SPECIALLY GIFTED ANGELS LEARNING CENTER OF DAVAO CITY

UCHIDA BLDG. Lot 18 Block 11 Jacana Street,

Belisario Hts, Lanang, Davao City
09234589907 / giftedangels.davao@gmail.com

INDIVIDUALIZED EDUCATION PROGRAM

Confidential

STUDENT INFORMATION:

Student’ Name: Derek LPB Sex: Male

Date of Birth : January 31, 2012 Age: 5 years and 1 month old

Place of Birth: USA

Student’s Dominant Language: English Parent’s Dominant Language: English, Tagalog

CONFERENCE AND REVIEW DATE:

Date of Conference: May 2, 2017 Review Date: April 26, 2017

PARENT INFORMATION:

Name Abby LPB Relationship to the Mother

(Biologi
Address: Davao City child:
cal
Home
parents Davao City
Telephon
:
Primary Language English , Tagalog
e:
ofPareParentsarents
parent/guardian:

RECOMMENDED PLACEMENT:

Present Eligibility Category of the Student: Autism Spectrum Disorder

Program Recommendation: Homeschool Program – Junior Kinder (PNJK IS)

School Placement : Specially Gifted Angels (SGA)

School Address: UCHIDA BLDG. Lot 18 Block 11 Jacana Street, Belisario Hts, Lanang, Davao City

Grade Level: Junior Kinder ( Homeschool Program) Class section : Group Session
Time/Schedule: 5 hours Mon, Tue, Wed & Fri (SGA) Thurs (PNJK IS)
SPED Teacher: Ruby Mae Veroy Regular School Teacher: N/A

Progress Report:

Page 1 of 9
Name of Student: _Derek LPB Date of Birth: January 31, 2012

Service Delivery
What are the total service delivery needs of this student?
Include services, related services, program modifications and supports (including positive behavioral supports,
school personnel and/or parent training/supports). Services should assist the student in reaching IEP goals, to be
involved and progress in the general curriculum, to participate in extracurricular/nonacademic activities and to
allow the student to participate with nondisabled students while working towards IEP goals.

Type of Service Type of Support

Part-Time: Avails the service of Occupational AS Autistic Support

Therapist for once a week, 1 hour per session

Full-Time: Homeschool Program using a regular

classroom instruction set-up from Monday to Friday with
the integration of Special Education Curriculum in
collaboration with his Occupational Therapist and
Developmental Pediatrician.

RELATED SERVICES

Program or
Service Frequency Duration Date Initiated
Agency
Full Time 5 hours a day Monday - Friday June 2017 SGA

Part Time 1 hour in a week Monday June 2017 Theracare Clinic

Part Time 2 hours Thursday June 2017 PNJK IS

Transportation

SPECIAL ALERTS (Disability, Illness, Important Reminders)

Autism Spectrum Disorder

Explanation of the extent, if any, to which the child will not participate with non-disabled children in the regular
class and in the general education curriculum

Derek will join SGA’s Homeschool Program with the integration of a SpEd and a Regular School curriculum (SGA
and Philippine Nikkei Jin Kai International School). He will have his regular classes in SGA and will join regular
classroom every Thursday for 2 hours. This experience will enhance his adapatation and social skills as he joins a
class of 30-35 students. He is also given a chance to respond to a regular classroom teachers’ instructions.
 Page 2 of 9

Name of Student: _Derek LPB Date of Birth: January 31, 2012

LEVEL OF PERFORMANCE AT THE TIME OF ASSESSMENT

ASSESSMENT TOOLS AND RESULTS DATE
TECHNIQUES ADMINISTERED
Behavior Modification Technique Echolalia and tip toeing were observed February 7, 2017
Teacher-made materials of letters -He has difficulty expressing himself in February 7, 2017
and numbers a sentence.
-Can understand 1-2 step instructions
Observation -He can establish good eye contact. February 7, 2017
-Loves to play with any toy
-playful
Paper and pencil test -Cannot follow the correct strokes February 7, 2017
-has difficulty holding his pencil
-Slingerland Visual Reading Test -cannot identify most of the alphabet February 7, 2017
-Phoneme Awareness Assessment sounds
Tools
-Teacher-Made Letter and Sound
Recognition Test
Developmental Checklist

