Standard 2: Individualized Education Plan – Part 1

Special Education Department

Individualized Education Program (IEP)
Student Name: Student Data/Cover Sheet (Form A-1) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022

Demographic Information

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

Name: 09\09\2006 Male 10th
1600968754 Malcolm Jeremy
Johnson

Student Address: Home Phone:

4950 Premiere Parkways Do not complete
City, State, Zip:
Bessemer, AL 35020
Parent 1 (Pseudo) Name: Parent 1 Relationship:
Shirley Johnson Mother
Parent 1 Address: Home Phone:
Do not complete. Do not complete.
City, State, Zip: Work Phone:
Do not complete. Do not complete.
Parent 1 Email:
Do not complete.
Parent 2 (Pseudo) Name: Parent 2 Relationship:
Malcolm Johnson Sr. Father
Parent 2 Address: Home Phone:
Do not complete. Do not complete.
City, State, Zip: Work Phone:
Do not complete. Do not complete.
Parent 2 Email:
Do not complete.
Primary Language of Home: Primary Language Survey Date: Language of Instruction:
English Primary Language Survey Results: English
Home District: Service Coordinator:
Attendance District: Bessemer City Schools Dr. Renee Holley
Home School: No Attending School: Bessemer City High School
Vision Screened On: Results: Hearing Screened On: Results:
04\16\2018 Passed 04\16\2018 Passed
Meeting Date:11\28\2022 Anticipated Duration of IEP: Re-evaluation Due:
From: 11\28\2022 To:11\27\2023 Current Evaluation:
Special Education Primary Category 1: Specific Learning Disability

Special Education Eligibility Category 2:

Special Education Eligibility Category 3:

For Students with SLD only, the following area(s) of eligibility was/were previously determined: The student

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 does meet AAC criteria for the suspected area of disability. The disability has an adverse effect on
educational performance. The student needs specially designed instruction in order to access and participate
in the general education curriculum.

Level of Services: (A)

Type of Meeting: Reevaluation
Date Meeting Notice Sent to the Date Procedural Safeguards given to the
Parent(s): 11\14\2022 Parent(s):11\14\2022

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 This page will not need to be completed because it is a signature page.
Special Education Department
Individualized Education Program (IEP)
Student (Pseudo) Student Data/Cover Sheet (Form A-2) IEP Meeting Date:

Student ID: DOB:

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.

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 Special Education Department
Individualized Education Program (IEP)
Student (Pseudo) Name: Student Data/Cover Sheet (Form B) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022
Student ID:1600968754 DOB:09\09\2006

PRESENT LEVEL OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

(PLAAFP)

Section 1: Current IEP Information

Summarize special education services the student is receiving Malcolm Johnson receives
accommodation in the general education classroom. He has the opportunity to attend or
receive assistance in an inclusion setting whenever he feels the need. He is only required to
be in the inclusion setting for 20% of his time. He does not receive any other services such
as occupational or speech at this time.

Section 2: Evaluation Information

Areas of Eligibility:

Special Education Primary Category: Specific Learning Disability

Special Education Eligibility Category 2:
Special Education Eligibility Category 3:
For students with SLD only, the following area(s) of eligibility was previously determined: Regular

education was considered and rejected because Malcolm qualifies for special education services

based on the current requirements of the Alabama Adminstrive Code and demonstrates a need

for specialized instruction.

State and District Assessment Scores: He has not taken any State or District Assessments recently

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) In Malcolm present level or classroom, he has
a 73 in Language Arts, 74 in Physical Science, 74 in Reading Intervention, 73 in World
History, 77 in Physical Education, and a 60 in Math.

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B. Physical (gross motor, fine motor, vision, and hearing). Malcolm Johnson is great with his gross and
fine motor skills. He has the ability to take notes and work on assignments. When he was tested for
vision and hearing he passed both tests.

C. Oral Language and Communication: Malcolm Johnson communication is good, he may stutter at
times, but it is nothing to seek services for. He is great with his oral language.

D. Social and Emotional Behavior: Malcolm Johnson does not have any issues with behaviors at this
time. He gets online great his peers and teachers.

