IEP Performance Template Steps 2-7

Individualized Education Program (IEP) Performance
Template
© 2019. Grand Canyon University. All Rights Reserved.

Table of Contents
Table of Contents......................................................................................................2
Standard 1: Contextual Factors: School and Community Demographics, Classroom
Demographics, Building Trust Relationships, and Classroom Management............3
Standard 2: Individualized Education Plan – Part 1..................................................4
Standard 3: Individualized Education Plan - Part 2.................................................12
Standard 4: Preparation for IEP Meeting................................................................17
Standard 5: Implementation, Communication, and Progress Reporting.................23
Standard 6: Revised IEP..........................................................................................25
Standard 7: Reflection of the IEP Process...............................................................26
© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 29

Standard 1: Contextual Factors: School and Community Demographics,
Classroom Demographics, Building Trust Relationships, and Classroom
Management
The IEP Performance Standards is the process for preparing and implementing the IEP
process. This template will be used to address specific standards and go through the process
of creating an IEP for a student in your placement.
Part I: Community, District, School, and Classroom Factors

Complete this portion of the IPE Template document using the following link:
Standard 1, Part I
After completing the e-doc portion, submit the PDF you receive into the digital classroom.
Part II: Demographic, Environment, and Academic Factors

Complete this portion of the IEP Template document using the following link:
Standard 1, Part II
After completing the e-doc portion, submit the PDF you receive into the digital classroom.
In order to submit this assignment, you must:

1. Complete each section of Standard 1.
Note: Closing your internet browser before the signing process is completed will result in
a loss of your work. If you will be completing this document in multiple sittings, it is
highly recommended to save and back up your work on another document. When you
are ready to make your final submission, copy and paste your responses into this
document. The data from this electronic document will not be saved until you complete
the signing process.
2. Complete the signing process by entering your name, selecting “Click to Sign,” and
entering your email address.
 An initial email will be sent to you to confirm your email address.
 A completed copy of the document will be emailed to you within minutes of
confirming your email address.
3. After completing the e-doc portion, submit the PDF you receive into the digital
classroom.

Standard 2: Individualized Education Plan – Part 1
Base the IEP on the student you are following throughout your student teaching placement.
All identifiable student information should be replaced with pseudonyms for confidentiality. In
addition, some information has been marked "Do not complete"’ due to confidentiality
concerns.
The present level of academic achievement and functional performance (PLAAFP) will guide
the development of the IEP. Teachers must describe student strengths, interests, and needs
within the PLAAFP. Assessment scores and a description of how the student is performing in
relationship to typically developing peers will provide the rationale for the development of
IEP goals, services, testing accommodations, and supplementary aides and services. It is
important that all sections of the IEP align with the PLAAFP.
Special Education Department

Individualized Education Program (IEP)
Student Name: Jessie Doe Student Data/Cover Sheet (Form A-1) IEP Meeting Date:
Demographic Information
Student Number: Student (Pseudo) Birthdate: Gender: Grade:

Name: 5/26/15 Female 2nd
249806423
Jessie Doe
Student Address: Home Phone:
3500 West Camelback Road Do not complete
City, State, Zip:
Phoenix, Arizona 85017
Parent 1 (Pseudo) Name: John Doe Parent 1 Relationship:
Parent 1 Address: Home Phone:

Do not complete. Do not complete.
City, State, Zip: Work Phone:
Parent 1 Email:
Do not complete.
Parent 2 (Pseudo) Name: Jane Doe Parent 2 Relationship:
Parent 2 Address: Home Phone:

City, State, Zip: Work Phone:
Parent 2 Email:
Do not complete.
Primary Language of Home: Primary Language Survey Date:9/1/2019 Language of Instruction:
English Primary Language Survey Results: English

Home District: District 11 Service Coordinator:
Attendance District: District 11
Home School: Bronx Charter School for Better Attending School: Bronx Charter School for Better
Learning Learning
Vision Screened On: Results: Hearing Screened On: Results:
Meeting Date: Anticipated Duration of IEP: Re-evaluation Due:
From: To: Current Evaluation:
Special Education Primary Category 1: Speech and Language Impairment
Special Education Eligibility Category 2: Other health
Special Education Eligibility Category 3: Language Processing Disorder
For Students with SLD only, the following area(s) of eligibility was/were previously determined:
Level of Services: (A) Speech Therapy

Type of Meeting: Initial IEP Meeting
Date Meeting Notice Sent to the Date Procedural Safeguards given to the
Parent(s):11/4/22 Parent(s):11/4/22

This page will not need to be completed because it is a signature page.
Student (Pseudo) Name: Jessie Doe Student Data/Cover Sheet
(Form A-2) IEP Meeting Date:
Student ID: DOB:
The following persons participated in the conference and/or the development of the IEP. Additionally, parents have
been given a copy of their rights regarding the student’s placement in special education and understand that they
have the right to request a review of their child’s IEP at any time.
Position/Relation to Student Participant Date (MM/DD/YY)
If during the IEP year the student turns 16, if the student is not present at the IEP meeting, the service coordinator
must review the IEP with the student and obtain the student’s signature and the date of this review.

Student (Pseudo) Name: Jessie Doe Student Data/Cover Sheet
(Form B) IEP Meeting Date:
Student ID: DOB:
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

(PLAAFP)
Section 1: Current IEP Information
Summarize special education services the student is receiving:
Jessie benefits from speech and language services to address her articulation, expressive, and responsive
language DELAYS. It is recommended that she receives speech two times a week for thirty- minute
sessions, one individual and one group session.
Section 2: Evaluation Information
Areas of Eligibility:
Special Education Primary Category: Speech and Language Impairment

Special Education Eligibility Category 2: Other health
Special Education Eligibility Category 3: Language processing disorder
For students with SLD only, the following area(s) of eligibility was previously determined:
State and District Assessment Scores: None. Testing is in grades 3-5
Section 3: Present Level of Academic Achievement and Functional Performance
A. Cognitive (academic performance in content areas, e.g., ELA/Reading/Writing, Math, Science, Social
Studies, Technology and Fine Arts, as applicable)
Reading:
 Decoding :First Grade Level
 Comprehension: First Grade Level
 Fluency: Beginning of First Grade
Writing:
 Written Language: First Grade Level
 Spelling/ Organization: Beginning of First Grade
Math
 Calculations: First grade Level
In reading , Jessie can :
 Jessie can read grade level text with purpose and understanding.
 Jessie can make text to text and self to text connections when reading.

 Jessie can retell a story using key details.
Writing :
Writing Strengths (include spelling, organization, and grammar)
 Jessie can write sentences using punctuation and capitalization.
 Jessie can write a story with a beginning, middle and end.
Math:
Math strengths (computations and problem solving)
 Jessie can add and subtract double digit numbers using manipulatives.
 Jessie can count by 10s, 5s, and 2s.
Student’s strengths, Preferences, Interests:
As per teacher report, Jessie’s strength is that she uses her initiatives to complete task.
Jessie prefers to do math. Jessie is interested in writing stories about past experiences and about her
family.
B. Physical (gross motor, fine motor, vision, and hearing)

Jessie is physically a healthy student who has no allergies to food or medicine. Her immunizations are
up to date and her hearing and vision are within normal limits. Her mother takes her to the
pediatrician regularly for yearly physicals, and illnesses.
Student’s strengths:
Jessie is a healthy student who is able to run, jump and play. She is able to participate in all school
activities. Parents has no physical development concerns for Jessie.
C. Oral Language and Communication Jessie is still working on her self-confidence due to her struggles
with oral speaking. She gets frustrated at times when asked to repeat what she is saying.
D. Social and Emotional Behavior

Although shy and quiet, Jessie was cooperative, friendly, jolly motivated girl. Jessie is described as a
friendly girl who is liked by her classmates and teachers. There are no behavioral issues at school nor at
home. Jessie is well behaved and mannered. Jessie is always ready for school.
As per teacher report, Jessie is eager to help her friends, she gets along with both adults and peers. She is
always polite.
E. Adaptive
Jessie is able to engage in social activities within in the class and school day.
Current Classroom-Based Data:

Family’s Input on Student’s Current Performance: The parental concerns are Jessie having speech
difficulties and being informed she is below grade level in reading.
Summary of Work Habits: She works well in small groups but tends to hide in whole group lessons
because she lacks confidence due to speech issues. She completes and submits classwork sometimes
rushes and makes careless mistakes. Jessie has a very positive attitude.

Section 4: Summary of Educational Needs and General Accommodations

Student (Pseudo) Name: Jessie Doe Considerations Form (Form C) IEP Meeting Date:
Student ID DOB :
ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS
Considered
Not Needed Included
Individual Transition Plan ☒ ☐

Statement of Transfer of Parental Rights at Age of Majority ☐ ☐
Statement of Positive Behavior Interventions, Strategies, and Supports ☒ ☐
Considered for a Student Whose Behavior Impedes his or her Learning,
or That of Others
Statement of Language Needs in the Case of a Child with Limited ☒ ☐

English Proficiency
Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

a Visually Impaired Child
Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Communication with Peers in the Child’s Language, and
Communication Mode
Statement of Required Assistive Technology Devices and Services ☒ ☐

Statement of Communication Needs for a Child with a Disability ☒ ☐

Student (Pseudo) Name: Jessie Doe Accommodations (Form F) IEP Meeting Date:
Student ID: DOB:

ASSESSMENTS
(Rationales for the accommodations that are being chosen specific to assessments.)
Rationale: N/A
State Assessments
Standard Accommodation(s): N/A
District Assessments
Standard Accommodation(s):
N/A
CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS
Testing Area Test Results Grade Semester Year

Reading NWEA Assessment (155- below grade level) 2 Fall 2022
Writing
Math NWEA Assessment (161- below grade level) 2 Fall 2022
Science
LEAST RESTRICTIVE ENVIRONMENT (LRE)

Provide an explanation of the extent, if any, to which the student will NOT participate with non-
disabled students in the general curricular, extracurricular, nonacademic activities, and program
options. §300.347(a) (4): None
Consider any potential harmful effects of this placement for the child or on the quality of
services that he or she needs §300.552 (a-b): None

Reason for different services at school:
OR, if the above LRE information does not apply to this student, explain why : Jessie can benefit
from more interaction with non-disabled peers. The benefits from speech and language services
to address her articulation, expressive and receptive language delays.

