INDIVIDUALIZED EDUCATION PROGRAM (IEP)

Student’s Name: Michael Gill

INDIVIDUALIZED EDUCATION PROGRAM (IEP) School Age

Student’s Name: Michael Gill

IEP Team Meeting Date (mm/dd/yy): 05/20/2018
IEP Implementation Date (Projected Date when Services and Programs Will Begin): 5/21/2018
Anticipated Duration of Services and Programs: 5/21/2018 – 5/20/2019
Date of Birth: 10-4-2012
Age: 5
Pre-
Grade:
Kindergarten
Anticipated Year of Graduation: 2031
Local Education Agency (LEA):
County of Residence: Jefferson County
Name and Address of Parent/Guardian/Surrogate: Phone (Home): (740) 555-5555
Dean and Michelle Gill Phone (Work): (740) 444-4444
1235 Brookwood Ct
Steubenville, Ohio
43952
Other Information:

The LEA and parent have agreed to make the following changes to the IEP without convening an IEP meeting, as documented by:
Not applicable

Date of Revision(s) Participants/Roles IEP Section(s) Amended

Not applicable Not applicable Not applicable
Not applicable Not applicable Not applicable
Not applicable Not applicable Not applicable

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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Michael Gill

II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

 Present Level of Academic Achievement

o Michael is a student in pre-kindergarten whose chronological age is five years and six months. Results from the standardized
Brigance Inventory of Early Development III show Michael’s Academic/Cognitive scores are equivalent to the chronological age of
four years and six months. When completing the literacy portions, his raw score was a 94 and his composite score was an 85. This
score placed Michael in the 16th percentile. Michael seemed very experienced with books and texts, was able to effectively
identify uppercase letters, showed age appropriate phonological awareness, and additionally scored well on auditory
discrimination. However, his word recognition, reading words from common signs, phoneme manipulation, and recitation of the
alphabet were all low. In regards to mathematics, Michael’s raw score was a 45 with his composite score being an 85. This placed
him again in the 16th percentile. When asked to compare different amounts or sort a variety of objects, Michael scored very well.
Michael is able to count by rote number up to the number 13 consistently. When asked to add or subtract numbers, Michael did
not earn any points in either section. Additionally, he struggled to read numerals, solve word problems, and find the missing
number in sequences.

 Present Level of Functional Development

o Michael’s overall developmental score showed his chronological age equivalent to be five years and zero months. This places his
instructional range at four years and eleven months to five years and one month.
o Behavior
 Michael is a quiet but calming presence in the classroom. He frequently follows directions the first time he is asked, and
quietly encourages his peers to do so as well. When lining up, he always lines up with a finger on his lips, a bubble in his
mouth, and one hand in the air – this is the hallway procedure for the school he attends. Michael is a leader inside and
outside of the classroom.
 Michael is very caring and compassionate to his fellow students. He frequently checks in with his peers to ensure they are
happy and on task. When another classmate is upset, Michael is typically the first student there to make sure they are
okay.
o Communication
 In preschool, Michael had an Individualized Education Plan (IEP) for communication. When he first began preschool at Help
Me Grow he was nonverbal. Now, Michael is able to communicate with his peers and teachers to a much more significant
degree. When he gives one-word answers he is clearly understood. When Michael tries to form fully sentences, sometimes
he is harder to understand, especially when he is excited. His communication can sometimes be a barrier for him, which
frustrates him. When he is angry, he has difficulty verbalizing his feelings.
o Social Skills
 In regards to social and emotional development, Michael ranked in the 93 rd percentile overall. For interpersonal
development his raw score is a 21 while his composite score is a 123. His chronological age equivalent for this is seven
years and three months. For self-regulatory development, Michael’s raw score is 28 while his composite score is 115. This
places him in the 84th percentile with a chronological age equivalent of six years and nine months.
 Michael is a very social student, always checking in with those around him. He always has a smile on his face and wants to
keep his teachers and his classmates happy.
o Adaptive Skills
 Michael’s adaptive behavior skills scored in the 31st percentile. His chronological age equivalent is five years and three
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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Michael Gill

months, just slightly below where he should be scoring. In terms of eating, he is able to feed himself, use a utensil
correctly and only spills minimally. He also scored well at dressing/undressing, toileting, and bathing. In terms of personal
information, Michael confidently said his first and last name and his age. He was unable to answer questions regarding his
birthday, phone number, or address.

 Parental Concerns for Enhancing the Education of the Student

o Michael’s parents have expressed concerns in the past regarding his communication and speech. However, they agree that he has
come a long way. They also expressed concerns regarding his emotional development. He has a younger brother with more
severe disabilities who had frequent and disruptive outburst. Parents are worried that because of this Michael internalizes his
feelings and only expresses his emotions inwardly.

 How the Student’s Disability Affects Involvement and Progress in the General Education Curriculum
o Michael’s communicative disability sometimes limits his engagement with same aged peers in the general education setting. He
leaves the classroom for speech therapy once a week for around 30 minutes. Otherwise, Michael receives all of his instruction in
the general education inclusive classroom.
o Cognitively, Michael is behind his peers in terms of literacy and mathematics. In particular, this shows that he may not be on
track to enter into Kindergarten in the fall semester.

 Strengths (per information above):

1. Michael’s social and emotional development in terms of interpersonal relations was very high for his age. He scored in the 94th
percentile, which greatly exceeded his expected results. The chronological age equivalent of his scores is seven years and six
months. He shows exceptional relationships with adults and also with his peers. He forms solid relationships with peers and
engages in active play.
2. Another one of Michael’s strengths is in his gross motor development. In this category, Michael scored in the 89 th percentile,
above his expected age equivalent. In this section, Michael had a lot of fun balancing and walking, skipping, and galloping down
the hallway. He additionally enjoyed interacting with the ball.
3. A third strength for Michael is his self-regulatory skills. In this category, he scored in the 84th percentile. The chronological age
equivalent of this is seven years and three months. Michael had advanced motivation and self-confidence. He is always eager to
learn, and remains engaged throughout lessons and activities. Additionally, Michael shows great use of pro-social skills and other
behavioral development.

