INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:
4-20-2004

DOB

Carrie Smith
SCHOOL YEAR

IEP INITIATION/DURATION DATES

FROM

2014

12-2-14

2015

GRADE
TO

4th

5th

12-1-15

THIS IEP WILL BE IMPLEMENTED DURING THE REGULAR SCHOOL TERM UNLESS NOTED IN EXTENDED SCHOOL YEAR SERVICES.

STUDENT PROFILE WILL INCLUDE GENERAL STATEMENTS REGARDING:

Strengths of the student:

Carrie is a 10-year-old girl who lives at home with her mom. Carrie attends Samford Elementary. Carrie is very
respectful to her peers and adults, and she is a very personable young lady. She works well with her peers in group
settings. Carrie is very willing to accept support or help from adults or peers.
Carrie can understand and follow 1-3 step directions, and she will attentively listen to a story read by the teacher.
Carrie is able to comprehend various grade level passages that she reads silently to herself. Carrie can decode and
correctly pronounce all consonants and the consonant blends including: sl/pl/dr/pr/fl/tr. Carrie can correctly name
pictured objects that are used on a daily basis. Carrie enjoys spelling and she is able to spell single syllabic words.
Carrie is able to perform basic addition, subtraction, and 1-digit multiplication problems. Carrie can create very
elaborate sculptures and paintings in art class. Carrie is always very focused and works very hard during art class
and after school during gymnastics and dance class.
Parental concerns:
Mrs. Smith is concerned about Carries ability to read stories on grade level. She is concerned about Carries
inability to decode multisyllabic words and long/short vowel sounds. Mrs. Smith is also worried because of how
much Carrie expresses her dislike for reading. Regarding math, Mrs. Smith has noticed Carries difficulty in
solving addition and subtraction problems with regrouping. Mrs. Smith is concerned about how nervous and
frustrated Carrie becomes when trying to complete her math homework.
Student Preferences and/or Interests:
Carrie is extremely personable and enjoys all different types of group activities. She enjoys Spelling and Art class
because she is able to express her creativity through the creation of sculptures and paintings. Carrie loves to paint
pictures of New York because that is her favorite place to visit. She loves learning about nursing because that is
what she wants to be when she grows up. After school, Carrie enjoys attending gymnastics classes where she is able
to dance and spend time with her friends.
Results of the most recent evaluations:
On 10-26-14 the Wechsler Intelligence Scale for Children-Third Edition (WISC_III), which is an intelligence test
that measures overall intellectual functioning, was completed. The scores are listed below:
-Full Scale IQ= 96
-Verbal IQ=89, Performance IQ=102
On 10-27-14 the Woodcock Johnson Test of Achievement-Third Edition (WJ-III), which is a comprehensive
collection of tests measuring level of achievement in reading, mathematics, written language, and knowledge, was
completed. Carries scores for Letter-Word Identification were in the low range, and the other scores are listed
below:
-Full Scale Achievement=80
-Letter-Word Identification=76, Passage Comprehension=99, Word Attack=82, Understanding Directions=100,
Picture Vocabulary=98, Calculation=84, Applied Problems=92, Spelling=84, Writing Samples=89
The academic, developmental, and functional needs of the student:
Carrie struggles to read stories on grade level. Carrie has both poor sight word vocabulary and difficulty decoding
and reading multisyllabic words. Specifically, Carrie struggles in decoding short/long vowel sounds. Carrie has
difficulty differentiating between homonyms and understanding silent letters. Regarding math, Carrie has
difficulty solving addition and subtraction problems with regrouping. Carrie also has trouble memorizing her
multiplication facts and solving 2-3 digit long division problems. Carries most recent grades are listed below:
Reading-F
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English Language Arts-F

Social Studies-F
Math-D
Science-C
Carrie has difficulty staying on task when she is supposed to be independently working. Carrie also frequently
turns in assignments that are incomplete or inaccurate.
Other:

For the child transitioning from EI to Preschool, justify if IEP will not be implemented on the childs 3 rd birthday:

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ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:

Carrie Smith

SPECIAL INSTRUCTIONAL FACTORS

Items checked YES will be addressed in this IEP:
Does the student have behavior which impedes his/her learning or the learning of others?

Does the student have limited English proficiency?

