KDE IEP
IEP Guidance Document Sample
Individual Education Program (IEP)
Kentucky County Public Schools
500 Main Street
Riverview, KY 40000
Meeting Date:
2/2/12
Special Ed Status:
Plan Information
Start Date: 2/2/12
End Date: 2/1/13
Active
Special Education Setting: (age 6-21) 40-80% of day
in general ed. programs
Primary Disability: Mild Mental Disability
Student Information
DOB: 7/15/03
Student Number: 122033
District of Residence: Kentucky County
Student Name: Candace L. Newstatt
Address: 2232 South 3rd Street # 14,
Riverview, KY 40000
School of Attendance: Westside Elementary
Grade:
03
Gender: Race (Ethnicity Code): W
F
Present Level of Academic Achievement and Functional Performance
Present Levels of Academic Achievement and Functional Performance, including how the disability affects
the student’s involvement and progress in the general curriculum:
(For preschool children include the effect on participation in appropriate activities; Beginning in the child’s
8th grade year or when the child has reached the age of 14, a statement of transition is included.)
Communication Status
Performance commensurate with similar age peers
Candace’s articulation, voice, and fluency skills are within normal limits. Per formal language assessment,
Candace demonstrates strength in identifying word relationships by pointing to pictures. Given formal
assessment, results of language interventions and observation, Candace demonstrates severe language
deficits in comprehension of basic concepts (0%), attributes (adjectives describing color, size, shape, etc. at
25%), prepositional phrases (i.e., on, under, behind 25%), sorting and labeling a category (40%), following
oral directions (20%), answering /wh/ questions (who/where/when - 40% to 60%, what/why 10 to 40%),
and formulating sentences (44%). Expressively, Candace uses past tense – ed in sentences at 0% .
Candace’s language disorder negatively affects her ability to follow teacher directions, communicate in the
classroom and in social settings, comprehend classroom instruction, understand and use a variety of words
in her oral speech and written work.
Academic Performance
Performance commensurate with similar age peers
Reading
Candace is a beginning reader. In November 2011, she scored a Level 2 on the Developmental Reading
Assessment (DRA2) which is the Kindergarten level of reading ability. She enjoys looking at picture
books and listening to picture books on tape/CDs at the classroom listening station. She often listens to the
same book multiple times. Given multisensory, direct instruction in phonological awareness, phonics,
vocabulary, fluency and comprehension, Candace recognizes upper and lower case letters (90%),
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demonstrates letter/sound correspondence (65%), identifies single syllable consonant/vowel/consonant
words (62%), identifies high frequency sight words (Dolch words at 42% at the Kindergarten level). Given
a guided reading passage on her instruction level, and following multiple exposures to the passage,
Candace reads 50 words with 18 miscues, responds to literal questions at 70% (e.g., main idea and key
details, retell story), and inferential questions (e.g., making prediction, making connections between
events, characters, ideas) at 45%. Candace listens to the oral reading of grade level texts across core
content areas. She does not volunteer during text discussion. With teacher prompting, she answers basic
factual questions (main character, setting - 30%) and is unable to answer questions requiring deeper
meaning (e.g., point of view, moral, theme, cause/effect - 0%).
Severe deficits in phonemic awareness, phonics, word recognition, comprehension and reading fluency
significantly impact Candace’s ability to gain information and demonstrate knowledge from grade level
reading materials.
Math
Candace reports that math is her favorite subject. Given daily direct instruction using manipulatives,
Candace demonstrates slow but steady progress in the domains of Counting and Cardinality and Operations
and Algebraic Thinking (basic addition and subtraction) at an entry-Kindergarten level. Candace counts
objects 1-20 (100%), recognizes numerals 1-20 (80%), and adds sets 1-10 using manipulatives or her
fingers (no regrouping - 80%, regrouping 30%). Subtraction poses greater challenge. She performs one
digit subtraction problems with objects 1-10 (no regrouping - 60%). She demonstrates minimal
understanding of math attributes of less than, greater than and equal (0%).
Candace’s math fluency in counting beyond 20, problem solving and understanding math concepts is
significantly and consistently below that of age peers thus affecting involvement in and progress in the
third grade math curriculum.
