Kelsey Olson

IEP

Assessment Report Form

Student: Amy (Changed)
Birthdate: XX/XX/XX
School: Elementary School
Grade/Teacher: 3rd

Age at Evaluation: 8-1

Date of Report: 11/15/14
Evaluator: RSP teacher and Kelsey Olson
Major Area(s) of testing: Reading and
Writing

Evaluation Dates: 11/5/14, 11/6/14,11/10/14

1. Reason for Referral:
Amy was referred for assessment by her student study team. She has received
targeted reading interventions for the past two years yet has not made expected progress.
In addition, her parents and classroom teacher were concerned about her difficulty with
reading, particularly in comparison to others in her grade.
2. Background Information:
Amy is a very articulate and social third grader. She has a twin brother who is
reading at grade level. According to her teacher, Amy feels a lot of pressure to improve
her own reading skills due to her familys expectations. The family speaks English at
home. They are very involved in Amys and her brothers education and attend many
school events. Amy has a lot of friends at school and is very active. She enjoys playing
sports, particularly basketball.
Amy did attend pre-school and has has attended Vallecito since kindergarten in
2011. She has always struggled with reading compared to her peers, most noticeably
decoding. She received reading interventions focusing on decoding and phonics in her
general education classroom starting in first grade.
3. Assessment Results:
The Kaufman Test of Educational Achievement, Second Edition (K-TEA-II) is a
comprehensive, nationally normed assessment tool that measures a students cognitive

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and academic ability. It consists of 14 subtests, which evaluate reading, math, written
language, oral language, sound-symbol, decoding, oral fluency, and reading fluency.
Standard Scores (SS) between 85 and 115 and percentile scores (%) between 25 and 75
are considered within the average range.
Kaufman Test of Educational Achievement, 2nd Edition (KTEA-II)
Subtest

Standard
Score (SS)

Percentile
(%)

Age Equivalent
(AE)

Descriptor

Letter & Word Recognition

79

8th

6-9

Borderline

Reading Comprehension

79

8th

7-0

Borderline

Reading Composite

77

6th

Math Concepts & Applications

92

30th

8-0

Average

Math Computation

95

37nd

8-3

Average

Math Composite

93

32nd

Written Expression

126

96th

14-8

Superior

Spelling

86

18th

7-0

Low Average

Written Language Composite

106

66th

Borderline

Average

Average

READING
Letter & Word Recognition: For this subtest the student identifies letters and pronounces
words of gradually increasing difficulty. Most words are irregular to ensure that the
subject measures word recognition (reading vocabulary) more than decoding ability.
Amy performed in the borderline range with a standard score of 79. The age equivalent
score is 6-9.
Reading Comprehension: For the easiest items, the student reads a word and points to its
corresponding picture. In following items, the student reads simple directions and
responds by performing an action. In later items, the student reads passages of increasing
difficulty and answers literal or inferential comprehension questions about them. Finally

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the student rearranges five sentences into a coherent paragraph and then answers
questions about the paragraph.
Amy performed in the borderline range with a standard score of 79. The age equivalent
score is 7-0.
MATH
Math Concepts & Applications: For this subtest the student responds orally to test items
that focus on the application of mathematical principles to real-life situations. Skill
categories include number concepts, operation concepts, time and money, measurement,
geometry, data investigation, and higher math concepts.
Amy performed in the average range with a standard score of 92. The age equivalent
score is 8-0.
Math Computation: For this subtest the student writes solutions to math problems printed
in the student response booklet. Skills assessed include addition, subtraction,
multiplication, and division operations; fractions and decimals; square roots; exponents;
signed numbers; and algebra.
Amy performed in the average range with a standard score of 95. The age equivalent
score is 8-3.
WRITTEN LANGUAGE
Written Expression: At grade 1 and higher, the student completes writing tasks in the
context of an age-appropriate storybook format. Tasks at those levels include writing
sentences from dictation, adding punctuation and capitalization, filling in missing words,
completing sentence, combining sentences, writing compound and complex sentences,
and writing an essay based on the story the student helped complete.
Amy performed in the superior range with a standard score of 126. The age equivalent
score is 14-8.
Spelling: For this subtest the student writes words dictated by the examiner from a
steeply graded word list. Early items require students to write single letters that represent

