Madison Lacombe
IEP Project
Record Review
See record review template.
General Student Information
Student’s pseudonym
Date of birth
Age
Grade
Primary and additional
disabilities
Initial Referral and Identification of Disability
Referred by (position of
person such as general
education teacher, parent,
etc.)
Year of initial referral
Age of student at time of
initial referral
Concerns about student
performance that lead to
initial referral
Developmental History
Describe developmental
milestones (e.g., birth,
walking, talking, other
notable milestones)
Family Characteristics
List family members and
relationship to student to aunt, grandmother, and grandfather.
student who live at home
with student
Avery Grey
August 2012
11 years old
6th Grade
Intellectual Disability (Moderate), Down Syndrome, Speech,
and Language Deficit
Avery was referred by BabyNet early intervention services in
2015 after PT, OT, and psychological evaluations.
2015
Two years, eleven months
Avery was diagnosed with Down Syndrome at birth. He had
received services for speech therapy, occupational therapy,
physical therapy, and early intervention. On developmental
profile 3, his averages were in the average range in
social/emotional skills and in the low average range for
physical. His cognitive standard score fell within the
borderline range and his adaptive behavior standard score
fell in the impaired range. Avery’s communication skills are
delayed, and his fine and gross motor skills are in the
significantly delayed range.
Avery crawled at 1 year, walked on his own at 2 years, spoke
his first words at 8 months and began to self-feed at 18
months.
Avery lives at home with his mother, brother, three uncles,
Madison Lacombe

Note other relevant home Spanish and English are spoken in the home.
environment information
Describe engagement in Mom attends every IEP meeting; no other family members
education and IEP process have attended in the past.
among family members
Document special No related information in the file
challenges at home
Cultural and Linguistic Factors
Describe cultural factors Avery ‘s family speaks both English and Spanish at home
apparent in the child’s equally. His grandmother and uncle speak only Spanish to
records (including him, and his aunt and other uncle only speak English to him.
languages spoken at Mom uses both.
home, values shared by
individuals in IEP process,
“way of life” information)
Note participation in social No related information in the file. Mom had not shared any
groups information about participation in social groups with the IEP
team.
Medical History
Current medical No related information in the file. Mother had chosen not to
information including share medication information with the IEP team.
medication and allergies
Previous serious illnesses At birth, Avery was jaundice and had to be under a light for 2
and accidents days after his birth. When Avery was 18 months, he was
taken to the emergency room for a cough, then was. Given
breathing treatments and sent home.
Vision information (date In 2015 he was screened for vision at the Medical University
tested, deficiencies, of South Carolina and was received a glasses prescription.
corrections) Avery no longer wears glasses. No information on transition
from glasses to no glasses in file.
Hearing information (date In 2015 Avery was screened for hearing at the Medical
tested, deficiencies, University of South Carolina and passed.
corrections)
Provide information about Avery feeds himself (with support to open container), clothes
daily living habits. himself, and uses the restroom independently.
(Note: you can use your
own observations for this,
just mark “own
observations”)
School History
Previous learning Avery did not attend preschool, although he received early
environments intervention services at home and onsite through BabyNet.
From 2015 to 2019 Avery attended Carolina Forest
Madison Lacombe

Elementary school, from 2019 to 2021 he attended

Forestbrook Elementary and from 2021 to 2023 he attended
Palmetto Bays Elementary. In these three elementary schools
Avery was placed in a self-contained moderate/severe
classroom with alternative curriculum.
Current learning Now Avery attends Ten Oaks Middle School in a self-
environments contained, moderate/severe classroom with alternative
curriculum. Small class size with the ratio of teachers and
paraprofessionals to students being 1:3.
Special education services Pre-k – 5

Speech and Language: Small group direct instruction, 240

minutes quarterly

Occupational Therapy Services: Individual direct instruction,

60 minutes monthly

Physical Therapy Services: Individual direct instruction, 240

minutes quarterly

Pre-academic/Readiness Skills: Special education classroom

with direct instruction, 60 minutes daily

Daily Living Skills: Special education classroom with direct

instruction, 30 minutes daily

Middle School

Reading: Mod/Severe self-contained direct instruction, 60

minutes daily

Math: Mod/Severe self-contained direct instruction, 60

minutes daily

Daily Living Skills: Mod/Severe self-contained direct

instruction, 30 minutes daily

Social/Emotional: Mod/Severe self-contained direct

instruction, 60 minutes daily

Related services (previous Transportation: Specialized bus transportation, daily to and

and current) from school.
Madison Lacombe

Speech and Language: Small group direct instruction, 180

minutes quarterly

Supplementary Speech and Language: Indirect instruction, 30

minutes quarterly

Other supportive services No related information in the file, student does not use
such as assistive assistive technology currently or in the past.
technology including
augmentative
communication (previous
and current)
Attendance patterns in Over the past 3 years Avery has been absent from school
last three years infrequently, when he is sick, he is out for multiple days each
time.
Participation in district Due to Avery’s significant cognitive delays, he is exempt from
and state assessments, DIBELS and MAP assessments. Avery participates in the
including accommodations alternative state assessments for reading and math, he also
and alternate assessments takes the state ACCESSS for ELL assessment.
Postschool outcomes (if No related information in the file, student is under the age of
applicable) transition planning.
Current IEP goals and Goal 1: Reading
STOs/BMs By October 2023, given specially designed instruction and
multiple opportunities to practice, Avery will be able to
identify from a choice of 3 the correct high-frequency sight
words with at least 80% accuracy in 3 out of 4 opportunities
as measured by reading data sheet.
Objectives:
By March 2023, given specially designed instruction and
multiple opportunities to practice, Avery will be able to
identify from a choice of 3 the correct high-frequency sight
words with at least 40% accuracy in 3 out of 4 opportunities
as measured by reading data sheet.
By June 2023, given specially designed instruction and
multiple opportunities to practice, Avery will be able to
identify from a choice of 3 the correct high-frequency sight
words with at least 60% accuracy in 3 out of 4 opportunities
as measured by reading data sheet.
By October 2023, given specially designed instruction and
multiple opportunities to practice, Avery will be able to
identify from a choice of 3 the correct high-frequency sight
words with at least 80% accuracy in 3 out of 4 opportunities
as measured by reading data sheet.
Madison Lacombe

Goal 2: Mathematics
By October of 2023, when given up to 20 objects and cued
(count the object) Avery will count the objects and match the
correct number set, from a baseline of (0/20) 0% accuracy to
(14/20) 70% accuracy, over 3 consecutive data points, as
measured by a 1:1 correspondence data chart.
Objectives:
By March of 2023, when given up to 20 objects and cued
(count the object) Avery will count the objects and match the
correct number set, from a baseline of (0/20) 0% accuracy to
(6/20) 30% accuracy, over 3 consecutive data points, as
measured by a 1:1 correspondence data chart.
By June of 2023, when given up to 20 objects and cued
(count the object) Avery will count the objects and match the
correct number set, from a baseline of (0/20) 0% accuracy to
(10/20) 50% accuracy, over 3 consecutive data points, as
measured by a 1:1 correspondence data chart.
By October of 2023, when given up to 20 objects and cued
(count the object) Avery will count the objects and match the
correct number set, from a baseline of (0/20) 0% accuracy to
(14/20) 70% accuracy, over 3 consecutive data points, as
measured by a 1:1 correspondence data chart.
Goal 3: Daily living skills
By October of 2023, given multiple opportunities to practice,
Avery will identity by matching personal information facts in
the correct order, from memorization, with 80% accuracy, in
4 out of 5 opportunities, as measured by daily living skills
data.
Objectives:
By October of 2023, given multiple opportunities to practice,
Avery will identity by matching personal information facts in
the correct order, from memorization, with 40% accuracy, in
4 out of 5 opportunities, as measured by daily living skills
data.
By October of 2023, given multiple opportunities to practice,
Avery will identity by matching personal information facts in
the correct order, from memorization, with 60% accuracy, in
4 out of 5 opportunities, as measured by daily living skills
data.
By October of 2023, given multiple opportunities to practice,
Avery will identity by matching personal information facts in
the correct order, from memorization, with 80% accuracy, in
4 out of 5 opportunities, as measured by daily living skills
data.
Madison Lacombe

