Iep Performance Template

Individualized Education Program (IEP) Performance
Template
© 2019. Grand Canyon University. All Rights Reserved.

Table of Contents
Table of Contents......................................................................................................2
Standard 1: Contextual Factors: School and Community Demographics, Classroom
Demographics, Building Trust Relationships, and Classroom Management............3
Standard 2: Individualized Education Plan – Part 1..................................................4
Standard 3: Individualized Education Plan - Part 2.................................................11
Standard 4: Preparation for IEP Meeting................................................................16
Standard 5: Implementation, Communication, and Progress Reporting.................18
Standard 6: Revised IEP..........................................................................................20
Standard 7: Reflection of the IEP Process...............................................................21
© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 26

Standard 1: Contextual Factors: School and Community Demographics,
Classroom Demographics, Building Trust Relationships, and Classroom
Management
The IEP Performance Standards is the process for preparing and implementing the IEP
process. This template will be used to address specific standards and go through the process
of creating an IEP for a student in your placement.
Part I: Community, District, School, and Classroom Factors

Complete this portion of the IPE Template document using the following link:
Standard 1, Part I
After completing the e-doc portion, submit the PDF you receive into the Learning Management
System (LMS).
Part II: Demographic, Environment, and Academic Factors

Complete this portion of the IEP Template document using the following link:
Standard 1, Part II
After completing the e-doc portion, submit the PDF you receive into the Learning Management
System (LMS).
In order to submit this assignment, you must:

1. Complete each section of Standard 1.
Note: Closing your internet browser before the signing process is completed will result in
a loss of your work. If you will be completing this document in multiple sittings, it is
highly recommended to save and back up your work on another document. When you
are ready to make your final submission, copy and paste your responses into this
document. The data from this electronic document will not be saved until you complete
the signing process.
2. Complete the signing process by entering your name, selecting “Click to Sign,” and
entering your email address.
 An initial email will be sent to you to confirm your email address.
 A completed copy of the document will be emailed to you within minutes of
confirming your email address.
3. After completing the e-doc portion, submit the PDF you receive into the Learning
Management System (LMS).

Standard 2: Individualized Education Plan – Part 1
Base the IEP on the student you are following throughout your student teaching placement.
All identifiable student information should be replaced with pseudonyms for confidentiality. In
addition, some information has been marked "Do not complete"’ due to confidentiality
concerns.
The present level of academic achievement and functional performance (PLAAFP) will guide
the development of the IEP. Teachers must describe student strengths, interests, and needs
within the PLAAFP. Assessment scores and a description of how the student is performing in
relationship to typically developing peers will provide the rationale for the development of
IEP goals, services, testing accommodations, and supplementary aides and services. It is
important that all sections of the IEP align with the PLAAFP.
Special Education Department

Individualized Education Program (IEP)
Student Name: Student Data/Cover Sheet (Form A-1) IEP Meeting Date:
Johnny Doe 04/09/2021
Demographic Information
Student Number: Student (Pseudo) Birthdate: Gender: Grade:

Name:
555 10/09/2014 Male K
Johnny Doe
Student Address: Home Phone:
3500 West Camelback Road Do not complete
City, State, Zip:
Phoenix, Arizona 85017
Parent 1 (Pseudo) Name: Parent 1 Relationship:
Laura Doe Mother
Parent 1 Address: Home Phone:
Do not complete. Do not complete.
City, State, Zip: Work Phone:
Parent 1 Email:
Do not complete.
Parent 2 (Pseudo) Name: Parent 2 Relationship:
Patrick Doe Father
Parent 2 Address: Home Phone:
City, State, Zip: Work Phone:
Parent 2 Email:
Do not complete.
Primary Language of Home: Primary Language Survey Date: Language of Instruction:
Spanish Primary Language Survey Results: English
Home District: Spring Lake Park Service Coordinator:
Attendance District: Spring Lake Park Megan Blakely

Home School: Park Terrace Elementary Attending School: Park Terrace Elementary
Vision Screened On: Results: Passed Hearing Screened On: Results: Passed
Meeting Date: 4/9/2021 Anticipated Duration of IEP: Re-evaluation Due: 3/31/2024

From: 5/5/2021 To: 5/4/2022 Current Evaluation: 3/31/2021
Special Education Primary Category 1: Developmental Cognitive Disabilities: Mild-Moderate
Special Education Eligibility Category 2: Visually impaired
Special Education Eligibility Category 3: Speech/Language Impaired
For Students with SLD only, the following area(s) of eligibility was/were previously determined:
Level of Services: (A)

Type of Meeting:
Annual IEP Meeting
Date Meeting Notice Sent to the Date Procedural Safeguards given to the
Parent(s): 4/8/2021 Parent(s): 4/9/2021

This page will not need to be completed because it is a signature page.
Student (Pseudo) Name: Student Data/Cover Sheet (Form A-2) IEP Meeting Date:
Student ID: 555 DOB: 10/09/2014
The following persons participated in the conference and/or the development of the IEP. Additionally, parents have
been given a copy of their rights regarding the student’s placement in special education and understand that they
have the right to request a review of their child’s IEP at any time.
Position/Relation to Student Participant Date (MM/DD/YY)
If during the IEP year the student turns 16, if the student is not present at the IEP meeting, the service coordinator
must review the IEP with the student and obtain the student’s signature and the date of this review.

