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.

  1. Academic:
  1. Social/Emotional:
  1. Independent Functioning:
  1. Speech/Language/Communication:
  1. Vocational Skills:
  1. Motor Skills:
  1. 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, Specify
Needed 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.