Written Language
Given direct instruction in written language focusing on writing production and conventions of Standard
English, Candace demonstrates beginning writing skills. Given a teacher prompt, Candace produces upper
(85%) and lower case letters (90%) when an alphabet strip is on her desk. Without the alphabet strip on
her desk, Candace produces the letters but looks about the room for letter examples (80% upper and lower
case). Candace copies single syllable words given a copy of the word at her desk (70%) and she is starting
to copy a sentence including capital letter and end punctuation (40%) when given a copy of the sentence at
her desk. She categorizes familiar nouns (person, place, thing 80%) and acts out familiar action verbs
(80%) and constructs a simple sentence using a sentence strip and picture prompts (The boy/walks - 75%).
Candace does not independently generate a simple sentence (at least one noun, one verb, capital letter, and
end punctuation). When given a grade level writing prompt and teacher assistance, Candace will write a
series of letters and pictures (scribbles). With multiple teacher prompts, Candace will explain her piece and
dictate sentences to the teacher.
Candace’s deficits in writing adversely impact her ability to produce different types of written products for
varied purposes as required by grade level curriculum (e.g., opinion pieces, informative and explanatory
texts, and narratives).
Health, Vision, Hearing, Motor Ability
Performance commensurate with similar age peers
Candace wears prescription glasses. Her mother reports that Candace has been diagnosed with asthma and
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allergies. She takes medication for asthma.
Social and Emotional Status
Performance commensurate with similar age peers
Candace is a quiet, compliant student. Her adaptive skills are significantly below same age peers.
Candace appears hesitant to join small group student conversations given language deficits. She requires
specific role assignments to participate in cooperative group activities (e.g., distribute materials, match
labels to diagram). In large group activities, Candace follows the lead of others (e.g., looking at reading
passage, working quietly during independent seatwork, listening during class discussion). She is unable to
read grade level materials, seatwork tasks are often blank, and she is unable to respond to comprehension
checks during a listening activity (see baseline references in Communication and Academic sections
above). Candace struggles to follow oral teacher directions announced to the class. She requires
individual repetition of the directions and teacher prompting (see baseline in Communication section).
Deficits in adaptive skills significantly impact classroom participation in small and large group activities,
following teacher directions, and peer interaction.
General Intelligence
Performance commensurate with similar age peers
Candace performed in the well below average range score on a cognitive assessment administered in
January, 2012 (Mental Processing Index of 65). Candace demonstrated a relative strength on one subtest
which requires the students to integrate parts of a picture to make a whole. Assessment subtests revealed
that Candace has significant deficits in problem solving involving the sequencing of information and the
ability to plan and solve non-verbal problems. Further, she demonstrated significant deficits in the ability
to store and retrieve new or previously learned information.
Reflecting on cognitive, language, academic and social deficits in total, Candace requires a variety of
supports for learning (See Communication Status, Academic Performance and Social Emotional Status
sections for specific skill deficits and baseline references). In order to follow teacher directions, Candace
benefits from peer and adult models and teacher prompts. She needs visual supports to promote
understanding and retention of new concepts (e.g., real objects for categorizing, manipulatives for
counting, alphabet/word/sentence models for writing, pictures to enhance understanding of reading
materials). She requires multiple models, ongoing review and multiple practices to master and retain a
skill (e.g., Consonant Vowel Consonant (CVC) words). She requires specific instruction and examples to
generalize a concept (e.g., written letters). Candace is more successful when a complex concept is broken
into smaller chunks (e.g., CVC word family>present CVC words randomly;
generate>letter>word>sentence).
Candace’s deficits in general intelligence adversely impact all areas of learning including acquisition of
information through verbal communication and print, storage of information over time, demonstration of
competence through oral and written communication.
Transition Needs
Not an area of concern at this time (Checking this box is not an option when the student is in the 8th
Grade or 14 years or older because transition must be addressed for these students)
Instruction
Related Service
Community Experience
Employment
Daily Living Skills
Post School Adult Living Objectives
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Functional Vocational Evaluation
Functional Vision/Learning Media Assessment
Not an area of concern at this time
Consideration of Special Factors for IEP Development
(The ARC must address each question below and consider these issues in the review and revision of the
IEP)
Does the child’s behavior impede his/her learning or that of others?