Student (Pseudo) Name: Student Data/Cover Sheet (Form B) IEP Meeting Date:
Student ID: 555 DOB: 10/09/2014
PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

(PLAAFP)
Section 1: Current IEP Information
Language
Reading
Writing
Mathematics
Vision - Technology
Section 2: Evaluation Information
Areas of Eligibility:
Special Education Primary Category: Developmental Cognitive Disabilities: Mild-Moderate

Special Education Eligibility Category 2: Visually Impaired
Special Education Eligibility Category 3: Speech/Language Impaired
For students with SLD only, the following area(s) of eligibility was previously determined:
State and District Assessment Scores:

Northwest Evaluation Association
(NWEA)-Measures of Academic
Progress (MAP)
Not appropriate for this student
Section 3: Present Level of Academic Achievement and Functional Performance
A. Cognitive (academic performance in content areas, e.g., ELA/Reading/Writing, Math, Science, Social
Studies, Technology and Fine Arts, as applicable)
Reading
Johnny receives his reading instruction in the center-based classroom from a special education teacher.
Classroom instruction is designed to develop and build Johnny's skills in letter identification and phonetic
sounds, word recognition, and reading comprehension. Johnny has been working on his consistency in
identifying uppercase and lowercase letters and letter sounds when presented with 2 choices. His accuracy
and consistency continue to vary from session to session with lower case letters. Most recently, Johnny
was able to correctly identify 19 out of 26 lowercase letters and 9 sounds, and he consistently knows 14
letters over multiple sessions. When it comes to reading comprehension, Johnny has been working on
answering WH questions about a text that has been read to him in class. To answer these questions,

Johnny is presented with 3-4 pictures and asked to select the correct answer from the field of pictures. So
far this school year, Johnny typically answers these questions with 90% accuracy.
Math
Johnny receives his math instruction in the center-based classroom from a special education teacher. In
the area of math, Johnny has been working on reading and representing numbers 1 through 20 and
counting from 1-20. When presented with 2 choices of numbers Johnny can only consistently, over
multiple sessions, identify 10 numbers. When asked to count objects up to 10, Johnny has demonstrated
the ability to count up to 10 cubes with 1 or fewer prompts. Johnny has consistently been able to count 1-
10, with a prompt of "1,...".
Written Language
Johnny receives his written language instruction in the center-based classroom from a special education
teacher. In this area, Johnny has been working on formation of uppercase and lowercase letters and
writing his name. With a model, Johnny is able to correctly write the letters with 70% accuracy and can
write his name with 90% accuracy.
B. Physical (gross motor, fine motor, vision, and hearing)

Vision
Johnny was seen at Associated Eye Care in Woodbury, MN by Dr. Jeffrey Lynch on June 14, 2018.
Johnny has severe myopia (nearsightedness), astigmatism (blurred vision) and exotropia (eye(s) turn
outwards). His estimated acuity is between 20/60 and 20/100. His prognosis is considered stable. It is
recommended that Johnny avoid high speed/impact activities. Johnny has a moderate field cut on his left
and a mild field cut on his right. He also appeared to have a field cut in the upper and lower fields. Johnny
is able to identify objects with complex and simple backgrounds. He is able to identify various colors
consistently. He is able to track objects when they have small movement but needs to move his head to
track longer distances. This past year, Johnny has been working on his self-advocacy skills in regards to
his visual access. In a controlled lesson, Johnny is able to consistently identify when he does not have
visual access to content and what the issue is (small print, being too far away, low contrast, or
obstruction). He has begun to advocate appropriately in the classroom by telling staff, “I can’t see”. At
this time, no primary learning mode has been determined or established. Johnny will have materials
presented visually, in auditory format, and tactile formats as much as possible. Johnny is a visual learner
and able to access materials within the classroom successfully with accommodating actions and use of
magnification aids. It has been determined by the IEP team that Johnny will not learn braille as he uses
print effectively and approaches educational tasks through the use of vision. Auditory information will be
used as a secondary learning mode during academic tasks.
C. Oral Language and Communication

