Iep Barnedo
Iep Barnedo
Data
Date: May 7, 2023
STUDENT INFORMATION
Student Carl P. Reyes Date of Birth: March 10, 2015 Age: 9
Grade: 4 SSID Number: 76539 Student Identification Number: 01234567 Gender: Male
Migrant Program Eligibility: ☐Yes ☑ No English Proficiency: EO EL IFEP RFEP TBD
Home Language: Filipino
School of Residence*: Trece Martires Rd. Tanza, Cavite School of Attendance*: Holy Nazarene Christian School
*If Different, Give Reason: N/A School Type: SPED School
Setting (ages 3-22): 9
Residence: Specify Residence Name (if applicable):
Parent/Guardian: Elizabeth Reyes Email: [email protected]
Street Address/P.O. Box: Barangay Sapa 1 City: Cavite_
Zip: 4106
Home Phone:_ 555-0012 Work Phone: Cell Phone: 09348629556
Parent/Guardian: Arnold Reyes Email: [email protected]
Street Address/P.O. Box. Barangay Sapa 1 City: Cavite Zip: 4106
Home Phone: 555-0012 Work Phone; 888-346-654 Cell Phone: 09655420876
Other Contact: Rosenda Pavia_ Email: [email protected]
Street Address/P.O. Box: Tanza City: Cavite Zip : 4106
Main Phone:888-876-675 Alternate Phone: 444-567-435 Cell Phone: 09854463826
Educational Rights: Parent/Guardian Educational Representative: ☐ Surrogate Parent 🗸Adult Student
Ed. Rep./Surrogate (if applicable):Email: N/A
Street Address/P.O. Box: N/A City:N/A Zip: N/A
Main Phone:N/A Alternate Phone:N/A Cell Phone: N/A
ABDITIONAL ACTORS:
Yes No
☑ ☐ This is an initial placement and student received coordinated general education early intervening services (CEIS)
using Federal IDEA funds in one or both of the preceding two years.
☑ ☐ Student exhibits behavior that requires a behavior intervention plan.
☑ ☐ Student is transitioning from special class or NPS to general education class on public campus.
☑ ☐ Student is transitioning from preschool to elementary school and may require a less intensive program.
☑ ☐ Student is being considered for possible change in placement due to disciplinary action {more than 10 days of
suspension or possible expulsion).
IEP 1 (11/16)
iEP — Eligibility
Student: Carl P. Reyes Date of Birth: March 10, 2015 Date: May 7,2023
ELIGIBILITY
Carl is on his fourth grade level who has an autism disorder Despite of his
disorder, Carl excel in arts and science he has a creative and imaginative mind. He
loves to draw anything that he want and have a detail observation on what is
happening around him.
The parent of Carl feel burden of long term finances in raising Carl in terms of his needs
and wants in everyday living. They cannot work totally because they need to take care of Carl.
Carl parents face the challenge that their child are unable to communicate properly .Sometimes they
cannot understand what Carl is saying because he is struggling to express his thoughts. They are
worried about how Carl able to interacts with others in school because he doesn’t want to play with
others and he don’t make eye contact.
☑Student is eligible for special education and related services in the area(s) identified below.
Primary Disability: Autism Spectrum Disorder Secondary disability: Behavioral Disorder
☐ Student is eligible for low incidence funding (visual impairment, deaf/hard-of-hearing, er severe orthopedicimpairment).
☐ Student is not eligible for special education and related services (explain on Notes/Additional information page page).
