Completed+IEP

Bristol Township School District ||
 * Child's Name:** James
 * School Age Individualized Education Program (IEP)


 * **IEP Team Meeting Date:** 2/23/2010 ||
 * **IEP Implementation Date (Projected Date when Services and Programs Will Begin):** 2/24/2010 ||
 * **Anticipated Duration of Services and Programs:** 2/23/2011 ||


 * Student Name: || James || Date of Birth: || 6/17/2000 ||
 * Age: || 9 || Grade: || 04 ||
 * Anticipated Year of Graduation: || 2019 || Local Education Agency (LEA): || Bristol Township School District ||
 * Name of Parent/Guardian/Surrogate: || Mr. || County of Residence: || Bucks ||
 * Address: ||  || Phone: (H) || 215- ||
 * || Levittown, Pennsylvania 19057 || Phone: (W) ||  ||
 * Other Information: ||||||  ||


 * **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 ||


 * IEP TEAM/SIGNATURES* ||
 * The Individualized Education Program (IEP) Team makes the decisions about the student's program and placement. The student's parent(s), the student's 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 || Printed Name || Signature ||
 * Parent/Guardian/Surrogate || Mr. ||  ||
 * Parent/Guardian/Surrogate ||  ||   ||
 * Student* ||  ||   ||
 * Regular Education Teacher ||  ||   ||
 * Special Education Teacher || Crystal Smith-Herman ||  ||
 * Local Ed. Agency Rep. || Joanne Allison ||  ||
 * Career/Tech Ed. Rep.* ||  ||   ||
 * Community Agency Rep. ||  ||   ||
 * Teacher of Gifted ||  ||   ||
 * Speech ||  ||   ||

One individual listed above must be able to interpret the instructional implications of any evaluation results. ||
 * || * || 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:**

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. ||  ||
 * Transfer of Rights at Age of Majority**
 * 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: _ ||


 * Child's Name:** James
 * || 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 student’s reading and writing skills, needs, and appropriate reading and writing media (including an evaluation of the student’s 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. ||
 * || 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 student’s language and communication mode; academic level; full range of needs, including opportunities for direct instruction in the student’s 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 ||
 * || 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.) ||
 * || 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.) ||
 * || No ||
 * Does the student have limited English proficiency? ||
 * || Yes. The IEP team must address the student’s language needs and how those needs relate to the IEP. ||
 * || No ||
 * Does the student exhibit behaviors that impede his 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 ||
 * || No ||
 * Other (specify): ||
 * ||  || II. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE ||
 * Include the following information related to the student: ||
 * Present levels of academic achievement (e.g., most recent evaluation of the student, results of formative assessments, curriculum-based assessments, transition assessments, progress toward current goals) ||
 * Reading 4-Sight- (Sept. 2009) Basic, (January 2010) Proficient
 * Reading 4-Sight- (Sept. 2009) Basic, (January 2010) Proficient

Math 4-Sight- (Sept. 2009) Below Basic, (January 2010) Proficient Oral Reading Fluency- Winter 2010 - 63 cwpm at 4th grade level (by end of the year it should be 118 correct words per minute at 4th grade level).

Fry 1000 Word List- January 2010 - Identified 1,000 words out of 1,000. (100% of the words able to be identified.)

Grades at the Glance Report__**
 * 2nd Marking Peri****__od (January 2010)


