Parenting

Completed Sample IEP

Eileen Bailey Health Guide October 27, 2009
  •  Do you wonder what type of information should be included in an IEP? The following provides a basic IEP, filled out for you to review. You can print out a blank sample IEP as well, and complete information specific to your child.

     

    For more information:

     

    Documentation and Reports to Bring to an IEP Meeting

    The Difference Between Accommodations and Modifications

    When Parents Feel Their Child Needs Special Accommodations

    Suggestions for IEPs and Section 504s

    How IDEA Applies to Children with ADHD

     

    Next week, I'll provide tips to help you write an IEP for your child.

     

    IEP For School Age Children

     

    School: Western Middle School

     

    Student Name:     Jennifer McCormick                  Student ID#  123456

     

    Age:      12                                           Date of Birth:  June 23,1997

     

    Disability Classification:  Learning Disabled/ADHD

     

    Student Information:  

     

    Street: 123 Barton Road

     

    City: Any City

     

    State/Zip:            55555

     

    Phone:  555-555-5555                                            

     

    County: Any County

     

    Current Grade: 7th Grade

     

    Ethnic Group: Caucasian

     

    Gender: Female

     

    Native Language: English

     

    Interpreter Needed:    Yes    **No

     

    Medical Alerts: None

     

     

     

    Additional Information:

     

    Jennifer has been diagnosed with Learning Disabilities and ADHD.

     

     

     

    Parent/Guardian Information

     

    Parent/Guardian Name(s): Thomas and Marta McCormick 

     

    Street: 123 Barton Rd       

     

    City: Any City

     

    State/Zip: PA

     

    Phone:  555-555-5555                                                        

     

    County: Any County

     

    Ethnic Group: Caucasian

     

    Native Language: English

     

    Interpreter Needed:    Yes   ** No

     

     

    General IEP Information

     

    Date of Initial Referral:  09     /    15      /     2009

     

    Date of Initial IEP Meeting:    10      /   15        /2009

     

    Date IEP Initially Implemented:         /            /   

     

    Projected Date of Next Review:  04        /     15       /   2009

     

     

    Current Meeting

     

    Date: 10      /  15            / 2009

     

    Type of Meeting:     **Initial             Requested Review            Annual Review

     

    Attendees:

     

    Joan Carson (School Psychologist)

    Thomas Dunn (Principal)

    Roberta Davis (Teacher

    Theresa Snyder (Teacher)

    Thomas McCormick (Parent)

    Marta McCormick (Parent)

     

     

     

     

     

    If Requested Review, Reason for Request:

     

     

    Current Student Needs

     

    Student Strengths:

     

    Positive responses to positive reinforcement programs

    High level in mathematics

    Desire to do well

    Gets along with other

    Enjoys drawing

     

     

    Parent Concerns:

     

    Below grade level in reading

    Difficulties with spelling and writing

    Takes extended amounts of time to complete homework each night

    Forgets assignments or materials/books to complete assignments

     

     

     

    Teacher Concerns:

     

    Behavior issues within the classroom, can be disruptive

    Problems with fluency in reading

    Poor spelling and writing skills

    Misses completing or handing in assignments

    May understand work but performs poorly on tests

     

     

    Student Needs

     

    Specific Student Needs: (list assistive technology, use of Braille, limited English proficiency, etc.)

     

     

    Specific Ways Disability Interferes with Academic Abilities:

     

    Comprehending 7th grade curriculum, especially when reading and writing required

    Reading Comprehension

    Staying organized

    Coming to class prepared

  • Taking tests within allotted time

     

     

    Transitional Needs: (based on student's age)

     

     

    Not applicable

     

     

    Current Student Performance and Accommodations

     

    (Please attach copy of most recent evaluations, report card and state or district performance tests.)

     

    Current level of knowledge, level of intellectual functioning, expected rate of progress, current accommodations:

     

    In reading, Jennifer is currently testing on a 5.9 grade level but has been making progress

    She has decoding skills

    Fluency is hindered by word recognition

    Reading comprehension is difficult, Jennifer can read a paragraph but not retain the information as she does not grasp the concept immediately

    Jennifer does well in math, she is currently working on grade level in math

     

     

    Social Development and Current Accommodations:

     

    Jennifer does get along well with classmates but can be disruptive at times. She is likable and friendly but can be hyperactive and have a difficult time focusing, possibly because of her energy level.

    Because this is an initial evaluation Jennifer does not have any formal, current accommodations however, her teachers have been giving spelling tests orally rather than written and she has responded well to this.

     

     

    Physical Development and Current Accommodations:

     

    Not applicable

     

    Annual Goals

     

     

    Goal: Will be reading on a 6th grade level by 4/15/2010

     

    Procedures for Evaluation: Use current testing procedures to determine reading level

     

    Evaluation Schedule: Test between 4/1/2010 and 4/10/2010 so results will be available for follow up meeting on 4/15/2010 

     

     

    Goal: Jennifer will raise her hand during class time for attention

     

    Procedures for Evaluation: Teacher will provide tick mark each time Jennifer calls out and disrupts class without raising her hand

     

    Evaluation Schedule: Teacher will share information with parents on a daily basis on whether Jennifer succeeded in raising her hand during class that day.

     

     

     

    Goal: Raise spelling test scores to be above 80% each week

     

     

    Procedures for Evaluation: Spelling tests will continue to be given orally

     

    Evaluation Schedule: Teacher will share spelling test grade with parents weekly via email.

     

     

     

    Recommendation Services and Programs

     

    (Include Special Education Services, Related Services, Modifications/Accommodations, Assistive Technology, Aids)

     

    Service: Provide spelling tests orally

     

    Frequency: Weekly

     

    Duration: Remainder of school year

     

    Location: Jennifer will take spelling tests in the resource room

     

    Start Date: 10/15/09

     

    End Date: Continue until end of school year 2010

     

     

     

    Service: Jennifer will be given extended time for completing tests

     

    Frequency: For all tests

     

    Duration:Until the end of the school year

     

    Location: Within the regular classroom

     

    Start Date:10/15/2009

     

    End Date: End of school year 2010

     

     

     

    Service: Jennifer will have an extra set of books at home

     

    Frequency: N/A

     

    Duration: Until the end of the school year 2010

     

    Location: N/A

  •  

    Start Date: 10/15/2009

     

    End Date: June 2010

     

     

     

    Service: Seating in the front of the classroom

     

    Frequency: Every day

     

    Duration: Until review of IEP

     

    Location: Within regular classroom

     

    Start Date: 10/15/2009

     

    End Date: 4/15/2010

     

     

     

    Service: Teachers will provide a written study guide 3-4 days prior to tests

     

    Frequency: Before each test

     

    Duration: Until IEP review

     

    Location: Within regular Classroom

     

    Start Date: 10/15/2009

     

    End Date: 4/15/2010

     

     

     

     

     

    Testing Accommodations for State and District Achievement Tests

     

    Is Student Eligible for Testing Accommodations:  Yes     **No

     

    Student Will Participate in Testing:  **Yes      No

     

    If No, Reason Why Student Should Not Participate:

     

     

     

     

     

    Student Will Participate With:            **Grade Level Peers           Chronological Peers

     

    Testing Accommodation: None at this time, will review needs again at follow up meeting in April 2010

     

    Conditions for Accommodations:

     

     

     

    Testing Accommodation: None at this time, will review needs again at follow up meeting in April 2010

     

    Conditions for Accommodations:

     

     

     

    Testing Accommodation: None at this time, will review needs again at follow up meeting in April 2010

     

    Conditions for Accommodations: