Drexel University

INDIVIDUALIZED EDUCATION PROGRAM (IEP)

School Age

Student'sName:

RobertJones

IEPTeamMeetingDate(mm/dd/yyyy):

3/18/2016

IEPImplementationDate(ProjectedDatewhenServicesandProgramsWillBegin):
AnticipatedDurationofServicesandPrograms:
DateofBirth:

9/28/2004

3/18/2016

3/17/2017

Age:

11

Grade:

5th

AnticipatedYearofGraduation:

2023

LocalEducationAgency(LEA):

DrexelUniversity

CountyofResidence:

BucksCounty

NameandAddressofParent/Guardian/Surrogate:

Phone
(Home):

7125570006

Email
(Home):

Phone
(Work):

Email
(Work):

Phone(Cell):

Mrs.RosaJones

123SchoolStreet

Southampton,PA18966

NameandAddressofParent/Guardian/Surrogate:

Phone
(Home):

7125570006

Email
(Home):

Phone
(Work):

7124520006

Email
(Work):

Mr.JohnJones

123SchoolStreet

Southampton,PA18966

Phone(Cell):

RobertJones,DUSD57006
OtherInformation:

TheLEAandparenthaveagreedtomakethefollowingchangestotheIEPwithoutconveninganIEPmeeting,asdocumentedby:

Date of Revision(s)

Participants/Roles

IEP Section(s) Amended

IEP TEAM/SIGNATURES

TheIndividualizedEducationProgramteammakesthedecisionsaboutthestudentsprogramandplacement.Thestudentsparent(s),thestudentsspecialeducationteacher,andarepresentativefrom
theLocalEducationAgencyarerequiredmembersofthisteam.SignatureonthisIEPdocumentsattendance,notagreement.

Printed Name

Role

Signature

RosaJones

Guardian

AngeliqueEGiannascoli

RegularEducationTeacher

StephanieSouthard

SpecialEducationTeacher

ShawnKohler

LocalEd.AgencyRep.(Chair)

*
TheIEPteammustinvitethestudentiftransitionservicesarebeingplannedoriftheparentschoosetohavethestudentparticipate.
** Ifthestudentis,ormaybe,participatingintheregulareducationenvironment
*** AsdeterminedbytheLEAasneededfortransitionservicesandothercommunityservices
****AteacherofthegiftedisrequiredwhenwritinganIEPforastudentwithadisabilitywhoalsoisgifted.
Oneindividuallistedabovemustbeabletointerprettheinstructionalimplicationsofanyevaluationresults.

Writteninputreceivedfromthefollowingmembers:

Transfer of Rights at Age of Majority

Forpurposesofeducation,theageofmajorityisreachedinPennsylvaniawhentheindividualreaches21yearsofage.Likewise,forpurposesoftheIndividualswithDisabilitiesEducationAct,the
ageofmajorityisreachedforstudentswithdisabilitieswhentheyreach21yearsofage.
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RobertJones,DUSD57006
PROCEDURAL SAFEGUARDS NOTICE

IhavereceivedacopyoftheProcedural Safeguards Noticeduringthisschoolyear.TheProceduralSafeguardsNoticeprovidesinformationaboutmyrights,includingtheprocessfordisagreeing

withtheIEP.TheschoolhasinformedmewhomImaycontactifIneedmoreinformation.

SignatureofParent/Guardian/Surrogate:

I. SPECIAL CONSIDERATIONS THE IEP TEAM MUST CONSIDER BEFORE DEVELOPING THE IEP. ANY FACTORS CHECKED
AS "YES" MUST BE ADDRESSED IN THE IEP.

Is the student blind or visually impaired?

TheIEPmustincludeadescriptionoftheinstructioninBrailleandtheuseofBrailleunlesstheIEPteamdetermines,afteranevaluationofthestudent'sreadingand
Yes
writingskills,needs,andappropriatereadingandwritingmedia(includinganevaluationofthestudent'sfutureneedsforinstructioninBrailleortheuseofBraille),that
instructioninBrailleortheuseofBrailleisnotappropriateforthestudent.

No
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Is the student deaf or hard of hearing?

TheIEPmustincludeacommunicationplantoaddressthefollowing:languageandcommunicationneeds;opportunitiesfordirectcommunicationswithpeersand
Yes
professionalpersonnelinthestudentslanguageandcommunicationmode;academiclevel;fullrangeofneeds,includingopportunitiesfordirectinstructioninthe
studentslanguageandcommunicationmode;andassistivetechnologydevicesandservices.IndicateinwhichsectionoftheIEPtheseconsiderationsareaddressed.
TheCommunicationPlanmustbecompletedandisavailableatwww.pattan.net

No

Does the student have communication needs?

