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2016SBIEP.docx

Appendix A: Sample IEP: General Curriculum

Present Level of Academic and Functional Performance

Student Name: _Jane Smith_ Date 12/10/15 Page of Student Number_99999

The Present Level of Academic Achievement and Functional Performance summarize the results of assessments that identify the student’s interests, preferences, strengths and areas of need. It also describes the effect of the student’s disability on his or her involvement and progress in the general education curriculum, and for preschool children, as appropriate, how the disability affects the student’s participation in appropriate activities. This includes the student’s performance and achievement in academic areas such as writing, reading, mathematics, science, and history/social sciences. It also includes the student’s performance in functional areas, such as self-determination, social competence, communication, behavior and personal management. Test scores, if included, should be self-explanatory or an explanation should be included, and the Present Level of Academic Achievement and Functional Performance should be written in objective measurable terms, to the extent possible. There should be a direct relationship among the desired goals including postsecondary goals, the Present Level of Academic Achievement and Functional Performance, and all other components of the IEP.

Jane’s Present Level of Performance: Grade 4

Jane is a fourth-grade student who is included in general education classes with accommodations and supports. A review of classroom assessments, Standards of Learning Assessments, and input from parents and teachers indicates that Jane’s reading comprehension is a weakness. Jane’s strength in reading includes understanding the meaning of unknown words by reading the words in context and the application of word structures (prefix, base words, and suffix). She has difficulty with higher order thinking skills, such as predicting, summarizing and making inferences. She is currently receiving reading instruction in direct instruction intervention curriculum and is working to improve her reading fluency and applying comprehension strategies. Even though her decoding skills have improved, Jane’s reading fluency remains weak and has adversely impacted her reading comprehension. To ensure that she can demonstrate her knowledge of science and social studies content and decrease the impact of the lack of fluency and inattentiveness to detail, she receives the read aloud accommodation for these content areas and she has consistently performed above average in these areas. On the third-grade science and social studies SOL, she scored above 450.

Jane is functioning two years below grade-level in mathematics. She knows her addition and subtraction facts, but has not mastered her multiplication facts. Her knowledge of place value allows her to successfully compare and order whole numbers, but due to her abstract reasoning deficit, the concept of fractions and their use and solving multi-step word problems are difficult for her. Her third-grade SOL assessment and classwork indicates that she has strengths in understanding probability and measuring. Visuals, hands-on experiences and real-life connections enhance her mathematics performance. In writing, analysis of her writing samples indicates that she writes simple sentences with limited descriptive language. Her paragraphs are under-developed.

Jane is easily distracted and demonstrates inattentive behavior that impacts her learning. She is distracted by any noise or movement in the classroom and is able to remain on task and focused for 20 minutes when monitored by an adult, without reinforcement. Her inattentive behaviors also impact her reading comprehension and ability to complete assignments.

Teachers and her parents report that she becomes frustrated when she makes a mistake. Frequent checks for understanding by adults eliminate this problem.

( 42 ) ( Standards-Based Individualized Education Program (IEP) - 2/22/11 Revised 3/28/16 )

Annual Goals (General Curriculum)

Reading Content Standard:

4.5 The student will read and demonstrate comprehension of nonfiction.

a) Use text organizers, such as type, headings, and graphics, to predict and categorize information.

b) Formulate questions that might be answered in the selection.

c) Explain the author’s purpose.

d) Make simple inferences, using information from texts.

e) Draw conclusions, using information from texts.

f) Summarize content of selection, identifying important ideas and providing details for each important idea.

g) Describe relationship between content and previously learned concepts or skills.

h) Distinguish between cause and effect and between fact and opinion.

i) Identify new information gained from reading.

MEASURABLE ANNUAL GOALS (sample):

Student Name: Jane Smith_ Date 12/10/15 Page of Student Number_999999

# 1 MEASURABLE ANNUAL GOAL: By the end of the current school term, using grade-level reading materials and graphic organizers, Jane will draw conclusions, summarize content, make inferences and locate evidence from text to support generalizations with 80 % accuracy on 3 out of 4 collected work samples.