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sounds. The remaining items require students to spell regular and irregular words of
increasing complexity.
Amy performed in the low- average range with a standard score of 86. The age equivalent
score is 7-0.
4. Observations:
Amy was positive and cooperative throughout the administration of the
assessments. She appeared at ease, comfortable, and attentive to the tasks during the
examination. Amy responded promptly to test questions. She read text quickly when
asked to read aloud, often skipping over words. This was most noticeable during the
reading comprehension subsection. During the Written Expression sub-section, Amy
hesitated during writing and asked a few times for help spelling. She wrote slightly more
quickly once she was told to not worry about spelling and just focus on writing. Amy was
generally persistent with difficult tasks and tried hard to do her best during the
assessment.
5. Interpretation:
Amys performance on the reading sub-sections of the KTEA-II, when compared
to others at her age, was in the borderline range. She performed at practically the same
level in both Letter & Word Recognition and Reading Comprehension. On the Letter &
Word Recognition subtest she achieved a standard score of 79, which is in the 8th
percentile with an age equivalent score of 6-9. On the Reading Comprehension subtest
she also achieved a standard score of 79, which is in the 8th percentile, but the age
equivalent score is 7-0. These scores show that Amy does indeed struggle with reading
skills and is reading below her age level.
Amys performance on the math sub-sections of the KTEA-II, when compared to
others at her age, was in the average range. Of the two subtests, she scored highest on the
Math Computation subtest. She achieved a standard score of 95, which is in the 37th
percentile with an age equivalent score of 8-3. Amy scored almost as high on the
Concepts & Applications subtest. She achieved a standard score of 92, which is in the
30th percentile with an age equivalent score of 8-0. Amy did very well on the math

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portion of the assessment. These scores, along with the fact that she is performing at
grade level in the classroom, show that she does not require additional math supports at
this time.
Amys performance on the writing sub-sections of the KTEA-II, when compared
to others at her age, was in the low average to superior range. In Written Language
Composite she was in the average range. Her strongest area is Written Expression. She
achieved a standard score of 126, which is in the 96th percentile and has an age equivalent
score of 14-8. She struggled more comparably with the Spelling sub-section. She
achieved a standard score of 86, which is in the low-average range, in the 18th percentile,
and has an age equivalent of 7-0. Amy is a very thoughtful student and her writing skills
are very high for her age, but she could use additional support with spelling to further
expand her abilities.
These scores indicate that Amy does struggle with reading comprehension and
decoding as well as spelling. Since decoding and reading vocabulary is a large
contributing factor for reading comprehension it is likely that Amy will improve her
reading comprehension skills once she receives more support for phonics and word
recognition. Overall, she is in the average range for the math and writing subject areas.
6. Summary and Conclusions:
Amy is an 8 year-1 month old student currently in third grade. She was referred
due to concerns regarding her academic skills in reading and writing. Amy is a very
motivated student and has expressed a strong desire in improving her academic skills.
Amys results on the KTEA-II show that she is performing academically in the
borderline range in the reading. In addition to these assessment results, classroom
observations and communications with her teacher have also shown that Amy
struggles with decoding and reading comprehension. Overall, it seems that Amy
could use help mainly focusing on her decoding skills as well as learning more
spelling rules to help her improve her spelling and word recognition.

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7. Recommendations (Include statement of eligibility for special education services based
upon SELPA
It is recommended that Amy is qualified for special education services. Amy
continues to perform significantly below her classroom peers academically in Reading
and Writing. Given that she is of average to above-average intelligence and considering
that the interventions put in place in the general education classroom have not resulted in
significant progress in Amys reading and writing skills, she should be considered for a
Specific Learning Disability determination. It is recommended that she be considered for
services in the Resource room for a percentage of the day. Other recommendations
include:
Reading:
-Support and explicit instruction on picking out books at her independent reading
level
-Teach reading decoding strategies and provide a checklist to remind her of the
different methods she can use to figure out unknown words.
-Focus on phonics support
-Explicitly teach reading comprehension strategies such as monitoring your
comprehension while reading, questioning, and inferring.
Writing:
-Explicitly teach common spelling rules to help her improve her spelling skills
and her confidence.
-Have her create her own dictionary with words she struggles with, in both
reading and writing.

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Individualized Education Program

Eligibility
First Name (Changed): Amy
Purpose of Meeting: Initial
Birthdate: 9/15/06
Age: 8-1
Gender: Female
Grade: 3rd
Native Language: English
Residency: Parents
Ethnicity: Not Hispanic or Latino
Race: White
Indicate Disability: 290 SLD
Describe how students disability affects involvement and progress in the general
curriculum:
Amy is currently struggling academically in reading as well as spelling. She is
performing below her grade level peers despite academic targeted interventions and having an
average intelligence. Amys difficulty with decoding and reading comprehension has made it
very difficult for her to keep up with the assignments in her third grade classroom and affects
every subject area.

