Iep Performance Template

Individualized Education Program (IEP) Performance
Template
© 2019. Grand Canyon University. All Rights Reserved.

Table of Contents
Table of Contents......................................................................................................2
Standard 1: Contextual Factors: School and Community Demographics, Classroom
Demographics, Building Trust Relationships, and Classroom Management............3
Standard 2: Individualized Education Plan – Part 1..................................................4
Standard 3: Individualized Education Plan - Part 2.................................................11
Standard 4: Preparation for IEP Meeting................................................................16
Standard 5: Implementation, Communication, and Progress Reporting.................18
Standard 6: Revised IEP..........................................................................................20
Standard 7: Reflection of the IEP Process...............................................................21
© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 25

Standard 1: Contextual Factors: School and Community Demographics,
Classroom Demographics, Building Trust Relationships, and Classroom
Management
The IEP Performance Standards is the process for preparing and implementing the IEP
process. This template will be used to address specific standards and go through the process
of creating an IEP for a student in your placement.
Part I: Community, District, School, and Classroom Factors

Complete this portion of the IPE Template document using the following link:
Standard 1, Part I
After completing the e-doc portion, submit the PDF you receive into the digital classroom.
Part II: Demographic, Environment, and Academic Factors

Complete this portion of the IEP Template document using the following link:
Standard 1, Part II
After completing the e-doc portion, submit the PDF you receive into the digital classroom.
In order to submit this assignment, you must:

1. Complete each section of Standard 1.
Note: Closing your internet browser before the signing process is completed will result in
a loss of your work. If you will be completing this document in multiple sittings, it is
highly recommended to save and back up your work on another document. When you
are ready to make your final submission, copy and paste your responses into this
document. The data from this electronic document will not be saved until you complete
the signing process.
2. Complete the signing process by entering your name, selecting “Click to Sign,” and
entering your email address.
 An initial email will be sent to you to confirm your email address.
 A completed copy of the document will be emailed to you within minutes of
confirming your email address.
3. After completing the e-doc portion, submit the PDF you receive into the digital
classroom.

Standard 2: Individualized Education Plan – Part 1
Base the IEP on the student you are following throughout your student teaching placement.
All identifiable student information should be replaced with pseudonyms for confidentiality. In
addition, some information has been marked "Do not complete"’ due to confidentiality
concerns.
The present level of academic achievement and functional performance (PLAAFP) will guide
the development of the IEP. Teachers must describe student strengths, interests, and needs
within the PLAAFP. Assessment scores and a description of how the student is performing in
relationship to typically developing peers will provide the rationale for the development of
IEP goals, services, testing accommodations, and supplementary aides and services. It is
important that all sections of the IEP align with the PLAAFP.
Special Education Department

Individualized Education Program (IEP)
Student Name: John Doe Student Data/Cover Sheet (Form A-1) IEP Meeting Date: 10/17/23
Demographic Information
Student Number: Student (Pseudo) Birthdate: Gender: Grade:

Name:
123456 John Doe 11/23/2010 Male 6
Student Address: Home Phone:

3500 West Camelback Road Do not complete
City, State, Zip:
Phoenix, Arizona 85017
Parent 1 (Pseudo) Name: Jane Doe Parent 1 Relationship: Mother
Parent 1 Address: Home Phone:

Do not complete. Do not complete.
City, State, Zip: Work Phone:
Parent 1 Email:
Do not complete.
Parent 2 (Pseudo) Name: James Doe Parent 2 Relationship: Father
Parent 2 Address: Home Phone:

City, State, Zip: Work Phone:
Parent 2 Email:
Do not complete.
Primary Language of Home: Primary Language Survey Date: N/A Language of Instruction:
English Primary Language Survey Results: N/A English
Home District: Bedford County Service Coordinator:
Attendance District: Bedford County Samantha Baldwin

Home School: Liberty Middle School Attending School: Liberty Middle School
Vision Screened On: Results: No vision problems Hearing Screened On: Results: No hearing
10/03/2023 were found. 10/03/2023 problems were found.
Meeting Date: 10/23/2023 Anticipated Duration of IEP: Re-evaluation Due: 10/20/2026
From: 10/23/2023 To: 05/31/2024 Current Evaluation:
10/20/2023
Special Education Primary Category 1: Other Health Impairment
Special Education Eligibility Category 2: N/A
Special Education Eligibility Category 3: N/A
For Students with SLD only, the following area(s) of eligibility was/were previously determined:
N/A
Level of Services: (A) Support for Reading (30 minutes, 5 times weekly)
(B) Support for Math (30 minutes, 5 times weekly)
(C) Support for Behavior (60 minutes, 5 times weekly)
(D) Resource (45 minutes, 5 times weekly)
Type of Meeting:
IEP Review
Date Meeting Notice Sent to the Date Procedural Safeguards given to the
Parent(s): 10/18/2023 Parent(s): 10/18/2023

