Seton 

Hill University

INDIVIDUALIZED EDUCATION PROGRAM (IEP)
School Age
 
Student's Name: Pearl H Richards  
IEP Team Meeting Date (mm/dd/yyyy): 5/11/2021
IEP Implementation Date (Projected Date when Services and Programs Will Begin): 5/12/2021
Anticipated Duration of Services and Programs: 5/10/2022

Date of Birth: 6/2/2012  
Age: 8
Grade: 4th
Anticipated Year of Graduation: 2029

Local Education Agency (LEA): Seton Hill University  
County of Residence: Luzerne County

Name and Address of Parent/Guardian/Surrogate:
  Mr. Stephen R Richards   Phone (Home): 7125560227   Email (Home): srichards0227@home.iep
1428 Fifth Boulevard   Phone (Work): 7124559227   Email (Work):

Leaderton, PA 18123   Phone (Cell):  

    Phone (Other):   Email (Other):
 
 
Name and Address of Parent/Guardian/Surrogate:
  Mrs. Sandra N Richards   Phone (Home): 7125560227   Email (Home): srichards0227@home.iep
1428 Fifth Boulevard   Phone (Work): 7125559227   Email (Work):

Leaderton, PA 18123   Phone (Cell):  

    Phone (Other):   Email (Other):

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    Pearl H Richards, SHU56227

Name and Address of Parent/Guardian/Surrogate:
 
 
Other Information:

The LEA and parent have agreed to make the following changes to the IEP without convening an IEP meeting, as documented by:

Date of Revision(s) Participants/Roles IEP Section(s) Amended

     
     
     

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    Pearl H Richards, SHU56227

IEP TEAM/SIGNATURES

The Individualized Education Program team makes the decisions about the student’s program and placement. The student’s parent(s), the student’s special education teacher, and a representative
from the Local Education Agency are required members of this team. Signature on this IEP documents attendance, not agreement.
Printed Name Role Signature
Sandra Richards Mother
Stephen Richards Father
Carly Meye Resource Room Teacher
Jim O'Leary Local Ed. Agency Rep. (Chair)
Laura O'Leary Regular Education Teacher
Pearl Richards Student
     
     
     

* The IEP team must invite the student if transition services are being planned or if the parents choose to have the student participate.
** If the student is, or may be, participating in the regular education environment
*** As determined by the LEA as needed for transition services and other community services
****A teacher of the gifted is required when writing an IEP for a student with a disability who also is gifted.
One individual listed above must be able to interpret the instructional implications of any evaluation results.

Written input received from the following members:

Transfer of Rights at Age of Majority

For purposes of education, the age of majority is reached in Pennsylvania when the individual reaches 21 years of age. Likewise, for purposes of the Individuals with Disabilities Education Act, the
age of majority is reached for students with disabilities when they reach 21 years of age.

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    Pearl H Richards, SHU56227

PROCEDURAL SAFEGUARDS NOTICE

I have received a copy of the Procedural Safeguards Notice during this school year. The Procedural Safeguards Notice provides information about my rights, including the process for disagreeing
with the IEP. The school has informed me whom I may contact if I need more information.

Signature of Parent/Guardian/Surrogate: ________________________________________________
Signature of Parent/Guardian/Surrogate: ________________________________________________
 

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    Pearl H Richards, SHU56227

I. SPECIAL CONSIDERATIONS THE IEP TEAM MUST CONSIDER BEFORE DEVELOPING THE IEP. ANY FACTORS CHECKED AS "YES" MUST
BE ADDRESSED IN THE IEP.

Is the student blind or visually impaired?
Image

The IEP must include a description of the instruction in Braille and the use of Braille unless the IEP team determines, after an evaluation of the student's reading and
description
. not
checked
End of
image
.description

 Yes
writing skills, needs, and appropriate reading and writing media (including an evaluation of the student's future needs for instruction in Braille or the use of Braille), that
instruction in Braille or the use of Braille is not appropriate for the student.
Image

 
description
. checked
End
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description
.

 No
 
Is the student deaf or hard of hearing?
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The IEP must include a communication plan to address the following: language and communication needs; opportunities for direct communications with peers and
description
. not
checked
End of
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description
.

