Wake County Schools

IEP Document
Student: Lucas Contreras Villalobos Student UID #: 3261689617 DOB: 12/15/2020
School: CECAS Grade: P2 Age: 2
Primary Eligibility: AU Secondary Eligibility:

INDIVIDUALIZED EDUCATION PROGRAM (IEP)

Meeting Purpose: Initial
Meeting Date: 11/30/2023
From: 12/15/2023 To: 11/29/2024

Student Profile
Student's overall strengths that contribute to success in the educational environment:
Lucas loves music, bubbles, and active play. He comes from a loving and supportive family who are strong advocates for
his needs. He is interested in other children. Lucas has functional gross and fine motor skill to access an educational setting.

Parental concerns, if any, about their child's academic and functional performance in school:
Parents' primary concerns for Locus are his communication and social interactions.
Parent /student's vision for the future: (Include, specifically, vision for after high school, if appropriate.)
Parents would like Lucas to make gains in his communication, be happy and build his independence. They would really like
him to speak.

Present Level(s) of Academic and Functional Performance

Complete the current descriptive information by using norm-referenced, criterion-referenced, or any other valid data
sources, as well as descriptive information for each of the relevant areas. Include current academic and functional
performance, behaviors, social/emotional development, transition and other pertinent information. All areas asses-
sed should be addressed and a determination made as to whether the data indicates an area is in need of specially
designed instruction.

AREA(S) IN NEED OF SPECIALLY DESIGNED INSTRUCTION (SDI) must be addressed within the IEP (e.g.
annual goals, accommodations, specially-designed instruction, behavior intervention plan, etc.)
Area Assessed: Source(s) of Relevant Information: Area in Need of
SDI:
Communication · Date: 11/30/2023, Assessment Area: Speech-Language Yes
Screening, Assessment: Clinical Observations and Scre-
enings, Subject Area:
Narrative: 11/08/2023- Articulation, Voice, Fluency and Oral
Motor skills were not able to be formally assessed at this
time due to limited expressive language skills. These areas
should continue to be monitored as language skills increase
· Date: 11/30/2023, Assessment Area: Speech-
Language/Communication Evaluation, Assessment: Speech
Language - Toni Linder's Transdisciplinary Play-Based Asses-
sment, 2nd Ed: Communication, Subject Area:

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Narrative: 11/08/2023- Based upon parent input, observat-
ions and guidelines from Toni Linder's Play Based Asses-
sment, Lucas demonstrates language comprehension skills
that fall in the delayed range with skills clustering below12
months. His language production skills fall in the delayed
range with skills clustering below 12 months Lucas demon-
strates delayed pragmatic language with skills are clustering
below 12 months.
· Date: 11/30/2023, Assessment Area: Speech-
Language/Communication Evaluation, Assessment: Speech-
Language/Communication Evaluation (About Speech,
Speech and Language Therapy, PLLC), Subject Area: The
Receptive-Expressive Emergent Language Test-Fourth Edition
(REEL-4)
Narrative: 06/23/2023-
Receptive Language-
Raw Score: 16
Ability Score:55 (delayed)

Expressive Language-
Raw Score:10
Ability Score:55 (delayed)

**A standard score below 70 indicates a delay. Average

scores range from 90-109

Present Level of Performance:

Lucas's Speech Language skills were assessed by About Speech, Speech and Language Therapy on 6/23/2023. The Receptive-
Expressive Emergent Language Test - Fourth Edition (REEL-4) was used to assess his language ability and need for services.
Lucas' mother provided information on his current level of performance with language. The clinician also observed Lucas
while he engaged in his usual home activities and attempted to elicit language from him. Based on reported results, Lucas
achieved receptive and expressive language skills that fell within the delayed range. Lucas's current communication skills
were assessed as part of a multi-team multi-disciplinary evaluation utilizing Toni Linder's Transdisciplinary Play-Based
Assessment-2 which was completed by parent report and observation of skills. This evaluation includes assessments of
language, articulation, oral-motor, voice, and fluency skills.