Communication
Johnny currently receives speech-language therapy services focusing on improving his overall
communication skills including language and speech production. Johnny receives services for 30 minutes
9 times monthly. Johnny has progressed from using gestures, visuals and a speech generating device and
some verbalizations to communicate to now primarily using verbal speech to communicate. He does have
a privately owned speech-generating communication device that he brings back and forth to school.
Johnny's use of his device has decreased as his verbal speech abilities have improved. It is still utilized on
occasion during speech-language therapy sessions while modeling and practicing new sentence structures
and to help facilitate clarity during communication breakdowns; however, Johnny's typical preference is
to use his verbal speech skills to expressively communicate versus using his device. Johnny's progress on
his current speech-language objectives per his March 2021 progress report is as follows: Johnny is able to
produce approximations of one- and two-syllable words both by imitation and independently with 85%
success; It is recommended that this objective be continued for additional targeted phonemes. During this

reporting period, Johnny has targeted CVCV sounds with /ai/ and /ee/ vowels this reporting period.
Johnny has done an excellent job working on his /ai/ and /ee/ vowel production and is producing these
vowels and consonants practiced with 70-85% success. Johnny's language skills and overall functional
communication skills have shown tremendous and consistent progress. Johnny will utilize his device
when there are words, he is unable to communicate clearly and has not been able to clarify after several
attempts. Johnny is able to put phrases together (I want...I see...I have.... You have....) with 85% success
or more and has met this objective. He is beginning to spontaneously utilize articles and plurals primarily
in structured settings but is beginning to generalize their use into unstructured settings. He is able to
produce NVO/NV + locative, Adjective N/V. It is recommended that continued expansion of structures
continue, and that pronoun use continue to be targeted.
D. Social and Emotional Behavior
E. Adaptive
Current Classroom-Based Data:

The typical classroom assessments are not appropriate for Johnny as his cognitive level is significantly
lower than his same-aged peers and would not lead to him achieving a valid score. Instead, Johnny's
academic progress on his IEP goals will be regularly measured by special education staff and kept on the
district progress-monitoring form.
Family’s Input on Student’s Current Performance:

Johnny’s mother, Laura, did not express any educational concerns at this time.
Summary of Work Habits:

Johnny is a quiet, sweet, attentive boy. Johnny always seems happy and friendly with his peers. Johnny is
becoming more interactive with his peers and teachers and is reciprocating conversations more. Johnny
always comes to school with a smile on his face and is eager to learn.
Section 4: Summary of Educational Needs and General Accommodations

Student (Pseudo) Name: Considerations Form (Form C) IEP Meeting Date:
Student ID 555 DOB : 10/09/2014
ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS
Considered
Not Needed Included
Individual Transition Plan ☒ ☐

Statement of Transfer of Parental Rights at Age of Majority ☒ ☐

Statement of Positive Behavior Interventions, Strategies, and Supports ☒ ☐
Considered for a Student Whose Behavior Impedes his or her Learning,
or That of Others
Statement of Language Needs in the Case of a Child with Limited ☒ ☐

English Proficiency
Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

a Visually Impaired Child
Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Communication with Peers in the Child’s Language, and
Communication Mode
Statement of Required Assistive Technology Devices and Services ☐ ☒

Statement of Communication Needs for a Child with a Disability ☐ ☒

Student (Pseudo) Name: Accommodations (Form F) IEP Meeting Date:
Student ID: 555 DOB: 10/09/2014

ASSESSMENTS
(Rationales for the accommodations that are being chosen specific to assessments.)
Rationale: These assessments are not appropriate for Johnny as his cognitive level is significantly lower than his same-aged
peers and would not lead to him achieving a valid score. Instead, Johnny's academic progress on his IEP goals will be regularly
measured by special education staff and kept on the district progress-monitoring form.
These assessments are not appropriate for Johnny as his cognitive level is significantly lower than his same-aged peers and would
not lead to him achieving a valid score. Instead, Johnny's academic progress on his IEP goals will be regularly measured by
special education staff and kept on the district progress-monitoring form.
State Assessments
Standard Accommodation(s): Northwest Evaluation Association (NWEA)-Measures of Academic Progress (MAP)

District Assessments
Standard Accommodation(s): End of Trimester Common Assessment

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS
Testing Area Test Results Grade Semester Year

Reading N/A N/A N/A N/A
Writing N/A N/A N/A N/A
Math N/A N/A N/A N/A
Science N/A N/A N/A N/A

