STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

INDIVIDUALIZED EDUCATION PROGRAM (CONFERENCE SUMMARY REPORT)

DATE OF MOST RECENT EVALUATION:_10__/_23___/_2012__DATE OF NEXT REEVALUATION:__10__/__24__/2015_
PURPOSE OF CONFERENCE (Check all that apply)
Review of Existing Data Initial Eligibility Reevaluation Initial IEP IEP Review/Revision Transition Manifestation Determination Graduation STUDENTS DATE OF BIRTH 2/15/2001 CURRENT GRADE LEVEL 5 DISABILITY (S) D SERVING DISTRICT #25 Monticello SERVING SCHOOL Washington Grade School (Piatt County) MEDICAID NUMBER NO Termination of Placement Other (e.g. FBA/BIP)________ SIS ID NUMBER 123456789 ANTICIPATED DATE OF HS GRADUATION

STUDENT IDENTIFICATION INFORMATION

STUDENTS ADDRESS (Street, City, State, Zip Code) 123 Main St. Monticello, IL 61884 MALE ETHNICITY LANGUAGE/MODE OF COMMUNICATION USED BY STUDENT 0 English

05 FEMALE PLACEMENT (To be completed after placement determination) YES NO Placement is in Resident School RESIDENT DISTRICT #25 Monticello RESIDENT SCHOOL Washington Grade School (Piatt County) (1) PARENTS NAME

PARENT/GUARDIAN INFORMATION
Educational Surrogate Parent (2) PARENTS NAME Educational Surrogate Parent

(1) PARENTS ADDRESS (Street, City, State, Zip Code)

(2) PARENTS ADDRESS (Street, City, State, Zip Code)

(1) PARENTS TELEPHONE NUMBER (include Area Code) (1) LANGUAGE/MODE OF COMMUNICATION USED BY PARENT (S) Yes No Interpreter

(2) PARENTS TELEPHONE NUMBER (Include Area Code) (2) LANGUAGE/MODE OF COMMUNICATION USED BY PARENT (S) Yes No Interpreter

PARTICIPANTS
Signature indicates attendance. Check appropriate boxes to indicate which meetings were attended. Anyone serving in a dual role should indicate so on the following lines. If a required participant participates through written input or is excused from all or part of the IEP meeting, the required excusal and written report, as necessary, is attached.
ELIG. REVIEW

IEP Parent Parent Student LEA Representative General Education Teacher Special Education Teacher School Psychologist

ELIG. REVIEW

IEP School Social Worker Speech-Language Pathologist Bilingual Specialist Interpreter Other (specify) Other (specify) Other (specify)

If the parent(s) did not attend the IEP meeting, document the attempts to contact the parent(s) prior to the IEP meeting.

PROCEDURAL SAFEGUARDS
Explanation of Procedural Safeguards were provided to/reviewed with the parent(s) on _____________________________________________________ Transfer of Rights - Seventeen-year old student informed of his/her rights that will transfer to the student upon reaching age 18. Parent(s) were given a copy of the: Evaluation report and eligibility determination Districts behavioral intervention policies IEP Districts behavioral intervention procedures (initial IEP only) Yes NA

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ DOCUMENTATION OF INTERVENTION/EVALUATION RESULTS (SPECIFIC LEARNING DISABILITY)

