Individual education plan

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 Assessment Description

Follow the instructions and complete Standards 5-7 of the “IEP Performance Template.” Base the IEP on the student you are following throughout your student teaching placement. All identifiable student information should be replaced with pseudonyms for confidentiality.

IEP Performance Standards 5-7 must be completed by the end of Week May 6

APA format is not required, but solid academic writing is expected.

Individualized Education Program (IEP) Performance Template


Table of Contents


Table of Contents





2



Standard 1: Contextual Factors: School and Community Demographics, Classroom Demographics, Building Trust Relationships, and Classroom Management





3



Standard 2: Individualized Education Plan – Part 1





4



Standard 3: Individualized Education Plan – Part 2





11



Standard 4: Preparation for IEP Meeting





16



Standard 5: Implementation, Communication, and Progress Reporting





18



Standard 6: Revised IEP





20



Standard 7: Reflection of the IEP Process





21


Standard 1: Contextual Factors: School and Community Demographics, Classroom Demographics, Building Trust Relationships, and Classroom Management


The IEP Performance Standards is the process for preparing and implementing the IEP process. This template will be used to address specific standards and go through the process of creating an IEP for a student in your placement.


Part I: Community, District, School, and Classroom Factors

Complete this portion of the IPE Template document using the following link:


Standard 1, Part I

After completing the e-doc portion, submit the PDF you receive into the digital classroom.

Part II: Demographic, Environment, and Academic Factors

Complete this portion of the IEP Template document using the following link:

Standard 1, Part II

After completing the e-doc portion, submit the PDF you receive into the digital classroom.

In order to submit this assignment, you must:

1. Complete each section of Standard 1.


Note:
Closing your internet browser before the signing process is completed will result in a loss of your work. If you will be completing this document in multiple sittings, it is highly recommended to save and back up your work on another document.  When you are ready to make your final submission, copy and paste your responses into this document. The data from this electronic document will not be saved until you complete the signing process.

2. Complete the signing process by entering your name, selecting “Click to Sign,” and entering your email address. 

· An initial email will be sent to you to confirm your email address. 

· A completed copy of the document will be emailed to you within minutes of confirming your email address.

3. After completing the e-doc portion, submit the PDF you receive into the digital classroom.

Standard 2: Individualized Education Plan – Part 1

Base the IEP on the student you are following throughout your student teaching placement.

All identifiable student information should be replaced with pseudonyms for confidentiality. In addition, some information has been marked “Do not complete”’ due to confidentiality concerns.


The present level of academic achievement and functional performance (PLAAFP) will guide the development of the IEP. Teachers must describe student strengths, interests, and needs within the PLAAFP. Assessment scores and a description of how the student is performing in relationship to typically developing peers will provide the rationale for the development of IEP goals, services, testing accommodations, and supplementary aides and services. It is important that all sections of the IEP align with the PLAAFP.


Special Education Department

Individualized Education Program (IEP)

Student Name: Student Data/Cover Sheet (Form A-1) IEP Meeting Date:

Demographic Information

Student Number:

Student (Pseudo) Name:

Birthdate:

Gender:

Grade:

Student Address:

3500 West Camelback Road

Home Phone:

Do not complete

City, State, Zip:

Phoenix, Arizona 85017

Parent 1 (Pseudo) Name:

Parent 1 Relationship:

Parent 1 Address:

Do not complete.

Home Phone:

Do not complete.

City, State, Zip:

Do not complete.

Work Phone:

Do not complete.

Parent 1 Email:

Do not complete.

Parent 2 (Pseudo) Name:

Parent 2 Relationship:

Parent 2 Address:

Do not complete.

Home Phone:

Do not complete.

City, State, Zip:

Do not complete.

Work Phone:

Do not complete.

Parent 2 Email:

Do not complete.

Primary Language of Home:

Primary Language Survey Date:

Primary Language Survey Results:

Language of Instruction:

Home District:

Attendance District:

Service Coordinator:

Home School:

Attending School:

Vision Screened On:

Results:

Hearing Screened On:

Results:

Meeting Date:

Anticipated Duration of IEP:

From: To:

Re-evaluation Due:

Current Evaluation:

Special Education Primary Category 1:

Special Education Eligibility Category 2:

Special Education Eligibility Category 3:

For Students with SLD only, the following area(s) of eligibility was/were previously determined:

Level of Services: (A)

Type of Meeting:

Date Meeting Notice Sent to the Parent(s):

Date Procedural Safeguards given to the Parent(s):

This page will not need to be completed because it is a signature page.

Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Student Data/Cover Sheet (Form A-2) IEP Meeting Date:

Student ID: DOB:

The following persons participated in the conference and/or the development of the IEP. Additionally, parents have been given a copy of their rights regarding the student’s placement in special education and understand that they have the right to request a review of their child’s IEP at any time.

Position/Relation to Student Participant Date (MM/DD/YY)

If during the IEP year the student turns 16, if the student is not present at the IEP meeting, the service coordinator must review the IEP with the student and obtain the student’s signature and the date of this review.

Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Student Data/Cover Sheet (Form B) IEP Meeting Date:

Student ID: DOB:

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE (PLAAFP)


Section 1: Current IEP Information

Summarize special education services the student is receiving:


Section 2: Evaluation Information

Areas of Eligibility:

Special Education Primary Category:

Special Education Eligibility Category 2:

Special Education Eligibility Category 3:

For students with SLD only, the following area(s) of eligibility was previously determined:

State and District Assessment Scores:


Section 3: Present Level of Academic Achievement and Functional Performance

A. Cognitive (academic performance in content areas, e.g., ELA/Reading/Writing, Math, Science, Social Studies, Technology and Fine Arts, as applicable)

B. Physical (gross motor, fine motor, vision, and hearing)

C. Oral Language and Communication

D. Social and Emotional Behavior

E. Adaptive

Current Classroom-Based Data:

Family’s Input on Student’s Current Performance:

Summary of Work Habits:


Section 4: Summary of Educational Needs and General Accommodations

Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Considerations Form (Form C) IEP Meeting Date:

Student ID DOB:

ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS


Considered Not Needed




Included

Individual Transition Plan

Statement of Transfer of Parental Rights at Age of Majority

Statement of Positive Behavior Interventions, Strategies, and Supports Considered for a Student Whose Behavior Impedes his or her Learning, or That of Others

Statement of Language Needs in the Case of a Child with Limited English Proficiency

Statement of Provisions of Instruction in Braille and User of Braille for a Visually Impaired Child

Statement of the Language of Needs, Opportunities for Direct Communication with Peers in the Child’s Language, and Communication Mode

Statement of Required Assistive Technology Devices and Services

Statement of Communication Needs for a Child with a Disability


Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Accommodations (Form F) IEP Meeting Date:

Student ID: DOB:

ASSESSMENTS

(Rationales for the accommodations that are being chosen specific to assessments.)

Rationale:

State Assessments

Standard Accommodation(s):

District Assessments

Standard Accommodation(s):

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS

Testing Area

Test Results

Grade

Semester

Year

Reading

Writing

Math

Science

LEAST RESTRICTIVE ENVIRONMENT (LRE)

Provide an explanation of the extent, if any, to which the student will NOT participate with non-disabled students in the general curricular, extracurricular, nonacademic activities, and program options. §300.347(a) (4):

Consider any potential harmful effects of this placement for the child or on the quality of services that he or she needs §300.552 (a-b):

Reason for different services at school:

OR, if the above LRE information does not apply to this student, explain why:


Standard 3: Individualized Education Plan – Part 2

Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Student Goals and Performance Objectives IEP Meeting Date:

Student ID: Progress Report DOB:


Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:


Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:


Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:


Skill Area:

Standard:

Annual Goal:

Baseline Level of Mastery:

Service Provider(s) for this goal:

Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Accommodations (Form E) IEP Meeting Date:

Student ID DOB:

ACCOMODATIONS

Date Given to General Education Teacher: Service Coordinator:

Accommodations

Type

Location

LEGEND FOR TYPE AND LOCATION FIELDS

Type:

1 = Class work/assignments 2 = Assessments/tests 3 = Both class work/assignments/assessments

Location:

A = All Subjects B = Language Arts/English C = Reading D = Spelling E = Math

F = Science G = Social Studies H = Health I = Electives J = Physical Education

K = Lunch L = Transition / Vocation M = Library N = Title 1 O = Special/Exploratory

Family Communication

How will the family be informed of their child’s academic progress and the extent to which that progress is sufficient to enable the child to achieve annual goals by the end of the year?

