Part B - Recommended IEP Template

This proposed redesigned IEP templates highlights my own professional

preferences and connect directly with your stated IEP rationale in the section above.

This template emphaises the important information and knowledge required to

know/understand the child to help reach their full potential with the help of many

stakeholders.

This IEP template was redesigned based on the templates by:

 EduGAINS. 2016.. Individual Education Plans (IEP) and Transitions.

Retrieved 18th August 2016.

<http://www.edugains.ca/newsite/SpecialEducation/transitions.html>

 The Department of Education and Early Childhood Development and the

Department of Human Services. 2016. Individual Education Plans.

Education.vic.gov.au. Retrieved 18th August 2016.

<http://www.education.vic.gov.au/school/teachers/health/Pages/oohcedplans.a

spx>

 Queensland Curriculum and Assessment Authority. 2016. Individual

Education Plan (IEP). Retrieved 18th August 2016.

<https://www.qcaa.qld.edu.au/kindergarten/professional-topics/inclusion-

diversity/children-with-disability/individual-education-plan-iep>

 Family members past IEP plan

Student Profile:
Last Name: Given Name:

Gender: Date of Birth: Age:

Student description:

School and start date:

Current Grade/Special Class:

Days attending school:

Funding/support:

Student Medical and Support Information

Diagnosis or disorder:

Health and Safety Information:

Medical notes:

Triggers:

Interventions to Manage Disorder:

Support staff/agencies:

Attendance of programs/appointments in and out of school:

Relevant Assessment Data

Information Source Date Summary of Results

Contributor/Stakeholders consulted in devising IEP

Name: Agency/Relationship Contact details Signature:
to child: (address and
number):
Parent - Mother
Parent - Father
Principle
Classroom teacher
Integration Aide
Doctor
 Health Support Services in the School Setting
Yes or No
If Yes, What’s required?

Student’s areas of Strength, Skill, Interest and Areas of Need

Area of Strength, Skill, Area of Need Triggers
Interest:

Educational adjustments and inclusive strategies, including required equipment

Instructional Environmental Assessment
Accommodations Accommodations Accommodations

Learning Goals:
Learning Current Long Term Short Term Goals Strategies/ Mode of Success
Areas: Performance: Goals: (What): Methods, Delivery/Impleme Criteria and
assessments ntation: Evaluation/
, teaching Who/Stakeholder Review:
and learning s? Frequency? Analysis
adjustments and further
(How)? planning:

Meeting
Date:
Review
Date/s:
How’s
present?

Meeting
Date:
Review
Date/s:
How’s
present?
 Meeting
Date:
Review
Date/s:
How’s
present?

Meeting
Date:
Review
Date/s:
How’s
present?

Meeting
Date:
Review
Date/s:
How’s
present?

Meeting
Date:
Review
Date/s:
How’s
present?

Evaluation (comments pertaining to the students’ performance/learning against

the set goals)

Number of days absent:

Log of Parent/Student Consultation

Date: Description of consultation Parent/Student
Feedback/Outcome of
Consultation:

Schools Responsibility
__________________________________ ___________________________
_______________
Principles Name Signature Date

__________________________________ ___________________________
_______________
Teachers Name Signature Date

__________________________________ ___________________________
_______________
Parent/Guardian Name Signature Date

__________________________________ ___________________________
_______________
Students Name (If over 16 years) Signature Date