Individual Education Plan Student

Template for EDUC

312 and 525(Pohl)

!"I#E$

%&e '''' (rade ''''

Di)a*ilit+

E,D or !-I or %UTIS.

Present Level of Academic Achievement and Functional Performance / includin& 0a )tatement of

)tren&th())/ concern()) and1 ho2 the di)a*ilit+ affect) the )tudent3) involvement and pro&re)) in the &eneral curriculum4

Communication Status
similar age peers.

Performance commensurate with

Academic Performance
similar age peers.

Performance commensurate with

Health, Vision, Hearing,

time.

otor A!ilities

"ot an area of concern at this

#liver has !een diagnosed with Attention $eficit $isorder as confirmed !% a medical statement provided !% his parents.

Social and (motional Status

Performance commensurate with similar age peers.

Oliver plays sports, enjoys computer games and likes to take a leadership role in the classroom. Classroom observation and behavioral data indicate that he tries to stay on task but loses focus insert data especially when learning complex concepts. He has difficulty completing insert data and submitting assignments on time insert data. Fre uently, he blurts out, makes irrelevant statements and doesn!t seem to know they are inappropriate insert data. His problems with social interactions cause him to become easily frustrated and discouraged. insert data Occasionally, he argues and becomes aggressive. insert data "hese behaviors adversely affect his academic progress #grades$ and significantly disrupt the learning of others.

&eneral 'ntelligence
peers.

X Performance commensurate with similar age

)ransition "eeds
is in the -th

"ot an area of concern at this time. *Chec+ing this !o, is not an option when the student
grade or ./ %ears or older !ecause transition must !e addressed for these students0

Check all areas of need identified by the %&C #more than one may be checked$ 'nstruction 1elated Services Communit% (,perience (mplo%ment $ail% Living S+ills Post School Adult Living #!2ectives

Functional Vision3Learning
time.

edia Assessment

"ot an area of concern at this

Individual Education Plan Student

Template for EDUC

312 and 525(Pohl)

!"I#E$

%&e '''' (rade ''''

Di)a*ilit+

E,D or !-I or %UTIS.

Consideration of Special Factors for '(P $evelopment4 A1C must address each 5uestion !elow.

5 6e)

7o

Doe) the )tudent3) *ehavior impede hi)8her learnin& or that of other)9 If +e)/ Include appropriate )trate&ie)/ )uch a) po)itive *ehavior intervention) and )upport) in the :Statement of Device)8Service)3 at the *ottom of thi) pa&e4 Doe) the )tudent) have En&li)h "an&ua&e proficienc+9 If +e)/ 2hat i) the lan&ua&e need) to the IEP9

6e) ; 7o relation)hip of 6e) ; 7o con)ider 6e) 6e) ; 7o ; 7o

I) the )tudent vi)uall+ impaired (includin& *lindne)))9 If +e)/ the IEP Team mu)t ''''''''''''''''''''''''''''''''''''''''''''''''''

Doe) the )tudent have communication need)9 If +e)/ )pecif+ *elo2 ''''''''''''''''''''''''''''''''''''''''''''''''''''''' I) the )tudent deaf or hard of hearin&9 If +e)/ the IEP Team mu)t con)ider '''''''''''''''''''''''''''''''''''''''''''''''''' %re a))i)tive technolo&+ device) and )ervice) nece))ar+ in order to implement the )tudent3) IEP9 If +e)/ include appropriate device) in the :Statement of Device)8Service)3 at the *ottom of thi) pa&e4

;6e)

; 7o

Statement of $evices3Services If the %$C an)2er) 6e) to an+ of the <ue)tion) a*ove/ include a )tatement of )ervice) and8or device) to *e provided to addre)) the a*ove )pecial factor)4 5 See Speciall+ De)i&ned In)truction Intervention Plan ;!ther
; See Supplementar+ %id)8Service) ; See ,ehavior

automatic and vi)ual timer) to )elf monitor on ta)= *ehavior and ta)= compeletion

Individual Education Plan

Template for EDUC

312 and 525(Pohl)

Student !"I#E$ %&e '''' (rade '''' easura!le Annual &oals and 6enchmar+s

Di)a*ilit+

E,D or !-I or %UTIS.

Annual easura!le &oal4 Oliver will increase academic achievement by completing and submitting assignments on time '() of the time as measured by weekly review of checklists*agenda.

Speciall% $esigned 'nstruction4 ,xplicit instruction in maintaining agenda and work completion checklists ,xplicit instruction in use of color folders and memory devices "each self-monitoring skills for assignment completion and submission .rovide social skills instruction to ask for help and his accommodations 1eview of Progress of Annual &oal Schedule for reporting progress

ethod of

easure3(valuation4

Teacher o*)ervation) Teacher>made te)t) Pro&re)) Data State8Di)trict a))e))ment) Standardi?ed te)t) !ther'''''''''''''''''''''''''''''''''''''''''''''''''''

6enchmar+ or Short7term o!2ective4 Oliver will demonstrate appropriate use of color coded organi+ers and mnemonics .