Standard 3: Individualized Education Plan - Part 2

Student (Pseudo) Name: Jessie Doe Student Goals and
Performance Objectives IEP Meeting Date:
Student ID: Progress Report DOB:
Skill Area: Speech/Language:

Standard:2SL.6: Express thoughts, feelings and ideas clearly, adapting language according to
context.
Annual Goal: In one year using a variety of content materials. Jessie will increase her
morphology, syntax, and semantic language skills by applying grade-level appropriate
grammatical rules in verbal and written form as indicated by word choices, elaboration
and creativity using grade appropriate vocabulary given verbal and visual cues with 80%
accuracy.
Baseline Level of Mastery:80% accuracy. Progress will be measured by : Teacher made

materials, class activities, Teacher/Provider observations, verbal explanation
Service Provider(s) for this goal: Speech services and progress will be measured 1 time per
month
Skill Area: Speech and Language

Standard:2L#: Use knowledge of language and its conventions when writing , speaking, reading, or
listening.
Annual Goal: In one year using a variety of content materials. Jessie will be developing her
articulation and intelligibility by producing all target phonemes in spontaneous and
connected speech given verbal and visual prompts with 80% accuracy.
Baseline Level of Mastery: 80% accuracy. Progress will be measured by : Teacher made
materials, class activities, Teacher/Provider observations, verbal explanation
Service Provider(s) for this goal: Speech services and progress will be measured 1 time per
month
Skill Area:

Standard:
Annual Goal:
Baseline Level of Mastery:

Service Provider(s) for this goal:
Skill Area:
Standard:
Annual Goal:
Baseline Level of Mastery:

Service Provider(s) for this goal:

Student (Pseudo) Name: Jessie Doe Accommodations (Form E) IEP Meeting Date:
Student ID DOB:
ACCOMODATIONS
Date Given to General Education Teacher: Service Coordinator:
Accommodations Type Location

None
LEGEND FOR TYPE AND LOCATION FIELDS

Type:
1 = Class work/assignments 2 = Assessments/tests 3 = Both class work/assignments/assessments
Location:
A = All Subjects B = Language Arts/English C = Reading D = Spelling E = Math
F = Science G = Social Studies H = Health I = Electives J = Physical Education
K = Lunch L = Transition / Vocation M = Library N = Title 1 O = Special/Exploratory
Family Communication
How will the family be informed of their child’s academic progress and the extent to which that progress
is sufficient to enable the child to achieve annual goals by the end of the year?
The parents will be informed at the same time school report cards are issued.
IEP Team Consideration for Extended School Year
Consideration for eligibility:
Eligible for ESY: No
Written explanation as to why ESY is or is not needed: Jessie doesn’t need ESY because she is just
receiving services for speech and language.

Student (Pseudo) Name: Jessie Doe Services and Environment (Form I) IEP Meeting Date:
Student ID: DOB: 5/26/15
SPECIAL EDUCATION SERVICES TO BE PROVIDED

Special education services necessary to meet special education goals and objectives during the school
calendar year.
The child is in need of specially designed instruction in the following areas:
Special Instructional
Education Setting/ Start Date Frequency Provider Duration/ End
Services Location Date
Clarification:
EDUCATIONALLY RELEVANT RELATED SERVICES
Speech/ General 11/5/22 2x a week TBD June 27,2022
language Education
Class
Clarification:
EDUCATIONALLY RELEVANT SUPPLEMENTARY AIDS/ASSISTIVE TECHNOLOGY and

SERVICES for STUDENTS
.
Clarification:
SUPPORTS FOR SCHOOL PERSONNEL

Clarification:

Standard 4: Preparation for IEP Meeting
The IEP team must cover mandated topics during the IEP meeting. Topics that must be
addressed during the IEP include, but are not limited to, an introduction of team members,
clarifying the type of meeting (initial, review, amendment/addendum to current IEP), the
required components of the IEP, the procedural safeguards, and prior written notice.
IEP Meeting Planning

Required Participants/Roles: List the participants of an IEP meeting and their roles, including
whether or not the student is expected to participate.
Mrs. Farese- Student support Service Coordinator

