Rita G.

IEP Assignment

Directions: Number your paper from 1 to 30. Fill in the blanks of this IEP with
creative answers that would facilitate learning for Rita and help her become
successful in school. Attach a cover sheet, to the IEP, and then your answer sheet.
Due at the beginning of class.

INDIVIDUAL EDUCATION PLAN Rita G.

Reason for Development of IEP
X Student identified as exceptional by IEP

Student not formally identified by requires special education program/services including

modified/alternative learning expectations and/or accommodations

Name: Rita G. Gender: F Date of Birth: 2-26-04

School: Rock Star Academy
Student ID#: 1234567 Principal: Mrs. Riceberg
Current Grade/Special Class: 3.6 School Year: 2013
Most Recent IEP Date: 2-26-13 Date Annual Review Waived by Parent: No
Exceptionality Learning Disability
:
IEP Placement Decision: (check one)
Regular Class With Indirect Support Special Education Class With Partial
Integration
X Regular Class With Resource Assistance Special Education Class Full Time
Regular Class With Withdrawal Assistance

Assessment Data: List relevant educational, detailed medical/health (hearing, vision, physical,
neurological) psychological, speech/language, occupational, physiotherapy, and behavioral
assessments.
Information Source Date Summary of Results
Keystone Visual Screening 10-01-12 Normal range
Service
Wechsler Intelligence Scale 10-03-12 Tested high in verbal, tested low in test taking while
for Children-Third Edition visualizing object in space
(WISC-111)
Peabody Individual 10-09-12 Math below grade level. A year and half to two years
Achievement Test-Revised behind current grade level
(PIAT-R) and Brigance
Comprehensive Inventory of
Basis Skills-Revised
Brigance Comprehensive 10-11-12 Scored satisfactory in word recognition performance
Inventory of Basic Skills- dropped considerably when reading comprehension
Revised, Woodcock Reading was required
Mastery Tests-Revised and
Gray Oral Reading Tests,
Third Edition
Brigance Comprehensive 10-15-12 Handwriting poses a major problem for her
Inventory of Basic Skills-
Revised and through

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Observation

Spelling: Brigance 10-17-12 Scored at second grade level. Analysis of her spelling
Comprehensive Inventory of errors showed that she usually spelled words
Basic Skills-Revised, the according to phonics rules
Woodcock-Johnson
Psychoeducational Battery-
111 (WJ-111), and the Wide
Range Achievement Test-111
Adaptive Behavior: Vineland 10-23-12 Lowest scores are in daily living and socialization
Adaptive Behavior Scales
Learning Strengths and 10-25-12 Scored three years below chronological age
Weaknesses visual
perception: Developmental
Test of Visual-Motor
Integration

Students Strengths and Needs:

Areas of Strength (add 2) Areas of Need (Add 2)

Word recognition Work Independently
Areas that use language Reading comprehension
Auditory discrimination (organization, Cursive writing
makes sense of language) Manuscript writing
_______1___________ Word problems
________2__________ Numerical reasoning
_______3_________
_______4_________

Specialized Health Support Services/Personal Support Required Yes (List Below) X No

Subjects, courses, or alternative programs to which the IEP applies: Identify by placing an X in
each box that applies as Modified (MOD) and/or Accommodation (AC)
1. Writing skills MOD X AC 6. Social X MOD AC
skills
2. Arithmetic MOD X AC 7. MOD AC
3. Word X MOD X AC 8. MOD AC
problems
4. Reading MOD X AC 9 MOD AC
Comp
5. Cognitive LS X MOD AC 10. MOD AC

Elementary Program Exemptions or Secondary School Compulsory Course

Substitutions
Yes (Education rationale required) X No

Student is currently working toward the attainment X Secondary School

of Diploma

2
 Secondary School
Certificate
Certificate of
Accomplishment

3
 Instructional Environmental Accommodations Assessment
Accommodations (Add 2) Accommodations
(Add 2) (Add 2)

Writing Skills:
The rate of producing Work in small Portfolio
written work group settings or assessment
The volume pairs Shorten tests
The complexity of the Actively involve Computer visual
written task Rita in lesson learning using
plans
The tools used to produce Smart Board in
the written product
Give Rita credit group settings and
for class I Pad for individual
The format of the product participation and learning
Change the demands of effort Notes
writing rate Modify physical Additional test
Allow more time for written education taking time
tasks including note taking program
Audio Text Books
copying and tests Alter location of
personal or Use positive
_______5__________ classroom reinforcements
supplies for (rewards)
_______6__________ easier access or Use negative
to minimize reinforcements
distraction (consequences)
Arithmetic: (Add 2)
Allow extra time on tests Seat Rita away Establish a weekly
from doors and progress report
Provide frequent checks for windows with signature
accuracy when students
______14_____ required by Ritas
are doing classwork mother for a
List and color code steps accountability of
________15___
home/school
and procedures
Keep sample math communication
and behavior
problems on the board
monitoring
_______7__________
Write a contract for
child behavior
_______8__________
______16_____
Word Problems: (Add 1)
Incorporate smart board for ______17_______
visual learning
__________9______