Does the student need instruction in Braille and the use of Braille?
Does the student have communication needs (deaf or hearing impaired only)?
Does the student need assistive technology devices and/or services?
Does the student require specially designed P.E.?
Is the student working toward alternate achievement standards and participating in the
Alabama Alternate Assessment?
Are transition services addressed in this IEP with an annual goal(s)?

YES
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]

NO
[]

[ ]
[ ]

[]
[]

[]
[]
[]
[]
[]

TRANSPORTATION AS A RELATED SERVICE

Students mode of transportation:
[ ] Bus for special needs
[ ] Parent contract
[] Regular bus
[ ] YES
Does the student require transportation as a related service?
If yes, check any transportation needs:
[
[
[
[
[

]
]
]
]
]

Bus assistance:
[ ] Adult support
Preferential seating
Behavioral Intervention Plan
Wheelchair lift and securement system
Restraint system
Specify type:

[ ] Other:

[] NO

[ ] Medical support

[ ]

Other. Specify:

[ ]

Bus driver and support personnel are aware of the students behavioral and/or medical concerns.
NONACADEMIC and EXTRACURRICULAR ACTIVITIES

Will the student have the opportunity to participate in nonacademic/extracurricular activities with his/her nondisabled
peers?
[] YES.
[ ] YES, with supports. Describe:
[ ]

NO. Explanation must be provided:

METHOD/FREQUENCY FOR REPORTING PROGRESS OF ATTAINING GOALS TO PARENTS

Annual Goal Progress reports will be sent to parents each time report cards are issued (every
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ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:
[ ]
[ ]
[ ]

CARRIE SMITH

This student is in a middle school course of study that will help prepare him/her for transition.
This student was invited to the IEP Team meeting.
After prior consent of the parent or student (Age 19) was obtained, other agency representatives were invited to the
IEP Team meeting.
EXIT OPTIONS (Complete for students in Grades 9-12)

[ ]
[ ]
[ ]

Alabama High School Diploma

Alabama Occupational Diploma
Graduation Certificate

Anticipated Date of Exit:

Month:

Year :

PROGRAM CREDIT TO BE EARNED (Complete for students in grades 9-12)

For each course taken, indicate
program credit to be earned.

ENGLISH

MATH

SCIENCE

SOCIAL
STUDIES

Alabama High School Diploma

Alabama Occupational Diploma
Graduation Certificate
TRANSITION: (Beginning not later than the first IEP to be in effect when the student is 16, or earlier if appropriate, and
updated annually thereafter)
Transition Assessments (Check the assessment(s) used to determine the students measurable transition goals):
[ ]

Transition Planning Assessments

[ ] Interest Inventory

[ ]

Other

Goals for Postsecondary Transition:

Postsecondary Education/Training Goal
If Other is selected, specify
Employment/Occupation/Career Goal
If Other is selected, specify
Community/Independent Living Goal
If Other is selected, specify
Transition Services: Based on the student's strengths, preferences, and interests, the following coordinated transition
services will reasonably enable the student to meet the postsecondary goals. Consider these service areas: Vocational
Evaluations (VE), Community Experiences (CE), Personal Management (PM), Transportation (T), Employment Development (ED),
Medical (M), Postsecondary Education (PE), Living Arrangements (LA), Linkages to Agencies (LTA), Advocacy/Guardianship (AG),
Financial Management (FM), and if appropriate Functional Vocational Evaluation (FVE).

Transition Strands
Academics/Post Secondary
Education/Training

Employment/Occupations/
Careers

Personal/ Social

Daily Living

Service(s)

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INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:

CARRIE SMITH

[ ] This goal is related to the students transition services needs.

AREA:

Reading

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:

Carrie can attentively listen to a story read by the teacher. Carrie is able to comprehend various grade level
passages that she reads silently to herself. Carrie can decode and correctly pronounce all consonants and the
consonant blends including: sl/pl/dr/pr/fl/tr. Carrie struggles to read stories on grade level. Carrie has both poor
sight word vocabulary and difficulty decoding and reading multisyllabic words. Specifically, Carrie struggles in
decoding short/long vowel sounds.
MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By December 2015, Carrie will decode words when reading a grade-level text with 80% accuracy. [RF.5.3]
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ ] Curriculum Based Assessment [ ] Teacher/Text Test
[] Data Collection
[ ] Other:

[ ]

[] Teacher Observation

State Assessment(s) [ ]
[ ]

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Grades

Work Samples
Other:

BENCHMARKS:
1. BY FEBRUARY 2015, CARRIE WILL DECODE WORDS WHEN READING
A GRADE-LEVEL TEXT WITH 30% ACCURACY.
2. BY MAY 2015, CARRIE WILL DECODE WORDS WHEN READING A
GRADE-LEVEL TEXT WITH 50% ACCURACY.
3. SEPTEMBER 2015, CARRIE WILL DECODE WORDS WHEN READING A
GRADE-LEVEL TEXT WITH 70% ACCURACY.
4. DECEMBER 2015, CARRIE WILL DECODE WORDS WHEN READING A
GRADE-LEVEL TEXT WITH 80% ACCURACY.

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[ ]

Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:

CARRIE SMITH

[ ] This goal is related to the students transition services needs.

AREA:

Math

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:

Carrie is able to perform basic addition, subtraction, and 1-digit multiplication problems. Carrie has difficulty
solving addition and subtraction problems with regrouping. Carrie also has trouble memorizing her multiplication
facts and solving 2-3 digit long multiplication and division problems.
MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By December 2015, Carrie will solve multi-digit multiplication problems with 80% accuracy. [5-NBT5]

TYPE(S) OF EVALUATION FOR ANNUAL GOAL:

[ ] Curriculum Based Assessment [ ] Teacher/Text Test
[ ] Data Collection
[ ] Other:

[] Teacher Observation

[] State Assessment(s) [ ]
[ ]

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Grades

Work Samples
Other:

BENCHMARKS:
1. BY FEBRUARY 2015, CARRIE WILL SOLVE MULTI-DIGIT
MULTIPLICATION PROBLEMS WITH 30% ACCURACY
2. BY MAY 2015, CARRIE WILL SOLVE MULTI-DIGIT MULTIPLICATION
PROBLEMS WITH 50% ACCURACY
3. BY SEPTEMBER 2015, CARRIE WILL SOLVE MULTI-DIGIT
MULTIPLICATION PROBLEMS WITH 70% ACCURACY
4. BY DECEMBER 2015, CARRIE WILL SOLVE MULTI-DIGIT
MULTIPLICATION PROBLEMS WITH 80% ACCURACY

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Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:

CARRIE SMITH

[ ] This goal is related to the students transition services needs.

AREA:

Behavior

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE:

Carrie has difficulty staying on task when she is supposed to be independently working.
MEASURABLE ANNUAL GOAL related to meeting the students needs:

DATE OF MASTERY:

By December 2015, Carrie will exhibit productivity and on task behavior while independently working in 4/5
opportunities. [A:A3.4]
TYPE(S) OF EVALUATION FOR ANNUAL GOAL:
[ ] Curriculum Based Assessment [ ] Teacher/Text Test
[] Data Collection
[ ] Other:

[ ]

[] Teacher Observation

State Assessment(s) [ ]
[ ]

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Grades

Work Samples
Other:

BENCHMARKS:
1. BY FEBRUARY 2015, CARRIE WILL EXHIBIT PRODUCTIVITY AND ON
TASK BEHAVIOR WHILE INDEPENDENTLY WORKING IN 1/5
OPPORTUNITIES.
2. BY MAY 2015, CARRIE WILL EXHIBIT PRODUCTIVITY AND ON TASK
BEHAVIOR WHILE INDEPENDENTLY WORKING IN 2/5
OPPORTUNITIES.
3. BY SEPTEMBER 2015, CARRIE WILL EXHIBIT PRODUCTIVITY AND ON
TASK BEHAVIOR WHILE INDEPENDENTLY WORKING IN 3/5
OPPORTUNITIES.
4. BY DECEMBER 2015, CARRIE WILL EXHIBIT PRODUCTIVITY AND ON
TASK BEHAVIOR WHILE INDEPENDENTLY WORKING IN 4/5
OPPORTUNITIES.

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Date of Mastery:
Date of Mastery:
Date of Mastery:
Date of Mastery:

ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

Students Name:

Carrie Smith

SPECIAL EDUCATION AND RELATED SERVICE(S): (Special Education, Supplementary Aids and Services,
Program Modifications, Accommodations Needed for Assessments, Related Services, Assistive Technology, and Support
for Personnel.)

Special Education
Service(s)

The special education teacher will work 1:1

with student to remediate her deficits with
decoding and reading texts.
Inclusion support during math to monitor
comprehension of material.