General Education teacher
Special Education teacher
CSE chairperson
Parents
Students are not expected to participate in this meeting
Required Agenda Outline: In 500-750 words, create an agenda for the IEP meeting. Discuss the
required topics you must address (i.e., introduction of team members, whether or not this is an initial or
review or an annual IEP, discussion of test results, present levels, goals, services, Least Restrictive
Environment (LRE) statement, Extended School Year (ESY) services, procedural safeguards, and prior
written notice.
IEP AGENDA:
1. Opening
A. Introduction: You will hear the names and the roles they play in your child’s education
 Michelle Farese: Student support service coordinator
 General Education Teacher: Mr. King
 Special Education Teacher: Mrs. Medina
 CSE Chairperson- TBD
 Mr and Mrs. Doe parents of Jessie Doe
 Administration if need be : Principal : Anne Clarke- Raysor Assistant Principal:
Dr. Amanda Santos
B. Purpose: The Chairperson will state the purpose of the meeting, which should match the
information on your Notice of Meeting.
The purpose of this meeting is an initial meeting to discuss Jessie Doe and academic needs and
the results of her evaluation and the related services she will receive based off it. We will also
discuss the classification Jessie falls in and what that means for her going forward and how we
can help her reach her academic goals as a team. Also in this meeting we will discuss her Present
Level of Performance (PLOP) which describes Jessie’s current abilities, skills, weaknesses and

strengths , academically, socially, and physically. Then we will create as a team some
measurable annual goals for Jessie which will allow us to monitor her progress. Based off the
information we have received from Jessie’s evaluation we have determined that she falls under
the classification of Speech- Language Impairment. Jessie will receive speech services based off
her evaluation and parents request for assistance. We will also determine if any testing
accommodations are needed with her classification.
C. Establish Time Parameters: The Chairperson will make sure everyone knows if someone
has to leave early. Typically, meetings are scheduled for no more than two hours, as it is
hard to process more information than that in one sitting.
D. Notice of Procedural safeguards: These are referred to as the “ Parent’s Rights.” Parents
should have received a copy if they signed an Assessment plan. They are offered every
year. Also the SELPA website has an abridged version (see Appendices) that summarizes
what each of the lengthy sections in this version. If you have already looked over this
document and have any questions now is the time to discuss them . If you wish to wait or
have a question later do not hesitate to ask your child’s assigned Case Manager.
E. Review the Agenda: The chairperson will review the Agenda and ask if anyone has
anything they wish to add. Parents may feel free to do so but it is best to let your Case
Manager know before hand so they can gather research or any information you may
need.
F. Ground Rules: To ensure everyone is comfortable , The Chairperson usually has a set of
ground rules
2. Review of the Draft IEP:
A. Notice of Meeting: If you have not done so already Chairperson will request you to sign
the Notice of Meeting , indicating your attendance at this meeting.
B. Information/ Eligibility: Here is where the Chairperson will ask you to verify all the
identifying information as your name and address. If any information is different you
must confirm that and be asked to go through the Address Verification process again, just
as any family would be expected to do (Not an IEP matter, but a district policy).
Jane Doe parent of Jessie Doe we reside at 3500 West Camelback Road.
C. For students who are in ninth through twelfth grades, the Chairperson will begin by
reviewing the components of the transition Plan: This doesn’t apply to Jessie Doe as she
is in second grade so we will begin her Initial meeting discussing her classification and
leading us into our next section which is her Present Level Of performance (PLOP)
D. Present Level Of Performance : Inform parents this section will begin with a review of
your child’s strength and interest. Your input will be requested if there is anything you
wish to add on your child. This will be followed by asking you to state any concerns you
have about your child ‘s progress at school. Then you hear a description of your child’s
current functioning in the areas of academics, communication, gross/fine motor, social
emotional/behavior, vocational, adaptive/daily living, skills, and health. The final pieces
of data that will be reported are the areas of needs for Jessie that must be addressed
through specific goals. These areas must be addressed by goals for your child to attain
Educational Benefit is defined as the ability to earn passing grades and be promoted from
grade to grade with same-age-peers.
Cognitive (academic performance in content areas, e.g., ELA/Reading/Writing, Math, Science, Social
Studies, Technology and Fine Arts, as applicable)

Reading:
Writing:
 Written Language: First Grade Level
 Spelling/ Organization: Beginning of First Grade
Math
 Calculations: First grade Level
In reading , Jessie can :
 Jessie can read grade level text with purpose and understanding.
 Jessie can make text to text and self to text connections when reading.
 Jessie can retell a story using key details.
Writing :
Writing Strengths (include spelling, organization, and grammar)
 Jessie can write sentences using punctuation and capitalization.
 Jessie can write a story with a beginning, middle and end.
Math:
Math strengths (computations and problem solving)
 Jessie can add and subtract double digit numbers using manipulatives.
 Jessie can count by 10s, 5s, and 2s.
Student’s strengths, Preferences, Interests:
As per teacher report, Jessie’s strength is that she uses her initiatives to complete task.
Jessie prefers to do math. Jessie is interested in writing stories about past experiences and about her
family.
Physical (gross motor, fine motor, vision, and hearing)