E. Adaptive: He is working on his adaptive skills, during transition.

Current Classroom-Based Data:

Family’s Input on Student’s Current Performance: Parent anticipates Malcolm will attend a junior

college or trade school once he graduates from high school. She also anticipates Malcolm will not need

assistance getting and keeping a job. She expressed following graduation from high school he will live

with a friend and no extra help would be needed. His mother stated he does not have any paid or not paid

work experience. His mother said for his leisure and recreational activities Malcolm enjoys drawing, she

also anticipates he will obtain his driver’s license and will own and maintain a vehicle. Money

Management, Drivers’ Education, and Time Management will be his area of need.

Summary of Work Habits: From the teacher observation, Malcolm gets along with his teachers and

peers. He will assist other students to complete class assignments. His English teacher stated Malcolm is a

very good student. She stated he is cooperative, turns assignments in a timely manner, and actively

participates during class time.

Section 4: Summary of Educational Needs and General Accommodations

Special Education Department

Individualized Education Program (IEP)
Student (Pseudo) Name: Considerations Form (Form C) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022

Student ID:1600968754 DOB :09\09\2006

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 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 ☒ ☐

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 Special Education Department
Individualized Education Program (IEP)
Student (Pseudo) Name: Accommodations (Form F) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022

Student ID: 1600968754 DOB:09\09\2006

ASSESSMENTS
(Rationales for the accommodations that are being chosen specific to assessments.)

Rationale: He does not require any accommodations.

State Assessments

Standard Accommodation(s): Accommodations are not required for the student to participate.

District Assessments

Standard Accommodation(s): Accommodations are not required for the student to participate.

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

Testing Area Test Results Grade Semester Year

Reading His results are he is on the reading level of 6th 10th 1st 2022
grade
Writing N\A
Math His results are he is reading on a level of a 5th 10th 1st 2022
grade
Science 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): 80% percent of the day inside the Gen Ed classroom environment.

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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): There are no potential harmful effects of this
placement.

Reason for different services at school: Malcolm requires small group instruction to address his
deficits in reading, math, and transition; therefore, an environment that offers intensive
intervention is needed for him to progress.

OR, if the above LRE information does not apply to this student, explain why:

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 Standard 3: Individualized Education Plan - Part 2

Special Education Department

Individualized Education Program (IEP)
Student (Pseudo) Name:
Malcolm Jeremy Johnson Student Goals and Performance Objectives IEP Meeting Date:11\28\2022

Student ID:1600968754 Progress Report DOB:09/09/2006

Skill Area: Postsecondary Education/Training

Standard: TS.AT10.1. A Identify four or more ways in which postsecondary learning affects
personal goals and status (e.g., wider social network and experiences, increased earnings and
opportunities, preparation for career).

Annual Goal: By May 2023, Malcolm will summarize admission standards of five
postsecondary education and training options relevant to his post school goals in 4 out of 5
opportunities.

Baseline Level of Mastery: Malcolm will summarize admission standards of three

postsecondary education and training options relevant to his post school goals in 3 out of 5
opportunities.

Service Provider(s) for this goal: Special Education Teacher, Student, Job Coach

Skill Area: Employment/Occupation/Career

Standard: TS. OC10.3. A List standards and qualifications that must be met to enter at least five
given industries/careers.

Annual Goal: By May 2023, Malcolm will list standards and qualifications that must be
met to enter five given industries and careers in 4 out of 5 opportunities.

Baseline Level of Mastery: Malcolm will list standards and qualifications that must be
met to enter three given industries and careers in 3 out of 5 opportunities.
Service Provider(s) for this goal: Special Education Teacher, Student, Job Coach

Skill Area: Community/Independent Living

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Standard: TS. DL11.1. B Create personal budget according to daily living needs (e.g., food, clothing,
housing, transportation, wellness needs, healthcare, utilities, insurance, and benefits).

Annual Goal: By May 2023, Malcolm will create personal budget according to his daily
living needs 4 out of 5 opportunities.

Baseline Level of Mastery: Malcolm with create a budget according to his daily living needs 2
out of 3 opportunities.
Service Provider(s) for this goal: Special Education Teacher, Student, Job Coach,

Skill Area: Reading

Standard: R.8.1

Annual Goal: By May 2023, Malcolm will compare and contrast two events in a text drawing of
specific details in the text with 80% accuracy on class assignments.