Complete for initial evaluations, reevaluations, or a review of an independent or outside evaluation when a specific learning disability is suspected. As part of the evaluation process, relevant behavior noted during observation in the childs age -appropriate learning environment, including the general education classroom setting for school-age children, and the relationship of that behavior to the childs academic functioning and educationally relevant medical findings, if any, must be documented.
PROBLEM IDENTIFICATION / STATEMENT OF PROBLEM: Using baseline data, please provide an initial performance discrepancy statement for all identified areas of concern in the r elevant domains (academic performance; functional performance; cognitive functioning, communicative status (for ELL students includes an explanation of ELL status and any change in linguistic status); social/emotional status/functioning, motor abilities, health, hearing and vision) including information about the students performance discrepancy prior to intervention. Attach evidence. MS is currently in the 5th grade at Washington School. He was initially evaluated and determined eligible for special education services as a student with a learning disability in reading fluency, reading comprehension, math calculation, and written expression when he was in 2nd grade and attending school in West Frankfort, IL. MS moved into the Monticello School District while in 3 rd grade. Since his initial evaluation, MS has made great progress in his reading and written expression skills. After a review of data by the IEP team it was determined that there is enough information at this time to conclude that MS is no longer eligible for special education services in the areas of reading and writing, as he has closed the gap between his abilities in these areas and those of peers. I n math, however, the data is less conclusive, as MSs scores on universal screening benchmarks are inconsistent, and his performance can vary greatly from day to day. he scored below expectations on the 2012 ISAT in math. At a domain meeting held on 9/11/12, the IEP team requested additional testing in math to help determine MSs true functioning levels and need for continued special education services. MS is currently earning all As and Bs on his report c ard. Teachers report that he is a hard worker but needs help getting into an organizational routine at the beginning of each school year. MS currently receives pushin resource support in math for 150 minutes per week, push-in support for study skills 25 minutes per week, resource math instruction for 75 minutes per week, and resource support instruction for 75 minutes per week. The resource teacher reported that MSs performan ce is inconsistent from day to day. he seems to solidly grasp concepts certain days to the point that he can help other students who are struggling and yet on other days he is the one who needs help. He is also described as an emotional young boy whose academic performance can be affected by how he is feeling. PROBLEM ANALYSIS / STRENGTHS AND WEAKNESSES: Describe students skill strengths and weaknesses in the identified area(s) of concern within the relevant domains. Attach evidence, including evidence of skills deficit versus performance deficit. MS is a hard worker who wants to do well. His confidence has improved. Reading and written expression skills have shown great improvement since his previous evaluation. MS has limited mental math and numeration skills. He does not, for example, quickly compute a problem like 60 plus 27 in his head and will work a problem like this out on paper rather than use more efficient mental math. He has difficulty with the concepts of rounding, expanded notation, and simple fractions. MS asked for example, if 1 hours was more than 1 hour. Applied problems involving money and multiplication and division were difficult for him. PLAN DEVELOPMENT / INTERVENTION(S): Describe the previous and current intervention plans (core/Tier 1, supplemental/Tier 2, and intensive/Tier 3) including evidence that the intervention is scientifically based and was implemented with integrity. Attach plan/evidence. MS has received core/Tier 1 instruction within his general education classroom. Since last year, he received this instruction using a co-teaching model. This support is delivered daily during his math instruction time. MS has been receiving supplemental/Tier 2 through daily RTI math reteaching for 30 minutes 4 out of 6 days since Sept. of his 4 th grade year. This intervention includes using re-teaching of concepts using manipulatives, memory triggers, and Pin-point math for the area of math application and math computation. For intensive/Tier 3 intervention he receives small group daily re-teaching of math concepts for 15 minutes a day in the resource room. The following programs are implemented: Drops in the Bucket, Memorization Triggers, and Moby Math. PLAN EVALUATION / EDUCATIONAL PROGRESS: Provide documentation of student progress over time as a result of the intervention. Attach evidence/graphs. There is only two AIMSWEB progress monitoring data point available so far for this school year. During the previous school year, MS was on target to meet his RTI Tier 3 intervention goal in math computation after 7 data points from September through November 2011. Math Computation benchmarks: 23, 51, 32 Math Computation scores in small group: 21, 50, 45 Math Application benchmarks: 6, 12, 8 Math Application scores in small group: 2, 7, 5, 13, 7, 14, 14 In the area of math computation, MS demonstrated knowledge of 98% of all multiplication facts in the resource room. he has also shown great progress in math application increasing his scores (in AIMSWEB assessment) from a 6 at the beginning of the 4 th grade to a 14 at the end of 4th grade. For the first quarter of the 5th grade, using AIMSWEB benchmarking in the area of math application, MS scored a 3. This puts him below the 10%ile for his age-group. Since Sept 27th, in his math RTI group, he has been receiving interventions using the 4 th grade progress monitoring in the area of math application, MS has shown the following progress: 9 (25%ile), 10. For the first quarter of the 5 th grade, using AIMSWEB benchmarking in the area of math computation, MS scored an 11. This puts him in the 10%ile for his age-group. Since Sept 27th, in his math RTI group, he has been receiving interventions in the area of computation. Every two weeks, he has been assessed using AIMSWEB progress monitoring at the 4th grade level. He has the following scores: 34 & 56 (50%ile at 4th grade level)