The IEP team considered the need for short-term objectives/benchmarks.

o Short-term objectives/benchmarks are included for this goal. (Required for students participating in the VAAP)

x Short-term objectives/benchmarks are not included for this goal.

( Criterion-referenced test: Norm-referenced test: Other: Observation Special Projects X_ Tests and Quizzes Written Reports Classroom Participation Worksheet X_ Classwork Homework How will progress toward this annual goal be measured? (check all that apply) )

Mathematics Content Standard:

4.2 The student will

a) compare and order fractions and mixed numbers;

b) represent equivalent fractions; and

c) identify the division statement that represents a fraction.

MEASURABLE ANNUAL GOALS (sample):

Student Name _Jane Smith_ Date 12/10/15 Page of Student Number_999999

# 2 MEASURABLE ANNUAL GOAL: Using manipulatives, models and drawings, Jane will be able to compare, order and represent fractions having denominators of 12 or less with 80 % accuracy by the end of the third nine weeks.

The IEP team considered the need for short-term objectives/benchmarks.

o Short-term objectives/benchmarks are included for this goal.

(Required for students participating in the VAAP)

x Short-term objectives/benchmarks are not included for this goal.

( Criterion-referenced test: Norm-referenced test: X_ Other: Student-made graph or chart Observation Special Projects X_ Tests and Quizzes Written Reports Classroom Participation Worksheet X_ Classwork Homework How will progress toward this annual goal be measured? (check all that apply) )

Functional Goal (General Curriculum) MEASURABLE ANNUAL GOALS (sample):

Student Name: _Jane Smith_ Date 12/10/15 Page of Student Number_999999

# 3 MEASURABLE ANNUAL GOAL: During daily independent practice, Jane will self-monitor her frustration level by asking for help when she does not understand what to do or comprehend the next step in the directions without teacher prompting in 3 of 5 situations.

The IEP team considered the need for short-term objectives/benchmarks.

o Short-term objectives/benchmarks are included for this goal.

(Required for students participating in the VAAP)

x Short-term objectives/benchmarks are not included for this goal.

Progress Reporting Tool:

Student Name _Jane Smith_ Date 2/10/16 Page of Student Number_999999

Progress must be reported at least as often as parents of nondisabled students are informed of their child’s progress. Progress on this goal will be reported to the parent or adult student using the following codes. To provide a more detailed summary of a student’s performance, a narrative summary with discussion of the evaluation tool is encouraged. Attach comments using progress report comment form.

By the end of the current school term, using grade-level reading materials and graphic organizers, Jane will draw conclusions, summarize content, make inferences and locate evidence from text to support generalizations with 80 % accuracy on 3 out of 4 collected work samples.

Anticipated Date of Progress Report* 2/5/2016 Actual Date of Progress Report 2/10/2016

Progress Code * SP

* SP -The student is making Sufficient Progress to achieve this annual goal within the duration of this IEP.

ES - The student demonstrates Emerging Skill but may not achieve

IP -The student has demonstrated Insufficient Progress to meet this annual goal and may not achieve this goal within the duration of this IEP. (explanation needed)

this goal within the duration of this IEP. NI -The student has Not been provided Instruction on this goal.

M -The student has Mastered this annual goal.

Sample of Narrative: PROGRESS REPORT COMMENTS, Continued (This document is optional)

Student Name: _Jane Smith_ Date 2/10/16 Page of Student Number_999999

*Goal #_1_ Progress Report Code _SP Jane is currently accurately drawing conclusions

and summarizing on 75 % of her assignments. She is consistently using her strategies and independently requesting the graphic organizers that work for her. Generalizing and making inferences is still weak with only 65 % accuracy on classroom assignments and quizzes. We will continue to work on these skills.