 Yes
professional personnel in the student’s language and communication mode; academic level; full range of needs, including opportunities for direct instruction in the
student’s language and communication mode; and assistive technology devices and services. Indicate in which section of the IEP these considerations are addressed. The
Communication Plan must be completed and is available at www.pattan.net
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description
. checked
End
imageof
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.

 No
 
Does the student have communication needs?
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Student needs must be addressed in the IEP (i.e., present levels, specially designed instruction (SDI), annual goals, etc.)
description
. not
checked
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 Yes
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description
. checked
End
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.

 No
 
Does the student need assistive technology devices and/or services?
Image

Student needs must be addressed in the IEP (i.e., present levels, specially designed instruction, annual goals, etc.)
description
. not
checked
End of
image
description
.

 Yes
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description
. checked
End
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.

 No
 
Does the student have limited English proficiency?
Image

The IEP team must address the student’s language needs and how those needs relate to the IEP.
description
. not
checked
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description
.

 Yes
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description
. checked
End
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.

 No
 
Does the student exhibit behaviors that impede his/her learning or that of others?
Image

The IEP team must develop a Positive Behavior Support Plan that is based on a functional assessment of behavior and that utilizes positive behavior techniques. Results of
description
. not
checked
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 Yes
the functional assessment of behavior may be listed in the Present Levels section of the IEP with a clear measurable plan to address the behavior in the Goals and Specially
Designed Instruction sections of the IEP or in the Positive Behavior Support Plan if this is a separate document that is attached to the IEP. A Positive Behavior Support
Plan and a Functional Behavioral Assessment form are available at www.pattan.net
Image

 
description
. checked
End
imageof
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.

 No
 
Other
(specify):

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Include the following information related to the student:

• Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments,
   progress toward current goals)
Pearl is a 4th grade student who has been diagnosed with dyscalculia. She receives direct instruction in a learning support
classroom for math. On April 2, 2020 the WAIT (3rd edition) mathematical subsets were administered. Pearl scored 1.8
grade level equivalency in the area of Mathematical Reasoning and 2.0 grade level equivalency in the area of Numerical
Operations. On the PSSA, administered April 4, 2019, Pearl scored a 1082 which translates to below basic. Due to
COVID-19 restrictions, PSSA's were not administered during the 2019-2020 school year.

In the math classroom setting, Pearl has been successful across many disciplines. She has demonstrated the ability to add
and subtract 2 digit numbers (without regroupings), and solve single step word problems involving basic addition and
subtraction. She has memorized the basic facts for the 1s, 2s, 5s, and 10s of multiplication with aid from base 10 blocks.
Pearl can successfully identify the numerator and denominators of fractions. Simple addition and subtraction of fraction
with the same denominator can be completed; however, she has not worked with mixed numerals or multiplying
fractions. Pearl is able to identify pennies, quarters and their values with 91% accuracy. In class, she is adding coins to
reach a desired amount of $5.00 with an 89% accuracy rate. Pearl can tell time to the minute with a 56% accuracy. She
has the abilities to name the days of the week and months of the year chronologically, demonstrating a basic
understanding of calendar usage. In class, Pearl can compute elapsed time in terms of days and weeks.

In independent activities, Pearl is able to use a calculator. On a daily basis, she was expected to work independently for
at least 10-15 minutes. Her work output did decrease compared to one on one instruction, but she continued to work.

Pearl's previous IEP goals were divided into two categories: Math Computation and Math Applications. The Math
Computation goal was based off the Common Core Standard CCSS.2.1.6.E.2, "Given an assessment of thirty mathematic
computation problems, at a second-grade grade level, Pearl will be able to correctly solve 80% of the problems on 4 out
of 5 trials, over 3 consecutive bi-weekly assessments". Pearl did achieve this goal during the lifetime of this IEP. They
were able to achieve their target goal three weeks consecutively on the April 1st assessment. The Math Application goal
was based off the Common Core Standard CCSS.2.4.6,

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

• Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments,
   progress toward current goals)
“Given an assessment of twenty mathematic application problems at a second-grade level, Pearl will be able to correctly
answer 75% of the problems, on 4 out of 5 trials, over 3 consecutive bi-weekly assessments”. Pearl did achieve this
target goal. She was able to reach this target on the April 5th assessment.