In the area of Language Comprehension (Receptive Language), Lucas reportedly is exposed to both English and Spanish
at home. A language interpreter was present for the assessment. Directions were given in English and repeated in Spanish
by the Language interpreter. According to mom, Lucas inconsistently responds to sound sources and to his name. Mom
reported that Lucas does respond to tone of voice and understands the meaning of no. He can follow routine directions and
anticipates familiar events, such as bath time and mealtime. During the assessment, Lucas did not imitate actions or follow
the examiner's directions without hand over hand assistance. Per mom, Lucas is not really interested in many toys and does
not attempt to search for objects if they are hidden. According to mom, Lucas does show interest light up toys and music. He
will move his body and jump while listening to music. Mom shared that Lucas only likes three songs which are in Spanish.
Lucas's overall receptive language skills are clustering below 12 months

In the area of Language Production (Expressive Language), Lucas primarily communicates his wants and needs by guiding
her to items, bringing items and sometimes by whining and crying. He also produces consonant and vowel sounds. Per
mom, Lucas will randomly and inconsistently say the words [ball, baby, papa, bubble]. Mom shared that Lucas has said
"mama" when he was desperate to gain her attention. According to mom, usually she just knows Lucas wants and needs
and if Lucas is crying or whining, it is usually because he is either hungry or sleepy. During the assessment, Lucas was
observed to produce consonant and vowels sounds and to increase the volume of his vocalizations when he was frustrated.
He randomly said "hi" but did not say any other words. Per mom, Lucas can sign "more" and understands the sign for "all

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done." Mom shared that Lucas recently started using Proloquo2Go to help with his communication skills. Reportedly, Lucas
"can" point, but he is not yet independently pointing to the pictures. Parents usually must guide Lucas' hand to touch the
pictures on his tablet. Lucas's expressive language skills are clustering below 12 months.

In the area of Pragmatic Language Skills (Social Language), Lucas was accompanied to the assessment by his mother. Lucas
was whining as he entered the room. His mother sat on the floor near the table and instructed Lucas to come sit in the chair
at the table. One of the examiners presented an animal shape puzzle. Lucas touched the shapes, let them fall to the table and
onto the floor but did not attempt to place them in the puzzle. When the shape sorter was presented, Lucas held the shape
sorter in his lap but did not attempt to place any of the shapes into the shorter, he did, however, allow the examiner to guide
his hand to place several shapes into the shape sorter. Lucas stacked seven wooden blocks and said, "no" when they fell. He
then briefly walked over and climbed onto his mom's lap. When one of the examiners started to blow bubbles, Lucas was
noted to whine, clap his hands, and cover his ears. Throughout the assessment, Lucas demonstrated limited eye contact and
limited joint attention with examiners. He walked across the room and walked in circles while tapping the table and tapping
one of the examiner's shoulders. Reportedly, Lucas protests and sets limits by clapping, pushing items away, whining, and
crying. Mom shared that Lucas "sometimes" shows interest in social games, such as Peek-A-Boo, but he participates more
in physical play, such as riding a tricycle. According to mom, Lucas will play near peers, and he has a friend that jumps with
on the trampoline. Lucas's pragmatic language skills are clustering below 12 months.

Lucas's Speech production skills could not adequately be assessed due to Lucas's limited spontaneous output during the
assessment. Lucas was observed to say a few sounds and to randomly say "hi" during the assessment. He did not say
any other words or word approximations. This area should continue to be monitored as Lucas's expressive language skills
increases. Lucas's voice and fluency skills could not adequately be assessed due to his limited use of spontaneous language.
Oral motor skills could not formally be assessed at this time. Based upon parent input, observations, and assessment results,
Lucas demonstrates communication delays that have an adverse effect on his ability to communicate his thoughts, ideas and
interact with adults and peers in his environment.

Area Assessed: Source(s) of Relevant Information: Area in Need of

SDI:
Motor Skills and · Date: 11/30/2023, Assessment Area: Motor Evaluat- No
Patterns ion, Assessment: Motor - Transdisciplinary Play-Based
Assessment - Sensory Motor Scales, Subject Area:
Narrative: 11/8/23- Overall, Lucas exhibits gross motor
skills necessary to access and be safe in a pre-school envir-
onment. Based on Toni Linder's Transdisciplinary Play-Based
Assessment: 2nd edition, Lucas presents with an arm and
hand use profile ranging between 18 to 24 months. Lucas
primarily engaged in movement seeking in the assessment
room rather than exploring or playing with toys. Parent rep-
orts that Lucas is able to complete the fine motor toys pres-
ented in assessment, but does not do so on command. When
attempting to engage Lucas in table top fine motor toys
Lucas waited for an adult to complete the task for him with
hand over hand assistance, rather than completing the task
himself even with toys his reported to be able to complete
independently. Significant self-directed behavior, refusal
to engage in adult-directed activities, and sensory seeking
behaviors made it difficult to fully assess the scope of Lucas
fine motor skills on the day of his assessment. Therefore,
these scores should be interpreted with caution. Overall,
Lucas is reported to demonstrate the fine motor skill nec-
essary to access a developmentally appropriate educational
setting.

