Page 1 of 12 IEP DATES IEP Team Meeting 3/7/11 Initial IEP Offer of a FAPE: Implementation: Annual/Review IEP Offer

of a FAPE: 3/7/11 Implementation: 3/8/11 Reevaluation IEP Offer of a FAPE: Implementation:

Individualized Education Program (IEP)

Section 1 Demographic Information
Student Last: Bean First: Jack M: M Birth Date: 1/1/93 City: Happy Valley Gender: M Grade: 12 State: MI UIC: Zip: 49444

Ottawa Area Intermediate School District

Address: 123 Stalk Street Phone: 616-123-4567 Resident District: Happy Valley County: Ottawa Parent Last: Bean First: Mary M: W

Operating District: Happy Valley Public Schools Attending Building: Happy Valley High School Relationship to Student: Mother

Native Language or Other Communication Mode: English Address (if different): Home Phone: 616-123-4567 Email: [email protected] Parent Last: Bean First: Dale M: P Relationship to Student: Father City: Work Phone: 616-123-7654 State: Pager/Cell: 616-234-5671 Zip:

Native Language or Other Communication Mode: English Address (if different): Home Phone: 616-123-4567 Email: [email protected] PURPOSE OF MEETING Check one of the following: Initial IEP Annual/Review IEP Reevaluation IEP Check all others that apply: Change of Placement Suspension/Expulsion Secondary Transition Change of Eligibility Other: Graduation Other: City: Work Phone: 616-345-6712 State: Pager/Cell: 616-234-1765 Zip:

OFFICE USE PARENT CONTACT The parent/adult student was contacted to explain the purpose of the meeting and the roles and responsibilities of each participant via (check all that apply): IEP Invitation Letter Phone Other: Parent Teacher Conferences

Results: Possible dates for an IEP were discussed at Parent Teacher Conferences. An invitation was sent out on 2/7/2011 An attendance confirmation phone call made on 3/5/2011.

IEP

Ottawa Area ISD November 2010

Page 2 of 12 PARENTAL RIGHTS AND AGE OF MAJORITY Check all that apply: The student will be age 17 during this IEP and the student was informed of parental rights that he or she will receive at age 18. The student has turned age 18 and the student and parent were informed of parental rights that were transferred to the student at age 18, including the right to invite a support person such as a parent, advocate, or friend. The student has turned age 18 and there is a guardian established by court order. The guardian is: . The student has turned age 18 and a legally designated representative has been appointed. The representative is: as (e.g., power of attorney, trustee). IEP MEETING PARTICIPANTS IN ATTENDANCE Check the box indicating the IEP participant(s) who can explain the instructional implications of evaluation results.

_________________________________________ Student (must invite at age 16 and older) _________________________________________ Parent _________________________________________ Parent _________________________________________ Agency Providing Secondary Transition Services (consent on file) _________________________________________ Other

_________________________________________ District Representative/Designee _________________________________________ General Education Teacher _________________________________________ Special Education Teacher _________________________________________ Other

_________________________________________ Other

Parent and District Agreement on Attendance Not Necessary These members are absent; their curricular area/related services are not being modified or discussed in the meeting: Parent and District Agreement on Excusal Prior to Meeting These members are absent and have submitted written input to the IEP team, including the parent, prior to the meeting: ELIGIBILITY FOR SPECIAL EDUCATION Eligible Ineligible

Area of disability: Specific Learning Disability If the student is determined ineligible as a student with a specific learning disability (SLD), provide a statement of the basis for the determination of ineligibility: If the student is determined eligible as a student with an SLD, check all that apply: Oral expression Reading fluency skills Listening comprehension Reading comprehension Written expression Mathematics calculation Basic reading skill Mathematics problem solving

Determination of eligibility was made in accordance with IDEA regulations at 300.306(c)(1).