StudentneedsmustbeaddressedintheIEP(i.e.,presentlevels,speciallydesignedinstruction(SDI),annualgoals,etc.)
Yes

No

Does the student need assistive technology devices and/or services?

StudentneedsmustbeaddressedintheIEP(i.e.,presentlevels,speciallydesignedinstruction,annualgoals,etc.)
Yes

No

Does the student have limited English proficiency?

TheIEPteammustaddressthestudentslanguageneedsandhowthoseneedsrelatetotheIEP.
Yes

No

Does the student exhibit behaviors that impede his/her learning or that of others?
TheIEPteammustdevelopaPositiveBehaviorSupportPlanthatisbasedonafunctionalassessmentofbehaviorandthatutilizespositivebehaviortechniques.Results
Yes
ofthefunctionalassessmentofbehaviormaybelistedinthePresentLevelssectionoftheIEPwithaclearmeasurableplantoaddressthebehaviorintheGoalsand
SpeciallyDesignedInstructionsectionsoftheIEPorinthePositiveBehaviorSupportPlanifthisisaseparatedocumentthatisattachedtotheIEP.APositiveBehavior
SupportPlanandaFunctionalBehavioralAssessmentformareavailableatwww.pattan.net

No

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Other(specify):

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

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RobertJones,DUSD57006

Include the following information related to the student:

Presentlevelsofacademicachievement(e.g.,mostrecentevaluationofthestudent,resultsofformativeassessments,curriculum-basedassessments,transitionassessments,progresstowardcurrent
goals)
STANDARDIZED TEST RESULTS:

---------------------------------------------Measures of Academic Progress (MAP) Assessment

---------------------------------------------RobertwasadministeredtheMeasuresofAcademicProgress(MAP)AssessmentinWinter2016.Theassessmentisgiventodetermine
instructionallevelandtomeasureacademicgrowthfromyeartoyearintheareasofmathematics,language,andreading.
A Note about Percentile Rank
ArangeofscoresrelatedtoGoalsPerformance.Low(percentile<21),LowAverage(percentilebetween21and40),Average(percentilebetween
41and60),HighAverage(percentilebetween61and80),andHigh(percentile>80).
MATHEMATICS:
TheMeasuresofAcademicProgress(MAP)assessment(grades25)wasadministeredintheareaofMathematics.Thisassessesmathskillsinthe
areasofNumbersandOperations,Geometry,Algebraicconcepts,andMeasurementandData.Robertscoredatthe39%percentileincomparison
toasamegradenormgroup.
MAP ASSESSMENT PERCENTILE RANK PERFORMANCE
Mathematics 39%ile ----NumbersandOperationsAvg
GeometryAvg
AlgebraicConceptsLoAvg
MeasurementandDataLoAvg
READING:
TheMeasuresofAcademicProgress(MAP)assessment(grades25)wasadministeredintheareaofReading.Thisassessesreadingskillsinthe
areasofReadingLiterature(literacyskillswithnon-informationaltext),ReadingInformationaltext(findinginformationandevaluatinginformation
innon-fictiontext),andVocabularyAcquisitionandUse(phonics,wordrecognition,contextclues,wordrelationships).Robertscoredatthe25%
percentileincomparisontoasamegradenormgroup.
MAP ASSESSMENT PERCENTILE RANK PERFORMANCE
Reading 25%ile ----ReadingLiteratureLoAvg
VocabularyAcquisitionandUseLow
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RobertJones,DUSD57006

