Student Name: Abby Normal Meeting Date: 12/11/18

Neighborhood _SCHOOL SYSTEM

INDIVIDUALIZED EDUCATION PROGRAM (IEP)
IEP Meeting Date: 4/28/21 Purpose of IEP Meeting : Initial  Annual Review  Amendment 
Student Name: Abby Normal Date of Birth: GTID#
Eligibility Category(s): Learning Disability and Dyslexia Most Recent Eligibility Date(s):
School: Neighborhood Middle School Grade: 7th School Year: 2018-19
Parent(s):
Address: Email:
Phone (home): (work): (cell phone):

TEAM MEMBERS IN ATTENDANCE

REQUIRED MEMBERS ADDITIONAL MEMBERS
Parent: Name/Title:

Parent: Name/Title:

Local Education Agency Representative (LEA): Name/Title:

Special Education Teacher: Name/Title:

Regular Education Teacher: Name/Title:

Student (age 18 or if transition is being discussed): Name/Title:

Agency representative (responsible for transition services): Name/Title:

I. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Results of initial or most recent evaluation and results of state and district assessments:
Word Reading on the WIAT-III: SS= 84
Reading Comprehension on the WIAT-III: SS=98
Oral Reading Fluency on the WIAT-III: SS=89
Oral Reading Rate on the WIAT-III: SS=89
Oral Reading Accuracy on the WIAT-III: SS=83
Math Problem Solving on the WIAT-III: SS=78
Numerical Operations on the WIAT-III: SS=96
Spelling on the WIAT-III: SS=78
Description of academic, developmental and/or functional strengths:
Test scores show that Abby shows strengths in reading in literal comprehension.
Test scores show that Abby shows strengths in mathematics in math calculation skills.
Teacher reports her best mode of communication is oral expression.
Parent’s and teachers report that Abby’s adaptive behavior skills were within normal limits.
According to the WIAT-III Abby correctly responded to 91% of the items involving literal comprehension
School psychologist reports that Abby readily accompanied her to the evaluation room, and she related in a friendly or cooperative manner.
School psychologist reports that Abby demonstrated good attention and consistently appeared motivated to perform well.
Woodcock-Johnson IV test of Cognitive Abilities and Comprehensive Test of Phonological Processing showed Abby had average range in crystalized knowledge, fluid
reasoning, visual processing, visual processing, long-term retrieval, and processing speed.
The FCC indicates that Abby is functioning overall within normal limits.
The school psychologist Abby is attentive, participates in class discussions, offers appropriate comments, and takes notes during instruction.
Description of academic, developmental and/or functional needs:
Test scores show that Abby experiences a deficit in word reading.
Test scores show that Abby experiences a deficit in oral reading accuracy.
Test scores show that Abby experiences weaknesses in inferential comprehension.
Test scores show that Abby experiences a deficit in spelling.
Test scores show that Abby experiences deficits in math problem solving including time, place value, fractions, decimals, and multiple step operations.
According to the WIAT-III Abby correctly responded to only 73% of questions involving inferential comprehension.
School psychologist reports that Abby relied on text lookback when answering comprehension questions this is consistent with her weakness in short term memory.
Woodcock-Johnson IV test of Cognitive Abilities and Comprehensive Test of Phonological Processing showed below average scores in short-term memory and auditory
Georgia Department of Education
Model Form July 2011
 Student Name: Abby Normal Meeting Date: 12/11/18
processing.
A reading assessment conducted at the beginning of the year showed that Abby is reading at a 4th grade level.
Parental concerns regarding their child’s education:
Grandmother reported no family stressors.
Grandmother reported no significant emotional or behavioral problems.
Grandmother is primary guardian.
Impact of the disability on involvement and progress in the general education curriculum (for preschool, how the disability affects participation in appropriate
activities):
According to the Dyslexia Handbook: Procedures Concerning Dyslexia and Related Disorders Abby met all four of the criteria for dyslexia and all criteria for a learning
disability in the areas of basic reading and reading fluency.
According to the WIAT-III her math skills are not commensurate with her classmates.
According to the WIAT-III Abby’s spelling skills are not commensurate with her peers.
According to the WIAT-III Abby’s oral reading fluency skills are not commensurate with her peers.

