Professional Documents
Culture Documents
STATE OF NEVADA
INFORMATION
STUDENT/PARENT INFORMATION ELIGIBILITY CATEGORY MEETING INFORMATION
Student G,Rita Sex Female Autism Spectrum Disorder DATE OF MEETING 08/16/2021
DATE OF LAST IEP MEETING NA
Birthdate 08/20/2012 Grade 03 Student ID # 12345678 Deaf/Blind
Student Primary Language English PURPOSE OF MEETING
Developmental Delay
Student English Proficiency Code (optional) Interim IEP
Emotional Disturbance
✔ Initial IEP
Address 123 Horizon Circle, Henderson, NV 89052 Health Impairment
Student Phone NA Annual IEP
Hearing Impairment/Deaf
IEP Following 3-Yr Reevaluation
Intellectual Disability
Parent/Guardian/Surrogate Mrs G (mother) Revision To IEP Dated
Multiple Impairment
Parent Phone (Home) (702)123-4567 (Work) (702)213-4567 Exit/Graduation
Orthopedic Impairment
Optional: Cell NA Email mrsritag@yahoo.com
IEP Revision Without A Meeting:
✔ Specific Learning Disability
Primary Language Spoken at Home English At the request of : Parent or ✔ School District
Speech/Language Impairment
LEP Status Not LEP Other
Federal Placement Code NA Traumatic Brain Injury
IEP SERVICES WILL BEGIN 08/16/2021
Federal Student Ethnicity Code NA Visual Impairment/Blind
ANTICIPATED
Interpreter or Other Accommodations Needed No ELIGIBILITY DATE 08/16/2021 DURATION OF SERVICES 08/15/2022
Emergency Contact/Phone Number (702)312-4567 ANTICIPATED IEP REVIEW DATE 08/15/2022
3-YR REEVALUATION 08/15/2024
Current School 123: Jones ES Zoned School COMMENTS
IEP PARTICIPATION
Parent/Guardian/Surrogate* Mrs G (mother) Speech/Language Therapist/Pathologist/Specialist
Student** Rita G School Nurse
LEA Representative* Mrs Young Interpreter
Special Education Teacher* Mrs Resource Other (name and role)
Regular Education Teacher*** Mr Mild Other (name and role)
School Psychologist Mrs Wellman Other (name and role)
*Required participant.
** Student must be invited when transition is discussed (beginning at age 14 or younger if appropriate).
***The IEP team must include at least one regular education teacher of the student (if the student is, or may be, participating in the regular education environment).
PROCEDURAL SAFEGUARDS
✔ I have received a statement of procedural safeguards under the Individuals with Disabilities Education Act (IDEA) and these rights have been explained to me in my primary language.
Parent Signature
AT LEAST ONE YEAR PRIOR TO REACHING AGE 18, STUDENTS MUST BE INFORMED OF THEIR RIGHTS UNDER IDEA AND ADVISED THAT THESE RIGHTS WILL TRANSFER TO THEM AT AGE 18.
✔ Not applicable. Student will not be 18 within one year, and the student's next annual IEP meeting will occur no later than the student's 17th birthday.
The student has been informed of his/her rights under IDEA and advised of the transfer of these rights at age 18.
academic achievement, language/communication skills, social/emotional/behavior skills, cognitive abilities, health, motor skills, adaptive skills, pre-vocational skills, vocational skills, and other skills as
appropriate. For students who are 16 or older, or will turn 16 when this IEP is in effect, also consider the results of age appropriate transition assessments related to training/education, employment,
ASSESSMENTS CONDUCTED ASSESSMENT RESULTS EFFECT ON STUDENT'S INVOLVEMENT AND PROGRESS IN GENERAL EDUCATION
CURRICULUM OR, FOR EARLY CHILDHOOD STUDENTS, INVOLVEMENT IN
DEVELOPMENTAL ACTIVITIES
All assessments WISC-111: Rita's overall performance of full scale IQ score of 109 was
administered by Full Scale IQ: 109 within the average range, although her verbal and
Multidisciplinary Team Verbal IQ: 128 performance IQ scores suggest a discrepancy between her
(MDT) Performance IQ: 87 verbal and performance abilities, impacting her academic
progress.