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

PLAN EVALUATION / DISCREPANCY: State the current performance discrepancy after intervention, i.e., the difference between a students level of performance c ompared to the performance of peers or scientifically-based standards of expected performance. Attach evidence. On the most recent AIMSWEB universal screening, MS scored below the 10 th percentile relative to local peers, in the Well Below Average ranger, on math concepts and applications. On math computation, he scored between the 10 th and 25th percentiles, in the below average range. He did not meet expectations in math on the 2012 ISAT. On four subtests of the KEYMATH3 Form A, he scored in the below average range, with scaled scores ranging from 6 to 7, or from the 9 th to 16th percentile. On AIMSWEB universal screening in reading, MS scored most recently in the 10-25th percentile in reading CBM and reading MAZE. His most recent F&P testing showed him reading at a level T. He scored in the average range (25-75th percentile) in written expression WSC and CWS. PLAN EVALUATION / INSTRUCTIONAL NEEDS: Summarize the students needs in the areas of curriculum, instruction, and environment. Include a statement of whether the students needs in terms of materials, planning, and personnel required for intervention implementation are significantly different from those of general education peers. Attach evidence. MS requires continued intervention to improve his numeration and mental computation skills and to increase his ability to function independently in math. ADDITIONAL INFORMATION NECESSARY FOR DECISION-MAKING (INCLUDE AS APPROPRIATE): Report any educationally relevant information necessary for decision-making, including information regarding eligibility exclusionary and inclusionary criteria. Attach evidence.

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ ELIGIBILITY DETERMINATION (SPECIFIC LEARNING DISABILITY) (Required as of the 2007-2008 School Year) Complete for initial evaluations, reevaluations, or a review of an independent or outside evaluation when a specific learning disability is suspected. DETERMINANT FACTORS
The determinant factor for the students suspected disability is: Yes Yes Yes X X X No No No Lack of appropriate instruction in reading, including the essential components of reading instruction (Evidence Provided)___scientific, research-based curriculum used_________________________________ Lack of appropriate instruction in math (Evidence Provided)_research based curriculum used____________ Limited English Proficiency (Evidence Provided)___English is primary language_______________________

If any of the above answers is yes, the student is not eligible for services under IDEA and the team must complete the Eligibility Determination section accordingly. If all of the answers are no, complete the following sections.

EXCLUSIONARY CRITERIA
The team determined that the following factors are the primary basis for the students learning difficulties. Document the source of evidence in each area: Yes X No A visual, hearing or motor disability: none identified Yes X No Cognitive Disability: none identified Yes X No Emotional disability: none identified Yes X No Cultural factors: none identified Yes X No Environmental or economic disadvantage: none identified If any of the boxes immediately above is checked yes, the student cannot have a primary eligibility of specific learning disability and the team must complete the Eligibility Determination section accordingly.

INCLUSIONARY CRITERIA

Educational Progress (Over Time)

Evidence in the Documentation of Evaluation Results should support the teams answer to this question. Is the student progressing at a significantly slower rate than is expected in any areas of concern? (Select One) No Yes - The student is progressing at a significantly slower rate than expected Yes - The student is currently making an acceptable rate of progress but only because of the intensity of the intervention that is being provided. If yes, in which area(s)? Mathematical calculation and mathematical problem solving

Discrepancy (At One Point in Time)

Evidence in the Documentation of Evaluation Results should support the teams answer to this question. Is the students performance significantly below performance of peers or expected standards in any areas of concern? (Select One) No Yes - The students performance is significantly discrepant. Yes - The students performance is not currently discrepant but only because of the intensity of the intervention that is being provided. If yes, in which area(s)? Mathematical calculation and mathematical problem solving

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ ELIGIBILITY DETERMINATION (SPECIFIC LEARNING DISABILITY) (Required as of the 2007-2008 School Year)

Instructional Need
Evidence in the Documentation of Evaluation Results should support the teams answer to this question. Are this students needs in any areas of concern significantly different from the needs of typical peers and of an intensity or type that exceeds general education resources? (Select One) No Yes - The students instructional needs are significantly different and exceed general education resources. If yes, in which area(s)? Mathematical calculation and mathematical problem solving If any of the boxes in this section (Inclusionary Criteria) are marked No, the student does not have a Specific Learning Disability and the team must complete the Eligibility Determination section accordingly.