IEP Team Consideration for Extended School Year

Consideration for eligibility:

Eligible for ESY:

Written explanation as to why ESY is or is not needed:


Special Education Department

Individualized Education Program (IEP)

Student (Pseudo) Name: Services and Environment (Form I) IEP Meeting Date:

Student ID: DOB:

SPECIAL EDUCATION SERVICES TO BE PROVIDED

Special education services necessary to meet special education goals and objectives during the school calendar year.

The child is in need of specially designed instruction in the following areas:

Special Education Services

Instructional Setting/ Location

Start Date

Frequency

Provider

Duration/ End Date

Clarification:

EDUCATIONALLY RELEVANT RELATED SERVICES

Special Education Services

Instructional Setting/ Location

Start Date

Frequency

Provider

Duration/ End Date

Clarification:

EDUCATIONALLY RELEVANT SUPPLEMENTARY AIDS/ASSISTIVE TECHNOLOGY and SERVICES for STUDENTS

.

Special Education Services

Instructional Setting/ Location

Start Date

Frequency

Provider

Duration/ End Date

Clarification:

SUPPORTS FOR SCHOOL PERSONNEL

Special Education Services

Instructional Setting/

Location

Start Date

Frequency

Provider

Duration/ End Date

Clarification:


Standard 4: Preparation for IEP Meeting

The IEP team must cover mandated topics during the IEP meeting. Topics that must be addressed during the IEP include, but are not limited to, an introduction of team members, clarifying the type of meeting (initial, review, amendment/addendum to current IEP), the required components of the IEP, the procedural safeguards, and prior written notice.

IEP Meeting Planning

Required Participants/Roles: List the participants of an IEP meeting and their roles, including whether or not the student is expected to participate.

Required Agenda Outline: In 500-750 words, create an agenda for the IEP meeting. Discuss the required topics you must address (i.e., introduction of team members, whether or not this is an initial or review or an annual IEP, discussion of test results, present levels, goals, services, Least Restrictive Environment (LRE) statement, Extended School Year (ESY) services, procedural safeguards, and prior written notice.

Plan for Conflicts: Provide a description of ways you can involve parents in the development of the IEP. Discuss whether you anticipate issues or conflicts that may arise during the meeting and your plan on addressing those concerns.

Mock IEP Introduction Video

Now that you have outlined the IEP meeting agenda, you are prepared to conduct the meeting. In order to prepare for running your first official IEP meeting, record yourself as if you were conducting the IEP meeting. Your video should not exceed 15 minutes in length.

Focus your practice on the meeting introduction. Include the following components within your recording:

· An introduction of all parties represented and their roles

· Reason for the meeting (initial IEP or IEP review)

· Meeting norms so all parties are heard and respected

· Review of the PLAAFP including the discussion of test results, present levels, goals, services, Least Restrictive Environment (LRE) statement, Extended School Year (ESY) services, procedural safeguards, and prior written notice (PWN).

Conclude your video by providing an explanation of how you would actively listen to and address the needs of families and other stakeholders throughout the meeting.

After recording yourself, review and reflect upon the video below.

Mock IEP Introduction Video Link:

Video Recording Link: If you are submitting your video to OneDrive, note it here.

Reflection: In 250-500 words, reflect on your IEP meeting practice session. In what areas do you feel you did well? In what areas would you like to have more guidance and coaching before conducting your first official IEP on your own? What plan of action do you have for more coaching and guidance?



Standard 5: Implementation, Communication, and Progress Reporting

Accountability of Free Appropriate Public Education (FAPE) is mandated by the Individuals with Disabilities Education Act of 2004 (IDEA). IEP teams must have a plan to document the provision of services as written in the IEP. Appropriate and accurate data must also be collected to document quarterly progression toward mastery of IEP goals. Teams must have a plan for on-going data collection, communication, and presentation of data to the parents/guardians during quarterly progress reports and annual IEP review meetings.

