INDIVIDUALIZED EDUCATION PROGRAM (IEP) Students Name: Applewood Sandel

INDIVIDUALIZED EDUCATION PROGRAM (IEP)

Students Name: IEP Team Meeting Date (mm/dd/yy): Anticipated Duration of Services and Programs: Date of Birth: Age: Grade: 14 8th 2014 Disney School District Beaver Phone (Home): Phone (Work): 717-783-3369 N/A 10/15/94 Applewood Sandel 5/10/09 5/10/09 5/09/10

School Age

IEP Implementation Date (Projected Date when Services and Programs Will Begin):

Anticipated Year of Graduation: Local Education Agency (LEA): County of Residence: Frank and Sue Sandel 232 Ship Tomy Loo Disney, PA 12345 Other Information: N/A

Name and Address of Parent/Guardian/Surrogate:

The LEA and parent have agreed to make the following changes to the IEP without convening an IEP meeting, as documented by:

Date of Revision(s)

Participants/Roles

IEP Section(s) Amended

Page 1 of 27

July 2008 Revisions

IEP TEAM/SIGNATURES The Individualized Education Program team makes the decisions about the students program and placement. The students parent(s), the students special education teacher, and a representative from the Local Education Agency are required members of this team. Signature on this IEP documents attendance, not agreement. Role Parent/Guardian/Surrogate Parent/Guardian/Surrogate Student* Regular Education Teacher** Special Education Teacher Local Ed Agency Rep Career/Tech Ed Rep*** Community Agency Rep Teacher of the Gifted**** Printed Name Mr. Frank Sandel Mrs. Sue Sandel Applewood Sandel Mr. Sand Mrs. Ocean Miss Palmtree N/A N/A N/A Signature

* The IEP team must invite the student if transition services are being planned or if the parents choose to have the student participate. ** If the student is, or may be, participating in the regular education environment *** As determined by the LEA as needed for transition services and other community services **** A teacher of the gifted is required when writing an IEP for a student with a disability who also is gifted. One individual listed above must be able to interpret the instructional implications of any evaluation results. Written input received from the following members: N/A Transfer of Rights at Age of Majority For purposes of education, the age of majority is reached in Pennsylvania when the individual reaches 21 years of age. Likewise, for purposes of the Individuals with Disabilities Education Act, the age of majority is reached for students with disabilities when they reach 21 years of age.

PROCEDURAL SAFEGUARDS NOTICE

I have received a copy of the Procedural Safeguards Notice during this school year. The Procedural Safeguards Notice provides information about my rights, including the process for disagreeing with the IEP. The school has informed me whom I may contact if I need more information. Signature of Parent/Guardian/Surrogate:

I. SPECIAL CONSIDERATIONS THE IEP TEAM MUST CONSIDER BEFORE DEVELOPING THE IEP. ANY FACTORS CHECKED AS YES MUST BE ADDRESSED IN THE IEP. Is the student blind or visually impaired? Yes The IEP must include a description of the instruction in Braille and the use of Braille unless the IEP team determines, after an evaluation of the students reading and writing skills, needs, and appropriate reading and writing media (including an evaluation of the students future needs for instruction in Braille or the use of Braille), that instruction in Braille or the use of Braille is not appropriate for the student. X No Is the student deaf or hard of hearing? Yes The IEP must include a communication plan to address the following: language and communication needs; opportunities for direct communications with peers and professional personnel in the students language and communication mode; academic level; full range of needs, including opportunities for direct instruction in the students language and communication mode; and assistive technology devices and services. Indicate in which section of the IEP these considerations are addressed. The Communication Plan must be completed and is available at www.pattan.net X No

Does the student have communication needs? Yes Student needs must be addressed in the IEP (i.e., present levels, specially designed instruction (SDI), annual goals, etc.) X No

Does the student need assistive technology devices and/or services? Yes Student needs must be addressed in the IEP (i.e., present levels, specially designed instruction, annual goals, etc.) X No

Does the student have limited English proficiency? Yes The IEP team must address the students language needs and how those needs relate to the IEP. X No

Does the student exhibit behaviors that impede his/her learning or that of others? Yes The IEP team must develop a Positive Behavior Support Plan that is based on a functional assessment of behavior and that utilizes positive behavior techniques. Results of the functional assessment of behavior may be listed in the Present Levels section of the IEP with a clear measurable plan to address the behavior in the Goals and Specially Designed Instruction sections of the IEP or in the Positive Behavior Support Plan if this is a separate document that is attached to the IEP. A Positive Behavior Support Plan and a Functional Behavioral Assessment form are available at www.pattan.net X No

