Beverly Powers Shu56329 Iep 462186882 09 28 2017-567304309805

SetonHillUniversity
INDIVIDUALIZEDEDUCATIONPROGRAM(IEP)
SchoolAge
Student'sName: BeverlyRPowers
IEPTeamMeetingDate(mm/dd/yyyy): 9/4/2017
IEPImplementationDate(ProjectedDatewhenServicesandProgramsWillBegin): 9/5/2017
AnticipatedDurationofServicesandPrograms: 9/3/2018
DateofBirth: 12/20/1997
Age: 19
Grade: 10th
AnticipatedYearofGraduation: 2015
LocalEducationAgency(LEA): SetonHillUniversity
CountyofResidence: LuzerneCounty
NameandAddressofParent/Guardian/Surrogate:
Mr.DarrenCPowers Phone(Home): 7125560329 Email(Home): dpowers0329@home.iep
1530HazleCourt Phone(Work): 7124559329 Email(Work):
Leaderton,PA18123 Phone(Cell):

NameandAddressofParent/Guardian/Surrogate:
Mrs.ChristineAPowers Phone(Home): 7125560329 Email(Home): cpowers0329@home.iep
1530HazleCourt Phone(Work): 7125559329 Email(Work):
Leaderton,PA18123 Phone(Cell):

OtherInformation:
IEP 9/28/2017 BeverlyRPowers

TheLEAandparenthaveagreedtomakethefollowingchangestotheIEPwithoutconveninganIEPmeeting,asdocumentedby:
Date of Revision(s) Participants/Roles IEP Section(s) Amended


IEPTEAM/SIGNATURES
TheIndividualizedEducationProgramteammakesthedecisionsaboutthestudentsprogramandplacement.Thestudentsparent(s),thestudentsspecialeducationteacher,andarepresentative
fromtheLocalEducationAgencyarerequiredmembersofthisteam.SignatureonthisIEPdocumentsattendance,notagreement.
Printed Name Role Signature
BeverlyRPowers Student
ChristinePowers Mother
DarrenPowers Father
KoraManning Principal
KatieKelly SchoolPsychologist
HowardEDaniel RegularEducationTeacher

* TheIEPteammustinvitethestudentiftransitionservicesarebeingplannedoriftheparentschoosetohavethestudentparticipate.
** Ifthestudentis,ormaybe,participatingintheregulareducationenvironment
*** AsdeterminedbytheLEAasneededfortransitionservicesandothercommunityservices
****AteacherofthegiftedisrequiredwhenwritinganIEPforastudentwithadisabilitywhoalsoisgifted.
Oneindividuallistedabovemustbeabletointerprettheinstructionalimplicationsofanyevaluationresults.
Writteninputreceivedfromthefollowingmembers:
Jon'sfatherwillnotbepresentatthemeeting.
TransferofRightsatAgeofMajority
Forpurposesofeducation,theageofmajorityisreachedinPennsylvaniawhentheindividualreaches21yearsofage.Likewise,forpurposesoftheIndividualswithDisabilitiesEducationAct,the
ageofmajorityisreachedforstudentswithdisabilitieswhentheyreach21yearsofage.

PROCEDURALSAFEGUARDSNOTICE
IhavereceivedacopyoftheProceduralSafeguardsNoticeduringthisschoolyear.TheProceduralSafeguardsNoticeprovidesinformationaboutmyrights,includingtheprocessfordisagreeing
withtheIEP.TheschoolhasinformedmewhomImaycontactifIneedmoreinformation.
SignatureofParent/Guardian/Surrogate:

I.SPECIALCONSIDERATIONSTHEIEPTEAMMUSTCONSIDERBEFOREDEVELOPINGTHEIEP.ANYFACTORSCHECKEDAS"YES"MUST
BEADDRESSEDINTHEIEP.
Isthestudentblindorvisuallyimpaired?
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TheIEPmustincludeadescriptionoftheinstructioninBrailleandtheuseofBrailleunlesstheIEPteamdetermines,afteranevaluationofthestudent'sreadingandwriting
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skills,needs,andappropriatereadingandwritingmedia(includinganevaluationofthestudent'sfutureneedsforinstructioninBrailleortheuseofBraille),thatinstruction
inBrailleortheuseofBrailleisnotappropriateforthestudent.
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Isthestudentdeaforhardofhearing?
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TheIEPmustincludeacommunicationplantoaddressthefollowing:languageandcommunicationneeds;opportunitiesfordirectcommunicationswithpeersand
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professionalpersonnelinthestudentslanguageandcommunicationmode;academiclevel;fullrangeofneeds,includingopportunitiesfordirectinstructioninthestudents
languageandcommunicationmode;andassistivetechnologydevicesandservices.IndicateinwhichsectionoftheIEPtheseconsiderationsareaddressed.The
CommunicationPlanmustbecompletedandisavailableatwww.pattan.net
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Doesthestudenthavecommunicationneeds?
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StudentneedsmustbeaddressedintheIEP(i.e.,presentlevels,speciallydesignedinstruction(SDI),annualgoals,etc.)
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Doesthestudentneedassistivetechnologydevicesand/orservices?
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StudentneedsmustbeaddressedintheIEP(i.e.,presentlevels,speciallydesignedinstruction,annualgoals,etc.)
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DoesthestudenthavelimitedEnglishproficiency?
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TheIEPteammustaddressthestudentslanguageneedsandhowthoseneedsrelatetotheIEP.
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Doesthestudentexhibitbehaviorsthatimpedehis/herlearningorthatofothers?
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TheIEPteammustdevelopaPositiveBehaviorSupportPlanthatisbasedonafunctionalassessmentofbehaviorandthatutilizespositivebehaviortechniques.Resultsof
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thefunctionalassessmentofbehaviormaybelistedinthePresentLevelssectionoftheIEPwithaclearmeasurableplantoaddressthebehaviorintheGoalsandSpecially
DesignedInstructionsectionsoftheIEPorinthePositiveBehaviorSupportPlanifthisisaseparatedocumentthatisattachedtotheIEP.APositiveBehaviorSupportPlan
andaFunctionalBehavioralAssessmentformareavailableatwww.pattan.net
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Other(specify):

II.PRESENTLEVELSOFACADEMICACHIEVEMENTANDFUNCTIONALPERFORMANCE
Includethefollowinginformationrelatedtothestudent:
Presentlevelsofacademicachievement(e.g.,mostrecentevaluationofthestudent,resultsofformativeassessments,curriculum-basedassessments,transitionassessments,
progresstowardcurrentgoals)
GeneralInformation
Jonisa13-year-oldstudentwhocurrentlyisin7thgradeatABCAcademy.Heisdetermined,kind,andlikestoknowhowthingswork.
PersonalInterests/Preferences
Jonisinterestedinvariousrockformationsandmoneyfromothercountries.Hecurrentlyhasacollectionofeachoftheseitems.Hehas
expressedinterestinanimals.Jonhelpsathomewithlayinghens,honeybees,andhealsohasapuppythathehelpswith.Heenjoysanimals
andacareerworkingwiththemisofinteresttohim.Jonisnotsurewhathewilldoafterhighschoolatthistime.
BackgroundInformation
Currently,Jonliveswithhisadoptiveparents,Mr.andMrs.Stark.Heandhistwinwerebornprematurely,withalowbirthweight,and
positiveforcrack/cocaine.Therewasalsoprenatalexposuretoalcoholanddrugs.Jonalsohasahistoryofphysicalabuseandneglectbyhis
birthmotherandsexualabusewhileinfostercare.
JonandhisbrotherwereadoptedbytheStarkswhentheywere5yearsold.Ms.StarkhaslittleinformationaboutJonsinfancyotherthan
knowingthathewasseverelydelayedinallareaswhenhewasadoptedatage5.
Jonliveswithhisparents,twinbrother,andoldersister.Jonenjoyssportssuchasbasketball,soccer,andswimming.Healsoenjoysplaying
videogames,reading,andwatchingmovies.Ms.StarkdescribedJonasbeingkind,solicitous,charming,anddeterminedwhenthereis
somethinghewants.Heworkswelltowardsgoalshewantstoachieveoronprojectsinwhichheisinterested.Joncanbecomevery
belligerentanddisrespectfulattimes.Hemaythreatenorhitothers.Ms.StarkreportthatJontypicallyrequiresdisciplining3to5timesdaily
foranythingfromdisrespecttolyingtodestroyingsomeoneelsesproperty.Disciplinetechniquesusedathomeincludelossofprivileges,
assignmentofadditionalchores,andremovingJonfromthesituation.
EducationalBackground
AttendingHeadStartandthenpublicschool,hehadhisprimaryIEPunderOtherHealthImpairment(OHI)duetohisADHDinthe1stgrade.
Athisinitialevaluation,hewasalsodiagnosedashavingthefollowingdisorders:
1. DepressiveDisorder
2. MixedReceptive-Expressivelanguagedisorder