Optional Criteria
After determining that the criteria in the preceding section are met, the district may choose to use an IQ-achievement discrepancy model. If using this model, complete this section. IQ-Achievement Discrepancy: Yes No NA Does a severe discrepancy exist between achievement and ability that is not correctable without special education and related services? (Please refer to evidence in Documentation of Evaluation Results) If yes, in which area(s)?

ELIGIBILITY DETERMINATION
Step 1: Disability Adversely Affecting Educational Performance Yes No Based on the answers to the questions in the Determinant Factors, Exclusionary Criteria, and Inclusionary Criteria, sections, does the student have a specific learning disability?

If the answer is no the student is not eligible for special education services under the category of Specific Learning Disability and the team must complete Step 2 below. If the answer is yes, indicate the area below and complete Step 2. Basic reading skills Mathematical calculation Reading fluency skills Mathematical problem solving Reading comprehension Written expression

Oral expression Listening comprehension

Step 2: Special Education and Related Services Specialized instruction is required in order for the student to make progress and reduce discrepancy (Eligible) Specialized instruction is not required in order for the student to make progress and reduce discrepancy (Not Eligible)

Each team member must sign below to certify that the report reflects his/her conclusions for specific learning disability. Any participant who disagrees with the teams decision must submit a separate statement presenting her/his conclusions. Yes Yes Yes Yes No No No No Yes Yes Yes Yes No No No No

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE Complete for initial IEPs and annual reviews. When completing this page, include all areas from the following list that are impacted by the students disability : academic performance, social/emotional status, independent functioning, vocational, motor skills, and speech and language/communication. This may include strengths/weaknesses identified in the most recent evaluation. Students Strengths MS has worked very hard and improved his academic skills in every area since the beginning of last school year. MS likes to help others when he is in small group settings. He is very articulate and creative.

Parental Educational Concerns/Input MSs step-mom has expressed concern for MS not always telling the truth. She also expressed that MS may not perform as well when he is upset or concerned about something. She has seen improvements on his math and reading abilities. She would like to see him become more independent.

Students Present Level of Academic Achievement (Include strengths and areas needing improvement) MS has improved his reading comprehension level to that of his peers and continues to stay with them without supports. He has been scored at a level T using Fontas and Ponell. His fluency is also at grade level reading at 117 wpm. MS received a B on his report card in reading for last quarter, and is currently progressing quite well. MS knows his multiplications facts through 12 and can perform them quickly. In the area of math application MS has been scoring in the 10%ile for his age group. th In math computation, MS has been scoring in the 50%ile for the 4 grade level. When MS is in a setting where he feels confident of himself, he is able to perform at a higher level than when he feels self-conscious. MSs performance on class work and assessments fluctuates greatly based on how hes feeling. His test scores reflect ups and downs in his performance. He needs continued support in math concepts. He is able to grasp new math concepts at an average rate, but has a rather hard time applying new concepts successfully. MS needs consistent repetition of math facts in order to meet goals he sets for himself. He needs go back over his work once its completed and pencil-check it before turning it over to an adult to check. He consistently makes little mistakes th at are easily caught as hes going back over the work. When hes in a small group setting, such as pull out or in the resource room, he demonstrates more self-monitoring and self-control. His math scores reflect ups and downs and he continues to need work in the areas of math computation and application. MS struggles mostly in interpreting information displayed on graphs, charts, and tables in order to answer application problems. MS also struggles with accurately determining an answer when asked to estimate. On his 2012 math ISAT scores, MS scored below average. MS struggles to apply new th math concepts taught in the 5 grade curriculum. Students Present Levels of Functional Performance (Include strengths and areas needing improvement) Using MSs daily performance in the classroom, performance on AIMSWEB testing from Fall of 4 grade to Fall of 5 grade, as well as ISAT scores, teacher observation, and parental input;
th th

MS has shown improvements in his writing and reading skills and is functioning on grade-level. MS has made great th strides in math computation, but struggles to apply his skills to concepts taught in 5 grade. MS struggles with confidence and handling stress. This effects his ability to perform consistently with his ability level. Hi s tests reflect ups and down which correlate with stressful times in his life.