Other (specify):

N/A II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE Include the following information related to the student: Present levels of academic achievement (e.g., when and why placed in special education, where the child has received instruction, types of supports, most recent evaluation of the student results and analysis of formative assessments-PSSA, PASA, 4-Sight, Terra Nova, Dibels, G-Made, KTEA, curriculum-based assessments, transition assessments, progress toward current goals, classroom observations, grades, in put from regular education teachers, IQ)

When and why placed in special education: Applewood was initially evaluated at the end of 2nd grade (May 2003) and was determined to have a primary disability of Specific Learning Disability in reading and math. Where the child has received instruction: This year, in eighth grade, Applewood remains in learning support classes for reading and math. He is in regular education classes for English, science, and history with support Types of supports: Applewood currently receives specially designed instruction and support in his regular education classes to ensure success. He is receiving services in learning support classes for both reading and math. He requires extra assistance in homeroom for his regular education class work. He needs to utilize the resource room for regular education classes, to have tests read orally and explained if requested. Applewood is also enrolled in regular education classes with support in English, science, and history. Most recent evaluation of the student results and analysis of formative assessments-PSSA, PASA, 4-Sight, Terra Nova, Dibels, G-Made, KTEA: PSSA

State Assessments
PSSA 2005-2006 PSSA 2006-2007 PSSA 2007-2008

Grad Math e
5 6 7 Below Basic Below Basic Below Basic

Reading
Below Basic Below Basic Below Basic

Writing
Basic

Anchor R.A R.B M.A M.B M.C M.D M.E

PSSA 2007-2008 Description Comprehension and Reading Skills Interpretation And Analysis of Fiction and Nonfiction Texts Numbers and Number Operations Measurement Geometry Algebraic Concepts Data Analysis and Probability

Possible Score 26.00 26.00 16.00 10.00 12.00 15.00 13.00

Student Score 10 7 2 4 5 4 2

Applewoods PSSA results from 5th through 7th grade yielded below basic scores in both math and reading. In 2007-08, his strongest areas were Comprehension and Reading Skills, Measurement, and Geometry. The areas that he performed the poorest on were Interpreting and Analyzing Fiction and Nonfiction Texts, Data Analysis & Probability, and Numbers and Number Operations. PASA- Applewood participated in the PSSA.

4-Sight Local Assessments 4Sight Benchmark Assessment 2007-2008 4Sight Benchmark Assessment 2007-2008 4Sight Benchmark Assessment 2007-2008 4Sight Benchmark Assessment 2008-2009 4Sight Benchmark Assessment 2008-2009 4Sight Benchmark Assessment 2008-2009 Read Pct Score Math Pct Score Ger. 7 7 7 8 8 Testing Pd Baseline 2 4 Baseline 2 Gains 0.0 12.1 Math Below Basic (1063) Below Basic (1087) Below Basic (941) Below Basic (1069) Basic (1172) Read Below Basic (1052) Below Basic (1013) Proficient (1281) Below Basic (949) Below Basic (976)

4Sight Benchmark Assessment 2008-2009 Comp Reading Pct Score Interp Anal Fict/NonFict Pct Score Read Independently Pct Score Read Critically Pct Score Read Analyze Interpret Pct Score Read Open-Ended Pct Score Numbers and Operations Pct Score Measurement Pct Score Geometry Pct Score Algebraic Concepts Pct Score

Gains 7.7 -7.1 11.1 -12.5 0.0 0.0 0.0 25.0 25.0 28.6

Data Analysis and Probability Pct Score Math Open-Ended Pct Score

20.0 -12.5

Applewood scored Below Basic in math and Proficient in reading on the Pennsylvania 4Sight Benchmark Assessments on the final assessment in 2007-08. He scored Basic in math and Below Basic in reading on the second testing period of 2008-09. These tests are administered three times annually and measure progress from initial administration to the end of the year. Gains were made in 2008-09 in Reading Comprehension, Reading Independently, Measurement, Geometry, Algebraic Concepts, and Data Analysis & Probability. Losses were in Interpreting/ Analyzing Fiction/ Nonfiction, Reading Critically, and Open-Ended Math. Applewoods achievement remained the same in Reading Analysis, Reading Open Ended, and Numbers and Operations. Overall, he gained 12% in math and remained the same in reading for 2008-09. Terra Nova- assessment was not given. Dibels- student is not assessed using Dibels testing. G-Made- Applewood is currently in 8th grade; G-Made assessments are used in Kindergarten.