Goal 4: Social/Emotional
By October 2023, when given a visual prompt with no more
than a 7-minute break, Avery will return to activity with a
visual prompt to return with no behaviors (walking away
from group, saying no I don't want to, refusing to move) from
a baseline of 1 out of 10 days to 10 out of 10 days.
Objectives:
By March 2023, when given a visual prompt with no more
than a 7-minute break, Avery will return to activity with a
visual prompt to return with no behaviors (walking away
from group, saying no I don't want to, refusing to move) from
a baseline of 1 out of 10 days to 4 out of 10 days.
By June 2023, when given a visual prompt with no more than
a 7-minute break, Avery will return to activity with a visual
prompt to return with no behaviors (walking away from
group, saying no I don't want to, refusing to move) from a
baseline of 1 out of 10 days to 8 out of 10 days.
By October 2023, when given a visual prompt with no more
than a 7-minute break, Avery will return to activity with a
visual prompt to return with no behaviors (walking away
from group, saying no I don't want to, refusing to move) from
a baseline of 1 out of 10 days to 10 out of 10 days.
Goal 5: Speech and Language
By October of 2023, given a total communication approach
(signs, verbal, pictures and/or voice output device) Avery will
independently use 3–4-word combinations to request
wants/needs from a baseline of 0% accuracy and progress to
80% accuracy, over 4 consecutive sessions, as measured by
SLP Logs, observation, and Probes.
Objectives:
By March of 2023, given a total communication approach
(signs, verbal, pictures and/or voice output device), Avery
will independently use 3–4-word combinations to request
wants/needs from a baseline of 0% accuracy and progress to
40% accuracy, over 4 consecutive sessions, as measured by
SLP Logs, observation, and Probes.
By October of 2023, given a total communication approach
(signs, verbal, pictures and/or voice output device), Avery
will independently use 3–4-word combinations to request
wants/needs from a baseline of 40% accuracy and progress
to 80% accuracy, over 4 consecutive sessions, as measured
by SLP Logs, observation, and Probes.
Goal 6: Speech/Language - Related Service
Madison Lacombe

By October of 2023, given a total communication approach

(signs, verbal, pictures and/or voice output device), Avery
will use 3–4-word combinations to comment from a baseline
of 15% accuracy and progress to 75% accuracy, over 4
consecutive sessions, as measured by LP Logs, observation,
and Probes.
Objectives:
By March of 2023, given a total communication approach
(signs, verbal, pictures and/or voice output device) Avery will
use 3–4-word combinations to comment from a baseline of
15% accuracy and progress to 45%
accuracy, over 4 consecutive sessions, as measured by SLP
Logs, observation, and Probes.
By October of 2023, given a total communication approach
(signs, verbal, pictures and/or voice output device) Avery will
use 3–4-word combinations to comment from a baseline of
45% accuracy and progress to 75% accuracy, over 4
consecutive sessions, as measured by LP Logs, observation,
and Probes.
Goal 7: Speech/Language - Related Service
By October of 2023, given a group of pictures, Avery will
identify the category of the pictures using augmentative
symbols or picture cards from a baseline of 0% accuracy and
progress to 80% accuracy, over 4 consecutive sessions, as
measured by SLP Logs, observation, and Probes.
Objectives:
By March of 2023, given a group of pictures, Avery will
identify the category of the pictures using augmentative
symbols or picture cards from a baseline of 0% accuracy and
progress to 40% accuracy, over 4 consecutive sessions, as
measured by SLP Logs, observation, and Probes.
By October of 2023, given a group of pictures, Avery will
identify the category of the pictures using augmentative
symbols or picture cards from a baseline of 40% accuracy and
progress to 80% accuracy, over 4 consecutive sessions, as
measured by SLP Logs, observation, and Probes.
Involvement with outside No information on outside agencies was provided in the IEP
agencies and description
of provided services
Individual Differences
Dates and bulleted results • Cognitive Profile Third Edition (DP-3) 2015: Standard
of Intelligence testing score of 72 (3rd Percentile)
Madison Lacombe

Dates and bulleted results Reading (Unique Learning System) 9/27/2023

of achievement testing Early Learning Benchmark: Identification Upper Case
(include MAPs here) Score: 11

Reading (Unique Learning System) 9/27/2023

Word Recognition List 1
Score: 2/18

Math Unique Learning System 9/27/2023

Math Benchmark
Score: 6/18

Math Unique Learning System 9/28/2023

System Number and Counting Benchmark
Score: 8

Dates and bulleted results N/A, Avery does not have any CBM data in his IEP.
of CBM
Dates and bulleted results N/A, Avery has not had a behavior assessment completed
of behavior assessment
Dates and bulleted results Daily Living Skills Assessment: 10/2/2023
of adaptive behavior Unique Learning System
assessments and Score: 4 out of 10 correct for 40% Accuracy
observations When presented with a choice of 3 pictures, Avery was asked
to choose a specific picture related to one of the following
categories:
• Self-Management
• Basic Communication
• Dressing
• Toileting
• Grooming
• Bathing
• Health, Safety and First Aid

Daily Living Skills Assessment: 10/2/2023

Personal Information Adapted Notebook Logs and
Observation
Score: 1 out of 4 completed for 25% Accuracy
Avery was given a personal information notebook. Each page
of the notebook contains a different question regarding his
personal information. Avery was prompted to answer the
questions by completing his name address phone number and
school. Avery completed his name only.
Madison Lacombe

• Adaptive Behavior Third Edition (DP-3) 2015:

Standard score of 68 (2nd Percentile)
• Motor/Sensory Third Edition (DP-3) 2015: Standard
score of 84(13th Percentile)
• Fine Motor Scales 2nd Addition 2015: Quotient score
of 73 (3rd Percentile)
• Gross Motor Scales 2nd Addition 2015: Quotient
score of 65 (significantly delayed range)
• Social/Behavior/Emotional Third Edition (DP-3) 2015:
Standard score of 86 (18th Percentile)

Core academic strengths Reading

- Avery can name uppercase and lowercase letters in a
mixed range when not timed.
- Avery can trace highlighted words and short
sentences.
Mathematics:
- Avery can label his shapes and colors.
- Avery can count from 1-10
- Avery can match numbers independently in a field of
2-3
Core academic needs Reading
- Avery has difficulty with letter-sound symbol
relationships decoding words.
- Avery does not understand nor use the structure of
language when reading unfamiliar sight words.
Mathematics:
- When given 20 objects Avery is unsuccessful in
counting the objects and matching the correct
number set in 1:1 correspondence.
Interests Avery is interested in movies and shows (Mario, Minions,
Hotel Transylvania, and Madagascar). He enjoys singing and
dancing with peers and teachers as well as laughing with
others.
Adaptive behavior and - Avery can write his name using a model to copy.
cross-curricular strengths - Avery is independent with eating, dressing, using the
bathroom and with adult supervision, navigating the
school
Adaptive behavior and - Avery requires maximum support to recognize his
cross-curricular needs personal information.
- Avery cannot use a pencil with large grip and uses
larger sized crayons and markers due to his gross
motor deficit.
Madison Lacombe