ReadingInformationalTextLoAvg
LexileRange501-651
YEAR-END PROFICIENCY LEXILE RANGE:GRADE5expectationis830-1015
LANGUAGE USAGE:
TheMeasuresofAcademicProgress(MAP)assessment(grades212)wasadministeredintheareaofLanguageUsage.Thisassesseslanguage
skillsintheareasofWriting(Plan,Organize,Develop,Revise,Research),Language(Understand,EditMechanics),andLanguage(Understand,
EditforGrammar,Usage).Robertscoredatthe21%percentileincomparisontoasamegradenormgroup.
MAP ASSESSMENT PERCENTILE RANK PERFORMANCE
Language Usage 21%ile ---Writing:Write,ReviseTextforPurposes,AudiencesLow
Language:Understand,EditMechanicsLow
Language:UnderstandEditforGrammar,UsageLoAvg
----------------------------------------------------------------------------------------------------CURRICULUM BASED ASSESSMENT RESULTS:
1st and 2nd Quarter Grades
* PSSA Writing (Grade 4 6 Rubric) 1st Quarter ELA Writing Prompt (independent)
Focus:2,Basic
Content:1,BelowBasic
Organization:2,Basic
Style:2,Basic
Conventions:3,Proficient
PSSA Writing (Grade 4 6 Rubric) Fictional Narrative Writing (with guidance) 2nd quarter
Focus:2,Basic
Content:2,Basic
Organization:2,Basic
Style:2,Basic
Conventions:1,BelowBasic
* Reading
SRI(ScholasticReadingInventory)-(MeetingtheStandardfor5thgrade:8301015)
September2015589
November2015574
February2016640
JourneysLesson1
VocabularyinContext70%
Comprehension70%
JourneysLesson2
VocabularyinContext20%
Comprehension80%
JourneysLesson3
VocabularyinContext80%
JourneysLesson4
Comprehension30%
VocabularyinContext70%
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RobertJones,DUSD57006
JourneysLesson5
Comprehension80%
VocabularyinContext100%
* Math
Topic1Test53%
Topic2Test50%
Topic3Test96%
Topic4Test79%
Topic5Test39%
Quarter1Average68%
DistrictTestTopics1560%
Topic6Test73%
Topic7Test53%
Topic8Test77%
Geography and Government (1st Quarter)
Chapter1quiz-69
Chapter10test-63
Districttest-71
Q1grade68%,Improvementneeded
Explorers (2nd Quarter)
CompassRosenotgraded
Lesson1&2Quiz84
Lesson3,4,&5Quiz67
DistrictTest75
Q2grade75%,approachingthestandard
* Science
Ecosystems (1st Quarter)
VocabularyQuizA83%
VocabularyQuizB87%
DistrictTest87%
MicroWorlds (2nd Quarter)
LensQuiz58%
MicroscopeQuiz74%
CellQuiz100%
DistrictTest86%
PROGRESS MONITORING RESULTS:
(1stand2ndquarterscores)
* Reading Comprehension Probes (Level 5) responses correct in 3 min (goal: 26 rc)
passage16:16rc
passage17:16rc
passage18:26rc
passage19:15rc
passage20:18rc
* Reading Comprehension Probes - IRI (Level 4.5) percent of responses correct (goal:
passage1:70%
passage2:80%
passage3:60%
passage4:100%
passage5:90%
* Math Computation Probes (Level 4) digits correct per minute (goal: 18 dcpm)
probe16:12.7dcpm
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RobertJones,DUSD57006
probe17:15.7dcpm
probe18:15.7dcpm
probe19:15.0dcpm
probe20:17.6dcpm
* Math Application Probes (Level 4) percent of responses correct (goal: 85%)
Topic1:33%
Topic2:46%
Topic3:47%
Topic4:67%
Topic5:66%
Topic6:43%
ACADEMIC PERFORMANCE:
Robertiscurrentlyafifthgradestudent.Robertwasreferredforamulti-disciplinaryevaluationafterreceivingintensivereadinginterventionsduringkindergartenaswellasISTsupport.Theresults
oftheevaluation,endofkindergartenyear,showedthatRobertqualifiedforspecialeducationservicesduetohisotherhealthimpairmentaswellashisspeechandlanguagedisorderintheareasof
semanticsandsyntax.RobertbeganreceivinglearningsupportservicesattheendofhisKindergartenyear.Duringthe20152016schoolyear,Roberthasbeeninstructedintheregulareducation
classroomformath,Englishlanguagearts,science,andsocialstudieswithsupport.AdditionalsupportisgivenduringLibraryandComputerspecialsduetothewritinginvolvedduringthese
classes.
Inmath,Roberthasbeenworkingtolearnandapplynewskills.Hehascompletedthefollowingtopicsinmath:
*Topic1Numeration
*Topic2AddingandSubtractingWholeNumbersandDecimals
*Topic3MultiplyingWholeNumbers
*Topic4Dividingby1-DigitDivisors
*Topic5Dividingby2-DigitDivisors
*Topic6-VariablesandExpressions
*Topic7MultiplyingandDividingDecimals
*Topic8Shapes
*Topic9FractionsandDecimals
DuringamathlessonRobertwillsitonthecarpetwiththeotherstudentswhilethelessonisbeingtaught.Helearnsnewskillsandappliestheminconsistently.Afterthelessonistaughtandpriorto
independentwork,Robertandtheotherstudentsdosomeguidedpracticeonwhiteboards.Duringthistime,Robertisabletocompletetheproblemscorrectlysometimes.Duringindependentwork,
Robertwillgobacktohisseatandworkslowlyonhisclasswork.Hedoesnottypicallycompletetheentireassignment.Robertwillonlyoccasionallyaskforassistance.Heisinconsistentinhis
accuracywithhisguidedpractice,classworkandhomework.Hehideshiserrorswhenanadultwalksbyanddoesnotwantanyonetolookoverhisclassworkandhomework.
RoberthasbeenmakingadequatechoiceswhenselectinghisSSRbooks.Hisreadinglogisincompleteandhedidnotturninanyofthe5requiredreadingresponsesduringthe2ndquarter.Earlyin
theschoolyear,Robertwasapartofasmallbookgroupinwhichthestudentsareassignednightlyreadingfromacommonbook.Roberthadaliteraturediscussionwiththisgroupafewdaysa
week.Robertwasnotparticipatingduringthediscussionandexpresseddispleasurefromworkingonthisnovel.Hedidnotcontinuetoparticipatewiththissmallbookclub.Robertalsowasgiven
individualattentioninregardstohisindependentnightlyreadingassignments.Mosttimeshewasunabletoanswerbasicquestionsaboutthestorystatingthathehadforgottenwhathehadread.
WhenRobertisgivenclasstimetocompleteaspecificreadingassignment,hehasshownthatheisabletoanswertheteachersquestionsaccuratelyandmakemeaningfulconnectionstowhathe
hasread.
Inwriting,RobertislearningnewskillsfromtheJourneysProgram.Onanindependentwritingproject,RobertwasabletowriteapaperscoringBasic,withguidanceandgraphicorganizersto
assist,ontheCRSDGrades4-6WritingRubric.Robertstrugglesinallareasofwritingexceptforconventionswhereheisproficient.Duringwritingtime,hewillsitquietlyandwriteverylittleon
hispaper.Whenheispromptedhewillstarttowriteforabriefperiodandthenstopwritingagain.Whenworkingwiththeteacherhedoesnotgivesuggestionsofwhathemayneedtoeditnotwill
hediscusspossiblewaystoaddmoredetailstohiswriting.