This page will not need to be completed because it is a signature page.
Student (Pseudo) Name: John Doe Student Data/Cover Sheet (Form A-2) IEP Meeting Date:
10/23/2023
Student ID: 123456 DOB: 11/23/2010
The following persons participated in the conference and/or the development of the IEP. Additionally, parents have
been given a copy of their rights regarding the student’s placement in special education and understand that they
have the right to request a review of their child’s IEP at any time.
Position/Relation to Student Participant Date (MM/DD/YY)
If during the IEP year the student turns 16, if the student is not present at the IEP meeting, the service coordinator
must review the IEP with the student and obtain the student’s signature and the date of this review.

10/23/2023
Student ID: 123456 DOB: 11/23/2010
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

(PLAAFP)
Section 1: Current IEP Information
Summarize special education services the student is receiving:

John is a rising 7th grade student at Liberty Middle School. John will be receiving Behavior support in all
content areas due to his Emotional Disability. He will also be receiving support for his Other Health
Impairment in all of his core content classes. This will come in the form of adult proximity or repetition.
Section 2: Evaluation Information
Areas of Eligibility:
Special Education Primary Category: Other Health Impairment

Special Education Eligibility Category 2:
Special Education Eligibility Category 3:
For students with SLD only, the following area(s) of eligibility was previously determined:
State and District Assessment Scores: Grade 5 Mathematics SOL- 335 (Failed Below Basic), grade 5
Reading SOL- 299 (Failed), Grade 5 Science SOL- 325 (Failed Basic)
Section 3: Present Level of Academic Achievement and Functional Performance
A. Cognitive (academic performance in content areas, e.g., ELA/Reading/Writing, Math, Science, Social
Studies, Technology and Fine Arts, as applicable): John was given the WISC-V to measure his
cognitive abilities. Overall, he performed in the Very Low range compared to same age peers,
however his skills ranged from Average to Extremely Low. One area of significant weakness was his
ability to compare two unlike words and define words. He performed in the Extremely Low range
compared to same age peers on this composite. When defining words, he demonstrated difficulty
defining the words without using the given word in his answer. His ability to perceive, analyze,
synthesize, and think with visual patterns was in the Low Average range. In the classroom, these
skills are related to interpreting graphs, charts, maps, spacing and organizing written work, and
tracking when reading. One area of strength for John was his ability to problem solve, think flexibly,
and use quantitative reasoning. Classroom tasks related to these skills include drawing inferences,
thinking conceptually, solving abstract problems, problem solving through rule application, and
transferring/generalizing information. He performed in the Very Low range in his ability to recall and
manipulate both auditory and visual information after a short period of time. His auditory memory is