Pearl does continue struggle with solving word problems. She can read the problems fluently with the ability to identify
key terms; however, she does not know which operation to employ to solve the problem. This was assessed at a 62%
success rate. We have decided to incorporate a word wall that has key terms that are related to operations. Pearl has said
that this has been an effective strategy, but our hope is to continue to deviate away from the word wall. This would allow
her to make connections on her own and not need a jumping off point. A second strategy that has been employed is
having Pearl write world problems for the class. Since she excels with writing, it is a way for her to make these
connections, while having fun.

In our curriculum this year, we have not spent many hours on geometry. We will be working on these skills in the second
half of the year. Looking at a report from last year's math progress monitoring, she is able to identify simple geometric
shapes and can solve problems involving perimeter and area of quadrilaterals.

Report from regular education teacher:

• Continues to work well in class

• Reads at a 4.5 grade level (Stanford Achievement test 9/11/21)

• Spelling work in the 4th grade workbook – writing on grade level – student’s work is consistently handed in on
time, and is high quality

• Went through MTSS beginning at the start of the school year. Still indicated a need for math instruction in a LS
environment

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

• Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments,
   progress toward current goals)
• Benefits from taking tests in separate room when math is assessed (especially in Science class)

• Benefits from modeling, visual cues paired with auditory information, repetition and extra skill practice

Report from general education teachers:
Social Studies and Science (Mrs.Thomas) ––

• In the classroom, continues to enjoy reading – will volunteer to read aloud in class as well as with her peers,
fluency is very smooth, high homework completion rate, works well in small groups
• Is a very energetic student
• Accommodations in the classroom – use of a planner, visual prompts for on-task performance

Reading/Language Arts (Mrs.Fluent) ––

• Loves reading short stories, poems, but is not interested in novels or books that take longer than a class session to
read. She is reading verbally (fluency) at a 4.5 grade level, and his comprehension was scored at a 4th grade level

• He has a solid grasp of the writing process. He is beginning to write very detail- oriented samples

• Accommodations in the classroom – use of a planner, paraeducator support (on task behavior

World Language (Mr.Hernandez) ––

• We meet once a week for 1 hour.
• She is extremely interested in class.
• So far we have covered basic German and French. She preferred French.

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

• Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments,
   progress toward current goals)
• Our next unit - Spanish -Is something that she is particularly interested in, as she reported that her grandparents
speak Spanish as their native language.

Physical Education (Ms.Fitt) ––

• We meet two times a week.

• She currently has a B in class.

• She does have appropriate coordination skills, as compared to her peers.

• She is a pleasure to have in class.

Music (Mr.Tune) ––

• We meet once a week.

• She loves music, and has particular interest in playing the drums.

• She currently has an A in class.

Art (Mr.Picasso) ––

• We meet weekly.

• She does enjoy drawing, and painting, but doesn't like the feel of working with materials with her hands
(especially wet clay). On those days, she is given the option to paint instead.

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

• Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments,
   progress toward current goals)

• She currently has an A.

• Present levels of functional performance  (e.g., results from a functional behavioral assessment, results of ecological assessments, progress toward current goals)
Pearl is a very social student with a core group of friends, but will interact with all of her classmates. She is able to
request and obtain necessary materials without aid and proves to be self-sufficient. If work is difficult, Pearl does well
verbally expressing her frustration. She strives to please the teacher and completes work independently. Pearl has yet to
miss any school days this year and only had 2 excused absences the previous school year.
Pearl has shown an interest in Social Studies, often participating and leading the class discussions. In Science class, she
will get discouraged when math is required. She is an active participant in art, music, and physical education classes.

There is no need for functional behavioral assessment at this time. Pearl's classroom behavior meets grade level
expectations. She works well with the classroom paraprofessional when Math skills are needed. She also responds well
to redirection when off task behaviors occur.

