Page 1 of IEP IEP Annual Meeting Date: __April 28, 2010____________ Date of Last Comprehensive Evaluation: ___N/A__ INDIVIDUALIZED

EDUCATION PROGRAM (IEP) STUDENT INFORMATION Student Name Sebastian Stump Grade PreSchoolGender Male Birthdate Feb 26, 2004 ID Number Number Street Address 715 Nth 54th Ave W City/State/Zip Rochester, MN 55902 Native Language/Primary Communication Mode English School of Enrollment Rochester Public School School Phone Providing District # 555-5555 Student Permanent Residence Address (if different) Resident District # 535 PARENT/GUARDIAN INFORMATION Parent(s) Bo Stump Home Phone # Daytime Phone # Ext. (507) 358-0879 Parent(s) Street Address City/State/Zip (if different) Native Language/Primary English Communication Mode Parent/Guardian/Surrogate Parent Name(s) Parent Guardian(s) Surrogate Parent(s) Parent/Guardian/Surrogate Parent Address (if different) Home Phone # Daytime Phone # IEP INFORMATION IEP Manager Zach Selnes Phone # (507) 358-0879 Federal Setting 32 Primary Disability Developmental Delay (DD) Type of IEP: Initial PROGRESS REPORTING Frequency and method(s) to be used for reporting progress to parent(s): Initial IEP Review TRANSFER OF RIGHTS AT AGE OF MAJORITY
Address only in IEPs for students who will reach age 17 during tenure of this IEP. The student, upon reaching age 17, has been informed the rights which will transfer to him/her upon reaching the age of majority (18), unless legal guardian or conservator has been appointed. Date Notice Was Provided:

MARSS

Team Members (List Name and Title of All team members) Bo Stump Zach Selnes Jennifer Brenda Tara Erin Father ECSE Teacher ECSE Teacher General Education Teacher Occupational Therapist EC Director

IEP Annual Date

April 28, 2010

Student s Name Sebastian Stump

STUDENT PERFORMANCE AND MEASUREMENT OF PROGRESS: GOAL 1 Performance Areas Motor Ability Present Level(s) of Academic and Functional Performance: Sebastian was able to walk backward for 5 feet, jump forward with both feet together, remove forms from a form board, string 4 large beads, stack 8 cubes vertically and copy a circle. He had difficulty walking down stairs without assistant, alternating feet, use pads of fingertips to grasp a pencil and copy a cross. He was not able to copy the letters V, H, L, draw a person with 6 parts trace designs with curved part or walk in a straight line, heel-to-toe for 4 or more steps. Student-Based Need: Sebastian needs to improve his gross and fine motor skills, including being able to walk down stairs without assistance, to copy simple letters and shapes and develop a mature grasp. Measurable Annual Goal (1 of 3): Sebastian will be able to walk down stairs unassisted using alternating feet, be able to copy simple letters and shapes and develop a mature grasp by April 28, 2011. How will progress toward meeting this goal be measured? Observations Short Term Objectives or Benchmarks: Objective 1: Sebastian will use alternating feet when walking down stairs. We will know he can do this when observed 9 out of 10 times by April 28, 2011. Objective 2: Sebastian will walk down stairs unassisted. We will know he can do this when observed 9 out of 10 times by April 28, 2011. Objective 3: Sebastian will trace designs with straight and curved edges. We will know he can do this when observed 8 out of 10 times by April 28, 2011. Objective 4: Sebastian will use his fingertips to grasp a pencil. We will know he can do this when observed 8 out of 10 times by April 28, 2011.

IEP Annual Date: April 28, 2010

Student s Name: Sebastian Stump

STUDENT PERFORMANCE AND MEASUREMENT OF PROGRESS: GOAL 2 Performance Areas (One goal per page) Functional Skills Present Level(s) of Academic and Functional Performance: He was able to feed himself, remove his own clothing, unassisted, show care when handling an infant or a small animal and demonstrates caution and avoids common dangers. He had difficulty initiating and organizing his own activities and responding yes or no when asked if he needed to use the toilet. He was not able to control his bowel movements, express a need to use the toilet and answer what to do if questions involving personal responsibility.

Student-Based Need: Sebastian needs to increase his self help skills including being able to express a need to use the toilet and being able to control his bowel movements Measurable Annual Goal (2 of 3): Sebastian will express a need to use the toilet and be able to control his bowel movements. How will progress toward meeting this goal be measured? Periodic Tracking Observations Short Term Objectives or Benchmarks: Progress Notes: Objective 1: Sebastian will notify an adult if he soils himself. We will know he can do this when he does so by April 28, 2011. Objective 2: Sebastian will attempt to use the toilet when prompted by adults. We will know he can do this when he does so 4 out of 6 times by April 28, 2011. Objective 3: Sebastian will respond yes or no when asked if he needs to use the toilet. We will know he can do this when he can do this when he does so 7 out of 8 times by April 28, 2011. Objective 4: Sebastian will express a need to use the toilet. We will know he can do this when he verbally expresses a need to use the toilet 9 out of 10 times by April 28, 2011. Objective 5: Sebastian will control his bowel movements. We will know he can do this when he does so 8 out of 10 times by April 28, 2011.