Jessie is physically a healthy student who has no allergies to food or medicine. Her immunizations are
up to date and her hearing and vision are within normal limits. Her mother takes her to the
pediatrician regularly for yearly physicals, and illnesses.
Student’s strengths:
Jessie is a healthy student who is able to run, jump and play. She is able to participate in all school
activities. Parents has no physical development concerns for Jessie.
Oral Language and Communication Jessie is still working on her self-confidence due to her struggles with
oral speaking. She gets frustrated at times when asked to repeat what she is saying.
Social and Emotional Behavior

Although shy and quiet, Jessie was cooperative, friendly, jolly motivated girl. Jessie is described as a
friendly girl who is liked by her classmates and teachers. There are no behavioral issues at school nor at
home. Jessie is well behaved and mannered. Jessie is always ready for school.
As per teacher report, Jessie is eager to help her friends, she gets along with both adults and peers. She is
always polite.
Adaptive
Jessie is able to engage in social activities within in the class and school day.

Current Classroom-Based Data:
Family’s Input on Student’s Current Performance: The parental concerns are Jessie having speech
difficulties and being informed she is below grade level in reading.
Summary of Work Habits: She works well in small groups but tends to hide in whole group lessons
because she lacks confidence due to speech issues. She completes and submits classwork sometimes
rushes and makes careless mistakes. Jessie has a very positive attitude.
E. Special factors: Not applicable to Jessie Doe
F. Review Progress on Previous Goal: This section would be where we discuss the progress your
child made on the previous year’s goals before creating new goals. However this doesn’t apply to
Jessie as this is her initial IEP meeting and we will be discussing goals for her and how we will
monitor her progress in achieving those goals.
G. Discussion of Proposed Goals ( and Benchmarks): Benchmarks are only required if the student is
assessed by alternative means including English learners.
Measurable Goals for Jessie will be:
Skill Area : Speech and Language
Annual Goal: In one year using a variety of content materials. Jessie will increase her
morphology, syntax, and semantic language skills by applying grade-level appropriate
grammatical rules in verbal and written form as indicated by word choices, elaboration
and creativity using grade appropriate vocabulary given verbal and visual cues with 80%
accuracy.
Baseline Level of Mastery:80% accuracy. Progress will be measured by : Teacher made materials, class
activities, Teacher/Provider observations, verbal explanation
Service Provider(s) for this goal: Speech services and progress will be measured 1 time per month
Skill Area: Speech and Language

Annual Goal: In one year using a variety of content materials. Jessie will be developing her
articulation and intelligibility by producing all target phonemes in spontaneous and
connected speech given verbal and visual prompts with 80% accuracy.Baseline Level of
Mastery: 80% accuracy. Progress will be measured by : Teacher made materials, class activities,
Teacher/Provider observations, verbal explanation
Service Provider(s) for this goal: Speech services and progress will be measured 1 time per month
H. Offer of FAPE (Services):

 Discuss all options available to your child in the district and the IEP Team’s rationale for
the one chosen by the team as being most appropriate.
 Additionally, the IEP Team will have a statement that addresses the team’s thoughts on
any potential harmful effect on your child, or the quality of services in this placement .
 Discuss which special education and Related services your child will need. Related
services can range from speech and language, occupational therapy, adapted physical
education, counseling, or other supports needed for your child to benefit from their
specialized academic instruction.
Based off the information we have received from Jessie’s evaluation we have determined that

she falls under the classification of Speech- Language Impairment. Jessie will receive speech
services based off her evaluation and parents request for assistance. Jessie can remain in her
general education classroom setting and doesn’t require any testing accommodations at this
moment.
Jessie doesn’t need ESY( Extended School Year). Jessie doesn’t need ESY because she is just
receiving services for speech and language.
3. Closing: The chairperson will ask if anyone has anything else to add or any objects of
what was discussed in this meeting. If there are no objects or questions the meeting will
end and the parents will get the notes from the IEP meeting . From here the Special
education teacher will create the IEP for Jessie which will be reviewed yearly and
adjusted as need be.
Plan for Conflicts: Provide a description of ways you can involve parents in the development of the
IEP. Discuss whether you anticipate issues or conflicts that may arise during the meeting and your plan
on addressing those concerns.
Parents will share what they are noticing at home in regard to academics and related services.
They have the right to agree or disagree with the recommended services offered at an IEP
meeting. They can also have an advocate or lawyer present to speak on their child’s behalf.
Conflicts are bound to arise during an IEP meeting. Being proactive may reduce conflicts during
the meeting. Weekly and monthly communication with the parent is essential. This also builds a
trusting relationship. This is done with weekly check-ins and monthly parent meetings. At the
parent meeting, progress is reported to the parents, data is analyzed with the parent, and the next
steps for the child are planned with the team and parent. Parents are given a copy of the report
and a copy of the notes from the meeting for their records. If a conflict should arise during an
IEP meeting, following an agenda to keep the meeting on track is most helpful. The agenda is
shared with the parent at the meeting to support the pace and flow. Items not on the agenda can
be discussed at a scheduled meeting, at another time. A meeting between the teacher and parent
before the scheduled IEP meeting should take place. At this time, the parent can ask questions
and the teacher can listen to parents' concerns. This way, both parties will feel prepared for the
IEP meeting. Building a relationship with the parent during the school year, most often,
reduces conflict as parents are well informed of their child's progress. The parents will feel and
see a community and relationship between the school and themselves.

