. _ Regular class and special education class (e.g. resource) combination
23. _John require special instruction in reading and writing
24. _John needs additional time to work on assignments, additional time to read, and needs an outline
and list to help him be successful in general education classroom.
25. _ John needs cannot be meet in general education setting because he has difficulty keeping up with
grade level materials in reading, and difficulty doing correct written expression with essay and
constructed response answer; he needs one on one instruction to help improve and master
concepts in reading and writing at his grade level.
26. _