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ Describe the effect of this individuals disability on involvement and progress in the general education curriculum and the functional implications of the students skills. For a preschool child, describe the effect of this individuals disability on involvement in appropriate activities. By age 14, describe the effect of this individuals disability on the pursuit of post -secondary expectations (living, learning, and working).

Due to MSs disability in the areas of math, he will require instruction and support in the special education setting to best meet his needs. This will reduce the amount of times in the general education setting

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ GOALS AND OBJECTIVES/BENCHMARKS

Complete for initial IEPs and annual reviews. (Anyone responsible for implementing the IEP (e.g., goals and objectives/benchmarks, accommodations, modifications and supports) must be notified of her/his specific responsibilities.)

REPORTING ON GOALS
The progress on annual goals will be measured by the short-term objectives/benchmarks. Check the methods that will be used to notify parents of the students progress on annual goals and if the progress is sufficient to achieve the goals by the end of the IEP year: Report cards Progress reports

Parent conference

Other (specify) __________________________

CURRENT ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Results of the initial or most recent evaluation and results on district-wide assessments relevant to this goal; performance in comparison to general education peers and standards. On MSs most recent AIMSWEB math comp benchmarking test, he scored a 33%. This benchmark test contained 5 grade level facts.
th

GOALS AND OBJECTIVES/BENCHMARKS

The goals and short-term objectives or benchmarks shall meet the students educational needs that result from the students disability, including involvement in and progress in the general curriculum, or for preschool students, participation in appropriate activities. Goal Statement #_1__of__3__

On biweekly progress monitoring using AIMSWEB M-Comp forms, MS will write down the correct answer for two single digit factors in 1 minute for 80% of the problems. Indicate Goal Area: Academic Functional Transition Illinois Learning Standard: #___6.B.2_____
Title(s) of Goal Implementer(s)

Special Education and General Education Teachers

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal On biweekly progress monitoring using AIMSWEB M-Comp forms, MS will write down the correct answer for two single digit factors in 1 minute for 50% of the problems. Evaluation Evaluation Schedule for Dates Reviewed/ Criteria Procedures Determining Progress Extent of Progress (Optional)

50 /

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal On biweekly progress monitoring using AIMSWEB M-Comp forms, MS will write down the correct answer for two single digit factors in 1 minute for 60% of the problems. Evaluation Evaluation Schedule for Dates Reviewed/ Criteria Procedures Determining Progress Extent of Progress (Optional)

60 /

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal Evaluation Criteria Evaluation Procedures Schedule for Determining Progress Dates Reviewed/ Extent of Progress (Optional)

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify)

Daily Weekly Quarterly Semester Other (specify)

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ EDUCATIONAL ACCOMMODATIONS AND SUPPORTS

Complete for initial IEPs and annual reviews. (Anyone responsible for implementing the educational accommodations must be notified of her/his specific responsibilities). TRANSITION
Yes No NA Consideration of service needs, goals, and support/services is required (by age 14 , the team must address transition Service needs). If yes, complete the Transition Services section of the IEP. Consideration of Home-Based Support Services Program for Mentally Disabled Adults for eighteen-year-old student is Required. If yes, complete the Home-Based Support Services Program section of the IEP.

Yes

No

NA

CONSIDERATION OF SPECIAL FACTORS Check the boxes to indicate if the student requires any supplementary aids and/or services due to the following factors. For any box checked yes, specify the special factors in the Supplementary Aids, Accommodations and Modifications section listed below.
Yes Yes Yes Yes Yes Yes No No No No No No Assistive technology devices and services Communication needs Deaf/hard of hearing languages and communication needs Limited English proficiency language needs Blind/visually impaired provision of Braille instruction Behavior impedes students learning or that of others. If yes, the team must consider strategies, including positive behavioral interventions and supports to address behavior. This may include a Functional Behavioral Assessment and/or a Behavioral Intervention Plan. If, so attach any completed forms.