LEAST RESTRICTIVE ENVIRONMENT (LRE)
Provide an explanation of the extent, if any, to which the student will NOT participate with non-
disabled students in the general curricular, extracurricular, nonacademic activities, and program
options. §300.347(a) (4):
Johnny needs specialized instruction in occupational therapy (OT) to support his fine motor coordination skills. He will receive
this instruction during non-core academic times in a resource area with a certified occupational therapy assistant under the
supervision of an occupational therapist. Johnny needs specialized instruction in speech-language therapy to improve his
communication skills. He will receive this instruction during non-core academic times in a resource room with the speech-
language pathologist. For the 2021-2022 school year, direct speech-language therapy services will begin, as noted on the service
page, on Monday, September 20, 2021. Johnny will have access to become familiar with the classroom norms, routines, and
building peer and staff relationships. Building these relationships and routines will benefit him greatly. If there are concerns
during this time, the IEP team can meet and determine a new start date and make adjustments as needed
Consider any potential harmful effects of this placement for the child or on the quality of
services that he or she needs §300.552 (a-b):
Johnny will spend most of his school day in a special education classroom but will still have interaction with typically developing
peers during recess, lunch and special activities.
Reason for different services at school:

Johnny's intellectual abilities and developing adaptive skills negatively impact his ability to participate in the mainstream
curriculum with typically developing peers without significant supports. Johnny requires a significant amount of support from
staff in order to complete required academic and fine motor tasks, participate appropriately in groups, show age-appropriate
behavior, manage his emotions, and communicate his wants and needs. Johnny's receptive needs negatively impact his ability to
effectively follow directions, learn and understand new concepts, his expressive language and speech articulation needs
negatively impact his ability to effectively communicate his thoughts, needs, wants and ideas with peers and classroom staff in
the educational setting.

Standard 3: Individualized Education Plan - Part 2

Student (Pseudo) Name: Student Goals and Performance Objectives IEP Meeting Date:
Student ID: 555 Progress Report DOB: 10/09/2014
Skill Area: Communication: Language

Standard: 0.10.1.1 Demonstrate command of the conventions of standard English grammar and usage when writing or
speaking.
Annual Goal: By the next annual IEP, Johnny will improve his language skills from a level of primarily using two-word
phrases and utterances containing carrier phrases and sentence starters to a level of spontaneously and independently producing
complete utterances using mastered concepts and phonemes on 80% of trials as measured by observation of student performance
by the speech-language pathologist and classroom staff.
Baseline Level of Mastery: Given direct instruction and practice and visual supports, Johnny will use pronouns
(I/You/She/He) in sentences with 80% success over three data collection opportunities as measured by the speech-
language pathologist and classroom staff.
Service Provider(s) for this goal: Speech-Language Pathologist
Skill Area: Math

Standard: K.1.1.3 Count, with and without objects, forward and backward to at least 20.
Annual Goal: By the next annual IEP, Johnny will increase his basic math skills from a level of being able to count
independently from 1-15 to a level of being able to count independently from 1-40.
Baseline Level of Mastery: Given the verbal prompt to count from 1 to 40, Johnny will perform this task with
80% accuracy and 1 or fewer prompts from an adult over 3 consecutive sessions by April of 2022 as measured by
special education staff.
Service Provider(s) for this goal: Special Education Teacher
Skill Area: Reading

Standard: 0.3.0.3 Know and apply grade-level phonics and word analysis skills in decoding words.
Annual Goal: By the next annual IEP, Johnny will increase his basic reading skills from a level of identifying 15 out of 26
letter names and 9 out of 26 sounds to identifying 26 out of 26 letters and sounds and reading CVC words with 60% accuracy and
answering WH questions with 1-2 word responses as measured by special education staff.
Baseline Level of Mastery: Given 2 choices, Johnny will correctly identify 26 out of the 26 letters and sounds
over 3 consecutive sessions by April 2022 as measured by special education staff.

Skill Area: Writing
Standard: 0.6.5.5 With guidance and support from adults, respond to questions and suggestions from adults and peers and add
details to strengthen writing as needed.
Annual Goal: By the next annual IEP, Johnny will increase his written language and fine motor skills from a level of
requiring significant support and modeling to write his name and form letters and shapes to a level of writing his name
independently and forming letters and shapes without a modeling on 4 out of 5 opportunities as measured by special education
staff.
Baseline Level of Mastery: Without a model of his first name and with a model of his last name, Johnny will
legibly write his name with minimal support from an adult (2 or fewer prompts) on 4 out of 5 opportunities by April 2022 as
measured by special education staff.
Given all letters and shapes without models to trace or imitate, Johnny will legibly write the various letters and
shapes with minimal support from an adult (2 or fewer prompts) on 4 out of 5 opportunities by April 2022 as measured by special
education staff.
Skill Area: Vision – Assistive Technology

Standard: N/A
Annual Goal: Johnny will go from a level of no knowledge of assistive technology tools nor ever using them in the
classroom to a level of being able to independently demonstrate a basic understanding of assistive technology tools and how to
use them with 80% accuracy.
Baseline Level of Mastery: Given a school tablet and a controlled 1:1 lesson, Enrique will be able to
independently demonstrate how to use built inaccessibility features (e.g. pinch zoom, 3-finger tap zoom, magnifier) with 80%
accuracy as measured in 4 out of 5 opportunities by staff.
Service Provider(s) for this goal: Blind/Vision Impairment Teacher