Reading Comprehension:
(Add 2)
Provide Rita with a list of
important vocabulary
before reading the test
Provide Rita with a study
guide of the test
Allow her to use sticky
notes, highlighter tape and
highlighters to mark
important information
__________10_________

__________11_________
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Accommodations and Modifications:
(Assume common to all subjects unless indicated)

Special Education Program

To be completed for each subject/course with modified expectations Student ID# 1234567
and/or alternative expectations.

SUBJECT/COURSE/ALTERNATIVE PROGRAM:

Current Level of Achievement: Current Level of Achievement for Alternative Program:

(Describes starting point for plan development)
Below current 3rd grade level
Curriculum Grade Level is 1.5
Letter Grade/Mark is 60%
Annual Program Goal(s): A goal statement describes what a student can reasonably be
expected to accomplish by the end of the school year in a particular subject, course or alternative
program.

WRITING SKILLS

Annual Goal: Rita will write legibly, using manuscript writing, one paragraph consisting of 10
sentences with 90% accuracy and compose a one page book report using cursive writing with
75% accuracy by 1/1/2013

Benchmarks:

Manuscript writing:
Rita will trace 5 letters using a stencil
Using a white board Rita will copy 10 letters in upper and lower case
Rita will write 10 words legibly using manuscript form
Writes legibly a paragraph consisting of 5 sentences
Rita will compose a 2 paragraph paper using manuscript writing with 90% accuracy
____________________________21________________________
Cursive writing:
Using a cursive workbook Rita will trace 5 cursive letters
Using an individual white board Rita will copy 10 letter using cursive writing in upper and
lower case
Rita will write legibly using cursive writing in upper and lower case on her papers
Rita will write her name using cursive writing on all her papers
Rita will legibly compose a paragraph consisting of 5 sentences with 80% accuracy
_________________________________22_______________________________

ARITHMATIC

Annual Goal: Rita will be able to solve mathematical problems including multiplication,
subtraction, and addition with 80% accuracy by 6/1/2013

Benchmarks:

5
 Be able to solve 20 addition problems in 7 minutes
Be able to solve 20 subtraction problems in 7 minutes
Be able to solve 20 multiplication problems in 5 minutes
Be 85% fluent in addition on Reflex Math Game
Be 80% fluent in subtraction or Reflex Math Game
______________________23___________________________________

WORD PROBLEMS

Annual Goal: Rita will be able to solve mathematical word problems with 75% accuracy by
6/1/2013

Benchmarks:

Be able to solve 10 mathematical word problem equations in 30 minutes with the

assistance of a peer tutor
Be able to incorporate basic money solving skills and will learn rounding to the nearest
whole number
Will learn rounding to the nearest whole number
Rita will demonstrate common knowledge with the basic symbols for multiplication,
subtraction and addition
Rita will learn basic knowledge with place value and decimals by using classroom dollars
and a hundreds chart
_________________________________24______________________________

READING COMPREHENSION

Annual Goal: Rita will read fiction and non-fiction passages from the third grade reader, identify
who, what, when and why and answer reading comprehension questions with 9-% accuracy by
6/1/013

Benchmarks:

Using the SQ3R method Rita will explain a passage in a third grade textbook with 80%
accuracy
After reading a third grade level story, Rita will answer 4 out of 5 comprehension
questions
Using the Inspiration software Rita will create a story map to compare the differences
between fiction and non-fiction with 90% accuracy
Working in a small group Rita will discuss a third grade level short story with her peers
and then paraphrase who, what, where, why, and how of the story
Using music as a topic Rita will compose a one page fiction or non-fiction short story
using 5 out of 10 spelling words with 90% accuracy
__________________________________25________________________________

COGNITIVE LEARNING SKILLS

Annual Goal: Rita will express verbally basic sentence structure and understand concepts with
80% accuracy by 6/1/2013

Benchmarks:

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 Rita will be able to work independently on modified homework completing assignments
and understanding the importance of turning the assignments in on time
Rita will be allowed to use study guides while taking tests
With use of peer tutors and groups, Rita will be able to complete in classroom
assignments
With prompts by the 3rd Grade Teacher and Resource Teacher, Rita will be able to answer
questions in classroom discussions
___________________________________26____________________________

SOCIAL SKILLS

Annual Goal: Rita will work in small peer groups or in pairs with each assigned task throughout
the day at 75% accuracy by 6/1/2013

Benchmarks:

Rita will show interaction and initiative while participating in the classroom learning
setting
Rita will choose to participate in outside games and activities during recess and not sit
alone
Rita will verbally interact with her peer tutor each day while working on assignments
Rita will participate in non-preferred discussions
Rita will choose a topic of discussion 3 times a week out of 5 school days and the other 2
days will participate in non-preferred topic

_____________________________27_________________________________

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 Learning Expectations
(Knowledge and/or skills to be (List only those that are
assessed by reporting period, different for this student and
including Grade level)
subject/course/ program)
Annual Goal: Rita will
write legibly, using
manuscript writing,
one paragraph
consisting of 10
sentences with 90%
accuracy and
compose a one page
book report using
cursive writing with
75% accuracy by
1/1/2013
Annual Goal: Rita will
be able to solve
mathematical
problems including
multiplication,
subtraction, and
addition with 80%
accuracy by 6/1/2013
Annual Goal: Rita will
be able to solve
mathematical word
problems with 75%
accuracy by 6/1/2013
Annual Goal: Rita will
read fiction and non-
fiction passages from
Teaching Strategies Assessment Methods
(For expectations for each
reporting period)
specific to the learning
expectations for the
Color coded Peer assistance
workbooks, list and Teach spot checks
color code steps and Resource spot checks
procedures Short quizzes
Modified seating Weekly progress
Study guides for tests reports
Modified homework
Teacher visually spot
Time in class to start checks work done in
homework groups and
Use of mechanical individually
devices documenting progress
Provide Rita with a list and participation
of important
vocabulary before
reading the test
Provide Rita with a
study guide of the test
Allow her to use sticky
notes, highlighter tape
and highlighters to
mark important
information
Allow extra time on
tests
Keep sample math
problems on the board
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 the third grade reader, Use individual dry
identify who, what, erase boards
when and why and Reduce the number of
answer reading assigned math
comprehension problems
questions with 9-% Incorporate smart
accuracy by 6/1/013 board for visual
Annual Goal: Rita will learning
express verbally basic Provide dictionary
sentence structure
Reduce the number of
and understand
assigned math
concepts with 80%
problems
accuracy by 6/1/2013
Reduce the number of
Annual Goal: Rita will
assigned math
work in small peer
problems
groups or in pairs with
each assigned task
throughout the day at
75% accuracy by
6/1/2013

IEP Developed by: Sources Consulted in the Development of

Staff Member Position the IEP: (check)
Mrs. Riceberg Principal IEP Statement of Decision (if applicable)
Mr. Mild 3rd Grade Teacher Provincial Report Card
Mrs.OK Special Ed Teacher Previous IEP
Mr. Frank Resource Teacher X Parents/Guardian
Ms. Honest 4th Grade Teacher X Student
Ms. Good School Psychologist Other (List Below)
Mrs. G Mother Other
Sources:

Date of Placement in Special Education Program: (select and appropriate option and
provide date)

1) First day of attendance in new special education program

2) First day of the new school year or semester in which the student is continuing in a
placement
3) First day of students enrollment in a special program that he/she begins mid-year or mid-
semester as
a result of a change in placement

Date of Placement: November 1, 2012

Completion Date of IEP Development December 18, 2013
Phase:
(Within 30 school days following the Date of Placement)
Transition Plan:
For Student who are 14 years of age or older, unless solely identified as gifted.

Transition Goal
Specific Goal(s) for Transition to Postsecondary Activities:
Due to Ritas strengths and use of language, the team has set goals:
At 12 years old Rita will be able to participate in group activities

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 Class readings and discussions
Rita will begin working with two to three peers in a group setting. She will gradually work
her way toward a group setting with 20 or more peers.
By 6/9/2013, Rita will maintain communication 75% of the time with two to three peers in
a group setting.
Actions Required Name of Person(s) Responsible Timelines
Rita will be able to
Rita will be able to express 1. Mr. Mild 3rd Grade communicate in
with confidence while Teacher groups of 5 people
participating communication 2. Mrs. OK Special 75% of the time by
skills in a social setting Education teacher the end of year
3. Mr. Frank Resource 2013.
Teacher Rita is working
4. Ms. Honest 4thGrade toward
Teacher communicating with
5. Mrs. G. Ritas Mom 20 or more students
in a group setting
Rita will complete
her communication
task 80% of the time
by 12 years of age.