Behavioral strengths - Avery will initiate greeting and social interactions with
peers and adults if it is something that he is
interested in.
- Avery has positive peer relationships in class and
enjoys interacting during peer group activities.
Behavioral needs - Avery is functioning below his chronological age in
social development.
- Avery refuses to go back to the group after given a
short break.
- Avery had an inability to stay on task and follow
directions.
- Avery needs maximum support and a first then token
reinforcement system to rejoin groups.
Emotional strengths - Avery often works well with other students during
group work.
- Avery often displays appropriate listening behavior
(facing speaker, nodding head, etc.)
Emotional needs - Avery rarely tolerates being told “no” or not getting
what he wants.
- Avery rarely expresses frustration and disagreement
appropriately.
Additional Assessment
Name and describe two formal assessments that you would select to complete with your
student. These assessments need to minimize bias for the student and be appropriate, given the
student’s individual differences. Provide a rationale for selecting this assessment, how it
minimizes bias for the student, and why it is appropriate for your student. (You do not need to
give these assessments.)
The first assessment that should be selected for Avery would be a functional behavior
assessment due to disruptive and dangerous behaviors that occur when he does not get his way
in class. The functional behavior assessment will be done by the special education teacher. His
behavior will be pinpointed and define the behavior that is occurring, The IEP team will then
gather information about the student and decide the function of his behavior. This will
minimize bias for the student because once the behavior is identified, it will be defined in a
specific way that shows what counts and does not count as the problematic behavior. It is
appropriate for this student because due to his disabilities he is exhibiting social and emotional
behaviors that cause distraction in the classroom and require intervention to support him with
using proper behaviors and coping skills.

The second assessment that should be selected for Avery would be the Kauffman Assessment
for children 2 which assess intelligence. The test is broken into 3 subtest, verbal knowledge,
matrices, and riddles. This would be an appropriate test for the student due to his intellectual
disability and the fact he has not had any intelligence testing done since 2015, it would be
appropriate to have another assessment done now that he is older. There is also a nonverbal
option of this test for students like Avery who have minimal verbal skills. The benefit of this
test is that is fairly assesses children of different backgrounds and diverse intellectual deficits.
Madison Lacombe

The assessment gives a look into how the student receives and processes information to help
find cognitive strengths and weaknesses which can be used in the classroom when planning
instruction.

Additional Resources
For each of your three additional resources, please provide the following information:
• Provide a rationale for selecting this resource linked to findings of the record review
(what data were you missing?)
• For an interview - Summarize the findings of the interview in a narrative with important
quotes, maintaining professionalism and anonymity OR
• For the skills checklist, work samples/data sheets - Summarize findings for each source of
data or individual work sample with important notes about student performance,
maintaining professionalism and anonymity OR
• For observations - Summarize findings for each observation individually with important
notes about setting and student performance, maintaining professionalism and anonymity
Provide the following information:
• Describe how you integrated technology.
• Describe how the informal assessment minimizes bias for this student.
Attach the completed resources to your submission.
Skills Checklist Summary

A social skill and play based skill checklist were completed based on Avery’s performance.
This checklist was broken into three categories, cannot do, can partially do, and can do
independently. Based on a play and social skill checklist, Avery has many strengths and areas
for growth in this category. Avery has strengths in his gross motor skills which includes,
throwing balls, using pencil and crayons to color, stacking, and scooping water or sand. This
means he can participate in age-appropriate activities with his peers and complete arts and
crafts activities in class. Avery also can sit and play by himself for longer periods of time
without needing others to be entertained. All these strengths he can do independently with no
help. He also had many checks for being able to partially complete tasks, meaning he would
require some assistance. In this column he was said to partially be able to pay attention, follow
1-2 step directions, play simple games, use scissors and glue, throw balls over 6 feet, and kick
a ball while running. These tasks could be completed but with modifications, prompts or
assistance from a peer or adult. With time he would most likely be able to complete these tasks
independently with practice. For tasks that Avery requires full assistance are following
directions that are more than 2 steps, doing moderate/complex puzzles and games, hitting a
baseball when pitched, riding a bike, and using a scooter. These skills show that his
intellectual disability does affect his memory and comprehension skills as well as his balance
and athletic skills. With time and practice some of these tasks may be able to be completed
independently, but many he will require assistance with for the rest of his life.

Other Resource 1: Special Education Teacher Interview

Rationale: The student's special education teacher spends the entire school day with the
student and has a lot of information on how the student behaves in class. This year he has been
exhibiting behaviors in the classroom that are not documented in any of his records.
Madison Lacombe

Summary: Avery is a happy boy who loves coming to school and seeing his peers and
teachers. He also enjoys singing, dancing, and laughing with others. He is interested in movies
such as Super Mario, Minions, and Spiderman. In the classroom, the student gets really
frustrated when recess is over and he must put his iPad away, this usually results in a tantrum
where he tips over his chair and desk, pulls on teachers’ clothes, attempts to climb a teacher or
paraprofessional, cries and throws his shoes. These tantrums can last up to 30 minutes and
distract the rest of the students from other activities. Avery also struggles to transition from
place to place, refusing to move although when he gets to the next place, he is content. The
teacher and paraprofessionals in the class care about Avery and want him to feel welcomed
and have a good time in school, but the behaviors that he has been exhibiting is not allowing
for a relationship to form between the student and the staff in the classroom.

Other Resource 2: Behavior Observation

On October 2nd, 2023, the student was observed after lunch from 11:00am to 11:15am.

Observation: The whole class was to look up at the board for the interactive reading lesson.
Approximately 5 minutes into the lesson the student took out his stuffed animal. The teacher
attempted to redirect the student one time. The student refused to look at the board and
continued to play with his stuffed animal. When asked to pay attention by the paraprofessional
the student verbally protested by yelling “No!”. After being asked 4 times to pay attention to
the lesson by the teacher and paraprofessional Avery got up from his chair and ran to the
beanbag chair at the back of the class and put a blanket over his head. The student was
vocalizing while in the beanbag, distracting the class. Vocalizations stopped after a few
minutes, and the student fell asleep in the beanbag chair.

Findings: Avery tends to seek control of situations. At the start of the lesson, he wanted to
continue to play with his stuffed animal although it was not the appropriate time. Once Avery
has made up his mind on what he wants to do, no adult can change his mind. Based on the fact
he then fell asleep in the beanbag chair in the back of the classroom, I assume the student was
tired. This may explain why the student did not want to participate in the group lesson. The
vocalizations made while he was in the beanbag chair may have been to seek attention from
the adults in the classroom or to self soothe until he eventually fell asleep.
Present Level of Academic Achievement and Functional Performance
Construct a present level of academic achievement and functional performance from your
record review and additional resources. Describe the student’s strengths and limitations for
both academics and functional performance. Be sure to include baseline data and source, and
the impact on progress in the general education curriculum. Your present level should be
presented in a respectful and positive tone. In addition, describe of the complex human issues
present in the student’s life and provide two specific ways in which the complex human issues
present interact with the delivery of special education services.
(Note: Copying the PLAAFP from the student’s IEP is cheating and will result in a grade of 0,
and a disposition concern.)
Madison Lacombe

Avery is an 11-year-old, 6th grade Hispanic male student at Ten Oaks Middle School. Avery is
placed in the TMD/PMD self-contained classroom on an alternative curriculum. He is eligible
for this placement under intellectual disability(moderate). He is very social and loves being
around his peers and teachers at school. Avery enjoys singing, laughing with friends, and
playing with various toys. Avery is currently receiving services for reading, math, functional
communication, social/emotional, and daily living skills in the self-contained special education
classroom.

Academic Achievement
In the area of reading, Avery has academic strengths in identifying upper and lowercase letters
and tracing words and short sentences. In August of 2023, Avery was given the unique
learning system early learning benchmark for uppercase letter identification. When asked to
identify an uppercase letter from a set of 3, Avery was able to correctly choose the correct
letter 11 times. In the area of reading, Avery has a relative area for growth in sight word
recognition. Avery has a relative area for growth in identifying unfamiliar sight words and
letter-sound relationships. Using the unique learning system word recognition assessment,
Avery was able to identify 2/18 sight words in August of 2023.

