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STUDENTS NAME:
DOB
4-20-2004
Carrie Smith
SCHOOL YEAR
FROM
2014
12-1-2014
2015
GRADE
TO
12-1-2015
THIS IEP WILL BE IMPLEMENTED DURING THE REGULAR SCHOOL TERM UNLESS NOTED IN EXTENDED SCHOOL YEAR SERVICES.
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Parental concerns:
Carries parents are most concerned about Carries poor report card grades. She is currently failing reading, language arts,
and social studies, with no grades higher than a C in any subject area. Her parents are also concerned with Carries
growing dislike of reading. They do not notice her reading at home, for school or for leisure, and they do not know how to
motivate her to read. They have also been contacted by Carries teacher because Carrie often turns in incomplete
assignments, and her parents are concerned about Carries lack of attention to her tasks.
Student Preferences and/or Interests:
Carrie enjoys taking lessons in dance and gymnastics, and she also participates in baton twirling camps when they are
offered. Her favorite subject is art, and she loves to be creative. She also enjoys science because she is able to observe and
participate in experiments. Her favorite vacation was when she traveled to visit family in New York City, and she is
fascinated by big cities. Carrie also enjoys playing with her little brother and her two golden retriever puppies.
Results of the most recent evaluations:
On 10/26/14, Carrie was evaluated using the Wechsler Intelligence Scale for Children- Third Edition (WISC-III), which
measures a childs overall intellectual functioning. Her full-scale IQ score of 96 falls within the average range of scores
for her age group. In the Verbal IQ subtest, her score of 89 indicates that Carrie scored slightly below average in the area
of verbal reasoning. Her Performance IQ score, however, was 102, which is within the average range for nonverbal
reasoning skills.
On 10/18/14, Carrie was evaluated using the Woodcock Johnson Tests of Achievement-Third Edition (WJ-III), which
assesses a students academic performance in a variety of skill areas. Carrie scored a composite value of 80, which is
below average for her age group. The subtest scores indicate that Carrie is performing in the average range in the areas of
Passage Comprehension, Understanding Directions, and Picture Vocabulary. The scores also indicate areas of need in
Letter-Word Identification, Word Attack skills, Math Calculation, Applied Math Problems, and Spelling, as Carries scores
are below average in these areas.
On 10/15/14, Carries fourth grade teacher completed documentation for Carries Response to Intervention sessions.
Despite small group instruction using evidence-based reading strategies, Carrie has not shown improvement in her
reading and English language arts skills.
On 10/1/14, Carries fourth grade teacher completed a behavior observation checklist. He reports that Carrie struggles
with task initiation and sustained attention while she works on an assignment. She often turns in incomplete work, which
has contributed to her poor report card grades.
The academic, developmental, and functional needs of the student:
Carries test scores and classroom performance indicate several areas of need:
Reading/Language Arts/Writing:
Carrie has difficulty using grade-level phonics skills to decode real and nonsense words [RF.4.3], which impacts her
fluency and comprehension of a text. She also struggles to spell grade-level words correctly and use appropriate
conventions of the English language in her writing [L.4.2].
Mathematics:
Carrie has difficulty with multi-digit addition and subtraction problems that require regrouping [4-NBT4], as well as
multi-digit multiplication and long division problems [4-NBT5], [4-NBT6]. She also struggles to apply math operations to
word problems [4-OA3].
Behavior/Self-Direction:
Carrie has difficulty with initiating and completing assignments in a reasonable amount of time [A:A2.1].
Other:
For the child transitioning from EI to Preschool, justify if IEP will not be implemented on the childs 3 rd birthday:
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Carrie Smith
Does the student have behavior which impedes his/her learning or the learning of others?
Does the student have limited English proficiency?
Does the student need instruction in Braille and the use of Braille?
Does the student have communication needs (deaf or hearing impaired only)?
Does the student need assistive technology devices and/or services?
Does the student require specially designed P.E.?
Is the student working toward alternate achievement standards and participating in the
Alabama Alternate Assessment?
Are transition services addressed in this IEP with an annual goal(s)?
