INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
Gina Hightower
11/21/1999
DOB
SCHOOL YEAR
IEP INITIATION/DURATION DATES
FROM
2010
1/1/2010
-
2011
GRADE
4
-
5
TO 1/31/2011
THIS IEP WILL BE IMPLEMENTED DURING THE REGULAR SCHOOL TERM UNLESS NOTED IN EXTENDED SCHOOL YEAR SERVICES.
STUDENT PROFILE – WILL INCLUDE GENERAL STATEMENTS REGARDING:
Strengths of the student:
Gina is a ten-year old young lady in fourth grade at Bullard Elementary School. Gina and her mom recently moved in
with Gina’s grandmother.
When Gina is prompted, she is typically able to attend to classwork. She is able to follow a process given during class.
Gina excels in Science and is enthusiastic when it comes to learning new content in Social Studies.
Previously, Gina has received Tier-II interventions through the problem solving team and BBSST at Bullard Elementary
School. She has also received differentiated small group instruction, My sidewalks intervention, and additional time on
classwork when necessary.
Parental concerns:
Ms. Hightower is concerned with her daughter’s performance in reading and math. She reports that her behavior at home
is very active and it is a challenge to get Gina to complete any homework at home. She is concerned that the same
behavior that is exhibited at home is impeding her learning while at school. Since soccer season is over, she does not
have anywhere to let out all of her built up energy accumulated during the school day. Gina does not seem to be
interested in any of the same books that her peers are reading or the books that are required for class. Ms. Hightower
notes that she has been working late hours. Gina grandmother is the only one present during afterschool hours and is
willing to help with homework. However, she does not always understand the concepts and is not always checking to
make sure Gina completes her homework.
Student Preferences and/or Interests:
Gina is particularly interested in the volcano and electricity unit in science. She likes sports and is very active outside of
the classroom, especially soccer.
She is especially interested in nonfiction texts. She is not interested in fantasy novels.
Results of the most recent evaluations:
Gina’s intelligence score on the Stanford-Binet was a 100, however, her achievement scores on the Diagnostic
Achievement Battery-Third Edition was an 80. The discrepancy between these two scores was 20 points. This is greater
than the 16-point requirement to be considered eligible for services. Due to this discrepancy, she is being classified as
having a Specific Learning Disability under the area of mathematics. There was not a large enough discrepancy in any
other area to classify Gina as having a Specific Learning Disability for reading or writing.
Evaluations and assessments:
Stanford-Binet Intelligence Scales
Full Scale- 100
Verbal Intelligence Quotient- 102
Non-verbal Intelligence Quotient- 97
Diagnostic Achievement Battery-Third Edition-80
Kaufman Test of Educational Achievement
Letter/word recognition- 95
Reading comprehension- 98
Reading total- 95
Math concepts & applications- 82
Math computation- 84
Math total- 80
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ALSDE Approved Feb. 2012
Written expression- 90
Spelling- 95
Written language total- 91
Listening comprehension- 88
Oral expression- 87
Oral language total- 84
Behavior Assessments:
Adaptive behavior evaluation scale- revised second edition- school- 108
Behavior evaluation scale- third edition- school- 101
Behavior rating inventory of executive functioning- home- 128
Behavior rating inventory of executive functioning- school- 110
Behavior rating inventory of executive functioning-school- <101
For the behavior-rating inventory of executive functioning, standard scores of 130 and above are considered clinically
significant. None of the scores mentioned above are greater than 130. The concerns at home appeared much higher than
those from teachers in the school. Since the scores were not significant, behavior is not being considered as a factor that
is directly impeding learning and will therefore not be addressed.
The academic, developmental, and functional needs of the student:
Math Computation
Math Concepts
For the area of reading, Gina will continue to receive Tier-II intervention services with the program My Sidewalks, by
Scott Forestman.
In math, Gina understands the basic concepts of addition and subtraction but is unable to apply her knowledge of those
concepts when it comes to more complex principles such as multiplication and fractions. Gina needs assistance in
comprehending the concept of the role that addition plays in multiplication. She also needs help learning to apply those
skills regarding fractions.