Mock IEP Introduction Video
Now that you have outlined the IEP meeting agenda, you are prepared to conduct the meeting. In order to
prepare for running your first official IEP meeting, record yourself as if you were conducting the IEP
meeting. Your video should not exceed 15 minutes in length.
Focus your practice on the meeting introduction. Include the following components within your
recording:
 An introduction of all parties represented and their roles
 Reason for the meeting (initial IEP or IEP review)
 Meeting norms so all parties are heard and respected
 Review of the PLAAFP including the discussion of test results, present levels, goals, services,
Least Restrictive Environment (LRE) statement, Extended School Year (ESY) services,
procedural safeguards, and prior written notice (PWN).
Conclude your video by providing an explanation of how you would actively listen to and address the
needs of families and other stakeholders throughout the meeting.
After recording yourself, review and reflect upon the video below.

Mock IEP Introduction Video Link: https://youtu.be/vcCWC1q7UNA
Video Recording Link: If you are submitting your video to OneDrive, note it here.
Reflection: In 250-500 words, reflect on your IEP meeting practice session. In what areas do you feel
you did well? In what areas would you like to have more guidance and coaching before conducting your
first official IEP on your own? What plan of action do you have for more coaching and guidance?
In my meeting practice session, I feel like it was good practice for what an IEP meeting should look
and sound like even though there weren’t any guest but myself for the drill. It was helpful to
prepare myself for the what ifs before there were actual people present. Having been involved or
attended I should say an IEP meeting for annual reviews last year and had to write teacher reports
for the student as the general education teacher. I now see the importance of each teacher in an ICT
room and how all those anecdotal notes, classroom observations from both the teachers and
academic leaders can help us create a plan that will work for the student. Also speaking with
parents and getting their input on how their child is and what they notice will also be helpful in
creating this plan because they know their child better than anyone else. I also feel like this mock
meeting and using this IEP template was extremely helpful especially being a new special education
teacher, it gives me a lot to work with and get more practice for my new role. And making sure I
am accurately filling out the forms correctly. I feel I did well in Section 3, “the present level of
academic achievement and function performance.” I used what the student is capable of in the
classroom and her strengths for planning her goals. Classwork and assessments were also used to
report the student’s academic performance. Also being familiar with the thirteen classifications
helped when looking over Jessie’s information and determining that her classification is speech and
language impairment. Area I feel I can improve on would be making the IEP Agenda and what
information goes in it .My plan going forward is to take time to work with the student services
coordinator and see how she does IEPS and meetings so I can get better familiar with the ropes of
the IEP and the meetings itself.

Standard 5: Implementation, Communication, and Progress Reporting
Accountability of Free Appropriate Public Education (FAPE) is mandated by the Individuals with
Disabilities Education Act of 2004 (IDEA). IEP teams must have a plan to document the provision of
services as written in the IEP. Appropriate and accurate data must also be collected to document
quarterly progression toward mastery of IEP goals. Teams must have a plan for on-going data
collection, communication, and presentation of data to the parents/guardians during quarterly
progress reports and annual IEP review meetings.
Accommodations Progress and Communication Plan

Complete the Accommodations Table below, demonstrating how you plan to ensure all
accommodations are being met in the general education setting (if applicable). If the student is not in a
general education classroom, indicate how the student will receive accommodations in content specific
areas based on his or her PLAAFP and IEP goals.
On the Accommodations Table, note the dates when you will obtain progress reports from the general
education teacher or related services staff so that you can gather data on progress (if applicable). If no
general education teachers are reporting, indicate the dates of your (special education teacher)
reporting.
In addition, use the Accommodations Table to gather data on the student’s progress for the first
Quarterly Progress Report.
NOTE: Only two dates are included on the Accommodations Table for the purpose of this assignment.
You may not gather data on both dates in the duration of your placement, but dates should be noted.
Accommodations Table
Goal 1: In one year using a variety of content materials. Jessie will increase her morphology, syntax, and
semantic language skills by applying grade-level appropriate grammatical rules in verbal and written form
as indicated by word choices, elaboration and creativity using grade appropriate vocabulary given verbal
and visual cues with 80% accuracy.
Implemented Accommodations: Creating writing activities to promote use Person(s) Responsible: General ed
of grade level vocabulary and grammatical rules using morphology, teacher/ Speech pathologists
syntax and semantic language skills.
Quarterly Progress Report 1 Date: 11/16/22
Data Results: She passed her STAR assessment with a score of 837 (yellow) which is grade equivalent of a first grader
in the fifth month.

