Individual Education Plan

District/School? Logo Name of school and school Year

Student Details
Student Name: Sam Smith Primary Ministry Designation (s): G- Autism
Grade: 3 Additional Ministry Designation (s):
PEN: 12345678 IEP Date: August 1, 2021

Date of Birth: June 1, 2013 Case Manager: Jenny Stanek

Student Support Team: Role:

Sally Smith Mother
Samuel Smith Father
Clara Pereira Principal
Teresa Tang Education Assistant
Jo Jones Classroom Teacher
Jenny Stanek Case Manager
Louis Long Behaviour Consultant

Parent/Guardian consulted on: May 1, 2021

My Personal Profile
My Interests: Location of Evidence:
Playing outside
Badminton and frisbee
Minecraft iPad game
Soccer
I like swimming in my grandparent’s pool
My Learning Preferences: Location of Evidence:
Working with Ms. Tang
Using a device to help me type
Working in the hallway with a friend
What you need to know about me: Location of Evidence:
I don’t like to be touched
I don’t like being called on to answer questions or to read out loud
I need help with writing and math
I am tired in the mornings and like to be left along
I like to move around the classroom to learn

My Learning Profile
Thoughts from my Personal Social Intellectual
team. What I am able to do on What I am able to do with How I think.
my own. others.
My Strengths I can tell 5 things about myself I help my friends I can ask questions
I can say what I am good at I take care of my school I can share my ideas

MyEdBC Competency Based IEP Template v. XI


I can try new things
I can say what is important to me
I understand classroom rules
I can ask for help
I can ask for breaks
I can handle changes in my
routine
I know what makes me sad or
mad
I know what makes me happy
Respectfully disagreeing
Knowing the names of my
classsmates
Saying what I need to work on
My Stretches Explaining choices I make
Trying my best
Calming my mind and body
Naming different feelings
Individual Education Plan
District/School? Logo Name of school and school Year
I can work with others in a group I can learn information about a topic
I can explain why something is fair I can share some of my ideas with the
I can explain why something is unfair class
I can stand up for others I can describe new things I’ve learned
I can think of different solutions to a I can try new things
problem I can think of new ideas
I have a friend I know that mistakes are okay
Solving problems peacefully Listening to others' ideas without
Walking away when I feel frustrated interrupting
with someone Doing my part in a group
Being kind to others Using my ideas to solve problems
Trying a new way if my idea doesn't work
Reflecting on my work
Figuring out the main idea

My focus Area This X X

Year X X
Core competency connections Core competency connections Core competency connections
These learning domains can
inform the IEP development Positive Personal + Communication Creative thinking
in these core competency
areas. Personal awareness +
Social responsibility Critical thinking

Support and Plans

Universal Classroom Supports: **** Essential Supports:
Calm space in classroom, additional time for tasks, flexible pacing, Personal visual schedule, sensory/movement breaks, work/break schedule,
differentiated content process, product and assessment, visuals, behaviour incentive reward program, preferred work space (hallway),
alternate ways of responding, reduced work load, alternate work preloading for transitions and 5-minute timer
spaces, provide breaks, visual classroom schedule, graphic
organizers/visual supports, Second Step program for self-regulation,
mindfulness activities, movement breaks

Supplementary Plans: Date:

N/A- NEEDING SUPPORT WITH COMPLETING THIS SECTION***

Core Competency-Based Goals

Core Competency: Personal Awareness Goal: I can use strategies that help me manage my feelings and
emotions

Objective: I will demonstrate use of calm down Instructional Strategies: Classroom SEL program (Second Step),
strategies when I encounter non-preferred Super Flex/Social Detective program with EA and IST, mindful
emotions breathing practice, taking a break to use a calm down strategy,
front end loading before an antecedent, social stories with EA

Core Competency-Based Goals

Core Competency: Social Responsibility Goal: I am kind to others, can work or play co-operatively, and can
build relationships with peers of my choosing

Objective: I will develop friendships with peers Instructional Strategies:

MyEdBC Competency Based IEP Template v. XI


by learning how to enter and exit play scenarios
and unstructured time in the classroom.
Individual Education Plan
District/School? Logo Name of school and school Year
Front end loading by CT and EA, social stories (EA), Super
Flex/Social Detective program with EA and IST, social group
facilitated by IST, role play (EA)
*support with helping Sam develop some catch phrases or
sentence starters to build his confidence when approaching a
group to play/learn. Example "hey friends, I am done here, I am
going to move on to another activity", “hi ________, this looks like
a fun game/activity, can I join you?”.

Curricular Competency-Based Goals

Area of Learning: Math Teacher: / Support Staff: CT, EA

Big Idea: Development of computational fluency in addition and subtraction with numbers to 100 requires an
understanding of place value
Learning Standard: Develop mental math strategies and abilities to make sense of quantities
Objective: Add and subtract up to two-digit numbers Instructional Strategies:
Base 10 blocks, ten frames, 100s chart
Small group instruction (CT)

Objective: Explain and use mental math strategies to compute Instructional Strategies:
simple addition and subtraction facts Daily flash card practice (EA)
Small group instruction (CT)

Curricular Competency-Based Goals

Area of Learning: Writing Teacher: / Support Staff: CT, EA

Big Idea: Stories and other texts can be shared through pictures and words
Learning Standard: Communicate using sentences and most conventions of Canadian spelling, grammar, and
punctuation
Objective: Write in complete sentences Instructional Strategies:
Small group instruction (CT)
1-1 (EA & CT)
Objective: Correctly spell the 300 most commonly used words Instructional Strategies:
(Fry’s first 300 sight words) Personal writing dictionary
Words Their Way daily program & home practice of
word sorts

Additional Comments

MyEdBC Competency Based IEP Template v. XI