 Areas for Improvement (per information above):

1. Language Development - Receptive. As indicated by the language development portion of the Brigance, Michael’s receptive
language is equivalent for the chronological age of four years and three months. He only scored in the 14 th percentile in this
section. While he showed many correct early receptive language skills and identified most pictures and parts of the body for the
receptive sections, he did miss a few parts in each section. The biggest section he missed points on was understanding verbal
concepts.
2. Academic/Cognitive Mathematics. Results from the Brigance indicate that Michael scored the age equivalent of four years and
five months in terms of mathematics. This placed Michael in the 16 th percentile. Michael scored well in terms of comparing
different amounts, and sorting objects by different criteria. However, Michael did not score any points when adding or
subtracting. The biggest concern is that Michael is only able to count to 13 by rote memorization and he can only consistently
match quantities with numerals up to 5. This sets him behind his peers developmentally.
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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Michael Gill

3. Academic/Cognitive Literacy. Results from the literacy portion of the Brigance indicate that Michael scored the equivalent of a
student who is four years and six months old. This puts him in the 16 th percentile. Michael scored well on the sections related to
experience with books and text, phonological awareness, and auditory discrimination. Some areas for improvement for Michael
include sections related to phoneme manipulation, reading words from common signs, and word recognition. However, the
greatest point of concern is that Michael was only able to recite the first three letters of the alphabet. This puts him
academically behind his peers, and does not set him up to be able to read and write.

V. GOALS AND OBJECTIVES

MEASURABLE ANNUAL GOAL Describe HOW the

Describe WHEN periodic
Include: Condition, Name, Behavior, and Criteria student’s progress toward
reports on progress will be Report of Progress
(Refer to Annotated IEP for description of these meeting this goal will be
provided to parents
components) measured

1. When presented with verbal concepts, Michael The teacher will engage in Quarterly reports will be
will demonstrate his understanding by completing direct observation of emailed home to parents
the required response with 90% accuracy, in four student practicing verbal containing a graph of
consecutive trials, by the end of this IEP. concepts. The teacher Michael’s progress.
will quiz the student
weekly to monitor
progress.

2. When prompted to count numbers, Michael will The teacher will ask Quarterly reports will be
count by rote memorization up to the number 30 Michael to count by rote emailed home to parents,
with 90% accuracy in 3 out of 4 consecutive trials weekly and will track his which will include a chart of
by the end of this IEP. counting using progress Michael’s progress in
monitoring. counting numbers.

3. When prompted to recite the letters of the The teacher will use Quarterly reports will be
alphabet, Michael will recite twenty-six out of direct observation of the emailed home to parents,
twenty-six letters of the alphabet in 3 out of 5 student and chart the which will include a chart of
consecutive trials, by the end of this IEP. student’s progress on Michael’s progress in
recitation of the letters of reciting letters of the
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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Michael Gill

the alphabet using a alphabet.

checklist.

VI. SPECIAL EDUCATION / RELATED SERVICES / SUPPLEMENTARY AIDS AND SERVICES / PROGRAM MODIFICATIONS – Include, as appropriate, for nonacademic
and extracurricular services and activities.

A. PROGRAM MODIFICATIONS AND SPECIALLY DESIGNED INSTRUCTION (SDI)

 SDI may be listed with each goal or as part of the table below.
 Include supplementary aids and services as appropriate.
 For a student who has a disability and is gifted, SDI also should include adaptations, accommodations, or modifications to the general
education curriculum, as appropriate for a student with a disability.

Projected Beginning
Modifications and SDI Location Frequency Anticipated Duration
Date
SDI for Goal 1:
1. General Education
1. General education teacher will provide explicit, 1. Weekly
Classroom
direct, small group instruction on verbal concepts.
Students will practice opposite verbal concepts using
bodily movements.

2. General education teacher will incorporate verbal

concepts into whole class instruction using explicit
2. General Education 5/21/2018 5/20/2019
methods. Teacher will model and demonstrate 2. 3x per Week
Classroom
opposite verbal concepts throughout core instruction.

3. Paraeducator will work with Michael individually

using direct instruction to complete repeated practice
3. Resource room
until mastery of the verbal concepts. Paraeducator 3. 2x per week
will use verbal prompting, corrective feedback, and
specific praise.

SDI for Goal 2:

1. The general education teacher will provide direct 1. General Education 1. 2x per Week
5/21/2018 5/20/2019
instruction on counting numbers 1-30. Teacher will Classroom
use manipulatives to model for small groups fluent,
proper counting.
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INDIVIDUALIZED EDUCATION PROGRAM (IEP)
Student’s Name: Michael Gill

2. The paraeducator will explicitly teach Michael 2. Resource Room 2. 2x per Week
counting numbers 1-30. Paraeducator will meet with
Michael individually using modeling, repeated
practice, corrective feedback, and positive
reinforcement.

SDI for Goal 3:

1. The general education teacher will provide direct 1. General Education 1. 2x per Week
instruction on the twenty-six letters of the alphabet Classroom
including their letter name and order. Students will
practice reciting the alphabet verbally and pointing to
an alphabet line while reading the letters.
5/21/2018 5/20/2019
2. The general education teacher will provide explicit 2. General Education 2. 2x per Week
instruction in small groups of students to model and Classroom
practice reciting the twenty-six letters of the
alphabet. Students will listen to recordings of fluent
reciting of the alphabet and practice along with them.

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