Confidential Student Information

Confidential Student Information

School-Age

Student Name: Raymond Babbitt / Date of Birth: 7/11/1999 Age: 8
Disability Classification: Autism Spectrum Disorder: Asperger’s
Street: 55 Main St Telephone: 516-555-2233
City: Long Beach County of Residence: Nassau
Zip: 11561 Male: X Female:
Student ID#: 336798 Native Language of Student: English
Current Grade/Grade Equivalent: Interpreter for Student Needed:
2.9 Yes: No: X
Medical Alerts: If yes, specify language:
Surrogate Parent Needed: Yes: No: X
Date of Committee on Special Education (CSE) Meeting: 5/17/2007
Type of Meeting:
X Initial Requested Review Annual Review Reevaluation
______
Date IEP is to be Implemented: 9/1/2007
Projected Date of Next Review: 3/1/2008
Projected Date of Reevaluation Meeting: 9/1/2009
Other Information:

Present Levels of Performance and Individual Needs

Current functioning and individual needs in consideration of:
-the results of the initial or most recent evaluation, the student’s strengths, the concerns of the parents, the results of the student’s performance on any State or district wide assessment programs;
-the student’s needs related to communication, behavior, use of Braille, assistive technology, limited English proficiency;
-how the students disability affects involvement and progress in the general curriculum;
-the student’s needs as they relate to transition from school to post-school activities (ages 14 and older).
Transcript Information- Secondary Students Only
Diploma Credits Earned: Expected Date of High
School Completion:
Commencement-level State Expected Diploma:
Tests Passed:
Academic/Educational Achievement and Learning Characteristics:
Current levels of knowledge and development in subject and skills areas, including activities of daily living, level of intellectual functioning, adaptive behavior, expected rate of progress in acquiring skills and information and learning style.
Language/Communication
-According to WISC testing, Raymond’s IQ is above average. He can recall facts, people, numbers, patterns, and objects; can follow single step directions.
-Raymond can communicate in choppy sentences with problems with fluency. He speaks in the third person.
-Cannot differentiate answers to specific questions; will repeat yes or no responses when he doesn’t understand a question, regardless of what the answer should be. Raymond will choose to ignore a question if he doesn’t understand.
-Difficulty expressing own emotions and sensing others emotions.
Cognitive
-Raymond tested above average on the WISC IV in rote calculations and memory. At this time, he has difficulty applying any information to the ‘real world.’
-Raymond is visually stimulated and often distracted by his surroundings if there is a lot going on visually or if there is a lot of noise. He may leave a certain activity if it is not part of his daily routine.
-Raymond learns best through repetition. He needs daily routines and does not like if any part of his routine is broken.
Social Development:
The degree and quality of the students relationships with peers and adults, feelings about self and social adjustment to school and community environments.
Socio-Emotional:
-Raymond has difficulty in peer settings. He has no peer relationships, although, he does express interests in others.
-Raymond often engages himself in independent activities such as looking at and memorizing facts from baseball cards, drawing exactly what he sees in great detail, writing, or watching his daily (routine) television.
-Raymond does not like his personal space invaded. He will become overly agitated and possibly self-injurious; however, he cannot verbally express his feelings and emotions.
Behavior:
-Extremely observant to surroundings.
-Follows directions exactly as stated.
-Outbursts may occur if his surroundings become too noisy, if his personal space is invaded, or if one of his routines is broken. If any of these things occur, he will have an outburst and can become self-injurious.
Physical Development:
The degree or quality of the student’s motor and sensory development, health, vitality, and physical skills or limitations that pertain to the learning process.
Motor Skills:
-According to the PDMS-2, Raymond tested at a 4.2 grade equivalent.
-Raymond’s gross and fine motor skills are above average.
-Raymond enjoys reading, writing, and illustrating.
-Raymond can feed and dress himself.
Health:
-Raymond is generally in good health.
-Is often self injurious during times of behavior outbursts.
Management Needs:
The nature of and degree to which environmental modifications and human material resourced are required to enable the student to benefit from instruction. Management needs are determined in accordance with the factors identified in the areas of academic/educational achievement and learning characteristics, social development and physical development.
-Tasks should be broken down into multiple steps.
-Visuals are necessary for transitions within the classroom.
-Routines should be intact from day one and continued throughout the year.
-Directions need to be clear and repeated. They should also be written down for Raymond, with visual prompts if possible.