Pearl is involved with the following extra-curricular activities: Art Club, Intramural basketball, and Choir

• Present levels related to current postsecondary transition goals if the student's age is 14 or younger if determined appropriate by the IEP team (e.g., results of formative
assessments, curriculum-based assessments, progress toward current goals)
This section is not applicable due to Pearl not being of age.

• Parental concerns for enhancing the education of the student
An email received from Mr. & Mrs. Richards on April 20, 2021:

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

• Parental concerns for enhancing the education of the student
Thanks for the email Ms. Meye! We are extremely pleased with Pearl’s progress. Enrolling her in LS math class has truly
helped her. At home, we see that our daughter is becoming more confident with her math skills. We have incorporated
using hands-on materials to help her understand her concepts with her homework. This is something that last year's math
teacher really stressed that we do. She does have a scheduled time each night that she has to do her homework. Math
seems to be the last subject that she works on (she's not a fan). We, as parents, would love to see her improve with her
money and time skills. She loves to shop (LOL), and both skills will really help her out. WE are very open to any
resources you can provide to help Pearl in Math. Thank you for offering!!!! Thank you for the email, asking for our input
and more importantly, helping Pearl! Email communication works best for our hectic schedules. Just know we do check
everyday, and if we don't answer one of your emails right away, it will be answered at some point that day. We are
looking forward to working with you this year!!

Mrs. & Mr. Richards
• How the student's disability affects involvement and progress in the general education curriculum
Due to Pearl's specific learning disability in Mathematics, she continues to demonstrate unique needs in the area of math.
The IEP team has determined that it would be difficult for her to maintain the pace or the level of instruction in the
general education curriculum for math. All other instruction is delivered in the general education setting.
•Strengths
Strengths from learning support teacher:

• Is pleasant and cooperative on a daily basis

• Is motivated to improve his skills

• Works hard to complete assignments as directed

• Completes homework assignments on a daily basis

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

•Strengths
• Displays appropriate peer/ staff interactions

Strengths from general education teacher:

• Reads/writes at grade level

• Consistent in completing assignments

• Is a ‘pleaser’

• Academic, developmental, and functional needs related to student's disability
Needs from learning support teacher:

• Become more independent when solving word problems

• Improve ‘mental math’ skills in regards to addition, subtraction and multiplication in regards to automaticity

• Improve confidence as a ‘math’ student

• Improve his focus/ attention spans while completing independent work

Needs from general education teacher:

• Attention issues becoming more frequent

• Individualized Math instruction

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    Pearl H Richards, SHU56227

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (Continued)

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    Pearl H Richards, SHU56227

III. TRANSITION SERVICES - This is required for students age 14 or younger if determined appropriate by the IEP team.

If the student does not attend the IEP meeting, the school must take other steps to ensure that the student’s preferences and interests are considered. 
Transition services are a coordinated set of activities for a student with a disability that is designed to be within a results oriented process, that is focused on improving 
the academic and functional achievement of the student with a disability to facilitate the student’s movement from school to post school activities, including postsecondary 
education, vocational education, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community 
participation that is based on the individual student’s needs taking into account the student’s strengths, preferences, and interests.

POST SCHOOL GOALS - Based on age appropriate assessment, define and project the appropriate measurable postsecondary goals that address education and training, employment, and
as needed, independent living. Under each area, list the services/activities and courses of study that support that goal. Include for each service/activity the location, frequency, projected
beginning date, anticipated duration, and person/agency responsible.

For students in Career and Technology Centers, CIP Code:  

Postsecondary Education and Training Goal: Not applicable due to student's age Measurable Annual Goal
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 Yes /   No
(Document in Section V)
Courses of Study:
Service/Activity Location Frequency Projected Anticipated Person(s)/Agency
Beginning Date Duration Responsible
           
           

Employment Goal: Not applicable due to student's age Measurable Annual Goal
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 Yes /   No
(Document in Section V)
Courses of Study:
Service/Activity Location Frequency Projected Anticipated Person(s)/Agency
Beginning Date Duration Responsible
           
           

February 1, 2020 5/11/2021 Page 14 of 28

    Pearl H Richards, SHU56227

III. TRANSITION SERVICES (Continued)

Independent Living Goal, if appropriate: Not applicable due to student's age Measurable Annual Goal
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 Yes /   No
(Document in Section V)
Courses of Study:
Service/Activity Location Frequency Projected Anticipated Person(s)/Agency
Beginning Date Duration Responsible
           
           

February 1, 2020 5/11/2021 Page 15 of 28

    Pearl H Richards, SHU56227

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS
Instructions for IEP Teams:
Please select the appropriate assessment option. Information on available testing accommodations may be found in the Accommodations Guidelines available on www.education.pa.gov.