Student (Pseudo) Name: Accommodations (Form E) IEP Meeting Date:
Student ID 555 DOB: 10/09/2014

ACCOMODATIONS
Date Given to General Education Teacher: 5/09/2021 Service Coordinator: Megan Blakeley
Accommodations Type Location

Short writing utensils to encourage correct grip 3 A
Visuals used to teach vocabulary 1 A
Preferential seating on the front left side of the room 3 A
LEGEND FOR TYPE AND LOCATION FIELDS

Type:
1 = Class work/assignments 2 = Assessments/tests 3 = Both class work/assignments/assessments
Location:
A = All Subjects B = Language Arts/English C = Reading D = Spelling E = Math
F = Science G = Social Studies H = Health I = Electives J = Physical Education
K = Lunch L = Transition / Vocation M = Library N = Title 1 O = Special/Exploratory
Family Communication
How will the family be informed of their child’s academic progress and the extent to which that progress
is sufficient to enable the child to achieve annual goals by the end of the year?
Progress reporting will be done on the district progress report.
IEP Team Consideration for Extended School Year
Consideration for eligibility:

Is the student likely to regress or lose critical skills during the time services are not provided?
Eligible for ESY: Yes
Written explanation as to why ESY is or is not needed:

Due to Johnny’s need for services with social skills and functional, adaptive skills the team believes he
would benefit from attending the extended school year.

Student (Pseudo) Name: Services and Environment (Form I) IEP Meeting Date:
Student ID: 555 DOB: 10/09/2014
SPECIAL EDUCATION SERVICES TO BE PROVIDED

Special education services necessary to meet special education goals and objectives during the school
calendar year.
The child is in need of specially designed instruction in the following areas:
Special Instructional
Education Setting/ Start Date Frequency Provider Duration/ End
Services Location Date
Speech/Language Special 05/05/2021 9.0 per month Speech-Language 05/04/2022
Therapy Education Pathologist
Classroom
Functional Skills Special 05/05/2021 1.0 per day Special Education 05/04/2022
Education Teacher
Classroom
Clarification: SLI - DCD
EDUCATIONALLY RELEVANT RELATED SERVICES
Math Special 05/05/2021 1.0 per day Special Education 05/04/2022
Education Teacher
Classroom
Written Language Special 05/05/2021 1.0 per day Special Education 05/04/2022
Education Teacher
Classroom
Reading Special 05/12/2021 1.0 per day Special Education 05/04/2022
Education Teacher
Classroom
Clarification: DCD
EDUCATIONALLY RELEVANT SUPPLEMENTARY AIDS/ASSISTIVE TECHNOLOGY and

SERVICES for STUDENTS
.
Visually Impaired Special 05/12/2021 4.0 per month Blind/Visual 05/04/2022
Education Impairment
Classroom Teacher
Clarification: Visually impaired - VI

SUPPORTS FOR SCHOOL PERSONNEL
Clarification: N/A

Standard 4: Preparation for IEP Meeting
The IEP team must cover mandated topics during the IEP meeting. Topics that must be
addressed during the IEP include, but are not limited to, an introduction of team members,
clarifying the type of meeting (initial, review, amendment/addendum to current IEP), the
required components of the IEP, the procedural safeguards, and prior written notice.
IEP Meeting Planning

Required Participants/Roles:
Megan Blakeley – Special Education Teacher
Heather Tan – Speech-Language Pathologist
Amy Thompson – Student Teacher
Laura Doe - Parent
Required Agenda Outline:
 Introductions
Each team member will introduce themselves and state their roles and responsibilities while
working with Johnny.
 Parents Rights
Parents will be given a copy of the Parent Rights packet, I will make sure to point out and
explain the contact page with the information to contact the head of special education services
of the district and the information of the parents’ right advocate.
 Parents Right Receipt
Parents will sign the receipt of the parents right to document they did receive the packet and
understand the information presented.
 Purpose of the meeting
This is an annual IEP meeting. Johnny has been in the DCD program at Park Terrace for one
year, so parents are familiar with the process, paperwork and classroom setting.
 Strengths and Concerns
The team will discuss the strengths we see Johnny display in the classroom and school setting.