Measurable Annual Goals and Short-Term Instructional

Objectives/Benchmarks

Annual Goal: Improve socialization and communication
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Establish and maintain eye contact when speaking to teachers and peers / 80% by January / Observation, charting / Weekly
Be respectful of peer's opinions / 8/10 times for a two week trial period / Observation, charting / Daily
Be positive in communicating with teachers and peers / 80% by January / Observation, charting / Monthly
Share expertise and special interests with peers / 80% by January / Observation, charting / Monthly
Respond appropriately to peers in social situations / 8/10 times in a two week trial period / Observation, charting / Weekly
Accept the success of peers without making negative comments / 8/10 times in a two week trial period / Observation, charting / Daily
·  Annual Goal: Learning and using relaxation techniques and other strategies for staying calm
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Raymond will work with the school social worker to make a plan to stay calm in uncomfortable situations / 7/10 times for a two week trial period / Written chart which will be taped to his desk / Weekly
Raymond will be actively involved in creating and maintaining his plan / 7/10 times for a two week trial period / Written chart with pictures / Daily
Raymond will end all self-injurious outbursts / 80% by January / Chart and strategies created with the social worker / Weekly
Annual Goal: Raymond will participate in whole class activities
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Raymond will sit and attend circle time activity for five minutes without leaving the group. / Daily for 3 weeks / Written and picture chart / Monthly
Raymond will sit and attend circle time activity, with participation for ten minutes without leaving the group / Daily for 3 weeks / Written and picture chart / Monthly
Raymond will sit and attend circle time activity, with participation for fifteen minutes without leaving the group / Daily for one month / Written and picture chart / Monthly
Raymond will sit and attend circle time activity with participation for the entire time / 80% by January / Written and picture chart / Monthly
Annual Goal: Raymond will successfully transition from one activity to the next
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Raymond will follow picture cues which will be hung on the board during periods of transition / 7/10 times during a two week trial period / Picture Cues / Weekly
Raymond will transition smoothly through the use of verbal and picture cues / 80% by January / Verbal cues and picture cues / monthly
Annual Goal: Raymond will participate in all small group activities
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Raymond will work collectively with a small group of students / 7/10 times during a two week trial period / Picture charting/verbal cues / Daily
Raymond will work collectively with a small group of students / 80% by January / Picture charting/verbal reminders / Monthly
Raymond will not ask to leave the group and work independently / 7/10 times per week / Verbal cues / Daily
Raymond will communicate positively with peers / 7/10 times for a two week trial period / Verbal and picture cues / Daily
Raymond will communicate positively with peers / 80% by January / Verbal and picture cues / Monthly
Annual Goal: Raymond will follow three step directions independently Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Raymond will follow three step directions with picture chart prompting for each step. / 8/10 times weekly / Daily charting / Quarterly
Raymond will follow three step directions with picture chart prompting for the initial step. / 8/10 times weekly / Daily charting / Quarterly
Raymond will follow three step directions with a picture chart and no prompting. / 9/10 times weekly / Daily charting / Quarterly
Annual Goal: Will increase his cognitive ability and his expressive and receptive language skills
Evaluation
Instructional Objectives or Benchmarks: / Criteria / Procedures / S
Schedule
Will identify 40 nouns by word, picture and object and will generalize to different settings / 80% accuracy by January / match word to object (with verbal label) and label object verbally / Monthly
Will recognize and identify 30 actions by word, picture and actions across settings / 80% accuracy by January / Match word to action picture and vice versa, identify action with word (with verbal label), label action verbally / Monthly
Receptively, will select an object or picture when presented with the verbal label with 80% accuracy / 90% accuracy by January / Colors, shapes, supplies in the classroom / Monthly