 * Advanced (A)= 90-100%, Proficient (P)= 80-89%, Basic (B)= 70-79%, Below Basic (BB)= 69% and below** || **//Area//** || **//Percentage//** || **//Performance Level//** ||
 * **Vocabulary Definitions** || **100%** || **A** ||
 * **Affixes** || **100%** || **A** ||
 * **Synonyms/Antonyms** || **100%** || **A** ||
 * **Context Clues** || **100%** || **A** ||
 * **Story Comprehension** || **96%** || **A** ||
 * **Making Inferences** || **83%** || **P** ||
 * **Fantasy/Realism** || **80%** || **P** ||
 * **Noting Details** || **80%** || **P** ||
 * **Compound Words** || **100%** || **A** ||
 * **Synonyms** || **100%** || **A** ||
 * **Words ending with –ed or –ing** || **100%** || **A** ||
 * **Past, Present, Future Tense Words** || **66%** || **BB** ||
 * **Plural Nouns that end with f or fe** || **100%** || **A** ||
 * **Possessives** || **80%** || **P** ||
 * **Suffix, able, er, est** || **100%** || **A** ||
 * **Compare and Contrast** || **80%** || **P** ||
 * **Spelling** || **79%** || **B** ||
 * **Fractions (Addition/Subtraction w/like denominators)** || **100%** || **A** ||
 * **Telling Time (minutes before and after & elapsed time)** || **79%** || **B** ||
 * **Graphing** || **100%** || **A** ||
 * **Money** || **100%** || **A** ||

Key Math Assessment (Feb. 22nd, 2010)


 * Area || Raw Score || Stand Score || 90% Conf Interval || Percent Rank || NCE || Stanine || Grade Equiv. || Age Equiv. ||
 * Basic Concepts || 55 || 134 || 127-141 || 99 || 98 || 9 || 9.1 || 14.11 ||
 * Operations || 45 || 108 || 102-114 || 70 || 61 || 6 || 4.7 || 10.3 ||
 * Present levels of functional performance (e.g., results from a functional behavioral assessment, results of ecological assessments, progress toward current goals) ||
 * Speech Language Input : Mary Ellen Maguire, MS-CCC-SLP
 * Present levels of functional performance (e.g., results from a functional behavioral assessment, results of ecological assessments, progress toward current goals) ||
 * Speech Language Input : Mary Ellen Maguire, MS-CCC-SLP
 * Speech Language Input : Mary Ellen Maguire, MS-CCC-SLP