In the area of math, Avery has academic strengths in identifying colors and shapes, counting
from 1 to 10 and match numbers given a choice of three. Using the unique learning system
math benchmark, Avery was to answer questions related to number sense, counting,
operations, patterns, and shapes. He had received a score of 8/18 correct answers. This places
him at the review/revise level, which means the student must review/revise goals to
appropriately address their learning potential. In the area of mathematics, Avery has a relative
area for growth in numbers and counting between 10 and 20. On the unique learning system
numbers and counting benchmark, Avery received a score of 8 which places him at the
emerging level. In this assessment he was to answer 18 questions about counting and number
correspondence up to 20.

Functional Performance
In the area of cognitive skills, Avery has functional strengths in following 1-2 step directions
when he is focused and ready. In adaptive skills his strengths are independently eating,
dressing, using the bathroom and with supervision, navigating the school building. Through
observation from the special education teacher, Avery is very independent with his hygiene
and navigation while at school. His functional mobility strengths are that he can manage his
morning routine of hanging up his belongings and taking out his morning binder. In the
cafeteria, he can sit at the table with peers, use manners and clean up after himself. In the area
of social skills, Avery has functional strengths with greeting and initiating conversations with
peers and adults when he is interested in a topic. His teacher reported that he has positive peer
relationships in class and enjoys working in groups with his peers. In the area of speech and
language, Avery has functional strengths in in hearing, utilizing gestures to communicate his
wants and needs. He also has a strength in vocalizing when he does not want to do something
by saying “No.”

Avery was given the cognitive profile third edition in 2015 where he scores a 72, placing him
higher than 3% of his same age peers. Avery shows relative functional areas for growth in
Madison Lacombe

following multistep directions, staying on task, completing work independently. In 2015,

Avery was given the motor/sensory third addition and the fine motor, and gross motor second
addition assessments. On the motor/sensory he scored a 68 which placed him higher than 13%
of his same age peers. When given the fine motor assessment he scored 73 which placed him
higher than 3% of his same aged peers and on the gross motor assessment he scored a 65
which placed him in the significantly delayed range. As Avery has aged his fine and gross
motor skills have improved and intervention for these deficits will not be required at this time.
In the area of social skills, Avery has functional areas for growth in rejoining the group after
breaks, staying on task, and following directions. In the area of daily living skills, Avery has a
functional area for growth in identifying his personal information, requiring maximum
prompts and supports to correctly identify his name, address, phone number and school. In the
area of speech and language, Avery has a functional communication deficit. Against his same
age peers, his receptive and expressive language skills are significantly delayed. Through
observation, Avery demonstrates that he has difficulties consistently verbalizing his needs and
commenting in class. Although he can repeat shorter sentences, Avery does not often use
appropriate sentence structures to explain what he wants or comment in class. In 2015 Avery
was given an adaptive behavior and social/emotional/behavioral assessment (Third Addition
DP-3). On the adaptive behavior assessment, Avery gained a score of 68 which placed him
higher than 2% of his same aged peers. On the social/emotional/behavioral assessment, Avery
gained a score of 86 which placed him higher than 18% of his same aged peers. In and out of
the classroom, Avery rarely tolerates being told no or not getting what he wants, which results
in him yelling and hitting those that surround him. Avery has showed that properly expressing
his frustration and disagreements are an area for growth.

Effects on Learning
Avery receives special education services with a primary eligibility for intellectual
disability(moderate) with a secondary eligibility for speech and language impairment. Both
eligibilities are due to his down syndrome diagnosis. The disabilities cause difficulties in his
social, emotional, and academic skills which lead to difficulty accessing the general education
curriculum. To access the curriculum and be provided with FAPE Avery is placed in a
TMD/PMD self-contained classroom with an alternative curriculum. Getting individualized
education with the help of a special education teacher, paraprofessionals and speech language
pathologist is the appropriate education for Avery. Although his same age nondisabled peers
can read, write, and complete basic math, Avery is unable to and requires direct and
foundational skill instruction. Due to his deficit in decoding, he is unable to access the grade
level readings that same aged peers can access. Avery’s math deficit doesn’t allow for him to
complete the number concept and computation skills required for grade level mathematics. In
his classroom the importance of social and daily living skills is stressed because the goal is to
help Avery become as independent as possible.
IEP Goals and Objectives
Write two measurable annual goals with objectives/benchmarks that relate to an area of need
in your PLAAFP. One MAG must be for grade-level academic instructional content and one
MAG must be for cross-curricular instructional content (e.g., self-advocacy, problem-solving,
organizational skills). Each MAG needs to include at least three short-term objectives or
benchmarks and a description of how data will be collected.
MAGs and STOs/BMs for grade-level academic content:
Madison Lacombe

By the end of the IEP term, when presented with 5 sets of 10 to 20 objects, Avery will be able
to accurately count and label 5/5 of the given sets for 3 consecutive trials.

By March of 2024, when presented with 5 sets of 10 to 20 objects, Avery will be able to
accurately count and label 1/5 of the given sets for 3 consecutive trials.

By June of 2024, when presented with 5 sets of 10 to 20 objects, Avery will be able to
accurately count and label 3/5 of the given sets for 3 consecutive trials.

By October of 2024, when presented with 5 sets of 10 to 20 objects, Avery will be able to
accurately count and label 5/5 of the given sets for 3 consecutive trials.

MAGs and STOs/BMs for cross-curricular content:

By the end of the IEP term, when given a verbal prompt to rejoin to an academic activity,
Avery will rejoin the activity with the support of a visual chart in under 4 minutes in 3
consecutive days.

By March of 2024, when given a verbal prompt to rejoin to an academic activity, Avery will
rejoin the activity with the support of a visual chart in under 12 minutes for 3 consecutive
days.
By June of 2024, when given a verbal prompt to rejoin to an academic activity, Avery will
rejoin the activity with the support of a visual chart in under 8 minutes for 3 consecutive days.
By October of 2024, when given a verbal prompt to rejoin to an academic activity, Avery will
rejoin the activity with the support of a visual chart in under 4 minutes for 3 consecutive days.
IEP Goals Rationale
Describe how you used your understanding of development and individual differences for this
student to respond to the needs of individuals with exceptionalities. Include a clear description
of how the MAGs match the PLAAFP.
Based on Avery’s past goals, assessments and observations, these goals are the most important
for him to receive support in reaching. Academically, he already has the foundation for letter
recognition and reading, but in math he struggles he requires more intensive intervention to
create a foundation. Avery has a functional need in counting and sorting with numbers
between 10-20 because in his last assessment he was placed in the emerging level for this
subtest on the unique learning system benchmark achievement assessment. Functionally,
Avery struggles with appropriate behavior when transitioning to unpreferred activities from
preferred ones. Avery’s social skill goal is the transition using a visual chart in under 12
minutes by March. This is a goal that should be worked on in every lesson when he receives
his required breaks. His teacher has reported that when he is told he needs to go back to
lessons he verbally protests which causes distraction for the whole class. The addition of this
goal in the lesson will help the student in every area of school and other settings.
Instructional Decisions
See lesson plan template.
Lesson Title: Counting to 20! Grade/Level: Middle school
TMD/PMD
Madison Lacombe

Curriculum Standards or IEP goal Essential Question(s)/I Can

Statement(s)
When presented with between 10 and 20 objects, Avery I can count and label sets of
will be able to accurately count and label the correct objects up to 20.
number of objects from a baseline of 0% to 80% for 3
consecutive trials by the end of the IEP term. I can use my first then chart
to return the lesson in under
Benchmark: By March of 2024, when presented with 12 minutes.
between 10 and 20 objects, Avery will be able to accurately
count and label the correct number of objects from a
baseline of 0% to 40% for 3 consecutive trials.