Accommodation/Modification

Student Name _Jane Smith_ Date_12/10/15 Page of Student Number_999999

This student will be provided access to general education classes, special education classes, other school services and activities including nonacademic activities and extracurricular activities, and education related settings:

with no accommodations/modifications x_ with the following accommodations/modifications

Accommodations/modifications provided as part of the instructional and testing/assessment process will allow the student equal opportunity to access the curriculum and demonstrate achievement.

Accommodations/modifications also provide access to nonacademic and extracurricular activities and educationally related settings. Accommodations/modifications based solely on the potential to enhance performance beyond providing equal access are inappropriate.

Accommodations may be in, but not limited to, the areas of time, scheduling, setting, presentation and response. The impact of any modifications listed should be discussed.

ACCOMMODATIONS/MODIFICATIONS (list, as appropriate)

Accommodation(s)/Modification(s)	Frequency	Location7(name of school* )	Instructional Setting	Duration m/d/y to m/d/y
Preferential seating in an area with minimal distractions	Daily	Division school	General classrooms	1/3//2015- 6/5/2016
Read aloud on test in math, science and social studies	Daily	Division school	General classroom	1/3//2015- 6/5/2016
Digital text in social studies and science	Daily	Division school	General classroom	1/3//2015- 6/5/2016
Graphic organizers	Weekly during summarizing activities	Division school	General classroom	1/3//2015- 6/5/2016

7 * IEP teams are required to identify the specific school site (public or private) when the parent expresses concerns about the location of the services or refuses the proposed site. A listing of more than one anticipated location is permissible, if the parents do not indicate that they will object to any particular school or state that the team should identify a single school.

Participation in the Statewide Assessment

Name: Jane Smith_ Date_12/10/15 Page_of Student Number_999999

Test	*Assessment Type Select the appropriate assessment (SOL, VSEP, VMAST*, VAAP, or Board of Education Approved Substitute)	Accommodations**	If yes, list accommodation(s)
Reading	x SOL o Not Assessed at this Grade-level	xYes oNo	Paper/pencil test Multiple sessions
Math	x VSEP o Not Assessed at this Grade-level	xYes oNo	Read aloud calculator
Science	o x Not Assessed at this Grade-level	oYes oNo
History/SS	o x Not Assessed at this Grade-level	oYes oNo
Writing	o x Not Assessed at this Grade-level	oYes oNo

* An IEP team may not exempt a student from participation in a content area assessment, only determine how the student will be assessed.

** Accommodation(s) must be based upon those the student generally uses during classroom instruction and assessment. For the accommodations that may be considered, refer to “Accommodations/Modifications” page of the IEP.

***VMAST is no longer available as alternate assessment, but may be used as a credit accommodation for End-of- Course Reading and Algebra I for students with a disability scoring 374 or below following two attempts at the corresponding SOL End-of-Course test.

EXPLANATION FOR NONPARTICIPATION IN REGULAR STATE ASSESSMENTS: If an IEP team

determines that a student must take an alternate assessment instead of a regular state assessment, the IEP team must explain in the space below:

q why the student cannot participate in the regular assessment;

q why the particular assessment selected is appropriate for the student, including that the student meets the criteria for the alternate assessments;

q how the student’s nonparticipation in the regular assessment will impact the child’s promotion; or other matters such as graduation and diploma options.

x Alternate/Alternative Participation Criteria is attached or maintained in the student’s educational record. Box must be checked (parent initials) Date

Due to Jane’s current level of performance in mathematics, even though she is working toward meeting grade-level expectations and is receiving grade-level content instruction, she is not expected to meet

Standards-Based Individualized Education Program (IEP) - 2/22/11 Revised 3/28/16

grade-level expectations within the year and is unable to demonstrate her math knowledge in a multiple choice and technology enhanced format due to her visual discrimination weakness.

Refer to the VDOE’s Students with Disabilities: Guidelines for Assessment Participation.