James has been receiving speech support services once weekly to address his articulation for /k/, /d/, /th/, /l/, and /l/ blends during conversational speech. He has made progress towards his speech goals. James correctly produces /k/ at the word level in all word positions with 100% accuracy. James can read sentences and correctly produce /k/ with 100% accuracy in initial and final positions and 95% accuracy in medial positions. James can produce /d/ at the word level with 100% accuracy in initial and final word positions and 95% accuracy n medial word position. At the sentence level, James correctly produced /d/ with 100% accuracy in initial and final positions and 95% accuracy in medial position. For /th/ sound, James requires verbal and visual modeling for correct tongue placement to correctly produce this sounds. He correctly produced /th/ at the word level with 80% accuracy in initial and medial position and 60% accuracy in final word position over 1 data session. At the sentence level, James correctly produced the /th/ at the sentence level with 60% accuracy in initial and medial word position and final word position with 100% accuracy over 1 data session. For /l/ sound, James can correctly produce /l/ at the word level with 100% accuracy in initial and final position and 90% accuracy in medial position over 3 data sessions. He correctly produced /l/ at the sentence level with 90% accuracy in initial position, 75% accuracy in medial position and 95% accuracy in final position over 3 data sessions. He still requires verbal reminders for correct tongue placement. The /l/ sound has not generalized in to connected speech. For /l/ blends, James therapy has been focusing on adding a schwa sound to increase intelligibility (i.e. ba-lue for blue). He requires verbal and visual modeling for correct tongue placement. During conversational speech, James has a tendency to speak quickly and this affects his speech intelligibility. He requires reminders to slow down his rate of speech. Therapy should continue to focus on correct production of /th/, /l/ and /l/ blends during conversation speech. ||
 * Present levels related to current postsecondary transition goals if the student’s 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) ||
 * Student not 14 years of age. ||
 * Parental concerns for enhancing the education of the student ||
 * Dawn Marie Perrine G, School Social Worker, took a complete social history from Mr. Thomas Alexander. The following information is reiterated from that report dated 4/25/05. As per Mr. Thomas**,** pregnancy was full term, without complications and delivery was normal. During James’ first year, he had ear infections. He had myringotomies inserted at age three. Developmental milestones were achieved at the following intervals: he just began talking within the last few months; walking within normal limits; bowel and bladder trained at 4 years. Behaviorally, he continues to tantrum. He screams and kicks, but does not hurt himself. Discipline includes time out, being sent to his room, and time off of the computer. His sleep is regular and uninterrupted. He has a great relationship with his sister, but some sibling rivalry with his brother. Father also reports that he has good peer relationships, but does not like to share toys. His health is good, vision is normal, and tubes have helped to make hearing normal, as well. 2009-2010- James' parents acknowledged the challenges that James faces everyday at school and at home. They have expressed similar behaviors that are displayed at school are displayed at home. Horshum has recommended wrap around services, in which the parents have attended appointments in order to gain the services of wrap around. ||
 * How the student’s disability affects involvement and progress in the general education curriculum ||
 * James is in need of specially designed instruction, in order for him to experience success in his academics, as well as ways in which to deal with his various emotions that are displayed throughout the day. This is due to James's impulsive actions and at times lack of self-control. He needs small group instruction in order to immediately reinforce desired behaviors, as well as to redirect James in making positive choices. In order to do so, James will receive instruction in a supplemental emotional support classroom, where he will complete work based upon the general education curriculum. James will receive general education curriculum in in special areas as well. ||
 * Strengths ||
 * James is a very bright child, who is able to comprehend grade level reading material, as well as excels in reading words in isolation. He is very good at working the computer, as well as putting together puzzles. James loves completing activities dealing with affixes (prefixes and suffixes), as well as typically scores proficient on this area on his weekly vocabulary tests. James is able to construct well developed sentences, when he is focused. James also enjoys playing kickball at recess. He likes completing tests and looks forward to test day every Friday. James enjoys routines and a high structured learning environment. Currently, James set a goal for himself to read 1,000 steps in 100 Book Challenge by the end of the year. (The goal each week is 22 steps.) Whenever there is a free moment James will pick up a book and read in order for him to reach his goal. ||
 * Academic, developmental, and functional needs related to student’s disability ||
 * James needs continued practice in speech therapy, reminders to slow down and look the person in the face when talking, continued reinforcement in stress/anger management techniques, cool down spots in the room and out of the room to help regroup and calm down, ways to control anger, following directions, as well as needs continued practice is learning how to accept consequences and accepting constructive criticism and/or authority's decisions. James also requires a highly structured learning environment, a visual schedule, and reinforcement in improving his wait time to be called on. ||  ||   ||


 * Child's Name:** James
 * **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 student’s 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 student’s 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 student’s needs taking into account the student’s 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.

Yes No (Document in Section V) || Yes No (Document in Section V) || Yes No (Document in Section V) ||
 * For students in Career and Technology Centers, CIP Code:** ||
 * **Postsecondary Education and Training Goal:** N/A || **Measurable Annual Goal**
 * **Courses of Study:** N/A ||
 * **Service/Activity** || **Location** || **Frequency** || **Projected Beginning Date** || **Anticipated Duration** || **Person(s)/Agency Responsible** ||
 * **Employment Goal:** N/A || **Measurable Annual Goal**
 * **Employment Goal:** N/A || **Measurable Annual Goal**
 * **Employment Goal:** N/A || **Measurable Annual Goal**
 * **Employment Goal:** N/A || **Measurable Annual Goal**
 * **Courses of Study:** N/A ||
 * **Service/Activity** || **Location** || **Frequency** || **Projected Beginning Date** || **Anticipated Duration** || **Person(s)/Agency Responsible** ||
 * **Independent Living Goal, if appropriate:** N/A || **Measurable Annual Goal**
 * **Independent Living Goal, if appropriate:** N/A || **Measurable Annual Goal**
 * **Independent Living Goal, if appropriate:** N/A || **Measurable Annual Goal**
 * **Independent Living Goal, if appropriate:** N/A || **Measurable Annual Goal**
 * **Courses of Study:** N/A ||
 * **Service/Activity** || **Location** || **Frequency** || **Projected Beginning Date** || **Anticipated Duration** || **Person(s)/Agency Responsible** ||