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Present Levels of Academic Achievement and Functional Performance

Strengths/Preferences/Interests: Amy performs very strongly in math and expresses an active
interest in science. She is very good at asking for help when she needs it. She is a very social and
considerate individual. Amy has a lot of friends in her grade and is known for her empathy. Amy
also has an interest in athletics and is very active.
Concerns of Parent relevant to educational progress: Amys parents are most concerned
about her reading skills. They would like to see her soon catch up and be reading at grade level.
They are also concerned that this process may impact Amys mood and self-confidence. They
would like to make sure that her positive attributes are focused on as well as ways to improve
Amys academic progress, instead of just where she is now academically.
Preacademic/Academic/Functional Skills: Amys biggest academic strength is in math. She is
currently performing at grade level in this subject area as well as in writing. Her favorites
subjects are science and math.
Reading: Amy reads clearly and confidently when she is comfortable with the words. However,
when she is asked to read text with new or more difficult words, Amy will often struggle to
sound out the word or skip over them completely while reading. Amys 3rd grade teacher has
been working with her to make sure that the books she is picking are at her independent reading
level. She is currently reading at an early 2nd grade level. Support when picking books should
continue to be provided to make sure that she reads books at her independent level. For class
reading, Amy should be notified before she is asked to read aloud in class. Even though she does
not express any embarrassment during read alouds, it will be beneficial to her if she has time to
pre-read and ask the teacher for help decoding any difficult words. Not only will this
accommodation help Amy read more accurately in front of her classmates, but she will also
receive more individualized reading and vocabulary support, which otherwise may not be
provided during full class or small group lessons. Although Amy has a very good spoken
vocabulary, she continues to struggle with recognizing sight words while reading. Her teacher
has provided her with a list of sight words to practice at home (Dolche Second Grade Sight
Vocabulary). Amy currently is able to correctly identify 80% of the Dolche Second Grade Sight

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Vocabulary words. Since she is in third grade, her teacher would like to begin introducing these
words to her soon. A way to support this should be to give Amy five to ten flashcards with
words that she has not yet mastered from the Dolche Second Grade Sight Vocabulary list. Amy
should review these flashcards during free moments. Three to four times a week the flash cards
should be reviewed with her teacher. When Amy correctly reads the word on the card, a star
should be added. Once she has five stars the flash card should be put in a separate bag so Amy
can still review if she needs to and more flash cards should be added to her original group.
Writing: Amy has a lot of great ideas for her writing and is very good at thinking of supporting
details when she is working in the classroom. However, Amy does struggle with spelling. She
will often swap letters or add letters that do not correspond to a sound in the target word. On 3rd
grade writing assignments, Amy will usually spell 6 out of every 10 words correctly. An
accommodation should be that when the focus of a writing assignment is not spelling, spelling
errors should not impact Amys grade when no opportunity for editing assistance and/or spell
check is available. Amy does have a good memory for language rules once they have been taught
and has been observed to be very proud of her knowledge during class activities. For example,
during a small group spelling activity focused on differentiating words that have ai and ay,
Amy was prompted by her teacher to think if there was a rule having to do with these letter
groupings from the previous weeks lesson. She then remembered that ay comes at the ends of
words, which she then shared with the whole group. The activity involved circling letters from a
few options to spell out the teacher-spoken word. It was evident during the task that Amy was
actively thinking of the rule because she changed her answers midway through, once realizing
that the A sound was the final sound for the word. After this activity the small group took a short
spelling quiz on different words with the same letter groupings. Amy spelled nine out of eleven
correctly. For the two she missed she added an extra letter, snaiul and traill, showing that she
did have a good understanding of the focus of that days lesson, but still needs additional spelling
support. These targeted spelling lesson interventions should continue for Amy.
Communication Development: Amy has age appreciate communication skills.
Gross/Fine Motor Development: Amy has age appropriate gross and fine motor development.
She is very athletic and active and her penmanship is also age appropriate.

