IEP with template PDF

Preview

Summary

IEP document with partially pre-filled template...

Description

INDIVIDUALIZED EDUCATION PROGRAM

Student Name:

DOB:

Grade:

CONFIDENTIAL DOCUMENT

General Student Information HOMEBASED SCHOOL: ______________________________________ IEP TYPE: __________________________

OTHER SCHOOL: __________________________________________

INDIVIDUAL EVALUATION / WAIVER DATE: __________________________

Primary / Other

Exceptionality

Detail(s)

Primary

This is based on evaluation there. In SER these items are Other would be where

Information that has been determined by pupil appraisal. When they provide their report it will be included Not in the form of blanks, but drop down menus where you can select from all disability categories. Information is included related to a secondary disability. For example a student may have SLD and Communicatio

Other Other Other Other

IEP Participants

Name

IEP Participants

ODR General Education Teacher Special Education Teacher Speech Therapist

Name

Parent Student School Nurse Other service providers- in SER it is possible to add as many individuals as needed

Include strengths; parental concerns; evaluation results; academic, developmental, and functional needs; statewide assessment results; progress or lack of expected progress in general education curriculum; and consideration of special factors: behavior, language needs for english learner, instruction in and use of braille, communication needs, assistive technology devices and services, and health needs. Directions: Check "Yes" or "N/A" for both questions. Does the student have limited or no verbal skills? Yes

N/A

Does the student have other significant impairment in the areas of receptive and/or expressive language, including but not limited to impairments in the areas of apraxia, articulation/phonology, fluency, pragmatics, or auditory processing. Yes •

N/A

In order to effectively plan for this student's unique communication support needs and facilitate his/her academic progress, ◦ In the General Student Information drop down list, the "Communication" item will self-populate. ◦ The "Communication Needs of Child" section must be completed. ◦ A communication plan must be developed for this student. "The Tools for Developing Communication Plans" is a resource for IEP teams to use in developing plans. ◦ At least 1 communication related goal must be included in the instructional pages of the IEP.

LOUISIANA DEPARTMENT OF EDUCATION

System:

Meeting Date:

State ID:

Local ID:

Page

of

General Information About the student

This is a review IEP for (STUDENT INITIALS), a (age) year old student enrolled in the ___ grade at (Name of school). (STUDENT INITIALS) receives all instruction from the general education ___ grade curriculum in general education classrooms. (STUDENT INITIALS) requires special education services and supports due to deficits in (Academic, social, and behavioral areas of weakness ie. Reading, math, written expression …. (STUDENT INITIALS) enjoys ______________; (s)he dislikes _____________.

Strengths:

He you will not students strengths that were indicated through assessment and evaluation. If necessary you can use non-academic strengths such as (Student Initials) evidences strengths related to social interaction, he/she does well interacting with others in the classroom. Or (Student Initials) evidences relative strength related to math computation (or another academic component)

Parent Concerns:

Parent Concerns Here you will note parent concerns related to their child. Parents may present these concerns during the IEP meeting, you might reach out and get the information before for the meeting via questionnaire or phone conference.

Evaluation/Reevaluation Results:

(STUDENT INITIALS)'s initial evaluation was disseminated on (Date of initial evaluations). Results from the (WJ-lll- or whatever test was used) found significant academic deficits in (Skill area with significant deficits). (Additional areas of deficit) were considered support need. (Areas of relative strength- can be academic or developmental) were relative strengths. The (KABC-ll- additional assessments used) indicated that (STUDENT INITIALS) showed weakness in (area of test measurement). Two areas of personal strength were (STUDENT INITIALS)'s (areas of personal strength listed here). After a thorough review of all evaluation information, it was determined that (STUDENT INITIALS) is eligible to receive special education services. According to the guidelines set forth in Bulletin 1508, the most appropriate exception for (STUDENT INITIALS) is Disability Classification. If triennial re-evals were waived that is noted here with the justification. If they were conducted than list that any new results or findings here that would alter the instructional plan. Subsequent waivers were obtained on (waiver date) and (waiver date). She/he continued to meet criteria as a student with a Disability classification with (support needs in (support needs here). Her/his next mandatory triennial re-evaluation will be on or before (3 years from last evaluation or waiver).