II.PRESENTLEVELSOFACADEMICACHIEVEMENTANDFUNCTIONALPERFORMANCE(Continued)
3. Developmentalcoordinationdisorder
4. Otherdevelopmentaldelays
Jonwasreevaluatedin2ndgradesothattheteamcouldgatheradditionaldataintheareaofneedforassistivetechnology.
In3rdgrade,JonsIEPaddressedweaknessesinreading,writing,math,articulation,andfunctionalbehavior.Supplementalservicesincluded
OTconsultandabehaviorinterventionplan.Ms.SnowhomeschooledJontowardtheendofthistime.InJanuary2010,Jonwasplacedat
KingsPlace,aresidentialtreatmentfacilitythatprovidesintensiveintermediateandlong-termcaretochildrenandadolescentswhohave
psychiatricandbehavioralhealthdisorders.DiagnosesatthetimeofplacementincludedADHD,MoodDisorder,OppositionalDefiant
Disorder,PosttraumaticStressDisorder,andReactiveAttachmentDisorder.Jonwasplacedinordertohaveservicesthatwouldaddresshis
emotional/behavioralissuesthatwereimpactinghiminhishomeandcommunitysettings.JonwasdismissedfromKingsPlacesometime
duringthe2010-11schoolyear.Hewasthenhomeschooledforthe2011-12schoolyearandenrolledatABCAinAugustof2012asa7th
grader.
JonspeaksinhisnativelanguageofEnglish.Hehasfullfunctioningandnoproblemsinhisvisionandhearing.However,intermsofhis
speech/language/communication,Jonhasreceivedspecialeducationservicestoaddressarticulationissuesthroughthirdgrade.Nosignificant
problemsarenotedwithhisarticulationatthistime.Ms.StarkreportedthatJonwasdiagnosedashavingalanguageprocessingdisorderlast
year.Duetothesedifficulties,theteamrequestedadditionalinformationprimarilyintheareaoflisteningcomprehensionandreceptive
language.
Concerningcognitiveandprocessing,areviewofinformationindicatedthatJonscognitiveprocessingskillshavebeenassessedatleast
twiceinthepastwithconsistentresults.AssessmentsindicatedthatJonhasaveragetoborderlineskillsintheareasofverbalcomprehension,
perceptualreasoning,workingmemory,andprocessingspeed.Fullscalescoreshaveconsistentlybeenwithinthelowaveragerange.
Concerninghisacademicachievement,Jonsmostrecentgradesindicatesignificantscatter.HeiscurrentlypassingSpanish,math,science,
andintroductiontofamilyandconsumerscience,butisfailingEnglish/languageartsandsocialstudies.Hisgradesfromfirsttosecondgave
variedaswellimprovinginsomeclassesandfallinginothers.InformationinJonspreviousIEPfromthirdgradeindicatedthathewasable
toreadandperformmathactivitiesongradelevelatthattime.HisIEPprovidedsupportinginstructiontoimprovehisskillsinreading,
writing,andmath.Theteamrequestedadditionalinformationinthisareatoassistwitheducationalplanning.
Concerninghisadaptivebehavior,Ms.StarkreportedthatJondemonstratesage-appropriateself-helpskills.Hehasdifficultyintheareasof
communicationandsocializationathomeandinthecommunity.Theteamrequestedadditionalinformationintheseareas.

Concerninghissocial,emotionalandbehavioralabilities,Jonhasalonghistoryofproblemsinthisarea.Earlyinschoolhisdifficultieswith
attention,concentration,andimpulsecontrolinterferedwithhisabilitytoconsistentlyaccessandprogressinthegeneralcurriculum.Ms.
Starkreportedthatacrosssettingsofhome,community,andschoolJonsbehaviorhasimpactedhisabilitytointeractwithothers.Building
andmaintainingrelationshipswithothersisverydifficultforJon.Hisbehavioraldifficultiesinthehomesettingledtohisplacementat
KingsPlaceinJanuaryof2010.Thesedifficultieswereaddressedthroughdirectandindirectinstruction,supplementaryservices,andother
supportsinhisIEPpriortoplacementatKingsPlace.
AsmentionedpreviouslyabehaviorinterventionplanwasimplementedatABCAsoonafterJonenrolled.Theplanwasimplementedon
9/18/2012andJonusedhisBIPpasstoleaveclasson6occasionsforanaverageof15minutesperouting.Hewassuccessfulincalming
himself,talkingthroughtheissues,andreturningtoclass.FromthedateofimplementationuntilNov.2thissystemworkedwell;Jononly
hadonereferralduringthistime.BeginningNov.2untilthedateofthisevaluationplanningmeeting,Jonhashad28referrals.Itisunclear
whatchangedorwhatpromptedthisincreaseindisruptivebehavior.Ofthe28referrals,59%(17referrals)wereforclassdisruption,28%(8
referrals)fordefiance,3%(1referral)forotherminoroffences,and3%(1referral)forphysicalaggression.Theremovalsfromclasswere
sometimesinitiatedbyJonandsometimesbytheteacher.OnanaverageJonwasoutoftheclassroomanywherefrom15minutesto3hours,
withanaveragetimebeing30minutes.Twoincidentsresultedinout-of-schoolsuspensions.
Themostrecenteventoccurredon1/14/2013.Jonslammedthedooronanotherstudent,thenbecameagitatedwhenquestionedbytwoofthe
teachers.Herefusedtogototheassignedclassroomforacooldowntimeandwasdisrespectfulwithhislanguage.Jonwassuspendedfor5
daysforthisevent.
DuetotheschoolhavingreasontosuspectJonmighthaveadisability,Jonsplacementwasplacementwaschangedtoaninterimalternative
settingwithhismothersconsentwhileanexpeditedevaluationascompleted.
Theteamrequestedadditionalinformationinthisareatoassistwitheducationalplanning.
Lastly,concerninghismotorandsensorystrengthsandweaknesses,Jonhasreceivedoccupationaltherapyinthepast(age9)toaddress
difficultiesinvariousareasthatincludedhandwriting(letterformation,spacing,sizing,positioning,andspeed);attentiontotask;emotional
andbehavioralregulation;andsensoryprocessing.Duetocontinueddifficultiesintheseareas,theteamrequestedupdatedinformation.
NosignificantproblemswithgrossmotorskillswerenotedbyMs.Snoworbyteachers.Noadditionalinformationwasrequestedinthisarea.
HealthInformation/Concerns

Hehadanappendectomyatage8;hedevelopedaninfectionandhadtobereadmittedtothehospitalfortreatment.Jonhasenvironmental
allergiesthataretreatedwithZyrtec.HehasalsobeendiagnosedwithEpisodicMoodDisorder,ImpulseControlDisorder,Antisocial
PersonalityDisorder,andADHD.HetakesVyvanse,Zoloft,Risperdal,andDepakotetohelpcontrolthesymptomsofthesedisorders.
SummaryofResearch-BasedAccommodations/Interventions
Asstatedabove,JonhadanIEPthroughouthistimeintheWinterfellschooldistrict.Healsoreceivedintensivesupportservices(counseling
inbothsmallgroupandindividualsettings,medicationmanagement,behaviorsupport,andeducationalsupport)throughaplanofcareat
KingsPlace.
ShortlyafterenrollingatABCA,abehaviorinterventionplanwasputintoplacetohelpdeescalatefrustration,defiance,andverbal
aggression.JonwasgivenaBIPpassthathecouldusetoleaveclassforadesignatedareawhenhefelttheneedforashortcooldowntime.
TeacherscouldalsosignalJonquietlytotakeabreakiftheynotedhewasbecomingagitated.
Joniscurrentlyunderthecareofanadolescentpsychiatristwhoprovidesmedicationmanagement.Hehasreceivedcounselingservicesto
addresshisbehavioral/emotionalissuesforthepast7years.
AreasofNeedforEvaluationPlan
Observation:3in2differentsettings
Interviewstudent
BehaviorLog/AnecdotalRecordsrecordsofbehaviorincidents,removalsfromclass,lengthofremovals,andcausesofremovals
Documentationofbehavioralinterventionsandresultsofprogressmonitoring:seeabove
Behaviorratingscales(social,emotional,behavioralfunctioning):socialandemotionalaswellasattention
Pre-academic,academic,orfunctionalacademicachievementORdevelopmentalskillsassessment
Areas:___Pre-academicskills___Functionalacademicskills
Developmentalskillsassessment

Oralexpression
Listeningcomprehension
Writtenexpression
Basicreadingskill
Readingfluencyskills
Readingcomprehension
Mathematicscalculation
Mathematicsproblemsolving
Language(receptive,listeningcomprehension)
Visual-motorskills
Finemotorskills(smallmusclemovements)
Sensoryfunctioning(processinginformationfromtheenvironmenttakeninbythesenses)
Assessmentofchildsneedforassistivetechnology(devicesandservicesthatassistthechildinadaptingtoand/oraccessing
educationalinstructionandsettings)
Assessmentofchildsinterestsandpreferencesregardingpostsecondaryoutcomesforthepurposeofdeterminingtransitionneeds
Services:
OccupationalTherapy
SpeechTherapy
AssistiveTechnology
ParentInput
Ms.Stark,Jon'smother,hadthefollowinginformationtoshare:
Mrs.StarksharedthatJonisakindandthoughtfulboy.Helovestoplaywithcarsandisinterestedinhowthingswork.Jonwasreferredfor
evaluationbyhismotherandteachersduetoconcernsabouthowhisemotionsandbehaviorsareimpactinghisabilitytoaccessandprogress
inthegeneralcurriculum.Jonhasdifficultycontrollinghisanger;heoftenreactsimpulsivelywhenheisfrustratedorwhenheperceivesheis
beingchallenged.Hewillreactbothverballyandphysically.