When given a verbal prompt to rejoin to an academic

activity, Avery will rejoin the activity with the support
of a visual chart in under 4 minutes for 3 consecutive
days during academic periods.

Benchmark: By March of 2024, when given a verbal

prompt to rejoin to an academic activity, Avery will rejoin
the activity with the support of a visual chart in under 12
minutes for 3 consecutive days during academic periods.

Lesson Objective(s)
Provide your student learning outcomes for this learning experience. Objectives use active
verbs and are measurable. They should be linked to standards or IEP goals, if applicable.
Please number objectives.

1. Student will independently count and label sets of 10 to 20 objects accurately in

1/5 trials.

2. Student will return to the group in under 12 minutes starting after being
verbally prompted.
Rationale
Address the following questions:
1. Why are you teaching this objective?
This lesson is being taught to increase Avery’s mathematic skills. Currently he is
working towards increasing his ability to identify sets with between 10 and 20 objects.
Counting is a foundation of early mathematic skills, mastering this skill will allow for
him to work on adding and subtracting skills as well. Avery receives frequent sensory
breaks when in the classroom and struggles to return to the group once his break has
ended. Using a visual first then chart, he will decrease the time it takes for him to
return. Teaching him to use the chart will support him in reaching his goal of
returning in under 12 minutes.
2. Where does this lesson fit within a larger plan?
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By March 2024 Avery must meet the benchmark of correctly counting and labeling the
correct number of objects 40% of the time given 10 sets for 3 consecutive trials. Avery
will be assessed once a week to measure his progress in reaching his mathematics goal.
He will continue to work one on one with his teacher on his math skills. By March of
2024, when given a verbal prompt to rejoin to an academic activity, Avery will rejoin
academic activities with the support of a visual schedule in under 12 minutes for 3
consecutive days. This lesson allows for Avery to practice using his visual, first then
chart, to assist him with reaching his goal by March.
3. Why is it important for students to learn this concept?
It is important to learn these concepts for life skill and job skill training that Avery will
encounter in school. Following directions and getting back to work is important when
working towards independence. Jobs such as stocker or cashier will need these skills
and building the foundation for the skills will make it so he will master them by the
time job training occurs.
Knowing Your Learners
Describe contextual factors and how they impact learning.

Avery is a Hispanic 11-year-old boy in a self-contained moderate to severe disability

classroom. His contextual factors of affect how we approach teaching him. At home,
where he lives with his mom, brothers, uncles, aunts, and grandparents, Spanish is
spoken most often. His family is in the lower middle class socioeconomic group, they
have access to all the electronic and other device necessary for Avery to be successful
in school. He tends to get off task in class and need to be redirected to stay engaged in
the lesson. Verbal and non-verbal prompts will be given to him when he begins to
defocus from activities. Avery has suffered from trauma caused by past teachers who
treated him poorly, so it important to speak calmly and ask him to complete activities
with a kind demeaner to prevent any anxiety or protesting from him. Avery has been
in self-contained classes for most of his life due to his down syndrome and intellectual
disability diagnoses. This impacts his learning because he has only been exposed to
alternative curriculum and each lesson is individualized to his academic level and
abilities.
Describe pre-requisite skills students have that will help them meet the lesson objective(s).
What is your evidence that students have acquired this/these skill(s)?
Avery has the prerequisite skills of counting and identify sets of 1-10 correctly. The
evidence that he can successfully complete this is from the unique learning system
math benchmark assessments that he completed at the beginning of the school year.
Avery has been using a visual chart in the classroom to support him transitioning and
he also follows a visual schedule that is placed in the classroom. His prior knowledge of
colors and shapes will support him in the lesson because there are different colored
circles that are used to count to 20 and when he is asked to place a certain number of
red or yellow circles, he will know which to put and how many.
Describe any other information about your students that is important to know (e.g., student
skills, knowledge, interests, communication, sensory challenges, motor considerations,
cultural background, specific learning needs, disability, linguistic considerations).
Avery has a speech and language deficit along with learning English, that means when
he is being taught you must be patient for him to form words and sentences when
Madison Lacombe

responding. He meets with the speech and language pathologist two times a week to
work with him on his deficits with communication. There are students in the class with
ADHD and autism who can be a distracter for Avery. To minimize the effects from
environmental distractions, Avery is given constant redirection to the lesson if he is
unable to ignore the distractions.
How will this information be used in planning the lesson?
When writing the lesson plan, the information will be used to determine where and
how the student will be taught. Based on his language deficits certain medications will
be added to the lesson such as reading the instruction to him and giving him the
opportunity to point instead of speaking when he is asked about what goes on the first-
then chart. His interests were taken into consideration as well when making the lesson
to create an engaging and relatable assessment.
Assessment Plan
How will students demonstrate understanding of lesson objective(s)? Attach all assessments
separately (on a new page or in an additional document).
Formative:
What formative evidence will you use to document student learning/mastery of lesson?
objectives(s)?
Objective 1: Avery will be given a worksheet with 5 sets of random objects with
varying amounts. Avery must write in the blank spot how many are in each set of
objects ranging from 10-20.
Objective 2: Avery will place what he happens “first” and what is comes after, “then”.
He then will have to return to the lesson with full attention within 15 minutes.
What modifications will you make on this assessment to meet the needs of individual
students, if applicable?
Modifications for the assessment will be that he is given an adaptive pencil to write his
answers since he cannot properly hold a regular pencil. He will also be read the title
and any other text on the page or visual chart due to his reading deficit.
How does this type of assessment support the needs of your learners?
This type of assessment supports the needs of the learner because it will be direct, and
it uses skills that he already has mastered to complete.
Summative:
What summative evidence will you collect, either during this lesson or in upcoming lessons?
Summative evidence that will be collected will occur during his progress monitoring
which will occur of the same assessment that is being given as a formative assessment
but include sets of 1-20 instead of 10-20 to ensure he is maintaining previously learned
skills. It will be logged and used to create future IEP goals and lessons that benefit
Avery.
What modifications will you make on this assessment to meet the needs of individual
students, if applicable?
Modifications for the assessment will be that he is given an adaptive pencil to write his
answers since he cannot properly hold a regular pencil. He will also be read the title
and any other text on the page or visual chart due to his reading deficit.
How does this type of assessment support the needs of your learners?
This assessment is modified to meet all the needs of the learner because it is
individualized for his academic level.
Madison Lacombe

Evaluation Criteria:
For each assessment, list and/or describe the performance indicators or dimensions that are
used to assess the evidence of learning. Evaluation criteria must be aligned with objectives
and may examine correctness/accuracy, sophistication or elaboration of response, or
quality of explanation. Often these are included in rubrics, performance checklists, or rules
for awarding full versus partial credit.

Objective 1 Assessment: Avery must answer 4/5 of the counting questions correctly to
receive full credit and reach proficiency for the objective.

Objective 2 Assessment: Avery must correctly place what is comes first and what
happens after on the first try followed by returning to the lesson with full attention
within 15 minutes to receive proficiency for the objective.
Academic Feedback:
For each assessment, describe how you will give academic feedback? How will your
academic feedback promote student understanding of the learning objective(s)?
Also explain how you might prevent student misconceptions during the lesson.

Objective 1: When Avery gets a question correct, he will be given verbal praise. “Great
job, there are (number of objects) in that set.” If he is incorrect with his answer he will
be prompted to count again. “That’s not quite right, lets count again.” On the second,
try he will write the down the answer he got if it is right or wrong.

Objective 2: When Avery shows that he can use the visual chart to transition quickly
to back to the lesson he will receive a token, the token will allow for him to have 5
minutes of iPad time after the lesson is over. If he cannot place the correct first and
then activity he will be verbally prompted “First we break, then we…?” Allowing for
him to place the correct then activity.
Language Demands
Content Vocabulary
What are the key vocabulary words, symbols, or sounds in this lesson?
The vocabulary in the lesson will include numbers between 1 and 20, names of the
different objects that were being counted in sets.

