Weishaar, PCSE, 1eAppendixAP-1
Appendix:
Individual Education Plan Drafting Activities and Templates
Activity
Several students in this text have been identified as having a disability and as needing special education and related services. Although forms for Individual Education Plans (IEPs) vary and the law detailing exact components of the IEP changes, it is useful to think critically about the individual needs of the student. On the next few pages, you will find blank forms for the following pieces of an IEP.
•Current Levels of Performance and Goals
•General Education Modifications/Adaptations/Supplemental Aids and Services and/or Supports for School Personnel; Special Education and Related Services
•Transition Plan (for students age 14 and over)
•Participation in State and Local Assessments
As you reflect on the case studies, you may want to form mock IEP teams for a particular case. Each person should assume an appropriate role (e.g., parent, special education teacher). In a role-play, you will then discuss the specific needs of the student in the case and complete appropriate pieces of the IEP. Note that all pieces will not be appropriate for all students. For example, if the student is ten years old, transition is not likely to be completed. If the student is three years old, participation in state and local assessments would not be completed.
CURRENT LEVELS OF PERFORMANCE AND GOALS
Current Performance Levels:
Descriptive statements of all areas that are impacted by the student’s disability. What is the student able to do and where are the areas of concern? Includes how the student’s disability affects his/her involvement and progress in the general education curriculum.
- Academic:
- Social/Emotional:
- Independent Functioning:
- Speech/Language/Communication:
- Vocational Skills:
- Motor Skills:
- Other:
Annual Goals:
Must be measurable and address meeting the student’s needs that result from the disability to enable him/her to be involved and progress in the general curriculum. What do we want the student to be able to do?
Goal Type: __Annual __Transition
Goal Statement:
Implementer: Projected Completion Date:
Monitoring ScheduleEvaluation ProceduresCriteria for Mastery
__Daily__Tests__71–81% Accuracy
__Weekly__Charting__81–90% Accuracy
__Monthly__Observations__91–100% Accuracy
__Quarterly__Daily Log__ of ____ Trials
__Grade period__Other ______Other______
__Other ______
Goal Type: __Annual __Transition
Goal Statement:
Implementer: Projected Completion Date:
Monitoring ScheduleEvaluation ProceduresCriteria for Mastery
__Daily__Tests__71–81% Accuracy
__Weekly__Charting__81–90% Accuracy
__Monthly__Observations__91–100% Accuracy
__Quarterly__Daily Log__ of ____ Trials
__Grade period__Other ______Other______
__Other ______
Goal Type: __Annual __Transition
Goal Statement:
Implementer: Projected Completion Date:
Monitoring ScheduleEvaluation ProceduresCriteria for Mastery
__Daily__Tests__71–81% Accuracy
__Weekly__Charting__81–90% Accuracy
__Monthly__Observations__91–100% Accuracy
__Quarterly__Daily Log__ of ____ Trials
__Grade period__Other ______Other______
__Other ______
GENERAL EDUCATION MODIFICATIONS/ADAPTATIONS/SUPLEMENTAL AIDS AND SERVICES AND/OR SUPPORTS FOR SCHOOL PERSONNEL;
SPECIAL EDUCATION AND RELATED SERVICES
Subject Area (Academic and Nonacademic) / Explanation of General Education Modifications/Adaptations/Supplemental Aids and Services and/or Supports for School Personnel / Special Education Support Necessary? (Yes/No) If Yes, SpecifyNeeded Service: Special Education or Related Service / Location of Service (General or Special Education or Other) / Minutes per Day / Date of Initiation Services / Anticipated Duration / Frequency of Service
TRANSITION PLAN
Post-School Vision (Include Employment, Education, and Living Arrangements):
Course of Study:
Year 1______
Year 2______
Year 3______
Year 4______
Other______
Annual Needed Services (School, Community, and Agency Services for the Next School Year in Order for This Student to Progress Toward His/Her Post-School Vision):
Instruction: __Yes __No
Community Experiences: __Yes __No
______
Employment and other post-school adult living objectives: __Yes __No
______
As appropriate, daily living skills and functional vocational evaluation: __Yes__No
______
If Appropriate, a Statement of Each Outside Agency’s Responsibilities, or Linkage Before the Student Leaves the School Setting:
______
______
______
______
PARTICIPATION IN STATE AND LOCAL ASSESSEMENTS
Grade Placement of Student:______
The student will:
__Participate in the entire State assessment with no accommodations
__Participate in the entire State assessment with accommodations
__Participate in part(s) of the State assessment (specified below)
__NOT participate in the State assessment
__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 (specified below)
__NOT participate in the district-wide assessment
If the student is completing the assessment(s) with accommodations, specify the needed accommodations (e.g., extended time, alternate setting)
If the student will not participate in part or all of the assessment(s), specify why the assessment is not appropriate and document the alternate assessment to be given, including any needed accommodations.