INDIVIDUALIZED EDUCATION PLAN (IEP)

Overview – This IEP has been designed in accordance with the World Health Organization International Classification of Functioning Disability and Health. In
accordance with this approach Disability is defined as impairment in interaction with a wide range of environmental barriers. In this IEP, teachers are asked to
identify the learner’s impairment in combination with their school environment. The learning barriers should be documented alongside accommodations designed
to remove the participation barriers and improve educational success.

SECTION A: PERSONAL INFORMATION

LEARNER/PARENT INFORMATION: DIFFICULTIES (select most relevant): MEETING INFORMATION

DATE OF MEETING: September 5, 2022
Learner: __________________ Sex: Female ___ Difficulty in Seeing DATE OF LAST IEP: October 12, 2021
Birth Date: ____________________
Grade/Level:Transition Program–SPED LRN: PURPOSE OF MEETING :
Current School: Odiongan National High School ___ Difficulty in Hearing ___ Interim IEP**
Address of School: Dapawan, Odiongan, Romblon
Mother Tongue Spoken: Filipino
/
___ Initial IEP
___ Term IEP
___ Difficulty in Communicating
Address: Panique, Odiongan, Romblon ___ IEP Following 3-Yr Re-evaluation**
Learner’s Phone (if there is): ____________________ ___ Revision to IEP Date_________
___ Difficulty in Moving/Walking
Parent/Guardian/Caregiver: _______________________ ___ Exit/Graduation_____________
Work & Workplace: Housewife ___ IEP Revision Without a Meeting:
Landline/Mobile/Cell Phone No. ______________________ ___ Difficulty in Concentrating/Paying At the request of ___Parent
Mother Tongue Spoken: Filipino Attention ___School
Interpreter or Other Accommodations Needed – Sign Language
way of communication IEP Review Date: Quarterly
___ Difficulty in Remembering/ COMMENTS:
Understanding

___ Others (please specify)

__/__ Medical diagnosis (if yes, please attach)
Communication Disability

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 IEP TEAM MEMBERS IN ATTENDANCE

School: ODIONGAN NATIONAL HIGH SCHOOL

Psychologist**______________________________________________________
Parent/Guardian/Caregiver: __________________ _
*Learner: _____________________ Guidance Counsellor /Designate: _________________________-
School Nurse :
Principal/School Head: ____________________ _____________________
Other (name and role) ________________________________________________ _______________________________________________________________
Special Education Teacher: Lorelie D. Gaspar, Joana Marie F. Forio
Shaine Fetalco Therapist/Pathologist/Specialist_________________________________________
**Regular Education /Receiving Teacher:______________ Other (name and role) Speech/Language Interpreter __________________________________________
*Learner must be invited when transition is discussed.
**The IEP team must include at least one regular education teacher of the learner (if the learner is or may be participating in the regular education environment)

_______________________________________________
Signature over Printed Name of Parent/Guardian/Caregiver:

AT LEAST ONE YEAR PRIOR TO REACHING AGE 18, LEARNER MUST BE INFORMED OF THEIR RIGHTS UNDER THE LAW AND ADVISED THAT THESE
RIGHTS WILL BE ENJOYED AT AGE 18.

Not Applicable (learner will not be 18 within one year

__/__ The learner has been informed of his/her rights under law and advised of the transfer of rights at age 18

Distribution:√ Learner’s Folder

√ Parent/Guardian/Caregiver Ed Special Education/Receiving Teacher)

LEARNER: ___________________________
DATE: September 21,2021

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I. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE
Results of initial or most recent evaluation and results of school and division assessments:
Jocelyn was seen by a Municipal General Doctor and was diagnosed to have Communication Disability.

Description of academic, developmental and/or functional strengths:

As stated by the parents, Jocelyn can learn easily with the use of sign language. She is highly functional and very industrious.

Description of academic, developmental and/or functional needs:

Jocelyn has a hard of hearing. She used hearing aid before but it broke. She learns sign language to express herself but she finds difficult to understand people
because some cannot communicate through signs. The only words that she can speak are mama and papa.

Parental concerns regarding their child’s education:

Jocelyn’s parents wish that Jocelyn can learn functional academics and skills needed in everyday living and to prepare her for the work opportunities when the
time comes.

Impact of the disability on involvement and progress in the general education curriculum (for preschool, how the disability affects participation in appropriate
activities):
Jocelyn finds difficulty in communicating and understanding things and people around her. This difficulty causes her to fell that she can’t do well in a regular class.

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II. CONSIDERATION OF SPECIAL FACTORS
a) Does the learner have difficulty relating with people which impedes his/her learning or the learning of others? √ No Yes
b) If yes, consider the appropriateness of developing a Behavior Intervention Plan.

Behavior Intervention Plan developed? √ No Yes

Refer to Behavior Intervention Plan for additional information.