( 49 ) ( Standards-Based Individualized Education Program (IEP) - 2/22/11 Revised 3/28/16 )

Least Restrictive Environment - (Service documentation)

Student Name _Jane Smith_ Date _12/10/15_ Page X of_ _X

Student Number 999999

SERVICES: Identify the service(s), including frequency, duration and location that will be provided to or on behalf of the student in order for the student to receive a free appropriate public education. These services are the special education services and as necessary, the related services, supplementary aids and services based on peer-reviewed research to the extent practicable, assistive technology, supports for personnel*, accommodations and/or modifications* and extended school year services* the student will receive that will address area(s) of need as identified by the IEP team. Address any needed transportation and physical education services including accommodations and/or modifications.

Service(s)

Frequency

Location

(name of school **)

Instructional

Setting

Duration

m/d/y to m/d/y

Mathematics

minutes/day

5 days/wk

Elementary school

general classroom

1/3/2016-6/1/2016

excluding holidays,

summer breaks

Language arts

minutes/day 5 days/wk

Elementary school

general classroom

1/3/2016-

6/1/2016 excluding holidays, summer breaks

* These services are listed on the “Accommodations/Modifications” page and “Extended School Year Services” page, as needed.

** IEP teams are required to identify the specific school site (public or private) when the parent expresses concerns about the location of the services or refuses the proposed site. A listing of more than one anticipated location is permissible, if the parents do not indicate that they will object to any particular school or state that the team should identify a single school.

LEAST RESTRICTIVE ENVIRONMENT – (PLACEMENT document)

Student Name _Jane Smith_ Date _12/10/15_ Page _x of x_ Student ID Number _999999_

( PLACEMENT CONTINUUM OPTIONS CONSIDERED: (check all that have been considered): )No single model for the delivery of services to any population or category of children with disabilities is acceptable for meeting the requirement for a continuum of alternative placements. All placement decisions shall be based on the individual needs of each student. The team may consider placement options in conjunction with discussing any needed supplementary aids and services, accommodations/modifications, assistive technology/accessible materials, and supports for school personnel. In considering the placement continuum options, check those the team discussed. Then, describe the placement selected in the PLACEMENT DECISION section below. Determination of the Least Restrictive Environment (LRE) and placement may be one or a combination of options along the continuum.

( q general education class(es) q special class(es) q special education day school q state special education program/school q Public residential facility q Private residential facility q Homebound q Hospital q Other )

PLACEMENT DECISION: General classroom

Based upon identified services and the consideration of least restrictive environment (LRE) and placement continuum options, describe in the space below the placement. Additionally, summarize the discussions and decision around LRE and placement. This must include an explanation of why the student will not be participating with students without disabilities in the general education class(es), programs, and activities. Attach additional pages as needed.

Explanation of Placement Decision:

Based on Jane’s present level of performance and her goals in mathematics and language arts, the IEP team agrees that the required specialized instruction, supplemental aids and services to meet her educational needs can be provided in the general education class in collaboration with the special education teacher.

Extended School Year Services

 The IEP team determined that the student needs ESY services.

ý The IEP team determined that the student does not need ESY services. Describe: Jane’s progress on current goals will not be significantly jeopardized by the lack of the services beyond the normal school term.

Student Name: Jane Smith_ Date_12/10/15

Page of

Student Number_999999

( Summarize the IEP team’s discussions and decision about ESY: Based on current performance and review of data, Jane‘s performance will not be jeopardized by the lack of services beyond the normal school term. Extended Year Services are not required at this time. )

( If ESY services are to be provided, identify which goals in the current IEP will be addressed by the ESY service. )

Identify the Extended School Year services needed to meet these goals:

Service(s)

Frequency

Location

(name of school **)

Instructional Setting

Duration

m/d/y to m/d/y

**IEP teams are required to identify the specific school site (public or private) when the parent expresses concerns about the location of the services or refuses the proposed site. A listing of more than one anticipated location is permissible, if the parents do not indicate that they will object to any particular school or state that the team should identify a single school.