significantly stronger than his visual memory. His ability to scan through and transfer simple visual
information was in the Very Low range. He performed the tasks with 100% accuracy but at a slower
rate when compared to same age peers. His results indicate he is likely to need more time to respond
to questions or complete tasks. The results of the cognitive evaluation indicated that John’s cognitive
skills range from Average to Extremely Low. He demonstrated an area of strength in fluid reasoning
and a significant weakness in verbal comprehension.
B. Physical (gross motor, fine motor, vision, and hearing): John has no hearing problems and he wears
prescription glasses while in the home and school setting. John is distractible, impulsive, and has a
limited attention span. John’s gross and fine motor skills appear to be in the Average range when he
was tested during his evaluation.
C. Oral Language and Communication: John is able to communicate and speaks fluently. He does not
have any weaknesses in his oral language or communication with his peers, teachers, and other adults.
D. Social and Emotional Behavior: John is currently in the 6th grade at Liberty Middle School and there
appear to be no attendance or behavioral concerns. John has a tendency to be a loner and not very
social, but it has been noted that he seems to have made a few friends and is enjoying school more
this year. John becomes upset if he receives a poor grade, especially if he is unable to redo the
assignment.
E. Adaptive: John does not have any Adaptive behavior at this time.
Current Classroom-Based Data: John is able to complete his assignments with passing scores most days.
On other days, he will rush through his assignments in order to complete them and has the tendency to put
down the wrong answers. In class, he seems to be engaged and prepared for the lesson. His teachers state
that they have not had any problems arise where he would need to utilize his calming strategies and he is
capable of asking questions when he needs clarification. In the first quarter, he passed all of his classes.
His math class seemed to be his biggest weakness this past quarter due to lower assessment scores.
Family’s Input on Student’s Current Performance: Parent reports that he seems to be doing well this
school year and she is pleased with his progress. She states that he is doing better at home.
Summary of Work Habits: John needs support to address deficits in reading, math, and content areas.
Many days he is guessing answers and not applying the skills he has acquired to the lessons being
presented in the classroom. He is off task and not engaged. He needs support for attending to tasks and
maintaining alertness and resisting impulsivity, as well as support in behaviors throughout his day. He
does prefer to work on the computer and to play games on the computer and that has been used as
motivation for him, however it can also be something that he gets highly attached to and does not want to
leave when other activities are required. He also prefers to not have to take work home to be completed.
Staff has found that fewer out of class transitions are better for John. Reading tests aloud to John helps
with motivation to stay focused on the task at hand, as well as to not get overwhelmed with the entire test
at one time but to take it one question at a time and focus just as they are read to him.
John has the ability to meet most of the grade level expectations presented to him. He is approaching
grade-level skills when he is engaged and attending to the class and participating. He strives to have all
the answers correct and wants to do his very best. He can often complete the assignments on the first
attempt and achieve passing scores. Other days he will click or circle any answer just to have the
assignment complete. On these days, his grades are impacted in a very negative way.

Section 4: Summary of Educational Needs and General Accommodations

10/23/2023
Student ID: 123456 DOB: 11/23/2010
ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS
Considered
Not Needed Included
Individual Transition Plan ☒ ☐

Statement of Transfer of Parental Rights at Age of Majority ☒ ☐
Statement of Positive Behavior Interventions, Strategies, and Supports ☒ ☐
Considered for a Student Whose Behavior Impedes his or her Learning,
or That of Others
Statement of Language Needs in the Case of a Child with Limited ☒ ☐

English Proficiency
Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

a Visually Impaired Child
Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Communication with Peers in the Child’s Language, and
Communication Mode
Statement of Required Assistive Technology Devices and Services ☒ ☐

Statement of Communication Needs for a Child with a Disability ☒ ☐

10/23/2023
Student ID: 123456 DOB: 11/23/2010

ASSESSMENTS
(Rationales for the accommodations that are being chosen specific to assessments.)
Rationale: Reading tests aloud to John helps with motivation to stay focused on the task at hand, as well
as to not get overwhelmed with the entire test at one time but to take it one questions at a time and focus
just as they are read to him.
State Assessments
Standard Accommodation(s): Grade 6 Reading- 31. Flexible Schedule, 32. Setting

Grade 6 Mathematics- 11. Audio Test, 19. Math Aids, 32. Setting, 31. Flexible Schedule
District Assessments
Standard Accommodation(s): Student does not have any district-wide testing accommodations.
CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS
Testing Area Test Results Grade Semester Year

Reading 299- Failed 5 Second 2023
Writing N/A N/A N/A N/A
Math 335- Failed Below Basic 5 Second 2023
Science 325- Failed Basic 5 Second 2023
LEAST RESTRICTIVE ENVIRONMENT (LRE)

Provide an explanation of the extent, if any, to which the student will NOT participate with non-
disabled students in the general curricular, extracurricular, nonacademic activities, and program
options. §300.347(a) (4):

Consider any potential harmful effects of this placement for the child or on the quality of
services that he or she needs §300.552 (a-b):
Reason for different services at school:
OR, if the above LRE information does not apply to this student, explain why:
John is a rising 7th grader attending his base school for the 2023-2024 school year. He is a
student identified as having an Other Health Impairment. Based on the present levels of
performance and his most recent eligibility testing, John will receive support for behaviors,
reading, math, and other content area skills in the general education classroom. He will
participate in the general education classroom with his non-disabled peers. He will also have
access to the resource room each day for calming, small group testing, make-up work,
remediation, and a quiet working environment when needed. While in the resource room, he will
be working either alone or in a small group of other disabled peers. The resource room will be
available to him at any time during the day for academic and behavior needs, in addition to his
scheduled class period. When finished he will return to the general education classroom with his
other non-disabled peers. If at any time during the school year BCPS is required to go to virtual
instruction, John will receive support for Reading, Math, and content support. The IEP team
determined these services are appropriate to meet John’s learning needs by providing him with a
free and appropriate education while participating in virtual instruction.