Data Results:
Goal 2: Annual Goal: In one year using a variety of content materials. Jessie will be developing her
articulation and intelligibility by producing all target phonemes in spontaneous and connected speech
given verbal and visual prompts with 80% accuracy
Implemented Accommodations: One session in whole group she will Person(s) Responsible: Speech
practice conversation skills and then in her individual session she will Pathologist
work on phonemes games to gain accuracy .
Data Results: Monthly report comes to teacher to inform the teacher of her progress.
Data Results:
Accommodations Summary:
In 100-150 words, summarize information from the Accommodations Table as well as data you have gathered
through teaching and observing the student. Address mastery of goals, progress towards mastery, and overall
service provision.
For my accommodations table, for her first goal Jessie will work on using grade
appropriate vocabulary to increase her speech and apply it in her writing. By doing this
she will be able to build her vocabulary bank and increase the writing she produces using
grade appropriate grammatical rules and utilizing morphemes, syntax, and semantic
language skills. For her second goal, she will work with the school’s speech pathologist
both in small group and solo sessions. In these sessions she will practice her conversation
skills with her peers and perform a reader’s theater so she can hear how the words should
sound and mimic what she hears. In her individual session, she will play phonemes
games to build her articulation and intelligibility skills to gain accuracy.
Communication Plan for General Education Teachers and Related Services Staff:
After completing the accommodations table and summary, in 150-250 words, describe a communication plan that
outlines how you plan to share the student’s progress information with the necessary faculty and staff. Address how

you and your colleagues will continue to monitor progress along the way, prior to receiving the quarterly
progression updates.

Standard 6: Revised IEP
IEP teams are expected to regularly analyze and document students’ progress on their IEP
goals throughout the year. This includes identifying when there are changes affecting the
student and presenting evidence of attempts to meet student needs when there is a lack of
progress. To address times when information, services, or goals need to be changed or added
to an existing IEP, the Individuals with Disabilities Education Act of 2004 (IDEA) describes
the regulations and procedures for changing an IEP using an amendment or addendum. An
amendment is used to change something already in the IEP. An addendum is used to add
something new to the IEP, such as goals, services, or accommodations.
After reflecting on your completed Standard 5 content, create a progress report addendum and/or
amendment (based on changes needed) to be added to the initial IEP, or describe why neither an
addendum nor amendment are not needed.
Data Collection and IEP Modifications

Stakeholders involved in special education must be aware of the student progress monitoring
process, keeping the goal of mastering IEP goals and presenting evidence of attempts to meet
said goals in mind. It is vital to keep a record of new information affecting student needs,
including a lack of progress when an IEP is in effect, using an IEP amendment or addendum.
An amendment is a change to the IEP and an addendum is the addition of goals or services and
accommodations to the IEP.
IEP Modification Need

After monitoring and gathering data, analyze how the student is performing on his or her IEP
goals and with the accommodations. Consider whether there is a need for an addendum and/or
an amendment for the student. If there is a need, in 50-100 words explain this need and the
approach to be taken (an amendment or an addendum). If there is no need at this time, simply
explain how the student is performing and progressing toward their IEP goals.
Jessie doesn’t need an addendum or amendment because she is currently showing progress in
achieving her set goals. Based off her quarterly progress report she is working well with the
speech pathologist and her general education teacher in using proper grammar and morphemes
and syntax in both her spoken and written language.
Family Communication Plan

In 50-100 words, discuss how you plan to communicate the student’s progress on his or her
IEP goals with the parents/guardians. (You may want to discuss this process with your mentor
so you have a method to use for future practice.)
Our communication plan with parents is a parent teacher conference every six to eight weeks
to update the parents on Jessie’s progress thus far on working on her goal and make any

changes to her IEP goals based off of her progress if need be. Also, there is a weekly parent
phone call to communicate with parents that takes place between the parent and teachers.
Communication Plan: ( all necessary staff has access)
progress monitoring tracker – tracks weekly academic sessions
staying in touch with speech pathologist monthly
Monthly Progress Monitoring:

ELA/Math Monthly STAR Assessment
Parent conference every 6-8 weeks
Three benchmarks administered in October, January, and May using NWEA
Assessment
Update ILP (Individualized Learning Plan) goals every 6-8 weeks
Teacher anecdotal notes
Student work/ writing samples
Standard 7: Reflection of the IEP Process

Reflection is an important part of professional practice. Professional special education
teachers plan and frequently reflect on their delivery of services, instruction, data collection
procedures, and individual student progress. Identification of practices that have worked, and
those that have not, can help the special education teacher adjust instruction and services to
better meet the needs of students.
Continued Learning
After completing the Individualized Education Program (IEP) Performance Template, reflect
upon three best practices you have learned from this student teaching experience in 50-150
words.
1. Progress Monitoring- I learned all the different ways we as educators keep progress monitoring
and the proper way to gather the data from that to formulate an Individualized learning plan or
goals for that student. From our data we can formulate goals, differentiation and scaffolding for
our lessons to help them grasp and build their awareness of set skill. Thereby giving them the
tools they need to do it independently.