KTEA The results of the KTEA Comprehensive are included in the following chart:

KTEA-II Brief was given on 5/ 6/ 08, yielding the following standard scores and descriptive categories: Standard Scores Descriptive Category Reading 91 Average Math 69 Lower Extreme Writing 86 Average

Composite 82

Below Average

The Kaufman Test of Educational Achievement, Second Edition Comprehensive (KTEA-II) is an individually administered measure of academic achievement. The test assesses the achievement domains of reading, math, and written expression. Applewood was administered this assessment on March 28, 2009. He scored in the below average range for Math Concepts & Applications and average range for Math Computation. He scored in the Average range for Letter & Word Recognition and Below Average for Reading Comprehension. He scored in the average range for Spelling, but Below Average for Written Expression. He scored in the Average range for Decoding, Nonsense Decoding, and Decoding Fluency. He scored in the Below Average range for Word Recognition Fluency. Overall scores were in the Average range for Written Expression and Mathematics. Overall Reading score was Below Average. When comparing the KTEA Comprehensive of March 2009 with the KTEA Brief of May 2008, Applewoods reading standard score decreased by ten points. His math standard score increased by sixteen points, and his written expression score decreased by one point. Strengths: Written Expression: Capitalization Math: Division, Algebra Needs: Written Expression: Task, Structure, Word Form, Punctuation Math: Subtraction, Multiplication, Decimals and Percents Reading: Literal and Inferential Comprehension Curriculum-based assessments: Math: Quizzes: 75% Test: 72% Reading: Tests: 95, 75% English: Spelling: 68, 50% Subject/ Predicate: 45% Science: Tests: 76, 70% History: Vocabulary quizzes: 100, 83, 81, 75% Section quizzes: 80, 80% Vocabulary: 50% Dialogue: 45%

Transition assessments: Applewood completed a transition survey on 4/15/09. He reported that he enjoys swimming, fishing/ hunting, watching TV, and playing on the computer. He also enjoys going to the movies, mall, and to friends homes. At home, he is responsible for cleaning his room and caring for his pets. He would love to be an animal trainer, because he loves working with pets. His goals include moving into a regular education reading class and getting good grades. He would like to attend a two-or four-year college and live on campus. He reports that he is able to shop for clothes and food and cook meals. He would like to improve his reading and math abilities. Parent input form was sent home with student and mailed but never returned as noted above.

Input was received for his last IEP meeting, so that information is included. Applewoods parents would like him to attend a two-year college or vocational school, seek immediate employment, or attend an adult education/ training program after high school. They feel he may need an adult training program, supportive employment, or competitive employment. They would like to see him develop the following skills: social, self-advocacy, emotional/ behavior management, safety, money management, problem solving, and daily living. At home, he is responsible for cleaning his room, helping with the pets, and taking care of his grandfather. He has volunteered as a scout for food, with clothing drives, and on clean-up days. He has worked helping his grandfather clean, with fundraisers, car washes, and concession stands. They expect him to live at home or on a college campus while completing post-secondary studies. After graduation, he may have his own car, use family transportation, or use public transportation. The family is not receiving services from any outside agencies. Classroom observations: Applewood is said to be on time for class and prepared with all appropriate materials. He has a good attendance rate. Applewood participates in class by raising his hand. He speaks appropriately to peers and teachers. He remains in his seat and follows all directions. He remains on task for the entire period. He needs repeated instruction in a small group with extra guided and independent practice in order to be successful. He completes his homework on a regular basis. He follows all class and school-wide rules. He is respectful to both teachers and peers. He works well independently or with a partner. On occasion, he is chatty, but easily redirected. He asks for extra help when needed during and outside of class. His work is on time, neat, and complete. Grades: Grades for 2008-2009 (8th grade): Course Name Chorus 8 Family/Consumer Science 8 Technology Education 8 English 8 Science 8 History 8 Phys Ed Boys 8 Health 8 Math LS 8 Reading LS 8 Grades for 2007-2008 (7th grade): School Year 2008 Course Name Chorus 7 Q1 Gr Q2 Gr Q3 Gr Q4 Gr A A A A Final Grd A B C A C C B A C C B B C A B Q1 Gr A Q2 Gr A B