Presentlevelsoffunctionalperformance(e.g.,resultsfromafunctionalbehavioralassessment,resultsofecologicalassessments,progresstowardcurrentgoals)

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FUNCTIONAL PERFORMANCE:
REGULAR EDUCTION CLASSROOM:
Robertisastudentthatworkscomfortablyinthelargeclassroomsetting.TherearetimesthatRobertneedsindividualizedadultassistance
whenlearninganewskillinmathoreditinghiswriting.Robertdoesnotcompletehishomeworkassignmentsconsistently.Mathhomework
mayhaveanswerswithoutworkandreadingresponseshavenotbeenturnedinforseveralmonths.Heparticipatesoccasionally,more
frequentlywhenheisinterestedinthetopic.
Robertcanbecomedistractedduringindependentworkactivitiesand/oriftheteacherisgivingimportantdirectionstotheclass.Robertis
observedbecomingmoredistractedwithotherpeersinhisclassroom.Hewillturnaroundintheclassroomandgetverysillywithother
students.Thisoccurswhenimportantmaterialisbeingtaughtintheclassroom.Robertisremindedtomakeagoodchoicewithwhohe
choosestositnexttowhenduringgroupactivitieswherehesitsonthecarpet.
Robertsbinders,desk,andcubbyshowthatheisabletokeeptheseitemsorganized.Hedoesstruggleattimestolocateitemswhenneeded.
Heisfrequentlymissingapencilorawhiteboardmarkerduringmathclass.Duringhis5thgradeyear,hehasbeenswitchingroomsforeach
ofhisclasses.Healwayshasthecorrectmaterials,books,andbindersforeachclass.Robertdemonstrateshisknowledgebasictoproficient
onhisSocialStudiesandSciencetestsandquizzeswhenhestudiesandusesthestudyaidesthatareprovidedtohim.Manynewstudyskills
havebeenorwillbemodeledforRobertthroughoutthe5thgradesuchasnotetaking,useofstudyguide,andcreatingflashcards;heisstill
workingtoimplementandutilizethesestudyskillsinordertoenhancehislearningandtestscores.

Presentlevelsrelatedtocurrentpostsecondarytransitiongoalsifthestudent'sageis14oryoungerifdeterminedappropriatebytheIEPteam(e.g.,resultsofformativeassessments,curriculumbasedassessments,progresstowardcurrentgoals)
Notapplicable

Parentalconcernsforenhancingtheeducationofthestudent
PARENTAL INPUT:
Mr.andMrs.Jonesdonothaveanyadditionalinformationtoaddatthistime.

Howthestudent'sdisabilityaffectsinvolvementandprogressinthegeneraleducationcurriculum

BecauseofRobert'sdisabilityinareasrelatedtohishealthconditionandtheareaofmathapplicationskills,hisinvolvementinthegeneral
curriculumwillneedtobemodified.Inordertomaintainprogressinthegeneralcurriculum,Robertwillneedadditionalsupportsaswellas
modificationstoinstructionalstrategies,currricularmaterials,and/orassessmentsasdocumentedinthisIEP.