IEP

Ottawa Area ISD November 2010

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Section 2 Present Level of Academic Achievement and Functional Performance

FACTORS TO CONSIDER General The IEP team must consider each of the following: The strengths of the student: Jack has developed excellent cabinetry skills in the woods program at Happy Valley High School. He is an energetic student who demonstrates leadership skills when working with more inexperienced students in a team setting. Although he continues to struggle with reading skills, he has developed effective strategies for understanding the materials presented to him in his general education classes. He has excellent attendance and teachers report that he is a respectful student in his general education classes. The concerns of the parent for enhancing the education of the student: Parents are thrilled with the progress Jack has made during the last two years. They are excited that Jack is continuing his education in a field he is gifted in while having received the educational support for his learning disabilities. The results of the most recent evaluation(s) of the student: , WISC -IV (9/2009):Verbal comprehension 98, perceptual reasoning 90, working memory 94 and processing speed of 91. Full scale IQ is 91. On the Kaufman Test of Educational Achievement-II Jack scores are as follows: basic skills reading 75, reading comprehension 73, math calculation 75, math problem solving 70. Jack's current (9/2010) Lexile score is 1024. On an update of transition needs (ESTR-J assessment of transition skills) Jack scored 95% in employment, 100% in recreation and leisure, 90% in home living, 100% in community participation and 85% in post-secondary education for an overall score of 95% Jack used the accommodations of double time and the test on audio for the ACT test (March 2010) Scores are out of 36 points possible in each area: English 20, Math 20, Reading 18 and Science 25 for a Composite score of 21. Writing (out of 12) Jack's score was a 7. Special Factors The IEP team must consider the following for the student (check boxes to indicate consideration): The communication needs of the student. The need for assistive technology devices and services for the student. The IEP team must consider the following for the student, as appropriate (check all that apply): The use of positive behavioral interventions and supports, and other strategies, to address behavior because the student has behavior that impedes his or her learning or the learning of others. The language needs of the student because the student has limited English proficiency. Braille instruction because the student is blind or visually impaired. The mode of language and communication because the student is deaf or hard of hearing.

After reviewing the students progress in the general education curriculum and any prior special education goals and objectives, describe the students present level of academic achievement and functional performance. Report and describe baseline data such as curriculum-based assessments, student work, teacher observations, parent input, and other relevant data for each area of need. Area of need: Academic skills:Jack's first semsester grades are as follows: English Workshop 9a (Read 180) B, Resource A, Geometry 9a C-, Earth Science D+, and World Cultures C-. Although Jack attempts all of his work he does not always grasp what he reads and therefore struggles to answer questions for homework assignments. In general education classes, teachers report that Jack is a good listener when others speak and he makes good contributions to discussions. Parents report that Jack spends 2-3 hours each night on homework. He seems the most prepared for tests when he reviews concepts with parents auditorily. Unfortunately, Jack does not always score well on the written tests given in class. Jack's average on curriculum tests is 69%. His test average in World Cultures is 79%. This teacher reports that all test items are reviewed auditorily the day before the test and this method has been effective for many students in class. Area of need:Transition skills Jack has not had a job and is unsure about what career he would like to pursue. He does not have a driver's licence. He does not regularly participate with peers in activities outside of school. Jack has good self-care and citizenship skills. He helps around the house as directed but does not take initiative to complete tasks on his own.

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Ottawa Area ISD November 2010

Page 4 of 12 Describe how the students academic, developmental, and functional needs affect involvement and progress in the general education curriculum or participation in appropriate activities for preschool students. Jack's academic needs are to develop reading and math skills necessary for a career. He struggles to earn grades that reflect his knowledge in a class because of his difficulty with decoding the words and understanding what he is reading. As well, in math class, because the concepts are presented so quickly, Jack struggles to master the concepts and to carryout required calculations. The struggles Jack is having with his academic tasks are beginning to impact his confidence. He continues to work hard but is starting to question whether or not he will be able to find something he is good at. Jack has managed to earn passing grades in all courses required for graduation so far but may experience more difficulty with classes in his sophomore, junior and senior years. Describe how the student accesses or makes progress in the general education curriculum based on grade level content standards for the grade in which the student is enrolled or would be enrolled based on age. Jack uses the resource class to ask many of the questions he does not want to ask in large group settings. He has also learned how to schedule his tests in the testing center so that they are read to him rather than having to read his tests independently in a general education class. Jack takes general education tests in Earth Science and World Cultures. His English workshop class is designed to help him improve his basic reading and reading comprehension skills by presenting him with reading tasks a bit above his current level rather than in a general education English class which would present reading tasks 2-3 grade levels above his current reading level. Jack completes the basic skills questions for the math concepts presented in class and takes alternate assessments for these skills.