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Present Level of Performance:

The following information was obtained through record review, parent interview, play-based assessment Lucas demonstrated
the following gross motor skills: Demonstrated adequate muscle tone and strength to participate in this assessment; easily
transitioning between sitting, squatting, standing and moving between toys and activities. Adequate trunk support and
postural control in both seated and standing positions to support arm and hand function while playing. Strength and endurance
support participation in all preschool play activities presented during the assessment. Able to navigate the evaluation room
with ease and stepping over toys when needed. Able to ascend and descend stairs. Able to climb onto and out of adult
sized furniture such as chairs, couches, and beds. By report, plays on preschool apparatus safely. Coordinates movements
to throw a ball forward, kick a ball forward. Reported to pedal tricycle. Overall, Lucas exhibits gross motor skills necessary
to access and be safe in a pre-school environment. The following information was obtained through record review, parent
interview, play-based assessment Lucas demonstrated the following skills: Muscle tone within the functional range. Strength
and endurance support participation in all preschool play activities presented during the assessment. Upper extremity range
of motion within functional range. Assumes positions where hands are free for play. Uses two hands at midline. Crosses
midline. Reported to isolate index finger. Used a variety of grasp patterns and adjusts grasp to object's size. Precision tasks
are performed with fingertip such as pinch grasp on small items and a 3 or 4 fingered grasp on larger items. Demonstrates age
appropriate palmer arch development and brought thumb and fingers together in smooth pad to pad opposition. Reported
to display precision and control of release and released items land on target. Reported able to position toys for accurate,
controlled release for letting go of toys. Reported to place coin in slot of piggy bank when of his choosing. Reported to
be able to stack 3-4 blocks when of his choosing. Reported to manipulate pieces into shape sorter when of his choosing.
Reported to manipulate pieces into inset puzzles when of his choosing. Lucas was not observed to engage in play with toys
that required the skilled use of two hands at this time. Emerging in hand manipulation skill of rotation. Reported to turn door
knobs and caps off bottle inconsistently. In hand manipulation skill of shift. Turned pages in books. Reported to demonstrate
a fisted grasp on marking tools. Reported to scribble when of his choosing. Lucas is reported not to be exposed to scissors
at this time. Based on Toni Linder's Transdisciplinary Play-Based Assessment: 2nd edition, Lucas presents with an arm and
hand use profile ranging between 18 to 24 months. Lucas primarily engaged in movement seeking in the assessment room
rather than exploring or playing with toys. Parent reports that Lucas is able to complete the fine motor toys presented in
assessment, but does not do so on command. When attempting to engage Lucas in table top fine motor toys Lucas waited
for an adult to complete the task for him with hand over hand assistance, rather than completing the task himself even with
toys his reported to be able to complete independently. Significant self-directed behavior, refusal to engage in adult-directed
activities, and sensory seeking behaviors made it difficult to fully assess the scope of Lucas fine motor skills on the day of
his assessment. Therefore, these scores should be interpreted with caution. Overall, Lucas is reported to demonstrate the
fine motor skill necessary to access a developmentally appropriate educational setting.

Area Assessed: Source(s) of Relevant Information: Area in Need of

SDI:
Social-Emotional · Date: 11/30/2023, Assessment Area: Psychological Yes
Evaluation, Assessment: DAYC-2 Social Emotional Domain,
Subject Area:
Narrative: 11/8/23
Results from the DAYC-2 Social Emotional domain indi-
cate that Lucas demonstrates delays in social and emot-
ional development (standard score = 69; age equivalent =
11 months; 2nd percentile).
· Date: 11/30/2023, Assessment Area: Sensory Processing
Evaluation, Assessment: Sensory Processing - Other, Sub-
ject Area:

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Narrative: 11/8/23- The results of the occupational ther-
apist's sensory processing evaluation indicate that Lucas does
have differences in their ability to process sensation. Lucas
presents with some under response to auditory stimuli as well
as some sensitivity to auditory stimuli. Lucas demonstrated
significant movement (vestibular) and deep pressure (propr-
ioceptive) seeking behaviors and engaged in these almost
exclusively during the assessment. Per the evaluation results,
these differences impact Lucas 's ability to access the educat-
ional environment.