2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008

Art 7 Computer 7 Family/Consumer Science 7 Technology Education 7 Science 7 History 7 Phys Ed Boys 7 Health 7 English LS 7 Math LS 7 Reading LS 7

A A A B B B A B B B B B A B A B B B B B B C C B B A B A A

A A A B B B A B B B

In put from regular education teachers: Teacher Reports: Math Applewood currently has a B in learning support math class. He needs repeated instruction in a small group with extra guided and independent practice in order to be successful. He completes his homework on a regular basis. He follows all class and school-wide rules. He is respectful to both teachers and peers. He works well independently or with a partner. On occasion, he is chatty, but easily redirected. He asks for extra help when needed during and outside of class. His work is on time, neat, and complete. He often needs re-taught and retested when learning new skills and concepts in the curriculum. He has struggled with learning fractional operations without a calculator. He is able to solve one-step equations, proportions, and fractions with a calculator. He relies on a calculator most of the time. His averages for the year are: Quiz 86%, Test 76%, and Homework 87%.

Science Applewood currently has a C. He completes his homework. He performs the following skills at grade level: comprehends text, defines and uses vocabulary, uses text to locate information and is able to use it correctly, completes study guides and is able to use them correctly, reads and completes tests for this course, uses appropriate materials, and participates in group activities. He works fairly hard, is quiet and studious, and works well with others in class. He is cooperative and attentive. His work is well-prepared, satisfactory, on time, neat, and complete. He follows directions and uses his time well. He asks for extra help at times. History

Applewood currently has a C. He completes his homework. He performs the following skills at grade level: comprehends text, uses text to locate information and is able to use it correctly, completes study guides and is able to use them correctly, reads and completes tests for this course, uses appropriate written skills for history, uses appropriate materials, and participates in group activities (prefers them). Applewood is cooperative, attentive, and prepared. His work is typically well thought out and completed, neat and on time. Applewood is quiet in class, but is willing to work with other students and contributes to discussions and group efforts well. He does ask questions of the teachers when he needs assistance and is not afraid to answer when he is sure of himself and his knowledge of the topic. He is one of the hardest working students and is a pleasure to work with. Applewood is capable of: following directions, using time well, and responding positively to adults/peers. He works well with others, but is also capable of doing an assignment well on his own (independently). Specially designed instruction that Applewood utilizes for this class include: Repeated information, assistance as requested, agenda, organizational folders, testing in small setting to stay focused and feel comfortable asking questions, asks for test items read to him and clarified, and modified assignments/tests. Applewood needs to work at improving: Using technology to complete assignments and written language skills. He needs to continue to improve his mechanics and grammar with his writing. He needs to work on creating appropriate open responses with organization, introduction sentences, elaboration, and conclusive paragraphs. Reading: Applewood is currently in learning support class for reading. His current grade is a B. Applewood can read 121 words correct per minute at the 7th grade level with 96.8% accuracy. He can identify plot, setting, characters, point of view and mood. He can paraphrase what has been read, sequence, use most vocabulary appropriately and predict outcomes. Applewood still struggles with comprehension skills such as inference, drawing conclusions and identifying main ideas. Applewood is cooperative, attentive and well prepared for class. He will ask questions if he does not understand the assignment. His work is neat, complete and turned-in in a timely manner. He follows directions and uses his time well in class. Applewood works hard and wants to succeed. He has expressed that he wants to get out of learning support classes and has worked toward that goal since the beginning of the school year. English: Applewoods grade fluctuates between a B and a D. He has returned to regular education after at least four years in learning support, so he is being challenged. He is able to identify types of sentences. He needs assistance with prewriting, proofreading, and revising. He often writes fragments instead of sentences. He is unable to identify subject/ predicate. He has difficulty identifying and using grammar. He uses ending punctuation well, but cannot punctuate within a sentence. Spelling skills are also below grade level. He does not seem to understand a lot of the class content. His work is on time and neat, but he does not always follow the directions. He works hard, but still struggles. He needs the specially designed instruction, including retests and review before tests to be successful. Due to the large amount of reading within the English class in ninth grade, the teacher is unsure of his ability to be successful in regular education. IQ: WISC III IQ Scores Verbal Performance Full Scale Index/ IQ 83 84 82 Classification Low Average Low Average Low Average

Applewood was initially evaluated at the end of 2nd grade (May 2003) and was determined to have a primary disability of Specific Learning Disability in reading and math. His IQ was evaluated using the WISC-III and yielded the following scores:

Results indicated Applewood was functioning within the low average range of cognitive potential. Low average verbal skills and nonverbal abilities are noted. Stronger nonverbal skills were found in sequential reasoning. Specific skills vary from the mildly impaired range to the average range. Low average skills were revealed in mathematics and written language. Borderline mildly impaired reading achievement was reported.