IEP

Ottawa Area ISD November 2010

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Section 3 Secondary Transition Considerations

Secondary transition services are required to be in effect when the student turns 16. IEP teams are recommended to consider secondary transition services at a younger age if appropriate. Secondary transition considerations must be updated annually thereafter. STUDENTS POSTSECONDARY GOALS (VISION) Data Sources Used Educational Development Plan (EDP) Transition Assessment(s) (specify): ESTR-J update, Student interview, Tour feedback from MCTI, Living on my own Survey, Daily Living Skills Competency Rating If the student did not attend the IEP team meeting, describe steps taken to ensure consideration of the students preferences/vision: Adult LivingAs an adult, where do you want to live? Jack will live in a dorm setting at MCTI until he completes his cabinet making training. Career/EmploymentAs an adult, what kind of work do you want to do? Jack will be employed in the construction industry. Community ParticipationAs an adult, what hobbies and activities do you want to do (e.g., arts, recreational activities, shopping, eating out, etc.)? Jack will volunteer with Habitat for Humanity building projects with his church young adult group as well as pursue other outdoor recreational activities as an assistant Boy Scout leader. Postsecondary Education/TrainingAfter high school, what additional education and training do you want? Jack will complete the cabinet making training at MCTI.

PLANNING/COMMUNITY SECONDARY TRANSITION SERVICES Needed Service Related to the Students Strengths, Postsecondary Goals, and Present Level Identify the service needed in at least one of the six areas below. Include the coordinated activity/activities for the service. Identify the responsible agency/other for each activity for the needed service. Instruction Service: Jack will sign an IPE with MRS. Activity: Jack will attend meeting with MRS rep to discuss supports for post-secondary training. Activity: Jack will tour MCTI Cabinet program and living halls Activity: Jack will meet with MCTI residence hall supervisor about living arrangements Considered, not needed (explain): IEP Team Must Consider Community Experiences Service: Jack will make connections in the community. Activity: Jack will make contact with local Habitat for Humanity organization. Activity: Jack will attend church youth group functions Activity: Jack will explore Eagles Scout requirements with his Scoutmaster. Considered, not needed (explain): Jack has a driver's license, can access public services and is involved in 2 community organizations. Development of Employment Service: Employment Training Activity: Jack will complete enrollment process at MCTI Activity: Jack will attend MCTI orientation. Activity: Jack will pursue options about a transfer form the Happy Valley Lowe's lumber dept. to the Plainwell Lowe's lumber dept. Considered, not needed (explain): Other Post-School Adult Living Objectives Expected completion date: IEP Ottawa Area ISD November 2010 Responsible agency/other: MCTI/Jack Responsible agency/other: MCTI/Jack/Parents Responsible agency/other: Jack/Parents Expected completion date: 11/1/2011 Responsible agency/other: Jack/Parents Responsible agency/other: Jack Responsible agency/other: Jack/Parents Expected completion date: 5/26/11 Responsible agency/other: Jack/MRS Responsible agency/other: MCTI/Jack/Parents Responsible agency/other: Jack Expected completion date: 5/26/11

Page 6 of 12 Service: Activity: Activity: Activity: Responsible agency/other: Responsible agency/other: Responsible agency/other:

Considered, not needed (explain): Jack scored above 95% on Daily Living Skills Competency Rating and Living on My Own Survey. Planning/Community Secondary Transition Services continues on next page PLANNING/COMMUNITY SECONDARY TRANSITION SERVICES continued Acquisition of Daily Living Skills Service: Consider When Appropriate Activity: Activity: Activity: Responsible agency/other: Responsible agency/other: Responsible agency/other: Expected completion date: ______________