Present Level of Performance:

Information regarding Lucas's social and emotional development and current behaviors was gathered through record review,
observations, parent interview, and the DAYC-2 Social Emotional Domain. Lucas recognizes familiar people. Per parent
report, he approaches familiar people, but is not yet greeting them. Per parent report, he separates from parents in familiar
environments. Per parent report, he plays near other children and may attempt to run with others. He may tolerate other
children in his space and will push them away when he does not want them near him. He sometimes plays with the same toys
with other children. Per parent report, he sometimes shows excitement when he sees preferred children. Lucas indicates he is
unhappy by clapping his hands, vocalizing, covering/hitting his ears, and with facial expressions. It can often be challenging
to determine what he is upset about. Per parent report, he sometimes hits parents and his behavioral therapist when upset.
Per parent report, he is not aggressive towards other children. Per parent report, he follows safety rules at home. He knows
that he is allowed to jump or climb on certain furniture, but not others. He recognizes parents' tone of voice and responds
to a stern tone. He does well with "stop" commands, such as "no thank you"/"no gracias." Results from the DAYC-2 Social
Emotional domain indicate that Lucas demonstrates delays in social and emotional development (standard score = 69; age
equivalent = 11 months; 2nd percentile).

Lucas demonstrated the following sensory processing profile: No noted observable differences in visual processing. Is
bothered by loud noises. Lucas was observed to tap on the surface of the play kitchen and then cover his ears and run away.
He recovered quickly and returned to play with the kitchen. Aversive response to noisy or crowded places. Lucas is reported
to have headphone he wears when entering a crowded environment. He is reported to remove them independently with some
time to warm up to the environment. Inconsistent response to environmental sound. Inconsistent response to name being
called. Tolerates physical assistance. Will tolerate messy play. Demonstrates typical response regarding food on hands
and/or washing hands. Lucas is reported to use a paci to help self calm. Seeks out opportunities for movement at a high
level. Lucas primarily engaged in moving around the assessment room to the exclusion of exploring toys. He spent most
of the evaluation pacing the room or walking in circles. He is also reported to spin in circles. Seeks out opportunities for
crashing or jumping to an excessive degree. Walks on toes, with a heavy step, or shuffles feet. Lucas was observed to clap his
hands as he became upset at something. Lucas was observed to frequently tap his hands on surfaces in the assessment room.
Demonstrates repetitive movements (finger posturing, shaking hands at the wrist). Lucas has access to a small trampoline at
home and will frequently seek this out on his own. The results of the occupational therapist's sensory processing evaluation
indicate that Lucas does have differences in their ability to process sensation. Lucas presents with some under response to
auditory stimuli as well as some sensitivity to auditory stimuli. Lucas demonstrated significant movement (vestibular) and
deep pressure (proprioceptive) seeking behaviors and engaged in these almost exclusively during the assessment. Lucas may
benefit from sensory processing supports in his educational environment.

Additional social skills and interactions are addressed in communication, cognitive/pre-academic, and adaptive goal areas.

Area Assessed: Source(s) of Relevant Information: Area in Need of

SDI:
Acquisition and Use · Date: 11/30/2023, Assessment Area: Psychological Yes
of Knowledge and Evaluation, Assessment: Cognitive and Early Learning
Skills Skills, Subject Area:
Narrative: 11/8/23

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Per parent report, he does not often play with toys and in-
stead prefers active play (e.g. riding bike, swinging, jumping
on the trampoline) and sensory exploration (e.g. playing with
sand, rocks). In the past he has engaged in early pretend play
(e.g. rocking a baby doll, feeding a baby doll), but no longer
does this. Per parent report, he enjoys cause-and-effect toys
that light up or make noise. Per parent report, he watches sp-
ecific videos and songs in Spanish. He dances along to them,
but is not attempting to sing-a-long. Per parent report, he is
able to stack about 3 to 4 blocks, though often avoids doing
this. Per parent report, he looks at pictures in books. He is
not yet listening to a story. Lucas did not engage in adult-
directed activities throughout the evaluation or interact with
toys in the room. Per parent report, he has a lot of the skills
needed to interact with toys, but often resists/avoids these
tasks. He may spontaneously play appropriately with toys,
but this is rare.
· Date: 11/30/2023, Assessment Area: Psychological
Evaluation, Assessment: DAYC-2 Cognitive Domain, Sub-
ject Area:
Narrative: 11/8/23
Results from the DAYC-2 Cognitive Domain indicate
that Lucas demonstrates delays in cognitive developm-
ent (standard score = 73; age equivalent = 14 months; 4th
percentile).
· Date: 11/30/2023, Assessment Area: Observation,
Assessment: Observation/Preschool - in natural setting,
11/16/23, Subject Area: Observation in the natural setting

