ADAPTED PHYSICAL EDUCATION REPORT

Initial Evaluation
Childs Information Connor, 5/2/1998, Down Syndrome, Male, 16 years old
Assessors Information: Garet Sagami, 11/19/2014
General Information: The assessment was given to Connor in the Dubuque Hempstead High
school gymnasium. It was given to the student in the same gym as his regular physical
education class. The testing was given to him while his class was also doing their
activities; the assessment was in the corner of the gym enough room for him to do all the
intended testing skills. Connor has Down syndrome; this disability affects him mainly in
object control subtests where he lacks some skills. He performs the locomotor subtests
pretty well, some areas he still needs work on more than others. Information about standard
scores and percentiles are not accurate because of Connor being over 11 years of age.

Test of Gross Motor Development (TGMD-2)

Overall Raw Score: _____71/96_____________
Gross Motor Quotient: _____70___________
Overall Percentile: _______2____________
FORMAL ASSESSMENT AND OBSERVATIONS:

Locomotor Skills
Raw Score______37/48_________
Age Equivalent ______6yr_____________
Percentile: ________9____________
Description of performance of subtests:
GALLOP= 4 out of 8 criteria met
When Connor galloped he displayed a brief period when his arms were not bent and didnt lift to
waist level at takeoff. His arms would be down at his side both times demonstrated. Also Connor
didnt maintain a rhythmic pattern for four consecutive gallops. He would gallop but not
rhythmically it was tough for him but he tried his best to get to four consecutive times.
HORIZONTAL JUMP= 4 out of 8 criteria met
When Connor would do the horizontal jump he did not have his arms extended forcefully
forward and upward. He did not fully extend above his head either time. Also, Connor was
unable to thrust downward during his landing; he would gradually put his arms down slowly or
just have his arms at his sides and not thrust at all.

RUN 7 out of 8
GALLOP 4 out of 8
HOP 8 out of 10
LEAP 6 out of 6
HORIZONTAL JUMP 4 out of 8
SLIDE 8 out of 8
.

Object Control Skills:

Raw Score_____34/48_______
Age Equivalent ______5 year 9 months____
Percentile: ________2____________

Description of performance of subtests:

STRIKING 5 out of 10 criteria met
When Connor would attempt at striking the ball with the bat he had a hard time rotating his hips
and shoulders during the swing. It was mostly just his arms that would swing at the ball. Connor
was also unable to transfer body weight to front foot; both of his feet were planted on the ground.
KICKING 5 out of 8 criteria met
The first time Connor tried to kick the ball he did not have a rapid continuous approach to the
ball the first time. After demonstration again he was able to run up to the ball and kick it. Connor
also had trouble when it came to an elongated stride or leap immediately prior to ball contact. He
showed no evidence because he would run up to it kick the ball and stop prior to contact.
STRIKING 5 out of 10
STATIONARY DRIBBLE 6 out of 8
CATCHING 6 out of 6
KICKING 5 out of 8
OVERHAND THROW 5 out of 8
UNDERHAND ROLL 7 out of 8
OBSERVATIONS and CONVERSATIONS
1. Physical/motor characteristics Connor needs some improvement when it comes to
performing activities that require upper body strength as well as lower body strength.
Connor was good at doing some of these characteristics during the test such as running,
hopping, and throwing. But he still needs some improvement when it comes to such
activities like gallop, horizontal jump, kicking and striking. Overall he performs all
physical/motor skills to the best of his ability.

