The IEP example below is not provided in its entirety. Sections such as present levels of performance and goals have been shortened to give you a couple of examples of what you should expect to see in each section.
Name: John Doe
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Eligibility: Specific Learning Disability
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Meeting Information |
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| Date of Initial Team Meeting: | July 25, 2005 |
| Date of Present Meeting: | December 15, 2009 |
| Next Three Year Review: | December 15, 2011 |
| Type of Meeting: | Annual Review |
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Student Information |
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| Age: | 9 |
| Grade: | 3rd |
| Gender: | Male |
| Limited English Proficient: | No |
| Home Language: | English |
| Student Language: | English |
| Current School: | Attends School of Residence |
| Name of Parent or Guardian: | John Sr. & Jane Doe |
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Goal Achievement from Current IEP |
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| Articulation | Not Met | New Goal created on 9/29/09 |
| Reading | Met | |
| Writing | Not Met | Needs more time |
| Motor (OT) | Met | |
| Gross Motor (APE) | Not Met | New Goal. Needs more time |
| Math | Not Met | Needs more time and instruction |
| Behavior Support | Met | |
| Pragmatics | Not Met | New Goal created on 9/29/09 |
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Present Level of Performance |
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| Performance Area: | Gross Motor Abilities |
| Assessment Process Used: | Teacher Observation |
| State/District Assessment Results: | |
| Strengths: Shows good overall perceptual motor and object control ability with the exception of catching from distance beyond 12 feet. Needs: Has difficulty with catching quality. He needs to correct his hand position and learn to absorb the impact of the ball. This will alleviate some of the fear he has of catching. Impact of Disability: His SLD affects his ability to catch with the proper form, impacting his ability to fully access play on the yard at recess, lunch and during physical education. Adapted Physical Education is recommended.
Accommodations/Modifications: Get attention prior to directive, pair model with directive, multiple trials to complete directed tasks, task analysis, consistent structure, clear expectations , modified equipment such as success ball (soft). Prepared by APE Teacher |
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Present Level of Performance |
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| Performance Area: | Reading |
| Assessment Process Used: | Woodcock-Johnson III, School Unit Tests, informal & Teacher Report |
| State/District Assessment Results: | Basic |
| Standard Scores by age (average range 85-115) | |
| Broad Reading | 98 |
| Letter-Word Identification | 105 |
| Reading Fluency | 99 |
| Passage Comprehension | 82 |
| Sound Awareness | 104 |
| School Unit Test: Reading Comprehension 3/10
Strengths: He is able to read grade level materials with appropriate speed and accuracy. He reads orally with expression. He is able to decode through unknown words and has a good sight word vocabulary. He is able to recall details and to answer factual questions about self-read short passages. He is able to ask clarifying questions about grade level materials as well. His reading comprehension appears to be stronger when the passages are shorter and when he is able to read aloud. Needs: His performance on reading comprehension is inconsistent. He sometimes has difficulty answering questions both orally and in writing. He has difficulty distinguishing main ideas from supporting ideas. Impact of Disability: His SLD impacts his ability to read with comprehension which impedes his access to the general education curriculum and ability to meet grade level standards. Prepared by Resource Specialist |
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Eligibility |
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| Eligible as a student with the following disability: | Specific Learning Disability |
| Code: | SLD |
| Related Services determined as necessary for the Student to benefit from Special Education: | Adapted PE, Speech/Language Therapy, Resource, Occupational Therapy, & Recreation Therapy. |
| The IEP Team has considered and agrees that the educational needs of the student are not primarily due to, social maladjustment, lack of instruction in math, temporary physical disability, limited English proficiency, lack of instruction in reading or environmental, cultural or economic factors. | |
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Goals |
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| Performance Area Identified: | Gross Motor |
| Related Service: | APE |
| Begin Date: | December 2009 |
| Responsible Personnel: | APE Teacher |
| Goal to be achieved by: | December 2010 |
| Frequency: | 2 times per week |
| Time: | 30 minutes each time |
| He will catch an 8-inch ball, directly tossed from 15 feet, with hands only, using proper body/hand position and absorption, 3 out of 5 times on 2 consecutive trials. | |