State Assessments

Not Assessed
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No statewide assessment is administered at this student’s grade level
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No English proficiency assessment administered because the student is not an English Learner.
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PSSA (Math and English Language Arts (ELA) administered in grades 3-8; Science administered in grades 4 and 8)
Tested Subject Without With Accommodations to be Provided
Accommodations Accommodations
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Calculator
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Extended time
Visual/Graphic Organizers
Small group setting  
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Calculator
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Extended time
Small group setting
Visual/Graphic Organizers  
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Keystone Exam (Replaces the 11th grade PSSA in high school; Student must participate by 11th grade)
Tested Subject Without With Accommodations to be Provided
Accommodations Accommodations
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Algebra I End of End of

 
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Literature
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Biology
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    Pearl H Richards, SHU56227

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS (Continued)

Keystone Project Based Assessment (Available when student is unable to demonstrate proficiency on a Keystone Exam or Keystone Exam module.)
Tested Subject Without With Accommodations to be Provided
Accommodations Accommodations
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Algebra I End of End of

 
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Literature
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Biology
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Validated Local Assessment (Available when selected as option by LEA)
Tested Subject Without With Accommodations to be Provided
Accommodations Accommodations
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Algebra I End of End of

 
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Literature
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Biology
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February 1, 2020 5/11/2021 Page 17 of 28

    Pearl H Richards, SHU56227

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS (Continued)

PASA (Administered in grades 3-8, 11 for English Language Arts (ELA) and Math; Grades 4, 8, 11 for Science)

Student will participate in the PASA:

The IEP team must review each of Pennsylvania’s 6 eligibility criteria to determine participation in the PASA. The IEP team must answer “YES” to ALL six criteria in order for the student to
participate in the PASA. If the answer is “NO” to any of the questions, the student must participate in the PSSA/ Keystones with or without accommodations, as determined appropriate by the
IEP team.

1. Will the student be in grade 3,4,5,6,7,8, or 11 by September 1st of the school year during which the IEP will be operative?
2. Does the student have significant cognitive disabilities? Pennsylvania defines significant cognitive disabilities as pervasive and global in nature, affecting student learning in all
academic content areas, as well as adaptive behaviors and functional skills across life domains.
3. Does the student require intensive, direct, and repeated instruction in order to learn and generalize academic, functional, and adaptive behavior skills across multiple settings?
4. Does the student require extensive adaptations and support in order to perform and/or participate meaningfully and productively in the everyday life activities of integrated school,
home, community, and work environments?
5. Does the student require substantial modifications to the general education curriculum?
6. Does the student’s participation in the general education curriculum differ substantially in form and/or substance from that of most other students? Students found eligible to take the
PASA must have measurable annual goals AND short-term objectives reflected in the IEP.

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Student will participate in the PASA.
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Explain why the student cannot participate in the PSSA or the Keystone Exams, even with accommodations:

Explain why the PASA is appropriate considering the six eligibility criteria:

Explain any specific accommodations the student may require on the PASA (i.e. Assistive Technology, Signing):

February 1, 2020 5/11/2021 Page 18 of 28

    Pearl H Richards, SHU56227

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS (Continued)

ACCESS for ELs (Administered in grades K-12)
Domains Without With Unable to Accommodations to be Provided or Rationale for Inability to Participate in Selected Domains
Accommodations Accommodations Participate
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Listening End of End of End of

 
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Reading End of End of End of

 
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Writing End of End of End of