• PSSA-M for Math and PSSA for Reading, or • Pennsylvania Alternate System of Assessment (PASA)
 * Child's Name:** James
 * IV. PARTICIPATION IN STATE AND LOCAL ASSESSMENTS ||
 * **Pennsylvania System of School Assessment (PSSA) or Pennsylvania Alternate System of Assessment (PASA)** ||
 * • PSSA for Math and Reading, or

Students will be taking the PSSA, PSSA-M for Math, or the PASA in the grade levels below. • Reading (Grades 3-8, and 11) • Math (Grades 3-8, and 11) (PSSA-M, grades 4-8, and 11) • Writing (Grades 5, 8, and 11) • Science (Grades 4, 8 and 11) ||
 * **Assessment is not administered at this student’s grade level; OR** ||
 * **Student will participate in the PSSA (Reading, Writing, and Science) without accommodations; OR** ||
 * **Student will participate in the PSSA (Reading, Writing, and Science) 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):** Small group setting, frequent breaks, un-timed, test parts read aloud when allowed, oral directions, reading tracking device to help keep track of which lines are being read, headphones to help block out background noise, written responses scribed for James when needed (written response will be what exactly James is saying), use of highlighter, if needed (due to behavior outbursts) a separate room for testing. ||
 * **Student will participate in the PSSA (Math) without accommodations; OR** ||
 * **Student will participate in the PSSA (Math) 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):** Small group setting, frequent breaks, un-timed, test parts read aloud and simplified when allowed, oral directions, manipulatives for math, headphones to help block out background noise, written responses scribed for James when needed (written response will be what exactly James is saying), use of highlighter, if needed (due to behavior outbursts) a separate room for testing. ||
 * **Student will participate in the PSSA-Modified for Math without accommodations; OR** ||
 * **Student will participate in the PSSA-Modified for Math 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):** ||
 * **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 student’s 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 student’s grade level** ||
 * **OR** ||
 * **Student will participate in local assessments without accommodations** ||
 * **OR** ||
 * **Student will participate in local assessments with the following accommodations:** Small group setting, frequent breaks, un-timed, test parts read aloud and simplified when allowed, oral directions, reading tracking device to help keep track of which lines are being read, manipulatives for math, headphones to help block out background noise, written responses scribed for James when needed (written response will be what exactly James is saying), use of highlighter, if needed (due to behavior outbursts) a separate room for testing. ||
 * **OR** ||
 * **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:** ||


 * Child's Name:** James
 * 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 and/or listed in Section VI.

Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the student’s gifted program may be listed under Goals or Short Term Objectives. ||


 * **MEASUREABLE ANNUAL GOAL** - Include: Condition, Name, Behavior, and Criteria (Refer to Annotated IEP for description of these components) || **Describe HOW the student's progress toward meeting this goal will be measured** || **Describe WHEN periodic reports on progress will be provided to parents** || **Report of Progress** ||
 * When asked to take a cool down or time-out to regain focus and composure, James will follow directions for taking time appropriately and will return to the lesson within 5 minutes, 100% of the time. || Daily Charting || Daily behavior notes will be sent home through use of a communication book. Also, results will be summarized quarterly along with report card. || 1st M.P: (Date: ___)__ _

__2nd M.P: (Date:__ _) _

3rd M.P: (Date: ___)__ _

__4th M.P: (Date:__ ___)__ ||


 * Child's Name:** James
 * 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 and/or listed in Section VI.

Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the student’s gifted program may be listed under Goals or Short Term Objectives. ||


 * **MEASUREABLE ANNUAL GOAL** - Include: Condition, Name, Behavior, and Criteria (Refer to Annotated IEP for description of these components) || **Describe HOW the student's progress toward meeting this goal will be measured** || **Describe WHEN periodic reports on progress will be provided to parents** || **Report of Progress** ||
 * When given corrective feedback or a consequence for not following classroom expectations, James will accept consequences for behavior without arguing or justification, across all settings, 90% of the time, on a daily basis. || Daily Charting || Daily behavior notes will be sent home through use of a communication book. Also, results will be summarized quarterly along with report card. || 1st M.P: (Date: _) _

2nd M.P: (Date: ___)__ _

__3rd M.P: (Date:__ _) _

4th M.P: (Date: _) ||


 * Child's Name:** James
 * 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 and/or listed in Section VI.

Short term learning outcomes are required for students who are gifted. The short term learning outcomes related to the student’s gifted program may be listed under Goals or Short Term Objectives. ||


 * **MEASUREABLE ANNUAL GOAL** - Include: Condition, Name, Behavior, and Criteria (Refer to Annotated IEP for description of these components) || **Describe HOW the student's progress toward meeting this goal will be measured** || **Describe WHEN periodic reports on progress will be provided to parents** || **Report of Progress** ||
 * James will correctly produce /th/, /l/ and /l/ blends in all words positions during conversational tasks with 80% accuracy over 3 consecutive sessions.

(PA Academic Standards- 1.63-C- Pronounce most words correctly) || Data Collection by SLP Observations || Quarterly ||  ||


 * Short Term Objectives** - Required for students with disabilities who take alternate assessments aligned to alternate achievement standards (PASA).
 * **Short term objectives/benchmarks** ||
 * When presented with a picture card and/or word, James will correctly articulate his targeted sounds in all word positions at the word level 4 out of 5 opportunities over 3 consecutive sessions. ||
 * When presented with a phrase, James will correctly articulate his targeted sounds in all word positions at the phrase level 4 out of 5 opportunities over 3 consecutive sessions. ||
 * When asked to read a sentence containing his targeted sounds, James will correctly articulate his targeted sounds in all word positions at the sentence level 4 out of 5 opportunities over 3 consecutive sessions. ||


 * Child's Name:** James
 * VI. SPECIAL EDUCATION/RELATED SERVICES/SUPPLEMENTARY AIDS AND SERVICES/PROGRAM MODIFICATIONS ||
 * Include, as appropriate, for nonacademic and extracurricular services and activities.

Regular Education Speech Room Lunch/Recess (All settings) || Daily, 7 hours || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || Daily || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || Daily || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || Daily || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || Daily || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || When needed || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || When needed || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || When needed || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || Daily || 2/24/2010 || 2/23/2011 || Regular Education Speech Room Lunch/Recess (All settings) || When needed || 2/24/2010 || 2/23/2011 ||
 * 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 & SDI || Location || Frequency || Projected Beginning Date || Anticipated Duration ||
 * Personal Care Assistant to help reinforce rules, expectations, track behavior, enforce proper cool town techniques, and to provide support for James across all academic settings. || Special Education
 * Behavior Chart to tract specific behavior goals throughout the day & Positive Behavior Support Plan. (See plan for further details.) || Special Education
 * Positive reinforcement, when goals are positively met. || Special Education
 * Verbal and non-verbal cues to redirect James. || Special Education
 * Small class instruction for core subject areas (reading, writing, math, science/social studies, power hour). || Special Education & Speech Room || Daily || 2/24/2010 || 2/23/2011 ||
 * Communication Agenda Book to write all assignments in and daily behavior choices, to be checked by teacher and parent. || Special Education || Daily || 2/24/2010 || 2/23/2011 ||
 * Reminders for James to look the person in the eyes who he is talking to, as well as to talk slowly and clearly. || Special Education
 * Communication Agenda Book to write all assignments in and daily behavior choices, to be checked by teacher and parent. || Special Education || Daily || 2/24/2010 || 2/23/2011 ||
 * Consistent consequences for poor choices, and reasons why he has he consequence. || Special Education
 * Visual Schedule || Special Education || Daily || 2/24/2010 || 2/23/2011 ||
 * Curb to Curb Transportation Services, via van. || Home and School || Daily || 2/24/2010 || 2/23/2011 ||
 * A cool down at home when behaviors become too aggressive at school and James is not able to regain his composure. Also, when his safety and the safety of others is at risk. || Special Education
 * NVCPI (Restraint) Methods to be used as a last resort when other behavior management techniques have been exhausted and the safety of James and/or others is at risk. || Special Education
 * Cool down tools, such as weighted blank, body sock, couch, weighted pillow, stress ball, puzzles, taught how to use and reinforced daily. || Special Education
 * A cool down spot in and out of the classroom to help regain composure and get himself back to the ready to learn mode. || Special Education