Yes
No
If Yes, include appropriate strategies, such as positive behavioral interventions and supports in the
statement of device and services below.
Does the child have limited English proficiency?
Yes
No
If Yes, what is the relationship of language needs to the IEP?
Is the child blind or visually impaired?
Yes
No If Yes, the team must consider:
 Is instruction in Braille needed?
Yes
No
 Is use of Braille needed?
Yes
No
 Will Braille be the student’s primary mode of communication?
Yes
No
 (See evaluation data for supporting evidence)
Does the child have communication needs?
Yes
See Present Levels for Communication Status
Other (Specify):
No
Is the child deaf or hard of hearing?
Yes
No
 The child’s language and communication needs; Describe:
See Present Levels for Communication Status
Other (Specify):
If Yes, please specify below:
If Yes, the team must consider:

Opportunities for direct communications with peers and professional personnel in the child’s
language and communication mode, academic level and full range of needs; Describe:

Any necessary opportunities for direct instruction in the child’s language and communication
mode. Describe:
Are assistive technology devices and services necessary in order to implement the child’s IEP?
Yes
No
If Yes, include appropriate devices in the ‘Statement of Devices/Services’ below.
Statement of Devices/Services: If the ARC answered Yes to any of the above, include a statement of
services and or devices to be provided to address the above special factors.
See Specially Designed Instruction
See Supplemental Aids and Services
See Behavior Intervention Plan
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Other (Specify):
Measurable Annual Goals and Benchmarks
Annual Measurable Goal (#1):
Given oral classroom instruction, Candace will follow verbal directives regarding basic concepts of
attribute, space, and category with 80% accuracy over 3 consecutive sessions.
Method of Measurement:
Direct Measure: checklist, probes
Specially Designed Instruction:
Direct instruction using modeling, manipulatives, pictures
Guided practice
Prompt fading
Benchmarks/Short Term Instructional Objectives
1. Given objects or pictures of objects that differ in only one attribute, and asked “show me the adjective
one” (e.g., big, yellow, long, round), Candace will do so with 80% accuracy over 3 consecutive sessions.
2. Given objects or pictures of objects that differ in only their location in space, and asked “show me the
one that is preposition,” (e.g., on, under, behind) Candace will do so with 80% accuracy over 3 consecutive
sessions.
3. Given 6-8 objects or pictures of objects and asked to sort into 2 sets by either function (i.e., all the
things we eat) or category (i.e., put all of the animals here), Candace will do so with 80% accuracy over 3
consecutive sessions.
Annual Measurable Goal (#2):
Given a 4-step auditory command, Candace will complete all steps in the correct sequence, with 80%
accuracy over 3 consecutive sessions.
Method of Measurement:
Direct Measure: checklist
Specially Designed Instruction:
Direct instruction
Teacher modeling
Guided practice
Benchmarks/Short Term Instructional Objectives
1. Given a 1-step auditory command, Candace will follow the directive to completion, with 80% accuracy
over 3 consecutive sessions.
2. Given a 2-step auditory command, Candace will follow the sequential directions to completion, with
80% accuracy over 3 consecutive sessions.
3. Given a 3-step auditory command, Candace will follow the sequential directions to completion, with
80% accuracy over 3 consecutive sessions.
Annual Measurable Goal (#3):
When auditorally presented with a “wh-question,” Candace will verbally answer the question with 80%
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accuracy over 3 consecutive sessions.
Method of Measurement:
Direct Measure: checklist
Specially Designed Instruction:
Direct instruction including modeling, guided practice, and generalization practice
Use of real objects, pictures, diagrams, word banks/word wall/personal dictionary to promote
understanding of sentence parts
Benchmarks/Short Term Instructional Objectives
1. Given a picture scene and asked a “who/whose-question,” Candace will verbally answer the question by
identifying the correct person in the scene, with 80% accuracy over 3 consecutive sessions.