YES
[X]
[ ]
[ ]
[ ]
[ ]
[ ]
NO
[ ]
[X]
[X]
[X]
[X]
[X]
[ ]
[ ]
[X]
[X]
]
]
]
]
]
Bus assistance:
[ ] Adult support
Preferential seating
Behavioral Intervention Plan
Wheelchair lift and securement system
Restraint system
Specify type:
[ ] Other:
[X] NO
[ ] Medical support
[ ]
Other. Specify:
[ ]
Bus driver and support personnel are aware of the students behavioral and/or medical concerns.
NONACADEMIC and EXTRACURRICULAR ACTIVITIES
Will the student have the opportunity to participate in nonacademic/extracurricular activities with his/her nondisabled
peers?
[X] YES.
[ ] YES, with supports. Describe:
[ ]
Annual Goal Progress reports will be sent to parents each time report cards are issued (every
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weeks).
CARRIE SMITH
[ ] This student is in a middle school course of study that will help prepare him/her for transition.
[X] This student was invited to the IEP Team meeting.
[ ] After prior consent of the parent or student (Age 19) was obtained, other agency representatives were invited to the
IEP Team meeting.
EXIT OPTIONS (Complete for students in Grades 9-12)
[ ]
[ ]
[ ]
Month:
Year :
ENGLISH
MATH
SCIENCE
SOCIAL
STUDIES
[ ] Interest Inventory
[ ]
Other
Transition Strands
Academics/Post Secondary
Education/Training
Employment/Occupations
/
Careers
Personal/ Social
Daily Living
Service(s)
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CARRIE SMITH
Reading/Language Arts
Teacher Observation
Work Samples
[ ] Other:
Other:
[ ]
BENCHMARKS:
1. By February 2015, Carrie will be able to sort words into categories based on
beginning, middle, and ending sounds, including vowel teams and consonant
patterns, with at least 80% accuracy in 4 out of 5 trials.
2. By April 2015, Carrie will be able to decode one- and two-syllable nonsense words
using common vowel teams and consonant patterns with at least 80% accuracy in 4
out of 5 trials.
3. By September 2015, Carrie will be able to recognize grade-level sight words and
read them in the context of sentences with at least 80% accuracy in 4 out of 5 trials.
4. By November 2015, Carrie will be able to decode grade-level words in isolated
grade-level sentences with at least 80% accuracy in 4 out of 5 trials.
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[ ]
Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
CARRIE SMITH
Language Arts/Writing
Teacher Observation
Work Samples
[ ] Other:
Other:
[ ]
BENCHMARKS:
1. By February 2015, Carrie will be able to correctly place quotation marks in a given
sentence with at least 80% accuracy in 4 out of 5 trials.
2. By April 2015, Carrie will be able to correctly place commas in given a given
sentence with at least 80% accuracy in 4 out of 5 trials.
3. By September 2015, Carrie will be able to spell multi-syllable grade-level words
using vowel teams and consonant patterns with at least 80% accuracy in 4 out of 5
trials.
4. By November 2015, Carrie will be able to write a sentence using correct quotation
marks, commas, and grade-level spelling skills with at least 80% accuracy in 4 out of
5 trials.
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[ ]
Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
CARRIE SMITH
Mathematics
Teacher Observation
Work Samples
[ ] Other:
Other:
[ ]
BENCHMARKS:
1. By February 2015, Carrie will be able to fluently solve multi-digit addition problems
using regrouping with at least 80% accuracy in 4 out of 5 trials.
2. By April 2015, Carrie will be able to fluently solve multi-digit subtraction problems
using regrouping with at least 80% accuracy in 4 out of 5 trials.
3. By September 2015, Carrie will be able to fluently solve multi-digit multiplication
problems using regrouping, with the aid of a multiplication card, with at least 80%
accuracy in 4 out of 5 trials.
4. By November 2015, Carrie will be able to fluently solve multi-digit division
problems using her preferred long division strategy (Hangman or traditional) with
at least 80% accuracy in 4 out of 5 trials.
