Completing the

IEP/Curriculum Planning Matrix

Keep in mind as you use this form that it is meant to be a guideline for the students day, rather than an
inflexible schedule. It is expected that there will be changes based upon student and staff variables,
special events, etc. However, when designing it, try to do so with a typical day in mind.
1. List the students IEP objectives in the left-hand column.
2. Across the top row of boxes, list the separate activities or periods of the regular school day, including
arrival, lunch, recess, study hall, "specials," or any other normal parts of the school routine. These
periods do not need to be in exact chronological order, as some activities change from day to day.
3. As a team, look at the first IEP objective. Going across the row, decide in which activity, activities, or
period(s) the objective could be addressed. Under those headings, indicate that the students IEP
objective will be addressed then by putting an X in the box or shading the box. Continue for each of
the objectives until finished. This will provide you with a picture of all the times throughout the day
when the objective could be addressed.
4. OPTION: In the bottom row or in the box where an IEP objective is indicated, the group may decide if
the student will need assistance other than what the classroom teacher can provide. In the lower
half of the box, one of the following codes may be used:
P peer
A second adult
N no assistance
NOTE: The table will expand as you enter more rows

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

EDUCATION, 2006

MARYLAND COALITION

FOR INCLUSIVE

IEP/Curriculum Planning Matrix

Student: ___Johnathon________ Grade:
Penn__________

__2___ Date: _3/11/14____ School:

_South

Schedule and/or Environments:

IEP Objectives:
Identify and name upper and lower
case letters
Use pictures or symbols to cue
sound of the consonant letters in
class while reading
Identify letters that represent
common words
Explore addition and subtraction
with objects, fingers, mental
images, drawings, sounds, acting
out, or verbal explanations
Represent addition and subtraction
with objects, fingers, mental
images, drawings, sounds, acting
out, or verbal explanations,
expressions or equations

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

EDUCATION, 2006

MARYLAND COALITION

FOR INCLUSIVE

Use addition and subtraction within

20 to solve word problems
Name numbers from 1 to 20
Write numbers from 1 to 20
Use a combination of drawing,
dictating, and writing to share
opinions about an experience or
book he has read
Write simple sentences
Spell and write his name correctly
Write the ABCs in order
Sequence photos to tell a story
using the words first/next/last
Consistently answer why
questions
Identify age appropriate
vocabulary in a field of 4 pictures
Get needed materials ready for
learning
Wait for teacher directions before
starting an activity
Independently complete an
assignment
Stay in assigned area at all times
Keep hands to himself

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

EDUCATION, 2006

MARYLAND COALITION

FOR INCLUSIVE

Planning worksheets for

student supports
These forms are often the first thing that the
instructional team will complete at the start of the school year. If the
classroom and/or special education teacher does not yet know the student
very well, they may complete the first column (what all students are
expected to do) and come back to the second and third column after
observing the students performance and reviewing the IEP.
1. Circle the teaching strategies (classroom participation), common
daily routines, or the environments or settings in which the student
may participate in social interactions with peers. Blank rows are
available in each worksheet for teachers to add opportunities that
are not described.
2. Describe the behavior that is expected of all students. For example:
when students read aloud, they are expected to hold the
book/material, look at the words, turn pages, and speak clearly.
During lunch, students are expected to find their lunch or lunch
card, walk without running, stand in line, unpack or open lunch
items, eat without spilling on the floor, and put garbage in the
garbage can.
3. The team describes what the focus student will be expected to do.
For example one student may be expected to look at the words and
activate a voice output device when it is his or her turn to read
aloud. During lunch, that student may be expected to walk with a
walker, stand in line, unpack/open lunch items, but not put garbage
in the can.
4. The team can then identify any supports that will be provided so
that the student can participate in a meaningful way in instruction,
daily routines, and social interactions. The student may need a book
stand, constant access to a voice output device, highlighted words
(to signal use of the device), and peer support to turn a page and/or
point to words. The student may need to have the cafeteria worker
check on him/her and put the garbage in the can.
5. When the team has completed the form, they need to discuss who
has what responsibilities and how they will communicate to any

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

staff that were not present when completing the Supports

Worksheets.
NOTE: These forms were adapted from ones developed by the University of New Hampshire
Institute on Disability in 2002. Thanks to Michael McSheehan for his input on using the
forms.

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

Planning Worksheet for

Classroom Participation
STUDENT: __Johnathon_________________ Grade: __2___ School _South
Penn________
When:

Students are
expected to:

The focus
student will:

We will provide
these supports:

The teacher
is talking

Look at teacher

Look at teacher

Listen (not speak,

looking at person
talking)

Listen (not speak,

looking at person
talking)

-say his name and

visually model what
he is supposed to be
doing

Hands and feet to

themselves

Hands and feet to

themselves

-specific spot on
carpet away from
distracting
materials
-peer models
-Reminder to stop,
look, listen with
hand actions and
symbols

Teacher
guided whole
class
discussion

Look at teacher

Look at teacher

Listen (not speak,

looking at person
talking)

Listen (not speak,

looking at person
talking)

Hands and feet to

themselves

Hands and feet to

themselves

-say his name and

visually model what
he is supposed to be
doing
-specific spot on
carpet away from
distracting
materials (choices)
-peer models
-Reminder to stop,
look, listen with
hand actions and
symbols
-immediate positive
feedback

Cooperative
group or pair
activities

To talk to peers with

in group

To talk to peers
within group

-specific job within

group

Work with group

members

Work with group

members

Stay on task

Stay on task

-something related to
what to do when his
job is done

Raise hand if
something is unclear

Raise hand if
something is

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

-what to do instead of
tattling

Use an appropriate
voice level

unclear
Use an appropriate
voice level

- pair him with a

specific buddy
(peer supports)
-geared toward his
likes
- visual
supports/checklists

