INDIVIDUALIZED EDUCATION PROGRAM (IEP)

INDIVIDUALIZED EDUCATION PROGRAM (IEP) School Age

Student’s Name: Henry Johnson

IEP Team Meeting Date (mm/dd/yy): 04/19/2018
IEP Implementation Date (Projected Date when Services and Programs Will Begin): 04/30/2018
Anticipated Duration of Services and Programs: 04/30/2018 – 04/29-2019
Date of Birth: 9/21/2010
Age: 7
Grade: 1st
Anticipated Year of Graduation: 2029
Local Education Agency (LEA): Steubenville City Schools
County of Residence: Jefferson County
Name and Address of Parent/Guardian/Surrogate: Phone (Home): 740-444-4444
Joseph and Linda Johnson Phone (Work): 740-555-5555
1234 Pleasantview Circle
Steubenville, OH 43952

Other Information:

The LEA and parent have agreed to make the following changes to the IEP without convening an IEP meeting, as documented by:
Not applicable

Date of Revision(s) Participants/Roles IEP Section(s) Amended

Not applicable Not applicable Not applicable
Not applicable Not applicable Not applicable
Not applicable Not applicable Not applicable

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Henry is a 1st grader who is typically developing. Academically, results from the Brigance Inventory of Early Development III show
that Henry is at an appropriate level for his chronological age in mathematics. His composite score for mathematics was 104, which is
within the average range for his age. Henry was in the 60th percentile for mathematics. He only missed two questions in this section:
the most difficult addition problem and the most difficult subtraction problem. Henry performed below average in the literacy section
of the Brigance, receiving a composite score of 83. Average scores should fall between 90 and 110. His scores in literacy placed him
within the 13th percentile for his age group. Within the literacy section, Henry demonstrated experience with books and could recite
the entire alphabet. He has strong auditory discrimination skills and knows how to manipulate phonemes when asked to do so. Henry
had difficulty with skills such as visual discrimination and reading words from common signs. He did not correctly name the letter X,
but he could point to it when instructed to do so. Henry could name all other letters. He also demonstrated minor difficulty identifying
rhymes. He demonstrated minor difficulties with word recognition as well.

When assessed on physical development skills within the Brigance, Henry fell within the average range for his age in both gross
motor and fine motor skills. His composite score for gross motor was 101. Henry completed this entire portion of the assessment with
without missing a question. His composite score for fine motor was 99. Henry demonstrated strong early fine motor skills. He could
build a tower with 12 blocks. He can print numbers and letters well and the quality of his printing is high. However, Henry does not
grasp his pencil correctly.

Henry is well behaved. He follows directions and does as he is told. He speaks to people, both adults and peers, politely and shares his
thoughts in a respectful manner. Henry is non-confrontational and does not demonstrate aggressive behavior. Henry stays on task,
even when minor distractions are present, and is confident in himself. He maintains his appropriate behavior even when something
upsetting happens.

Henry’s communication skills are appropriate for his age. He is willing to speak and share his thoughts with others, even those he has
meet only recently. Although he is a little shy at first, he quickly warms up to new people. His receptive and expressive language
development are within the average range for his age. In receptive language, Henry received a composite score of 99 on the Brigance,
placing him within the 48th percentile for his age. Henry demonstrated mastery of early receptive language skills. He can identify
pictures by pointing and can identify parts of the body and colors receptively. Henry follows verbal directions. The one area in which
Henry did not score perfectly was within understanding verbal concepts. He struggles to understand right and left of others. In
expressive language, Henry received a composite score of 109 on the Brigance. Henry falls within the 73rd percentile for his age in
this subdomain. He missed no questions on his section of the Brigance, demonstrating his mastery of expressing his thoughts.

Social skills are one of Henry’s greatest strengths. He is comfortable with both adults and peers. He interacts with all people in a
respectful and kind manner. Henry is motivated and confident. He believes in himself and is excited to show what he knows but he is
not discouraged when he doesn’t know something. He remains engaged in tasks even when there are minor distractions. He focuses
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INDIVIDUALIZED EDUCATION PROGRAM (IEP)

on the people he is working with and listens to them. He shares his own thoughts in an appropriate and respectful manner, making
sure he is heard but not coming off as overbearing or rude. He has friends and prefers spending time with his peers than with adults,
yet he is happy and willing to spend time with adults as well. On the Brigance, Henry received a composite score of 115 in both the
interpersonal and self-regulatory domains. This places him above the average range. In both of these areas, Henry falls within the 84th
percentile for his age.

Adaptive skills are another of Henry’s strengths. Henry is an independent young boy. He can ask for food when he is hungry, eat
without spilling food, dress himself and fasten all fasteners, care for all his toileting needs, and bath himself. He received a composite
score of 113 in the adaptive behavior domain of the Brigance. This places him above the average range for his age. Henry falls within
the 81st percentile in this area. Within this domain, Henry still needs to learn his street address and complete mailing address.