Woodcock-JohnsonTestsofAchievementIII
AdministeredbyMichaelRetan,SpecialEducationTeacherintheareasof:readingfluency,readingcomprehension,mathcalculation,math
reasoning,andwrittenexpression:
ReadingFluency
Jontriedhisbestonallsubtests,butdidstatethatmathwashisleastfavoriteandthathedidnotlikemath.Standardscoresrangedfrom62-94
(theaveragerangeis90-109).Jonsreadingfluencywashishighestscore.Hewasabletoreadsmoothlyandquickly.Readingfluencywasin
theaveragerangeforhisage.Passagecomprehensionstandardscorewasan88,whichisinthelowaveragerange.
WritingFluency
Writingfluencysubteststandardscorewasan84,whichfellinthelimitedrange.ObservationsofJonswritingsampleduringthissubtest
werevaried.Jonwasabletocomposesimplesentencesgiventhreewordsandapicturefairlyeasily.Hedidnotusecapitalizationor
punctuationinmostofhissentences.However,hewasabletoconstructsimplesentencesatanaverageratewithminimaleffort.Spelling
subteststandardscorewas79,whichfellwithinthelimitedrange.Jontendstospellwordsjusthowtheysoundtohim,anddidsoonthe
subtest.
Mathematics
Jonreportedpriortothetestingthatmathwashisleastfavoritesubjectandthathedidnotliketodomath,especiallywithoutacalculator.Jon
achievedastandardscoreof62onthesubtestformathcalculation,anda75subtestscoreforappliedproblems.Hewasunabletosubtract
withre-groupingormultiplyotherthanabasicmultiplicationfact.Hedidnotattempttodivideandstatedthathedidnotknowhowtodivide.
Hewasunabletocompleteanyfractionproblemseither.Hisstandardscoreformathcalculationfellintheverylimitedrangebasedonage
levelnorms.Duringtheappliedreasoningsubtest,Jondidnotusepaperorpenciloranyapparentstrategytosolvetheproblems.Hereported
thathedidtheminhishead,andoncehewasunabletodothat,hesimplysaidhedidnotknow.Hisscoreformathreasoningagainfellinthe
verylimitedrangebasedonagelevelnorms.
Science/PE

CurrentlyJonispassingsciencewitha78averageandPEwitha97average.Heisfailingsocialstudies,math,andEnglish/languagearts.His
behaviorissignificantimpactinghisclassroomperformanceandachievement.Ms.CalvoreportedthatwhenJontooktherecentMeasuresof
AcademicProgress(MAP)test,shehadgivendirectionstotheclasstocarefullyreadquestionsbeforeclickinganswersonthecomputer.Jon
immediatelybegantoclickanswersindiscriminately.Hisscore,ofcourse,waslowerthanhisfallscoreonthesamemeasure.Thisistypical
ofhowJonsbehavioroftenimpactshisclassroomperformance.
Presentlevelsoffunctionalperformance(e.g.,resultsfromafunctionalbehavioralassessment,resultsofecologicalassessments,progresstowardcurrentgoals)
BehaviorInterventions/Concerns
Jonsfunctionalbehaviorwasassessedusingavarietyofmethodsincludingdirectobservationsacrosstimesandsettings;informationfrom
parents,teachersandJonhimselfviaratingscalesandinterviews;reviewofbehavioraldataincludingreferralreasons,times,anddetailsand
anecdotaldata.
Atthistime,Jonmaintainsgoodmobilityandphysicaldevelopment.
PreviousSpeechandLanguageInformationIncluded:
SpeechandLanguageSupportServices:ThefollowinginformationwasprovidedbySpeech-LanguagePathologistStaceyBogac,M.S.
CCC,SLP.
Jonsspeechfunctionswereinformallyassessedduringtheevaluationsession.Hisarticulation,voice,andfluencyappearedadequateto
communicateintheeducationalenvironment.
TheClinicalEvaluationofLanguageFundamentals-4(CELF-4)wasadministeredtoassessJonscomprehensionandmemoryskills.The
CELF-4evaluateslanguagethroughtwoareas:receptiveandexpressiveskills.Receptivelanguagetasksassesscomprehensionofspoken
language,identificationofvocabulary,andtheabilitytofollowdirections.Expressivelanguagetasksassesstheabilitytocommunicateorally,
participateinconversations,usageofappropriategrammar,andtheabilitytoprovideinformationuponrequest.
JonslanguagewasassessedviatheCoreLanguage,ExpressiveLanguage,andMemoryportionsoftheevaluationinstrument.Thecore
languagescoreyieldsanoveralllanguagescore.Thereceptivelanguageareaincludesreceptivevocabulary,understandingspoken
paragraphs,andsemanticrelationships.Theexpressivelanguageareacoversrecallingsentences,formulatingsentences,andexpressive
vocabulary.Andthelanguagememoryareacoversrecallingsentences,formulatingsentences,andsemanticrelationships.

ThefollowingtableisaprofileofJonsperformance.
ScaledScore/StandardScore
CoreLanguageScore:24/76
ReceptiveLanguage:16/72
ExpressiveLanguage:17/73
LanguageMemory:11/60
Eachsubteststandardscorehasameanof100andastandarddeviationof15.Jonsoveralllanguagescoreis1.5standarddeviationsbelow
themean.Hisreceptiveandexpressivelanguagescoresfellinthesamerange,whilehislanguagememoryscorewas2.5standarddeviations
belowthemean.
Jonsstrongestareawasinreceptivevocabulary.Theotherareasrevealedweaknessesinhisoveralllanguageusagewiththelowestarea
beinglanguagememory.Hisabilitytochunkinformationforstorageandlaterretrieveitappeartobethebreakdowninhislanguage
functioning.Heappearedtoeitherpickuponandretainthefirstpartofwhatwasbeingsaidorthelastpart,ifhewasattendingduringthe
discussion.ItshouldbenotedthatJonwastestedunderdistress.Therefore,itisdifficulttotrulyassessifheperformedpoorlyduetolackof
skillorlackofcooperation.
FineMotor/SensoryProcessing:
Jonpresentswithissuesinthewritinglegibility,sensoryissuesandbehaviorproblems.
BackgroundinOccupationalTherapy:
ReferralwasmadeforOccupationalTherapyevaluationduetodifficultywithhandwritingandillegiblewrittenworkintheclassroom,which
resultsinbehavioralepisodes.ParentreportsJonhashadOccupationalTherapyinthepastinschoolandonanoutpatientbasis.Parentreports
hewasdischargedfromoutpatientservicesduetomeetinggoals.Studentintheassessmentprocessforspecialeducation.
Jonisnotedtoobtainhyperflexiblejointsinhishands.
Thesearetheresultsofthefollowingassessments(ThePrintToolHandwritingAssessment,Beery-BuktenicaDevelopmentalTestof
Visual-MotorIntegration,Worksamples,observation,teacherreportandparentreport.

RESULTS:
FineMotor/GraspingSkills:Finemotorskillsincludeallthemusclesofthehandrequiredtocompletefinemanipulativework.Radial
manipulationistheabilityofastudenttousetheirthumb,indexandmiddlefingerstoperformmovementsofobjects(suchastweezersand
scissors)whiletheringandlittlefingerareinactiveandarestabilizedintothepalmofthestudentshand.In-handmanipulationistheability
toseparatebothsidesofthehandinordertomoveobjectssuchasapencilwithoutassistanceoftheotherhand.Distalfingercontrol
movementsarethesmallmovementsofthethumbandindexfinger.Poorfinemotorskillsmayleadtodecreasedefficiencyandfluidityof
finemovementssuchashandwriting,coloringandcutting.Jonwasabletoholdhispencilwitharightdominanttripodgraspandheavy
pressurenoted.
FineMotorSkills:
Functional:HandDominance,RadialManipulation,PencilGrasp
VisualMotor:BeeryTestofVisualMotorIntegration:VMI:Rawscore:28AgeEquivalent:14yr.10Mths.
Visualmotorskillsincludetheabilitytotransferwhatisperceivedvisuallyintoamotoroutput.Inotherwords,visualmotorskills
demonstratehowachildinterpretswhatheorsheseeswiththeirhands.Copyingshapes,forexample,requirethestudenttoprocessvisual
informationfromamodelandrecreatetheimagethroughamotorresponse.Jonwasabletocopyallitemsduringtheassessment.He
attemptedalltheitemswithnofrustrationnoted.
SensoryProcessing:
Sensoryprocessingreferstothewayinwhichachildregistersandperceivedinformationfromavarietyofsensorychannelsincluding
auditory,visual,tactile(touch),proprioceptive(inputfromthemusclestothejoints)andvestibular(movement)systems.Thissensoryinput
providesthechildwithinformationabouttheenvironment,whichallowsthechildtorespondpurposefullyandsuccessfullytothedemandsof
theenvironment.OTwasunabletogivefullsensorychecklistduetotimeconstraintsforassessmenttobeadministered.Parentreportshe
likesvestibularandproprioceptiveinputandhasalwayshadheavypressurewithwriting.
Handwriting:
The Print Toolassesses7areas(memory,orientation,placement,size,start,sequence,control)andspacing(optional).

Thefollowingdefineswhateachareameans:
MemoryRememberingandwritingdictatedletters
OrientationFacinglettersinthecorrectdirections
PlacementPuttinglettersonthebaseline
SizeWritingtoolargeforcurrentgrade
StartWhereeachletterbegins
SequenceOrderandstrokedirectionoftheletterparts
ControlNeatnessandproportionoftheletterparts
SpacingAmountofspaceleftbetweenlettersinwordsandwordsinsentences
Jonisscoringonly2%behindotherstudentshisage.Hehasdifficultywithplacement,memoryofhowtoformthelettersandoccasional
controlofhispencil.Jonreportshishandscannotkeepupwithhisthoughts.Healsocomplainsofhandfatigueduetoheavypressureonhis
pencil.Jonwroteone4-wordsentencethenstoppedwhenaskedtowritesomething.
AssistiveTechnology
JonwasgivenIpadtotypethesame4-wordsentenceasabove.Hewasveryfamiliarwiththekeyboardandwasabletotouchtypequickly
andwithconfidence.Hethencontinuedandtyped5sentencesinlessthan5minutesusingtheWordpredictionandIpadapplication.Mother
reportshehasbeendoinglongassignmentsonhislaptopathomeandnowistrainingdragondiction.
Conclusion:
Jonwasverycalmduringtheevaluationandparticipatedfully.Initially,hehadhisheadonthetablebutquicklybecameengagedin
conversationandtheassessment.Jonsvisualmotorskillsarehigherthanhischronologicalage.HealsoscoredwelloverallonthePrintTool
assessmentbuthassomeweakareaswhenwriting.Writingislaboriousforhimduetohishyperflexibilityinhisfingerjointsandhisneedfor
proprioceptiveinput.Hedidextremelywellontheassistivetechnologyportionandwascontinuingwiththedeviceuntilhehadtoleave.
Thefollowinginformationwasobtainedfromobservationsthatwereconductedacrosssmallandlargegroupandone-on-onesessions
andinstructional,transition,andevaluativesessions:
ObservationsofFunctionalBehavior:
Jonwasobservedwithotherseventhgradestudentsduringtransitioninthehallway.Joncameoutofhisclassroomveryhurriedly,bumping
intoastudentandcontinuedtothelockerarea.Hedidnotgotohislocker,butstoodinthehallway,asifwaitingforsomething.Hedidnot
talkwithotherstudents,includinghisbrother.Heignoredhisbrotherwhenhewasspokentoduringthistime.