2. Given a picture scene and asked a “where-question,” Candace will answer the question by pointing
and/or verbally answering the question with 80% accuracy over 3 consecutive sessions.
3. Following a short description of a picture scene, and asked a “why-question” about the picture, Candace
will verbally answer the question using a 4+ word sentence, with 80% accuracy over 3 consecutive
sessions.
4. When read a story aloud and asked “wh-questions” related to the story, Candace will verbally answer
the questions with 80% accuracy over 3 consecutive sessions.
Annual Measurable Goal (#4):
Given a controlled text reading passage at her instructional level, Candace will read aloud a 50 word
passage with 2 miscues or less on 3 out of 4 reading assessments.
Method of Measurement:
Direct Measure: running record
Specially Designed Instruction:
Drill and practice of word types
Use of controlled text passages that have repeated sentence patterns, vocabulary words used repeatedly,
pictures to enhance comprehension
Pre-teaching of new vocabulary words prior to reading a text
Modeling (e.g., multiple exposures to the same text by teacher reading aloud, peer reading aloud, recording
of the text)
Benchmarks/Short Term Instructional Objectives
1. Candace will distinguish long and short vowel sounds in single syllable words.
2. Candace will read single syllable words with consonant blends.
3. Candace will read words with common consonant diagraphs.
4. Candace will read high frequency sight words.
Annual Measurable Goal (#5):
Given a controlled text reading passage at her instructional level including literature and informational
texts, Candace will independently read the passage and respond orally to literal and inferential
comprehension questions with 80% accuracy over 3 out of 4 reading assessments.
Method of Measurement:
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Direct Measure: teacher made tests
Specially Designed Instruction:
Direct instruction in identifying key details, sequencing story parts, identifying main characters, setting,
and major events in a story.
Use of controlled text passages that have repeated sentence patterns, vocabulary words used repeatedly,
pictures to enhance comprehension.
Pre-teaching of new vocabulary words prior to reading a text.
Modeling (e.g., multiple exposures to the same text by teacher reading aloud, peer reading aloud, recording
of the text)
Benchmarks/Short Term Instructional Objectives
1. Candace will answer comprehension questions about main idea and key details.
2. Candace will retell the story including key details.
3. Candace will make prediction and connections between events/characters/ideas within a text.
Annual Measurable Goal (#6):
Given 10 addition or subtraction problem with regrouping (two and three digit numbers), Candace will
solve the problems with 80% accuracy over 3 consecutive sessions.
Method of Measurement:
Indirect Measure: permanent product (math problems), teacher made tests
Specially Designed Instruction:
Direct instruction in addition, subtraction using strategies of counting, and decomposing
Direct instruction in math concepts of adding to, taking from, putting together, taking apart, and matching
Provision of teacher modeling, drill and practice
Explicit instruction in the use of manipulatives, drawings, and pictures
Benchmarks/Short Term Instructional Objectives
1. Candace will add and subtract numbers from 11 to 19 (no regrouping).
2. Candace will add and subtract numbers from 11 to 19 (regrouping).
3. Candace will add and subtract numbers from 20 to 100 (regrouping).
Annual Measurable Goal (#7):
Given access to word banks and following a writing prompt, Candace will construct 10 complete simple
sentences (capital letter, end punctuation, at least one noun/one verb) with at least 8 out of 10 sentences
correct in four 4 out of 5 sessions.
Method of Measurement:
Indirect Measure: permanent product, teacher made tests
Specially Designed Instruction:
Instruction in nouns, action verbs, state of being verbs
Instruction use of capital letters, end punctuation
Instruction in simple sentence construction
Instruction in use of an editing routine (checking simple sentence for capital letter, end punctuation, one
noun, one verb)
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Benchmarks/Short Term Instructional Objectives
1. Candace will identify action verbs and state of being verbs.
2. Candace will use capital letters at the beginning of a sentence.
3. Candace will use end punctuation at the end of a sentence.
4. Candace will construct simple sentences with at least one noun and one verb.
5. Candace will apply an editing routine to check the components of a simple sentence.
Reporting Progress
Concurrent with the issuance of Report Cards
Other, specify
Supplementary Aids and Services
Statement of Supplementary Aids and Services, to be provided to the child on behalf of the child.
