INDIVIDUALIZED EDUCATION PROGRAM (IEP)

Student’s Name: Zach Apple

INDIVIDUALIZED EDUCATION PROGRAM (IEP) Weirton Elementary School - 7

Student’s Name: Zach Apple

IEP Team Meeting Date (mm/dd/yy): December 6th, 2017
IEP Implementation Date (Projected Date when Services and Programs Will Begin): January 6th, 2017
Anticipated Duration of Services and Programs: December 6th, 2017 - December 5th, 2018
Date of Birth: June 6th, 2010
Age: 7
Grade : 2nd
Anticipated Year of Graduation: May 2029
Local Education Agency (LEA): Hancock County Schools
County of Residence: Hancock
Name and Address of Parent/Guardian/Surrogate: Phone (Home): (304) 105-9898
Scott & Emma Apple Phone (Work): (304) 205-5604
3428 Pennsylvania Ave
Weirton, WV 26062

Other Information:

The LEA and parent have agreed to make the following changes to the IEP without convening an IEP meeting, as documented by:
N/A

Date of Revision(s) Participants/Roles IEP Section(s) Amended

N/A N/A N/A

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Zach Apple

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Include the following information related to the student:

● Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based
assessments, transition assessments, progress toward current goals)
● Present levels of functional performance (e.g., results from a functional behavioral assessment, results of ecological assessments, progress
toward current goals)
● Present levels related to current postsecondary transition goals if the student’s age is 14 or younger if determined appropriate by the IEP team
(e.g., results of formative assessments, curriculum-based assessments, progress toward current goals)
● Parental concerns for enhancing the education of the student
● How the student’s disability affects involvement and progress in the general education curriculum
● Strengths
● Academic, developmental, and functional needs related to student’s disability

Zach is seven years old and is currently in the second grade. He is in the special education classroom majority of the day but participates in his
specials throughout the week.

Zach tends to do well interacting with teachers and peers and participates in activities with appropriate manners. However, Zach struggles
with staying on task during instructional classroom time and has difficulty verbalizing his needs in full sentences. Due to these barriers Zach
tends to lash out in frustration when he is unable to follow these tasks for the teacher. Zach’s focus can be redirected with prompting and
reinforcement. In addition, modifications are used to assist Zach so he can fully communicate his needs, questions, and answers with others.

In order to assess Zach’s present levels, the Brigance III assessment was administered to him. Zach was placed in the 1st percentile due to his
overall composite score of 66. Therefore, his overall age equivalent calculated to be 4 years and 5 months with an instructional range of 4
years and 4 months to 4 years and 6 months. The results of this assessment led to a confidence interval of 63-69. In addition, after the
assessment was administered and the results were added up, it was more reliable to determine the areas of strength and the areas needed for
improvement.

Zach’s physical development calculated to a composite score of 67 which placed him in the 1st percentile. His gross motor skills were a
composite score of 82, whereas, his fine motor skills were a composite score of 56. This showed that his gross motor skills were much closer to
the average range than his fine motor skills. Due to Zach’s lower range with fine motor skills, it is clear to see he has difficulty writing his last
name and writing lowercase and uppercase letters.

Zach’s language development calculated to a composite score of 73 which placed him in the 4th percentile. His receptive language skills and
expressive language skills were both close to the average range. For example, his receptive language skills composite score was 79, whereas,
his expressive language skills composite score was 75. Zach shows he understands verbal concepts but will not completely follow directions
when given the command to do something. In addition, his articulation of words is unclear when speaking.

Zach’s academic skills/cognitive development calculated to a composite score of 75 which placed him in the 5th percentile. His literacy and
mathematics skills were both below the average range. His literacy skills composite score was 69, whereas, his mathematics skills composite

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Zach Apple

score was 55. The results of this section indicated that Zach is at an instructional range of a 4 year and 6-month to a 4 year and 8-month. Also,
he had difficulty recognizing words, adding and subtracting numbers, and knowing missing numerals in sequences.

Zach’s adaptive behavior composite score calculated to a composite score of 69 which placed him in the 2nd percentile. As a result, this
section determined that Zach has an age equivalent to 3 years and 6 months which puts him at an instructional range of 3 years and 5 months
to 3 years and 7 months. Zach had the most difficulty being able to know personal information.

Zach’s social and emotional development calculated to a composite score of 91 which placed him in the 27th percentile. This domain was his
strongest and most consistent one. Zach shows kindness and compassion towards his peers, teachers, and others.

Zach’s strengths:
● Domain: Physical Development
○ Subdomain: Gross Motor
■ Zach is capable of using his early gross motor skills to stand, walk, skip, gallop, run, jump, hop, climb, etc.
● Domain: Social and Emotional Development
○ Subdomain: Interpersonal
■ Zach is attentive, kind, and compassionate, responds with facial expressions, watches others’ faces for emotional
cues, and builds relationships with his peers, teachers, and others.
● Domain: Social and Emotional Development
○ Subdomain: Self-regulatory
■ Zach gets excited when something he is interested in is presented, interacts with his peers and teachers, and plays
with toys in his own way.
● Domain: Adaptive Behavior
○ Subdomain: Daily Living
■ Zach is able to properly feed himself, put clothing items on and take clothing items off such as shoes and jackets, and
does not need assistance when using the restroom.