The vocabulary related to transitions are the words and symbols in the first, then
chart: Break, Lunch, Work, Home, and Bathroom.

General Language Supports

Provide strategies used to support the whole class (e.g., Venn diagram, learning partners,
word wall, anchor chart, vocabulary cards, graphic organizer, sentence stems, pictures,
table, chart, thinking map, modeling, sort, song, body movements, gestures, games). These
strategies can cross disciplines and be used in a variety of lessons.

In the classroom, there is a visual schedule to support students with routine and
understanding what is coming next in the day and how much of the school day is left.
Around the classroom there are labels with images for various things such as
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bathroom, bookcase, games, iPads, and folders. This allows students who struggle with
reading to identify where different items are in the class.
Targeted Supports
Provide supports used to target the specific needs of an individual student or students.
Examples might be Venn diagrams, graphic organizers, outlines, examples, sentence stems,
modeling, which have been designed for the purpose of supporting a specific language
demand.
For Avery he is given a visual first then chart to support his transitioning behaviors
and allow for him to see what he needs to do currently and what will follow. The chart
uses activities/tasks/places that are personalized to him with images because of his
reading deficit. The assessment is also a targeted support because it uses characters
that he is interested in to keep him engaged and count the characters to get the totals.
He will also be read all instructions due to his deficit in reading.
Higher Ordered Thinking Questions, Activities, Engagement
Questions and/or activities for higher order thinking:
These are open-ended and cannot be answered by yes or no. There should be a high
frequency of questions, asked at various points throughout the lesson to guide rather than
direct student thinking.
“What number comes after 10?”
“How many circles are in total/How many circles are there” this question will be asked
6 times during the lesson.
Avery will be asked to place red circles, which adds the elements of color and shapes as
well as counting. Colors and shapes are prior knowledge topics that he knows and can
help him with learning the new skill.
Avery will have to decide what goes in each box on the first-then chart.
Activities that require high levels of student engagement.
Please describe the activities that students do in the lesson that require high levels of
engagement. (These activities are more student-centered, requiring students to take more
responsibility for learning.)
After the teacher models using the tens blocks to count, the student interacting with
the teacher and online manipulatives. Avery will physically and counting and moving
the circles to count. The student-centered lesson is important especially during a one-
on-one lesson. Avery will have to set up his first then chart during his break by himself
with only verbal prompting from the teacher is necessary.
Lesson Part Description of Activities and Description of Activities and
Instruction Instruction
(Teacher Does) (Students Do)
What exactly do you plan to do in What do you plan for students
teaching this lesson? Be thorough to do during the major steps
and provide a script. Act as if you of this lesson? Please make
needed a substitute to carry out the your numbers correspond to
lesson for you. the numbered steps in the
Where applicable, be sure to other columns.
address the following:
□ How will materials be
distributed?
Madison Lacombe

□ Who will work together in

groups?
□ How will students transition
between activities?
□ What are other adults in the
room doing? How are they
supporting students’ learning?
□ What model of co-teaching are
you using?
Opening 1. This lesson is one on one with 1. Avery will go with the
Describe the the student and the special teacher to the back
beginning of your education teacher in the back table.
lesson which should of the classroom with an iPad,
include bell work (if worksheet, one’s blocks and
needed), a the students “first -then”
book/motivator, chart. On the first-then chart,
presentation of in the first square should say
objectives, state the work and in the then square
learning or should say break. In the
Essential Question, classroom, paraprofessionals
introduction of helping other students with 2. Avery will be listening
topic. Additionally, independent work. and focused on the
relevance and 2. Once student is seated the teacher.
connections must be teacher will say “Together we
made to prior are going to practice counting
learning, personal, sets of objects between 11 and 3. As the teacher adds
cultural, or 20. blocks, Avery will count
community assets. 3. Teacher says to Avery “Let’s starting with 2, “2, 3, 4,
use the ones blocks to make 5, 6, 7, 8, 9, 10.” Avery
ten. Avery, you are going to will then answer what
count while I place the add the comes after 10. “11.”
blocks together.” The teacher
will hold up the first block and
say “One” to get the student
started. Teacher will begin
attaching the blocks leaving 3
seconds in-between adding the
next allowing time for the
student to say the number.
Once the student has counted
all the way up to ten the
teacher will give verbal praise,
“I love that you remembered
the order of the number from
1 to 10. Teacher will then ask,
“What number comes after
Madison Lacombe

10?” if the student says 11 give

verbal praise (Yes Avery, 11
comes after 10, you did great.)
If he did not say 11, prompt
Avery saying, “11 comes after
10, What comes after 10?” and
wait for his response.
Instructional 4. Teacher opens the class iPad 4. Avery will wait for
Procedures/Learni and goes to the online teacher to go to the
ng Tasks manipulative website. manipulative website.
Continue numbering (https://www.didax.com/apps/t
your steps as they en-frame/)
continue from the 5. The teacher says “Avery, 5. Avery will count to 10
Opening. Provide watch me fill in the first ten’s with the teacher.
specific step-by-step block, count with me as I put
details of lesson the yellow circles in.” Avery
content aligned with and the teacher count to ten as
objectives, utilizing the yellow circles go into each
a variety of teaching square in the tens block.
strategies. 6. Teacher says, “Now I am 6. Avery will watch the
going to add 3 red circles to teacher drag the 3 red
the second ten’s block.” circles and repeat the
Teacher drags 3 red circles total amount once the
into the squares and says, teacher asks, “How
“Since the first tens block is many circles are there in
filled, we are going to start total?” Avery will repeat
counting in the second tens “13.” He will do this
block with 11, the number that again after the teacher
comes after 10. Watch and adds 2 more red circles,
listen to me as I count. 11, 12, repeating the answer,
13. All together we have 13 “15.”
circles. How many circles do
we have?” Student will
respond with 13. Teacher will
do this one more time with the
number 15. Teacher drags 3
more red circles into the
second ten’s block. “Watch
and listen and I count starting
from 11. 11,12,13,14,15. How
many circles are there?”
Avery will answer with 15. 7. Avery will give a verbal
7. Teacher clears the red circles or physical indicator
from the second ten’s block that he is ready to start
and says, “Let’s count the red counting. He will then
circles together, I will drag the count with the teacher as
Madison Lacombe

circles and we will count how they drag 4 red circles

many circles there are in total into the ten’s block
starting with 11. Ready?” The starting from 11. “11, 12,
teacher will drag 4 red circles 13, 14.” Once the
on to the ten’s block, one they teacher clears the board
are placed they will count. and places the 7 red
Together they say, “11, circles, the teacher and
12,13,14.” Teacher will then Avery will count them
ask, “How many circles in together. “11, 12, 13, 14,
total do we have?” Avery will 15, 16, 17.” Avery will
answer 14. Teacher will give then repeat the total.
verbal praise. “Great job “17.”
Avery, we have 14 circles in
total. Let’s do it together one
more time.” Teacher will clear
the board. The teacher will ask
Avery if he is ready then place
7 red circles in the ten’s block.
Once they are placed Avery
and the teacher will count
them together starting from
11. “11, 12, 13, 14, 15, 16, 17.”
Once they counted all the
blocks the teacher will ask,
“How many circles do we have
in total?” Avery will respond
with 17. 8. Avery will drag the
8. Teacher will say “Now I want number of red circles
you to try counting on your that the teacher tells him
own. I will tell you how many to drag, which will be 2
red circles to drag into the tens the first time and 10 the
block, then I want you to second time. Avery will
count them. Ready?” Once verbally count each set
Avery indicates he is ready the starting from 11. “11,
teacher will say “2” then will 12.” And “11, 12, 13, 14,
watch Avery drag 2 red circles 15, 16, 17, 18, 19, 20.”
to the ten’s block. “Count how Avery will clear the
many are in total.” Avery will board after the first
count to 12. If he does not example and after the
count to 12 remind him to second example.
start counting from 11 and
point at the circles as he
counts. If he is correct give
verbal praise. “I love how you
counted the circles to get the
total. You can clear the
Madison Lacombe