Other:
It is important to increasing Gina’s interest in reading. Her grades are low primarily because she chooses not to read if
the book does not interest her.
Gina receives free/reduced lunch.
For the child transitioning from EI to Preschool, justify if IEP will not be implemented on the child’s 3 rd birthday:
Since this student is older than three, transition services to school have
already been implemented and transition services out of school will not
be implemented until Gina’s 16th birthday.
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INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
GINA HIGHTOWER
SPECIAL INSTRUCTIONAL FACTORS
Items checked “YES” will be addressed in this IEP:







Does the student have behavior which impedes his/her learning or the learning of others?
Does the student have limited English proficiency?
Does the student need instruction in Braille and the use of Braille?
Does the student have communication needs (deaf or hearing impaired only)?
Does the student need assistive technology devices and/or services?
Does the student require specially designed P.E.?
Is the student working toward alternate achievement standards and participating in the
Alabama Alternate Assessment?
 Are transition services addressed in this IEP with an annual goal(s)?
YES
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]
NO
[X]
[X]
[X]
[X]
[X]
[X]
[ ]
[ ]
[X]
[X]
TRANSPORTATION AS A RELATED SERVICE
Student’s mode of transportation:
[ X ] Regular bus
[ ] Bus for special needs
[ ] Parent contract
[ ] YES
Does the student require transportation as a related service?
If yes, check any transportation needs:
[
[
[
[
[
]
]
]
]
]
Bus assistance:
[ ] Adult support
Preferential seating
Behavioral Intervention Plan
Wheelchair lift and securement system
Restraint system
Specify type:
[ ] Other:
[ ] NO
[ ] Medical support
[ ]
Other. Specify:
[ ]
Bus driver and support personnel are aware of the student’s behavioral and/or medical concerns.
NONACADEMIC and EXTRACURRICULAR ACTIVITIES
Will the student have the opportunity to participate in nonacademic/extracurricular activities with his/her nondisabled
peers?
[ X ] YES.
[ ] YES, with supports. Describe:
[ ]
NO. Explanation must be provided:
METHOD/FREQUENCY FOR REPORTING PROGRESS OF ATTAINING GOALS TO PARENTS
Annual Goal Progress reports will be sent to parents each time report cards are issued (every
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ALSDE Approved Feb. 2012
INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
[ ]
[ ]
GINA HIGHTOWER
This student is in a middle school course of study that will help prepare him/her for transition.
This student was invited to the IEP Team meeting.
After prior consent of the parent or student (Age 19) was obtained, other agency representatives were invited to the
IEP Team meeting.
[ ]
EXIT OPTIONS (Complete for students in Grades 9-12)
[ ]
[ ]
[ ]
Alabama High School Diploma
Alabama Occupational Diploma
Graduation Certificate
Anticipated Date of Exit:
Month:
Year :
PROGRAM CREDIT TO BE EARNED (Complete for students in grades 9-12)
For each course taken, indicate
program credit to be earned.
ENGLISH
MATH
SCIENCE
SOCIAL
STUDIES
Alabama High School Diploma
Alabama Occupational Diploma
Graduation Certificate
TRANSITION: (Beginning not later than the first IEP to be in effect when the student is 16, or earlier if appropriate, and
updated annually thereafter)
Transition Assessments (Check the assessment(s) used to determine the student’s measurable transition goals):
[ ]
Transition Planning Assessments
[ ]
Interest Inventory
[ ]
Other
Goals for Postsecondary Transition:
Postsecondary Education/Training Goal
If Other is selected, specify
Employment/Occupation/Career Goal
If Other is selected, specify
Community/Independent Living Goal
If Other is selected, specify
Transition Services: Based on the student's strengths, preferences, and interests, the following coordinated transition
services will reasonably enable the student to meet the postsecondary goals. Consider these service areas: Vocational
Evaluations (VE), Community Experiences (CE), Personal Management (PM), Transportation (T), Employment Development (ED),
Medical (M), Postsecondary Education (PE), Living Arrangements (LA), Linkages to Agencies (LTA), Advocacy/Guardianship (AG),
Financial Management (FM), and if appropriate Functional Vocational Evaluation (FVE).