Present levels of functional performance (e.g., results from a functional behavioral assessment, results of ecological assessments, progress toward current goals, attendance, discipline, related services, nursing information, ADL information) Results from a functional behavioral assessment: Applewood does not have any emotional or behavioral concerns.

Results of ecological assessments: Attendance:

Year 2008 2009

Applewood does not have any emotional concerns.

Applewood has very good attendance. Excused 9 5 Excused Half Day Half Day Unexcused Tardy Excused Unexcused 1 2 1 3 1 Unknown

Behaviors:

Applewood is respectful to both teachers and peers. He works well independently or with a partner. On occasion, he is chatty, but easily redirected. Alpplewood completes his homework on time and neatly. Applewood is quiet in class, but is willing to work with other students and contributes to discussions and group efforts well. He is one of the hardest working students and is a pleasure to work with. Applewood is capable of: following directions, using time well, and responding positively to adults/peers. He works well with others, but is also capable of doing an assignment well on his own (independently). Related services: Applewood does not currently receive any related services.

Nursing information:

The nurse and parent report there have been no changes in his physical conditions/health. Mrs. Sandel is going to have a mental health evaluation completed because Applewood was previously on medication for ADHD. However Applewood had significant side effects when taking the medication. The parents do not feel he needs medication but want to make sure his mental health needs are being met. Applewood passed his hearing and vision screening but he does wear glasses.

Present levels related to current postsecondary transition goals if the students age is 14 or younger if determined appropriate by the IEP team (e.g., results of formative assessments, curriculum-based assessments, progress toward current goals, parent and student input regarding transition, WACTC input, TEC input) Applewood completed a transition survey on 4/15/09. He reported that he enjoys swimming, fishing/ hunting, watching TV, and playing on the computer. He also enjoys going to the movies, mall, and to friends homes. At home, he is responsible for cleaning his room and caring for his pets. He would love to be an animal trainer, because he loves working with pets. His goals include moving into a regular education reading class and getting good grades. He would like to attend a two-or four-year college and live on campus. He reports that he is able to shop for clothes and food and cook meals. He would like to improve his reading and math abilities. Parent input form was sent home with student and mailed but never returned as noted above. Input was received for his last IEP meeting, so that information is included. Applewoods parents would like him to attend a two-year college or vocational school, seek immediate employment, or attend an adult education/ training program after high school. They feel he may need an adult training program, supportive employment, or competitive employment. They would like to see him develop the following skills: social, self-advocacy, emotional/ behavior management, safety, money management, problem solving, and daily living. At home, he is responsible for cleaning his room, helping with the pets, and taking care of his grandfather. He has volunteered as a scout for food, with clothing drives, and on clean-up days. He has worked helping his grandfather clean, with fundraisers, car washes, and concession stands. They expect him to live at home or on a college campus while completing post-secondary studies. After graduation, he may have his own car, use family transportation, or use public transportation. The family is not receiving services from any outside agencies. Applewoods parents would like him to attend a two-year college or vocational school, seek immediate employment, or attend an adult education/ training program after high school. They feel he may need an adult training program, supportive employment, or competitive employment. They would like to see him develop the following skills: social, self-advocacy, emotional/ behavior management, safety, money management, problem solving, and daily living. Applewood is enrolled in Learning Support of Reading and Math class. Applewood participates in the regular education classes with support for English, history, and science. He participates in learning support for math and reading. Applewood is a very polite and respectful young man. He seems to always try his best in his classes. He always completes his class assignments and most often completes his homework. He has been very successful in regular education science, history, and English with specially designed instruction. Strengths: Written Expression: Capitalization Math: Division, Algebra

Written Expression Reading Comprehension Word Recognition Operation Fluency Order of Operations with a Calculator Dividing Whole Number Multiplying Whole Number