IEP Annual Date

April 28, 2010

Student s Name Sebastian Stump

STUDENT PERFORMANCE AND MEASUREMENT OF PROGRESS: GOAL 3 Performance Areas Emotional, social, behavioral development Present Level(s) of Academic and Functional Performance:

Sebastian is able to help with simple household tasks, show appropriate affection toward people, pets or possessions, express affection or liking of a peer, show sympathy for others and is aware of the differences between males and females. Sebastian has difficulty showing a positive attitude toward school and responding to positively to adult praise, rewards or promise of rewards. Sebastian is not able to initiate social contact or interactions with familiar adults, play cooperatively with peers or demonstrate the ability to show and tell.
Student-Based Need:

Sebastian needs to develop social skills by using language for social contact and interactions.
Measurable Annual Goal (1 of 3): Sebastian will develop social skills by using language for social contact and interactions by April 28, 2011. How will progress toward meeting this goal be measured? Observations Short Term Objectives or Benchmarks: Objective 1: Sebastian will respond positively to adult praise, rewards or promise of rewards when given by familiar adults. We will know he can do this when he does so 4 out of 6 times by April 28, 2011. Objective 2: Sebastian will greet familiar adults spontaneously. We will know he can do this when he does so 6 out of 9 times by April 28, 2011. Objective 3: Sebastian will respond positively when familiar adults initiate in positive social contact. We will know he can do this when observed 5 out of 7 times by April 28, 2011. Objective 4: Sebastian will allow others to participate in his activities during free choice. We will know he can do this when observed doing so 6 out of 8 times by April 28, 2011. Objective 5: Sebastian will initiate cooperative play with a peer ( Can I join , Hey, let s make a ____ . Etc.). We will know he can do this when he does so 2 times during 4 separate play sessions without prompting based on staff observations by April 28, 2011. Objective 6: After either initiating or joining others in cooperative play, Sebastian will sustain play at a cooperative level. We will know he can do this when he engages in cooperative play for 5 or more consecutive minutes during 4 separate play sessions by April 28, 2011.

IEP Annual Date: April 28, 2010

Student s Name: Sebastian Stump

ADAPTATIONS IN GENERAL AND SPECIAL EDUCATION Adaptations, including 1) supplemental aids and services in general and special education, and 2) program modifications or supports for school personnel to met the needs of the student, and 3) assistive technology: Direct ECSE services will be provided by the ECSE teacher at Rochester Public School District. It does not appear that there is a need for assistive technology at this time. Sebastian may leave the classroom for occupational therapy sessions with the ECSE teacher to work on specific goals and objectives. No assistive technology needs at this time. (All sections listed below are conditional.) DISTRICT-WIDE ASSESSMENTS X District-wide assessments are NOT administered at the grade level covered by this IEP. District-wide assessments ARE administered at the grade level covered by IEP (if checked, continue below). District-Wide Assessment: (List each assessment administered district-wide for all students in this grade.) Is this assessment plan appropriate for the student (check below)? ___Yes ___No Don t need to mark if no assessments are given. If YES, for each assessment, indicate if the student needs accommodation(s) & what is needed. No accommodations needed at the Pre-School level. If NO, state reason the specific district-wide assessment is not appropriate for the student and indicate what alternative assessment the student will be administered and why it is appropriate: Parental Notification of Alternative Assessment _______ If this box is checked, your child s academic achievement will be assessed using alternate academic achievement standards or modified academic standards as indicated above, on State or Districtwide assessments. Your child s proficiency must always be based on the academic content standards for his or her grade level. LIMITED ENGLISH PROFICIENCY (LEP) STATE ASSESSMENTS FOR ACCOUNTABILITY Reading/Writing (Grades 3-12) The student will participate in: Test of Emerging Academic English (TEAE) (Reading/Writing) without accommodations. Test of Emerging Academic English (TEAE) with accommodations: (Reading/Writing accommodations link.) Listening/Speaking (Grades K-12) The student will participate in: Minnesota Student Oral Language Observation Matrix (MN- SOLOM) Math (Grades 3, 4, 5, 6, 7, 8, and 11) The student will participate in: Mathematics Test for English Language Learners (MTELL) without accommodations. Mathematics Test for English Language Learners (MTELL) with the listed accommodations: (Math accommodations link.) Alternative assessment based upon alternative achievement standards for Math (MN Test of Academic Skills MTAS). Document IEP team decisions: Explain why this assessment option is appropriate No assessments at this time.

IEP Annual Date: April 28, 2010 SERVICE Early Childhood Special Education in Community Based Preschool ECSE Home Visits ECSE Resource Room Occupational Therapist FREQUENCY 3 x / Week

Student s Name: Sebastian Stump Indirc. Mins / ses. 10 / Session Dir. Mins. 120 / Session 45 / Session 10 / Session 15 / Session Gen. Ed. X Special Ed. Start Date 5/1/2010 End Date 4/27/2011

5 x / School Year 2 x / Week 1 x / month

15 / Session 5 / Session 5 / Session

X X X

5/15/2010 4/27/2011 5/1/2010 5/1/2010 4/27/2011 2/27/2011

INTERAGENCY SERVICES Agency Name Interagency/Organization Linkages (Identify services, funding, responsibilities, etc.) None at this time LRE EXPLANATION If the student is not able to participate full time with students without disabilities in the regular classroom in extracurricular and non-academic activities, this statement explains the extent of nonparticipation.

All of Sebastian s activities during his preschool experience are with typically developing peers except occasional times that he leaves the room with the ECSE teacher. In addition Sebastian attends an Early Childhood Special Education Resource Room to work on his specific goals and objectives.

EXTENDED SCHOOL YEAR Are extended school year services required for this student? , A) Regression and Recoupment, B) Self-Sufficiency, or C) Unique Needs.) ____ Yes _X___No _____More Data Needed If yes, describe goals and services (must be described within this IEP or attached documentation):

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