(i.e. Johnny is very social and enjoys waving and saying hi to peers and teachers he passes in
the hallway). The team will also address any concerns they have with Johnny’s progress or
assessment results from the year. Parents will be given time to share the strengths they see at
home and raise any concerns they have as well.
 Progress on Current Goals
We will look at Johnny’s current IEP goals and discuss whether or not we believe he has met
these goals or if they should be carried on to his new IEP so we can continue to target these
skills or goals.
 Discuss potential new goals
After discussing if Johnny has met his current goals, the team and parents will work together to
develop potential new goals for him. These goals will be based off of any concerns parents
have raised, Johnny’s progress and assessment or testing results.
 Discuss timeline of new IEP
After we hold the IEP meeting the special education team will have ten school days write the
new IEP. Once the IEP is completed it will be sent home to parents, who will have fourteen
calendar days to sign that they agree or disagree with the new IEP. Since this is an annual IEP,
the IEP will go into effect in fourteen days if parents do not send back a signed form. Only if
parents disagree to an annual IEP will it not automatically go into effect in fourteen days after
it is written.
 Additional Questions or Concerns
Before ending the meeting, we will give parents and team members an additional
opportunity to ask any questions they have or raise any additional concerns. It is
important to give parents ample opportunity to use their voice and advocate for their
child.
Plan for Conflicts:

It is important to be an active listener during these IEP meetings and while developing a new IEP with the
student’s family. I do not anticipate any conflicts arising during Johnny’s IEP meeting, but in order to be
prepared I will bring my data and documentation in order to address any concerns or issues parents have
during the meeting. It is important parents feel supported and heard during these types of meetings.
Mock IEP Introduction Video

Now that you have outlined the IEP meeting agenda, you are prepared to conduct the meeting. In order
to prepare for running your first official IEP meeting, record yourself as if you were conducting the IEP

meeting. Your video should not exceed 15 minutes in length.
Focus your practice on the meeting introduction. Include the following components within your
recording:
 An introduction of all parties represented and their roles
 Reason for the meeting (initial IEP or IEP review)
 Meeting norms so all parties are heard and respected
 Review of the PLAAFP including the discussion of test results, present levels, goals, services,
Least Restrictive Environment (LRE) statement, Extended School Year (ESY) services,
procedural safeguards, and prior written notice (PWN).
Conclude your video by providing an explanation of how you would actively listen to and address the
needs of families and other stakeholders throughout the meeting.
After recording yourself, review and reflect upon the video below.
Mock IEP Introduction Video Link: https://youtu.be/2uzv2wX3hME
Reflection:
Doing the mock IEP video was uncomfortable for me. I need more practice using the language of an
IEP and IEP goals. I also felt like I did not know how to make it flow as fluently and smoothly as a true
IEP meeting should. However, I do think that was partly because I was simply recording myself and
not actually having a meeting with Johnny’s family. I think I would be more comfortable holding an
IEP meeting when it is an authentic meeting with other staff members and the student’s family. Once I
have been able to sit in on more IEP meetings and observe the flow and language Megan or other
special education teachers use, I think this will all come more naturally to me. I do think I do a good
job of showcasing how much growth a student has made and keeping the meeting in a positive
atmosphere. It is important to me to focus on how well a student has done and present the IEP goals
and accommodations as the next steps to continue the growth in the student.
My next steps or plan of action to continue getting comfortable in IEP meetings an using this type of
language would be to not only attend more meetings, but to also continue practicing. Even if it is
simply me talking to a computer screen, I want to master the flow and structure of holding a meeting
like this. An IEP meeting is a very important moment for the special education staff as well as the
student’s family and therefore I want to treat it as such.

Standard 5: Implementation, Communication, and Progress Reporting
Accountability of Free Appropriate Public Education (FAPE) is mandated by the Individuals with
Disabilities Education Act of 2004 (IDEA). IEP teams must have a plan to document the provision of
services as written in the IEP. Appropriate and accurate data must also be collected to document
quarterly progression toward mastery of IEP goals. Teams must have a plan for on-going data
collection, communication, and presentation of data to the parents/guardians during quarterly
progress reports and annual IEP review meetings.
Accommodations Progress and Communication Plan

Complete the Accommodations Table below, demonstrating how you plan to ensure all
accommodations are being met in the general education setting (if applicable). If the student is not in a
general education classroom, indicate how the student will receive accommodations in content specific
areas based on his or her PLAAFP and IEP goals.
On the Accommodations Table, note the dates when you will obtain progress reports from the general
education teacher or related services staff so that you can gather data on progress (if applicable). If no
general education teachers are reporting, indicate the dates of your (special education teacher)
reporting.
In addition, use the Accommodations Table to gather data on the student’s progress for the first
Quarterly Progress Report.
NOTE: Only two dates are included on the Accommodations Table for the purpose of this assignment.
You may not gather data on both dates in the duration of your placement, but dates should be noted.
Accommodations Table
Goal 1: By the next annual IEP, Johnny will improve his language skills from a level of primarily using two-word phrases and
utterances containing carrier phrases and sentence starters to a level of spontaneously and independently producing complete utterances
using mastered concepts and phonemes on 80% of trials as measured by observation of student performance by the speech-language
pathologist and classroom staff.
Implemented Accommodations: Communication Device Person(s) Responsible: Speech-
Language Pathologist
Quarterly Progress Report 1 Date: June 2021
Data Results: Continued Progress:

Johnny has shown improvement in his communication skills. He is able to produce two or more utterances when using
complete sentences 50% of the time without using his communication device. Johnny has been able to stop requiring his
communication device at all times and is able to communicate independently with single words or gestures. Johnny will
continue to work on this goal.
Quarterly Progress Report 2 Date: December 2021
Data Results:

Goal 2: By the next annual IEP, Johnny will increase his written language and fine motor skills from a level of requiring significant support and
modeling to write his name and form letters and shapes to a level of writing his name independently and forming letters and shapes without a modeling
on 4 out of 5 opportunities as measured by special education staff.
Implemented Accommodations: Short writing utensils to encourage correct Person(s) Responsible: Special
grip Education Classroom Teacher
Quarterly Progress Report 1 Date: June 2021
Data Results: Johnny has continued to show progress on this goal. He is able to independently write his J, O without
modeling in 2 out of 5 opportunities. He is also attempting to write his H without modeling but does require modeling to
write it eligibly. He will continue to work on this goal.
Quarterly Progress Report 2 Date: December 2021
Data Results:
Accommodations Summary:
Since Johnny received majority of his instruction in a special education classroom there are not many specific
accommodations needed to target his skills, as most accommodations are automatically part of the classroom
structure and routine. Johnny has shown progress on all of his goals throughout the year. While Johnny does still
require visuals to clearly communicate at times, especially when asked a question about the lesson material or
assessments, he is doing very well with using independent and spontaneous speech to communicate. He is still
mostly using single word utterances, so we are continuing to target his speech to use full sentences or complete
utterances.
Johnny is also showing progress in his writing goal, using the shorter writing utensils has helped him move from
using a fist grip to a correct pencil grip when writing. He still needs prompting sometimes to use the correct grip but
is moving to do it more independently.
Communication Plan for General Education Teachers and Related Services Staff:
The special education team meets once a month to collaborate about students, their needs, goals and services. This
time is used to address any successes or challenges the student has been showing in the classroom, whether that be
behaviors or academics. If any interventions or extra accommodations are needed for the student to be successful
this is when that is addressed and a plan is created among the entire team.

Standard 6: Revised IEP
IEP teams are expected to regularly analyze and document students’ progress on their IEP
goals throughout the year. This includes identifying when there are changes affecting the
student and presenting evidence of attempts to meet student needs when there is a lack of
progress. To address times when information, services, or goals need to be changed or added
to an existing IEP, the Individuals with Disabilities Education Act of 2004 (IDEA) describes
the regulations and procedures for changing an IEP using an amendment or addendum. An
amendment is used to change something already in the IEP. An addendum is used to add
something new to the IEP, such as goals, services, or accommodations.
After reflecting on your completed Standard 5 content, create a progress report addendum and/or
amendment (based on changes needed) to be added to the initial IEP, or describe why neither an
addendum nor amendment are not needed.
Data Collection and IEP Modifications

Stakeholders involved in special education must be aware of the student progress monitoring
process, keeping the goal of mastering IEP goals and presenting evidence of attempts to meet
said goals in mind. It is vital to keep a record of new information affecting student needs,
including a lack of progress when an IEP is in effect, using an IEP amendment or addendum.
An amendment is a change to the IEP and an addendum is the addition of goals or services and
accommodations to the IEP.
IEP Modification Need

There is no need for an IEP amendment or addendum at this time. Johnny has been showing
progress on his IEP goals, he is progressing at the rate his special education team would expect
him to and has not surpassed any goals or failed to make progress. The goals on his current
IEP are found to be appropriate and adequate for Johnny’s needs at this time.
Family Communication Plan

Johnny’s family will receive a progress report at the end of every trimester showing how he is
progressing with his IEP goals. In addition, there are also parent-teacher conferences in
October, December and if needed in May as well. Johnny’s family will be regularly contacted
by special education staff (once a month) to check in if there is any questions or concerns from
his family.