Narrative: Observation in the natural setting – Vicki Lucas-

Crowder, Speech-Language Pathologist, 11/16/23

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During the virtual observation Lucas was interacting with his
ABA therapist. Lucas was wondering around the room. He
walked up and touched his AC device, mom indicated that
Lucas asked for a different song. He then walked up to the
device and tapped pancakes. Mom said, "I think he is hun-
gry." Mom sat pancakes on a plate on the table. Lucas in-
dependently picked up pieces of pancake with his fingers and
placed them in his mouth as he wondered around the room.
Lucas briefly sat in a recliner chair, rocking, and chewing
his pancake. When his therapist held up the stacking ring,
Lucas removed one ring before wondering off. The therapist
then guided Lucas to the table to work. Lucas sat at the table
and ate a few more pieces of his pancake. His therapist hit a
peg on a peg/bench toy with a toy hammer and then handed
Lucas the hammer and said, your turn. Lucas shook the ham-
mer and moved it down towards the peg but did not hit it.
When a xylophone toy was presented, Lucas hit the keys on
the xylophone with the hammer. He then stood up holding
the hammer in his hand and briefly walked into the bedroom
before returning to the living room. Ms. Rothford offered
Lucas a stacking ring, he placed the ring on and then walked
away. Ms. Rothford then presented an 8-piece puzzle. Lucas
sat on the Ms. Rothford's lap on the floor and placed the
pieces into the puzzle with some physical prompts from his
therapist. Lucas stood up and began to wonder around the
room, jumping as he walked. He grabbed his mom's hand
and held her hand as he walked around the house. Ms. Roth-
ford presented a musical toy, Lucas sat on the floor, holding
the toy, and listened to the music. He was noted to look at
his mom holding the phone. Ms. Rothford commented that
Lucas was looking at himself on the phone and appeared a
little confused by the phone. Lucas sat on his therapist's lap
and touched the buttons on the toy. He listened to several
songs on the toy and when the toy, asked can you find the
cow, Ms. Rothford asked, Lucas, "can you find the cow?"
Lucas pressed a button on the toy and his therapist said, "yes,
can you find the cow?" Lucas then hopped up from the floor,
His therapist said, "all done?" Lucas again began to won-
der around the room. He wondered over and stood near an
alphabet puzzle and placed in two pieces with physical and
verbal prompts. He vocalized, jumped up and down and then
wondered over to give his mom a hug. Ms. Rothford pres-
ented a light board sensory toy. Lucas held the light board,
and he independently turned the key on the light board. He
then explored a sensory block toy by pressing buttons, turn-
ing buttons, pressing buttons, opening flaps etc.
· Date: 11/30/2023, Assessment Area: Observation,
Assessment: Observations during the play-based assessment,
Subject Area:
Narrative: 11/8/23

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Lucas attended the play-based assessment with his mother.
An interpreter was present to assist as needed. Lucas jumped,
spun, and vocalized repeatedly. He sought out his mother
often and sat in/laid across her lap. When allowed to play in-
dependently, he walked in circles around the room, climbed
on and off an adult sized chair, and repeatedly jumped up
and down. He did not spontaneously engage with any of
the toys available in the room. He spontaneously said "hi"
though did not clearly direct this at anyone. He then tapped
on the table and looked at an adult until she looked up and
said "hi." Lucas transitioned from the playroom to a differ-
ent room for an audiological evaluation. Upon returning to
the room, he showed distress and vocalized. He clapped
his hands and moved away from other people. With parent
support he sat in a cube chair. When a form-board puzzle
was presented, he did not engage with it and continued to
vocalize. He did not engage with other toys presented and
continued to appear distressed (e.g. covering ears, clapping
his hands, vocalizing with an angry tone, furrowing brow).
Once other adults moved away from him, he vocalized less
and sat quietly in the cube chair. He repeatedly yawned.
His mother presented him with various toys and he did not
engage with them. While his mother was engaged in conver-
sation with examiners, Lucas walked around the room and
ran his hand along furniture. He climbed on and off an adult
sized chair. He walked in circles around an examiner, occ-
asionally running his hand along her as he paced. He laid in
his mother's laugh and spontaneously laughed. His mother
offered him some food and he fed himself a few pieces of it,
then resumed walking around the room.
Overall, he did not attempt to communicate using clear words
(aside from saying "hi" on one occasion). While he appeared
distressed and agitated, it was often difficult to determine
why or what he wanted. He did not engage with any toys
in the room and spent the majority of the observation period
engaged in movement activities (walking, moving in circles,
climbing, jumping).

Present Level of Performance:

The DAYC-2 Cognitive Domain was completed to provide an overall estimate of Lucas' current cognitive development. Per
parent report, he does not often play with toys and instead prefers active play (e.g. riding bike, swinging, jumping on the
trampoline) and sensory exploration (e.g. playing with sand, rocks). In the past he has engaged in early pretend play (e.g.
rocking a baby doll, feeding a baby doll), but no longer does this. Per parent report, he enjoys cause-and-effect toys that
light up or make noise. Per parent report, he watches specific videos and songs in Spanish. He dances along to them, but is
not attempting to sing-a-long. Per parent report, he is able to stack about 3 to 4 blocks, though often avoids doing this. Per
parent report, he looks at pictures in books. He is not yet listening to a story. Lucas did not engage in adult-directed activities
throughout the evaluation or interact with toys in the room. Per parent report, he has a lot of the skills needed to interact with
toys, but often resists/avoids these tasks. He may spontaneously play appropriately with toys, but this is rare. Results from
the DAYC-2 Cognitive Domain indicate that Lucas' cognitive development is delayed (standard score = 73; age equivalent
= 14 months; 4th percentile).

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Area Assessed: Source(s) of Relevant Information: Area in Need of
SDI:
Adaptive Behavior · Date: 11/30/2023, Assessment Area: Adaptive Behavior Yes
Evaluation, Assessment: Adaptive Behaviors, Subject Area:

Narrative: 11/8/23
Information was gathered through parent interview and ob-
servations
Lucas communicates his wants and needs by pulling parents
to things he wants or handing him objects. He is learning to
use an AAC device to communicate. He sometimes points
to things he wants, though this is rare. He has some clear
words, including "baby" "bubbles" "papa" and "ball." He bec-
omes frustrated when others are unable to tell what he wants.
He feeds himself with his hands. When offered utensils, he
throws them to the side. He drinks from a cup with help and
drinks from a straw/sippy cup. He independently removes
his socks and shoes. He assists with dressing routines. He is
working on toilet training within ABA therapy. He will sit
on the toilet for about 5 minutes when placed and sometimes
uses it. He tolerates having his hands washed, but is not yet
attempting to wash them on his own. On a few occasions
he has shown an interest in household tasks his parents were
engaged with, but overall does not attempt to help with tasks
around the house.
· Date: 11/30/2023, Assessment Area: Adaptive Behav-
ior Evaluation, Assessment: DAYC-2 Adaptive Behavior
Domain, Subject Area:
Narrative: 11/8/23
Results from the DAYC-2 indicate his adaptive behaviors fall
well below expected levels for his age (standard score = 68;
age equivalent= 13 months; 2nd percentile).

Present Level of Performance:

Information about Lucas's adaptive functioning was provided through review of records, parent interviews, observations,
and the DAYC-2 Adaptive Domain. Lucas communicates his wants and needs by pulling parents to things he wants or
handing him objects. He is learning to use an AAC device to communicate. He sometimes points to things he wants, though
this is rare. He has some clear words, including "baby" "bubbles" "papa" and "ball." He becomes frustrated when others
are unable to tell what he wants. He feeds himself with his hands. When offered utensils, he throws them to the side. He
drinks from a cup with help and drinks from a straw/sippy cup. He independently removes his socks and shoes. He assists
with dressing routines. He is working on toilet training within ABA therapy. He will sit on the toilet for about 5 minutes
when placed and sometimes uses it. He tolerates having his hands washed, but is not yet attempting to wash them on his
own. On a few occasions he has shown an interest in household tasks his parents were engaged with, but overall does not
attempt to help with tasks around the house. Lucas demonstrates delays in adaptive behaviors. Results from the DAYC-2
indicate his adaptive behaviors fall well below expected levels for his age (standard score = 68; age equivalent= 13 months;
2nd percentile).

Describe any relevant medical information:

None at this time.