Standard 3: Individualized Education Plan - Part 2

10/23/2023
Student ID: 123456 DOB: 11/23/2010
Skill Area: Mathematics

Standard: Any of the Grade 6 Standards of Learning due to the goal being in relation to the topic that
they are on.
Annual Goal: Given a set of 10 math problems on the current topic, John Doe will solve
problems using learned strategies (ex: not guessing, using facts, making a drawing or model, or
eliminating possible answers) with at least 70% accuracy on 3 out of 4 observations, by
05/31/2024.
Baseline Level of Mastery: John is able to solve problems using learned strategies with at least
50% accuracy.
Service Provider(s) for this goal: General Education Teacher and Special Education Teacher
Skill Area: English

Standard: SOL 6.5 The student will read and demonstrate comprehension of a variety of fictional texts,
narrative nonfiction, and poetry.
h) Identify the main idea.
i) Identify and summarize supporting details.
Annual Goal: Given fiction and nonfiction texts at his independent reading level, John Doe will
recall details and the main idea with at least 80% accuracy by 05/31/2024.
Baseline Level of Mastery: John is able to recall details and the main idea with at least 60%
accuracy.
Skill Area: Behavioral

Standard: N/A

Annual Goal: Given an assignment in class John Doe will complete it within the time given by
the teacher with no more than two verbal prompts by 05/31/2024.
Baseline Level of Mastery: John is able to complete an assignment in class within the time given
by the teacher with no more than 4 verbal prompts.
Skill Area: Behavioral

Standard: N/A
Annual Goal: Given a whole group situation John Doe will use a self-regulation/coping strategy
(movement break, deep breathing, quiet space break, etc.) to avoid engaging in an undesired behavior
(destroying materials, being argumentative or disrespectful, etc.), with one reminder, on 4 out of 5
opportunities by 05/21/2024.
Baseline Level of Mastery: John is able to self-regulate/use his coping strategies to avoid
engaging in undesired behaviors with only 2 reminders.

10/23/2023
Student ID: 123456 DOB: 11/23/2010
ACCOMODATIONS
Date Given to General Education Teacher: Service Coordinator:
Accommodations Type Location

Audio/read Aloud Tests except for Reading 2 A
Dictate to a scribe 3 A
Flexible Schedule 3 A
Math Aids 3 E
Reduce length of assignments 1 A
Setting 3 A
Visual Schedule/Visual Aids 3 A
LEGEND FOR TYPE AND LOCATION FIELDS
Type:
1 = Class work/assignments 2 = Assessments/tests 3 = Both class work/assignments/assessments
Location:
A = All Subjects B = Language Arts/English C = Reading D = Spelling E = Math
F = Science G = Social Studies H = Health I = Electives J = Physical Education
K = Lunch L = Transition / Vocation M = Library N = Title 1 O = Special/Exploratory
Family Communication
How will the family be informed of their child’s academic progress and the extent to which that progress
is sufficient to enable the child to achieve annual goals by the end of the year?
John’s family will be informed of their child’s academic progress through progress reports halfway
through and at the end of the four quarters. There will also be an open line of communication with John’s
family throughout the school year when any questions, concerns, or changes arise.
IEP Team Consideration for Extended School Year
Consideration for eligibility: No
Eligible for ESY: No
Written explanation as to why ESY is or is not needed:

The team determined that ESY services are not required for John to receive and appropriate program at
this time but ESY services can be discussed at any time in the duration of this 2023-2024 IEP.

10/23/2023
Student ID: 123456 DOB: 11/23/2010
SPECIAL EDUCATION SERVICES TO BE PROVIDED

Special education services necessary to meet special education goals and objectives during the school
calendar year.
The child is in need of specially designed instruction in the following areas:
Special Instructional
Education Setting/ Start Date Frequency Provider Duration/
Services Location End Date
Support for General 10/23/2023 30 minutes, General 10/23/2023
Reading Education 5 times Education/Special to
Setting weekly Education 05/31/2024
Teacher/Paraprofessiona
l
Math Education 5 times Education/Special to
l
Behavior Education 5 times Education/Special to
l
Resource Special 10/23/2023 45 minutes, Special Education 10/23/2023
Education 5 times Teacher to
Setting weekly 05/31/2024
Clarification:
John needs support to address deficits in reading, math and content areas. He also needs support for
attending to the task and maintaining alertness and resisting impulsivity, as well as support in behaviors
throughout his day.
EDUCATIONALLY RELEVANT RELATED SERVICES
N/A
N/A
N/A
Clarification: N/A

