Appendix 1-A

Sample IPP Template

Individualized Program Plan

Individualized Program Planning

Student Information Student: Alice XXX Date of Birth: May 12, 2003 Parents: Christine and John XXX Address: XXX Age as of Sept. 1/200X: 9 yrs, 4 mos Date I.P.P. Created: September 2012 Phone #: XXX-XXXX Eligibility Code: 54 Year of School/Grade: 4 (mild/moderate learning disability)

Background information: Classroom context School: XXX Elementary I.P.P. Coordinator and Classroom Teacher: Ms. Xteacher Additional IPP Team Members: Ms. Xresource, Resource teacher Alice is in a regular stream Grade 4 class in XXX Elementary school. There are currently 18 students; 4 have been identified as having special education needs, one has assigned part-time support. A resource teacher in the school provides extra assistance in reading and writing strategies on an as-needed basis. Background Information: Parental input and involvement
November 14 Parents met with Ms. Xteacher, discussed Alices learning challenges and goals for the year. They completed a Parents Input form and signed the IPP at this meeting. They have committed to supporting Alice at home with reading and writing exercises. December 18 Parents have discussed with Ms. Xteacher the attention problems that Alice also experiences and together with the teacher developed a list of strategies to address these problems at home and in the classroom. Discussed the possibility of more extensive computer use to support literacy development. March 8 Telephone conference. Parents have mentioned that Alices reading has noticeably improved, but she is still struggling with the writing, and she finds it difficult to concentrate on writing exercises. Parents agreed on assigning a peer tutor to Alice. June 15 Telephone conference to review the final scores and the progress. Parents are satisfied with the progress and plan to encourage Alice to read during the summer.

Alberta Education, Alberta, Canada (2006)

Appendix VI

Appendix 1-A

Sample IPP Template (continued) page 2/5

Individualized Program Planning

Strengths Enjoys working with other students, has many friends, always willing to help her classmates Is very interested and creative in art projects, enjoys role playing Is eager to participate in class discussions, is very articulate Is more willing to participate in peer tutoring if she can offer some help in return Strategies to increase reading comprehension Strategies to increase the time efficiency and accuracy of writing Reduce anxiety around approaching reading and writing tasks Build confidence to ask for help and clarifications Coordinated Support Services

Areas of Need

Medical Conditions that Impact Schooling

While having attention problems, student was not yet tested for ADHD as these problems might be a consequence of a learning disability No current medical conditions that impact schooling
Date Test

None required at this time

None required at this time

Assessment Data (Specialized Assessment Results)

Results

November 2012 Dr. Xdoctor November 2012

WISC-IV

average range of intellectual ability Difficulties with reading comprehension and written expression Working to grade level in math

WIAT-II

Alberta Education, Alberta, Canada (2006)

Individualized Program Planning

Alberta Education, Alberta, Canada (2006)

Appendix 1-A

Sample IPP Template (continued) page 3/5

Individualized Program Planning

Current Level of Performance and Achievement

September Grade 3 report card indicates Alice is working at grade level in math and science Burns and Roe Informal Reading Inventory indicates she is shows basic reading skills at grade 1 level Writing samples indicate that Alice has serious difficulty forming words and sentences, she has very basic writing vocabulary, and the writing assignments lack structure.

Year-end Summary
June Although Alice fluency is still below grade level, her readying speed and comprehension has improved. Alive showed a lot of interest to illustrating the stories, and chose to combine the drawing with writing for her writing assignments. Using the new reading strategies at home and in the classroom, as well as the peer tutoring, helped Alice to keep up with completing all the grade appropriate reading materials. Alice became more active advocating for herself, and asking for help when she needs it.

Classroom observation Alice is actively participating in the classroom discussions, but she is reluctant to ask for help when she needs it. She tends to be unable to concentrate during the silent readying time or during the written assignments.

Grade Level of Achievement Reporting Information Adapted programming (graded curriculum) Modified programming (nongraded curriculum)
If student is on a modified program, indicate category of each goal and achievement level relative to each goal category:

foundational skills (e.g., communications, classroom behaviour, gross and fine motor skills) Goals achieved: all most some none not applicable academic readiness skills (e.g., readiness skills to prepare student for learning outcomes in the programs of study in Grade 1 and subsequent grade levels) Goals achieved: all most some none not applicable life skills (e.g., skills that will assist the student in developing independence in the home, school and community) Goals achieved: all most some none not applicable

Alberta Education, Alberta, Canada (2006)

Appendix 1-A

Sample IPP Template (continued) page 4/5

Individualized Program Planning

Goal #1__
Long-term Goal: Alice will independently read and demonstrate understanding of selected grade 4 level passages Short-term Objectives Assessment Procedures Progress Review By November 20 Alice will read selected end-of- Grade 2 level passages Read two selected reading passages at end-of-Grade 2 level and answer 3 comprehension questions per each passage. November, 30 Achieved Alice is independently reading material at Grade 2 level.