☑Student will be exiting special education and related services effective:
This exit is due to:
EFFECT OF DISABILITY AND AREAS OF NEED (complete for eligible students only)
This student’s disability causes difficulty developing skills in the areas checked below which might affect his or her ability to
participate anti progress in the general curriculum or (for preschoolers) participate in appropriate activities:
☑Reading — Decoding / Fluency ☐ Receptive Language ☑Recreation/Leisure
☑Reading — Comprehension ☑Expressive Language ☑Self-Care
☐ Math Calculation ☑Articulation/Voice/Fluency ☐ Mobility
☐ Math — Applications ☐ Study/Organization Skills ☐ Other:
☑Written Language ☑Social/Behavioral/Emotional ☐ Other:
Skills
☑Readiness — English Language Arts ☑Attention ☐ Other:
☐ Readiness — Math ☐ Vocational Skills ☐ Other:
IEP 2A (5/15)
IEP - Present Levels of Academic Achievement and Functional Performance
Score Level
English/Language Arts 5/10 3- intermediate
Math 7/10
Other Assessment Data (e.g., curriculum assessment, other district assessment, etc.):
Last vision screening: May 10,2023 ☑Pass Fail Last hearing screening. May 10, 2023 ☑ Pass Fail
PRE-ACADEMlC / ACADEMIC / FUNCTIONAL SKILLS
Carl has difficulty organizing his thoughts and writing cohesive sentences or paragraphs
Carl struggles with math concepts such as multiplication and division
Carl reading ability is on 2nd grade level
IEP 2B (9/15)
IEP - Present Levels of Academic Achievement and Functional Performance
Student: Date of Birth: Date:
COMMUNICATION DEVELOPMENT
Carl has difficulty understanding and using non verbal cues such as facial expressions, hand gestures and
tone of voice
He has limited vocabulary and struggles with communicating and interacting with others
Carl repeat and repeat what his saying
SOCIAL EMOTIONAL/BEHAVIORAL
SEP 2B (9/15)
UP - Present Levels of Academic Achievement and Functional Perfomance
Student*:Carl P. Reyes Date of Birth: March 10, 2015 Date: May 7, 2023
VOCATIONAL
Carl has difficulty with personal hygiene tasks such as taking a bath, brushing teeth,
wearing clothes ang grooming task
Carl also struggles in preparing his meal
ANNUAL GOALS
.Area Academic Skill (Optional) Writing skills
Baseline:
Carl can write two to three sentences but struggles to organize his thoughts and ideas.
Annual Goal:
By the end of the school year Carl will improve his writing skills by writing clear and organized sentences and paragraphs with
proper grammar and punctuation with 80% accuracy.
By the end of the school year, Carl will improve his ability to recognize and use non verbal cues
such as facial expressions, body language, and tone of voice when communicating in social
interactions with 80% accuracy.
IEP 3A (3/19)
IEP — Participation in District and Statewide
Student: Carl P. Reyes
Assessments Bate of Birth: March 10, 2015
Date: May 7, 2023
DESIRED RESULTS
DEVELOPMENTAL PROFILE ( Preschool Only)
Adaptations Required? ☑No Yes (specify below)
Non-Embedded Universal Tools that may be distracting for this student are identified below and should be deactivated.
IEP 4 (1 UI 6)
IEP — Special Factors
Student: Carl P. Reyes Date of Birth: March 10, 2015 Date: May 7, 2023
ASSISTIVE/AUGMENTATIYE DEVICES OR TOOLS
Does student require assistive/augmentative devices or tools to meet educational goals?
No ☑Yes (specify below and include justification)
Positive reinforcements
Visual supports
Structured routines
Sensory support
Applied Behavioral Analysis
IEP — Special Factors
HP 5 (8/15)
IEP — Instructional Accommodations &
Modifications
Student: Carl P. Reyes Date of Birth: March 10, 2015 Date: May 7, 2023
ACCOMMODATIONS
Instructional accommodation needed for the student to be involv ìn and p rogress i n t h e core curriculum(musst be related to the
student’s disability). Accommodations alter howinstruction is provided but de not alter the content of the curriculum.
The accommoóations listed below apply to all subjects a.nd seitings unless specifìed otherwise.
Setting/ Schedule Sensory Needs
Providing a quiet and calm environment Provide sensory tools
Consistent schedule and routine Provide designated space for physical activity
Limiting transitions and changes in schedule Providing a designated quiet space for the student to
retreat if needed
Directions/Instructions Students Response
Using visual aids such as pictures and diagrams Learn faster and understand better
Avoiding abstract or figurative language Improve language skills
Providing clear and concise instructions Avoids confusion
MODIFICATIONS
Modifications allow the student to be more successful but fundamentally alter or lower course standards or student
expectations. The provision of these modifications means that:
1. The student’s grade .may not coant towards the hener roll or acadern.c awards.
2. Modified grades may affect a student’s class ranking.v
3. The student may not be fully exposed to curriculum in preparation for taking the Statewide Assessment,
4. A student provided with medified curriculum/grades might not graétuate with a regular diploma.
Assigninents/Tests Cours
es
Subject Content Grading Requirements
ENGLISH ADJECTIVES A+ - Excellent Create sentences using adjectives 90-100 = Outstanding
B+ - Very Good 85-89 = Very Satisfactory
C – Poor 75-84= Satisfactory
D- Remedial 75 below= Fail
The modifications s’tated above are provided in the classroom on a daily basis for the duration ef instruction in the subject(s)
specified starting on the implementation of’the IEP.