 * **B. RELATED SERVICES** - List the services that the student needs in order to benefit from his special education program. ||
 * Service || Location || Frequency || Projected Beginning Date || Anticipated Duration ||
 * Social Work Services
 * Group** || Special Education Classroom || 20 times a year || 2/24/2010 || 2/23/2011 ||
 * Speech and Language Pathology/Therapy
 * Group**
 * Individual** || Speech Room &/or classroom || 25-30 (30) min sessions || 2/24/2010 || 2/23/2011 ||
 * Transportation || Door to Door (IU Van) || Daily || 2/24/2010 || 2/23/2011 ||
 * Other: PCA
 * Individual** || All settings inclusing lunch/recess || Daily, 7 hours || 2/24/2010 || 2/23/2011 ||


 * **C. SUPPORTS FOR SCHOOL PERSONNEL** - List the staff to receive the supports and the supports needed to implement the student's IEP. ||
 * School Personnel to Receive Support || Support || Location || Frequency || Projected Beginning Date || Anticipated Duration ||
 * Special Education Teacher || Speech/Language Therapist Consultation || James Buchanan || Quarterly || 2/24/2009 || 2/23/2010 ||
 * Special & Reg. Ed Teachers || Other || James Buchanan || Daily || 2/24/2009 || 2/23/2010 ||
 * Special Education || Other: Behavior Consults || James Buchanan || Quarterly || 2/24/2009 || 2/23/2010 ||


 * **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//** ||  ||


 * **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: After reviewing the factors outlined in Chapter 12.132(2) (regression, recoupment, maintenance, mastery/consolidation, independence from caretakers, withdraw, target group), the IEP team determined that James does require ESY services, (based upon daily data collection of behavior data, in which James displays increased behavior outbursts over long breaks and regression) as well as transportation to and from summer program. Any member of the team can request an IEP meeting at a later time to reconsider this decision.

OR 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:

The Annual Goals and, when appropriate, Short Term Objectives from this IEP that are to be addressed in the student’s ESY Program are: When asked to take a cool down or time-out to regain focus and composure, James will follow directions for taking time appropriately and will return to the lesson within 5 minutes, 100% of the time, as tracked by a behavior chart, documented by Personal Care Assistant.

If the IEP team has determined ESY is appropriate, complete the following: ||
 * ESY Service to be Provided || Location || Frequency || Projected Beginning Date || Anticipated Duration ||
 * Special Education Teacher || Bristol Twp. School District || 4 weeks,2.5 hrs/day || 6/21/2010 || 4 weeks. 7/16/2011 ||
 * Personal Care Assistant || Bristol Twp. School District || 4 weeks, daily || 6/21/2010 || 4 weeks, 7/16/2011 ||
 * None ||  ||   ||   ||   ||
 * None ||  ||   ||   ||   ||
 * None ||  ||   ||   ||   ||


 * Child's Name:** James
 * 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 regular educational environment occurs only when the nature or severity of the disability is such that education in regular education classes, EVEN WITH the use of supplementary aids and services, cannot be achieved satisfactorily.