III. TRANSITION SERVICES This is required for students age 14 or younger if determined appropriate by the IEP team. If the student does not attend the IEP meeting, the school must take other steps to ensure that the students preferences and interests are considered. Transition services are a coordinated set of activities for a student with a disability that is designed to be within a results oriented process, that is focused on improving the academic and functional achievement of the student with a disability to facilitate the students movement from school to post school activities, including postsecondary education, vocational education, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation that is based on the individual students needs taking into account the students strengths, preferences, and interests. POST SCHOOL GOALS Based on age appropriate assessment, define and project the appropriate measurable postsecondary goals that address education and training, employment, and as needed, independent living. Under each area, list the services/activities and courses of study that support that goal. Include for each service/activity the location, frequency, projected beginning date, anticipated duration, and person/agency responsible. For students in Career and Technology Centers, CIP Code: N/A

Postsecondary Education and Training Goal: Attend a two-or four-year college and live on campus.

Measurable Annual Goal Yes/No (Document in Section V)

Courses of Study: N/A

Service/Activity N/A Employment Goal: N/A

Location

Frequency

Projected Beginning Date

Anticipated Duration

Person(s)/Agency Responsible

Measurable Annual Goal Yes/No (Document in Section V)

Courses of Study:N/A

Service/Activity N/A Independent Living Goal, if appropriate: N/A

Location

Frequency

Projected Beginning Date

Anticipated Duration

Person(s)/Agency Responsible

Measurable Annual Goal Yes/No (Document in Section V)

Courses of Study:N/A

Service/Activity N/A

Location

Frequency

Projected Beginning Date

Anticipated Duration

Person(s)/Agency Responsible

IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS Pennsylvania System of School Assessment (PSSA) or Pennsylvania Alternate System of Assessment (PASA) Students will be taking the PSSA or the PASA in the grade levels below. Reading (Grades 3-8, and 11) Math (Grades 3-8, and 11) Writing (Grades 5, 8, and 11) Science (Grades 4, 8, and 11) Assessment is not administered at this students grade level; OR Student will participate in the PSSA without accommodations; OR X Student will participate in the PSSA with the following appropriate accommodations (allowable PSSA accommodations may be found in the PSSA Accommodations Guidelines at www.pde.state.pa.us under Pre K-12 and Assessment): OR Applewood will participate in the PSSA with extended time for testing and also having the test read aloud when needed.

Student will participate in the PASA (criteria regarding PASA eligibility may be found in the PSSA Accommodations Guidelines at www.pde.state.pa.us under Pre K-12 and Assessment). Explain why the student cannot participate in the PSSA:

Explain why the PASA is appropriate:

Choose how the students performance on the PASA will be documented. Videotape (will be kept confidential as all other school records) Written narrative (will be kept confidential as all other school records)

Local Assessments Local assessment is not administered at this students grade level; OR Student will participate in local assessments without accommodations; OR X Student will participate in local assessments with the following accommodations; OR Applewood will participate in the local assessments with extended time for testing and also having the test read aloud when needed.

The student will take an alternate local assessment. Explain why the student cannot participate in the regular assessment:

Explain why the alternate assessment is appropriate:

V. GOALS AND OBJECTIVES Include, as appropriate, academic and functional goals. Use as many copies of this page as needed to plan appropriately. Specially designed instruction may be listed with each goal/objective or listed in Section VI. Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the students gifted program may be listed under Goals or Short Term Objectives. MEASURABLE ANNUAL GOAL Include: Condition, Name, Behavior, and Criteria (Refer to Annotated IEP for description of these components) Given an 8th grade writing prompt, Applewood will write grammatically-correct paragraphs, using a good topic sentence, 3-4 details, and a concluding sentence with a 3 or better on a rubric. Short term objectives / Benchmarks Describe HOW the students progress toward meeting this goal will be measured Rubric Teacher Checklist

Describe WHEN periodic reports on progress will be provided to parents Every quarter with report cards.

Report of Progress

Given an 8th grade reading passage, Applewood will read aloud 110 wpm with 98% accuracy when assessed on an oral reading probe twice weekly for 5 consecutive weeks to increase word recognition on 8th grade level. Short term objectives / Benchmarks

Teacher Checklist Graph Observation Data

Every quarter with report cards.

Given a 5 minute computation probe, Applewood will correctly answer operational fluency problems with no more than 3 errors. Short term objectives / Benchmarks

Teacher Checklist Graph Observation Data

Every quarter with report cards.

