Modified IEP Practice Form

Student Information
Student Name: Nate Smith Date of IEP: 12/7/2020

Date of Birth: 5/22/2013 Chronological Age: 7-7

Grade: 2nd General Education Teacher: Mrs. Rogers

Name of School: Far Side Elementary School

IEP Team
IEP Case Manager: Ms. Evans

General Education Teacher: Mrs. Rogers

LEA Representative: Mr. Moneybags

Parent(s)/Guardian(s): Mr. and Mrs. Tony Smith

Special Education Teacher: Ms. Evans

Related Services: Speech and language Mr. Speech Pathologist

support/services

Present Level of Educational Performance

Academic Performance:
Nate’s 2nd grade teacher, Mrs. Rogers, reports that Nate is an excellent math student and is far
ahead of the other students in his class. She struggles to keep him active and engaged during
math and science class because he knows the curriculum as well as she does and becomes
easily bored in class. Mrs. Rogers reports Nate struggles with reading comprehension. He is a
fluent and fast reader but is not able to: sequence events to retell the story, name and describe
the main characters, explain the feelings of the characters, and make logical predictions about
what might happen next in the story. Mrs. Rogers also reports that Nate prefers to spend time
by himself doing complex math problems or drawing dinosaurs.
Nate scored below average on reading comprehension tests and demonstrated low scores in
retelling a story, sequencing, character description, and inferencing.

Functional Performance:
Nate does not understand why he cannot answer all the questions. He will interrupt his peers
when they answer or correct them when they are wrong. This impacts his peer relationships in
a negative way. Nate becomes upset and angry when the classroom routine changes. He does
not have peer relationships and struggles to make and maintain friendships. Mrs. Rogers
reports that Nate struggles to play games in gym class and will cry, yell, scream at his peers, and
lie down on the floor when he loses a game. This has impacted his relationships with his peers.
He often will sit alone at lunch and wanders around the playground during recess; he struggles
to join in the traditional games his peer play during recess like tag or capture the flag. Mrs.
Rogers has tried to support the development of peer relationships, but these attempts have not
been successful.
Nate spends most of his day alone and by himself. He does not have peer relationships and has
expressed to his parents that he feels sad and lonely. Nate demonstrates difficulties
understanding, expressing, and regulating his emotions and he will yell, scream, kick, and throw
himself on the ground when he is upset. Nate wants to have friends but is not able to develop
these relationships or understand the thoughts, feelings, and intensions of others.
Nate demonstrates difficulties with organization and planning. He does not have an
organizational system and does not use the colored folders his teacher provided him to help
organize his work. He will lose his papers and does not hand in his work. His grades have
started to suffer because he is not handing in his work, but Nate told his teacher he does not
care. He explained to his teacher that grades are not important, and they do not matter to him.
Nate scored below average in social cognition, self-awareness, social-awareness, and in
relationship development and management.
He demonstrated difficulties with sensory stimulation to light and sounds. He also
demonstrated difficulties with executive functioning in organization, planning, and initiation.
Strengths:

 strong family support

 strong interest and skill in math
 strong decoding reading skills
 strong memory
  strong artistic skills in drawing

Needs:

 reading comprehension
 executive functioning skills in planning, organization, and initiation
 social cognition (self-awareness and social awareness)
 sensory regulation to sounds, lights, and changes in routines

Annual Goals

Goal 1

Annual Goal: Nate will be able to sequence events to retell a grade level story with 80%
accuracy by the end of the year.

Objectives:
By week 8, Nate will be able to sequence and retell the beginning of a story.
By week 16, Nate will be able to sequence and retell the beginning and middle of a story.
By week 24, Nate will be able to sequence and retell the beginning, middle, and end of a
story.

Goal 1

Annual Goal: Nate will increase his rate of turning in homework by 90% by the end of the
school year through repetitive instruction and use of an organizational plan.

Objectives:
By week 8, Nate will have increased his rate of turning in homework by 60%.
By week 16, Nate will have increased his rate of turning in homework by 70%
By week 24, Nate will have increased his rate of turning in homework by 80%

Progress reporting
Progress toward annual goals will be measured through:
Written reports taken during checkpoints set up during certain weeks of the year.
Percentage increase of homework turned in
Parents will receive a quarterly written report on Nates progress

Specifically Designed Instruction (SDI)

The student will be provided with the following accommodations/modifications

Accommodation/Modification: Organizational plan creation (including color coded folders,

binders, reminders of when work is due)

Frequency: Once a week, 30-minute sessions Location: Far Side Elementary School

Instructional Setting: Create in resource room, use in all classes

Duration: Length of IEP 12/7/2020-12/6/2021

Accommodation/Modification: Social stories to address self-awareness and social

awareness

Frequency: Once a week, 45-minute sessions Location: Far Side Elementary School

Instructional Setting: Created in small groups in a resource room, use in all classes/settings

Duration: Length of IEP 12/7/2020-12/6/2021

Accommodation/Modification: Print all materials to help with sensory regulation to

computer light

Frequency: When needed Location: Far Side Elementary School

Instructional Setting: All classes

Duration: Length of IEP 12/7/2020-12/6/2021

Accommodation/Modification: Mute nonessential sounds/provide headphones to block out

noises (sensory regulation to noise)

Frequency: When needed Location: Far Side Elementary School

Instructional Setting: All classes and cafeteria

Duration: Length of IEP 12/7/2020-12/6/2020

Accommodation/Modification: Create groups of desks/chairs in classes to facilitate Nate’s

relationships

Frequency: Daily Location: Far Side Elementary School

Instructional Setting: All classes

Duration: Length of IEP 12/7/2020-12/6/2021

Accommodation/Modification: Small group reading comprehension instruction

Frequency: Daily, 30-minute sessions Location: Far Side Elementary School

Instructional Setting: Resource room

Duration: Length of IEP 12/7/2020-12/6/2021

Services (what special education services the child will get and for how long)

Service: Speech and language support Frequency: Twice weekly in 60-minute

sessions

Location: Far Side Elementary School Instructional Setting: Resource Room

Duration: Length of IEP 12/7/2020-12/6/2020

Participation

Nate has not responded to Mrs. Rogers attempts to facilitate peer relationships or improve
organizational skills. Nate’s relationship skills and some functional skills would be best
facilitated in a general education classroom. Small pull-out time for reading comprehension
instruction, organizational plan creation, social stories creation, and speech and language
support will give him the help he needs while keeping him in a general education classroom
for most of the day. It would also be beneficial to allow Nate to use the resource room when
he may be overwhelmed by sensory stimulation or changes in routine.