Henry’s parents would like to see him improve his reading skills by improving his visual discrimination and word recognition skills.
They have concerns that he will not be able to write quickly enough and continue to write neatly if he does not learn to hold his pencil
correctly.

 Strengths (per information above):

o Henry demonstrates strong auditory discrimination. He can easily hear the difference between words and between
sounds.
o Henry’s quality of printing is excellent. He prints with appropriate slant, size, spacing, shape and formation, and
alignment. He prints legibly and without reversal of letters. Henry prints neatly as well.
o Henry is able to express his needs and thoughts clearly and efficiently. His speak is 100% intelligible and he connects
his ideas well so that whoever he is talking to can understand exactly what he is trying to communicate.
o Henry is a friendly and pleasant person. His social skills are very well developed and this allows him to interact and
communicate with both adults and peers successfully.
o Henry has wonderful adaptive skills. He is independent and can care for himself in numerous ways, including feeding
himself without spillage, dressing and undressing himself, and bathing himself.

 Areas for Improvement (per information above):

o Henry needs addition instruction and practice with visual discrimination.
o Henry needs to improve his word recognition through further instruction.
o Henry needs to learn how to properly grasp a pencil.

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)

V. GOALS AND OBJECTIVES

MEASURABLE ANNUAL GOAL Describe HOW the

Describe WHEN periodic
Include: Condition, Name, Behavior, and Criteria student’s progress toward
reports on progress will be Report of Progress
(Refer to Annotated IEP for description of these meeting this goal will be
provided to parents
components) measured

When presented with both lowercase b and Once a week, Henry will Quarterly reports, in Henry’s progress will be graphed and
lowercase d, Henry will identify the name of each be presented with addition to report cards, the graph will be sent to his parents,
letter with 95% accuracy for 4 consecutive weeks lowercase bs and ds. He will be sent to parents by along with an explanation of the
by the end of this IEP. will be asked to name the email. graph and of what has been done
letters when the teacher that has and has not worked for
points to them. His score Henry.
will be recorded on a data
collection chart and the
results will be graphed so
his progress can be more
easily seen.

Given a list of familiar decodable words with Once a week, the teacher Quarterly reports, in Henry’s progress will be graphed and
regular vowel sounds, Henry will read 95% of will present Henry with a addition to report cards, the graph will be sent to his parents,
words correctly for 3 consecutive weeks by the list of words and ask him will be sent to parents by along with an explanation of the
end of this IEP. to read the words. The email. graph and of what has been done
number of words read that has and has not worked for
correctly will be recorded Henry.
and graphed.

When asked to write, Henry will grasp his pencil The teacher will engage in Quarterly reports, in Henry’s progress will be graphed and
properly (adult grasp between thumb and fingers) direct observation. addition to report cards, the graph will be sent to his parents,
with 95% accuracy for 4 consecutive weeks by the Weekly, the teacher will will be sent to parents by along with an explanation of the
end of this IEP. record how many times email. graph and of what has been done
Henry uses an adult grasp that has and has not worked for
on his pencil out of the Henry.
percent of opportunities
given. This data will be
graphed so as to show his
progress more clearly.

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS

A. PROGRAM MODIFICATIONS AND SPECIALLY DESIGNED INSTRUCTION (SDI)

Projected Beginning
Modifications and SDI Location Frequency Anticipated Duration
Date

Henry will be provided with cut out letters. He will be

asked to sort them into separate cups labeled b and d.
General Education
After sorting, the sorted letters will be taken out and 2 times per week 4/30/2018
Classroom 4/29/2019
checked. At that time, the teacher will provide
guidance as needed to help Henry correct mistakes.

Henry will be explicitly taught mnemonic devises to

General Education
help him remember which lowercase letter is a d and 2 times per week 4/30/2018 4/29/2019
Classroom
which is a b (“b is B without the top”).

Repeated readings will be used to build Henry’s General Education 4/29/2019

3 times per week 4/30/2018
automaticity when reading familiar decodable words. Classroom

Henry will receive direct instruction for phonics skills, General Education 4/29/2019
3 times per week 4/30/2018
especially vowel diagraphs. Classroom

Henry will be instructed to use a tripod pencil grasp

General Education
and hold an object against his palm with his other two 2 times per week 4/30/2018 4/29/2019
Classroom
fingers.

The teacher will model a proper pencil grasp for

Henry and will use classmates as peer models, General Education
2 times per week 4/30/2018 4/29/2019
providing behavior specific praise to both peer models Classroom
and Henry for proper pencil grasps.

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