Describe how the disability impacts involvement and progress in the general curriculum:
Lucas's impairments in social communication/interactions and RRBs impact his ability to communicate his wants and needs,

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use language for social purposes, develop peer relationships, participate in adult directed activities, engage in age appropriate
play, and demonstrate his full range of knowledge and skills. These challenges impact Lucas's overall development and he
demonstrates delays in multiple areas.

Consideration of Special Factors: YES / NO If Yes, Location in the IEP

Is the student an English Learner? No
Additional Information:

Does the student have any special communication needs? Yes Goals, Services
Additional Information:

Does the student require assistive technology devices or services? Yes Goals, Services
Additional Information:
Lucas could benefit from light tech assistive technology and multi-modal communication strategies, such as signs,
gestures, picture cards, picture symbols, communication boards, communication devices, etc. to support his ability to
communicate with others in his environment.
Does the student have a documented visual impairment including No
blindness?
Does the student have a documented hearing loss? No
Additional Information:

For the student who is deaf or hard of hearing, the following have No
been considered:
· The student's language and communication needs
· Opportunities for direct communications with peers and
professional personnel in the student's language and com-
munication mode
· Academic level
· Full range of needs, including opportunities for direct in-
struction in the student's language Communication mode

Additional Information:

Does the student have behavior(s) that impede his/her learning or that No
of others? If yes, how is behavior being addressed?
Behavior Intervention Plan (BIP)
Behavior Goal(s)
Supplemental Aids/Supports

Additional Information:

Does the student require Adapted Physical Education (APE) ? No

Additional Information:

Is student instructed towards the Extended Content Standards &

participating in the alternate achievement assessment?
Additional Information:

Are there additional parent concerns? No

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Supports for academic, functional, personal changes or circumstances (if applicable):

What information is known about the student that will assist in developing an individualized education program?
Not applicable at this time

Secondary Transition
The student is 14 years or older or will be during the duration of the IEP: Yes No

Measurable Annual Goals

Academic and/or functional goals designed to meet the student's needs. Goals should be clearly defined and meas-
urable. For students who take alternative assessments aligned to alternative achievement standards, include a des-
cription of benchmarks or objectives.
Specific Area of Need Communication
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Given visuals and models as 70.0 Data sheets, Therapy No No

needed, Lucas will follow notes
one step directions such as
Give me..., Get...., Put in. etc
in 70% of opportunities
Service(s) supporting · Communication Skills ESY Service(s) supp-
this goal: · Speech/Language orting this goal:

Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Given modeling and prom- 70.0 Data sheets, Therapy Yes No

pts, Lucas will use multi- notes
modal communication strat-
egies (e.g., signs, words,
word approximations, gest-
ures/pointing, picture cards,
activate AAC, etc.) for com-
municative intents (e.g., greet,
protest, make choice, requ-
est toy/action/object, tell
want/need, request help) in
70% of opportunities.
Service(s) supporting · Speech/Language ESY Service(s) supp-
this goal: · Communication Skills orting this goal:

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IEP Document
Specific Area of Need Social-Emotional
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

With adult facilitation and 75.0 Data sheets No No

given no more than 2 prom-
pts, Lucas will tolerate oth-
ers playing nearby or using
similar materials in a com-
munal supply bin for 4 min-
utes with 75% accuracy in
targeted opportunities.
Service(s) supporting · Social / Emotional Skills ESY Service(s) supp-
this goal: orting this goal:
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

With adult facilitation and 75.0 Data sheets No No

given no more than 2 add-
itional prompts, Lucas will
engage in back and forth
social play (such as "my
turn/your turn" toys or games,
rolling a ball to others, build-
ing structures, fingerplays,
etc...) for a minimum of 3
exchanges with others in 75%
of targeted opportunities.
Service(s) supporting · Social / Emotional Skills ESY Service(s) supp-
this goal: orting this goal:

Specific Area of Need Acquisition and Use of Knowledge and Skills

Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Given no more than 2 add- 75.0 Data sheets No No

itional prompts (such as
modeling, demonstrations
or visual cues), Lucas will
participate in 2 step play
sequences with 75% accuracy
of targeted opportunities.
Service(s) supporting · Cognitive/ Pre-Academic Skills ESY Service(s) supp-
this goal: orting this goal:
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

