Student: Allison

Brief Historical and Referral History: (5 sentence minimum that gives a good understanding of
Allison’s history)
Allison is a 6-year-old kindergarten student who has been diagnosed as falling on the Autism
Spectrum. Allison has difficulties with language skills, and being able to identify pictures of a
more abstract nature that is on par with kindergarten development. While her cognitive and
language development are behind, she is socially able to hold basic conversations with her peers
and has progressed well in her peer interactions as well. While she does need a small bit of
guidance in this area, she seems interested in pursuing it. Her parents would like to see her
develop these relationship and peer skill in a more meaningful and deeper way.

Goals: Each goal needs to be filled out completely with each goal being written in SMART form.
Please complete all 3 goals based on Allison’s needs.

Goal 1:

Area of need:
English Language Arts

Idaho Common Core Content Standard (or statement of goal objective for social/functional goals):
https://www.sde.idaho.gov/academic/standards/
RF.K.3 Know and apply grade-level phonics and word analysis
skills in decoding words.
a. Demonstrate basic knowledge of one-to-one letter sound correspondences by producing the
primary or many of the most frequent sound for each consonant.
b. Associate the long and short sounds with common spellings (graphemes) for the five major vowels.

Present Level of Performance:

Unable to identify upper- and lower-case letters consistently

Annual Goal:
Allison will be able to identify letters A-Z and the corresponding sound with minimal error on the
commonly mixed-up letters (ex. b/d, p/q/g) by next annual review.

Evaluation Procedure/Assessment Method

We will assess Allison’s progress through oral tests, and grades on various assignments.

Goal 2:

Area of need:
Social Speaking and Listening Skills
Idaho Common Core Content Standard (or statement of goal objective for social/functional goals):
https://www.sde.idaho.gov/academic/standards/
SL.K.1 Participate in collaborative conversations with diverse partners about kindergarten topics and
texts with peers and adults in small and larger groups.
a. Follow agreed-upon rules for discussions (e.g., listening to others and taking turns speaking about
the topics and texts under discussion).
b. Continue a conversation through multiple exchanges.

Present Level of Performance:

Allison currently has shown an interest in social relationships but is unsure how to form them. She
struggles with being able to identify human emotion and social cues presented by peers.

Annual Goal:
Allison will be able to hold meaningful peer interaction with minimal adult interaction. She will be able
to listen well and speak with others in turn with 3 interruptions per 3 consecutive tries by the next
annual IEP review.

Evaluation Procedure/Assessment Method

Allison will have access to various forms of communication, both individual and assisted. She will have
adult aide when needed to help her learn to form a bridge of communication with peers. She will also
be given a space to go to in case she needs to be alone to think out how she wants to proceed. We will
asses her progress by asking her how she feels she is doing with creating relationships with peers.

Goal 3:

Area of need:
Mathematics

Idaho Common Core Content Standard (or statement of goal objective for social/functional goals):
https://www.sde.idaho.gov/academic/standards/
K.CC. 1. Count to 100 by ones and by tens

Present Level of Performance:

Able to consistently identify numbers 1-5.

Annual Goal:
By the time of the next annual IEP review, Allison will be able to correctly identify numbers 1-100 with
4-5 errors within 3 consecutive tries.

Evaluation Procedure/Assessment Method

We will assess Allison’s progress through evaluation of number identification with flash cards.
 IEP Service and LRE

Please list out the special education services you believe Allison needs to successfully support her.
You will need to have at least 3 services fully filled out.

Service: Where the services will be: Minutes per Week:

(ie: Resource Room/Gen Ed Classroom/ Therapy Room)
Will be in the Gen Ed classroom
Reading in small Early Reading Intervention 150 minutes/ week
groups.
Social Speaking Therapy Room for part of week 150 minutes/week
And Listening Skills
Mathematics Gen Ed Classroom with aide 150 minutes/week

Please give a brief description justifying the need of these services. Within your description on
how this is the best placement, include a statement on how each of the services will support
Allison’s Least Restrictive Environment.
Allison will need to go to the therapy room once a day to help reinforce the skills she will need to
develop to interact properly with her peers. As is, she is struggling to identify human emotions, and
help from the therapy room will ensure she creates better social relationships later.

IEP ACCOMMODATIONS

Accommodations, Adaptations, Assistive Technology and or Supports

Please list out 5-6 accommodations that would help Allison successfully access the general education
setting and/or curriculum. Along with the accommodation, you need to list why you believe this
support is necessary for her.

And Aide to help with mathematic identification and possible social intervention as needed. This will
help Allison to catch up in her numbers and be there to help with any social interaction that she may
be struggling with. The aide is to be there to help, not to do things for her.
Flashcards and other forms of physical letter learning such as shaped blocks to help reinforce a
learning style she may be more receptive to.
Audio/Visual references for number learning (such as YT videos and songs).
A white board for her to write on if electronics are too overwhelming for her. This can giver her a
second form of communication if she finds that she is struggling.
Audio Visual media for letter learning (such as YT videos and songs) to help reinforce a learning style
she may be more receptive to.