Implementation and Monitoring:

Human Resources: (Teaching/non-teaching)

Include service, initiation date, frequency or intensity, and location.

Mr. Frank will work with Rita once a day for 1 hour beginning November 1 st 2012 . Rita will be
in a low stress environment and will be working on her communication skills in a group setting
in the Resource Room.

Mrs. OK will ____________________________________________________(_28_)________

__________________________________________________________________________

Evaluation
Reporting Dates: 4-30-2013

Reporting Format: (please check) X School Report Card Alternative Report

(Required if student has
modified expectations
and/or accommodations

Log of Parent/Student Consultation and Staff Review/Updating

Date Activity Outcome
(Indicate Parent/Student Consultation or Staff Review)

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 Rita will be able to tell her
11/7/13 -1/10/13 mother everything she did with
appropriate verbal skills 75% completion outcome

1/15/13 3/22/13 Rita will ________29_______

________________________ 75% completion outcome
________________________
Rita will _______30________
________________________
3/25/13 6/1/13 ________________________ 75% completion outcome

The Principal has the legal requirement to implement and monitor the IEP.

The plan has been developed according to the IEP standards, addresses the students strengths
and needs, and the learning expectations will be reviewed and student progress monitored at
least once every reporting period.

Principals Signature: Janis Riceberg Date: Today

Parent/Guardian/Student Involvement:
I was consulted in the development of this IEP
I declined the opportunity to be consulted in the development of this IEP
I have received a copy of this IEP

Parent/Guardian/Student Comments:

I feel that Ritas social skills are very important to her long term as well as short term
educational goals. I believe Rita will improve academically if she feels more comfortable
communicating and interacting with her peers.

Parent/Guardian Mrs. G Date: 2-26-13

Signature:

Student Signature: Date:

(If 16 or older)

Answer Sheet for IEP

Mrs. Riceberg, Instructor

Name__Krisina Ferguson________________________________
Date_01/28/2016________ Tue. or Thur.

Students Strengths and Needs:

Areas of Strength (add 2)

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 1. __________________________________________________________
2. __________________________________________________________
Areas of Need
3. Decision Making
4. _Socializing with peers. _______________
Instructional Accommodations
Writing Skills
5. Require a minimal amount of writing per day gradually increase expectations.
6. Give student specific instructions gradually decrease structure as confidence builds.
Arithmetic
7. Teach key math terms separately. ____________________________
8. Have student use graph paper or turn lined paper verticle so student
has ready made columns.______
Word Problems
9. Simplify and rephrase vocabulary in word problems and have student re-
Verbalize the process to you.
Reading Comprehension:

10._Read text aloud to the class or small groups._____________________

11._Simplify complex text by rewording it._______________________
Cognitive Learning Skills
12._Use mnenonics for repetition (song). _____________________
13._Have student repeat the directions for a test._________________
Environmental Accommodations
14.Make sure desk is clear except for topic materials. __________
15._Provide different seatting (quite) for test taking.____________________
Assessment Accommodations
16._Number and sequence the steps in a task.________________________
17._Allow student frequent breaks. ______________________________
Social Skills
18.Student introduces herself to someone new on the playground,________
19.Student accepts responsibility for her own behavior. _______
20._Student will work with assigned students in class. ____________

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Benchmarks:
Manuscript Writing
21._Rita will a triangle pencil grip for better control of her pencil.

Cursive Writing
22._Rita will use lined paper to practice the cursive alphabet with 80% accuracy by
December.

ARITMATIC
Benchmarks:
23._Rita will use graph paper for all math problems with 90 % accuracy by
December. ____

WORD PROBLEMS
Benchmarks:
24.__Rita will finish 5 word problems in 30 minutes with 90% accuracy by
December. ______

READING COMPREHENSION
Benchmarks:
25._Rita will use highlight tape to highlight important areas of text.____

COGNITIVE LEARNING SKILLS

Benchmarks:
26._Rita be able to restate information to her teacher. ________

SOCIAL SKILLS
Benchmarks:
27._Rita will be assigned a partner to work with 3 times per week and she
____work with this student toward a common goal._

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Implementing and Monitoring

28._Mrs. OK will assign a new partner for Rita to work with once a week.
__________________________________________________________

29._Rita will initiate a conversation with Mr. Martinez every day._______

__________________________________________________________

30._Rita will keep her desk organized everyday by the end of class.______
__________________________________________________________

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