Standard 7: Reflection of the IEP Process
Reflection is an important part of professional practice. Professional special education
teachers plan and frequently reflect on their delivery of services, instruction, data collection
procedures, and individual student progress. Identification of practices that have worked, and
those that have not, can help the special education teacher adjust instruction and services to
better meet the needs of students.
Continued Learning
After completing the Individualized Education Program (IEP) Performance Template, reflect
upon three best practices you have learned from this student teaching experience in 50-150
words.
1. Meeting students at their individual levels. Each student is going to have different needs and be
working at a different level. It is important to differentiate material and classroom instruction
to meet each student’s needs as best as possible. Even though all of the students I am working
with are in a center based special education classroom, there are still different levels of needs
and abilities represented that I need to always consider in my planning.
2. Provide accommodations and modifications to all students. Just as every student has different
needs and abilities, they all need different accommodations in the classroom to meet these
needs. Every student needs something to help them be as successful as possible and it is my
responsibility to make sure the class structure and environment provides that.
3. Gain insight from all class and team staff about how students are doing on their IEP goals.
Classroom paras as well as service providers who work with students are able to observe and
gain data or insight about each student that is important or sometimes missed by the special
education teacher. It is important to include the entire team when collecting data and insight,
each team member is an important part of a student’s services.
Improved Practice
Based on your experience of developing and delivering your Individualized Education
Program (IEP) Performance Template, list three implications for your future teaching practices
in 50-150 words. Consider concepts you want to take with you into your own classroom, such
as how you will establish and maintain organization in order to facilitate the IEP process in
your classroom.
1. Collecting student data – I really like the way my cooperating teacher collects and stores

students’ data, but I do plan to do it virtually instead of with physical pen and paper. Creating a
table for each student with their IEP goals and spaces to document my observations and data in
an organized and secure way will be very important in my future practice.
2. Regular communication with students’ families – My cooperating teacher makes it a goal to

communicate with every student’s family once a month. Since she does teach a smaller center-
based classroom this is an appropriate expectation based on the number of students she has. In
my future practice I want to set an expectation for communication as well, it is important all
families stay up to date with their child’s progress at school.
3. Team collaboration – I had never seen a team collaborate about students as regularly as my
cooperating teacher’s team does. All classroom staff and service providers meet once a month
to discuss each student and their successes and challenges. I want to continue this in my future
practice so as a team we can best support every student and create the best plan to meet their
needs.

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Individualized Education Program (IEP) Performance

© 2019. Grand Canyon University. All Rights Reserved.

© 2019. Grand Canyon University. All Rights Reserved. Page 2 of 26

Part I: Community, District, School, and Classroom Factors

Part II: Demographic, Environment, and Academic Factors

In order to submit this assignment, you must:

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Special Education Department

Student Number: Student (Pseudo) Birthdate: Gender: Grade:

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Meeting Date: 4/9/2021 Anticipated Duration of IEP: Re-evaluation Due: 3/31/2024

Special Education Eligibility Category 2: Visually impaired

Special Education Eligibility Category 3: Speech/Language Impaired

Level of Services: (A)

© 2019. Grand Canyon University. All Rights Reserved. Page 5 of 26

Student ID: 555 DOB: 10/09/2014

Position/Relation to Student Participant Date (MM/DD/YY)

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Student ID: 555 DOB: 10/09/2014

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Section 1: Current IEP Information

Section 2: Evaluation Information

Special Education Primary Category: Developmental Cognitive Disabilities: Mild-Moderate

State and District Assessment Scores:

Section 3: Present Level of Academic Achievement and Functional Performance

© 2019. Grand Canyon University. All Rights Reserved. Page 7 of 26

B. Physical (gross motor, fine motor, vision, and hearing)

C. Oral Language and Communication

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D. Social and Emotional Behavior

Current Classroom-Based Data:

Family’s Input on Student’s Current Performance:

Summary of Work Habits:

Section 4: Summary of Educational Needs and General Accommodations

Special Education Department

Student ID 555 DOB : 10/09/2014

ADDITIONAL DOCUMENTATION/CONSIDERATION OF SPECIAL FACTORS

Individual Transition Plan ☒ ☐

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Statement of Language Needs in the Case of a Child with Limited ☒ ☐

Statement of Provisions of Instruction in Braille and User of Braille for ☒ ☐

Statement of the Language of Needs, Opportunities for Direct ☒ ☐

Statement of Required Assistive Technology Devices and Services ☐ ☒

© 2019. Grand Canyon University. All Rights Reserved. Page 10 of 26

Student ID: 555 DOB: 10/09/2014

Standard Accommodation(s): Northwest Evaluation Association (NWEA)-Measures of Academic Progress (MAP)

Standard Accommodation(s): End of Trimester Common Assessment

CURRENT STATE STANDARDIZED TEST (i.e., AIMS, PSSA) RESULTS

Testing Area Test Results Grade Semester Year

© 2019. Grand Canyon University. All Rights Reserved. Page 11 of 26

Reason for different services at school:

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Special Education Department

Student ID: 555 Progress Report DOB: 10/09/2014

Skill Area: Communication: Language

Skill Area: Math

Skill Area: Reading

Service Provider(s) for this goal: Special Education Teacher

© 2019. Grand Canyon University. All Rights Reserved. Page 13 of 26