INDIVIDUALIZED EDUCATION PROGRAM LOUISIANA DEPARTMENT OF EDUCATION

Student Name: System:

DOB: Meeting Date:

Grade: State ID:

CONFIDENTIAL DOCUMENT Local ID:

Page

of

Academic, Developmental, and Functional Needs:

(STUDENT INITIALS) is in need of special education services due to meeting criteria for Disability classification. (STUDENT INITIALS) exhibits deficits in reading and math (List any other deficits here as well). (STUDENT INITIALS) is instructed from the ___ grade curriculum in all subjects with assistance provided in accordance with her/his IEP. (STUDENT INITIALS) was administered the (Name of Diagnostic measure used by your campus or district to determine functional levels) in math and reading. In Reading, (STUDENT INITIALS) attained a scaled score of ___, placing her/him at level (functional grade level). In reading, (STUDENT INITIALS) can _________________, _______________, and ________(list two or three things the student can do and at what functional level). (STUDENT INITIALS) requires additional support to ______,___________, and ________((STUDENT INITIALS). (S)he can _____,___________, and________ (list two or three things the student can do and at what functional level). (STUDENT INITIALS) requires additional support to __________, _______, and ________.________(list two or three things the student can do and at what functional level ). If a formal writing assessment in conducted that information can be shared here, as well as information related to any area of substantial strength and deficit. Statewide Assessment Results:

On the Spring (YEAR) LEAP test (STUDENT INITIALS) scored ELA ___________ and Math _____________ , Science _____________ and Social Studies___________.(S)he will take the LEAP 2025 Spring (YEAR). It the students takes the Louisiana Connect (alt. assessment) that would be included here rather than LEAP. Progress or lack of expected progress in general ed curriculum

(STUDENT INITIALS)’s deficits in reading and math due to Disability classification, negatively impact her/his full access to and progression in the presented ____ grade curriculum; therefore, (STUDENT INITIALS) is in need of special education services. (STUDENT INITIALS) reading and ELA teacher, (Teacher’s name) stated that ___ _________.(Teachers name) also added that ____________ (include positive and negative, many districts use a checklist to gain this info from Gen Ed teachers). (Teacher’s name) math teacher indicated that _____. (Teacher’s name) offered that___________. (include positive and negative, many districts use a checklist to gain this info from Gen Ed teachers) (STUDENT INITIALS) most recent grades are ELA ___, Reading___, Science ____, Resource ___ ___, Math ____, PE ____, and American History ____. (These grades and the correct courses should be taken from the most recent progress report or report card.) With the provision of the necessary accommodations and special education supports (STUDENT INITIALS) is expected to progress.

General Student Information (continued) Consideration of Special Factors Behavior (Behavior Support Plan needs to be attached to IEP): There are no behavioral concerns at this time. Or Due to (Students initials) classification of Disability classification a behavior plan is attached. Or Over the previous 9 weeks (Student initials) has received (Multiple or number) of behavior referrals. A (behavior plan/counseling/social skills instruction) are being added to this IEP.

Limited English Proficient: The primary language spoken in the home is English. Or The primary language spoken in the home is (language). Here you would discuss any issues this may cause for your student related to limited proficiency. Communication Needs of Child: There are no communication needs at this time Or Speech therapist should complete this section or provide the SPEd teacher with the necessary information to complete this section OR If the student communicates primarily with a device of some sort that would be included here Instruction in and use of Braille: This student does not require instruction in or the use of Braille. OR This student will be instructed in and use Braille. Assistive Technology Services / Devices-Please indicate AT devices used on the Accommodations Page A review of (STUDENT INITAILS) evaluation and needs indicates the use of (Text to Speech software to support reading deficits) (Speech to text software to support writing deficits) (use of a calculator to increase computational fluency) (use of a digital organizer to aid in organization of work and assignments) To complete this section you would apply the SETT framework to best determine what supports will aid the student in progressing effectively. You would also work with your AT team as well as the IEP team. Health needs – IHP needs to be attached to IEP No health plan is required OR (Student initials) has a medical diagnosis of (Diagnosis). He is under the care of (Doctors name). You would also include any medications the student takes, the dosage, whether it is administered at home or school. You would also include any allergies and the steps necessary if the student is exposed to the allergen. A current helath plan is attached.