Observation – lunch time -picky eater February 8, 2017

-not toilet trained

SUMMARY OF ASSESSMENT

AREAS STRENGTHS WEAKNESSES

Behavior He has good working behavior.
Sings while working
Interested in table top activities
Communication Can express himself in 2-3 word utterances
Can understand 1-2 step instructions
Can easily respond to English instructions
Socialization Has good eye contact, sitting and waiting skills
Interested in all table top activities
He likes nursery rhymes songs
Fine-motor Interested in most of fine-motor activities
Can paste well
Can fix 6-15 pcs picture puzzle
Cognitive Can label common objects in pictures
Can name letters and numbers 1-20
Knows common vehicles, animals,
instruments, shapes, colors , action pictures
and opposites
Knows common functions of objects
Knows the functions of common community
helpers
Self-help Can brush his teeth and wash his hands
Can feed himself
Seldom displayed adaptation problem to unfamiliar
person
Has tiptoeing, lining up of objects, cries quietly when
reprimanded
Would not answer to unfamiliar people
Has echolalia
Has trouble understanding visayan and tagalog
instructions
Has difficulty playing games with simple rules
Has difficulty cutting papers using a pair of scissors
Cannot color within boundary
Unable to write letters following the correct strokes
Unable to identify alphabet sounds
Has difficulty identifying numbers 21 and above
Poor reading skills
Seldom eats rice
Still wears diapers
 Page 3 of 9

Name of Student: Derek LPB Date of Birth: January 31, 2012

LONG RANGE EDUCATIONAL PLAN

Annual Goals
Present Level of Performance (PLOP)
PROBLEM BEHAVIOR
Derek walks on tiptoe and flaps his hands when Derek can walk properly with less verbal cueing.
excited.
COMMUNICATION SKILLS
Derek tends to cry and would not answer simple Derek will be able to answer questions of unfamiliar
questions of unfamiliar persons. persons without crying.
PLAY & SOCIAL SKILLS
Derek has difficulty playing games with simple rules. Derek can play the following group games with simple
He can sometimes imitate on what to do upon rules on his own
observing his playmates but he gets excited too much - Musical chairs
and would forget playing the game. He cannot also - Stop dance
understand the concept of winning the game. - Relay games
FINE-MOTOR SKILLS
Derek finds it difficult to color within boundary whether Derek can identify and trace the boundaries of each
he is using small or big crayons. He can hold it picture with his pointer finger.
correctly but would over color its boundary. He can
also identify the right color for each picture.
He has problem writing letters following the correct Derek can write uppercase letters (A-Z) of the
strokes. He can write his name but with different sizes alphabet following the correct line and strokes on a
of the letters. paper following the blue-red-blue line.
ACADEMICS
Derek can identify and label the 26 sounds of the
Derek finds it confusing to label the alphabet sounds.
alphabet presented in a flashcard with a minimum of 7
He usually names them as letter.
distracters.
Derek can label clearly and correctly the numbers 21-
He is still unfamiliar of numbers 21-30. He also needs
30 when presented in a flashcard.
to practice naming them clearly and correctly.

SELF-HELP SKILLS
Derek is not used of eating rice since he was born in Derek is able the right kind of food every meal without
USA. He only likes to eat pasta, nuggets, toasted displacing hesitations.
bacon, peanut butter sandwich and chicken joy.