 
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Speaking
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Alternate ACCESS for ELs (Administered in grades 1-12)
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Student will participate in the Alternate ACCESS for ELs.
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Explain why the student cannot participate in the ACCESS for ELs:

Explain why the Alternate ACCESS for ELs is appropriate:

Domains Without With Unable to Accommodations to be Provided or Rationale for Inability to Participate in Selected Domains

Accommodations Accommodations Participate
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Listening End of End of End of

 
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Reading End of End of End of

 
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Writing
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Speaking
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February 1, 2020 5/11/2021 Page 19 of 28

    Pearl H Richards, SHU56227

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS (Continued)

Local Assessments
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Local assessment is not administered at this student's grade level; OR
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Student will participate in local assessments without accommodations; OR
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Student will participate in local assessments with the following accommodations; OR
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  Pearl will be granted the following accommodations:

• Extended time

• Use of a calculator

• Small group

• Visual/graphic organizers

• Manipulatives

• Allow for breaks
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The student will take a local alternate assessment.
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  Explain why the student cannot participate in the local regular assessment:

Explain why the local alternate assessment is appropriate:

February 1, 2020 5/11/2021 Page 20 of 28

    Pearl H Richards, SHU56227

V. GOALS AND OBJECTIVES
Include, as appropriate, academic and functional goals. Use as many copies of this page as needed to plan appropriately. Specially designed instruction may be listed with each goal/objective or 
listed in Section VI.

Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the student's gifted program  may be listed under Goals or Short Term Objectives.

MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN

Include: Condition, Name, Behavior, and Criteria student's progress toward periodic
(Refer to Annotated IEP for description of these components) meeting this goal will be reports on progress
measured will be
provided to parents

Given an analog clock weekly, Pearl will correctly tell the time to the minute 80% of Teacher charting Quarterly

the time on 4 of 5 trials.

Report of Progress

Goal Specific SDI

SHORT TERM OBJECTIVES - Required for students with disabilities who take an alternate assessment aligned to alternate achievement standards (PASA).
Short term objectives / Benchmarks Level of Achievement Method of Evaluation Report of Progress
       
       

February 1, 2020 5/11/2021 Page 21 of 28

    Pearl H Richards, SHU56227

V. GOALS AND OBJECTIVES (Continued)

MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN

Include: Condition, Name, Behavior, and Criteria student's progress toward periodic
(Refer to Annotated IEP for description of these components) meeting this goal will be reports on progress
measured will be
provided to parents

Given a sheet of 10 word problems involving addition, subtraction, multiplication, and Teacher made Quarterly

division bi-weekly, Pearl will correctly solve 8 of the problems, on 4 of 5 trials. assessment

Report of Progress

Goal Specific SDI

SHORT TERM OBJECTIVES - Required for students with disabilities who take an alternate assessment aligned to alternate achievement standards (PASA).
Short term objectives / Benchmarks Level of Achievement Method of Evaluation Report of Progress
       
       

February 1, 2020 5/11/2021 Page 22 of 28

    Pearl H Richards, SHU56227

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS
Include, as appropriate, for nonacademic and extracurricular services and activities.

A. PROGRAM MODIFICATIONS AND SPECIALLY DESIGNED INSTRUCTION (SDI)
• SDI may be listed with each goal or as part of the table below.
• Include supplementary aids and services as appropriate.
• For a student who has a disability and is gifted, SDI also should include adaptations, accommodations, or modifications to the general education curriculum, 
as appropriate for a student with a disability.

Modifications and SDI Location Frequency Projected Beginning Date Anticipated Duration
Learning Support Seton Hill University Daily 5/12/2021 5/10/2022
Instruction in Math
Modeling, visual cues Seton Hill University As needed 5/12/2021 5/10/2022
paired with auditory
information, repetition
and extra skill practice
Tests/quizzes in a small Seton Hill University As requested by the student 5/12/2021 5/10/2022
group in a separate
classroom as deemed
necessary by the student
Provide calculator Seton Hill University As requested by the student 5/12/2021 5/10/2022
Access to manipulatives Seton Hill University As needed 5/12/2021 5/10/2022
in all classes when math
is involved

B. RELATED SERVICES - List the services that the student needs in order to benefit from his/her special education program.