Considered, not needed (explain): Jack scored above 95% on Daily Living Skills Competency Rating and Living on My Own Survey. Functional Vocational Evaluation Service: Activity: Activity: Activity: Responsible agency/other: Responsible agency/other: Responsible agency/other: Expected completion date: ______________

Considered, not needed (explain): Jack has identified and developed skills towards becoming a cabinet maker. He placed third in a district competition and has had a job at a wood supplier for the past 18 months. THE COURSE OF STUDY TRANSITION SERVICE Indicate how the students course of study aligns with the postsecondary goals (check one): Michigan Merit Curriculum (MMC) leading to a high school diploma (effective for students who entered 8th grade in 2006-2007 school year or later). MMC modification using Personal Curriculum on file: Yes No Curriculum leading to a high school diploma (effective for students who entered 8th grade prior to the 2006-2007 school year). Course of study leading to: Anticipated graduation or completion date: May 2011

IEP

Ottawa Area ISD November 2010

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Section 4 Goals and Objectives/Benchmarks

Instructional AreaList the appropriate content area (e.g., strand/domain): Michigan Content Expectations Upon Which Goal Will Be BasedList the appropriate GLCE, EGLCE, HSCE, EHSCE, or Early Childhood Standards of Quality for Pre-kindergarten: Baseline Data The student is currently Annual Goal By
(date), the student will (demonstrate skill) when/at (conditions criteria) on (assessment/evaluation). (data) on the (assessment).

Short-Term Objective/Benchmark: Performance Criteria: Evaluation Procedure: Evaluation Schedule: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments:

Short-Term Objective/Benchmark: Performance Criteria: Evaluation Procedure: Evaluation Schedule: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments: Status Date: Progress Toward Annual Goal: Comments:

SCHEDULE FOR REPORTING PROGRESS When: Position(s) responsible for implementing goal activities (check all that apply): Special Education Teacher School Social Worker Other: Position(s) responsible for reporting progress on goal: Teacher Consultant Occupational Therapist Speech and Language Provider Physical Therapist

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Ottawa Area ISD November 2010

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Section 5 Supplementary Aids and Services

Supplementary aids and services are provided to enable the student: To advance appropriately toward attaining the annual goals. To be involved and progress in the general education curriculum and to participate in extra-curricular and other nonacademic activities. To be educated and participate in activities with other students with disabilities and nondisabled students.

Supplementary aids and services are needed at this time. Ongoing Instruction and Assessment Scheduling, Presentation, Response, etc. Time/Frequency/Condition Location

Curriculum Supports and Adjustments Directions, Grading, Handwriting, Assignments, Tests, Books, etc.

Time/Frequency/Condition

Location

Supports and Modifications to the Environment Classroom Environment, Health-Related Needs, Physical Needs, Assistive Technology, Behavioral, Training Needs, Social Interaction Supports for the Student, etc.

Time/Frequency/Condition

Location

Other Supports, Accommodations, and Modifications

Time/Frequency/Condition

Location

All aids and services identified will begin on the implementation date of the IEP and continue for the duration of the IEP. Supplementary aids and services are not needed at this time. Explain the extent, if any, to which the student will not participate with nondisabled students:

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Ottawa Area ISD November 2010

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Section 6: Grades K-9 Assessment Participation and Provisions

Based on Grade Level, Independence Level, and English Language Proficiency State Assessments: Grades 3-9 Is a state assessment administered at the grade level(s) covered by this IEP? Yes No

If a state assessment is being administered, indicate in the Assessment column in which assessment the student will participate. If the IEP team determines the Michigan Educational Assessment Program (MEAP) is not appropriate, see the MEAPAccess eligibility criteria at www.michigan.gov/meap-access to determine if MEAP-Access is appropriate. If the IEP team determines that the student must take an alternate assessment (MEAP-Access, MI-Access, or a district-determined social studies assessment) instead of a particular MEAP assessment, complete the Rationale column. Identify any individual appropriate accommodations that are necessary on these state assessments. See the Revised Assessment Accommodation Summary Table at www.michigan.gov/meap. Assessment Area Reading Grades 3-8 Writing Grades 4 and 7 MEAP MEAP-Access MI-Access: Functional MEAP Mathematics Grades 3-8 MEAP-Access MI-Access: Functional MEAP MI-Access: Functional MEAP District-Determined Assessment Supported Participation Supported Participation Supported Participation Assessment Rationale The MEAP is not appropriate because: The alternate assessment is appropriate because: The MEAP is not appropriate because: The alternate assessment is appropriate because: The MEAP is not appropriate because: The alternate assessment is appropriate because: The MEAP is not appropriate because: The alternate assessment is appropriate because: Accommodations