Strengths

-Enjoystimewithpeers
-Cooperativeinlargeandsmallclassroomsettings
-Mathcomputationskills

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Academic,developmental,andfunctionalneedsrelatedtostudent'sdisability

-Writtenexpression(content)
-Mathapplication
-AttentiontoTasksandDirections(addressedinSDI)

III. TRANSITION SERVICES - This is required for students age 14 or younger if determined appropriate by the IEP team.

IfthestudentdoesnotattendtheIEPmeeting,theschoolmusttakeotherstepstoensurethatthestudentspreferencesandinterestsareconsidered.Transitionservicesareacoordinatedsetof
activitiesforastudentwithadisabilitythatisdesignedtobewithinaresultsorientedprocess,thatisfocusedonimprovingtheacademicandfunctionalachievementofthestudentwitha
disabilitytofacilitatethestudentsmovementfromschooltopostschoolactivities,includingpostsecondaryeducation,vocationaleducation,integratedemployment(includingsupported
employment),continuingandadulteducation,adultservices,independentliving,orcommunityparticipationthatisbasedontheindividualstudentsneedstakingintoaccountthestudents
strengths,preferences,andinterests.
POST SCHOOL GOALS-Basedonageappropriateassessment,defineandprojecttheappropriatemeasurablepostsecondarygoalsthataddresseducationandtraining,employment,andas
needed,independentliving.Undereacharea,listtheservices/activitiesandcoursesofstudythatsupportthatgoal.Includeforeachservice/activitythelocation,frequency,projectedbeginning
date,anticipatedduration,andperson/agencyresponsible.
For students in Career and Technology Centers, CIP Code:

Postsecondary Education and Training Goal: Not applicable due to student's age

Measurable Annual Goal

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Yes /
No
(Document in Section V)
Courses of Study:

Service/Activity

Location

Frequency

Projected
Beginning Date

Anticipated
Duration

Person(s)/Agency
Responsible

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Employment Goal: Not applicable due to student's age

Measurable Annual Goal

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Yes /
No
(Document in Section V)
Courses of Study:

Service/Activity

Location

Frequency

Projected
Beginning Date

Anticipated
Duration

Person(s)/Agency
Responsible

Independent Living Goal, if appropriate: Not applicable due to student's age

Measurable Annual Goal

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Yes /
No
(Document in Section V)
Courses of Study:

Service/Activity

Location

Frequency

Projected
Beginning Date

Anticipated
Duration

Person(s)/Agency
Responsible

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS

Instructions for IEP Teams:
Pleaseselecttheappropriateassessmentoption.InformationonavailabletestingaccommodationsmaybefoundintheAccommodationsGuidelinesavailableonwww.education.state.pa.us.
State Assessments
Not Assessed
Nostatewideassessmentisadministeredatthisstudentsgradelevel
NoEnglishproficiencyassessmentadministeredbecausethestudentisnotanEnglishLanguageLearner.

PSSA(Mathadministeredingrades3-8;Scienceadministeredingrades4and8;Readingadministeredingrades3-8;Writingadministeredingrades5and8;andELA*)
Tested Subject Without
With
Accommodations to be Provided
Accommodations Accommodations
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Math

Science
Reading
Writing

May2014

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AccommodationsforthePSSAwillbethosethatareallowedbyPDE'sPSSAAccommodations
GuidelinesandareincludedinthespeciallydesignedinstructionsectionofthisIEP.

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Tested Subject

Without
With
Accommodations to be Provided
Accommodations Accommodations
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ELA*

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AccommodationsforthePSSAwillbethosethatareallowedbyPDE'sPSSAAccommodations
GuidelinesandareincludedinthespeciallydesignedinstructionsectionofthisIEP.

*ELAwillreplacetheReadingandWritingPSSAsin2014-15forgrades3-8.

Keystone Exam(Replacesthe11thgradePSSAinhighschool;Studentmustparticipateby11thgrade)
Tested Subject Without
With
Accommodations to be Provided
Accommodations Accommodations
Algebra 1
Literature
Biology

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Keystone Project Based Assessment (AvailablewhenstudentisunabletodemonstrateproficiencyonaKeystoneExamorKeystoneExammodule.)

Tested Subject Without
With
Accommodations to be Provided
Accommodations Accommodations
Algebra 1
Literature
Biology

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Validated Local Assessment(AvailablewhenselectedasoptionbyLEA)

Tested Subject Without
With
Accommodations to be Provided
Accommodations Accommodations
Algebra 1
Literature
Biology

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PASA(Administeredingrades3-8,11forReadingandMath;Grades4,8,11forScience)
StudentwillparticipateinthePASA.

ExplainwhythestudentcannotparticipateinthePSSAortheKeystoneExamforReading/Literature,Math/Algebra1,Science/Biology,andComposition(TheCompositionexamwillbe
availableforthe2016-17schoolyear):

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ExplainwhythePASAisappropriate:

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Choosehowthestudent'sperformanceonthePASAwillbedocumented.