LINGUISTIC AND CULTURAL ACCOMMODATIONS

Yes No The student requires accommodations for the IEP to meet her/his linguistic and cultural needs. If yes, specify any needed accommodations:

Yes

No

Special education and related services will be provided in a language or mode of communication other than or in addition to English. If yes, specify any needed accommodations:

SUPPLEMENTARY AIDS, ACCOMMODATIONS, AND MODIFICATIONS

Specify what aids, accommodations, and modifications are needed for the child to make progress toward annual goals, to progress in the general education curriculum, participate in extracurricular and other non-academic activities, and to be educated and participate with other children with disabilities and/or nondisabled children (e.g., accommodations for daily work, environmental accommodations, moving from class to class, etc.). Supplementary aids, accommodations, and modifications must be based upon peer-review research to the extent practicable.

Re-teach math concepts Provide prompts and visual cues to aide in applying math skills Extended time Alternate setting with fewer distractions

SUPPORTS FOR SCHOOL PERSONNEL

Yes No Program trainings and/or supports for school personnel are needed for the student to advance appropriately toward attaining the annual goals, participate in the general curriculum, and be educated and participate with other students in educational activities. If yes, specify what trainings and/or supports are needed, including when appropriate, the information that clarifies when the trainings and/or supports will be provided, by whom, in what location, etc.

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ ASSESSMENT

CLASSROOM-BASED ASSESSMENTS
Yes Yes No No Student requires accommodations to participate in classroom-based assessments. Student requires alternate assessment/methods to participate in classroom-based assessments

DISTRICT-WIDE ASSESSMENTS
District does not administer district-wide assessments District does not administer district-wide assessments at this grade level: _________

Student will:
Participate in the entire district-wide assessment with no accommodations Participate in the entire district-wide assessment with accommodations Participate in part(s) of the district wide assessment (specify) Participate in the district-wide alternate assessment

STATE ACADEMIC ASSESSMENTS

The State academic assessments are the Illinois Standards Achievement Test (ISAT) at grades 3-8 and the Prairie State Achievement Exam (PSAE) at grade 11, Illinois Measure of Annual Growth in English (IMAGE) in grades 3-8 and 11 (for English Language Learner (ELL) students), and Illinois alternate Assessment (IAA) in grades 3-8 and 11.
State academic assessments are not administered at this grade level __________

Student will:
Participate in the ISAT/PSAE/IMAGE with no accommodations Participate in the ISAT/PSAE/IMAGE with accommodations Participate in the IAA

If the student will participate in the IAA, the following were met:
The ISAT/PSAE/IMAGE is not appropriate (specify) The IAA participation guidelines were met The alternate assessment selected is appropriate for the student (explain)

STATE ASSESSMENT OF LANGUAGE PROFICIENCY

The State assessment of language proficiency is Assessing Comprehension and Communication in English State to State (ACCESS) in grades K-12
Yes No ENGLISH LANGUAGE LEARNER (ELL). If NO, skip to next section

Student will:
Participate in the ACCESS with no accommodations Participate in the ACCESS with accommodations

ASSESSMENT ACCOMMODATIONS
If the student is participating in any of the above assessment(s) with accommodations, specify the needed accommodations (e.g., extended time, alternate setting, auditory testing) necessary to measure the students academic achievement and functional performance . The accommodations should be appropriate for that particular assessment and reflective of those already identified for the student in the Supplementary Aids, Accommodations, and Modifications section.

Access to posters in alternative settings Extended time

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ EDUCATIONAL SERVICES AND PLACEMENT

Initiation Date:__9__/___11__/_12___ Duration Date: _9__/__11__/__13__

PARTICIPATION IN GENERAL EDUCATION CLASSES The IEP must address all content areas, classes, and specify if the student will participate in general physical education. General Education with No Supplementary Aids
(Specify content areas, classes, whether or not the child will participate in general physical education, and extracurricular and other nonacademic activities.)