Given (25) 8th grade calculation fraction problems, Applewood will correctly use proper numbers and operations on a calculator with 95% accuracy. Short term objectives / Benchmarks

Teacher Checklist Graph Observation Data

Every quarter with report cards.

Given a weekly 8th grade division and multiplication of whole number probe (10 problems per problem type), Applewood will follow proper procedure to divide and multiply and write the correct answer to each problem with 95 % accuracy. Short term objectives / Benchmarks

Teacher Checklist Graph Observation Data

Every quarter with report cards.

Given an 8th grade reading passage, Applewood will correctly answer with 95 % accuracy 10 questions to build literal and inferential reading comprehension. Short term objectives / Benchmarks

Teacher Checklist Graph Observation Data

Every quarter with report cards.

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. Modifications and SDI Tests and assignments read aloud as needed or when requested by the student. Adapted test formats limit multiple choice answers to 4. Chunk long lists of matching to 5. word banks Extended time for tests and assignments as needed. Review before tests. Vocabulary tests- test for meaning only; not required to spell or write word for word definition. Ability to retake tests below a 70%. Spelling/ vocabulary words to 75% of that assigned to other students. Guide for the writing process. Math: Examples to follow Reading: Highlighting Preferential seating On-task reminders Location All Academic Classes All Academic Classes All Academic Classes All Academic Classes All Academic Classes All Academic Classes All Academic Classes Frequency Daily Daily Daily Daily Daily Daily Daily Projected Beginning Date 5/10/09 5/10/09 5/10/09 5/10/09 5/10/09 5/10/09 5/10/09 Anticipated Duration 5/09/10 5/09/10 5/09/10 5/09/10 5/09/10 5/09/10 5/09/10

All Academic Classes All Academic Classes All Academic Classes Math Reading All Academic Classes All Academic Classes

Daily Daily Daily Daily Daily Daily Daily

5/10/09 5/10/09 5/10/09 5/10/09 5/10/09 5/10/09 5/10/09

5/09/10 5/09/10 5/09/10 5/09/10 5/09/10 5/09/10 5/09/10

B. RELATED SERVICES List the services that the student needs in order to benefit from his/her special education program. Service N/A Location Frequency Projected Beginning Date Anticipated Duration

C. SUPPORTS FOR SCHOOL PERSONNEL List the staff to receive the supports and the supports needed to implement the students IEP. School Personnel to Receive Support Regular & Special Education Teachers Support Conference Location Disney Middle School Frequency Bi-Weekly Projected Beginning Date 5/10/09 Anticipated Duration 5/09/10

D. GIFTED SUPPORT SERVICES FOR A STUDENT IDENTIFIED AS GIFTED WHO ALSO IS IDENTIFIED AS A STUDENT WITH A DISABILITY Support services are required to assist a gifted student to benefit from gifted education (e.g., psychological services, parent counseling and education, counseling services, transportation to and from gifted programs to classrooms in buildings operated by the school district).

Support Service Support Service Support Service

N/A N/A N/A

E. EXTENDED SCHOOL YEAR (ESY) The IEP team has considered and discussed ESY services, and determined that: Student IS eligible for ESY based on the following information or data reviewed by the IEP team:

OR X As of the date of this IEP, student is NOT eligible for ESY based on the following information or data reviewed by the IEP team: N/A

The Annual Goals and, when appropriate, Short Term Objectives from this IEP that are to be addressed in the students ESY Program are: N/A If the IEP team has determined ESY is appropriate, complete the following: ESY Service to be Provided N/A Location Frequency Projected Beginning Date Anticipated Duration

VII. EDUCATIONAL PLACEMENT A. QUESTIONS FOR IEP TEAM The following questions must be reviewed and discussed by the IEP team prior to providing the explanations regarding participation with students without disabilities. It is the responsibility of each public agency to ensure that, to the maximum extent appropriate, students with disabilities, including those in public or private institutions or other care facilities, are educated with students who are not disabled. Special classes, separate schooling or other removal of students with disabilities from the general educational environment occurs only when the nature or severity of the disability is such that education in general education classes, EVEN WITH the use of supplementary aids and services, cannot be achieved satisfactorily.

What supplementary aids and services were considered? What supplementary aids and services were rejected? Explain why the supplementary aids and services will or will not enable the student to make progress on the goals and objectives (if applicable) in this IEP in the general education class. What benefits are provided in the general education class with supplementary aids and services versus the benefits provided in the special education class? What potentially beneficial effects and/or harmful effects might be expected on the student with disabilities or the other students in the class, even with supplementary aids and services? To what extent, if any, will the student participate with nondisabled peers in extracurricular activities or other nonacademic activities?