Page 4 of 9
Name of Student: Derek LPB
Short-term Objectives
Given 4 different exercises
in a day, within 3 months
Derek will be able to walk
correctly with his heels down
on the floor 80% of the time
with less verbal cues.
Within the 1st quarter, Derek
has to control his hand
flapping when he is excited
by shouting Yehey, clap his
hands together and smile
when he is happy using
minimal verbal instructions
75% of a time.
Within a month, Derek can
smile, say hi/hello and
answer to General
information questions
(name, age, school) of
unfamiliar people 80% of a
time using minimal verbal
cues.
Short-term Objectives
Date of Birth: January 31, 2012
I. PROBLEM BEHAVIOR
Date of
Methods and Materials Evaluation Master
y
1. The Teacher has to set up a situation wherein Derek has to
return one piece of the puzzle to its form board while walking
from one place to another.
2. He must be reminded to walk with his heels down.
3. He will be asked to go back in case he walks on a tip toe
4. remind him to walk correctly from time to time
5. generalize activity by practicing walking with his heels down on
the floor from the main door to his classroom
1. Derek must be given daily drill activities on how to respond
when he is excited.
2. He is only allowed to do the following responses with minimal
verbal cues:
shouts Yehey
clap his hands together
smile
3. This activity will not be stopped until he masters it
II. COMMUNICATION SKILLS
1. The Teacher has to structure the classroom by giving him
verbal warning on what to do when unfamiliar person will ask
him the following
-answers hi/hello
-What is your name?
-How old are you?
-Where do you go to school?
2. The Teacher should provide and practice him to answer
correctly
- I am Derek LPB
-I’m 5 years old
-I go to Specially Gifted Angels Learning Center
3. Assign and ask unfamiliar person to greet and ask Derek the 3
given questions
4. Provide minimal cues when he cannot give the correct answer
5. review activity until masters
6. Generalize activity by inviting another person in a natural
occurring situation.
III. PLAY AND SOCIAL SKILLS
Methods and Materials Evaluation Date of
Mastery
80% of the time, Derek can
play musical chairs, stop
dance and relay games
with his peers following the
rules correctly. He can also
understand the concept of
winning and losing a game.
He will congratulate his
playmates when they won
the game and would say
“Yehey, I won” when he
declared the winner and will
congratulate the winner by
shaking the hands of the
winner in case he lose.
Within 3 months Derek 1. Paper stencils will be initially used for familiarization and
will be given 50 coloring
exercises, Derek will be
able to color the picture 2. He will be given at least 3 coloring exercises in a day.
within boundary with
less promptings.
After 3 months, given 1. Letters are group according to its stroke
100 written exercises,
Derek will be able to
write uppercase letters
of the alphabet using the 2. He must be given 50 exercises for each letter category.
correct strokes following 3. Derek has to perform at least 5 writing worksheets per
the correct line with less
promptings with one
error or 90% proficiency.
1.
Within 3 months, Derek 2.
will be given 100
exercises of alphabet 3.
sounds identification
with less promptings 4.
1.
Given 100 worksheets
2.
within 3 months, Derek
will be able to point and
3.
name the 26 alphabet
sounds correctly with
4.
less verbal patterning.
1.
Within the 3 months,
2.
Derek will be able to
3.
express his needs to use
the toilet when the need
4.
arises with less wet
accidents.
1. The teacher has to prepare 5 chairs and lively music for 4
students. One of them is Derek.
2. Discuss the mechanics of the game.
3. Start playing the music as the class is dancing around the
circled chairs
4. When the music stops, everyone is tasked to sit on the chair,
whosever not sitting on the chair is out of the game.
5. Repeat steps 3 and 4
6. If he wins the game, he will cheer himself with a “yehey”
7. He will shake the hand of the winner if he lose the game and
say congratulations
IV. PageFINE-MOTOR
5 of 9 SKILLS
practice. He will be made realized in case he will hit the
boundary line.
Straight lines – E F H I L T
Slant lines – K M N V W X Y Z
Curve lines- B C D G J O P Q R S U
session
V. ACADEMIC SKILLS
Teacher will prepare flashcards of alphabet sounds
He will be made to identify and label 5 different sound in a
day
Review the mastered sounds before introducing the next 5
sounds
Different methods and strategies will be made in case he
shows difficulty understanding the concept of the lesson.
Teacher will prepare the needed materials
Derek has to point correctly at least 5 alphabet sounds in
a day
The child should be asked to name it unless he can
correctly identify the letter
Introduce another 5 sounds when mastered the previous
assigned task.
I. SELF-HELP SKILLS
Diapers will be removed when he gets inside the classroom
He will be brought to the toilet every 15 minutes
He has to ask “Can I use the toilet?” before going out of the
classroom
A power point presentation will be used as a SOCIAL
SKILLS TRAINING to show him the importance of going to
the toilet and not to wear his diapers.
II. SELF-HELP SKILLS
 5. Diapers will be removed when he gets inside the classroom
Within the 3 months,
6. He will be brought to the toilet every 15 minutes
Derek will be able to
7. He has to ask “Can I use the toilet?” before going out of the
express his needs to use
classroom
the toilet when the need
8. A power point presentation will be used as a SOCIAL
arises with less wet
SKILLS TRAINING to show him the importance of going to
accidents.
the toilet and not to wear his diapers.