6enchmar+ or Short7term o!2ective4 Oliver will maintain a work completion checklist with the use of visual*verbal reminders.

6enchmar+ or Short7term o!2ective4 Oliver will write due dates in his agenda*calendar with the use of visual*verbal reminders.

6enchmar+ or Short7term o!2ective4 Oliver will use self-talk or other metacognitive strategies to monitor work completion, re uest his accommodations and ask for help.

Individual Education Plan Student

Template for EDUC

312 and 525(Pohl)

!"I#E$

%&e '''' (rade ''''

Di)a*ilit+

E,D or !-I or %UTIS.

easura!le Annual &oals and 6enchmar+s Annual easura!le &oal4 Oliver will demonstrate the use of strategies to maintain self-control /() of the time as measured by teacher observation and self-monitoring checklists. Speciall% $esigned 'nstruction4 0irect instruction in 1ocials skills #for blurting out and anger management$ in small group using modeling, role play, rehearsal and practice, modeling of de-escalation strategies, visual cues of strategies, verbal*non-verbal prompting, verbal and physical redirection, social stories #feeling angry, using strategies, making choices$, use of figits for calming, behavior intervention plan. 1eview of Progress of Annual &oal ethod of easure3(valuation4 Teacher>made te)t) State8Di)trict a))e))ment) ; !ther Behavior Log, self monitoring Schedule for reporting progress

5 Teacher o*)ervation) 5 Pro&re)) Data Standardi?ed te)t)

6enchmar+ or Short7term o!2ective4 Oliver will identify and self monitor his blurting out and inappropriate comments.

6enchmar+ or Short7term o!2ective4 Oliver will model and practice replacement behavior#s$ for blurting out and inappropriate comments.

6enchmar+ or Short7term o!2ective4 Oliver will demonstrate use of one self-control strategy to replace blurting out and inappropriate comments in a situation when he becomes frustrated or discouraged.

6enchmar+ or Short7term o!2ective4 Oliver will demonstrate use of one anger management strategy to refrain from arguing and aggression.

Individual Education Plan Student

Template for EDUC

312 and 525(Pohl)

!"I#E$

%&e '''' (rade ''''

Di)a*ilit+

E,D or !-I or %UTIS.

Statement of Supplementar% Aids and Services *Accommodations0

child

to *e provided to the child or on *ehalf of the

Clearly defined classroom rules*expectations, rewards and conse uences. 2isually post assignments and due dates3 provide daily verbal reminders "eacher monitors 2ictor!s work completion form and agenda daily. .rovide a specific place for turning in completed assignments. .rovide reinforcement for assignment completion and submission 2isual prompt or silent signal to ask for help or accommodations. 4ehavior contract with reinforcement choices #including computer time and class leadership opportunities$ clear conse uences and self-monitoring options. 2erbal praise, proximity control and explicit prompts*cues from teacher. %void verbal confrontation using de-escalation techni ues4 4ehavior 5ntervention .lan Accommodations for Administration of State and Assessments in the Classroom In order to @u)tif+ appropriatene)) of accommodation) for an+ )tate mandated te)t)/ the te)tin& accommodation) mu)t *e u)ed con)i)tentl+ a) part of routine in)truction and cla))room a))e))ment a) 2ell a) meet all additional re<uirement) e)ta*li)hed *+ the 5nclusion of 1pecial .opulations in 1tate&e uired %ssessments and %ccountability .rograms , /(6 7%& 89(/( document.
5 $eader) )trate&ie) Promptin&8Cuein& U)e of Technolo&+ .anipulative) ,raille Interpreter) 5 E;tended Time !ther ,ehavior Intervention Plan Scri*e) 5 Paraphra)in& ; $einforcement and *ehavior modification

Student ha) *een determined eli&i*le for participation in the Alternate Assessment Program.

Program

odification3Supports for School Personnel that will !e provided4

Individual Education Plan Student

Template for EDUC

312 and 525(Pohl)

!"I#E$

%&e '''' (rade ''''

Di)a*ilit+

E,D or !-I or %UTIS.

Least 1estrictive (nvironment *L1(0 and &eneral (ducation4 E;plain the e;tent/ if an+/ to 2hich the
)tudent 2ill 7!T participate in &eneral education cla))e) (content area)

2ictor will receive instruction in general education classes for reading, writing, math, science, social studies and special area*related arts*elective class. "he special education teacher will collaborate with his general education teachers in his classes twice a day for 6( minutes to provide social skills instruction and implement his behavior intervention plan.