None at this time.

February 1, 2020 5/11/2021 Page 23 of 28

    Pearl H Richards, SHU56227

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS (Continued)

C. SUPPORTS FOR SCHOOL PERSONNEL - List the staff to receive the supports and the supports needed to implement the student's IEP.

School Personnel to Support Location Frequency Projected Beginning Date Anticipated Duration
Receive Support
Regular Education Access to IEP Seton Hill University Daily 5/12/2021 5/10/2022
Teacher
Regular Education Classroom Aid Seton Hill University As requested 5/12/2021 5/10/2022
Teacher Support
Para-professional Training Seton Hill University Annually 5/12/2021 5/10/2022

D. GIFTED SUPPORT SERVICES FOR A STUDENT IDENTIFIED AS GIFTED WHO ALSO IS IDENTIFIED AS A STUDENT WITH A DISABILITY - Support services are required
to assist a gifted student to benefit from gifted education (e.g., psychological services, parent counseling and education, counseling services, transportation to and from gifted programs to
classrooms in buildings operated by the school district).

None at this time.

E. EXTENDED SCHOOL YEAR (ESY) - The IEP team has considered and discussed ESY services, and determined that:
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Student IS eligible for ESY based on the following information or data reviewed by the IEP team:
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OR
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of

As of the date of this IEP, student is NOT eligible for ESY based on the following information or data reviewed by the IEP team:
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Data was collected on Pearl's measurable annual goals to determine if eligible to receive ESY. The collected data and
other required factors for consideration concluded that Pearl does not qualify for ESY services.  
The Annual Goals and, when appropriate, Short Term Objectives from this IEP that are to be addressed in the student's ESY Program are:

February 1, 2020 5/11/2021 Page 24 of 28

    Pearl H Richards, SHU56227

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS (Continued)

If the IEP team has determined ESY is appropriate, complete the following:
ESY Service to be Provided Location Frequency Projected Beginning Date Anticipated Duration
         
         
         

February 1, 2020 5/11/2021 Page 25 of 28

    Pearl H Richards, SHU56227

VII. EDUCATIONAL PLACEMENT
A. QUESTIONS FOR IEP TEAM - The following questions must be reviewed and discussed by the IEP team prior to providing the explanations regarding participation with students without 
disabilities.

It is the responsibility of each public agency to ensure that, to the maximum extent appropriate, students with disabilities, including those in public or private institutions or other care facilities, 
are educated with students who are not disabled. Special classes, separate schooling or other removal of students with disabilities from the general educational environment occurs only when 
the nature or severity of the disability is such that education in general education classes, EVEN WITH the use of supplementary aids and services, cannot be achieved satisfactorily.
• What supplementary aids and services were considered?
   
• What supplementary aids and services were rejected?
   
• Explain why the supplementary aids and services will or will not enable the student to make progress on the goals and objectives (if applicable) in this IEP in the
general education class.
   
• What benefits are provided in the general education class with supplementary aids and services versus the benefits provided in the special education class?
   
• What potentially beneficial effects and/or harmful effects might be expected on the student with disabilities or the other students in the class, even with supplementary aids and
services?
   
• To what extent, if any, will the student participate with nondisabled peers in extracurricular activities or other nonacademic activities?
   

Explanation of the extent, if any, to which the student will not participate with students without disabilities in the regular education class:
Pearl will receive direct instruction in Math in a learning support classroom. All other instruction is delivered in the general
education environment.
Explanation of the extent, if any, to which the student will not participate with students without disabilities in the general education curriculum:
Even though math instruction is delivered in learning support classroom, Pearl will be working with the regular education
curriculum for math.

February 1, 2020 5/11/2021 Page 26 of 28

    Pearl H Richards, SHU56227

VII. EDUCATIONAL PLACEMENT (Continued)

B. Type of Support
1. Amount of special education supports
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Itinerant: Special education supports and services provided by special education personnel for 20% or less of the school day
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.

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End of

Supplemental: Special education supports and services provided by special education personnel for more than 20% of the day but less than 80% of the school day
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Full-Time: Special education supports and services provided by special education personnel for 80% or more of the school day
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2. Type of special education supports
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 Autistic Support
.