Accommodations Progress and Communication Plan

Complete the Accommodations Table below, demonstrating how you plan to ensure all accommodations are being met in the general education setting (if applicable). If the student is not in a general education classroom, indicate how the student will receive accommodations in content specific areas based on his or her PLAAFP and IEP goals.

On the Accommodations Table, note the dates when you will obtain progress reports from the general education teacher or related services staff so that you can gather data on progress (if applicable). If no general education teachers are reporting, indicate the dates of your (special education teacher) reporting.

In addition, use the Accommodations Table to gather data on the student’s progress for the first Quarterly Progress Report.

NOTE: Only two dates are included on the Accommodations Table for the purpose of this assignment. You may not gather data on both dates in the duration of your placement, but dates should be noted.

Accommodations Table


Goal 1:

Implemented Accommodations:

Person(s) Responsible:

Quarterly Progress Report 1 Date:


Data Results:

Quarterly Progress Report 2 Date:


Data Results:


Goal 2:

Implemented Accommodations:

Person(s) Responsible:

Quarterly Progress Report 1 Date:


Data Results:

Quarterly Progress Report 2 Date:


Data Results:

Accommodations Summary:

In 100-150 words, summarize information from the Accommodations Table as well as data you have gathered through teaching and observing the student. Address mastery of goals, progress towards mastery, and overall service provision.

Communication Plan for General Education Teachers and Related Services Staff:

After completing the accommodations table and summary, in 150-250 words, describe a communication plan that outlines how you plan to share the student’s progress information with the necessary faculty and staff. Address how you and your colleagues will continue to monitor progress along the way, prior to receiving the quarterly progression updates.


Standard 6: Revised IEP

IEP teams are expected to regularly analyze and document students’ progress on their IEP goals throughout the year. This includes identifying when there are changes affecting the student and presenting evidence of attempts to meet student needs when there is a lack of progress. To address times when information, services, or goals need to be changed or added to an existing IEP, the Individuals with Disabilities Education Act of 2004 (IDEA) describes the regulations and procedures for changing an IEP using an amendment or addendum. An amendment is used to change something already in the IEP. An addendum is used to add something new to the IEP, such as goals, services, or accommodations.

After reflecting on your completed Standard 5 content, create a progress report addendum and/or amendment (based on changes needed) to be added to the initial IEP, or describe why neither an addendum nor amendment are not needed.

Data Collection and IEP Modifications

Stakeholders involved in special education must be aware of the student progress monitoring process, keeping the goal of mastering IEP goals and presenting evidence of attempts to meet said goals in mind. It is vital to keep a record of new information affecting student needs, including a lack of progress when an IEP is in effect, using an IEP amendment or addendum. An amendment is a change to the IEP and an addendum is the addition of goals or services and accommodations to the IEP.

IEP Modification Need

After monitoring and gathering data, analyze how the student is performing on his or her IEP goals and with the accommodations. Consider whether there is a need for an addendum and/or an amendment for the student. If there is a need, in 50-100 words explain this need and the approach to be taken (an amendment or an addendum). If there is no need at this time, simply explain how the student is performing and progressing toward their IEP goals.

Family Communication Plan

In 50-100 words, discuss how you plan to communicate the student’s progress on his or her IEP goals with the parents/guardians. (You may want to discuss this process with your mentor so you have a method to use for future practice.)


Standard 7: Reflection of the IEP Process

Reflection is an important part of professional practice. Professional special education teachers plan and frequently reflect on their delivery of services, instruction, data collection procedures, and individual student progress. Identification of practices that have worked, and those that have not, can help the special education teacher adjust instruction and services to better meet the needs of students.

Continued Learning

After completing the Individualized Education Program (IEP) Performance Template, reflect upon three best practices you have learned from this student teaching experience in 50-150 words.

1.

2.

3.

Improved Practice

Based on your experience of developing and delivering your Individualized Education Program (IEP) Performance Template, list three implications for your future teaching practices in 50-150 words. Consider concepts you want to take with you into your own classroom, such as how you will establish and maintain organization in order to facilitate the IEP process in your classroom.

1.

2.

3.

© 2019. Grand Canyon University. All Rights Reserved.

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