Science Grades 5 and 8

Social Studies* Grades 6 and 9

* If the MEAP Social Studies Assessment is not appropriate for the student, the IEP team MUST identify a district-determined assessment until there is a state-developed MI-Access Social Studies Assessment. District-wide Assessments: Grades K-9 Is a district-wide assessment administered at the grade level(s) covered by this IEP? Yes No

If a district-wide assessment is being administered, indicate in the Assessment column in which assessment the student will participate. If the IEP team determines that district-wide assessment is not appropriate and that the student must take an alternate assessment, identify the alternate assessment and complete the Rationale column. Identify any individual appropriate accommodations that are necessary on these assessments. Assessment District-wide Assessment Alternate Assessment Rationale The district-wide assessment is not appropriate because: The alternate assessment is appropriate because: Accommodations

District-wide Assessment Alternate Assessment

The district-wide assessment is not appropriate because: The alternate assessment is appropriate because:

District-wide Assessment Alternate Assessment

The district-wide assessment is not appropriate because: The alternate assessment is appropriate because:

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Ottawa Area ISD November 2010

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Section 6: Grades 10-12 Assessment Participation and Provisions

Based on Grade Level, Independence Level, and English Language Proficiency State AssessmentMichigan Merit Exam: Grades 11-12 For students at grade level 11: In which assessment will the student participate? Michigan Merit Exam (MME) MI-Access

For students at grade level 12: For MME retest eligibility, see details in the MME Student Eligibility document at www.michigan.gov/mme. Will the student participate in the MME? Yes No If the IEP team determines the student will participate in the MME, identify any individual appropriate accommodations that are necessary on these state assessments. See the MME Chart of Accommodations Dates ACT-Approved and State-Allowed at www.michigan.gov/mme. Assessment Area ACT Reading Comprehension ACT English ACT Mathematics ACT Science ACT Writing WorkKeys Reading for Information WorkKeys Applied Math WorkKeys Locating Information Michigan Mathematics Michigan Science Michigan Social Studies State AssessmentMI-Access: Grade 11 For Grade 11: If the IEP team determines the MME is not appropriate, identify the alternate assessment in which the student will participate and complete the Rationale column. Identify any individual appropriate accommodations that are necessary on these state assessments. See the Revised Assessment Accommodation Summary Table at www.michigan.gov/mi-access. Assessment Area English Language Arts Grade 11 MI-Access/ Alternate Assessment Functional Supported Participation Functional Supported Participation Functional Supported Participation District-Determined Assessment The MME is not appropriate because: The alternate assessment is appropriate because: The MME is not appropriate because: The alternate assessment is appropriate because: The MME is not appropriate because: The alternate assessment is appropriate because: Rationale The MME is not appropriate because: The alternate assessment is appropriate because: Accommodations Accommodations

Mathematics Grade 11

Science Grade 11

Social Studies* Grade 11

* If the MME Social Studies Assessment is inappropriate for the student, the IEP team MUST identify a district-determined assessment until there is a state-developed MI-Access Social Studies Assessment.

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Ottawa Area ISD November 2010

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District-wide Assessments: Grades 10-12 Is a district-wide assessment administered at the grade level(s) covered by this IEP?