James will not participate with peers that are non-disabled in all core subject areas, but will participate with students that are non-disabled in most special areas, assemblies, lunch and recess. This is so we can provided James with the level of academic and behavior support that he needs throughout the day in order to be successful in all areas of school. James will receive speech therapy for 25-30 (30) minute per week per IEP year with the exception of student absences, state and district assessments, school holidays and school closings.. || James will provided with grade level education curriculum, (with adaptations) but will be completing the general education curriculum in his small group setting, special education class. James will participate with non-disabled peers in the general education curriculum when he is in his special area classes. This is so we can provided James with the level of academic and behavior support that he needs throughout the day in order to be successful in all areas of school. Itinerant speech support will be provided for 25-30 (30) minute sessions per IEP year in speech room &/or classroom with the exception of absences, school holidays, state/district assessment days and school closings. || Blind-Visually Impaired Support Deaf and Hard of Hearing Support Emotional Support Learning Support Life Skills Support Multiple Disabilities Support Physical Support Speech and Language Support ||  ||
 * 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 regular 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 non-disabled peers in extracurricular activities or other nonacademic activities? ||
 * **Explanation of the extent, if any, to which the student will not participate with non-disabled students in the regular education class:**
 * **Explanation of the extent, if any, to which the student will not participate with non-disabled students in the general education curriculum:**
 * **B. TYPE OF SUPPORT** ||
 * ||  |||||| **1. Amount of special education supports** ||
 * ||  ||   || 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
 * **C. LOCATION OF STUDENT'S PROGRAM** ||
 * **Name of School District where the IEP will be implemented:** Bristol Township School District
 * Name of School Building where the IEP will be implemented:** Buchanan

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

(Complete either Section A or B; Select only one Educational Environment) ||
 * Child's Name:** James
 * VIII. PENNDATA REPORTING: 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 student’s 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.

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 ||
 * Calculation for this Student:** || **Column 1** || **Column 2** || **Calculation** || **Indicate Percentage** || **Percentage Category** ||
 * **Total hours the student spends in the regular classroom per day** || **Total hours in a typical school day (including lunch, recess & study periods)** || **(Hours inside regular classroom ÷ hours in school day) x 100 = % (Column 1 ÷ Column 2) x 100 = %** || **Section A: The percentage of time student spends inside the regular classroom:** || **Using the calculation result - select the appropriate percentage category** ||
 * 1.5 || 6.5 || (1.5 ÷ 6.5) x 100 = 23.0769% || 23% of the day ||  ||   || INSIDE the Regular Classroom 80% or More of the Day ||
 * || 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) ||   || Other Public Facility (Non Residential) ||
 * || Approved Private School (Residential) ||  || Hospital/Homebound ||
 * || Other Private Facility (Non Residential) ||  || Correctional Facility ||
 * || Other Private Facility (Residential) ||  || Out of State Facility ||
 * || Other Public Facility (Residential) ||  || Instruction Conducted in the Home ||   ||
 * **EXAMPLES for Section A:** How to Calculate PennData - Educational Environment Percentages ||  || **Column 1** || **Column 2** || **Calculation** || **Indicate Percentage** ||
 * || **Total hours the student spends in the regular classroom - per day** || **Total hours in a typical school day (including lunch, recess & study periods)** || **(Hours inside regular classroom ÷ hours in school day) x 100 = % (Column 1 ÷ Column 2) x 100 = %** || **Section A: The percentage of time student spends inside the regular classroom:** ||
 * Example 1 || 5.5 || 6.5 || (5.5 ÷ 6.5) x 100 = 85% || 85% of the day (Inside 80% or More of Day) ||
 * Example 2 || 3 || 5 || (3 ÷ 5) x 100 = 60% || 60% of the day (Inside 79-40% of Day) ||
 * Example 1 || 1 || 5 || (1 ÷ 5) x 100 = 20% || 20% of the day (Inside less than 40% of Day) ||