Recommended Special Education Programs and Services

Special Education Program/Services
Frequency / Duration / Location / Initiation Date
Self-Contained Classroom / Daily / Full Day / Separate Class / 9/1/2007
Related Services
Frequency / Duration / Location / Initiation Date
Speech/Language Therapy / 5 times per week / 40 minutes / Separate classroom / 9/1/2007
Occupational Therapy / 3 times per week / 30 minutes / Separate room / 9/1/2007
Computer training / 3 times per week / 35 minutes / In classroom / 9/1/2007
Social Worker / 1 time per week / 40 minutes / Separate room / 9/1/2007
Program Modifications/Accommodations/Supplementary Aids and Services
Frequency / Duration / Location / Initiation Date
Use of picture scheduling chart / Daily / Transition to new activities / Classroom / 9/1/2007
Paraprofessional aide / Daily / Full day / Classroom / 9/1/2007
Assistive Technology Devices/Services
Frequency / Duration / Location / Initiation Date
NA
Supports for School Personnel on Behalf of Student
Frequency / Duration / Location / Initiation Date
Consultation from Speech therapist, classroom teacher, occupational therapist / Every two months / One half hour observation / Classroom / 9/1/2007
Special Transportation Needs: Small bus with other students
Testing Accommodations
The following testing accommodations will be used consistently:
-in the student’s education program,
-in the administration of district wide assessments of student achievement, and,
-in the administration of State assessments of student achievement, consistent with State Education Department policy.
Testing Accommodation / Conditions / Specifications
Tests will be read to Raymond / Separate Classroom
Raymond will use manipulatives/calculators / All tests in math or science
Raymond will have all tests modified and picture cues will be given for questions / All tests
Raymond will be given unlimited amount of time to complete assessments / All assessments
Participation in Assessments
Raymond will not participate in any state tests or district wide testing. His special education teacher will create appropriate forms of assessment for him. Because of Raymond’s disability, any state assessment would be unfairly biased.
X New York State Alternate Assessment for Students with severe disabilities
Removal from the General Educational Environment occurs only when the nature or severity of the disability is such that, even with the use of supplementary aids and services, education cannot be satisfactorily achieved.
_X_ Explanation of the extent, if any, to which the student will not participate in general education programs, including extra curricular and other nonacademic activities:
Raymond will be receiving individual and small group instruction in adaptive behavior, gross motor skills, life skills, language, concept development and fine motor skills. He can only receive these services within his self-contained class. His needs cannot be met in a general education classroom.
______
_X_ The student will not participate in the general education physical education program, but will participate in specially designed of adapted physical education.
Language Other Than English Exemption __ NO
X__ Yes, the student’s disability adversely affects the ability to learn a language, and the student is excused from the language other than English requirement.

Coordinated Set of Transition Activities (School to Post School)

-For students ages 14 and older, courses of study (i.e., instructional activities and educational experiences) to meet transition needs:
-For students beginning at age 15 (and younger if deemed appropriate) needed transition services/activities in each area:
Coordinated Set of Transition Activities / Activity / School District/Agency Responsible / Date
Instruction
Related Services
Development of Employment/Other Post-School Adult Living Objectives
Community Experience
Acquisition of Daily Living Skills
Functional Vocational Assessment

Placement Recommendation

10 Month Placement: Self Contained Classroom
Extended School Year Eligible: Yes_X_ Projected dates of services:
/ to /
If yes: Provider: Nassau County Boces Site: Garden City, NY

Reporting Progress to Parents

The student’s progress towards the annual goals and the extent to which the progress is sufficient to enable the student to achieve the goals will be reported to parents as follows:
Manner:
Parent-teacher conferences / Frequency:
4 times per year
Communication Logs / Weekly
Phone Calls home / Monthly if necessary

Supplemental Information

Parent Information
Student’s Name: Raymond Babbitt
Mother’s/Guardian’s Name: NA
Father’s/Guardian’s Name: Thomas Babbitt Telephone: 516-555-5555
Street: 55 Main Street County of Residence: Nassau
City: Long Beach Native Language of Parent: English
Zip: 11561 Interpreter Needed for
Meeting: Yes__ No_X_
Student Information
For data collection purposes only:
Race/Ethnicity: Caucasian
Committee Participants
_X_ CSE __Subcommittee
Name / Professional Title / Committee Member Role
Lauren Moriarty / Special Education teacher / Explain why student requires certain support and accommodations
Caitlin Fuentes / General Education classroom teacher / Explains what a general education class could potentially offer or not offer for a student
Theresa Buckley / Parent Advocate / Aide parent whenever needed
Thomas Babbitt / Parent / Parent
Robin Gallimedi / School psychologist / Explain testing
Lauren Pullara / Reading specialist / Explain testing

The list of names or signatures above indicates attendance/participation at the Committee meeting and not necessarily agreement with the IEP recommendations developed at the meeting.