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[ ]
Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
CARRIE SMITH________________________________
Mathematics
Teacher Observation
Work Samples
[ ] Other:
Other:
[ ]
BENCHMARKS:
1. By February 2015, Carrie will be able to distinguish relevant information from
irrelevant information in word problems by crossing out unnecessary facts with at
least 80% accuracy in 4 out of 5 trials.
2. By April 2015, Carrie will be able to match key words in word problems to the
mathematical operations they indicate with at least 80% accuracy in 4 out of 5 trials.
3. By September 2015, Carrie will be able to correctly solve one- and two-step word
problems using the four mathematical operations with at least 80% accuracy in 4 out
of 5 trials.
4. By November 2015, Carrie will be able to solve one-step word problems involving
angle measurements and volume with at least 80% accuracy in 4 out of 5 trials.
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[ ]
Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
CARRIE SMITH________________________________
Behavior/Self-Direction
Teacher Observation
Work Samples
[ ] Other:
Other:
[ ]
BENCHMARKS:
1. By February 2015, Carrie will be able to initiate an assigned task within three
minutes of receiving instructions, as recorded on a self-monitoring behavior chart, in
at least 4 out of 5 observations.
2. By April 2015, Carrie will be able to complete an assigned task within the allotted
timeframe, as recorded on a self-monitoring behavior chart, in at least 4 out of 5
observations.
3. By September 2015, Carrie will be able to self-assess the quality of her work using a
checklist that covers task initiation, completion, and correctness in at least 4 out of 5
observations.
4. By November 2015, Carrie will be able to independently initiate tasks within three
minutes, complete tasks in the allotted timeframe, and assess the quality of her work
with no more than two adult prompts in 4 out of 5 observations.
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[ ]
Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
Carrie Smith
SPECIAL EDUCATION AND RELATED SERVICE(S): (Special Education, Supplementary Aids and Services,
Program Modifications, Accommodations Needed for Assessments, Related Services, Assistive Technology, and Support
for Personnel.)
Special Education
Service(s)
Related Services
Service(s)
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
30 min.
December 1, 2014 to
November 30, 2015
Special education
classroom
30 min.
December 1, 2014 to
November 30, 2015
Special education
classroom
Daily
60 min.
total
December 1, 2014 to
November 30, 2015
General education
classroom
[ ] Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
[X] Needed
[ ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Daily
Program Modifications
[ ] Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Service(s)
December 1, 2014 to
November 30, 2015
December 1, 2014 to
November 30, 2015
December 1, 2014 to
November 30, 2015
Daily
Daily
Beginning/Ending
Duration Dates
Location of Service(s)
Location of Service(s)
Location of Service(s)
General education
classroom
General education
classroom
General education
classroom
Location of Service(s)
to
[X] Needed
[ ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
As necessary
As necessary
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Beginning/Ending
Duration Dates
December 1, 2014 to
November 30, 2015
December 1, 2014 to
November 30, 2015
Location of Service(s)
Special education
classroom
General education
classroom
ALSDE Approved Feb. 2012
Assistive Technology
Service(s)
[ ] Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Location of Service(s)
to
to
[ ] Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Location of Service(s)
to
to
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CARRIE SMITH
TRANSFER OF RIGHTS
(Beginning not later than the IEP that will be in effect when the student reaches 18 years of age.)
Date student was informed that the rights under the IDEA will transfer to him/her at the age of 19
The IEP Team has considered the need for extended school year services.
[X] Yes
[ ] No
Carries least restricted environment places her in the general education classroom for more than 80% of each school day, with
no more than 20% of the day spent in the special education classroom for individualized instruction.
COPY OF IEP
Position
Signature
Date
Parent
Parent
General Education Teacher
Special Education Teacher
LEA Representative
Someone Who Can Interpret The Instructional
Implications Of The Evaluation Results
Student
Career/Technical Education Representative
Other Agency Representative
Leslie Smith
Jackson Smith
Mark Brown
Sarah Jones
Emily Parker
Leah Green
11-30-2014
11-30-2014
11-30-2014
11-30-2014
11-30-2014
11-30-2014
Carrie Smith
11-30-2014
Position
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Name
Date