Minutes Per Week in Setting (Optional)

Lunch, recess, all school activities, fine arts, music, computers, physical education

General Education with Supplementary Aids (as specified in the Supplementary Aids section)
(Specify content areas, classes, whether or not the child will participate in general physical education, and extracurricular and other nonacademic activities with supports, if applicable.) Reading, language arts, math, science, social studies

Minutes Per Week in Setting (Optional)

Special Education and Related Services within the General Education Classroom
(Specify content areas and classes in which the child will participate with the provision of special education and related services. List each special education and related service that will be provided during each class. )

Minutes Per Week in Setting 150

Math supports Study skills supports 25

PARTICIPATION IN SPECIAL EDUCATION CLASSES/SERVICES The IEP must address all special education and related services. Special Education Services Outside General Education Math instruction Resource instruction Minutes Per Week in Setting A. 75 75

Related Services Outside General Education

Minutes Per Week in Setting B.

Educational Environment (EE) Calculation (Ages 3-5) _________ 1. Minutes spent in regular early childhood program _________ 2. Minutes spent receiving special education and related services outside regular early childhood (A+B)

Educational Environment (EE) Calculation (Ages 6-21) __2075__ 1. Total Bell to Bell Minutes ___150__ 2. Total Number of Minutes Outside of the General Education Setting (A+B)

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________

EDUCATIONAL SERVICES AND PLACEMENT EDUCATIONAL ENVIRONMENT CONSIDERATIONS
To the maximum extent appropriate, all students shall be educated and participate with students who are non-disabled. Provide an explanation of the extent, if any, to which the student will not participate in general education classes and activities. Special education classes separate schooling, or removal from the regular education environment is required because the nature or severity Yes No of the students disability is such that education in general classes with the use of supplementary aids and services cannot be achieved satisfactorily. Explain: ___Due to deficits, MS requires special education services to best meet his need__________________________________ Yes No Will participate in nonacademic activities with nondisabled peers and have the same opportunity to participate in extracurricular activities as nondisabled peers? If no, explain: ____________________________________________________________________________________________________ Will attend the school he or she would attend if nondisabled? If no, explain: ____________________________________________________________________________________________________

Yes

No

PLACEMENT CONSIDERATIONS
When determining the placement, consider any potentially harmful effect either on the student or the quality of services that he/she needs. After determining the students placement, complete the Placement section on this cover sheet. Yes NA For a child who is deaf, hard or hearing, blind or visually impaired, parents have been informed of existence of the Illinois School for the Deaf or the Illinois School for the Visually Impaired, and other local schools that provide similar services. POTENTIALLY HARMFUL EFFECT/ REASONS REJECTED TEAM ACCEPTS PLACEMENT

PLACEMENT OPTIONS CONSIDERED

General Education General education classroom with modifications General education classroom with special education support

Not enough support to meet identified needs Not enough support to meet identified needs Best meets students needs but limits exposure to gen ed curriculum TRANSPORTATION

Yes Yes Yes

No No No

Check all that apply

Yes Yes Yes No No No Special transportation is required to and from schools and/or between schools. Special transportation is required in and around school buildings. Specialized equipment (such as special or adapted buses, lifts, and ramps) is required.

Please explain and/or detail transportation plan:

EXTENDED SCHOOL YEAR SERVICES

Yes No Extended school year services are needed. The IEP team must document the consideration of the need for extended school year services and the basis for the determination. MSs ability to recoup skills will be monitored

If yes, the IEP must indicate the type, amount and duration of services to be provided.

SPECIAL EDUCATION SERVICE (S)

LOCATION

AMOUNT/FREQUENCY OF SERVICES

INITIATION OF SERVICES

DURATION OF SERVICES

GOAL (S) ADDRESSED

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ GOALS AND OBJECTIVES/BENCHMARKS

Complete for initial IEPs and annual reviews. (Anyone responsible for implementing the IEP (e.g., goals and objectives/benchmarks, accommodations, modifications and supports) must be notified of her/his specific responsibilities.)

REPORTING ON GOALS
The progress on annual goals will be measured by the short-term objectives/benchmarks. Check the methods that will be used to notify parents of the students progress on annual goals and if the progress is sufficient to achieve the goals by the end of the IEP year: Report cards Progress reports

Parent conference

Other (specify) __________________________

CURRENT ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Results of the initial or most recent evaluation and results on district-wide assessments relevant to this goal; performance in comparison to general education peers and standards. MS struggles to answer questions that require him to apply skills taught in math. He especially has trouble reading and comprehending information on tables, graphs, and charts provided.