Teacherdirected
small
groups/guide
d reading
(ability
grouped)

Stay on task

Stay on task

Ask questions if
needed

Ask questions if
needed

Listen when other

students are talking

Listen when other

students are talking

-specific skills to work

on
-individualized
supports
-math groupsrepeated exposure to
skill in a different way
-embedded skills and
supports
-paw prints, etc, high
fives, verbal
recognition, lots of
adult attention and
feedback
-visual
supports/checklists

Individual
seatwork

-remain in seat and

work quietly

-remain in seat and

work quietly

-raise hand quietly

to get help

-raise hand quietly

to get help

-use resources in the

classroom to help
them

-use resources in
the classroom to
help them

-complete task

-complete task

-followed direction
for when activity is
completed

-followed direction
for when activity is
completed

-cushion for his seat

-motivators
(depending on the
task)
-alternatives to
writing and the
writing processindependent ways for
him to complete
those tasks
-visual supports for
reminders to stay on
task
-peer supports
-adult check-in
-visual
supports/checklists
-desk organization
(cant find materials)

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

extra pencils
-usually doesnt finish
work- modified tasks
Using
technology(la
ptops for
math
practice)

-complete
assignment

-complete
assignment

-use appropriately

-use appropriately

-differentiated skills
-peer supports?
-color-coded visual
supports for the
keyboard
-technology supports

ADATPED BY: MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006 FROM THE UNIVERSITY OF NEW HAMPSHIRE,
INSTITUTE ON DISABILITY

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

Planning Worksheet for

Daily Routines

STUDENT: __Johnathon_______________ Grade: __2___ School _South

Penn___________
When:

Students are
expected to:

The focus
student will:

We will provide
these supports:

Arrival &
Dismissal

-hang up coat and

backpack

-hang up coat and

backpack

-take out folder and

assignment notebook

-take out folder

and assignment
notebook

-teacher or IA help
to choose breakfast
(with spoon, napkin,
etc. organization)

-walk into classroom

-folder and assignment
notebook in desk
-make breakfast choice
and eat at desk, clean
up

-walk into
classroom
-folder and
assignment
notebook in desk

-reminders (counting
down time)
-follows routine for
clean-up, doesnt
eat off floor

-make breakfast
choice and eat at
desk, clean up

Morning
routine

-take out homework

and assignment
notebook to be
checked by teacher
-student collects
homework
-stay in seat

--take out
homework and
assignment
notebook to be
checked by teacher

-excused from
homework
-opportunities for
functional skills
jobs

-student collects
homework
-stay in seat

Lunch

-come down to
cafeteria

-come down to
cafeteria

-reminders of table
number

-wait in line to be
seated

-wait in line to be
seated

-food served to him

based on choice

-sit at table

-sit at table

-wait to be dismissed
to lunch line

-wait to be
dismissed to lunch
line

-reminders to not
take food or eat food
off floor

-tell an adult or choose

lunch item
-get all their materials

-tell an adult or
choose lunch item

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

-what to do when he
is done

(utensils, napkin, etc.)

-choose milk
-choose fruit or
vegetables
-punch in lunch number
(if getting ice cream or
other treat, put lunch
number in again)
-go to table to eat
-if they need anything
they raise hand
-wait to be dismissed
to dump tray based on
table number
-sit in hall quietly

-get all their

materials (utensils,
napkin, etc.)
-choose milk
-choose fruit or
vegetables
-punch in lunch
number (if getting
ice cream or other
treat, put lunch
number in again)
-go to table to eat
-if they need
anything they raise
hand
-wait to be
dismissed to dump
tray based on table
number
-sit in hall quietly

Recess

Navigating
hallway and
locker
Transitioning
from one
subject/class
to another
Using
bathrooms

ADATPED BY: MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006 FROM THE UNIVERSITY OF NEW HAMPSHIRE,
INSTITUTE ON DISABILITY

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

Planning Worksheet for

Promoting Positive Social Interactions

STUDENT: __Johnathon________________ Grade: _2____ School _South
Penn___________
When:

Students are
expected to:

The focus
student will:

Students
arrive in
classes
Students are
working in
cooperative
groups
The teacher
is calling for
answers to
questions
During lunch
in the
cafeteria
The student
needs help
or is
confused
To initiate
conversation
on ageappropriate
topics
During
recess
During
independent
free choice
activities

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

We will provide
these supports:

ADATPED BY: MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006 FROM THE UNIVERSITY OF NEW HAMPSHIRE,
INSTITUTE ON DISABILITY

TOOLS FOR INCLUDING STUDENTS WITH DISABILITIES

MARYLAND COALITION FOR INCLUSIVE EDUCATION, 2006

Student Action Plan

STUDENT: _______________________________________ Grade: _____ School
___________________________

SAMPLE
Areas of
Focus

Actions/Strategies:

By whom

Collaborative
Teaming
among service
providers
Delivering
Accommodatio
ns,
Supplementar
y
Aids/Services
and Program
Modifications
Delivering
Related
services
Equipment,
Materials, and
Assistive
Technology

Maryland Coalition for Inclusive EducationIndividual Student Action Plan

2000

By when

SAMPLE
Areas of
Focus

Actions/Strategies:

By whom

Physical and
Environmental
Arrangements
Personal care

Behavior
Support
Home / School
Communicatio
n
Safety
(including
evacuation
plans)
Team Planning

Disability
Awareness
Professional
Development
for Staff/
Family

Maryland Coalition for Inclusive EducationIndividual Student Action Plan

2000

By when

SAMPLE
Areas of
Focus

Actions/Strategies:

By whom

Support
Other

Maryland Coalition for Inclusive EducationIndividual Student Action Plan

2000

By when