Does the learner have difficulty in Moving/Walking?

√ No Yes
If yes, consider the mobility needs as related to the IEP and describe below.

Does the learner have difficulty in seeing or with blindness/visual impairment? √ No Yes
If yes, provide for instruction in Braille and the use of Braille, unless the IEP Team determines that instruction in Braille is not appropriate for the learner after an
evaluation of the learner’s reading and writing skills, needs, and appropriate reading and writing media, including evaluation of future needs for instruction in Braille
or the use of Braille. Describe below.

Does the learner have difficulty in communicating? No √ Yes

If yes, consider the communication needs and describe below.

Does the learner have difficulty in concentrating/paying attention? √ No Yes

If yes, consider the attention span needs and describe below.

Does the learner have difficulty in remembering/understanding? √ No Yes

If yes, consider the understanding needs and describe below.

Does the learner have difficulty in hearing or Is the learner deaf or hard of hearing? No √ Yes
If yes, consider and describe the learner’s language and communication needs, opportunities for direct communication with peers and professional personnel in the
learner’s language and communication mode, academic level and full range of needs, including opportunities for direct instruction in the learner’s language and
communication mode. Describe communication needs below.

Does the learner need assistive technology devices or services? √ No Yes

If yes, describe the type of assistive technology and how it is used. If no, describe how the learner’s needs are being met in deficit areas.

Does the learner require alternative format for instructional materials? √ No Yes

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If yes, specify format(s) of materials required below.

 Braille  Large type  Auditory  Electronic text

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 SECTION B: DIFFICULTIES, BARRIERS AND ENABLING SUPPORTS

DIFFICULTY (enter all ENVIRONMENTAL BARRIERS (describe ENVIRONMENTAL FACILITATORS (describe ACCOMMODATIONS (list
areas of difficulty) each factor restricting participation) each factor enabling participation in response items, staff resources and
to barriers) infrastructure changes required
to enable participation)

Hard of hearing School or home environment with limited Household members or teachers need to Communicate using sign
knowledge on sign language have training on sign language language

Download and send videos with

sign interpreter through
messenger to facilitate learning

Put pictures needed in

understanding the
module/activity
Difficulty in School or home environment with limited Household members or teachers need to Communicate using sign
Communicating knowledge on sign language have training on sign language language

Download and send videos with

sign interpreter through
messenger to facilitate learning

Put pictures needed in

understanding the
module/activity

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 Selection of Barriers and Qualifiers for Environmental Barriers and Facilitators (taken from ICF)

DIFFICULTIES (select all relevant categories) Qualifier for Environmental Barriers Qualifier for Environmental Facilitators
 Hearing .0 No barrier +1 Mild facilitator
 Communicating .1 Mild barrier +2 Moderate facilitator
.2 Moderate barrier +3 Substantial facilitator
.3 Severe barrier +4 Complete facilitator
.4 Complete barrier +8 Facilitator, not specified
.8 Barrier, not specified +9 Not applicable
.9 Not applicable

SECTION C: STUDENT GOALS

To support identification of learner goals, also confirm:

 What opportunities are available at the school to support learner goals?
 What are the student interest areas?
 What disability-specific skills does the learner need to develop to support their participation / attainment of goals?

Goals (eg – Skills to improve participation in education or daily living skills. Goals should be SMART (Strategic, Measurable, Achievable, Realistic and Time-
bound)

Jocelyn will be able to learn the competencies in functional academics (Science, English, Mathematics) as needed in everyday living with
80% mastery and do gardening as part of the school’s program.
INTEREST GOAL INTERVENTIONS TIMELINE INDIVIDUALS REMARKS PROGRESS /
RESPONSIBLE NEXT STEPS

Learning basic Jocelyn will Jocelyn will be given September-June SPED Teachers Jocelyn will Review goals
and essential learn and modules/activity sheets appreciate and quarterly –
competencies in understand based on the given enjoy the new way Continue doing the
Mathematics the basic and competency with clear, of learning tasks/activities
needed in essential direct and practical through printed given in the
everyday living competencies examples and exercises. modules. modules/activity

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 in Enrichment activities will Be motivated to sheets for better
Mathematics also be given if needed. learn and continue understanding and
with 80% her education mastery.
mastery. It Use and put pictures for even in this time See the importance
includes topic better understanding in of pandemic. of those
like whole modules/activity sheets or Use and apply the competencies and
numbers, send videos with sign learning for be able to use the
money, interpreter through independent learning gained in
fractions, messenger if needed. living. everyday living.
decimals and
geometry.

SECTION D: STUDENT TRANSITION

This section is for students exiting the school environment and transitioning into work.

INTEREST WORK OPPORTUNITIES INTERVENTIONS / INDIVIDUALS REMARKS

TRANSITION SKILLS RESPONSIBLE