Related Services
Service(s)

Anticipated
Frequency of
Service(s)

Amount
of time

Daily

60

Daily

30

Beginning/Ending
Duration Dates

12-2-14 to 12-1-15
12-2-14 to 12-1-15

[ ] Needed

[] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

General Education
Classroom/Resource
Room
General Education
Classroom

Location of Service(s)

to
to

Supplementary Aids and Services

Service(s)

[] Needed

[ ] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

As
needed
As
needed

12-2-14 to 12-1-15

Across All Settings

12-2-14 to 12-1-15

12-2-14 to 12-1-15

General Education
Classroom/Resource
Room
Across All Settings

Social Stories as needed

Daily

Extra time on assignments

Daily

Verbal prompting

Daily

Problems read aloud in math

Daily

As
needed
30

Manipulatives for math

Daily

30

12-2-14 to 12-1-15

All directions read aloud

Daily

As
needed

12-2-14 to 12-1-15

Program Modifications
Service(s)

12-2-14 to 12-1-15

[ ] Needed

[] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

General Education
Classroom/Resource
Room
General Education
Classroom/Resource
Room
Across All Settings

Location of Service(s)

to
to

Accommodations Needed for

Assessments
Service(s)
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[] Needed

Anticipated
Frequency of
Service(s)

[ ] Not Needed
Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)
ALSDE Approved Feb. 2012

The directions will be read aloud to the

student.

Daily

NA

12-2-14 to 12-1-15

Additional time will be given

Daily

12-2-14 to 12-1-15

Assistive Technology
Service(s)

[ ] Needed

[] Not Needed

Anticipated
Frequency of
Service(s)

Amount
of time

Beginning/Ending
Duration Dates

General Education
Classroom/Resource
Room
General Education
Classroom/Resource
Room

Location of Service(s)

to
to

Support for Personnel

Service(s)

[ ] Needed
Anticipated
Frequency of
Service(s)

[] Not Needed
Amount
of time

Beginning/Ending
Duration Dates

Location of Service(s)

to
to

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ALSDE Approved Feb. 2012

INDIVIDUALIZED EDUCATION PROGRAM

STUDENTS NAME:

CARRIE SMITH
TRANSFER OF RIGHTS

(Beginning not later than the IEP that will be in effect when the student reaches 18 years of age.)
Date student was informed that the rights under the IDEA will transfer to him/her at the age of 19
The IEP Team has considered the need for extended school year services.

[] Yes

[ ] No

LEAST RESTRICTIVE ENVIRONMENT

Does this student attend the school (or for a preschool-age student, participate in the environment) he/she would attend if
nondisabled?
[] Yes
[ ] No
If no, explain:
Does this student receive all special education services with nondisabled peers? [ ] Yes [] No
If no, explain (explanation may not be solely because of needed modifications in the general curriculum):
Carrie needs individual or small group reading instruction to affectively address IEP goals.

Least Restricted Environment:

[] 6-21 YEARS OF AGE

[ ] 3-5 YEARS OF AGE

01-80% of the day inside the regular education environment

COPY OF IEP

COPY OF SPECIAL EDUCATION RIGHTS

Was a copy of the IEP given to parent/student (age 19) at

the IEP Team meeting?
[ ] Yes
[ ] No

Was a copy of the Special Education Rights given to

parent/student (age 19) at the IEP Team meeting?
[] Yes
[ ] No

If no, date sent:

If no, date sent:

Date copy of amended IEP provided/sent to parent/student (age 19)

12-2-14

THE FOLLOWING PEOPLE ATTENDED AND PARTICIPATED IN THE MEETING TO DEVELOP THIS IEP.

Position

Signature

Date

Parent

Teri Smith
David Smith
Alan Brown
Lucy Cooper
Patricia Parker
Amanda Hilsmier

12-2-14

Peter Parker
Amy Hoaglund

12-2-14

Parent
General Education Teacher
Special Education Teacher
LEA Representative
Someone Who Can Interpret The Instructional
Implications Of The Evaluation Results
Student
Career/Technical Education Representative
Other Agency Representative

12-2-14
12-2-14
12-2-14
12-2-14
12-2-14

12-2-14

INFORMATION FROM PEOPLE NOT IN ATTENDANCE

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Position

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Name

Date

ALSDE Approved Feb. 2012