Jondidnotrespondtotheteachersinthehallwaywhenaskedtomoveonintoclass,ratherheappearednottohearthemandthenwalked
slowlyintotheclassroomafterotherstudentshadclearedthehall.Uponenteringtheroom,Jonsatatthesideofthedoor,neartheback,away
frommanystudents.TherewasnointeractionbetweenJonandtheotherstudents.Hewasinterestedinhisnotebookanddidnotseemto
noticethatclasswasbeginning.Hegotupandcametothedoorwayforabriefmoment,asifhewerelookingforsomeoneandthenreturned
tohisseat.Therewasasubstituteintheclassroomandhedidanswerwhentherollwascalled.Hedidnotengageinanyotherconversation
thatheobservernoticed.Additionally,hedidnotbeginthework,ratherafterhewasgiventheassignment;hegotupandlefttheroom.
TheobserverfollowedhimandobservedhimgoingtotheSTOProom.Hewentinsideandsaidheneededtoworkinthatroom.Hesaidthere
wasasubstituteandhecouldntstaythere,referringtotheotherclassroom.Afterrealizingtheobserverwaswatchinghim,hemumbledto
himself.Theobserverconcludedtheobservation.
JonwasobservedduringaPEclassaswell.Heenteredthegymwithother7thgradestudents.Hewalkedaroundwhileotherswereentering.
Astheclassbegan,Jontookpartinthewarmupactivity.Hedidnottalktootherstudentsandtendedtoseparatehimselffromthegroup.Jon
participatedandrespondedappropriatelywhencalledonbythecoachtodohispartofthestrengthtraining.Hecompletedtheactivitiesand
thenwalkedalongthestagefortheremaining10minutes.
Duringanobservationinthelargegrouplanguageartssetting,Ms.Calvo,theteacher,wasusingliteracycircles(peergroups)topromote
studentdiscussion.Studentswerecalledontoreporttheirinterpretationsofwhathadbeenread.Jonwasobservedtobewithoutapenciland
hadtogetapencilfromMs.Calvo.Within5minutes,heaskedforanotherpencil.Jondroppedthatpencilontheflooranddidnotattemptto
pickitup.Whennovelsforreadingwerepassedout,Jonplacedhisnovelunderhisdeskandputhisheaddown.Ms.Calvowalkedovertotry
andengageJoninthelesson.Shespokequietlytohim,butJondidnotrespondtothedirections.Hethenattemptedtoengageanotherstudent
inconversation,butwasignoredbythestudent.TheteacherattemptedtoredirectJonagaintobeginreading,butJonputhisheaddownonce
more.Hekepthisheaddownforanother25minutes.
Jonwasobservedagainduringlanguageartsandscienceandhisoff-taskbehaviorsweretalliedandcomparedtoatypicalstudentineach
class.Over2thirty-minuteobservations,Jonwasobservedtobeon-tasksignificantlymorethanthecomparisonstudent(Jonwasoff-task
only2-3timesin30minuteswhereasthecomparisonstudentwasoff-task12-16timesduringthesametimeperiod).
JonwasseenonMarch22and25,2013foralanguageevaluation.Hewasinquisitiveastothenatureofthetestingandrapportwasnoteasily
established.Hecomplainedaboutthelengthofthetestingandcontinuallyaskedwhenhecouldleave.Healsoexpressedattimesthatthe
tasksweretoohardorthathewastired.Theseconddayoftestingwasdifficultasherefusedtocooperateseveraltimesfinallyresultinginhis
motherremovinghimfromtotheroomtoaddresstheissue.Hereturnedandresumedtesting,butdidnotputforthmucheffort.

JonwasverycalmduringtheOTevaluationandparticipatedfully.Initially,hehadhisheadonthetablebutquicklybecameengagedin
conversationandtheassessment.Jonsvisualmotorskillsarehigherthanhischronologicalage.HealsoscoredwelloverallonthePrintTool
assessmentbuthassomeweakareaswhenwriting.Writingislaboriousforhimduetohishyperflexibilityinhisfingerjointsandhisneedfor
proprioceptiveinput.Jonwasveryfidgetyduringthewritingportionoftheassessment.Hechangedposturesandpositionsinhischair
frequently.Hedidextremelywellontheassistivetechnologyportionandwascontinuingwiththedeviceuntilhehadtoleave.
RatingScales:
Jonsbehaviorwasalsoassessedusingratingscalescompletedbyhismother,twoofhisteachers,andJonhimself.TheBehaviorAssessment
SystemforChildren-2(BASC2)andtheConners-3ratingscale.
Self-Rating
JoncompletedtheBASC-2self-report.ThisreportisbasedonJonsratingofhimselfusingtheBASC-2Self-ReportofPersonalityform.The
narrativeandscaleclassificationsinthisreportarebasedonTscoresobtainedusingnorms.ScalescoresintheClinicallySignificantrange
suggestahighlevelofmaladjustment.ScoresintheAt-Riskrangemayidentifyasignificantproblemthatmaynotbesevereenoughto
requireformaltreatmentormayidentifythepotentialofdevelopingaproblemthatneedscarefulmonitoring.Itshouldbenotedthatwhenthe
scaleswasadministeredtoJon,hedidnotappeartotakethetaskseriously.Thislackofvaliditywasverifiedbytheratingsofextreme
cautiononthevalidityindex.
SchoolProblems
TheSchoolProblemscompositescaleTscoreis73,witha90percentconfidenceintervalrangeof67-79andapercentilerankof98.JonsT
scoreonthiscompositescalefallsintheClinicallySignificantclassificationrange.JonsTscoreonAttitudetoSchoolis71andhasa
percentilerankof97.ThisTscorefallsintheClinicallySignificantclassificationrange.HisTscoreonAttitudetoTeachersis67andhasa
percentilerankof93.ThisTscorefallsintheAt-Riskclassificationrange.Also,JonsTscoreonSensationSeekingis65andhasa
percentilerankof93.ThisTscorefallsintheAt-Riskclassificationrange.
InternalizingProblems

TheInternalizingProblemscompositescaleTscoreis74,witha90percentconfidenceintervalrangeof71-77andapercentilerankof98.
JonsTscoreonthiscompositescalefallsintheClinicallySignificantclassificationrange.JonsTscoreonAtypicalityis66andhasa
percentilerankof92.ThisTscorefallsintheAt-Riskclassificationrange.HisTscoreonLocusofControlis68andhasapercentilerankof
94.ThisTscorefallsintheAt-Riskclassificationrange.HisTscoreonSocialStressis78andhasapercentilerankof99.ThisTscorefalls
intheClinicallySignificantclassificationrange.HisTscoreonAnxietyis53andhasapercentilerankof65.HisTscoreonDepressionis75
andhasapercentilerankof96.ThisTscorefallsintheClinicallySignificantclassificationrange.HisTscoreonSenseofInadequacyis73
andhasapercentilerankof97.ThisTscorefallsintheClinicallySignificantclassificationrange.Finally,JonsTscoreonSomatizationis
68andhasapercentilerankof93.ThisTscorefallsintheAt-Riskclassificationrange.
Inattention/Hyperactivity
TheInattention/Hyperactivitycomposite-scaleTscoreis68,witha90percentconfidence-intervalrangeof61-75andapercentilerankof95.
JonsTscoreonthiscompositescalefallsintheAt-Riskclassificationrange.JonsTscoreonAttentionProblemsis58andhasapercentile
rankof79.Also,hisTscoreonHyperactivityis73andhasapercentilerankof97.ThisTscorefallsintheClinicallySignificant
classificationrange.
EmotionalSymptomsIndex
TheEmotionalSymptomsIndexcompositescaleTscoreis73,witha90percentconfidenceintervalrangeof69-77andapercentilerankof
97.JonsTscoreonthiscompositescalefallsintheClinicallySignificantclassificationrange.
PersonalAdjustment
ThePersonalAdjustmentcompositescaleTscoreis26,witha90percentconfidenceintervalrangeof21-31andapercentilerankof2.Jons
TscoreonthiscompositescalefallsintheClinicallySignificantclassificationrange.JonTscoreonRelationswithParentsis30andhasa
percentilerankof4.ThisTscorefallsintheClinicallySignificantclassificationrange.HisTscoreonInterpersonalRelationsis23andhasa
percentilerankof2.ThisTscorefallsintheClinicallySignificantclassificationrange.HisTscoreonSelf-Esteemis30andhasapercentile
rankof5.ThisTscorefallsintheClinicallySignificantclassificationrange.Finally,JonsTscoreonSelf-Relianceis45andhasapercentile
rankof31.
JonsscoresonInterpersonalRelations,Depression,andHyperactivityfallintheclinicallysignificantrange,andprobablyshouldbe
consideredamongthefirstbehavioralissuestoresolve.
NotethatJonalsohadscoresonSocialStress,SenseofInadequacy,AttitudetoSchool,RelationswithParents,Self-Esteem,Somatization,
LocusofControl,AttitudetoTeachers,Atypicality,andSensationSeekingthatareareasofconcern.JonsBASC-2profileindicates
significantproblemswithDepression,Hyperactivity,andAttitudetoSchool.BasedonCHILDsratings,Jonisexperiencingproblemswith
thefollowingbehaviors:

Depression
havingthingsgoright
havingfun
beinglistenedto
caringaboutthings
feelingthingsaregettingworse
feelingunderstood
Hyperactivity
interruptingothers
remainingstill
talkwithoutwaitingforothers
AttitudetoSchool
notlikingschool
boredatschool
wantingtoquitschool
RatingsbyOthers:
Ms.Stark,Ms.Calvo(ELAteacher),andMr.Rider(mathteacher)alsocompletedBASC-2ratingscales.Areasratedasbeingwithinthe
clinicallysignificantrangebyall3ratersincludedHyperactivity,Aggression,andAtypicality.Areasthatwereratedasbeingwithineitherthe
clinicallysignificantoratriskrangebyall3ratersincludedConductProblems,Depression,AttentionProblems,Withdrawal,Adaptability,
SocialSkills,andAdaptiveSkills.BothteachersratedJonsskillsintheareasofSchoolProblems,Leadership,andStudySkillstobewithin
theatriskrange.Behaviorsofconcernincluded:
Aggression
treatingotherskindly
keepingtemper
speakingkindlytoothers
respectingauthority
beingflexible
Withdrawal
makingfriends
joiningactivities
joiningconversations

Hyperactivity
leavingseat
actingwithoutthinking
havingpoorself-control
beingoverlyactive
disruptingothers
Depression
beinglonely
beingpessimistic
gettingeasilyupset
ConductProblems
usingfoullanguage
stealing
sneakingaround
breakingrules
Lying

JonsbehaviorwasalsoratedusingtheConners-3.Areasthatwereratedasbeingwithintheveryelevatedorelevatedrangebyall3raters
includedHyperactivity/Impulsivity,LearningProblems,Defiance/Aggression,andPeerRelations.Ratingsindicatedthatbehaviorstypically
displayedmetthesymptomcountfortheConductDisorderandOppositionalDefiantDisorder.
ThereviewofdisciplinedataindicatedthatJonhashad39referralsatschoolthisyear.Thereferraltrendshowsthebeginningofanincrease
inreferralsinNovemberwithasharpspikeinDecember,thenagradualdeclineinthenumberofreferralssinceDecember(whenJonwas
placedintheinterimalternativesetting).Inlookingattheoffensedistribution,44%ofthereferrals(17)havebeenforclassdisruptions;28%
(11)havebeenfordefiance;8%(3)forotherminoroffenses;5%(1)forphysicalaggression;and3%(1)forprofanity.Themajorityof
offenseshasoccurredintheclassroomsettingduringseatworkactivitiesandisfairlyequallydistributedacrosssocialstudies,science,and
English/languageartsclasses.
Behaviorsthatareobservedsignificantlymorefrequentlythanwithtypicalpeersincluderefusaltocompleteworkorfollowdirection;verbal
orphysicalaggressiontowardpeersandteachers(threats,throwingobjects,breakingitems);andclassdisruptions(talkingout,arguing,
requiringsignificanttimefromtheteachertocoaxhimintoworking).TeachersreportthatwhenJonisasked/toldtodosomethinghedoes
notwanttodo,hebecomesdefiantandresistant.Heoftenrefusestofollowdirectionsandthenbecomesdisruptivetoinstruction.There
behaviorsinterferewithJonsabilitytocompleteworkindependentlyinthegeneraleducationsettingandwiththeinstructionofothers.Jon
doesnotofteninteractwithhispeersandwhenhedoes,itisusuallynotappropriate;heoftenteasesothersorseemstoannoyotherson
purpose.
Jonhasdifficultywithotherfunctionalbehaviorsincludingorganization,planning,andsequencingofevents/activities.Whenassignedatask,
Jonoftenhasdifficultyknowingwhattodotobegin,howtobreakthetaskintosmallersteps,andhowtokeepeverythingorganized.He
completeswork,thencannotfinditwhenitistimetoturnitin.Heisoftenunpreparedforclass(nopaper,pencils,orbooks).Hehas
difficultyfollowingmulti-stepdirections.
Jonappearstohaveverylittleinsightintohowhisbehaviormaybeimpactingthereactionofothers.Hedoesnottypicallytakeresponsibility
forhisactions,butratherblamesothers.Hesometimesreportsthathedoesnotremembereventsafterhebecomesangryanditisunclearto
teacherandhismotherifthisisanothermeansofavoidingresponsibilityforhisactionsorifheissoangrythathehasnorecollectionofhis
behaviorduringtheseepisodes.Jonsperceptionofeventsattimesdoesnotmatchactualevents.Heoftenreportsthatothershavesaidor
donethingstoprovokehisbehavior/outburstsorhemisinterpretsothersbehaviors.
InterventionsandaccommodationsattemptedhaveincludedallowingordirectingJontogotoadesignatedalternativelocationwhenhe
becomesagitatedordistractedsothathemaycalmdownormaycompletehisworkinaquietersetting(theCharacterEdroom);modifying
hisdaysothathehasashortenedday;removingJontoasettingwherehecantalkthroughtheproblemandfocusonamorepositiveresponse
tohisfrustration/agitation;in-schoolsuspensions;andout-of-schoolsuspensions.Jonsmotheralsohasalsobeenattheschoolorcometothe
schooltoallowJontositwithherawayfromtheclassroomsettingtocompletehiswork.Althoughthenumberofreferralshasdecreased,
Jonsbehaviorhasnotimproved.Heisspendingmoretimeeachdayoutofthegeneraleducationsettingandinanalternativesetting(the
CharacterEdroomortheoffice).Jonhasalsoreceivedcounselingconsistentlyforthepast8years.Ms.Snowreportedthatsheseesthesame
behaviorsofconcernthatshesawwhenJonwas5yearsold.ShealsostatedthatalthoughJonmadesomeprogresswhileatKingsPlace,he
reachedaplateauandstaffrecommendedhebedischargedbecausehewasunable/unwillingtomovepastthatpoint.
Summary:
TheinformationgatheredisconsistentwithJonshistoryintheeducationalandhomesettingsandalsoconsistentwithJonsdiagnosesfrom
hispsychiatrist.Jondemonstratesoppositionalbehaviorsacrosssettings.Heavoidsworkorothertasksthatheisnotinterestedinbyeither
ignoringdirections/requests(puttinghisheaddown,refusingtocomply)orovertlyrefusingbyverballystatinghewillnotcomplyor
physicallyavoidanceofleavingtheroom.Whenconfrontedwithhislackofcompliance,Jonisoftenvolatileandreactsaggressively.These
combinedbehaviorshavebecomeaveryeffectivemeansofavoidingtasksandactivitiesthatJondoesnotwanttoparticipateinorfinds
difficultathomeandatschool.TeachersreportthatitisofteneasiertoletJonsitquietlythantopushhimtoworkandriskanoutburst.Itis
verydifficulttopredicthowJonwillreacttoadirectionorinstruction.Therearetimeswhenhecomplieswithoutanyissueandthereare
othertimeswhenheexplodesverballyorphysicallyindefiance.
Baseduponthementionedandcollectedinformation,Joncurrentlycontinuestodemonstrateaneedforoccupationaltherapy,speechand
languageskillsandbehaviormanagement.

Presentlevelsrelatedtocurrentpostsecondarytransitiongoalsifthestudent'sageis14oryoungerifdeterminedappropriatebytheIEPteam(e.g.,resultsofformative
assessments,curriculum-basedassessments,progresstowardcurrentgoals)
Notapplicable.
Parentalconcernsforenhancingtheeducationofthestudent
Ms.StarkwascontactedonMonday,September1,2017at8:45a.m.inordertoconfirmJon'sinitialIEPmeeting.Sherequestedaphone
conference.
Howthestudent'sdisabilityaffectsinvolvementandprogressinthegeneraleducationcurriculum
ItisrecommendedthatJonbefurtherevaluatedtodeterminehisstrengthsandneedsashepotentiallymayhaveaSpecificLearning
Disability.
Strengths
Some of Jon's strength's include the following:
*Significant improvements in his communication skills; can be understood by others
*Able to calm himself when given the ability to do so
Some of Jon's needs include the following:

*Positively engaging and showing respect with his peers and others
*Increase of self-control in both his body and voice
*Refrain from physical aggression and use of calming down strategies to control his emotions
*Employ positive self-talk and coping strategies to handle stressful situations or work demands in which he/she obtains anxious or withdrawn behavior
*Improvement in his reading and comprehension skills and abilities
*Increased interest in mathematics
*Maintain more consistent attention and concentration in the classroom setting
Academic,developmental,andfunctionalneedsrelatedtostudent'sdisability
Jon's results of the reevaluation indicate that he continues to present with persistent problems in the following areas: concentration, attention,
aggression, impulsive behavior. These internal and external behavioral issues negatively influence his academic abilities and access to the
general education curriculum. He will continue to have a behavioral plan, and potentially begin to self-monitor his actions and behaviors
daily. He demonstrates a need for specially designed instruction (SDI) as he transitions to 8th grade. Secondly, he will benefit from assistive
technology. This will be an iPad to support him through writing, and other subject-related tasks. He will use the Word prediction and other
applications that may be decided as providing the best outcome.