EDUCATIONALLY RELEVANT SUPPLEMENTARY AIDS/ASSISTIVE TECHNOLOGY and
SERVICES for STUDENTS
.
N/A
N/A
N/A
Clarification: N/A
SUPPORTS FOR SCHOOL PERSONNEL
N/A
N/A
N/A
Clarification: N/A

Standard 4: Preparation for IEP Meeting
The IEP team must cover mandated topics during the IEP meeting. Topics that must be
addressed during the IEP include, but are not limited to, an introduction of team members,
clarifying the type of meeting (initial, review, amendment/addendum to current IEP), the
required components of the IEP, the procedural safeguards, and prior written notice.
IEP Meeting Planning

Required Participants/Roles: List the participants of an IEP meeting and their roles, including
whether or not the student is expected to participate.
Case Manager: The case manager facilitates the meeting and will lead the meeting. They are in
charge of ensuring the IEP is formatted correctly and that all signatures are obtained at the
meeting. They are ensuring that the IEP is being implemented and that all necessary changes
are added to the IEP if needed.
Administrator: The administrator is there to assist with any questions that may occur, to
discuss and discipline that may have occurred, and any observations that they may have. They
are also going to provide input on the IEP and what changes/concerns they may have
throughout the meeting.
General Education Teacher: The general education teacher is in charge of discussing any
behaviors that they have noticed in the classroom and their academic progress. They are going
to discuss how the IEP has been implemented into their classroom and any questions,
suggestions, or concerns that they may have.
Parent: The parent is there to discuss any observations that they may have seen at home. They
are also going to provide their opinions on needed changes or concerns they may have in
relation to the IEP. They can provide information on what their child needs in order to be
successful in the classroom.
Required Agenda Outline: In 500-750 words, create an agenda for the IEP meeting. Discuss the
required topics you must address (i.e., introduction of team members, whether or not this is an initial or
review or an annual IEP, discussion of test results, present levels, goals, services, Least Restrictive
Environment (LRE) statement, Extended School Year (ESY) services, procedural safeguards, and prior
written notice.
5 minutes: Procedural Safeguards: We will discuss the procedural safeguards and they will be
offered to the parent prior to the meeting starting.
5 minutes: Discussing that we are having an IEP Review for John Doe and start with
introductions: Case Manager, Administrator, General Education Teacher, and Parent will

introduce themselves to the group. This is the time where case manager will ask if there are
any questions from the table on John’s IEP.
25 minutes: Going over the IEP:

Present Levels: John’s current academic performance and his grades in his general education
classes (A’s, B’s, and C’s). We will also be going over his cognitive functioning and his
ability to complete tasks while in the classroom. Next, we will go over his needs while in the
classroom in order to be successful, which will justify the accommodations that we will go
over later.
Goals: We will go over John’s goals and what is needed in order to check those goals. We will
also discuss how this data will be collected and when the progress will be reported to the
parents (every 4.5 weeks and at the end of the quarter). John has goals in English, Math, and
Behavioral.
Services: We will go over John’s services and how he will be supported in the classroom. John
has support in his content areas of Reading and Math as well as behavior support in all of his
classes. We will discuss how long the supports are expected to be in the classroom. John will
receive his supports in multiple formats whether it is through the general education teacher,
special education teacher, or paraprofessional. He does not have any related services at this
time and does not need support in order to participate in extracurricular activities.
Accommodations: John will receive accommodations in order to be successful in the

classroom. We will discuss why he needs these accommodations and when they should be
given. Most of John’s accommodations can occur during assessments or during class activities.
He will also receive accommodations during his SOLs in order to be successful while taking
the test. We will discuss these accommodations and why they are needed.
LRE: We will discuss the Least Restrictive Environment. John will participate in his general
education classes and will also participate in a special education class (Resource) to work on
his behavior goals.
ESY: We will go over and discuss the extended school year, but at this time it is not needed in
order for John to be successful.
15 minutes: Discussion of any observations, questions or concerns that may arise. We will also
be discussing any changes that need to be made to the IEP in order for John to be successful in
the classroom. The floor is opened to all members to collaborate and decide on a plan.
5 minutes: Prior Written Notice- We will discuss the prior written notice and add any changes
that need to be made to the IEP as well as what options were considered during our
discsussion.

