Student:

Joshua Smith- P-3/MI Program

DOB: 2010
Age: 4
Grade: PreK

Guardian Information:
Mother
Relation:
Name: Mrs. Smith
Business
Phone:
Home
Phone:
Mobile
Phone:
Home
Address:

STN: N/A
Gender: M

Relation:
Name:
Business
Phone:
Home
Phone:
Mobile
Phone:
Home
Address:

Purposes of the Case Conference:

Initial Evaluation
Reevaluation Review
Annual IEP Review
Revise IEP
Transition IEP
Move-in
First Steps Intake
Exit from Secondary Education
Revoke Consent for Special
Education

Consider Placement in an Alternative

Program
Consider Placement at a State School
Consider Placement in a Private Facility
Consider Service Plan
Consider PA placement with a different PA
of Service
Manifestation Determination
Interim Alternative Educational Placement
Out-of-school placement 60-day Review

Additional Information regarding the purpose(s) of this Case Conference:

Annual Case Conference

Case Conference Committee Meeting Scheduled:

Dat
e:

11-21-14

Tim
e:

9 a.m.

Plac
e:

Principal's Office

Evaluation Information and Student Data:

Page 1 of 15

Strengths of the student:

Joshua is cooperative and affectionate. He seeks help when necessary, knows what he
wants to do and gets along with other peers well.
Response to instructional Strategies and research based interventions:
Joshua currently receives services through an ABA program that was referred
to the mother by a psychologist. Joshua was age two at this time. The program
required 42 hours a week. (Six hours per day at seven day per week) The
program was one on one and focused on increasing Joshua's attention memory.
He also receives speech therapy three times per week with occupational
therapy two times per week.
Progress Monitoring Data:
Joshua has made much progress through the ABA program offered through his home.
Present Level of Academic and Functional Performance:
Based on current evaluation data, Joshua demonstrates delays in verbal
expression with very few words expressed during observation. He also
demonstrates low muscle tone. In addition, Joshua has diffuculty with fine
motor skills which involved certain tasks. Josuhua demonstrates difficulties
with following directions, and staying on task.
Reevaluation:
The public agency must consider reevaluation for each student receiving special
education and related services at least once every three (3) years unless the parent and
the public agency agree that it is unnecessary. In addition, the public agency must
consider reevaluation if the public agency determines at any time during the three (3)
year cycle that additional information is needed to address the special education or
related services needs of the student, or if the students parent or teacher requests an
evaluation.
Initial Eligibility Date: 11-21-14
Anniversary Reevaluation Date: 11-21-2017
There is a need for reevaluation information to:
Reestablish eligibility for special education and related services
Determine that the student is eligible for special education under a different or
additional eligibility category
Inform the students case conference committee of the students special education
and related service needs
There is no need for reevaluation information
Concerns of Parent:

Page 2 of 15

Mrs. Smith described that Joshua was diagnosed with mild Autism at the age of two. He
earlier suffered a viral infection which placed him in the hospital for an extended
time.This occurred at eighteen months old. During this time, he displayed characteristics
of autism according to his mother. Before this occurred, Mrs. Smith voiced her concern
that he would bable and used a few words. According to Mrs. Smith, with the assistance
of the ABA home program and related services, he has made great gains.

Eligibility:
Is this student Eligible for Special Education Services?
Yes

No

Eligibility Areas: (Please indicate one Primary disability and all Secondary
disabilities)
Autism Spectrum Disorder
Blind or Low Vision
Cognitive Disability
Deaf or Hard of Hearing
Deaf-Blind
Developmental Delay
Emotional Disability

Language Impairment
Speech Impairment
Multiple Disabilities
Other Health Impaired
Orthopedic Impairment
Specific Learning Disability
Traumatic Brain Injury

Page 3 of 15

Reasons for Eligibility Decisions:

Joshua was examined with having behaviors/characteristics of Autism which will effect
his performance in the classroom setting. Joshua has delays in verbal expression and
fine motor skills.
Special Considerations:
Does the student have needs related to Limited English Proficiency?
Yes

No

If yes, please describe the students needs:

Are there considerations regarding the student's language and communication needs,
opportunities for direct communications with peers and professional personnel in the
student's language and communication mode, academic level, and full range of needs,
including opportunities for direct instruction in the student's language and
communication mode? (Only Deaf or Hard of Hearing or Deaf-Blind eligibility areas
require this response.)
Yes

No

If yes, please describe the students language and communication needs:

Are there considerations regarding the instruction in Braille and the use of Braille? (Only
Blind or Deaf-Blind Eligibility Areas require this response.)
Yes

No

If yes, please describe the considerations regarding Braille:

Does the Behavior of this student impede his or her progress or that of others?
Yes

No

If yes, please complete the following prompts:

Behaviors of Concern: (Please describe the patterns of concerning behaviors.)

