jaclyn iep3

8/14/2019 Jaclyn IEP3

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2/16

Monroe County Community School Corporation - 315 North Drive - Bloomington, IN 47401

(812)349-4756 or (812)349-4757 - FAX=(812)330-7811

Case Conference Summary Pa e

Student Performance

Evaluation procedures, assessments, records or reports utilized to help determine eligibility for special education services.

Cognitive:

Impact on involvement in general education curriculum:

Achievement: Evaluation Data:

Reading: Strengths

Weaknesses


Math: Strengths

Weaknesses


Social Emotional: Strengths

Weaknesses


Communication: Strengths

Weaknesses


Adaptive Behavior: Strengths

Weaknesses


Behavior: Strengths

Weaknesses


Other: Strengths

Weaknesses


WISC-III scores: Verbal IQ -95, Performance IQ- 110, Full-Scale IQ- 96

Derek has an average IQ which does not impact cognitive ability.

The achievement test administered was the Woodcock-Johnson III. Broad Reading score - 77, Letter-Word ID- 72, Spelling- 52. He qualifies for LD in these areas.

Derek's strengths in reading are his decoding skills or word attack.

Derek has weaknesses in reading comprehension, broad reading and fluency. His biggest weakness is in written spelling.

Derek may benefit from being placed in a resource room for reading.

Derek's strength in mathematics is calculation.

Derek's weakness in mathematics is applied problems.

Derek is able to participate in a mathematics general education curriculum.

Derek seems to have friends and able to be social with others.

Derek becomes argumentative with others at times.

Arguing with others may push other students away, Derek may need self-regulation skills.

Derek is able to form his own opinion and has age-appropriate skills.

Derek has no known deficits in communication.

Communication does not have an impact on Derek's education.

Derek is able to manage personal skills.

There are no known deficits in adaptive behavior.

There is no apparent impact on Derek's education.

Derek has good school attendance.

Derek is unfocused and possibly hyperactive.

Derek may need preferential seating.

NA

NA

NA

Derek Smith


3/16


4/16


(812)349-4756 or (812)349-4757 -- FAX (812)349-7811

Transition Plan Pa e

Individualized Transition Plan

Name: Social Security Number

School Anticipated final year of school

Initial

Plan Date Review Date Review Date Review Date Review Date Review Date

1. Projected Post-School Outcomes:

Post-Secondary Education

Vocational Training

Community Liv ing

Continuing/Adult Ed.

Integrated/Supported Employment

Community Participation

2. Statement of students interests and preferences:

3. This student is working toward: Credit - diploma Non-credit - certificate of completion GED

4. Ongoing Adult Services: NO YES - what information was given? Date given:

5. I have been informed that at the age of eighteen all rights accorded parents under special education legislation are transferred to the student and are concurrent with the parents.

(Must be completed if student is 17 at the time of conference.)

Student Signature/Date Parent Signature/Date

Derek Smith


5/16


(812)349-4756 or (812)349-4757 -- FAX (812)349-7811

Transition Plan Pa e

6. Statement of Needed Transition Services: (A statement of needed transition services describes services the student needs to gain the skills and connections necessary to

achieve his or her desired goals):

Transition Services Needed?

YES - See goal/objectives

NO - Explain

IEP must contain goals/

objectives related to allareas marked YES

Coordinated Sequential Set of

Activities/objectives

Person Responsible/Agency

Linkages

Instruction YES

NO

Related Services YES

NO

Community Experience YES

NO

Employment/Functional

Vocational Evaluation

YES

NO

Daily Living YES

NO

Residential YES

NO

Other (eg: medical, financial) YES

NO

Derek Smith


6/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e

Goals and Objectives

Students Name Identified Need:

Annual Goal

Measurable, Short-term Instructional Objectives

Including Objective Criteria to be reviewed annually

Person(s) Responsible

(By Title)

Procedures of

Evaluation

Progress Comments

Person(s) Responsible Procedures for Evaluation Progress

General Education Teacher Gen. Ed A. Observation i. Objective Met

Special Education Teacher Spec. Ed. B. Written/Oral Response ii. Progress made, but objective not yet met