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Social/Emotional/Behavioral: Amy has strong social skills. She is well liked and has many
friends. She enjoys working in groups and interacting with the other students in the class.
Emotionally, Amy does sometimes become stressed during reading and writing activities. She
tries very hard to succeed academically and when she struggles she can be hard on herself. Her
teacher has pulled her aside during these moments to remind her of her positive skills and
compliment her hard work. Reminders like these should be continued in order to support Amys
academic growth. Behaviorally, Amy does sometimes need to be reminded to stop talking during
class. It is recommended that Amys general education teacher talk to Amy about making better
choices during lesson activities. Amy should also be asked to consider, which students it might
not be the best idea to sit near during quite learning activities.
Vocational: Amy has age appropriate vocational aspirations. She has expressed an interest in
being a veterinarian.
Adaptive/Daily Living Skills: Amy has age appropriate daily living skills.
Health: Amy is perfectly healthy. She has 20/20 vision in both eyes and has recently passed
hearing tests for both her left and right ears.

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Special Factors
Does student require assistive technology devices and/or services? No
Does the student require low incidence services, equipment and/or materials to meet
educational goals? No
Does students behavior impede learning to self or others? No
For student to receive educational benefit, goals will be written to address the following
areas of need: Reading Decoding, Reading Comprehension, Sight Words, and Spelling

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Annual Goals
READING DECODING
Baseline: Amy is currently reading at a second grade level. She often struggles to sound out
unknown or more difficult words or skips over them completely when reading.
Goal 1: By 11/15/15, given an unfamiliar third grade narrative text, Amy will accurately read
with fewer than 5 errors per 100 words to her classroom or RSP teacher, 2 out of 3 times over
two weeks as measured by teacher observation and note taking.
READING COMPREHENSION
Baseline: Amy is currently able to correctly answer 6 out of 10 comprehension questions after
reading an independent level text.
Goal: By 11/15/15, given an independent level text, Amy will read independently and correctly
answer 8 out of 10 of comprehension questions with the use of taught comprehension strategies
and graphic organizers, 2 out of 3 times over two weeks as measured by teacher observation and
work samples.
SIGHT WORDS
Baseline: Amy currently is able to correctly identify 80% of the Dolche Second Grade Sight
Vocabulary words.
Goal 3: By 11/15/15, given the Dolche Third Grade Sight Vocabulary Words sheet and repeated
practice of the words on this list, Amy will be able to correctly identify 95% of the sight words to
her classroom or RSP teacher after repeated practice of the words on this list, 2 out of 3 times
over two weeks as measured by teacher observation and note taking.

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SPELLING
Baseline: Amy will often swap letters or add letters that do not correspond to a sound in the
target word. On 3rd grade writing assignments, Amy will usually spell 6 out of every 10 words
correctly
Goal 4: By 11/15/15, given teacher support, Amy will correctly spell words using double vowel
sounds 8 out of 10 times during classroom writing assignments in her general education
classroom or RSP room, 2 out of 3 times over two weeks as measured by teacher observation and
work samples.

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Offer of FAPE- Services

The service options that were considered by the IEP team: General education classroom and
Academic resource support.
Supplementary Aids, Services & Other Supports for School Personnel, or For Student, or
On Behalf Of The Student: None Needed
Special Education And Related Services
Service: Academic resource support
Provider: Resource teacher
Frequency: 3 times a week
Duration: 45 minutes each session for a total of 135 minutes weekly
Location: Resource room
Extended School Year: No
Education Setting: General
School Type: Public
All special education services provided at the students school of residence? Yes
8% of time student is OUTSIDE regular class
92% of time student is IN regular class
Student will not participate in the regular class & extracurricular & non-academic activities
because Amy needs additional academic support in order to progress through the general
education curriculum.
Activities to Support Transition
Amy will receive small group and individual academic support in reading and spelling in order
to help her access the general education curriculum and transition into 4th grade.

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Transition-Younger
Student Skills
Strengths: Amy is very good at asking for help when she needs it. She has very good
math and exceptional writing skills.
Limitations: Amy needs additional help with reading comprehension and decoding and
well as spelling.
Student Behavior
Strengths: Amy is a very empathetic and conscientious student.
Limitations: Amy can tend to talk with friends during class activities instead of focusing
on the assignment or the teacher.
Teacher Tips
What has worked- Classroom Environment: It has been helpful to make sure that Amy is
seated away from students who are tend to distract her. In addition, a quiet environment
has particularly helped Amy focus when reading.
What has worked- Teacher instruction: Frequent check ins with Amy has been very
helpful in making sure that Amy understands what she is working on and is able to access
the material.