Yes

No

If a district-wide assessment is being administered, indicate in the Assessment column in which assessment the student will participate. If the IEP team determines that district-wide assessment is not appropriate and that the student must take an alternate assessment, identify the alternate assessment and complete the Rationale column. Identify any individual appropriate accommodations that are necessary on these assessments. Assessment District-wide Assessment Rationale The district-wide assessment is not appropriate because: The alternate assessment is appropriate because: Accommodations

Alternate Assessment

District-wide Assessment

The district-wide assessment is not appropriate because: The alternate assessment is appropriate because:

Alternate Assessment

District-wide Assessment

The district-wide assessment is not appropriate because: The alternate assessment is appropriate because:

Alternate Assessment

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Ottawa Area ISD November 2010

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Section 6: ELPA/NAEP (Grades K-12) Assessment Participation and Provisions: ELPA

Based on Grade Level, Independence Level, and English Language Proficiency State Assessment: English Language Proficiency Assessment (ELPA) The Home Language Survey (HLS), a Title VI reporting requirement, is given to all students at the time of enrollment. Please consider these two questions annually: Is the students native tongue a language other than English? Yes No Is a language other than English spoken in the students home or environment? When either answer is Yes, complete the following section. Assessment Level and Grade for Spring ELPA and ELPA Initial Screening Level IGrade K Level IIGrades 1-2 Level IIIGrades 3-5 Level IVGrades 6-8 Level VGrades 9-12 For additional information regarding ELPA or the ELPA screener, or to identify any individual appropriate accommodations that are necessary for each of the ELPA domains, see the Revised Assessment Accommodation Summary Table at www.michigan.gov/elpa. Assessed Domains Listening Reading Writing Speaking Accommodations Initial Screening Spring ELPA

Yes

No

Assessment Participation and Provisions: NAEP

Based on Grade Level, Independence Level, and English Language Proficiency National Assessment: National Assessment of Educational Progress (NAEP) Is a NAEP assessment administered to the students district at the grade level(s) covered by this IEP? Yes No Yes No

Has the student participated in the Michigan Educational Assessment Program (MEAP) in the subject being tested?

Can the student participate in the NAEP with allowable accommodations? See the Revised Assessment Accommodation Summary Table at www.michigan.gov/naep. Yes No Can the student participate in the NAEP with allowable accommodations, even if the student did not participate in the MEAP, or needs accommodations not allowed by the NAEP? Yes No If YES, for each content area, indicate any assessment accommodation(s) that the student may need. If NO, state the reason why a specific NAEP assessment is not appropriate. Yes Yes Yes No No No

Assessment

Participation

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Ottawa Area ISD November 2010

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Section 7 Special Education Services and Programs

Related Service Rule Number Specific Amount of Time and Frequency Location Duration*

Does the student have needs that require placement with a teacher with a particular endorsement? Program Rule Number Departmentalized Yes Yes Yes No No No Specific Amount of Time and Frequency Location

Yes

No Duration*

* All programs and services listed above will begin on the implementation date of the IEP and continue for the duration of the IEP, unless otherwise indicated above in the column Duration. EXTENDED SCHOOL YEAR (ESY) SERVICES Extended School Year (ESY) services were considered. It was determined that no ESY services are needed. Current annual goals address one or more skills that require ESY services. Service Specific Amount of Time and Frequency Location Duration

INSTRUCTIONAL TIME General Education Instruction (minutes/hours per week) + EDUCATIONAL ENVIRONMENT The district ensures that, to the maximum extent appropriate, the student will be educated with students who are nondisabled; and special classes, separate schools, or other removal of the student from the general education environment occurs only when the students needs cannot be met satisfactorily in the general education setting with supplemental aids and services. Participation in a Regular Early Childhood Program (students age 3-5) At least 10 hours per week and: receives the majority of special education and related services IN a regular early childhood program. receives the majority of special education and related services OUTSIDE of a regular early childhood program. Less than 10 hours per week and: receives the majority of special education and related services IN a regular early childhood program. receives the majority of special education and related services OUTSIDE of a regular early childhood program. Participation in General Education (students age 6-26) 80% of the day or more 79% to 40% of the day less than 40% of the day separate facility (+) Special Education Instruction (minutes/hours per week) = (=) Total (minutes/hours per week)

SPECIAL TRANSPORTATION Yes (specify): No

IEP

Ottawa Area ISD November 2010