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Georgia Department of Education

Model Form July 2011
II. CONSIDERATION OF SPECIAL FACTORS
a) Does the student have behavior which impedes his/her learning or the learning of others?  Yes  No
If yes, consider the appropriateness of developing a Behavior Intervention Plan.
Behavior Intervention Plan developed?  Yes  No
Refer to Behavior Intervention Plan for additional information.

b) Does the student have Limited English proficiency?  Yes  No

If yes, consider the language needs as related to the IEP and describe below.

c) Does the student have blindness/visual impairment?  Yes  No

If yes, provide for instruction in Braille and the use of Braille, unless the IEP Team determines that instruction in Braille is not appropriate for the student
after an evaluation of the student’s reading and writing skills, needs, and appropriate reading and writing media, including evaluation of future
needs for instruction in Braille or the use of Braille. Describe below.

d) Does the student have communication needs?  Yes  No

If yes, consider the communication needs and describe below.

e) Is the student deaf or hard of hearing?  Yes  No

If yes, consider and describe the student’s language and communication needs, opportunities for direct communication with peers and
professional personnel in the student’s language and communication mode, academic level and full range of needs, including opportunities for direct
instruction in the student’s language and communication mode. Describe communication needs below.

f) Does the student need assistive technology devices or services?  Yes  No

If yes, describe the type of assistive technology and how it is used. If no, describe how the student’s needs are being met in deficit areas.

g) Does the student require alternative format for instructional materials?  Yes  No
If yes, specify format(s) of materials required below.

 Braille  Large type  Auditory  Electronic text

III. TRANSITION SERVICE PLAN

A transition service plan must be completed no later than entry into 9th grade or by age 16, whichever comes first, or younger, if determined appropriate by the
IEP team and updated annually. If transition service plan is developed, attach to the IEP.
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 Student Name: Abby Normal Meeting Date: 12/11/18

IV. MEASURABLE ANNUAL GOALS

Measurable Annual Goals: Academic and/or functional goals designed to meet the child’s Progress At Reporting Period
needs that result from the disability to enable the child to be involved in and make progress in Method of
Criteria for Mastery
the general education curriculum or to meet each of the child’s other educational needs Evaluation
that result from the disability. 1 2 3 4

(date) (date) (date) (date)

1. Abby will be able to solve math problems involving multiple 70% accuracy on Quizzes, test,
steps/operations and word problems with minimal teacher 3/4 classroom worksheets
assistance. assessments.
2. Abby will be able to properly spell words with minimal teacher 70% accuracy on Weekly
assistance. 3/4 classroom spelling test
assessments.
3. Abby will be able to properly solve math problems involving 70% accuracy on Fraction/
fractions and decimals with minimal teacher assistance. 3/4 classroom Decimal fact
assessments. worksheets
and test
4.Abby will be able to accurately read orally with minimal 70% accuracy on Reading
teacher assistance.
3/4 classroom fluency exams
assessments. where teacher
counts the
number of
words and the
number of
mistakes
made.

REPORT OF STUDENT PROGRESS

When will the parents be informed of the child’s progress toward meeting the annual goals?
Parents will be informed after the second and fourth progress reporting date.
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Georgia Department of Education

Model Form July 2011
 Student Name: Abby Normal Meeting Date: 12/11/18

V. MEASURABLE ANNUAL GOALS & SHORT TERM OBJECTIVES/BENCHMARKS

Academic and/or functional goals designed to meet the child’s needs that result from the disability to enable the child to be involved in and make progress in the general education curriculum or to meet each
of the child’s other educational needs that result from the disability.

MEASURABLE ANNUAL GOAL: Abby will be able to solve math problems involving multiple steps/operations and word problems with minimal teacher assistance, with 70%
accuracy on 3/4classroom assessments.

Progress At Reporting Period

Short term objectives/benchmarks: Measurable, intermediate steps or targeted sub-skills to Method of

Criteria for Mastery
enable student to reach annual goals. Evaluation
1 2 3 4

(date) (date) (date) (date)

By February of 2019, when given prompted by a teacher to 60% accuracy Worksheets

underline cue words, Abby will be able to accurately solve math graded by the
word problems. teacher

By February of 2019, Abby will be able to develop her problem- 60% accuracy Worksheets
solving skills, when asked to generate word problems to match graded by the
given equations. teacher

By February of 2019, when using a computerized mathematic 60% accuracy IXL generated
program for practice such as IXL, Abby will be able to accurately math
solve math problems involving multiple steps/operations. problems

By February of 2019, when provided with a list of key words and 60% accuracy Quizzes and
phrases to look for, Abby will be able to accurately solve word test
problems.