Explanation of the extent, if any, to which the student will not participate with students without disabilities in the regular education class: Applewood receives reading and math instruction in the learning support classroom. Applewood is in the included in the regular education classroom for science, English and history. He is also included with his non-disabled peers for lunch, homeroom, and special classes. Explanation of the extent, if any, to which the student will not participate with students without disabilities in the general education curriculum: Applewood does not participate in the general education curriculum for reading and math.

B. Type of Support 1. Amount of special education supports X Itinerant: Special education supports and services provided by special education personnel for 20% or less of the school day Supplemental: Special education supports and services provided by special education personnel for more than 20% of the day but less than 80% of the school day Full-Time: Special education supports and services provided by special education personnel for 80% or more of the school day 2. Type of special education supports Autistic Support Blind-Visually Impaired Support Deaf and Hard of Hearing Support Emotional Support X Learning Support Life Skills Support Multiple Disabilities Support Physical Support Speech and Language Support C. Location of students program Name of School District where the IEP will be implemented: Name of School Building where the IEP will be implemented: Disney School District Disney Middle School

Is this school the students neighborhood school (i.e., the school the student would attend if he/she did not have an IEP)? X Yes No. If the answer is no, select the reason why not. Special education supports and services required in the students IEP cannot be provided in the neighborhood school Other. Please explain:

VIII. PENNDATA REPORTING: Educational Environment (Complete either Section A or B; Select only one Educational Environment)
To calculate the percentage of time inside the regular classroom, divide the number of hours the student spends inside the regular classroom by the total number of hours in the school day (including lunch, recess, study periods). The result is then multiplied by 100.

SECTION A: For Students Educated in Regular School Buildings with Nondisabled Peers Indicate the percentage of time INSIDE the regular classroom for this student:
Time spent outside the regular classroom receiving services unrelated to the students disability (e.g., time receiving ESL services) should be considered time inside the regular classroom. Educational time spent in age-appropriate community-based settings that include individuals with and without disabilities, such as college campuses or vocational sites, should be counted as time spent inside the regular classroom.

Calculation for this Student: Column 1 Total hours the student spends in the regular classroom per day Column 2 Total hours in a typical school day (including lunch, recess & study periods) Calculation (Hours inside regular classroom hours in school day) x 100 = % (Column 1 Column 2) x 100 = % Indicate Percentage Section A: The percentage of time student spends inside the regular classroom: Percentage Category

Using the calculation result select the appropriate percentage category

300 minutes

390 minutes

76
76 % of the day

INSIDE the Regular Classroom 80% or More of the Day X INSIDE the Regular Classroom 79-40% of the Day INSIDE the Regular Classroom Less Than 40% of the Day

SECTION B: This section required only for Students Educated OUTSIDE Regular School Buildings for more than 50% of the day select and indicate the Name of School or Facility on the line corresponding with the appropriate selection: (If a student spends less than 50% of the day in one of these locations, the IEP team must do the calculation in Section A)
Approved Private School (Non Residential) Approved Private School (Residential) Other Private Facility (Non Residential) Other Private Facility (Residential) Other Public Facility (Residential) EXAMPLES for Section A: How to Calculate PennData Educational Environment Percentages Column 1 Total hours the student spends in the regular classroom per day Example 1 Example 2 Example 3 5.5 3 1 Column 2 Total hours in a typical school day (including lunch, recess & study periods) 6.5 5 5 Calculation (Hours inside regular classroom hours in school day) x 100 = % (Column 1 Column 2) x 100 = % (5.5 6.5) x 100 = 85% (3 5) x 100 = 60% (1 5) x 100 = 20% Indicate Percentage Section A: The percentage of time student spends inside the regular classroom: 85% of the day (Inside 80% or More of Day) 60% of the day (Inside 79-40% of Day) 20% of the day (Inside less than 40% of Day) Other Public Facility (Non Residential) Hospital/Homebound
1

Correctional Facility Out of State Facility Instruction Conducted in the Home

For help in understanding this form, an annotated IEP is available on the PaTTAN website at www.pattan.net Type Annotated Forms in the Search feature on the website. If you do not have access to the Internet, you can request the annotated form by calling PaTTAN at 800-441-3215.