Transition Strands
Academics/Post Secondary
Education/Training
Employment/Occupations/
Careers
Personal/ Social
Daily Living
Service(s)
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ALSDE Approved Feb. 2012
INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
GINA HIGHTOWER
[ ] This goal is related to the student’s transition services needs.
AREA:
Mathematics
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:
Gina’s recent achievement scores on the KTEA-II indicated that her math academic skills are below grade level (standard
math total score 80). Gina has received Tier-II intervention using a scientifically research based reading and math
program. Student has received instruction in small group settings and has been taught with appropriate instruction
strategies. Her teacher is qualified and uses standards based instruction. In Science and Social Studies, Gina’s grades
have remained high. However, her math grades have continued to decline and she is failing 4th grade math. Since the
Tier-II intervention plan has not been as successful as anticipated so she is now being referred to Special Education
services.
MEASURABLE ANNUAL GOAL related to meeting the student’s needs:
DATE OF MASTERY:
By January 2011, Gina will be able to represent multiplication as a comparison on teacher-made assessments (M:4.1)
while scoring 80% on 3 out of every 4 assessments.
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ ] Curriculum Based Assessment [ X ] Teacher/Text Test [ ] Teacher Observation
[ ] Data Collection
[ X ] State Assessment(s) [ X ] Work Samples
[ ] Other:
[ ]
Other:
BENCHMARKS:
1. BY MARCH OF 2010, GINA WILL BE ABLE TO REPRESENT
MULTIPLICATION AS A COMPARISON 70% OF THE TIME ON 2 OUT OF 4
TEACHER MADE ASSESSMENTS.
2. BY MAY 2010, GINA WILL BE ABLE TO REPRESENT MULTIPLICATION AS
A COMPARISON 70% OF THE TIME ON 3 OUT OF 4 TEACHER MADE
ASSESSMENTS.
3. BY OCTOBER 2011, GINA WILL BE ABLE TO REPRESENT
MULTIPLICATION AS A COMPARISON 80% OF THE TIME ON 2 OUT OF 4
TEACHER MADE ASSESSMENTS.
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[ X ] Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
ALSDE Approved Feb. 2012
INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
GINA HIGHTOWER
[ ] This goal is related to the student’s transition services needs.
AREA:
Mathematics
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:
Gina’s recent achievement scores on the KTEA-II indicated that her math academic skills are below grade level (standard
math total score 80). Gina has received Tier-II intervention using a scientifically research based reading and math
program. Student has received instruction in small group settings and has been taught with appropriate instruction
strategies. Her teacher is qualified and uses standards based instruction. In Science and Social Studies, Gina’s grades
have remained high. However, her math grades have continued to decline and she is failing 4th grade math. Since the
Tier-II intervention plan has not been as successful as anticipated so she is now being referred to Special Education
services.
MEASURABLE ANNUAL GOAL related to meeting the student’s needs:
DATE OF MASTERY:
By January 2011, Gina will be able to add and subtract fractions with unlike denominators (M:5.11) with 75% accuracy
on 3 out of 4 teacher made assessments.
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ ] Curriculum Based Assessment [ X ] Teacher/Text Test [ ] Teacher Observation
[ ] Data Collection
[ X ] State Assessment(s) [ X ] Work Samples
[ ] Other:
[ ] Other:
BENCHMARKS:
1. BY MARCH OF 2010, GINA WILL BE ABLE TO COMPARE FRACTIONS
WITH THE SAME DENOMINATORS WITH 80% ACCURACY ON 3 OUT OF 4
TEACHER MADE ASSESSMENTS.
2. BY MAY OF 2010, GINA WILL BE ABLE TO COMPARE AND CONTRAST
FRACTIONS WITH DIFFERENT DENOMINATORS WITH 80% ACCURACY
ON 3 OUT OF 4 TEACHER MADE ASSESSMENTS.