Parent Parent C. Performance iii. Little or no progress

Occupational Therapist OT D. Criterion Referenced Test iv. Met, but not maintained

Physical Therapist PT E. Student Self Assessment v. Other (specify)

Speech/Language Pathologist SLP F. Other (specify):

Hearing Impairment Specialist HI

Vision Impairment Specialist VI

Progress will be reported on the goals form Other (Specify)

Progress toward annual goals will be provided at time of report cards; or

Other (Specify)

Derek Smith

Student will improve reading comprehension skills at the 2nd grade level.

Reading Comprehension

(2.2.4) Ask and respond to questions to aid in comprehension aboutimportant elements of informational texts with fewer than 3 errors out of 12questions given weekly.

(2.2.5) Restate facts and details or summarize the main idea in the text toclarify and organize ideas with fewer than 5 errors out of 20 questions given

weekly.

Gen. Ed.Spec. Ed.

Gen. Ed.Spec. Ed.

A,B,D

A,B,D


7/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e



Annual Goal




(By Title)

Procedures of

Evaluation

Progress Comments












Other (Specify)

Derek Smith

The student will improve writing skills at a pre-primer level.

Writing

(K.6.2) Spell independently using an understanding of the sounds of thealphabet and knowledge of letter words with fewer than 6 errors out of 24words total.

(K.4.4) Write phonetically spelled words and consonant-vowel-consonantwords with fewer than 10 errors out of 40 possible given weekly.

Gen. Ed.Spec. Ed.

Gen. Ed.Spec. Ed.

A,B,D

A,B,D


8/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e



Annual Goal




(By Title)

Procedures of

Evaluation

Progress Comments












Other (Specify)

Derek Smith


9/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e



Annual Goal




(By Title)

Procedures of

Evaluation

Progress Comments












Other (Specify)

Derek Smith


10/16


11/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e



Annual Goal




(By Title)

Procedures of

Evaluation

Progress Comments












Other (Specify)

Derek Smith


12/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

IEP Pa e



Annual Goal




(By Title)

Procedures of

Evaluation

Progress Comments












Other (Specify)

Derek Smith


13/16


14/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

Case Conference Summary

Recommended Participation in Statewide or District standardized testing for the _______________ school year.

Indiana M C C S C

This student is not in a standardized testing mandated grade level.

This student will fully participate in the standardized testing program without accommodations.

This student will not participate in the standardized testing program (Specify reasons below).

This student will fully participate in the standardized testing program with accommodations (Specify below).This student will participate in the standardized testing program for diagnostic purposes.

This student will be subject to remediation.

This student will be subject to retesting.

This student will need the following testing accommodations (Specify):

This students essential skills will be tested using an alternate assessment (Specify, including why the statewide or district assessment is not appropriate and

how the student will be assessed):

Is extended school year recommended? YES NO

If yes, committee must document the degree of regression; amount of time for recoupment; and the extraordinary, irretrievable educational, emotional or vocational reversals.

If yes, describe the nature of the interventions, include interventions parents can provide to meet students needs.

Name(s) of person(s) who will submit a written opinion.

NA

08/09

X

Derek Smith

The student will receive 50% extra time, orally read tests (except in reading comprehension) and a calculator.


15/16


(812)349-4756 or (812)349-4757 -- FAX (812)330-7811

CaseConference Summary

Student Name:

School:

Parent Permission for Special Education Services

You have the right to request a case conference and/or revoke your written permission for services at any time. If you are prepared to decide at this time, please sign on one of

the lines below.

I/we agree with the services recommended and give permission for the plan to be implemented:

Parent Signature Date Student Signature (If 18) Date

I/we do not agree with the services recommended.

Parent Signature Date Student Signature (If 18) Date

Parental Rights have been explained and provided:

Parent Initials

Derek Smith

Wildrose Elementary


16/16

jaclyn iep3

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