Baseline Level of Mastery: Malcolm will compare and contrast one event in a text drawing of
specific details in the text with 60% accuracy on class assignments.

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

Skill Area: Mathematics

Standard: M. 8.9b.2: Solve multi-step equations.

Annual Goal: By May 2023, Malcolm will solve multi-step equations involving decimals with 80%
accuracy on class assignments.

Baseline Level of Mastery: Malcolm will solve multi-step equations involving decimals with
60% accuracy on class assignments.

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

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 Special Education Department
Individualized Education Program (IEP)
Student (Pseudo) Name: Accommodations (Form E) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022

Student ID:1600968754 DOB:09\09\2006

ACCOMODATIONS

Date Given to General Education Teacher: 11\28\2022 Service Coordinator: Tamela Stephens

Accommodations Type Location

Reading Comprehension: The special education teacher will provide 1 L
direct instruction to address deficits in compare and contrast two events
in a text utilizing guided instruction, repeated practice, worksheets, and
interactive activities.
Mathematics: The special education teacher will provide direct 1 L
instruction to address deficits in solving multi-step equations utilizing
guided instructions, repeated practices, worksheets, and interactive
activities.
Postsecondary Education\Training: The special education teacher will 1 L
provide direct instruction to address deficits in summarizing admission
standards of postsecondary and training utilizing guided instruction,
repeated practice, worksheets, and interactive activities.
Employment/Occupation/Careers: The special education teacher will 1 L
provide direct instruction to address deficits in listing standards and
qualifications of given industries and careers utilizing guided instruction,
repeated practice, worksheets, and interactive activities.
Community/Independent Living: The special education teacher will 1 L
provide direct instruction to address deficits in creating a budget utilizing
guided instruction, repeated practice, worksheets, and interactive
activities
Provide extended time to complete assignments (not to exceed on class 1 A
period.
Provide clear concise directions, and concrete examples for assignments.
Provide audio books as a tool when available
Check with student often to ensure understanding of assignment
Use of Calculator
Provide student with hands-on activities
English/Reading Inclusion: Special education staff will provide inclusion 1 B
support in English class to monitor understanding of concepts taught and
reinforce research-based strategies to promote independence.
Math Inclusion: Special education staff will provide inclusion support in 1 E
math class to monitor understanding of concepts taught and reinforce
research-based strategies to promote independences.
Provide extended time to complete tests (not to exceed one class period) 2 L

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 Allow for spelling errors if spelling is not the objective
Provide student with study guide
Provide clarification or restate directions
Use of calculator

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? There will be weekly

progress reports sent to the child’s parents. The parent will receive updates from the teachers with

information as needed. There will also be communication through email, Class Dojo, and or Google

Classroom.

IEP Team Consideration for Extended School Year

Consideration for eligibility: Yes, in the area of Specific Learning Disability

Eligible for ESY: Yes

Written explanation as to why ESY is or is not needed:

Some children with disabilities may not receive FAPE unless they receive needed services

during time periods when other children, normally would not be served. Malcolm may suffer

severe losses of social, behavioral, communication, academic, or self-sufficiency skills during

interruptions in instruction. He is progressing and a break may cause him to regress.

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 Special Education Department
Individualized Education Program (IEP)
Student (Pseudo) Name: Services and Environment (Form I) IEP Meeting Date:
Malcolm Jeremy Johnson 11\28\2022
Student ID:1600968754 DOB:09\09\2006

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 Education Instructional
Services Setting/ Start Date Frequency Provider Duration/
Location End Date
Direct Instruction to Resource 11\28\2022 1 time Special Ed 11\27\2023
address deficits in weekly for Teacher
Reading Comprehension 45 minutes
Direct instruction to Resource 11\28\2022 1 time Special Ed 11\27\2023
address deficits in Classroom weekly for Teacher
Mathematics 45 minutes
Direct Instructions to Resource 11\28\2022 1 time Special Ed 11\27\2023
address deficits in Classroom weekly for Teacher
Community\Independent 45 minutes
Living
Clarification: These services will be provided to Malcolm per his IEP.