III.TRANSITIONSERVICES-Thisisrequiredforstudentsage14oryoungerifdeterminedappropriatebytheIEPteam.
IfthestudentdoesnotattendtheIEPmeeting,theschoolmusttakeotherstepstoensurethatthestudentspreferencesandinterestsareconsidered.
Transitionservicesareacoordinatedsetofactivitiesforastudentwithadisabilitythatisdesignedtobewithinaresultsorientedprocess,thatisfocusedonimproving
theacademicandfunctionalachievementofthestudentwithadisabilitytofacilitatethestudentsmovementfromschooltopostschoolactivities,includingpostsecondary
education,vocationaleducation,integratedemployment(includingsupportedemployment),continuingandadulteducation,adultservices,independentliving,orcommunity
participationthatisbasedontheindividualstudentsneedstakingintoaccountthestudentsstrengths,preferences,andinterests.
POSTSCHOOLGOALS-Basedonageappropriateassessment,defineandprojecttheappropriatemeasurablepostsecondarygoalsthataddresseducationandtraining,employment,and
asneeded,independentliving.Undereacharea,listtheservices/activitiesandcoursesofstudythatsupportthatgoal.Includeforeachservice/activitythelocation,frequency,projected
beginningdate,anticipatedduration,andperson/agencyresponsible.
ForstudentsinCareerandTechnologyCenters,CIPCode:
PostsecondaryEducationandTrainingGoal: MeasurableAnnualGoal
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Yes/ No
(DocumentinSectionV)
After graduating high school, Jon will research for 10
hours and find vocational and college programs in
sports medicine or in athletic training.
CoursesofStudy:
Service/Activity Location Frequency Projected Anticipated Person(s)/Agency
Beginning Date Duration Responsible
CollegeResearchProgram Weekly(1hour)across10weeks 9/5/2017 9/3/2018
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Yes/ No
By December 2017, Jon will complete a career
assessment to identify careers that match his sports
and media-related interests, likes and dislikes.
CoursesofStudy:
Hewillvisitacareerlab2timesasemester. Once 9/5/2017 9/3/2018 Jon,histeachers,
careerlab

III.TRANSITIONSERVICES(Continued)
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Yes/ No
By December 2018, Jon will select certificate programs
for sports or media related jobs in lifeguarding,
coaching in swimming, soccer or basketball.
CoursesofStudy:

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Yes/ No
By March 2018, Jon will identify three types of sports
degrees he might be interested in pursuing in the
future.
CoursesofStudy:

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Yes/ No
By April 2018, Jon will identify 3 of his top vocational
schools, 2-year colleges, or four-year colleges with
programs shed like to find more about.
CoursesofStudy:



EmploymentGoal: MeasurableAnnualGoal
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Yes/ No
After high school graduation, Jon will seek out
employment that is related to sports. After attending
vocational or college training, Jon will work at a local
sports arena or recreational facility in his community.
CoursesofStudy:
CareerInformationSystem 2hours/weekly 9/5/2017 9/3/2018 Transition
specialist,Jon,
teachersandfamily

EmploymentGoal: MeasurableAnnualGoal
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Yes/ No
Jon will work 25 plus hours a week at a local school or
recreation center and provided temporary supports
through Vocational Rehabilitation.
CoursesofStudy:


IndependentLivingGoal,ifappropriate:Noneatthistime MeasurableAnnualGoal
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Yes/ No
After graduation, Jon will follow and maintain the
laws of his local community, demonstrating an
understanding of the need for laws for ensure ones
safety by exercising this in his local community center
1/hour daily.
CoursesofStudy:
Beginning Duration Responsible
Date
AccesstheInternetorvisitthelocallibrarytoobtainavoterregistrationform 1hourbi- 9/5/2017 9/3/2018 Jon,teachers,
weekly transition
specialist,family

IndependentLivingGoal,ifappropriate:Noneatthistime MeasurableAnnualGoal
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Yes/ No
After graduation, Jon will maintain his fine motor,
visual-motor, sensory functioning and assistive
technology needs by visiting his occupational therapy 2
-3 times monthly.
CoursesofStudy:
Date



IndependentLivingGoal,ifappropriate:NoneatthistimeJonwillutilize3specificself-determinationskillstohelpaidinhis MeasurableAnnualGoal
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transitiontoanindependentlivelihood. Yes/ No
CoursesofStudy:
Date
Skillsneededtoobtainthisgoal:communicatethenatureofhisdisability, Daily/Monthly 9/5/2017 9/3/2018 Disability
neededaccommodationsandstrengthsforpostsecondaryeducationand coordinator,Jon,
functioning.AttendIEPmeetingsandteacherconferencestostayinformed. family
Engageinappropriateconversationsutilizingthestrategieslearnedinaffective
skillsthroughfamilyconferencing.Lastly,setupamonthlymeetingwiththe
disabilityservicecenterrepresentativewithcollegesofinterest.

IV.PARTICIPATIONINSTATEANDLOCALASSESSMENTS
InstructionsforIEPTeams:
Pleaseselecttheappropriateassessmentoption.InformationonavailabletestingaccommodationsmaybefoundintheAccommodationsGuidelinesavailableonwww.education.state.pa.us.
StateAssessments
NotAssessed
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PSSA(Mathadministeredingrades3-8;Scienceadministeredingrades4and8;Readingadministeredingrades3-8;Writingadministeredingrades5and8;andELA*)
TestedSubject Without With AccommodationstobeProvided
Accommodations Accommodations
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ReadAloudDirections
Visual/GraphicOrganizers
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Extendedtime
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*ELAwillreplacetheReadingandWritingPSSAsin2014-15forgrades3-8.
KeystoneExam(Replacesthe11thgradePSSAinhighschool;Studentmustparticipateby11thgrade)
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IV.PARTICIPATIONINSTATEANDLOCALASSESSMENTS(Continued)
KeystoneProjectBasedAssessment(AvailablewhenstudentisunabletodemonstrateproficiencyonaKeystoneExamorKeystoneExammodule.)
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ValidatedLocalAssessment(AvailablewhenselectedasoptionbyLEA)
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PASA(Administeredingrades3-8,11forReadingandMath;Grades4,8,11forScience)
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ExplainwhythestudentcannotparticipateinthePSSAortheKeystoneExamforReading/Literature,Math/Algebra1,Science/Biology,andComposition(TheCompositionexamwillbe
availableforthe2016-17schoolyear):
ExplainwhythePASAisappropriate:
Choosehowthestudent'sperformanceonthePASAwillbedocumented.
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Videotape(preferredmethod)
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Writtennarrativenotes(requirespriorapprovalinaccordancewithPDEguidance)

ACCESSforELLs(AdministeredingradesK-12)
Domains Without With Unableto AccommodationstobeProvidedorRationaleforInabilitytoParticipateinSelectedDomains
Accommodations Accommodations Participate
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AlternateACCESSforELLs(Administeredingrades1-12)
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ExplainwhythestudentcannotparticipateintheACCESSforELLs:
ExplainwhytheAlternateACCESSforELLsisappropriate:
Domains Without With Unableto AccommodationstobeProvidedorRationaleforInabilitytoParticipateinSelectedDomains

Accommodations Accommodations Participate
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LocalAssessments
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Studentwillparticipateinlocalassessmentswiththefollowingaccommodations;OR
image
description
.
TohelpJonparticipateinthelocalassessments,hewillhaveresponse,settingandtime/schedulingaccommodations.Theseaccommodations
includethefollowing:keyboardorcomputertoformulateresponses,extendedtime,smallgroupsetting,andmanipulativetohelpinthe
mathematicsassessment.
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description
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Thestudentwilltakeanalternatelocalassessment.
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Explainwhythestudentcannotparticipateintheregularassessment:
Explainwhythealternateassessmentisappropriate:

V.GOALSANDOBJECTIVES
Include,asappropriate,academicandfunctionalgoals.Useasmanycopiesofthispageasneededtoplanappropriately.Speciallydesignedinstructionmaybelistedwitheachgoal/objectiveor
listedinSectionVI.
Shorttermlearningoutcomesarerequiredforstudentswhoaregifted.Theshorttermlearningoutcomesrelatedtothestudent'sgiftedprogrammaybelistedunderGoalsorShortTermObjectives.
MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN periodic

Include: Condition, Name, Behavior, and Criteria student's progress reports on progress will
(Refer to Annotated IEP for description of these components) toward be
meeting this goal will provided to parents
be measured
Self-Regulation Mayincludebutnot Quarterlyprogress
limitedto: reportswithdistrict
When Jon becomes upset, frustrated, or angry, he will use a self-regulation/coping strategy (movement reportcards
break, deep breathing, quiet space break, deep pressure/heavy work activity, etc.) to engage in appropriate *Progress
behavior, with one reminder as measured by observations and documentation 4/5 days per week. Monitoring
*DataCollection
*Observation
and/or
*Informaland
Formal
Assessments
Report of Progress
GoalSpecificSDI
*Smallgroupinstruction
*Multi-sensoryinstruction
*Cues/prompts
*RepeatedTrials
*PeerTutoring
*Self-MonitoringTechniques
*VarietyofPresentation
*ComputedAssistedInstruction
*Chunking

V.GOALSANDOBJECTIVES(Continued)
*RelaxationTechniques
SHORTTERMOBJECTIVES-Requiredforstudentswithdisabilitieswhotakealternateassessmentsalignedtoalternateachievementstandards(PASA).
Short term objectives / Benchmarks Level of Achievement Method of Evaluation Report of Progress