Page 6 of 9

Participants in the IEP Planning Conference

Name Relationship to Student or Profession/Service Signature

Mr. and Mrs. PB Parents
Ms. Rubie Mae Veroy SPED Teacher
Glexie Occupational Therapist

DATE OF IEP: June 2017

Name of Student: Derek LPB Date of Birth: January 31, 2012

Response Section
School Assurance

I certify that the goals in this IEP are those recommended by the Team and that the indicated services will
be provided.

Signature Principal/School Representative Date

Parent Options / Responses

It is important that the school knows your decision as soon as possible. Please indicate your
response by checking at least one (1) box and returning a signed copy to the Specially Gifted
Angels Learning Center. Thank you.

I accept the IEP as developed. I reject the IEP as developed.

I reject the following portions of the IEP with the understanding that any portion(s) that I do not reject will
be considered accepted and implemented immediately. Rejected portions are as follows:

I request a meeting to discuss the rejected IEP or rejected portion(s).

 Signature of Parent, Guardian, Educational Surrogate Parent, Student 18 and Over*
Date
*Required signature once a student reaches 18 unless there is a court appointed guardian.

Parent Comment: I would like to make the following comment(s) but realize any comment(s) made that
suggest changes to the proposed IEP will not be implemented unless the IEP is amended.

Page 7 of 9
SPECIALLY GIFTED ANGELS LEARNING CENTER OF DAVAO CITY
UCHIDA BLDG. Lot 18 Block 11 Jacana Street,
Belisario Hts, Lanang, Davao City
09234589907 / giftedangels.davao@gmail.com

Name of Student: Derek LPB Date of Birth: January 31, 2012

Progress Report on IEP Dated: from to

SPECIALLY GIFTED ANGELS LEARNING CENTER OF DAVAO CITY

UCHIDA BLDG. Lot 18 Block 11 Jacana Street,
Belisario Hts, Lanang, Davao City
09234589907 / giftedangels.davao@gmail.com

To: ____________________

Re: ___________________ Date of Birth: ___________________

Subject: MEETING INVITATION

Notice Date: ________________

Derek LPB

You are invited to a meeting to discuss the above-named student. Your participation is essential. The
purpose and details of the meeting are printed below. Other invited participants are listed on the enclosed
attendance form.

It is your legal right to be present and to participate. Also, the school values your input and hopes you will
make every effort to attend this meeting.

If the suggested meeting time is inconvenient, we will set a more convenient time. Please call the listed
contact person to request another meeting time. If you cannot attend, it is our responsibility to obtain your
participation, if at all possible, in another way.

You may invite other individuals to attend who have knowledge or special expertise regarding this student.
We request that you inform us in advance of the meeting if you plan to invite other individual(s) to join us.
Again, please call the listed contact person with this information.
We look forward to working cooperatively with you on behalf of this student.Meeting Purpose: Eligibility
Determination, IEP Development, Placement Determination, Transition Planning, Others, Please specify
_______________

Meeting Date/Time/Location:

Contact Person:

Contact Information:

Page 8 of 9

SPECIALLY GIFTED ANGELS LEARNING CENTER OF DAVAO CITY

UCHIDA BLDG. Lot 18 Block 11 Jacana Street,
Belisario Hts, Lanang, Davao City
09234589907 / giftedangels.davao@gmail.com

Attendance Sheet
Special Education Team Meeting

DATE
:
Student DOB ID#: Error! Not a valid
Name:
Purpose of Meeting: Check all boxes that apply. : bookmark self-

Eligibility Determination IEP Development reference.

Placement
Initial Evaluation Initial

Reevaluation Annual Review

Other:

Print Names of Print Roles of Initial

Team Members Team Members if in attendance
Prepared by: LInaver M. Cane

Page 9 of 9