EDUCATIONALLY RELEVANT RELATED SERVICES

Special Education Instructional

Services Setting/ Start Date Frequency Provider Duration/
Location End Date

Clarification:

EDUCATIONALLY RELEVANT SUPPLEMENTARY AIDS/ASSISTIVE TECHNOLOGY and

SERVICES for STUDENTS
.
Special Education Instructional
Services Setting/ Start Date Frequency Provider Duration/
Location End Date
Provide extended time General 11\28\2022 1 Time General 11\27\2023
to complete Education Daily Education
assignments (not to Classroom Teacher
exceed on class period.
Provide clear, concise
directions, and

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 concrete examples for
assignments.
Provide audio book as General 11\28\2022 1 time daily General 11\27\2023
a tool when available. Education Education
Check with student Classroom Teacher
often to ensure
understanding of
assignment.
Use of calculator, General 11\28\2022 1 time daily General 11\27\2023
Provide student with Education Education
hands-on activities Classroom Teacher
Clarification: These services will be provided to Malcolm per his IEP.

SUPPORTS FOR SCHOOL PERSONNEL

Special Education Instructional

Services Setting/ Start Date Frequency Provider Duration/
Location End Date

Clarification:

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 Standard 4: Preparation for IEP Meeting

IEP Meeting Planning

Required Participants/Roles:

Parents\Guardian- you have a say in your child’s education. You have valuable knowledge

about your child’s strengths, struggles, and goals. You can describe what is and isn’t working.

General Education Teacher- This person knows how your child is doing in the classroom

and

with the general education curriculum.

Special Education Teacher- This teacher offers input on what your child needs to thrive in

the general education classroom. Suggestions may include how to modify instruction or offer

accommodations for your child’s needs.

LEA Representative- The IEP must include a representative who has the power to approve

school resources for your child. This person must be qualified to provide or supervise special

education services. This person should understand and know the law.

Someone who can interpret the instructional implications of the evaluation results- This

could be a member of the team already, like the special education teacher. Or it could be

another person, like a school psychologist or optometrist

The student-The child has the right to make decision about their education and plans for

them.

Career\Technical Education Representative-will help with the transition goals and help

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 decide what the interest of the students are.

Required Agenda Outline:

 Introduction

I first will like to say thanks for everyone for coming to our revaluation IEP meeting for

Malcolm Johnson. We will start the meeting by allowing everyone to introduce themselves.

At this point in the meeting the Parents\Guardian, General Education Teacher, Special

Education Teacher, LEA Representative, someone who can interpret the instructional

implications of the evaluation results (Optometrist), the Student, Career\Technical Education

Representative.

 Purpose

We are here for the reevaluation and eligibility of Malcolm Johnson.

 Information\Eligibility

Thank you all we will now begin with our Optometrist who will give us the results of

Malcolm Johnson test results. Malcolm Johnson took the Reynolds Intellectual Assessment

Scales on 04\06\2015 and made a 97 Composite 95 Verbal Index and 101 Nonverbal Index.

Malcolm Johnson took the Woodcock-Johnson III Normative Update Tests of Achievement

(WJ III NU ACH) on 03\24\2015. His standard score was 81 Total Achievement. 88 Broad

Reading, 76 Broad Mathematics, 87 Broad Written Language, 100 Written Expressions, 87

Letter-Word Identification, 89 Reading Fluency, 77 spelling, 95 Writing Fluency, 96 Passage

Comprehension, 80 Applied Problems, and 105 Writing Samples. Malcolm Johnson took the

Environment, Cultural, Economic Checklist, students receive Title I services. Malcolm

Johnson took the Documentation of Appropriate Instruction (Prong I) on 02\01\2021. Zion has

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 participated in a scientifically research-based reading and math program; he has received

standard based instructions by qualified teachers. He does participate in small group

instruction. Documentation of Appropriate Instruction (Prong II) on 02\07\2021 The results:

Performance Assessment test in Reading. Scaled Score 2912, Performance Assessment test in

Math. Scaled Score 2588, Reading Plus Initial Reading Assessment. Comprehension GLE 7.8,

Vocabulary GLE 10.5. Malcom also took the Scales of Independent Behavior Revised (SIB-R)

School Version. 74 Motor Skills, 87 Social Interaction and Communication Skills, 89

Personal-Living Skills, 64 Community Living Skills.