After consideration by the IEP team, there are no special factors that need to be addressed at this time

Transition Courses of Study Attach plan to IEP: Educational Needs:

Individual Prescription for Instruction Academic/Cognitive

Individual Graduation Plan

Behavior

Individual Graduation Plan for LEAP Connect Students

Communication

Motor

Self-Help

Educational/Career Plan for LEAP Connect Students Social

The top row only applies to students 15 or older. In the educational row, check all areas that a goal will be created for.

INDIVIDUALIZED EDUCATION PROGRAM LOUISIANA DEPARTMENT OF EDUCATION

Student Name: System:

DOB: Meeting Date:

Grade: State ID:

Local ID:

CONFIDENTIAL DOCUMENT Page of

Instructional Plan # EDUCATIONAL NEED AREA: __ Reading ___Additional pages allow for inclusion of Math, Written expression, social, behavioral, life skills, This all depends on student need as determined by the evaluation.__ CONTENT AREA: ______Comprehension____________________________ ESY Instruction

Act 833 Applied

Targeted for Secondary Transition ACT 833 consideration begins once 6th and 7th grade state assessment data are available. Transition begins at 15 or 16

ESY is not checked until data is collected over 2 time frames during the school ytear and it is determined that the student will attend ESY in the summer. At that time an IEP ammendment is opened, the ESY box is checked and the IEP is ammended to reflect summer ESY instruction. Present Level of Academic Achievement and Functional Performance

(STUDENT INITIALS) is a (age) year old student with a primary exceptionality of Disability classification. Although (STUDENT INITIALS) is instructed from the ____ grade curriculum in all subjects his/her functional Reading Level is _____, putting (STUDENT INITIALS) significantly below his/her grade level peers. (STUDENT INITIALS) can ________________(list 3 items, Include functional levels). (STUDENT INITIALS) requires additional support to __________________________(3 items, Include functional levels). (STUDENT INITIALS) functional reading at level grade level hinders _his/her progress in the (grade placement) grade. (STUDENT INITIALS) Disability classification interferes significantly with (STUDENT INITIALS) ability to actively participate in instruction in his/her current grade placement. Therefore, (STUDENT INITIALS) requires support through the resource classroom to allow for focused small group support, instruction, and reinforcement to ensure her/his continued progress.

Measurable Academic / Functional Goal

With the provision of accommodations and supports, (STUDENT INITIALS) will expand her/his general and domain specific academic vocabulary through strengthening her/his ability to determine word meaning in context, and answer questions related to level ___ texts with 75% accuracy on 4 of five trials per IEP year as aligned with LA state standard LC.RL.7.4a, LC.RI.7.4a, LC.L.7.5d. (These are actually the accurate standards, you will of course want to use those appropriate to your goals)

There is a drop down menu within SER that allows you to choose method of measurement such as portfolio, graded assignments, assessment results and so on Method of Measurement: Additional Methods of Measurement: Date Achieved: If the student participates in Alternative assessment then their goal should be broken down into simplified objectives. It is also necessary to indicate which objective will be measured later in the year to determine if the student qualifies for extended school year services offered during the summer.

REQUIRED FOR STUDENTS PARTICIPATING IN ALTERNATE ASSESSMENT AND ACT 833 MEASURABLE SHORT-TERM OBJECTIVES or BENCHMARKS (Number each objective or benchmark)

# 1 2

3

THE STUDENT WILL

(ESY) (STUDENT INITIALS) will determine word meaning in level (functional grade level) texts with ___% accuracy on 4 of 5 trials per IEP year (Here you include the state standard or connector that the goal is aligned with) (STUDENT INITIALS) will expand domain specific and general vocabulary through the use of newly introduced strategies with ___% accuracy on 4 of 5 trials per IEP year Here you include the state standard or connector that the goal is aligned with) (STUDENT INITIALS) will answer questions related to level (functional grade level) texts with ___% accuracy on 4 of 5 trials per IEP year (Standard)

PERSONNEL RESPONSIBLE FOR IMPLEMENTING GOAL (Check by position) Special EducationTeacher

Parent

Other Related Service Providers (List) Other (List)

Speech/Language Pathologist

Regular EducationTeacher...