Videotape(preferredmethod)

Writtennarrativenotes(requirespriorapprovalinaccordancewithPDEguidance)

ACCESS for ELLs (Administered in grades K-12)

Domains
Without
With
Unable to
Accommodations to be Provided or Rationale for Inability to Participate in Selected Domains
Accommodations Accommodations Participate
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Listening
Reading
Writing
Speaking

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Alternate ACCESS for ELLs (Administered in grades 1-12)

StudentwillparticipateintheAlternateACCESSforELLs.

ExplainwhythestudentcannotparticipateintheACCESSforELLs:

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ExplainwhytheAlternateACCESSforELLsisappropriate:

Domains
Listening
Reading
Writing
Speaking

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Without
With
Unable to
Accommodations Accommodations Participate
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Accommodations to be Provided or Rationale for Inability to Participate in Selected Domains

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RobertJones,DUSD57006
Local Assessments

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Localassessmentisnotadministeredatthisstudent'sgradelevel;OR
Studentwillparticipateinlocalassessmentswithoutaccommodations;OR
Studentwillparticipateinlocalassessmentswiththefollowingaccommodations;OR

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Thestudentwilltakeanalternatelocalassessment.

Explainwhythestudentcannotparticipateintheregularassessment:

Explainwhythealternateassessmentisappropriate:

V. GOALS AND OBJECTIVES-Include,asappropriate,academicandfunctionalgoals.Useasmanycopiesofthispageasneededtoplanappropriately.Speciallydesignedinstructionmaybe

listedwitheachgoal/objectiveorlistedinSectionVI.
Shorttermlearningoutcomesarerequiredforstudentswhoaregifted.Theshorttermlearningoutcomesrelatedtothestudent'sgiftedprogrammaybelistedunderGoalsorShortTermObjectives.

MEASURABLE ANNUAL GOAL

Include: Condition, Name, Behavior, and Criteria
(Refer to Annotated IEP for description of these components)

Describe HOW the

student's progress toward
meeting this goal will be measured

Math Application: Givenanuntimedcurriculumbased

CurriculumBasedAssessments;Math
applicationprobeonthe5thgradelevel,Robertwillmaintain Probes;monitoredeveryotherweek
a70%averageon3consecutiveprobes.

Describe WHEN periodic

reports on progress will be
provided to parents

Quarterly

Report of Progress

Goal Specific SDI

SHORT TERM OBJECTIVES-Requiredforstudentswithdisabilitieswhotakealternateassessmentsalignedtoalternateachievementstandards(PASA).

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RobertJones,DUSD57006

Short term objectives / Benchmarks

Level of Achievement

MEASURABLE ANNUAL GOAL

Include: Condition, Name, Behavior, and Criteria
(Refer to Annotated IEP for description of these components)

Method of Evaluation

Describe HOW the

student's progress toward
meeting this goal will be measured

Written Expression:Givenawritingpromptandinstruction CurriculumBasedAssessment;Writing

Samples;monitoredeveryotherweek
throughthewritingprocess,Robertwillcomposeanessay
withaminimumof6completesentencesperparagraphfrom
abaselineof4completesentenceson3consecutiveprobes.

Describe WHEN periodic

reports on progress will be
provided to parents

Quarterly

Report of Progress

Goal Specific SDI

SHORT TERM OBJECTIVES-Requiredforstudentswithdisabilitieswhotakealternateassessmentsalignedtoalternateachievementstandards(PASA).

Short term objectives / Benchmarks

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Level of Achievement

Method of Evaluation

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RobertJones,DUSD57006
VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS-Include,asappropriate,fornonacademicand
extracurricularservicesandactivities.
A. PROGRAM MODIFICATIONS AND SPECIALLY DESIGNED INSTRUCTION (SDI)

SDImaybelistedwitheachgoaloraspartofthetablebelow.

Includesupplementaryaidsandservicesasappropriate.

Forastudentwhohasadisabilityandisgifted,SDIalsoshouldincludeadaptations,accommodations,ormodificationstothegeneraleducationcurriculum,asappropriateforastudent
withadisability.

Modifications and SDI

Location

Frequency

Projected Beginning Date

Anticipated Duration

highlight/color-code

importantfacts,information,
and/ordirectionson
worksheets,dailyactivities,
andtestsforincreasing
attentiontotaskand
completeallaspectsoftask
directives.

Daily

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Smallgrouptestingfor
additionalassistanceand
supports.