board.” Once the board is

clear the teacher will say, “I
am going to give you another
number and you are going to
do this one more time all by
yourself. Ready?” Once Avery
indicates he is ready the
teacher will say “10” then will
watch Avery drag 10 red
circles to the ten’s block. This
should fill the second ten’s
block. “Count how many are
in total.” Avery will count to
20. If he does not count to 20
remind him to start counting
from 11 and point at the
circles as he counts. If he is
correct give verbal praise. “I
love how you counted all the
way to 20 on your own.” Once
Avery has finished his
independent practice, he will
be given a 5-minute brain
break with a sensory toy 9. Avery will place break
before the assessment. in the first square and
9. The teacher will “It is time for work in the then square.
a 5-minute break. I want you If he does not do this on
to use your chart to show what the first, try he will be
you will do first and then what prompted until he gets it
we will do after. What are you correct. Avery will then
going to do first?” Avery have a 5-minute break.
should either say or point to
the break card and place it on
the first square. If he does this
properly the teacher will then
ask him what goes in the then
square. If he places the wrong
one in the first square the
teacher will prompt him,
“Now that you are done you
get a break, what is going to
come first?” Avery will place
break in the first square. Then
the teacher will ask him
“What goes in the then
square?” Avery should point
Madison Lacombe

to or say work and place work

in the then square. If he does
not the teacher will prompt
him, “We will complete work
after the break. If the break is
first, then what happens
after?” Avery will then point
or say work and place it in the
work square. He will then be 10. Avery will put away any
given a 5-minute break with a sensory toys that he is
timer set. playing with go back to
10. Once the timer goes off the the assessment within
teacher will say “Avery it is 10-minutes, he will
time to come back to work.” continue to be prompted
She will wait for him for 30 within the ten minutes
seconds and if he does not until he returns to finish
start putting away the sensory the assessment.
toy he will be prompted again.
“Avery please put away the
toy and come back to the
table.” Teacher will wait
another minute and if Avery
still does not begin to
transition back to the table the
teacher will walk over and tell
him “Break is over, time to
work.” This will continue until
Avery returns to his work
which should be under 10
minutes. When Avery comes
to the table for work, he will 11. Avery will sit at the table
receive praise, “Thank you so and write his name at
much for cleaning up and the top of the paper once
coming to finish your work.” the teacher hands it to
11. Avery will return to work on him. He will then start
the assessment. The teacher counting the first set, he
will hand him the worksheet should count 16 minions.
and a pencil. Teacher will say Then he will write the
“Please write your name at the answer in the box. He
top.” Once Avery writes his will repeat this with the
name at the top the teacher other 4 sets getting the
will explain the assessment. answers, 18 Mario’s, 14
“On this paper I want you to Alex’s, 20 Luigi’s and 12
count how many of each Mavis’s. If he gets any of
character there is. You can the answers incorrect, he
count out loud and then write
Madison Lacombe

the total number here will be given one chance

(pointing to the left boxes).” to recount each set.
Avery will then begin counting
the first set, starting from 1.
Once he finishes counting, the
teacher will either tell him to
write the answer if he is
correct or tell him that the
answer is incorrect and to
recount. Avery will only be
given one chance to recount
each set. He will repeat with
each of the 5 sets, counting out
loud and writing the answer is
the boxes. Avery will then give
the worksheet back to the
teacher and the teacher will
give him a sticker for his hard
work.
Closure 12. Once the assessment is done 12. Avery will count to 20 on
Continue numbering the teacher will ask Avery to his own. Avery will then
to describe the end count to 20 to review the return to his desk for a
of your lesson. Make counting skills that were group lesson.
clear connections to taught in the lesson. Praise will
real-world be given, “Avery I am so
situations and proud of you working so hard
require students to on using your counting skills.”
reflect on and apply Avery will then go back to his
their learning desk for a group lesson.
through verbal or
written expression.
Materials/Resources Technology
What do you need for this lesson? Identify, within a Describe the technology you
bulleted list, the specific materials, and resources that you plan to use in your lesson: (a)
will use. Describe how these materials and resources add How does the identified
value, depth, and extend students’ learning. Describe how technology in your lesson
instructional materials and resources consider student improve student learning? (b)
abilities, cultural, linguistic, and racial identities. explain how students will use
All materials should be submitted on a new page or in an this technology to engage
additional document. with the content & how it
supports their learning, and
- Pencil, (c) Explain how you used this
technology to design and
- Worksheet with 5 sets of varying numbers of implement formative and/or
characters that the student is a fan of to relate to summative assessments, if
him and keep him engaged in the assessment. applicable.
Madison Lacombe

Did you use the technology to

- First, then chart to assist the student with collect and/or analyze your
returning to the lesson and transition from and data to inform instruction?
to other activities throughout the day. The chart Explain.
uses a combination of words and pictures to
allow the student to understand the different https://www.didax.com/apps/t
options for the chart without having to read en-frame/
because he has a significant deficit in reading.
An iPad is used for this
- iPad, Online Manipulatives The website allowed lesson, to look back on his
for interactive counting using tens blocks, colors, prior knowledge for
and shapes. All of these relate to the student’s counting. During the lesson
prior knowledge that can be used to understand he will use a math
the new concepts being taught. manipulative website. On
(https://www.didax.com/apps/ten-frame/) the website Didax.com, he
will be showed 2 tens boxes
- Ones blocks will be used for the opener to review and be asked to fill in the
prior knowledge. The manipulatives will keep boxes with a certain number
the student engaged in the lesson and show the of red or yellow circles.
student what objects look like what there is 1 of Avery will then count and
them all the way through 10 of them. say the total of all the
circles. This technology is
engaging for the student
and allows for him to
engage with the material. It
improves student learning
by involving a preferred
tool, the iPad. The visuals
from the website allow for
him to use prior knowledge
which is counting sets from
1 to 10. He can show his
technological knowledge by
filling out the ten’s boxes
and on the website and
sharing the total amount.

To progress monitor Avery,

the unique learning system
will be used. This lesson is
based on his IEP that were
created based on his
mathematics benchmark
score on ULS. On this
benchmark Avery was sat a
computer and was asked to
Madison Lacombe

choose the corresponding

number that aligns with the
given number of objects on
the screen. This formal
progress monitoring is given
weekly to the student to
assist with instructional
decisions.

Management
What are your classroom management strategies? Explain the processes and/or procedures,
transitions from one activity to another, strategies for gaining attention, motivating students
to engage in the lesson and focus on learning (e.g., work boards, posted procedures,
modeling, positive feedback, redirection).
The management system in the classroom is based on routine, the schedule each day is
the same and they complete many of the same type of assignments each day. Routine is
important for the classroom because it helps keep the students focused because they
already know what they should be doing at each part of the day. Redirection is used
verbally for students to keep focus on the task at hand and verbally and social praise is
given to them when they can stay on track. Social praise is given in the way of high fives
and verbal praise is given specifically to what the student is doing. All students are given
verbal behavior specific praised throughout the day. When they have finished
assessments, they will be given rewards such as stickers to show that we are proud of
them for doing the work.
Evidence-based Practice
What evidence-based practice did you use in your lesson? Provide a resource and citation
that supports the use of this EBP to teach the objective.