Plan for Conflicts: Provide a description of ways you can involve parents in the development of
the IEP. Discuss whether you anticipate issues or conflicts that may arise during the meeting and your
plan on addressing those concerns.
I will involve parents in the development of the IEP by communicating with them through
emails and phone calls. I will also send home input forms home so that they are able to fill out
what they believe their child’s strengths, weaknesses, interests, and needs are. Through this
communication they are also able to ask questions and state any concerns that they may have.
For this particular student, I do not anticipate any conflicts in relation to the IEP. If there were
conflicts, then I would suggest that we should take a second to calm down and then discuss
everyone’s opinions because everyone should feel heard and that their opinions are valued.
Mock IEP Introduction Video

Now that you have outlined the IEP meeting agenda, you are prepared to conduct the meeting. In order
to prepare for running your first official IEP meeting, record yourself as if you were conducting the IEP
meeting. Your video should not exceed 15 minutes in length.
Focus your practice on the meeting introduction. Include the following components within your
recording:
 An introduction of all parties represented and their roles
 Reason for the meeting (initial IEP or IEP review)
 Meeting norms so all parties are heard and respected
 Review of the PLAAFP including the discussion of test results, present levels, goals, services,
Least Restrictive Environment (LRE) statement, Extended School Year (ESY) services,
procedural safeguards, and prior written notice (PWN).
Conclude your video by providing an explanation of how you would actively listen to and address the
needs of families and other stakeholders throughout the meeting.
After recording yourself, review and reflect upon the video below.
Mock IEP Introduction Video Link:

Video Recording Link:
https://youtu.be/lhYijA_v3eI?si=5bKJUN4DpfVwLa1Y
Reflection: In 250-500 words, reflect on your IEP meeting practice session. In what areas do you
feel you did well? In what areas would you like to have more guidance and coaching before conducting
your first official IEP on your own? What plan of action do you have for more coaching and guidance?
I believe I did well on ensuring that everyone understood that they had an opportunity to discuss their
concerns, any changes that they needed to make, or their opinions on how the IEP was working for
John Doe. I also feel like I did well on discussing John’s different parts to his IEP in a manner that
would be understandable to those in attendance of the meeting. I would like to have more guidance and
coaching on the Prior Written Notice part because I do not believe I have the correct terminology for
the PWN and I think I need to have a better understanding of what it is before discussing it in a

meeting. Another thing that I feel like I need to work on is being more assertive. I have the tendency to
be a little unsure of what I am saying, and I think I would need more coaching on ensuring that I was
more prepared and well-versed in the workings of the IEP. I do believe that this will come when I have
worked longer in this field, but it is something that I feel needs to be improved upon. I plan on working
with my colleagues at my school who have been in the special education field for much longer than
me, as well as those who are in the special education department in my school district. I believe this
field is a completely collaborative career and it is important to learn and grow with each other in order
to be the best possible versions of ourselves.

Standard 5: Implementation, Communication, and Progress Reporting
Accountability of Free Appropriate Public Education (FAPE) is mandated by the Individuals with
Disabilities Education Act of 2004 (IDEA). IEP teams must have a plan to document the provision of
services as written in the IEP. Appropriate and accurate data must also be collected to document
quarterly progression toward mastery of IEP goals. Teams must have a plan for on-going data
collection, communication, and presentation of data to the parents/guardians during quarterly
progress reports and annual IEP review meetings.
Accommodations Progress and Communication Plan

Complete the Accommodations Table below, demonstrating how you plan to ensure all
accommodations are being met in the general education setting (if applicable). If the student is not in a
general education classroom, indicate how the student will receive accommodations in content specific
areas based on his or her PLAAFP and IEP goals.
On the Accommodations Table, note the dates when you will obtain progress reports from the general
education teacher or related services staff so that you can gather data on progress (if applicable). If no
general education teachers are reporting, indicate the dates of your (special education teacher)
reporting.
In addition, use the Accommodations Table to gather data on the student’s progress for the first
Quarterly Progress Report.
NOTE: Only two dates are included on the Accommodations Table for the purpose of this assignment.
You may not gather data on both dates in the duration of your placement, but dates should be noted.
Accommodations Table
Goal 1: Given a set of 10 math problems on the current topic, James Doe will solve problems using learned
strategies (ex: not guessing, using facts, making a drawing or model, or eliminating possible answers) with
at least 70% accuracy on 30 out of 4 observations, by 05/31/2024.
Implemented Accommodations: Person(s) Responsible:
Audio/Read Aloud Tests except for Reading, math aids, reduce length of Special Education and General Education
assignments, setting, visual aids Teacher
Quarterly Progress Report 1 Date: 09/15/2023
Data Results: John is able to solve problems using learned strategies. He does have the tendency to guess on certain
questions that he does not know or understand.
Data Results: John struggles with not guessing on assessments when he does not know the answers to a problem. When
he takes his time on assessments, he is able to do well on the

Goal 2: Given an assignment in class, James Doe will complete it within the time given by the teacher with
no more than two verbal prompts by 05/31/2024.
Implemented Accommodations: Person(s) Responsible:
Setting, visual aids/schedule, reducing length of assignments, flexible Special Education and General
schedule Education Teacher
Data Results: John is able to complete his assignments within the time given by the teacher with no prompts.
Data Results: John is able to complete his assignments within the time given by the teacher with no prompts.
Accommodations Summary:
In 100-150 words, summarize information from the Accommodations Table as well as data you have gathered
through teaching and observing the student. Address mastery of goals, progress towards mastery, and overall
service provision.
John will need to receive read aloud of all tests except for reading due to his eligibility testing evaluations. Due to
deficits in Math, he will need to utilize math aids in order to complete computation assignments. He will also
require the use of visual schedules/aides in order to maintain attention to tasks and complete his
assignments/assessments within the classroom. In order to assist with his attention to tasks, he should receive
reduced length of his assignments and a flexible schedule to work on the assignments/assessments within his
classroom. He will require small groups or another setting when completing assessments to assist with attention to
the tasks.
Communication Plan for General Education Teachers and Related Services Staff:
After completing the accommodations table and summary, in 150-250 words, describe a communication plan that
outlines how you plan to share the student’s progress information with the necessary faculty and staff. Address how
you and your colleagues will continue to monitor progress along the way, prior to receiving the quarterly
progression updates.
I plan to share communication details with the necessary faculty and staff, as well as the parents, through emails,
phone calls, and meetings. Progress notes will also be given on a 4.5 week and quarterly basis. Through these forms
of communication, all necessary members of the IEP team will be kept up-to-date on any progress, changes, or
concerns in relation to the students IEP. My colleagues and myself will be continuing to monitor progress
throughout data sheets that will be handed out weekly to teachers. There will also be observations while the student
is in the classrooms. Teachers will also be asked to provide input on what they believe is working best and if there
should be any changes made to help the student progress towards meeting their goals. Without collaboration, we
will not be able discuss the students progress or what we can do better to help our student reach their annual goals
through their IEPs.

Standard 6: Revised IEP
IEP teams are expected to regularly analyze and document students’ progress on their IEP
goals throughout the year. This includes identifying when there are changes affecting the
student and presenting evidence of attempts to meet student needs when there is a lack of
progress. To address times when information, services, or goals need to be changed or added
to an existing IEP, the Individuals with Disabilities Education Act of 2004 (IDEA) describes
the regulations and procedures for changing an IEP using an amendment or addendum. An
amendment is used to change something already in the IEP. An addendum is used to add
something new to the IEP, such as goals, services, or accommodations.
After reflecting on your completed Standard 5 content, create a progress report addendum and/or
amendment (based on changes needed) to be added to the initial IEP, or describe why neither an
addendum nor amendment are not needed.
Data Collection and IEP Modifications

Stakeholders involved in special education must be aware of the student progress monitoring
process, keeping the goal of mastering IEP goals and presenting evidence of attempts to meet
said goals in mind. It is vital to keep a record of new information affecting student needs,
including a lack of progress when an IEP is in effect, using an IEP amendment or addendum.
An amendment is a change to the IEP and an addendum is the addition of goals or services and
accommodations to the IEP.
IEP Modification Need

After monitoring and gathering data, analyze how the student is performing on his or her IEP
goals and with the accommodations. Consider whether there is a need for an addendum and/or
an amendment for the student. If there is a need, in 50-100 words explain this need and the
approach to be taken (an amendment or an addendum). If there is no need at this time, simply
explain how the student is performing and progressing toward their IEP goals.
There is not a need for an addendum due to the student showing progress towards his goals. He is
currently able to complete assignments within the timeframe given in the classroom and typically does
not need any prompting in order to do so. He is able to complete math problems by completing them
with the use of math aids with 65% accuracy.
Family Communication Plan

In 50-100 words, discuss how you plan to communicate the student’s progress on his or her
IEP goals with the parents/guardians. (You may want to discuss this process with your mentor
so you have a method to use for future practice.)
I plan to communicate the student’s progress on his or her IEP goals with the parents/guardians by
sending home 4.5 week and quarterly progress reports to them. I also plan on communicating with
them through email and phone calls to discuss how he is doing while in the classroom. I plan to utilize
the progress reports and phone calls/emails to discuss behaviors and academic performance.