3. BY SEPTEMBER OF 2011, GINA WILL BE ABLE TO ADD AND SUBTRACT
FRACTIONS WITH THE SAME DENOMINATOR WITH 75% ACCURACY ON
2 OUT OF 3 TEACHER MADE ASSESSMENTS.
4. BY NOVEMBER OF 2011, GINA WILL ABLE ADD AND SUBTRACT
FRATIONS WITH DIFFERENT DENOMINATORS WITH 80% ACCURACY ON
2 OUT OF 3 TEACHER MADE ASSESSMENTS.
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[ X ] Grades
Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:
ALSDE Approved Feb. 2012
INDIVIDUALIZED EDUCATION PROGRAM
Student’s Name:
GINA HIGHTOWER
SPECIAL EDUCATION AND RELATED SERVICE(S): (Special Education, Supplementary Aids and Services,
Program Modifications, Accommodations Needed for Assessments, Related Services, Assistive Technology, and Support
for Personnel.)
Special Education
Service(s)
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Location of Service(s)
Special Education Teacher
Math Coach
2 days/week
3 days/week
30
30
2/1/10 to 1/31/11
2/1/10 to 1/31/11
General Ed/Resource
General Ed/Resource
Related Services
[ ] Needed
[ X ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Service(s)
Beginning/Ending
Duration Dates
Location of Service(s)
to
to
Supplementary Aids and Services
Service(s)
[ X ] Needed
[ ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Additional time to finish tasks
Daily
Program Modifications
[ ] Needed
[ X ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Service(s)
2/1/10 to 1/31/11
to
Beginning/Ending
Duration Dates
Location of Service(s)
Math
Location of Service(s)
to
to
Accommodations Needed for
Assessments
Service(s)
[ X ] Needed
[ ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Additional time for testing
Daily
Assistive Technology
[ ] Needed
[ X ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Service(s)
2/1/10 to 1/31/11
to
Beginning/Ending
Duration Dates
Location of Service(s)
General Ed/Resource
Location of Service(s)
to
to
Support for Personnel
Service(s)
[ ] Needed
[ X ] Not Needed
Anticipated
Frequency of
Service(s)
Amount
of time
Beginning/Ending
Duration Dates
Location of Service(s)
to
to
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INDIVIDUALIZED EDUCATION PROGRAM
STUDENT’S NAME:
GINA HIGHTOWER
TRANSFER OF RIGHTS
(Beginning not later than the IEP that will be in effect when the student reaches 18 years of age.)
Date student was informed that the rights under the IDEA will transfer to him/her at the age of 19
The IEP Team has considered the need for extended school year services.
[ ] Yes
[ X ] No
LEAST RESTRICTIVE ENVIRONMENT
Does this student attend the school (or for a preschool-age student, participate in the environment) he/she would attend if
nondisabled?
[ X ] Yes
[ ] No
If no, explain:
Does this student receive all special education services with nondisabled peers? [ ] Yes [ X ] No
If no, explain (explanation may not be solely because of needed modifications in the general curriculum):
Occasionally, this student receives services in the resource room.
[ X ] 6-21 YEARS OF AGE
[ ] 3-5 YEARS OF AGE
Least Restricted Environment:
General Education Room
COPY OF IEP
COPY OF SPECIAL EDUCATION RIGHTS
Was a copy of the IEP given to parent/student (age 19) at
the IEP Team meeting?
[ X ] Yes
[ ] No
Was a copy of the Special Education Rights given to
parent/student (age 19) at the IEP Team meeting?
[ X ] Yes
[ ] No
If no, date sent:
If no, date sent:
Date copy of amended IEP provided/sent to parent/student (age 19)
THE FOLLOWING PEOPLE ATTENDED AND PARTICIPATED IN THE MEETING TO DEVELOP THIS IEP.
Position
Signature
Date
Parent
Parent
General Education Teacher
Special Education Teacher
LEA Representative
Someone Who Can Interpret The Instructional
Implications Of The Evaluation Results
Student
Career/Technical Education Representative
Other Agency Representative
INFORMATION FROM PEOPLE NOT IN ATTENDANCE
Position
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