Functions of the Behavior: (Please include evidence of factors affecting behavior.)

Positive Strategies/Instructional Experiences: (Please articulate the plan to provide

behavioral support/intervention.)

Outcomes:
Summary of findings from Age Appropriate Transition Assessment:
This student does not have a transition plan.
Post Secondary Goals:
Regarding Employment after high school, I will

Regarding Education and Training after high school, I will

Regarding Independent Living Skills after high school, I will

Anticipated date of Graduation:

This student will pursue a Certificate of Completion.
Therefore, the student's goals and objectives are generally prerequisites to gradelevel academics or are highly individualized extensions to the standards.
The student will pursue a High School Diploma.

Therefore, the student's academic goals are the same as non-disabled peers at
grade-level or generally aligned to grade-level curriculum.

Participation in Testing Programs:

Student does not attend an accredited school and will not participate in statewide
assessments.
Student will not yet be in grade 3.
Student will be in grades 3-8 at an accredited school.
High School Diploma is the selected outcome for this student.
Math (grade 3-8)

Language Arts (grade 38)

Science (grade 4 & 6)

Social Studies (grade 5 &

7)

ISTEP+ without
accommodations
ISTEP+ with
accommodations
Modified Assessment

ISTEP+ without
accommodations
ISTEP+ with
accommodations
Modified Assessment

ISTEP+ without
accommodations
ISTEP+ with
accommodations
Modified Assessment

ISTEP+ without
accommodations
ISTEP+ with
accommodations
Modified Assessment

Certificate of Completion is the selected outcome of this student.

Math (Grade 3-8)
ISTAR for academic
competence
ISTAR for independent
functioning

Language Arts (grade 38)

ISTAR for academic
competence
ISTAR for independent
functioning

Science (grade 4 & 6)

ISTAR for academic
competence
ISTAR for independent
functioning

Social Studies (grade 5 &

7)
ISTAR for academic
competence
ISTAR for independent
functioning

Student will be in high school.

Student will not be in 10th grade. Therefore, State Assessment is not required.
High School Diploma is the selected outcome for this student.
Algebra (HS)
End of Course Assessment
without accommodations
End of Course Assessment with
accommodations
Student has passed this
assessment.
Tested course is not yet in
course of study.
GQE retake

Language Arts (HS)

End of Course Assessment
without accommodations
End of Course Assessment with
accommodations
Student has passed this
assessment.
Tested course is not yet in
course of study.
GQE retake

Biology (HS)
End of Course Assessment
without accommodations
End of Course Assessment with
accommodations
Student has passed this
assessment.
Tested course is not yet in course
of study.
GQE retake

Certificate of Completion is the selected outcome for this student.

Algebra (HS)
ISTAR for academic
competence
ISTAR for independent
functioning

Language Arts (HS)

Biology (HS)

ISTAR for academic competence

ISTAR for academic competence

ISTAR for independent

functioning

ISTAR for independent

functioning

Please explain why the chosen assessments are appropriate for this student:
N/A

Please explain the plan for the students participation in district-wide, national or
international assessments:

Annual Goals:
Title: Language
Needs addressed through this annual goal:
Joshua needs to participate in language therapy to increase his overall expressive
language skills to effectively communicate with others in his classroom and home like
settings.

Annual Goal Statement:

By November 2015, Joshua will properly use and demonstrate the knowledge of his
vocabulary by 50 new words. When asking Joshua to make a choice, he will clearly
answer with the choice he would like. Joshua will answer with a statement 4/5 times
when asking his choice.
If student is of transition age, which post-secondary goal(s) does this annual goal
support?
Employment
required)

Education and Training

Independent Living (if

Method/Instrumentation for Measuring Progress:

Classroom Assessment created by teacher, Teacher and Parent Input
Progress Monitoring Design:
Descriptive Documentation
Indicators

Single Point

Single Rubric

Collection of

Standards aligned to this Annual Goal:

ELA.4.115 Ask and answer simple questions.
ELA.4.122 Repeat simple sentences as presented.
ELA.4.123 Use six word vocalizations, signs, symbols, or gestures to communicate.
Progress Monitoring Parameters: (Please include Objectives, Benchmarks, Initial Dates
and Values, Metrics, Frequency of Collection, and Rubric information required by the
Progress Monitoring Design selected.)
Documentation of progress will be done every two weeks in the classroom
Annual Goals:
Title: Math
Needs addressed through this annual goal:
Joshua needs to increase his math skills to be able to meet age appropraite standards.
Annual Goal Statement:
By November 2015, Joshua will recognize numbers by getting at least 75% of the
numbers correct. He demonstrate his recognition of numbers 0 to 9 correctly 6 to 8
times.
Joshua will be able to count to atleast 10 by November 2015.
If student is of transition age, which post-secondary goal(s) does this annual goal
support?
Employment

Education and Training

Method/Instrumentation for Measuring Progress:

Independent Living (if required)

Class Assessment for Curriculum assessment, Teacher

Progress Monitoring Design:
Descriptive Documentation
Indicators

Single Point

Single Rubric

Collection of

Standards aligned to this Annual Goal:

M.1.35 Rote count to ten.
M.1.38 Identify the next number in a series of numbers up to ten.

Progress Monitoring Parameters: (Please include Objectives, Benchmarks, Initial Dates

and Values, Metrics, Frequency of Collection, and Rubric information required by the
Progress Monitoring Design selected.)
Rubric ; one per grading period
Annual Goals:
Title: Social/Behavior
Needs addressed through this annual goal:
Joshua needs to continue to improve his social skills to be able to express his wants and
needs, initiate interactions with others, and actively participate in structured activities.
Annual Goal Statement:
Joshua will initiate interactions with others in 4/5 times of being observed. He will also
demonstrate the wants and needs of himself in 75% of the day in which he is serviced.
If student is of transition age, which post-secondary goal(s) does this annual goal
support?
Employment

Education and Training

Independent Living (if required)

Method/Instrumentation for Measuring Progress:

Classroom Observation/Anecdotal Notes, Teacher and Parent Input
Progress Monitoring Design:
Descriptive Documentation
Indicators

Single Point

Standards aligned to this Annual Goal:

SE.1.44 Show interest in other children.
SE.2.14 Indicate a need.

Single Rubric

Collection of

Progress Monitoring Parameters: (Please include Objectives, Benchmarks, Initial Dates

and Values, Metrics, Frequency of Collection, and Rubric information required by the
Progress Monitoring Design selected.)
Chart; weekly
Annual Goals:
Title: Reading
Needs addressed through this annual goal:
Joshua needs to increase his awareness of letter recognition to meet age appropriate
standards
Annual Goal Statement:
Joshua will demonstrate his awareness of correctly identify 13/26 lowercase and
uppercase letters by November 2015.
Joshua will be able to demonstrate his awareness of the letters in his name 95% of the
time.

If student is of transition age, which post-secondary goal(s) does this annual goal
support?
Employment

Education and Training

Independent Living (if required)

Method/Instrumentation for Measuring Progress:

Check List/Observational
Progress Monitoring Design:
Descriptive Documentation
Indicators

Single Point

Single Rubric

Collection of

Standards aligned to this Annual Goal:

ELA.2.32 Name 13 uppercase letters.
ELA.2.35 Recognize own name in isolated print.

Progress Monitoring Parameters: (Please include Objectives, Benchmarks, Initial Dates

and Values, Metrics, Frequency of Collection, and Rubric information required by the
Progress Monitoring Design selected.)
Chart; weekly

Accommodations:

Please record all accommodations selected for state assessment purposes and additional
accommodations if appropriate: (All accommodations selected for assessment purposes
must be provided on a regular basis.)
Joshua will need directions repeated and reminder to stay on task.
He will need to walk in front of the line; close to teacher
Joshua will need a visual schedule
Not required to work on assignments for more than 25 minutes without taking a break.
Be given extra time to complete assignments/tests up to at least 1/2 the time
Able to dictate the answers orally
May need a small toy/object for comfort
May require sensory breaks as needed

Services and other Provisions:

Transition Services (if necessary)
Description

By Whom

To Support

Completion Date

(Transition IEP only) Please document the written information presented to the parent
and student regarding available adult services provided through state and local agencies
and other organizations to facilitate student movement from the public agency to adult
life:

Special Education Services

Description

Initiation
(date)

Frequenc
y

Direct Services

11-21-14

5x per

Length Duratio Location

(time) n
(date)
150
11-21- General

To Support
Support of

week

minut
es

15

Occupational
Therapy

11-21-14

2x per
week

30
minut
es

11-2115

Direct Services

11-21-14

3x per
week

20
minut
es

11-2115

Speech Therapy

11-21-14

3x per
week

30
minut
es

11-2115

Educati
on
Setting
General
Educati
on
Setting
General
Educati
on
Setting
General
Educati
on
Setting

general
curriculum
Support of
fine motor
skills and low
muscle tone
Behavior/Soci
al Skills
Support of
language
development