Reading: Brigance Rita's word identification, phonics, and Students in 3rd grade are expected to read and comprehend
Comprehensive reading vocabulary skills are at an grade appropriate texts. Rita's deficits in reading
Inventory of Basic adequate level. Reading comprehension impact her progress with the general
Skills - Revised, comprehension, particularly when using education curriculum.
Peabody Individual higher conceptual skills placed Rita at
Achievement an independent reading comprehension
Test-Revised level of 2nd grade.
(PIAT-R), Woodcock
Reading Mastery
Tests - Revised, Gray
Oral Reading Tests Rita is left-handed and has always Third grade students are expected to transition from
(3rd Edition) struggled with the visual-motor skill of manuscript to cursive writing, which Rita has resisted. Rita's
writing. Tall and small letters are the deficits in handwriting impact her progress with the general
Handwriting: Brigance same size, and her work is usually education curriculum.
Comprehensive illegible. Written expression could not
Inventory of Basic be assessed due to extremely poor
Skills - Revised handwriting skills.
Maths: Brigance Rita's most significant math difficulties Rita struggles to organize herself to think through math word
Comprehensive were in numerical reasoning, word problems and consider what operations are required. She has
Inventory of Basic problems. She also scored poorly in a tendency to give up as soon as a task becomes challenging.
Skills - Revised, addition, subtraction and multiplication.
PIAT-R Rita's math score indicated her
performance was 1.5 to 2 years below
her current grade.
STATEMENT OF STUDENT'S PREFERENCES AND INTERESTS (required if transition services will be discussed, beginning at age 14 or younger if appropriate)
Mrs G told the MDT Rita enjoys watching television, playing with her younger sister and her sister's friend, and eating. She earns
money by taking out the garbage and spends it on candy. Rita's favorite subject is music and she dislikes gym and arithmetic.
If student was not in attendance, describe the steps taken to ensure that the student's preferences and interests were considered:
1. Does the student's behavior impede the student's learning or the learning of others? ✔ No. Yes.
If YES, IEP committee must provide positive behavioral strategies, supports and interventions, or other strategies, supports and interventions to address that
behavior.
Addressed in IEP.
2. Does the student require assistive technology devices and services? ✔ No. Yes.
If YES, IEP committee must determine nature and extent of devices and services.
Addressed in IEP.
If YES, IEP committee must consider the following (check box if IEP committee considered the item):
Language needs of the student as those needs relate to the student's IEP.
5. Does the student have communication needs that require IEP services? ✔ No. Yes.
Addressed in IEP.
The availability to the student of a sufficient number of age, cognitive, academic and language peers of similar abilities.
The availability to the student of adult models who are deaf or hearing impaired and who use the student’s primary communication mode.
The availability of special education teachers, interpreters and other special education personnel who are proficient in the student’s primary communication mode.
The provision of academic instruction, school services and direct access to all components of the educational process, including, without limitation, advanced
placement courses, career and technical education courses, recess, lunch, extracurricular activities and athletic activities.
The preferences of the parent or guardian of the student concerning the best feasible services, placement and content of the student’s IEP.
The appropriate assistive technology necessary to provide the student with an appropriate and equal opportunity for communication access.
7. Does the student have a Specific Learning Disability and Dyslexia? No. ✔ Yes.
If YES, the IEP committee must consider the following instructional approaches (check box if IEP committee considered the item):
✔ Explicit, direct instruction that is systematic, sequential and cumulative and follows a logical plan of presenting the alphabetic principle that targets the specific needs of
the student.
✔ Individualized instruction to meet the specific needs of the student in an appropriate setting that uses intensive, highly-concentrated instruction methods and materials
that maximize student engagement.
✔ Meaning-based instruction directed at purposeful reading and writing, with an emphasis on comprehension and composition.