 Present Level of Performance

Malcolm Johnson was also observed, and the results were: He reported to resource on time

and sat in his assigned table. After morning announcements, he came over and showed that

Mr. Walker assigned him to work on classwork on his laptop. After showing it to me, he sat

down and started on his assignment. While walking around room and checking on the other

students, Malcolm raised his hand to sharpen his pencil. He returned back to his seat and

worked quietly and remained focused. In Malcolm present level or classroom, he has a 73 in

Language Arts, 74 in Physical Science, 74 in Reading Intervention, 73 in World History, 77 in

Physical Education, and a 60 in Math. The results of Malcolm most recent evaluations show

he is on the reading level consistent of students in the 6th Grade. His math assessments show he

is on the math level consistent of students in the 5th grade.

 Goals

The transition goals for Malcolm are the students will be prepared to participate in a 2 to 4-

year postsecondary education program based on completion of graduation requirements and

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 meeting college admission requirements. Malcolm will reach college and career readiness by

potentially earning an industry career credential. Malcolm will be prepared to participate in

community activities and live independently based on independent living skill level and

identification of community\living options. Malcolm reading goal is Malcolm will compare

and contrast two events in a text drawing on specific details in the text with 80% accuracy.

(ELA 8.3.2) Malcolm math goal is Malcolm will solve multi-step equations with 80%

accuracy on class assignments. (M.8.9b.2)

 Services Provided

The students receive special education services in reading and math. The special education

teacher will provide Malcolm with direction instruction address deficits in compare and

contrast two events in a text using guided instruction, repeated practice, worksheets, and

interactive activities. He also receives services in Mathematics, the special education teacher

will provide Malcolm, with direct instruction to address deficits in solving multi-step

equations using guided instruction, repeated practice, worksheets, and interactive activities. In

the gen ed classroom he will also receive many accommodations.

 LRE

Malcolm Least Restrictive Environment will consist of 80% of the day in the General

Education Classroom Environment and 20% in the resource room. This is because Malcolm

requires a small group instruction to address his deficits in reading, math, and transition.

 ESY

The IEP team has considered the need for Malcolm to have an extended school year, just

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 so he can stay on task and not lose information doing the summer months.

 Procedural Safeguards and Prior written notice

Both the procedural safeguards, and prior written notice were sent home two weeks prior

to the meeting.

 Signatures and Copies

Plan for Conflicts:

 Communication is the best way to involve parents in the development of the IEP:

Sending letters, phone calls, emails, and using Class Dojo or Google Classroom.

 Send Home a Questionnaire

 Get to know your parents a long time before the IEP

 Listen to the parents, do not try to be the expert

 Address concerns honestly and to the best of your ability

The only issue or conflict I anticipate that may arise during the meeting is the parent may not

attend. Some of the IEP meeting I have set it on have had to be virtual or the parent simply did

not attend. I also anticipate the parents not understanding certain parts of the plan. I will

address this issue by following up with the parent and also, I will make the meeting easy to

understand and address all concerns and questions. I will also explain anything someone in the

meeting may present that the parents may not understand.

Mock IEP Introduction Video

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 Mock IEP Introduction Video Link:
Video Recording Link: https://youtu.be/7_02XwpSb00

Reflection: As I was preparing for my first IEP meeting, I can say I was very nervous, and I

really noticed there were things I could have done better with. I loved my introduction of the

team as I believed I was able to capture the purpose and what each one was used for. In a real

IEP meeting this is something I believe could make up break the meeting, not having the

correct people present or having people who do not know the child could have a negative

effect on the meeting. I also believe I did well with the purpose of the meeting, I feel that

knowing why we are meeting is assistant to a great meeting. In many things we always discuss

the purpose of being there. Without knowing the purpose of the meeting, a parent or any other

member of the IEP team could take over the meeting and not focus on what we are there for. I

believe the biggest area I need to work on is understanding the PLAAFP. This is what I

consider the meat of the meeting and is most important to understand. I believe this is where

we have to really understand what we are talking about and the purpose of each category. I

know that I am not the one doing the talking at this point, but this is really good to understand.

I believe this is where the majority of parents questions and concerns will be. This is where the

student eligibility lies and I do not want to mess that up, by making a simple mistake. My plan

is to continue to work with my mentor teacher and watch sample IEP meetings online. I also

plan to attend as many IEP meetings as I can before I have my own, and I will attend

Professional Development’s as provided by my school or district.

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