2. Classifications- I learned how to distinguish all the classification for a disability when making
an IEP. And how to pinpoint which classification the student falls under. While some may be
harder than others knowing the base of this will help me correctly choose the right
classification.
3.Accommadations- I learned that not all students need an accommodations just because they have an
IEP nor do they always need to be in an ICT or LRE classroom.
Improved Practice
Based on your experience of developing and delivering your Individualized Education
Program (IEP) Performance Template, list three implications for your future teaching practices
in 50-150 words. Consider concepts you want to take with you into your own classroom, such
as how you will establish and maintain organization in order to facilitate the IEP process in
your classroom.
1. Parent Involvement /communication- creating a binder to show all communication between

teacher and parents and purpose of call, Text or email. Parent and teacher communication is
big because they know their child better than we do so working together will prove more
beneficial for the student.
2. Staff collaboration- Ensuring we are all on the same page when working with the student to
ensure her goals are being met and she is making progress rather than regressing. Staff
collaboration will also be helpful at meetings regarding the students’ IEP and their progress. If
we are not all communicating and collaborating it will show when we are in the meeting.
3.Progress Monitoring/Data collection- This will help me check on how my students are doing both in
my class and with their individual learning goals whether they are an RTI student or have an IEP. It
will show where they have grown and where they still may need help or where a lesson needs to be
retaught.

IEP Performance Template Steps 2-7

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

IEP Performance Template Steps 2-7

Uploaded by

Copyright:

Available Formats

Individualized Education Program (IEP) Performance

© 2019. Grand Canyon University. All Rights Reserved.

© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 29

Part I: Community, District, School, and Classroom Factors

Part II: Demographic, Environment, and Academic Factors

In order to submit this assignment, you must:

© 2019. Grand Canyon University. All Rights Reserved. Page 3 of 29

Special Education Department

Student Number: Student (Pseudo) Birthdate: Gender: Grade:

Parent 1 Address: Home Phone:

Parent 2 Address: Home Phone:

© 2019. Grand Canyon University. All Rights Reserved. Page 4 of 29

Special Education Eligibility Category 2: Other health

Special Education Eligibility Category 3: Language Processing Disorder

Level of Services: (A) Speech Therapy

© 2019. Grand Canyon University. All Rights Reserved. Page 5 of 29

Student ID: DOB:

Position/Relation to Student Participant Date (MM/DD/YY)

© 2019. Grand Canyon University. All Rights Reserved. Page 6 of 29

Student ID: DOB:

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Section 1: Current IEP Information

Summarize special education services the student is receiving:

Section 2: Evaluation Information

Special Education Primary Category: Speech and Language Impairment

State and District Assessment Scores: None. Testing is in grades 3-5

Section 3: Present Level of Academic Achievement and Functional Performance

© 2019. Grand Canyon University. All Rights Reserved. Page 7 of 29

B. Physical (gross motor, fine motor, vision, and hearing)

D. Social and Emotional Behavior

Current Classroom-Based Data:

© 2019. Grand Canyon University. All Rights Reserved. Page 8 of 29

Special Education Department

ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS

Individual Transition Plan ☒ ☐

Statement of Language Needs in the Case of a Child with Limited ☒ ☐

Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Statement of Required Assistive Technology Devices and Services ☒ ☐

© 2019. Grand Canyon University. All Rights Reserved. Page 9 of 29

Student ID: DOB:

Standard Accommodation(s): N/A

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS

Testing Area Test Results Grade Semester Year

LEAST RESTRICTIVE ENVIRONMENT (LRE)

© 2019. Grand Canyon University. All Rights Reserved. Page 10 of 29

© 2019. Grand Canyon University. All Rights Reserved. Page 11 of 29

Special Education Department

Student ID: Progress Report DOB:

Skill Area: Speech/Language:

Baseline Level of Mastery:80% accuracy. Progress will be measured by : Teacher made

Skill Area: Speech and Language

© 2019. Grand Canyon University. All Rights Reserved. Page 12 of 29

Baseline Level of Mastery:

Baseline Level of Mastery:

© 2019. Grand Canyon University. All Rights Reserved. Page 13 of 29

Date Given to General Education Teacher: Service Coordinator:

Accommodations Type Location

LEGEND FOR TYPE AND LOCATION FIELDS

IEP Team Consideration for Extended School Year

Consideration for eligibility:

Eligible for ESY: No

© 2019. Grand Canyon University. All Rights Reserved. Page 14 of 29