GOALS AND OBJECTIVES/BENCHMARKS

The goals and short-term objectives or benchmarks shall meet the students educational needs that result from the students disability, including involvement in and progress in the general curriculum, or for preschool students, participation in appropriate activities. Goal Statement #_2__of__3__

On biweekly progress monitoring, MS will use skills at reading tables, graphs, and charts to identify relevant information in order to answer 9/10 questions accurately. Indicate Goal Area: Academic Functional Transition Illinois Learning Standard: #__6.D.2____
Title(s) of Goal Implementer(s) Special Education and General Education Teachers Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal

On biweekly progress monitoring, MS will use skills at reading tables, graphs, and charts to identify relevant information in order to answer 7/10 questions accurately.
Evaluation Criteria
7/10

Evaluation Procedures

Schedule for Determining Progress

Dates Reviewed/ Extent of Progress (Optional)

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal

On biweekly progress monitoring, MS will use skills at reading tables, graphs, and charts to identify relevant information in order to answer 8/10 questions accurately.
Evaluation Criteria
8 /10

Evaluation Procedures

Schedule for Determining Progress

Dates Reviewed/ Extent of Progress (Optional)

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal

Evaluation Criteria

Evaluation Procedures

Schedule for Determining Progress

Dates Reviewed/ Extent of Progress (Optional)

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify)

Daily Weekly Quarterly Semester Other (specify)

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________ GOALS AND OBJECTIVES/BENCHMARKS

Complete for initial IEPs and annual reviews. (Anyone responsible for implementing the IEP (e.g., goals and objectives/benchmarks, accommodations, modifications and supports) must be notified of her/his specific responsibilities.)

REPORTING ON GOALS
The progress on annual goals will be measured by the short-term objectives/benchmarks. Check the methods that will be used to notify parents of the students progress on annual goals and if the progress is sufficient to achieve the goals by the end of the IE P year: Report cards Progress reports

Parent conference

Other (specify) __________________________

CURRENT ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Results of the initial or most recent evaluation and results on district-wide assessments relevant to this goal; performance in comparison to general education peers and standards. MS struggles in estimating measurements and numbers while computing math problems. He likes to know the exact answer and struggles with providing an answer that is not correct.

GOALS AND OBJECTIVES/BENCHMARKS

The goals and short-term objectives or benchmarks shall meet the students educational needs that result from the students disability, including involvement in and progress in the general curriculum, or for preschool students, participation in appropriate activities. Goal Statement #_3__of__3__

On progress monitoring checks, MS will estimate answers to measurement problems and determine an acceptably accurate answer for 9/10 problems. Indicate Goal Area: Academic Functional Transition Illinois Learning Standard: #__7.B____
Title(s) of Goal Implementer(s)

Special Education Teacher

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal

On progress monitoring checks, MS will estimate answers to measurement problems and determine an acceptably accurate answer for 6/10 problems.
Evaluation Criteria Evaluation Procedures Schedule for Determining Progress Dates Reviewed/ Extent of Progress (Optional)

6 /10

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-Term Objective/Benchmark for Measuring Progress on the Annual Goal

On progress monitoring checks, MS will estimate answers to measurement problems and determine an acceptably accurate answer for 7/10 problems.
Evaluation Criteria Evaluation Procedures Schedule for Determining Progress Dates Reviewed/ Extent of Progress (Optional)

7 /10

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

Short-term Objective/Benchmark for Measuring Progress on the Annual Goal

On progress monitoring checks, MS will estimate answers to measurement problems and determine an acceptably accurate answer for 9/10 problems.
Evaluation Criteria Evaluation Procedures Schedule for Determining Progress Dates Reviewed/ Extent of Progress (Optional)

8 /10

% Accuracy # of attempts Other (specify)

Observation Log Data Charts Tests Other (specify) X

Daily Weekly Quarterly Semester Other (biweekly)

STUDENT NAME:___MS____________________________________DATE OF MEETING:_____2/1/13_________