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.
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
1
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
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
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)
To be completed for each subject/course with modified expectations Student ID# 1234567
and/or alternative expectations.
SUBJECT/COURSE/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:
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________________________________
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 Teaching Strategies Assessment Methods
(Knowledge and/or skills to be (List only those that are (For expectations for each
assessed by reporting period, different for this student and reporting period)
including Grade level) specific to the learning
expectations for the
subject/course/ program)
Annual Goal: Rita will
write legibly, using Color coded Peer assistance
manuscript writing, workbooks, list and Teach spot checks
one paragraph color code steps and Resource spot checks
consisting of 10 procedures Short quizzes
sentences with 90% Modified seating Weekly progress
accuracy and Study guides for tests reports
compose a one page Modified homework
book report using Teacher visually spot
Time in class to start checks work done in
cursive writing with
homework groups and
75% accuracy by
1/1/2013 Use of mechanical individually
Annual Goal: Rita will devices documenting progress
be able to solve Provide Rita with a list and participation
mathematical of important
problems including vocabulary before
multiplication, reading the test
subtraction, and Provide Rita with a
addition with 80% study guide of the test
accuracy by 6/1/2013 Allow her to use sticky
Annual Goal: Rita will notes, highlighter tape
be able to solve and highlighters to
mathematical word mark important
problems with 75% information
accuracy by 6/1/2013 Allow extra time on
Annual Goal: Rita will tests
read fiction and non- Keep sample math
fiction passages from 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
Date of Placement in Special Education Program: (select and appropriate option and
provide date)
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.
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.
__________________________________________________________________________
Evaluation
Reporting Dates: 4-30-2013
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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
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.
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.
Name__Krisina Ferguson________________________________
Date_01/28/2016________ Tue. or Thur.
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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:
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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.____
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.
__________________________________________________________
30._Rita will keep her desk organized everyday by the end of class.______
__________________________________________________________
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