If the purpose of the IEP is First Steps Intake, please record the Service
Initiation Date: No related services required at this time.
Related Services
Description

Initiation
(date)

Frequenc
y

Lengt
h
(time)

Duratio
n
(date)

Locatio
n

To Support

Transportation:
If the students transit time or needs are different from that of non-disabled peers, please
describe and justify these needs. Please, record as a related service if additional
provisions are necessary.
n/a

Health Plan:
Please describe any medical conditions requiring school health or nurse services. The
description should include frequency, and the provider of this service. Be sure to record
any related services appropriately.

n/a
Does this student require an Emergency Evacuation Plan?
Yes

No

Accessible Materials:
If this student requires any instructional materials provided in an accessible format,
please describe the environments, tasks, tools, and services related to their provision:
n/a
Assistive Technology:
Please describe this students assistive technology needs:
n/a
Extended School Year:
Please record extended school year services required in order to provide a free and
appropriate education for this student: (Record ESY services under special education and
related services if needed.)
n/a
Technical Assistance:
Please document the types of supports necessary to provide public agency personnel
with the knowledge and skills necessary to implement the students individualized
education program and the general intent of the supports:
n/a
Program Modifications:
Please describe any program modifications needed to enable the student to advance
appropriately toward attaining the annual goals, be involved in and make progress in the
general education curriculum, participate in extracurricular and other nonacademic
activities or be educated or participate with other students with disabilities and nondisabled students.
n/a
Progress Reporting:
Please describe when periodic reports on the progress the student is making toward
meeting the annual goals will be provided:
Joshua will have monthly progress monitor reports sent home in his folder.
Least Restrictive Environment and Program:

School of Legal Settlement: Winter Springs Elementary School

School of Service: Winter Springs Elementary School
Additional information regarding school of service:

(For Transition IEPs) Course of Study focused on improving academic and functional
achievement of the student in order to support the attainment of post-secondary goals:

LRE Placement Category based Federal Program Types:

School
50
51
52
53
54
55
56
57

Age (6-21) - Student will be Age 6+ as of next December 1st

Regular class 80% or more (In a regular classroom for 80% or more of the day)
Resource Room (In a regular class for 40% to 79% of the day)
Separate Class (In a regular class for less than 40% of the day)
Separate day school facility
Residential Facility
Correctional Facility
Parentally placed in private school
Homebound/hospital

Preschool Age (3-5) - Student will not be 6+ as of the next December 1st
30 Regular Early Childhood class 80% of the time
31 Regular Early Childhood 40-79% of the time
32 Regular Early Childhood 40% or less of the time
33 Separate Class
34 Separate School
35 Residential Facility
36 Service Provider Location
37 Home
Additional Descriptors:
none
Any potentially harmful effects of the services on the student or on the quality of
services needed:
There are none.
Reasons for placement determination including reasons for rejecting other
options:

The preschool room will be the determination of placement due to having social
interaction with peers and a general education curriculum. He will have chances to
increase his vocabulary with the curriculum which is provided in the general education
classroom. Joshua will receive therapy sessions in the classroom for both occupational
and speech.
Considerations:
Please consider the student's participation in general education and record any
supplementary aids and services that are determined by the case conference committee
to be appropriate and necessary in order to afford the student equal opportunity for
participation with non-disabled students.
Student will be able to participate in all educational programs and activities
available to non-disabled students.
Yes

No

(If No, please state the exceptions and describe the reasoning for these exceptions:

Student will be able to participate in all non-educational and extracurricular

activities available to non-disabled students.
Yes

No

(If No, please state the exceptions and describe the reasoning for these exceptions:

Student will participate in the general physical education program available to

non-disabled students.
Yes

No

(If No, please state the exceptions and describe the reasoning for these exceptions:

Student will be educated in the school he or she would attend if not disabled.
Yes

No

(If No, please state the exceptions and describe the reasoning for these exceptions:

The length of the instructional day will be the same as the instructional day for
non-disabled peers.
Yes

No

(If No, please state the exceptions and describe the reasoning for these exceptions:

Participants:
The following individuals participated in the case conference committee meeting. Those
individuals identified as Teacher of Record, General Education Teacher, Public Agency
Rep and Instructional Strategist attended the entire meeting unless parental excusal was
obtained before the meeting.
Position
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Name
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Written Notes and Other Relevant Factors:

Additional Title
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