 Gifted Support
.

 Multiple Disabilities Support
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 Blind or Visually Impaired Support  Learning Support
.

 Physical Support
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 Deaf or Hearing Impaired Support  Life Skills Support  Speech and Language Support

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 Emotional Support

C. Location of student's program
Name of School District where the IEP will be implemented: PHILADELPHIA CITY SD
Name of School Building where the IEP will be implemented: SHU_Advanced_School

Is this school the student’s neighborhood school (i.e., the school the student would attend if he/she did not have an IEP)?
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 Yes
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 No
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Special education supports and services required in the student's IEP cannot be provided in the neighborhood school
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Other. Please explain:
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February 1, 2020 5/11/2021 Page 27 of 28

    Pearl H Richards, SHU56227

VIII. PENNDATA REPORTING: Educational Environment (Complete either Section A or B; Select only one Educational Environment)
To calculate the percentage of time inside the regular classroom, divide the number of hours the student spends inside the regular classroom by the total number of hours in the school day (including
lunch, recess, study periods). The result is then multiplied by 100.

SECTION A: For Students Educated in Regular School Buildings with Nondisabled Peers - Indicate the percentage of time INSIDE the regular classroom for this student:

Time spent outside the regular classroom receiving services unrelated to the student's disability (e.g., time receiving ESL services) should be considered time inside the regular classroom.
Educational time spent in age-appropriate community-based settings that include individuals with and without disabilities, such as college campuses or vocational sites, should be counted as time
spent inside the regular classroom.

Calculation for this Student:
Column 1 Column 2 Calculation Indicate Percentage Percentage Category
Total hours the student Total hours in a typical (Hours inside regular classroom Section A: The percentage of Using the calculation result -
spends in the regular school day (including ÷ hours in school day) x 100 = % time student spends inside select the appropriate percentage category
classroom per day lunch, recess & study periods) (Column 1 ÷ Column 2) x 100 = % the regular classroom:
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    INSIDE the Regular Classroom 80% or More of the Day
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5.30 6.50 (5.30 ÷ 6.50) x 100 = % 82.00% of the day

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  INSIDE the Regular Classroom 79-40% of the Day
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  INSIDE the Regular Classroom Less Than 40% of the Day 

SECTION B: This section required only for Students Educated OUTSIDE Regular School Buildings for more than 50% of the day - select and indicate the Name of School or Facility
on the line corresponding with the appropriate selection: (If a student spends less than 50% of the day in one of these locations, the IEP team must do the calculation in Section A)
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  Early Intervention   Approved Private School (Non Residential)
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  Other Public Facility (Non Residential)
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  Approved Private School (Residential)
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  Hospital/Homebound
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  Other Private Facility (Non Residential)
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  Correctional Facility
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  Other Private Facility (Residential)
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  Out of State Facility       .description

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  Other Public Facility (Residential)
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  Instruction Conducted in the Home

EXAMPLES for Section A: How to Calculate PennData – Educational Environment Percentages
  Column 1 Column 2 Calculation Indicate Percentage
(Hours inside regular classroom ÷ hours in
Total hours the student spends in the Total hours in a typical school day Section A: The percentage of time student
  school day) x 100 = %
regular classroom – per day (including lunch, recess & study periods) spends inside the regular classroom:
(Column 1 ÷ Column 2) x 100 = %
Example 1 5.5 6.5 (5.5 ÷ 6.5) x 100 = 85% 85% of the day (Inside 80% or More of Day)
Example 2 3 5 (3 ÷ 5) x 100 = 60% 60% of the day (Inside 79-40% of Day)
Example 3 1 5 (1 ÷ 5) x 100 = 20% 20% of the day (Inside less than 40% of Day)
For help in understanding this form, an annotated IEP is available on the PaTTAN website at www.pattan.net  Type "Annotated Forms" in the Search feature on the website. If you do not have
access to the Internet, you can request the annotated form by calling PaTTAN at 800-441-3215.

February 1, 2020 5/11/2021 Page 28 of 28