✔ Multisensory instruction that incorporates the simultaneous use of two or more sensory pathways during teacher presentations and student practice.
TRANSITION
DIPLOMA OPTION SELECTED FOR GRADUATION (Diploma option must be declared at age 14 and reviewed annually.)
Standard or Advanced High School Diploma. Must complete all applicable credit Adjusted High School Diploma. Must complete IEP requirements.
requirements and participate in a College and Career Readiness Assessment.
Alternative High School Diploma. Must complete all applicable credit requirements and participate in the Nevada Alternate Assessment.
Training/Education
Employment
Other
Instruction
Related Services
Community Experiences
Acquisition of Daily Living Skills and Functional Vocational Evaluation (if appropriate)
IEP GOALS, INCLUDING ACADEMIC AND FUNCTIONAL GOALS, AND BENCHMARKS OR SHORT-TERM OBJECTIVES
MEASURABLE ANNUAL GOAL (including how progress toward the annual goal will be measured) PROGRESS REPORT
1. Satisfactory Progress Being Made (continue)
Check here if this goal supports the student's postsecondary goal(s) and identify the goal(s) to which it relates:
2. Unsatisfactory Progress Being Made
(need to review/revise)
Training/Education Employment Independent Living Skills Other
3. Goal Met (note date)
Check here if this goal will be addressed during Extended School Year Services (ESY) Date Date Date Date
Solve problem.
Includes aids, services, and other supports provided in regular education classes, other education-related settings (including special education settings), and in
extracurricular and nonacademic settings to enable students with disabilities to be educated with nondisabled students to the maximum extent appropriate.
MODIFICATION, ACCOMMODATION, OR SUPPORT FOR STUDENT OR PERSONNEL BEGINNING AND FREQUENCY OF LOCATION OF
Provide specific description(s) below. ENDING DATES SERVICES SERVICES
All content area materials and tests to be read aloud 08/16/2021 - 08/15/2022 During assignments & tests General Ed Classroom
All content area materials and tests to be read aloud 08/16/2021 - 08/15/2022 During assignments & tests Resource Room
Take tests in the Resource Room to allow small group setting, have test read aloud, and extended time 08/16/2021 - 08/15/2022 During assessments Resource Room
Graphic organizer/word wall with vocabulary 08/16/2021 - 08/15/2022 Writing assignments General Ed Classroom
Graphic organizer/word wall with vocabulary 08/16/2021 - 08/15/2022 Writing assignments Resource Room
Math visuals (number line, 100s chart, addition/multiplication charts) 08/16/2021 - 08/15/2022 Independent math/assessments General Ed Classroom
Math visuals (number line, 100s chart, addition/multiplication charts) 08/16/2021 - 08/15/2022 Independent math/assessments Resource Room
PLACEMENT
PLACEMENT CONSIDERATIONS PERCENTAGE OF TIME
IN REGULAR EDUCATION ENVIRONMENT
Selected ✔ Rejected Regular class with supplementary aids and services (no removal)
Selected Rejected Regular class and special education class (e.g., resource) combination The student will spend 80 % of his or her school day in
Selected Rejected Self-contained program the regular education environment.
Selected Rejected Special school
Selected Rejected Residential
Selected Rejected Hospital
Selected Rejected Home
Selected Rejected Other
*Regular education environments include academic classes (which might include field trips linked to the curriculum), nonacademic settings (such as recess), and extracurricular activities (for
example, sports, after-school clubs, band, etc.).
IEP IMPLEMENTATION
As the parent, I agree with the components of this IEP. I understand that its provisions will be implemented as soon as possible after the IEP goes into effect.
As the parent, I disagree with all or part of this IEP. I understand that the school district must provide me with written notice of any intent to implement this IEP. If I wish to prevent the implementation of this IEP,
I must submit a written request for a due process hearing to the local school district superintendent.
Parent Signature
A copy of this IEP was provided to the studentʼs parent on: _________________________ by _________________________________________________________
(date) (name) (title)