Evidence Based Practice: Explicit instruction with cumulative practice, this is for students
who are learning a new skill. In this lesson, the skill being taught is one that the student is
unfamiliar with although it had been introduced to him in the benchmark assessment. The
benefit of this practice is that students are more likely to retain the concepts when it is
explicitly taught. The cumulative practice allows for the student to use their prior knowledge
to grasp newly learned skills.

https://www.understood.org/en/articles/evidence-based-math-instruction-for-
struggling-students
Madison Lacombe

Name:_____________________________________________ Date:_______________________

Practice Counting up to 20!

Count the objects in the left box. Write the number on objects in the right box.

FIRST THEN

Home Work Break Lunch Bathroom

Work Work Work
Madison Lacombe

Instructional Decisions Rationale

Describe how your lesson plan matches your STOs/BMs. Describe how your lesson plan
supports progress towards both grade-level academic and cross-curricular skills. Provide a
rationale for the adaptations that are needed for this student (be sure you relate this back to
assessment data). Describe the technology you used to support instructional planning and
provide a rationale for selecting this technology (try to relate back to individual needs).
Describe the evidence-based practices from the article that you incorporated into your
instructional procedures.
The lesson plan is based around the students IEP goals, specifically the first BMs for each of
the goals. Counting to 20 is what the lesson content consists of because of his academic math
goal is that he will be able to count sets of object between 10 and 20. For his cross-curricular
skill he will be using his first-then chart to support his goal of returning to lessons after his
break within 12 minutes by before going on the break he must decide that the break comes
first and then he will return to complete the assessment that goes along with the lesson.
Adaptations that were made for the student were individualized worksheets that incorporated a
small amount of text and mostly pictures because at this point the student cannot decode most
words except for I, a, and, me and am. The first-then chart was adapted to fit his personal
activities and needs that he would have to use the chart to understand what will happen after a
lesson or activity. The technology that was used for the student was for modeling, guided
practice, and independent practice. Technology is an important addition to the lesson because
the student can show their knowledge of counting using something that interests them. The
student receives an iPad after lunch for good behavior and including one in the lesson will
increase the likelihood of Avery staying focused and retaining the content. In the lesson I used
explicit instruction with cumulative practice, this is for students who are learning a new skill.
In this lesson, the skill being taught is one that the student is unfamiliar with although it had
been introduced to him in the benchmark assessment. The benefit of this practice is that
students are more likely to retain the concepts when it is explicitly taught. The cumulative
practice allows for the student to use their prior knowledge to grasp newly learned skills. I
used this throughout the entire lesson, having the student repeat answers that I tell him during
modelling and guided practice as well as when he used his first-then chart if he was unable to
complete it on his own.
Maintenance and Generalization
Describe your ideas for maintenance and generalization of these skills. Provide next steps for
future lesson ideas and an increase in difficulty of the skill.
For maintenance of the math skill, I would continue to have daily math lessons and individual
meetings with the student two times a week, once to continue working towards his math goal
and another time to progress monitor. As he masters this skill he will be increased to counting
and identifying groups of 20-30 objects. For these lessons you would start with counting to 20
as a prior knowledge opener and use the same format for modeling, guided practice,
independent practice, and the assessment except using sets of 20-30 objects. This would
increase the difficulty but use the previously taught skills to learn the new skills. For
generalization of this skill, Avery would be asked to count the amount of object in different
setting, such as how many students are sitting at the lunch table, how many goldfish are in
your snack bag or how many dollars do you need to buy this toy? These generalization skills
have Avery use the skills outside of the math lesson settings which will allow for the skill to
be in his long-term memory.
Madison Lacombe

For maintenance of the social skills, I would use the first – chart throughout the day during
most activities. By using this throughout the day, it will become part of his routine and he will
not need to be asked to place the activities on the chart and be able to transition from his
breaks without a reminder of what he needs to complete. The goal is to not use the first-then
chart and have Avery know that he needs to return to his work. For generalization of this skill,
Avery will be using the first then chart during other parts of the day in different settings when
it is time to transition from one activity to another. If he uses this in other setting it will make
overall transitions easier, not just making the transition from breaks back to lessons.
Eventually he should be able to begin transition in a short period of time in between any
activities without verbal or physical refusal.
Reflection
Reflect on areas of personal preparedness, including:
• Reviewing students’ records
• Using informal means to gather information and assess students’ performance
• Developing appropriate IEP components
• Instructional planning
Supply two resources to support continued professional development (e.g., life-long learning)
in your career. Be specific and realistic with your resources. In addition, review CEC’s Ethical
Principles and Professional Practice Standards for Special Education. Determine which of
these standards is easiest for you to uphold and which standard is the most difficult for you.
Provide a rationale for each.
When reflecting on this project, I believe that I was very prepared with my student’s
information to support me with creating the PLAAFP, goals, lesson and deciding which
assessment would benefit the student most. In addition to his past IEP, I had access to his early
intervention records, initial evaluation from early intervention to pre-kindergarten and medical
records that contained information related to his disability. As for informal ways of gathering
information, I had observed and worked closely with the student to learn more about him than
what is just in his paperwork. I also had spoken in depth about the student with his teachers
and paraprofessional to get an idea of progress or regressions that they have seen in the student
academically and functionally. Developing the PLAAFP was not an easy part of the IEP to
complete because the student does not have current data that shows how he ranks against same
age peers due to the fact he is except from any academic testing that would give that
information. For functional performance, that was easier to complete since the students’
records had a heavier focus on that aspect of his disability. In this instructional planning, I
found it easy to incorporate functional and academic objectives. Since I have worked in the
classroom and understand how it is run with students who have significant intellectual
disabilities, I could create a lesson easier than if I had to create a lesson for a different
classroom type. The lesson plan will be something that I can use with future students who
have behavior and academic deficits that need to be attended to. I enjoyed creating
individualized assessments and visual charts that best fit the student’s needs.
1. The first resource I could use to continue my professional development in my career
would be attending various webinars that are provided by the honors society, Kappa
Delta Pi that I am a member of. These webinars vary from topics such as “Sailing
Through Your Early Years,” which addresses issues that teachers face in their first few
years of teaching that result in burnout or the webinar “How to Create Clear Objectives
to Assess Student Learning” which teaches educators how to create goals that are clear
Madison Lacombe

and measurable. KDP has many different webinars that they provide to members
throughout the year that touch on every topic that teachers from any step in their teaching
careers could benefit from.
2. A second resource I could use to continue my professional development is the CEC
Learning library which is professional library that contains professional and published
academic texts, courses, evidence-based practices and more. The professional library will
allow for me to research ways to help improve my practices and give me ideas on how
different lesson types or interventions that would benefit my future students.

Of all the CEC’s Ethical Principles and Professional Practice Standards for Special Education,
what I believe would be the easiest for me to uphold is the ethical principles standard 5.
Developing relationships with families based on mutual respect and actively involving
families and individuals with exceptionalities in educational decision making. I believe this
would be easy for me to uphold because during my practicum internships, my cooperating
teachers stressed the importance in communication with parents of students with
exceptionalities and how their input is crucial to creating an education plan that is best fit for
the student. Speaking the parents as though we are a team helping their child will build a solid
relationship and allow for the student to thrive. This standard will be very important for me in
a moderate/severe classroom setting because in many cases a student cannot speak for them
self, and their parents/guardians are the only ones who can explain the child’s homelife which
can alter instruction and the students’ accommodations if properly used.
The CEC Ethical Principles and Professional Practice Standards for Special Education that
would be the hardest for me to uphold would be the professional practice standard 3.3
Maintain current knowledge of procedures, policies, and laws relevant to practice because in
the world of education, procedures, policies, and laws are always changing. At point in my
career, I may be overwhelmed with work or caught up in personal life issues that would not
allow for me to take the time to continuously look at all these important factors about teaching.
Although I will try to stay on top of the procedures, policies, and laws, there may be a few that
I do not see or hear that could be detrimental to my career.
Madison Lacombe

Skills Checklist:
Madison Lacombe