REPORT OF STUDENT PROGRESS

When will the parents be informed of the child’s progress toward meeting the annual goals?
Parents will be informed after the second and fourth progress reporting date.
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Georgia Department of Education

Model Form July 2011
Student Name: Abby Normal Meeting Date: 12/11/18
VI. STUDENT SUPPORTS
To advance appropriately toward attaining annual goals; to be involved and progress in the general curriculum; to be educated and participate with other
children in academic, nonacademic and extracurricular activities, the following accommodations, supplemental aids and services and/or supports for school
personnel will be provided:
Instructional Accommodations
Special education assistance including reteaching in content mastery for reading instruction.
Special education assistance including reteaching in content mastery for math instruction.
Provide direct instruction for self-monitoring, self-talk, and identifying relevant information.
Provide Abby with explicit systematic instructions in reading, as well as opportunity for repeated practice
Break down instructional steps for Abby and provide visual supports as needed.
Provide instructions in high frequency vocabulary as well as common word-parts and spelling patterns.
Teach comprehension monitoring
Reduce the accelerated reading requirement.
Provide modeling and guided instruction when teaching math concepts.
Use instructional strategies that involve hands-on activities and real-life experiences.
Move from concrete to representational to abstract teaching math concepts
Consider the use of schema-based instructions for math problem solving
Classroom Testing Accommodations
Oral administration of test that do not directly test reading skills.
Allow Abby to use math charts on assignments/test involving math computations.
Supplemental Aids and Services
Provide memory aids such as visual cues, step-by-step cards, etc.
Highlight important information.
Consider the use of a computerized mathematics program to encourage Abby to engage in repetitive practice of math-problem solving skills
Attempt to find ways to make text reading easier and more engaging such as using various forms of assisted reading
Instructions should use supplements to text reading such as word and sub-word study
To extent possible minimize noise, distractions, and competing activities in environment
Allow Abby access to Grand Central Station for assistance, reteaching, and other instructional support.
Supports for School Personnel
There is not need for any supports for school personnel.

VII. ASSESSMENT DETERMINATION FOR DISTRICT AND STATEWIDE ASSESSMENTS FOR GRADES K-12
a) The student will participate in the following regular required assessments (Each state mandated test and subtest must be considered individually and
documented below).

Specific Testing Accommodations (Accommodations used for assessment must be consistent with accommodations used for classroom instruction/testing and
specified in the IEP. Some accommodations used for instruction may not be allowed for statewide assessment. Refer to the GaDOE Student Assessment
Handbook for the only allowable accommodations. Conditional accommodations are only allowable for students who meet eligibility criteria.) All subtests must
be considered individually. If the CRCT-M is considered, the Participation Guidelines for the CRCT-M must be completed and attached.

Test Subtest Setting Timing/Scheduling Presentation Response None, Standard or Conditional

Milestone Reading Small group setting Extended time Larger text Scantron Standard

Milestone Math Small group setting Extended time Oral administration Scantron Conditional
Allowed to use math
charts

b) The student will participate in the Georgia Alternate Assessment (GAA)  Yes  No
If yes, provide a statement of why the child cannot participate in regular required assessment.
Georgia Department of Education
Model Form July 2011
Student Name: Abby Normal Meeting Date: 12/11/18

Georgia Department of Education

Model Form July 2011
Student Name: Abby Normal Meeting Date: 12/11/18

VIII. SPECIAL EDUCATION: Instruction/Related Services in General Education Classroom/Early Childhood Setting
Options Initiation of Anticipated Content/Specialty
Frequency Provider Title
Considered Services Duration Area(s)
 (mm/dd/yy) (mm/dd/yy)
 Consultative N/A

 Collaborative N/A

 Co-teaching 5 times a week 12/11/18 12/11/19

 Supportive Services N/A

Related Services

IX. SPECIAL EDUCATION: Instruction/Related Services Outside of the General Education Classroom
Options Initiation of Anticipated
Content/Specialty
Considered Frequency Services Duration Provider Title
Area(s)
 (mm/dd/yy) (mm/dd/yy)
 Separate Class N/A

Separate School

Home Instruction

Residential

Hospital/Homebound

Supportive Services

Related Services

X. The explanation of the extent, if any, to which the child will not participate with peers without disabilities in the regular
class and/or in nonacademic and extracurricular activities:

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Georgia Department of Education
Model Form July 2011
Student Name: Abby Normal Meeting Date: 12/11/18

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Georgia Department of Education
Model Form July 2011
XI. EXTENDED SCHOOL YEAR
a) Are extended school year services necessary?  Yes  No
If yes, complete the section below.
b) Goals to be extended or modified:

Initiation of Anticipated
Services Frequency Services Duration Provider Title Location
(mm/dd/yy) (mm/dd/yy)

XII. DOCUMENTATION OF NOTICE OF IEP MEETING

Date Method of Notification By Whom

1st Notification Invitation  Phone Call  In Person Reminder notice Other:

2nd Notification Invitation  Phone Call  In Person Reminder notice Other:

3rd Notification Invitation Phone Call  In Person Reminder notice Other:

XIII. PARENT PARTICIPATION IN THE IEP PROCESS

The following documents were provided to parent(s):

 Parental Rights in Special Education
 Individualized Education Program (IEP)
 Eligibility Report(s)
 Evaluation
 Other:

If parent did not attend the meeting, complete below:

On the documents were:  Mailed  Given In Person  Sent via Student  Other