Include: Condition, Name, Behavior, and Criteria student's progress toward reports on progress will
(Refer to Annotated IEP for description of these components) meeting this goal will be measured be
provided to parents
Organizational: Progresstowardsthisgoalwillbemeasured Progresswillbe
throughtheutilizationofweeklyorganizational reportedQuarterly
WhileusinganorganizationalscheduleonhisATandimplementing checkswithchecklist,dailycues/prompts,andbi- withthedistrict
learnedorganizationalstrategies,Jonwilloutlinedailytasksforeach weeklyself-monitoringsystems. reportcard.
subjectareaincludingduedates,assignmentspecifics,andmaterials
neededwith100%accuracy,5/5daysperweek.
Report of Progress
GoalSpecificSDI
*Sequentialchecklist
*Hourlyreminders/prompts
*Modifiedtimeinschoolschedule/tasks



Include: Condition, Name, Behavior, and Criteria student's progress reports on progress will be
(Refer to Annotated IEP for description of these components) toward provided to parents
meeting this goal will be
measured
OccupationalTherapySupportServices: MayIncludebutnot Quarterlyprogress
limitedto: reportswithdistrict
Whileutilizinganelectronickeyboardwithtouchscreenoptions,Jonwillcomposecomplete reportcards
sentencesandparagraphswith85%accuracyon4/5daysperweekwithcorrectusagein ProgressMonitoring
punctuation,capitalizationandgrammar,whilebuildinghissensoryprocessingskillsinagrading Writingprobes
period. Observations
DataCollection
Formal/Informal
Assessments
Report of Progress
GoalSpecificSDI
*Graphicorganizers
*Tactilekinesthetictracing
*Computer/iPadassistedinstruction
*RepetitivePractice


VI.SPECIALEDUCATION/RELATEDSERVICES/SUPPLEMENTARYAIDSANDSERVICES/PROGRAMMODIFICATIONS
Include,asappropriate,fornonacademicandextracurricularservicesandactivities.
A.PROGRAMMODIFICATIONSANDSPECIALLYDESIGNEDINSTRUCTION(SDI)
SDImaybelistedwitheachgoaloraspartofthetablebelow.
Includesupplementaryaidsandservicesasappropriate.
Forastudentwhohasadisabilityandisgifted,SDIalsoshouldincludeadaptations,accommodations,ormodificationstothegeneraleducationcurriculum,
asappropriateforastudentwithadisability.
Modifications and SDI Location Frequency Projected Beginning Date Anticipated Duration
WithregardstoJon'sspeciallydesigned SetonHillUniversity Daily 9/5/2017 9/3/2018
instruction,hewillbesuppliedwiththe
followingtypesofinstructionintheschool
setting:
AdaptationstoPresentation:
Provide verbal step- by-step directions

Provide explicit, clear and concise
directions to ensure the understanding of
a task
Provide verbal and visual cues for
modeling each task

Provide models and
examples for tasks

VI.SPECIALEDUCATION/RELATEDSERVICES/SUPPLEMENTARYAIDSANDSERVICES/PROGRAMMODIFICATIONS(Continued)
GeneralInstruction: SetonHillUniversity Daily 9/5/2017 9/3/2018
iPadforwritingandacademictaskwork
Provide repeated drill/trials
Provide small group instruction during

learning/activity time
Employ a variety of approaches; multi-
sensory instruction
Break instruction into small
parts/chunks of
information
Establish a set
routine to obtain
student attention
Provide frequent and
repeated review and
practice opportunities
Provide frequent
positive reinforcement and praise

Provide graphic organizer for daily tasks

Adaptions to Learning Environments: SetonHillUniversity Daily 9/5/2017 9/3/2018
Shortenedlearningperiods
Calmingbreaksthroughoutschoolday
AdaptationstoInstruction: SetonHillUniversity Daily 9/5/2017 9/3/2018
AcceptwritingassignmentsoniPad
Given frequent short quizzes and
progress checks
Given extra time and quieter space for
work and tests
Recognize and give credit for student's
oral participation
Break long assignments into smaller
chunks
Provide graphic organizers and charts to
help prepare the student for the task at
hand
AdaptationstoMaterials: SetonHillUniversity Daily 9/5/2017 9/3/2018
Provide the utilization of a number line

Provide manipulatives for mathematics
instruction
Provide adaptive keyboard/iPad

B.RELATEDSERVICES-Listtheservicesthatthestudentneedsinordertobenefitfromhis/herspecialeducationprogram.
Service Location Frequency Projected Beginning Date Anticipated Duration

AssistiveTechnology SetonHillUniversity 6time(s)perMonthfor60 9/5/2017 9/3/2018
DevicesandServices minutes/session6,thirty
minuteone-on-onesessions
permonth
OccupationalTherapy SetonHillUniversity 3time(s)perWeekfor60 9/5/2017 9/3/2018
minutes/session3twenty-
fiveminutesessionsper
week
C.SUPPORTSFORSCHOOLPERSONNEL-Listthestafftoreceivethesupportsandthesupportsneededtoimplementthestudent'sIEP.
School Personnel to Support Location Frequency Projected Beginning Date Anticipated Duration
Receive Support
RegularEducation OTConsultation SetonHillUniversity 5timesperquarter 9/5/2017 9/3/2018
Teacher/Staff
D.GIFTEDSUPPORTSERVICESFORASTUDENTIDENTIFIEDASGIFTEDWHOALSOISIDENTIFIEDASASTUDENTWITHADISABILITY-Supportservicesarerequired
toassistagiftedstudenttobenefitfromgiftededucation(e.g.,psychologicalservices,parentcounselingandeducation,counselingservices,transportationtoandfromgiftedprogramstoclassrooms
inbuildingsoperatedbytheschooldistrict).
Noneatthistime.
E.EXTENDEDSCHOOLYEAR(ESY)-TheIEPteamhasconsideredanddiscussedESYservices,anddeterminedthat:
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checked
StudentISeligibleforESYbasedonthefollowinginformationordatareviewedbytheIEPteam:
End of
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.description

OR
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description
. checked
End of
AsofthedateofthisIEP,studentisNOTeligibleforESYbasedonthefollowinginformationordatareviewedbytheIEPteam:
image
description
.

TheAnnualGoalsand,whenappropriate,ShortTermObjectivesfromthisIEPthataretobeaddressedinthestudent'sESYProgramare:
IftheIEPteamhasdeterminedESYisappropriate,completethefollowing:
ESY Service to be Provided Location Frequency Projected Beginning Date Anticipated Duration


VII.EDUCATIONALPLACEMENT
A.QUESTIONSFORIEPTEAM-ThefollowingquestionsmustbereviewedanddiscussedbytheIEPteampriortoprovidingtheexplanationsregardingparticipationwithstudentswithout
disabilities.
Itistheresponsibilityofeachpublicagencytoensurethat,tothemaximumextentappropriate,studentswithdisabilities,includingthoseinpublicorprivateinstitutionsorothercarefacilities,
areeducatedwithstudentswhoarenotdisabled.Specialclasses,separateschoolingorotherremovalofstudentswithdisabilitiesfromthegeneraleducationalenvironmentoccursonlywhen
thenatureorseverityofthedisabilityissuchthateducationingeneraleducationclasses,EVENWITHtheuseofsupplementaryaidsandservices,cannotbeachievedsatisfactorily.
Whatsupplementaryaidsandserviceswereconsidered?
JonisrecommendedtoreceiveItinerantLearningSupportServicesandoccupationaltherapyservices.Duetotheaccommodations
andadaptationsthatarenecessaryforJon'ssuccess,theIEPteamdecidedthatItinerantLearningSupportServiceswould
appropriatelymeethisneeds.Jonwillbeincludedforgoodportionsofthedaywithinthegeneraleducationclassroom.However,due
tohismathematicalandreading/writingabilities,hewillbeincludedinthelearningsupportclassroomforsmallgroupremediation
andinstructionathispresentlevel.Healsowillparticipatewithsame-agedpeersforportionsofthecoresubjects(languagearts,
readingandmathematics)withinthegeneraleducationenvironment.Occupationaltherapywillhelptosupporthiseducationalneeds
andhyperactivity.
Whatsupplementaryaidsandserviceswererejected?
JonwillcontinuetoreceiveOccupationaltherapyandassistivetechnologyservicesinordertoaddressdeficitsinhisfinemotor,
sensoryandacademicabilities.Hedoesnotqualifytoreceiveanyothertypesofitinerantaidsandservicesatthistime.
Explainwhythesupplementaryaidsandserviceswillorwillnotenablethestudenttomakeprogressonthegoalsandobjectives(ifapplicable)inthisIEPinthe
generaleducationclass.
Withtheutilizationofanitinerantreading,mathematicsandOTprogram,smallgroupinstructionandrepeatedpracticeathis
instructionallevel,Jonshouldstarttomakeprogressinmultipleareasofreadingandbegintodevelophisoralfluencyabilities,
comprehensionskills,andimprovehisself-regulationandorganizationalskills.Hewillalsobegintobuildconfidenceinhis
controllingofbehaviorsleadingtopositiveinteractionsandcontributionstotheclassroomenvironment.Alongwithspecifically
designedinstructionoutlinedinhisIEP,Jonshouldbegintofindsuccessandmakeadequateprogresswithinboththelearningsupport
andgeneraleducationenvironmentsandworktowardshisnewgoals.
Whatbenefitsareprovidedinthegeneraleducationclasswithsupplementaryaidsandservicesversusthebenefitsprovidedinthespecialeducationclass?
Jonwillbeincludedwithinthegeneraleducationclassroomforlanguagearts,reading,andmathematicsinstructionaswellas
extracurricularactivitiesthroughoutthedurationoftheschoolday.Hewilladditionallybeincludedwithinthelearningsupport
classroomforreadingandmathematicsremediationwithitinerantprogramsaswellasmaterialpresentedatherinstructionallevel.In
addition,smallgroupinstructionwillhelpJustintogaintheconfidenceandacademicskillsthatheneedstofindsuccessacrossall
learningenvironments.Hewilllearnamonghissame-agedpeersaswellasfromthemodificationsthatareoutlinedinherIEPwhile
beingapartofthegeneraleducationenvironment.Occupationaltherapycoupledwithhisassistivetechnologywillhelphimto
strengthen,buildandreinforcehiswritingandevenmathematicalabilities.
Whatpotentiallybeneficialeffectsand/orharmfuleffectsmightbeexpectedonthestudentwithdisabilitiesortheotherstudentsintheclass,evenwithsupplementaryaidsand
services?