2. Personal/social characteristics Connor is a well-rounded friendly student that is very

respectful and outgoing. Connor has some trouble with his speech but other than that he is
friendly and shy at times. He talks to you only if you initiate communication with him. He
does not have any behavioral issues in the class.
3. Learning characteristics Connor does seem to learn better with a visual demonstration rather
than just using vocal demonstration to him. After he sees what is supposed to be done he is
able to do that activity with little or no errors. He is able to read and hear directions
adequately during the lessons in class. Some of the tasks he may need some extra time to
complete the task but mainly during class he is able to complete the task in enough time
given by the instructor.
CONCLUSIONS
Overall, during the TGMD assessment and observation of Connor I have seen that he does a
great job following directions and performing the different skills. His strengths include most of
the locomotor skills mainly running, hopping, leaping and sliding is what he showed great
strength in. Only a few weaknesses he had during galloping and the horizontal jump. Within the
object control skills he performed good at a few skills such as dribble, catch and roll but most of
his weaknesses were shown during these skills. Within these different skills his gross motor
functioning was adequate but some of the items he could use some improvement on. Connor
behaves great inside and outside of the classroom. He follows directions, listens, uses equipment
correctly and doesnt act out of line during activity time.

IEP Goal and Objectives

INDIVIDUALIZED EDUCATION PROGRAM FOR
Connor
(I-12)
____Dubuque__Hempstead__________ SCHOOL DISTRICT

Measurable annual goal to enable the student to be involved in and progress in

the general curriculum, and to meet other educational needs that result from the
students disability (there must be a relationship between the annual goal and the
present level of performance):
Upon review:
Goal met
Goal not met
The overall goal for the student is to improve in the areas they he needs
improvement on. Some examples would be improvement of a few physical fitness
criteria: upper body strength, lower body strength, flexibility. Some Gross motor

skills: non locomotor skills such as horizontal jump and locomotor skills such as
galloping.
Procedures for measuring the students progress toward the annual goal: skills
checklist, videos, administer the TGMD test again if needed.
Procedures for informing parents of the students progress toward the
annual goal and the extent to which that the progress is sufficient to
enable the student to achieve the goal by the end of the year (parents of
non-disabled students are notified about progress):
In order to communicate the progress of Connor towards his parents I plan to Email,
send letters home with Connor and send progress reports about how well he is
doing. This will help the parents understand what I am working on with Connor and
how well he is improving or what he needs to work on.
(Using the ACC method for writing goals, insert your three IEP goals that
have been created for your student.)
1. Connor will gallop for 20 feet having arms bent and lifted to waist level 3 of 4 trials

2. Connor will strike the ball using hip and shoulder rotation 3 of 4 trials

3. Connor will be able to kick the ball and leap immediately prior to ball contact 3 of 4 trials.

Task Analysis
For each goal you created above, you will need to break it down into smaller steps that can be
measured throughout the course of the school year. Each goal should contain three (3) task
analyses.

Goal #1: Connor will gallop for 20 feet having arms bent and lifted to waist level 3 of 4 trials
Task Analysis of Goal #1:
Three months following implementation of IEP: Connor will run 10 feet with arms slightly bent
close to waist level 2 of 4 trials.

Six months following implementation of IEP: Connor will run 15 feet with arms bent completely
to waist level 2 of 4 trials.

Nine month 3 months following implementation of IEP: Connor will run 20 feet with arms bent
completely to waist level 3 of 4 trials.

1 year following implementation of IEP: Goal met: YES NO (circle)

Goal #2: Connor will strike the ball using hip and shoulder rotation 3 of 4 trials
Task Analysis of Goal #2:
Three months following implementation of IEP: Connor will strike the ball using slight hip and
shoulder rotation 2 of 4 trials

Six months following implementation of IEP: Connor will strike the ball using mostly hip and
shoulder rotation 3 of 4 trials

Nine month 3 months following implementation of IEP: Connor will use complete hip and
shoulder rotation 3 of 4 trials.

1 year following implementation of IEP: Goal met: YES NO (circle)

Goal #3: Connor will be able to kick the ball and leap immediately prior to ball contact 3 of 4
trials.
Task Analysis of Goal #3:
Three months following implementation of IEP: Connor will be able to kick the ball and leap
shortly after contact with ball 2 of 4 trials.

Six months following implementation of IEP: Connor will be able to kick the ball and leap almost
immediately prior to ball contact 3 of 4 trials.

Nine month 3 months following implementation of IEP: Connor will be able to kick the ball and
leap immediately prior to ball contact 3 of 4 trials.

1 year following implementation of IEP: Goal met: YES NO (circle)