Asdeterminedbyteacherstudentconsultation

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03/17/2017

Chunkingoflongterm
(morethan3nights)
assignmentsintosequential
steps

RegularEd.Classroom

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03/17/2017

Asassessmentsaregiven

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03/17/2017

Studyguidesforscience and
social studies quizzesand
testsprovideddueto
difficultywith
comprehensionofcontent
areafacts(tobegivenat
least5dayspriortoquizor
test).Quizortesttobegiven
tospecialeducationteacher
7dayspriortoquizortest,
orregulareducationteacher
providestudyguide5days
priortoquizortest.
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RobertJones,DUSD57006

Useofagraphicorganizer

forlongerwrittenexpression
assignments(essaysand
projects)

Asappropriateforthe
assignment

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Pre-teachingand/orreteachingofmathlessons(at
least2times/weekinsmall
classroomsettingforpreteachingofalesson,reteachingshouldoccuras
neededandcanbeinthe
regularorspecialeducation
setting)

Asappropriateforthe
assignment

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B. RELATED SERVICES-Listtheservicesthatthestudentneedsinordertobenefitfromhis/herspecialeducationprogram.

Service

Location

Frequency

Projected Beginning Date

Anticipated Duration

Noneatthistime

C. SUPPORTS FOR SCHOOL PERSONNEL-Listthestafftoreceivethesupportsandthesupportsneededtoimplementthestudent'sIEP.

School Personnel to
Receive Support

Regulareducation
teacher

Support

Consultationbetween
regulareducationstaff
andspecialeducation
stafftosupportthe
studentinregular
educationclasses.

Location

Frequency

Ontheaverageof1
timeperweek.

Projected Beginning Date

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Anticipated Duration

03/17/2017

Location:Regular
EducationClassroom

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RobertJones,DUSD57006
D. GIFTED SUPPORT SERVICES FOR A STUDENT IDENTIFIED AS GIFTED WHO ALSO IS IDENTIFIED AS A STUDENT WITH A DISABILITY-Supportservicesarerequiredto
assistagiftedstudenttobenefitfromgiftededucation(e.g.,psychologicalservices,parentcounselingandeducation,counselingservices,transportationtoandfromgiftedprogramstoclassroomsin
buildingsoperatedbytheschooldistrict).

Noneatthistime

E. EXTENDED SCHOOL YEAR (ESY) - The IEP team has considered and discussed ESY services, and determined that:

StudentISeligibleforESYbasedonthefollowinginformationordatareviewedbytheIEPteam:

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TheAnnualGoalsand,whenappropriate,ShortTermObjectivesfromthisIEPthataretobeaddressedinthestudent'sESYProgramare:

IftheIEPteamhasdeterminedESYisappropriate,completethefollowing:

OR
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AsofthedateofthisIEP,studentisNOTeligibleforESYbasedonthefollowinginformationordatareviewedbytheIEPteam:

Afterreviewingthe7factorsoutlinesinChapter14.132(2)(regression,recoupment,maintenance,mastery/consolidation,independence
fromcaretakers,withdrawal,targetgroup),theIEPteamdeterminedthatRobertdoesnotrequireESYservices.AnymemberoftheIEP
canrequestanIEPmeetingatalatertimetoreconsiderthisdecision.

ESY Service to be Provided

Location

Frequency

Projected Beginning Date

Anticipated Duration

VII. EDUCATIONAL PLACEMENT

A. QUESTIONS FOR IEP TEAM-ThefollowingquestionsmustbereviewedanddiscussedbytheIEPteampriortoprovidingtheexplanationsregardingparticipationwithstudents

withoutdisabilities.

Itistheresponsibilityofeachpublicagencytoensurethat,tothemaximumextentappropriate,studentswithdisabilities,includingthoseinpublic
orprivateinstitutionsorothercarefacilities,areeducatedwithstudentswhoarenotdisabled.Specialclasses,separateschoolingorotherremoval
ofstudentswithdisabilitiesfromthegeneraleducationalenvironmentoccursonlywhenthenatureorseverityofthedisabilityissuchthat
educationingeneraleducationclasses,EVENWITHtheuseofsupplementaryaidsandservices,cannotbeachievedsatisfactorily.

Whatsupplementaryaidsandserviceswereconsidered?

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RobertJones,DUSD57006

Explainwhythesupplementaryaidsandserviceswillorwillnotenablethestudenttomakeprogressonthegoalsandobjectives(if
applicable)inthisIEPinthegeneraleducationclass.

Whatbenefitsareprovidedinthegeneraleducationclasswithsupplementaryaidsandservicesversusthebenefitsprovidedinthe
specialeducationclass?

Whatpotentiallybeneficialeffectsand/orharmfuleffectsmightbeexpectedonthestudentwithdisabilitiesortheotherstudentsinthe
class,evenwithsupplementaryaidsandservices?

Towhatextent,ifany,willthestudentparticipatewithnondisabledpeersinextracurricularactivitiesorothernonacademicactivities?

Explanationoftheextent,ifany,towhichthestudentwillnotparticipatewithstudentswithoutdisabilitiesintheregulareducationclass:

Robertparticipatesinallregularclasseswithnon-disabledpeersforallinstruction.
Explanationoftheextent,ifany,towhichthestudentwillnotparticipatewithstudentswithoutdisabilitiesinthegeneraleducationcurriculum:

Robertparticipatesinthegeneralcurriculumwithnon-disabledpeersforallinstruction.

