Heather Soden

KIN 387
Individualized Educational Program

Student Name: Mallory Age: 10.5 HT: 4”9 Wt: 60 lbs

Educational Placement: General Physical Education
Disability (major health problems): N/A

Present level of academic achievement and functional performance:

Mallory is a typically developing 10-year-old girl attending Dunlap Elementary School. She
participates in general education in all classes, including physical education class. Mallory has
many friends and enjoys participating in PE class. She plays soccer in her spare time and enjoys
being physically active and being part of a team sport. She performed well in locomotor skills
including running and hopping. While performing the running locomotor skill, her arms moved
in opposition and she had a small flight phase between steps. While performing the hop
locomotor skill, Mallory was able to hop on both legs for four consecutive times while
maintaining her balance. She struggled with tasks involving ball skills including the one- handed
strike and dribbling. While performing the one- handed strike, the ball hit the ground before it hit
the wall on one of her attempts. While performing the dribbling skill, Mallory was not able to
maintain control of the ball and had to move her feet in order to regain control of the ball while
dribbling. Mallory was eager to attempt all the skills and maintained a positive attitude
throughout the entire test.

1. Annual Goal & Projected Date (start/stop):

Mallory will slide with her body facing sideways, leading with one foot on the preferred and
non-preferred side for four continuous slides with visual modeling demonstrated by the teacher
by November 24, 2021 for 4 out of 5 times as observed by the teacher.

Benchmarks & Projected Dates:

1. Mallory will slide with her body facing sideways, leading with one foot on the preferred side
for four continuous slides with visual modeling demonstrated by the teacher by February 24,
2021 for 2 out of 5 times as observed by the teacher.

2. Mallory will slide with her body facing sideways, leading with one foot on the preferred and
non-preferred side for four continuous slides with visual modeling demonstrated by the teacher
by May 24, 2021 for 2 out of 5 times as observed by the teacher.

3. Mallory will slide with her body facing sideways, leading with one foot on the preferred and
non-preferred side for four continuous slides with visual modeling demonstrated by the teacher
by August 24, 2021 for 3 out of 5 times as observed by the teacher.
Materials/Methods:
 Visual modeling demonstrated by the teacher
 Tape to represent a distance to perform movement
 Verbal feedback to provide corrective behavior such as “face the wall” and “keep one
foot in front.”

2. Annual Goal: & Projected Date (start/stop):

Mallory will dribble a basketball with the fingertips of one hand contacting the ball at waist level
and maintain control of the ball for four consecutive bounces with stationary feet and visual
modeling demonstrated by the teacher by November 24, 2021 for 4 out of 5 times as observed by
the teacher.

Benchmarks & Projected Dates:

1. Mallory will dribble a basketball with the fingertips of one hand contacting the ball at waist
level and maintain control of the ball for four consecutive bounces with stationary feet and visual
modeling demonstrated by the teacher by February 24, 2021 for 4 out of 5 times as observed by
the teacher.

2. Mallory will dribble a basketball with the fingertips of one hand contacting the ball at waist
level and maintain control of the ball for four consecutive bounces with stationary feet and visual
modeling demonstrated by the teacher by May 24, 2021 for 4 out of 5 times as observed by the
teacher.

3. Mallory will dribble a basketball with the fingertips of one hand contacting the ball at waist
level and maintain control of the ball for four consecutive bounces with stationary feet and visual
modeling demonstrated by the teacher by August 24, 2021 for 4 out of 5 times as observed by the
teacher.

Materials/Methods:
 Visual modeling performed by the teacher
 Tape on the ground to provide a target to dribble ball on
 Verbal feedback to provide corrective behavior such as “tap the ball using your
fingertips”, “bounce the ball by your waist.”
 Basketball

3. Affective or Cognitive Annual Goal & Projected Date (start/stop):

Mallory will list 4 behaviors that she can improve upon to help her become a better team player
when verbally prompted by the teacher every time she is asked by November 24, 2021 as
observed by the teacher.

Benchmarks & Projected Dates:

1. Mallory will list 1 behavior that she can improve upon to help her become a better team player
when verbally prompted by the teacher every time she is asked by February 24, 2021 as observed
by the teacher.

2. Mallory will list 2 behaviors that she can improve upon to help her become a better team
player when verbally prompted by the teacher every time she is asked by May 24, 2021 as
observed by the teacher.

3. Mallory will list 3 behaviors that she can improve upon to help her become a better team
player when verbally prompted by the teacher every time she is asked by August 24, 2021 as
observed by the teacher.

Materials/Methods:
 Verbal prompt by the teacher
 Visual representation of proposed behavior
 KIN 387
Individualized Education Program (IEP) Rubric
*SLO1

CSULB Student Name: ____________/15 Points Possible

____ Present Level of Performance Statement (3 pts)

(0-1) ____ Clearly, briefly written (one paragraph) statement of student's (1) strengths (first!!)
and (2) needs. GENERAL statements.
(0-2) ____ Measurable terms that positively reflect what the individual can accomplish. PLP for
all three goals.

____ Annual Goals (5 pts)

(0-1) ____ All annual goals are directly linked to present level of performance statement
(1-3) ____ Measurable include audience, behavior, condition, & degree. Includes prompts (e.g.,
verbal, visual, hand-over-hand assistance). Goal = 70%+
(0-1) ____ All goals are realistic, functional, age appropriate to individual, moving toward level of
independence with some process orientated goals, one sentence only! (2 motor goals, 1
cognitive OR 1 social goal; Total = 3)

____ Benchmark Objectives (5 pts)

(0-1) ____ Appropriate selection of 3 benchmarks - based on annual goal
(1-3) ____ Measurable include audience, behavior, condition, & degree. Includes prompts (e.g.,
verbal, visual, hand-over-hand assistance)
(0-1) ____ Sequential process orientated benchmarks to meet goals

____ Dates and materials/ methods (2 pts)

(0-1) ____ Dates (annual) are realistic to meet goals & benchmarks
(0-1) ____ Materials/Equipment (i.e., poly spots ) described

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