Auditory output of text grade level materials (e.g., text reader, tape, human reader)
Audio presentation of grade level text for assessments (text reader/ human reader)
Taped materials for select instructional level reading materials to provide opportunities for repeated
exposures
Calculator
Concrete objects (e.g., manipulatives for counting, geometric shapes, real objects)
Visual supports (e.g., pictures, diagrams, symbols to support instruction, word cards, word lists, alphabet
strip, copy of word or sentence at desk, highlighting of sentence parts)
Verbal prompts/cues
Alternate ways to demonstrate competence on grade level test requiring greater than one sentence response
(e.g., oral response, diagram response, scribe)
Paraphrasing of text and directions
Reinforcement
Accommodations for Administration of State Assessments and Assessments in the Classroom
In order to justify appropriateness of accommodations for any state mandated tests, the testing
accommodations must be used consistently as part of routine instruction and classroom assessment as well
as meet all additional requirements established by the Inclusion of Special Populations in the StateRequired Assessment and Accountability Programs,703 KAR 5:070 document.
ARC determined no accommodations needed.
Readers
Scribes
Paraphrasing
Reinforcement and behavior modification strategies
Prompting/cueing
Use of technology
Manipulatives
Braille
Interpreters
Extended time
Other: specify
Student has been determined eligible for participation in the Alternate Assessment Program.
Complete the Participation Guidelines for the KY Alternate Assessment form if selecting this
checkbox. If determined eligible for the Alternate Assessment, the ARC must also determine if the
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student is Dimension A or Dimension B.
Dimension A
Dimension B
Program Modifications/Supports for school personnel that will be provided
Supports for school personnel:
Training for teachers in the use of visual supports (e.g., schedule, simple diagrams, pairing picture prompts
with words).
Not needed at this time
Least Restrictive Environment (LRE) and General Education
Explain the extent, if any, to which the student will not participate in general education (content area):
Special Education: Reading, Written Language, Math, Speech
Co-Teaching: Class Meeting (Social Skill Instruction) , Guided Reading
Regular Education: Science, Social Studies, Related Arts
Type of
Service
Special Education Services
Anticipated Frequency and Duration of Service
Service
Service
Service
Minutes Frequency
Period
Start
End Date
(Per
(Number
(Daily,
Date
Service
of times
Weekly,
Frequency) provided
Monthly,
per Service Annually)
Period)
Special
60 minutes
Education
1 time
Daily
2-2-12
2-1-13
Special
60 minutes
Education
1 time
Daily
2-2-12
2-1-13
Special
50 minutes
Education
1 time
Daily
2-2-12
2-1-13
Special
30 minutes
Education
1 time
Daily
2-2-12
2-1-13
Related Services
Service
Provider
(by Position)
Location
(e.g.,
Regular
Classroom,
Resource
Room,
Separate
Class)
Special
Resource
Education
Class for
Teacher
Reading
Special
Resource
Education
Class for
Teacher
Writing
Special
Resource
Education
Class for
Teacher
Math
Special
Regular
Education
Class for
Teacher/Regular
Social
Education
Skills &
Teacher
Guided
Reading
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Type of
Service
Speech
Language
Therapy
Anticipated Frequency and Duration of Service
Service
Service
Service
Minutes
Frequency
Period
Start
End
(Per Service
(Number
(Daily,
Date
Date
Frequency)
of times
Weekly,
provided
Monthly,
per Service Annually)
Period)
30 minutes
2
week
2-2-12
2-1-13
Service
Provider
(by
Position)
Location
(e.g., Regular
Classroom,
Resource Room,
Separate Class)
Speech
Language
Pathology
Resource Room
Extended School Year
Are extended school year services required for this student?
Yes
No
More data needed
If the ARC determines ESY services are to be provided, describe the service and indicate to which
annual goal or goals the service is related. If the ARC determines no ESY services are to be provided,
please document the reason(s) for this decision.
Initial placement. Extended School Year is to be discussed at the Annual Review meeting or earlier if
necessary.
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