The report card will show a modified grade but will not indicate that the student has received special education and
related services unless doing so would help the parent or guardian to understand the progress his or her child is making in
specific classes, course content, or curriculum. High school transcripts will show a modified grade but will not indicate
that the student has received special education and related services. Post-secondary institutions will not be provided
with an explanation of the modified grade and of the student’s special education status without written consent of the
parent or adult student.
IEP 6A (1/2020)
IEP — Special Education and Related Services
Student: Carl P. Reyes Bate of Birth: March 10, 2015 Date: May 7, 2023
.SPECIAL EDUCATkON AND RELATED SERVICE OPTIONS CONSIDERED
The following service options were considered:
In selecting LRE, étescribe the consideration given to any potential harmful effect on the child or quality of services that the child needs:
)
IEP — Offer of FAPE Educational
Settings
Student: Carl P. Reyes Date of Birth: March 10, 2015 Date:
All special education services provided at student’s school of residence? Q Yes Q No (rationale)
% of time student is outside general education class & extracurricular & non academic activities
% of time student is in the general education class & extracurricular & non academic activities
F .ñr- i ill r ct pa?*icipa‘r iii tb.c general clazc 'd‹ Sx’.‹.acecularñ non academic actTVit*•s beva’4se
IEP 7B (8/18)
IEP — Supplementary Aids, Services &
Transportation
TRANSPORTATION
Special Education Transportation: No
Yes Transportation Needs:
Reg . Reg. ESY Reg ESY
ESY
A/C Required Electric Restraint Harness
Alternate Address LimitedRide Rides Cab
Firing M e dical Protocol Seat Belt
Equipment Transports Medication
Buckle Guard Nurse Aide on bus Transportation Behavior Plan
Car Seat Parent Travel Chair
Curb-to-curbVest
Other: TransportRelease Form Wheelchair
Other: Walker Access to Electronic Device
Station to Station
IEP 8 (8/19)
IEP — Consent and
Signatures
Studer.t: Date of Birth: Date:
PARENT CONSENTS
Check one of the following three boxes:
1. I agree with the determination of my child’s eligibility or Q ineligibility for special education.
2. I do not agree with the determination of my child’s eligibility or ineligibility for special education.
3 I have declined the offer of initiation of special education services.
If your child is eligible for special education, check one of the following three boxes:
1. I understand and consent to the contents of this IP.
2. I understand and consent to the contents of this IEP except for:
3. I do not consent to the contents of this IEP.
If your child is eligible for special education, check the box below, if applicable
I have received a copy of “Consent to Bill Medi-Cal and Release Information”.
I understand that services will not be made-up when my child is absent or when a normally scheduled session falls on a
non- student day unless otherwise agreed upon and that services will not be provided during school holidays and breaks
except âs• those provided during extended school year.
Signature of Parent/Adult Student: Date:
Signature of Parent/Adult Student: Date:
Parent/Guardian/Adult Student
Parent/Guardiae/Adult St'ud•nt
IEP 9A (IB/l5)
IEP — Consent and
Signatures
IEP 9B (10/15)
Notes/Additional Infomiation
Student: Date of Birth: Date:
IEP 12 (8/13)
Based on the IEP format you provided (for Carl P. Reyes) and tailoring it for a student with Asperger’s Syndrome,
here is a revised version. You can replace personal details as needed:
Juan is intellectually curious and highly verbal with strong memory and advanced vocabulary. He enjoys reading about
science, especially astronomy and animals, and shows a keen interest in technology and maps. Juan prefers structured
routines and excels in individual tasks.
Parent Concerns
Parents are concerned about Juan’s difficulty with peer interactions, understanding social cues, and coping with
changes in routine. They are also seeking support in helping Juan improve his emotional regulation, particularly in
stressful or overstimulating environments.
Baseline: Juan often misinterprets social cues and has difficulty initiating and maintaining peer conversations.
Annual Goal: By the end of the school year, Juan will demonstrate appropriate social interaction skills (e.g.,
initiating conversation, turn-taking, interpreting facial expressions) in structured settings with 80% accuracy as
measured by observation.
Accommodations:
Modifications:
Adjusted social studies content to focus on factual learning rather than interpretive tasks
Modified writing expectations (bullet points instead of full paragraphs when appropriate)
Behavioral Supports
Assistive Technology
Services Offered
If you’d like this IEP in editable Word format or need it customized further for a different student, just let me know!