Zach’s areas for improvement:

● Domain: Physical Development
○ Subdomain: Fine Motor
■ Zach has difficulty writing his full last name and uppercase/lowercase letters.
● Domain: Language Development
○ Subdomain: Expressive
■ Zach does not use sentences of at least 4 or more words majority of the time he speaks and does not produce clear
articulation when speaking.
● Domain: Academic Skills/Cognitive Development
○ Subdomain: Literacy
■ Zach verbally recites 40% of the alphabet, is not familiar with phonological or phoneme manipulation skills, or
recognize certain words such as down, can, do, yes.
● Domain: Academic Skills/Cognitive Development
○ Subdomain: Mathematics
■ Zach has trouble adding and subtracting numbers and knowing where numbers should go in a sequence.
Page 3 of 6 November 2017
INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Zach Apple

V. GOALS AND OBJECTIVES – Include, as appropriate, academic and functional goals. Use as many copies of this page as needed to plan appropriately.
Specially designed instruction may be listed with each goal/objective or listed in Section VI.

Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the student’s gifted program may be
listed under Goals or Short Term Objectives.

MEASURABLE ANNUAL GOAL Describe WHEN

Describe HOW the student’s
Include: Condition, Name, Behavior, and Criteria periodic reports on
progress toward meeting this goal Report of Progress
(Refer to Annotated IEP for description of these progress will be
will be measured
components) provided to parents

Student will be measured through Quarterly with N/A

Zach will use sentences of at least five words to informal observations during report cards.
express his wants and needs 6 out of 8 trials by regular class time.
the end of the IEP.

Progress will be monitored during Quarterly with N/A

Zach will be able to write his last name legibly
printing letters with appropriate shape and
formation 70% of the time, 4 days a week.
Zach will be able to explain the uses of common
objects when shown pictures with 80% accuracy
across five consecutive sessions.
Zach will be able to demonstrate his
understanding of number sequence by saying
which numeral is missing in a sequence of
numbers from 0-25 with 85% accuracy, three days
a week for five consecutive weeks.
Zach’s intervention time with Mrs. report cards.
McGlone. Additionally, every week
Zach’s teacher will collect writing
samples every Thursday to keep
track of his work.
Progress will be measured Quarterly with N/A
informally through worksheets and report cards.
questions asked in class, and
formally through a verbal
assessment.
The student’s progress will be Quarterly with N/A
measured informally through report cards.
observations, and formally through
class activities. He will be asked
to point and say the numbers that
are missing from the sequence.

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS – Include, as appropriate, for nonacademic
and extracurricular services and activities.

A. PROGRAM MODIFICATIONS AND SPECIALLY DESIGNED INSTRUCTION (SDI)

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Zach Apple

● SDI may be listed with each goal or as part of the table below.
● Include supplementary aids and services as appropriate.
● For a student who has a disability and is gifted, SDI also should include adaptations, accommodations, or modifications to the general
education curriculum, as appropriate for a student with a disability.

Projected Beginning
Modifications and SDI Location Frequency Anticipated Duration
Date

Zach will participate in a forward chaining Through the length of

Quiet room in library Duration of IEP 01/06/2017
procedure with a paraprofessional to learn how to this IEP
write his last name.

A medium sized laminated name tag will be

provided for the student on their desk. The name
tag will be removable so that the student can
Student Desk/Various Through the length of
transport their name tag through classroom Duration of IEP 01/06/2017
Classrooms this IEP
transitions and can use it as a reference as well as a
resource for practice by tracing their name with a
dry erase marker.

Zach will be provided with a laminated letter chart

Through the length of
where he can practice letter forming on lower and Homeroom Duration of IEP 01/06/2017
this IEP
upper-case letters.

Zach will be given his own personal iPad to which he

will be allowed to use it to work on a speech Speech Intervention Through the length of
Three times a week 01/06/2017
improvement app called ‘Wh - Questions’. An Room/Homeroom this IEP
educator will work along with him as he plays.

Mrs. McGlone, the speech therapist, will work with Speech Intervention Through the length of
Two times a week 01/06/2017
Zach to practice his sentence structure by Room or Music Room this IEP
incorporating singing activities.

Zach will be paired up with Mr. Rogers, Zach’s

Through the length of
homeroom teacher, during discussion time and will Homeroom Four times a week 01/06/2017
this IEP
work on expressing thoughts orally.

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Zach Apple

Zach will be given a visual chart every day that has

Through the length of
the object itself and a description (image or Homeroom/Specials Duration of IEP 01/06/2017
this IEP
sentence) of how to use the object.

Zach will be given the classroom IPAD to match

Through the length of
objects with words. This will be done during free Homeroom Duration of IEP 01/06/2017
this IEP
time and/or quiet time after lunch.

Zach’s homeroom teacher will provide him with a

social story during reading time. The social story
Reading class 4 times a week 01/06/2017
will help Zach to visualize certain objects in the Through the length of
story while also seeing the word. this IEP

Zach will be given flashcards with individual

01/06/2017 Through the length of
numbers, in order, and place them in the correct Math class 4 times a week
this IEP
sequence.

Zach will be provided with magnetic numbers to use

Through the length of
on the dry erase board and will practice putting Math class 3 times a week 01/06/2017
this IEP
numbers in order from 0-25.

Zach will be given an IPAD to play educational math

Through the length of
games that require him to place the numbers in Math class Duration of IEP 01/06/2017
this IEP
order from 0 to 25 and backwards from 25 to 0.

Page 6 of 6 November 2017