By March 20 Alice will read selected early-Grade 3 passages

Read two selected reading passages at early-Grade 3 level and answer 3 comprehension questions per each passage.

March 30 Achieved Alice is independently reading material at earlyGrade-3 level

By June 20 Alice will read selected mid-Grade 3 passages

Burns and Roe assessment

June 30 Achieved Alice has performed better than her objective. She is reading independently at the early-Grade 4 level.

Accommodations and strategies to support objectives Provide step-by-step instruction for the reading assignments, provide explicit phonics instruction sessions, encourage at-home reading, provide peer tutoring, encourage the use of reading support software in the classroom and at home.

If student is on a modified program, this goal is related to: foundational skills academic readiness skills

life skills

Alberta Education, Alberta, Canada (2006)

Goal #_2_
Long-term Goal: Alice will be able to concentrate on written assignments and demonstrate the written comprehension of Grade 3 level passages. Short-term Objectives Assessment Procedures Progress Review By November 20 Alice will be able to use drawings and short sentences to demonstrate the comprehension of endof-Grade 2 passages Write/illustrate 2 reading journal entries November 30 Achieved Alice did better than her objective. She has completed the journal entries in writing/drawing for all the 4 texts covered in the lessons, and she showed a lot of enthusiasm working on her assignments.
Individualized Program Planning

By March 20 Alice will be able to create a short written text by answering a series of questions for the Grade 3 level texts By June 20 Alice will be able to use the writing strategies to create descriptive sentences to demonstrate her comprehension for the Grade 3 level texts

Write the answer to the five March 30 Achieved questions Alice still needs some extra time to answer questions in writing, but given enough time she is able to answer Grade 3 level texts questions. Write a short (at least 4 sentences) paragraph as a response to the Grade 3 level text. June 30 Achieved Alice combined drawing and writing in making page-by-page illustration to the Grade 3 level story. While the writing structure might not have achieved the grade level, Alices comments and drawings showed the full comprehension.

Accommodations and strategies to support objectives Allowing to use drawings to convey the meaning, structuring the writing as a questionanswer activity, discussing the questions and answers first, making an answer plan with the teacher

If student is on a modified program, this goal is related to:

Alberta Education, Alberta, Canada (2006)

 foundational skills

academic readiness skills

life skills

Individualized Program Planning

Alberta Education, Alberta, Canada (2006)

Appendix Appendix 1-A 1-A

Sample IPP Template (continued) page 4/5

Individualized Program Planning

Goal #3__
Long-term Goal: Alice will learn to advocate for herself and ask for clarification or help when needed. Short-term Objectives Assessment Procedures Progress Review By November 20 Alice will flip a pink card colored side up when she needs help. Teachers record on how many times the card was used per week. November, 30 Achieved Alice is using the card sign to alarm the teacher that she needs help on a regular basis.

By March 20 Alice will make marks next to questions showing if she understands them or not.

Teacher will record on how often the mark is used to indicate the problems with comprehension.

March 30 Achieved Alice was able to independently identify the area of difficulty to receive support from the teacher/peer tutor June 30 Achieved Alice seems to be comfortable to ask for help from her teacher when needed. She also often addressed her peers when she needs support.

By June 20 Alice will raise her hand whenever she needs clarification on the current task assigned.

Teacher will record on how often Alice is initiating the request for help.

Accommodations and strategies to support objectives Create a system that would allow to ask a teacher for support without alarming the whole class, create the environment that would encourage peer-to-peer support

If student is on a modified program, this goal is related to: foundational skills academic readiness skills

life skills

Alberta Education, Alberta, Canada (2006)

Planning for Transition Next year will be Alices last year in the Elementary school, and she will need to be prepared for the longer writing assignments and higher expectations of reading proficiency. Alice might need extra support from the resource teacher and well accommodations regarding the format and the deadlines of her assignments. Combining the artistic/visual representations of comprehension with writing/reading has shown to be an effective way to engage Alice and to reach her learning potential.

Individualized Program Planning

Additional Information

Signatures
I understand and agree with the information contained in this Individualized Program Plan.

Parents

Date

IPP Coordinator/Teacher

Date

Principal

Date

Alberta Education, Alberta, Canada (2006)