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Goals |
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| Performance Area Identified: | Reading |
| Related Service: | Resource |
| Begin Date: | December 2009 |
| Responsible Personnel: | General Education Teacher & Resource Teacher |
| Goal to be achieved by: | December 2010 |
| Frequency: | 1-5 times per week |
| Time: | 180 minutes per week |
| When given a selected third grade expository passage, he will distinguish the main idea and supporting details in the passage with 75% accuracy in 2 of 3 trials as measured by student work samples and teacher charted data. | |
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Grade level standards based promotion |
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| Does the disability impact the student’s ability to meet District grade level standards? | Yes, explain below |
| His specific learning disability impacts his ability to read with comprehension and to reason in mathematics thereby impeding his ability to access the general education curriculum and to meet grade level standards. | |
| Is the student expected to meet grade level standards? | Yes |
| What is necessary to help the student progress in the general education curriculum? | |
| Preferential seating close to and facing the source of instruction with limited distractions; frequent checks to refocus attention; reduced workload as needed; break down task into smaller, more manageable segments; use multiple modalities when introducing new concepts or directions; limit number of required steps when presenting directions or information auditorily; have him repeat directions to ensure comprehension; use of manipulatives or different modalities to reinforce math concepts and to strengthen reasoning skills. Use of checklist for writing assignments. Small group testing for district tests and allow him to read tests aloud. | |
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Participation in State and District Wide Assessments |
| Student will participate in regular State and District Assessments:Variations:Test Student in a small group setting.Extra time on test within a testing day. |
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IEP Team Recommendations |
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| Location of Services in the Least Restrictive Environment: | District School of Residence |
| Instructional Setting: | General Education, Resource Specialist Services & Related Services |
| Reason the student’s needs cannot be met in the general education setting? | |
| He at times requires the benefit of a smaller, more specialized setting with a lower student to teacher ratio and less distractions than can be offered in the general education setting in order to access the general education curriculum. | |
| Assistive Technology Devices: | No |
| Percentage of time per week in special education: | 19% |
| Extended School Year: | Yes |
| Type of Physical Education: | Adapted |
| Transportation: | No |
| Curriculum Student will participate in? | District general education curriculum using accommodations already outlined. |
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Procedural Safeguards |
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| A Parent’s Guide to Special Education including Procedural Safeguards was provided to the parent in their primary language? | Yes |
| Copies of the following assessments were given to the parent? | Pschoeducational, Resource, Speech, OT and Adapted PE |
| Parent was informed of their right to a written translation of the IEP? | N/A |
| For Students that are 17 they have been informed of the educational rights that will transfer to them at the age of 18? | N/A |
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IEP Service Summary |
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| Service Description | Weekly Frequency | Total Weekly Minutes | Addresses Goals |
| Adapted PE | 2 | 60 | Gross Motor |
| Language/Speech | 1 | 60 | Articulation, Pragmatics |
| Occupational Therapy | 1 | 30 | Motor (OT) |
| RSP (Math) | 1-5 | 120 | Math |
| RSP (Reading) | 1-5 | 180 | Reading, Writing |
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Parent Consent and Concerns (This Section has not been filled in) |
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| Parent Consents to the IEP | |
| Parent Disagrees with the following:Assessment:
Eligibility: Instructional Setting: Services: |
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| If Parent disagrees, they wish to use what form of dispute resolution? | |
| Parent Concerns and Comments | |
| Signatures | |
Satish Chandra said on October 6, 2011
Really wonderful job you are doing. I will take help from you in developing IEP.
God bless you
Regards
Satish
vandana saxena said on November 23, 2011
What an organised way to support pupil’s learning !
Mary Curtis said on July 24, 2012
Thank you for having an example to see of an IEP.
eben said on February 20, 2013
the sample iep is so helping. wonderful idea.
D.L. Dixon said on March 21, 2013
I’ve worked with IEP’s in the past, and this is one of the best developed IEP’s I’ve seen. The format is easy to read and comprehend. Excellent work on this IEP example.