Standard 7: Reflection of the IEP Process
Reflection is an important part of professional practice. Professional special education
teachers plan and frequently reflect on their delivery of services, instruction, data collection
procedures, and individual student progress. Identification of practices that have worked, and
those that have not, can help the special education teacher adjust instruction and services to
better meet the needs of students.
Continued Learning
After completing the Individualized Education Program (IEP) Performance Template, reflect
upon three best practices you have learned from this student teaching experience in 50-150
words.
1. I have learned to be organized and store student information in their own files within a locked
cabinet.
2. Ensuring that data collection sheets are easy for all staff to understand and are simple for them
to fill out as they are collecting the data throughout their class time.
3. Communicating with families is vital to making changes, offering progress notes, and noting
any concerns that may arise with the students IEP. It is important to gain their opinion on the
topic to ensure that everyone is heard.
Improved Practice
Based on your experience of developing and delivering your Individualized Education
Program (IEP) Performance Template, list three implications for your future teaching practices
in 50-150 words. Consider concepts you want to take with you into your own classroom, such
as how you will establish and maintain organization in order to facilitate the IEP process in
your classroom.
1. I will continue to utilize the organizational methods that were taught to me. This can be done
through file folders, binders, and labeled bins for all of my students’ information.
2. I will continue to prepare for meetings by communicating with parents before we have the
meetings. I will ensure that I am hearing any concerns so I can be prepared to solve conflicts
before they actually arise.

3. I will ensure that all parties are informed on the ins and outs of the student’s IEP. That means
ensuring that they understand what their accommodations, goals, and services are in order to
give the students the best possible chance for success.

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Individualized Education Program (IEP) Performance

© 2019. Grand Canyon University. All Rights Reserved.

© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 25

Part I: Community, District, School, and Classroom Factors

Part II: Demographic, Environment, and Academic Factors

In order to submit this assignment, you must:

© 2019. Grand Canyon University. All Rights Reserved. Page 3 of 25

Special Education Department

Student Number: Student (Pseudo) Birthdate: Gender: Grade:

Student Address: Home Phone:

Parent 1 Address: Home Phone:

Parent 2 Address: Home Phone:

© 2019. Grand Canyon University. All Rights Reserved. Page 4 of 25

Special Education Eligibility Category 2: N/A

Special Education Eligibility Category 3: N/A

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Student ID: 123456 DOB: 11/23/2010

Position/Relation to Student Participant Date (MM/DD/YY)

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Student ID: 123456 DOB: 11/23/2010

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Section 1: Current IEP Information

Summarize special education services the student is receiving:

Section 2: Evaluation Information

Special Education Primary Category: Other Health Impairment

Section 3: Present Level of Academic Achievement and Functional Performance

© 2019. Grand Canyon University. All Rights Reserved. Page 7 of 25

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Special Education Department

Student ID: 123456 DOB: 11/23/2010

ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS

Individual Transition Plan ☒ ☐

Statement of Language Needs in the Case of a Child with Limited ☒ ☐

Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Statement of Required Assistive Technology Devices and Services ☒ ☐

© 2019. Grand Canyon University. All Rights Reserved. Page 9 of 25

Student ID: 123456 DOB: 11/23/2010

Standard Accommodation(s): Grade 6 Reading- 31. Flexible Schedule, 32. Setting

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS

Testing Area Test Results Grade Semester Year

LEAST RESTRICTIVE ENVIRONMENT (LRE)

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Reason for different services at school:

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Special Education Department

Student ID: 123456 DOB: 11/23/2010

Skill Area: Mathematics

Skill Area: English

Skill Area: Behavioral

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Skill Area: Behavioral

© 2019. Grand Canyon University. All Rights Reserved. Page 13 of 25

Student ID: 123456 DOB: 11/23/2010

Date Given to General Education Teacher: Service Coordinator:

Accommodations Type Location

IEP Team Consideration for Extended School Year