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B. Type of Support

1. Amount of special education supports

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Itinerant:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelfor20%orlessoftheschoolday

2. Type of special education supports

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Supplemental:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelformorethan20%ofthedaybutlessthan80%oftheschoolday
Full-Time:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelfor80%ormoreoftheschoolday

AutisticSupport
BlindorVisuallyImpairedSupport
DeaforHearingImpairedSupport
EmotionalSupport
GiftedSupport
LearningSupport
LifeSkillsSupport
MultipleDisabilitiesSupport
PhysicalSupport
SpeechandLanguageSupport

C. Location of student's program

NameofSchoolDistrictwheretheIEPwillbeimplemented:

DrexelUniversity

NameofSchoolBuildingwheretheIEPwillbeimplemented:

DUSD_Special_School

Isthisschoolthestudentsneighborhoodschool(i.e.,theschoolthestudentwouldattendifhe/shedidnothaveanIEP)?

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Yes
No.Iftheansweris"no,"selectthereasonwhynot.

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Specialeducationsupportsandservicesrequiredinthestudent'sIEPcannotbeprovidedintheneighborhoodschool
Other.Pleaseexplain:

VIII. PENNDATA REPORTING: Educational Environment (Complete either Section A or B; Select only one Educational Environment)
Tocalculatethepercentageoftimeinsidetheregularclassroom,dividethenumberofhoursthestudentspendsinsidetheregularclassroombythetotalnumberofhoursintheschoolday(including
lunch,recess,studyperiods).Theresultisthenmultipliedby100.
SECTION A: For Students Educated in Regular School Buildings with Nondisabled Peers - Indicate the percentage of time INSIDE the regular classroom for this student:

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RobertJones,DUSD57006
Timespentoutsidetheregularclassroomreceivingservicesunrelatedtothestudent'sdisability(e.g.,timereceivingESLservices)shouldbeconsideredtimeinsidetheregularclassroom.
Educationaltimespentinage-appropriatecommunity-basedsettingsthatincludeindividualswithandwithoutdisabilities,suchascollegecampusesorvocationalsites,shouldbecountedastime
spentinsidetheregularclassroom.
Calculation for this Student:
Column1

Column2

Calculation

Totalhoursthestudent
spendsintheregular
classroomperday

Totalhoursinatypical
schoolday
(includinglunch,recess&
studyperiods)

IndicatePercentage

PercentageCategory

(Hoursinsideregular
classroomhoursin
SectionA:Thepercentageof
schoolday)x100=%
timestudentspendsinside
(Column1Column2)x100
theregularclassroom:
=%

Usingthecalculationresultselecttheappropriatepercentage
category
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6.50

6.50

(6.506.50)x100=
%

100.00 % of the day

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INSIDE the Regular Classroom 80% or More of the Day

INSIDE the Regular Classroom 79-40% of the Day
INSIDE the Regular Classroom Less Than 40% of the Day

SECTION B: This section required only for Students Educated OUTSIDE Regular School Buildings for more than 50% of the day - select and indicate the Name of School or Facility on
the line corresponding with the appropriate selection:(Ifastudentspendslessthan50%ofthedayinoneoftheselocations,theIEPteammustdothecalculationinSectionA)
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ApprovedPrivateSchool(NonResidential)

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ApprovedPrivateSchool(Residential)

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OtherPrivateFacility(NonResidential)

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OtherPrivateFacility(Residential)

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OtherPublicFacility(Residential)

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OtherPublicFacility(NonResidential)
Hospital/Homebound
CorrectionalFacility
OutofStateFacility
InstructionConductedintheHome

EXAMPLES for Section A: HowtoCalculatePennDataEducationalEnvironmentPercentages

Column1

Column2

Calculation

IndicatePercentage
SectionA:Thepercentageoftimestudent
spendsinsidetheregularclassroom:

Totalhoursthestudentspendsinthe
regularclassroomperday

Totalhoursinatypicalschoolday
(includinglunch,recess&studyperiods)

(Hoursinsideregularclassroomhoursin
schoolday)x100=%
(Column1Column2)x100=%

Example1

5.5

6.5

(5.56.5)x100=85%

85%oftheday(Inside80%orMoreofDay)

Example2

(35)x100=60%

60%oftheday(Inside79-40%ofDay)

Example3
1
5
(15)x100=20%
20%oftheday(Insidelessthan40%ofDay)

Forhelpinunderstandingthisform,anannotated IEPisavailableonthePaTTANwebsiteatwww.pattan.netType"AnnotatedForms"intheSearchfeatureonthewebsite.Ifyoudonothaveaccess
totheInternet,youcanrequesttheannotatedformbycallingPaTTANat800-441-3215.

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