VII.EDUCATIONALPLACEMENT(Continued)
Jon will benefit from positive interactions while learning amongst his same-aged peers while in the general education classroom. His
behavioral plan will help to initiate positive interactions with his peers and the classroom at large.
Towhatextent,ifany,willthestudentparticipatewithnondisabledpeersinextracurricularactivitiesorothernonacademicactivities?
Jonwillreceivelanguagearts,reading,andmathematicsinstructionwithinthegeneraleducationclassroomandreadingandmathematics
instructioninthelearningsupportenvironment.Hewillalsoparticipatewithhissame-agedpeersforallextracurricularactivities.His
sensory,self-regulation,andmeditativecalmingstrategieswillhopefullyhelp.
ImIm
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Image description. page35image8112 End of image description.
Explanationoftheextent,ifany,towhichthestudentwillnotparticipatewithstudentswithoutdisabilitiesintheregulareducationclass:
Jon will be fully included in the general education classroom, except for the times when he receives services for occupational therapy and in the
learning support classroom.
Explanationoftheextent,ifany,towhichthestudentwillnotparticipatewithstudentswithoutdisabilitiesinthegeneraleducationcurriculum:
Jonwillbeincludedinthegeneraleducationcurriculumwithhissame-agedpeers,exceptforthetimeswhenheisreceivingoccupational,
curriculuminthelearningsupportclassroomandcalmdownbreaksinthelearningsupportroomaswell.
B.TypeofSupport
1.Amountofspecialeducationsupports
Image
description
. checked
End of
Itinerant:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelfor20%orlessoftheschoolday
image
description
.
Image
description
. not
checked
Supplemental:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelformorethan20%ofthedaybutlessthan80%oftheschoolday
End of
image
description
.
Image
.description
not
checked
Full-Time:Specialeducationsupportsandservicesprovidedbyspecialeducationpersonnelfor80%ormoreoftheschoolday
End of
image
.description
2.Typeofspecialeducationsupports
Image
description Image
description Image
description
. not
checked . not
checked . not
checked
End
image of End
image of End
image of
description
. description description
AutisticSupport
.
GiftedSupport
.
MultipleDisabilitiesSupport
Image
description Image
description Image
description
. not
checked . checked
End of . not
checked
End of
image image
description End of
image
.description . .description
BlindorVisuallyImpairedSupport LearningSupport PhysicalSupport

Image
description Image
description Image
description
. not
checked . not
checked . not
checked
End of
image End of
image End of
image
description
. description description
DeaforHearingImpairedSupport
.
LifeSkillsSupport
.
SpeechandLanguageSupport
Image
description
. checked
End of
image
description
.
EmotionalSupport

VII.EDUCATIONALPLACEMENT(Continued)
C.Locationofstudent'sprogram
NameofSchoolDistrictwheretheIEPwillbeimplemented: MountLebanonAcademy
NameofSchoolBuildingwheretheIEPwillbeimplemented: AdministrativeBuilding
Isthisschoolthestudentsneighborhoodschool(i.e.,theschoolthestudentwouldattendifhe/shedidnothaveanIEP)?
Image
description
. checked
End of
image
description
.
Yes
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description
. not
checked
End of
image
description
.
No
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description
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checked
Specialeducationsupportsandservicesrequiredinthestudent'sIEPcannotbeprovidedintheneighborhoodschool
End of
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description
.
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description
. not
checked
Other.Pleaseexplain:
End of
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.

VIII.PENNDATAREPORTING:EducationalEnvironment(CompleteeitherSectionAorB;SelectonlyoneEducationalEnvironment)
VIII.PENNDATAREPORTING:EducationalEnvironment(Continued)
Tocalculatethepercentageoftimeinsidetheregularclassroom,dividethenumberofhoursthestudentspendsinsidetheregularclassroombythetotalnumberofhoursintheschoolday(including
lunch,recess,studyperiods).Theresultisthenmultipliedby100.
SECTIONA:ForStudentsEducatedinRegularSchoolBuildingswithNondisabledPeers-IndicatethepercentageoftimeINSIDEtheregularclassroomforthisstudent:
Timespentoutsidetheregularclassroomreceivingservicesunrelatedtothestudent'sdisability(e.g.,timereceivingESLservices)shouldbeconsideredtimeinsidetheregularclassroom.
Educationaltimespentinage-appropriatecommunity-basedsettingsthatincludeindividualswithandwithoutdisabilities,suchascollegecampusesorvocationalsites,shouldbecountedastime
spentinsidetheregularclassroom.
CalculationforthisStudent:
Column1 Column2 Calculation IndicatePercentage PercentageCategory
Totalhoursthestudent Totalhoursinatypical (Hoursinsideregularclassroom SectionA:Thepercentageof Usingthecalculationresult-
spendsintheregular schoolday(including hoursinschoolday)x100=% timestudentspendsinside selecttheappropriatepercentagecategory
classroomperday lunch,recess&studyperiods) (Column1Column2)x100=% theregularclassroom:
Image
.description
Endchecked
of
image
description
.
INSIDEtheRegularClassroom80%orMoreoftheDay
Image
description
5.00 6.00 (5.006.00)x100=% 83.00%oftheday

. not
checked
End of
image
description
INSIDEtheRegularClassroom79-40%oftheDay
Image
description
. not
checked
End
image of
description
INSIDEtheRegularClassroomLessThan40%oftheDay
SECTIONB:ThissectionrequiredonlyforStudentsEducatedOUTSIDERegularSchoolBuildingsformorethan50%oftheday-selectandindicatetheNameofSchoolorFacility
onthelinecorrespondingwiththeappropriateselection:(Ifastudentspendslessthan50%ofthedayinoneoftheselocations,theIEPteammustdothecalculationinSectionA)
Image Image

description
. not description
. not
checked
End of checked
End of
image
description image
description
.
ApprovedPrivateSchool(NonResidential)
.
OtherPublicFacility(NonResidential)
Image Image

description
. not description
. not
checked
End of checked
End of
image
description image
description
.
ApprovedPrivateSchool(Residential)
.
Hospital/Homebound
Image Image

description
. not description
. not
checked
End of checked
End of
image image
OtherPrivateFacility(NonResidential) CorrectionalFacility
Image Image

description
. not description
. not
checked
End of checked
End of
image
description image
description
.
OtherPrivateFacility(Residential)
.
OutofStateFacility
Image Image

description
. not description
. not
checked
End of checked
End of
image
description image
description
.
OtherPublicFacility(Residential)
.
InstructionConductedintheHome
EXAMPLESforSectionA:HowtoCalculatePennDataEducationalEnvironmentPercentages
Column1 Column2 Calculation IndicatePercentage
(Hoursinsideregularclassroomhoursin
Totalhoursthestudentspendsinthe Totalhoursinatypicalschoolday SectionA:Thepercentageoftimestudent
schoolday)x100=%
regularclassroomperday (includinglunch,recess&studyperiods) spendsinsidetheregularclassroom:
(Column1Column2)x100=%
Example1 5.5 6.5 (5.56.5)x100=85% 85%oftheday(Inside80%orMoreofDay)
Example2 3 5 (35)x100=60% 60%oftheday(Inside79-40%ofDay)
Example3 1 5 (15)x100=20% 20%oftheday(Insidelessthan40%ofDay)
Forhelpinunderstandingthisform,anannotated IEPisavailableonthePaTTANwebsiteatwww.pattan.netType"AnnotatedForms"intheSearchfeatureonthewebsite.Ifyoudonothave
accesstotheInternet,youcanrequesttheannotatedformbycallingPaTTANat800-441-3215.

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SetonHillUniversity

IEP 9/28/2017 BeverlyRPowers

Date of Revision(s) Participants/Roles IEP Section(s) Amended

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The Print Toolassesses7areas(memory,orientation,placement,size,start,sequence,control)andspacing(optional).

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Some of Jon's needs include the following:

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Service/Activity Location Frequency Projected Anticipated Person(s)/Agency

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Reading End of image

Math End of image

Writing End of image

ELA* End of image

Literature End of End of

Biology End of End of

IEP 9/28/2017 BeverlyRPowers

Literature End of End of

Biology End of End of

Biology End of End of

IEP 9/28/2017 BeverlyRPowers

Listening End of End of End of

Image Image Image

Reading End of End of End of

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Domains Without With Unableto AccommodationstobeProvidedorRationaleforInabilitytoParticipateinSelectedDomains

Listening End of End of End of

Reading End of End of End of

Image Image Image

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MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN periodic

IEP 9/28/2017 BeverlyRPowers

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MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN periodic

IEP 9/28/2017 BeverlyRPowers

MEASURABLE ANNUAL GOAL Describe HOW the Describe WHEN periodic

IEP 9/28/2017 BeverlyRPowers

Provide verbal step- by-step directions

modeling each task

examples for tasks

IEP 9/28/2017 BeverlyRPowers

Provide repeated drill/trials