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Given no more than 2 add- 75.0 Data sheets No No
itional prompts, Lucas will
participate by physical use
of materials during an adult
directed task for 4 minutes,
with 75% accuracy of tar-
geted opportunities.
Service(s) supporting · Cognitive/ Pre-Academic Skills ESY Service(s) supp-
this goal: orting this goal:
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Given no more than 2 add- 75.0 Data sheets No No

itional prompts (such as
modeling, demonstrations
or visual cues), Lucas will
imitate or utilize suggestions
from others to problem solve
with items or in situations,
with an accuracy rate of 75%
in targeted opportunities.
Service(s) supporting · Cognitive/ Pre-Academic Skills ESY Service(s) supp-
this goal: orting this goal:

Specific Area of Need Adaptive Behavior

Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Given no more than 2 addit- 75.0 Data sheets No No

ional prompts, Lucas will fol-
low the sequence of a visual
task schedule to anticipate
next steps or to participate in
classroom activities (such
as transitions, daily rout-
ines, or directives), with
75% accuracy of targeted
opportunities.
Service(s) supporting · Adaptive Behavior ESY Service(s) supp-
this goal: orting this goal:
Observable Skill / Behavior Criterion for Method of Measur- Assistive Related to Transition
Mastery ing Progress Technology Goals

Upon a cue and given no 75.0 Data sheets No No

more than 2 additional prom-
pts, Lucas will assist others
to clean up (such as putt-
ing items in a container or
in a specified location), with
75% accuracy of targeted
opportunities.

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IEP Document
Service(s) supporting · Adaptive Behavior ESY Service(s) supp-
this goal: orting this goal:

Least Restrictive Environment

Description of Specially Designed Instruction and Related Services
Indicate the least restrictive environment in which the student can achieve the goal(s).

Specially Designed Instruction:

Service Amount of Time Frequency Location Duration
in Minutes
Communication Skills 96 minute(s) 5 per week Special Education 12/15/2023 to 11/29/2024
Adaptive Behavior 96 minute(s) 5 per week Special Education 12/15/2023 to 11/29/2024
Cognitive/ Pre-Academic 96 minute(s) 5 per week Special Education 12/15/2023 to 11/29/2024
Skills
Social / Emotional Skills 95 minute(s) 5 per week Special Education 12/15/2023 to 11/29/2024

Related Services and/or Other Support Services:

Service Amount Frequency Location Duration Service Method
of Time in
Minutes
Speech/Language 30 1 per week Special 12/15/2023 to Goal
minute(s) Education 11/29/2024
Given visuals and models as
needed, Lucas will follow
one step directions such as
Give me..., Get...., Put in.
etc in 70% of opportunities

Given modeling and prom-

pts, Lucas will use multi-
modal communication strat-
egies (e.g., signs, words,
word approximations, gest-
ures/pointing, picture cards,
activate AAC, etc.) for com-
municative intents (e.g.,
greet, protest, make choice,
request toy/action/object, tell
want/need, request help) in
70% of opportunities.

Supplemental Aids /
Services

Occupational Therapy Special 12/15/2023 to Goal

Education 11/29/2024
Supplemental Aids /
Services

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Describe the Supplemental Aids and Services, including frequency, to be provided on behalf
of or to the student.

Occupational therapy will be available to classroom staff to collaborate on sensory strateg-

ies for the learning environment at least three times per reporting period. The results of the
occupational therapist's sensory processing evaluation indicate that Lucas does have differ-
ences in their ability to process sensation. Lucas presents with some under response to aud-
itory stimuli as well as some sensitivity to auditory stimuli. Lucas demonstrated significant
movement (vestibular) and deep pressure (proprioceptive) seeking behaviors and engaged in
these almost exclusively during the assessment. See social emotional present level for full
sensory profile. Lucas may benefit from sensory rich experiences and sensory breaks to fos-
ter his participation and learning in the classroom. Sensory strategies may include but are not
limited to the following: movement breaks, heavy work, flexible seating, oral input strateg-
ies, strategies to limit auditory input, and other deemed appropriate and necessary by treating
school-based occupational therapist.

Required based on Accommodations

Describe special transportation services:
Lucas's impairments in social communication/interactions and RRBs impact his ability to follow directions including safety
commands. He requires a small setting for close supervision along with hand to hand transfer to arrive to and from school in
a safe manner. An integrated booster seat is required if the student is assigned to a yellow bus to accommodate for staying
in the seat for an extended period of time.
Supplemental Aids/Services/Accommodations/Modifications:
In the space provided, list the subject/activity area in which the student will participate and the supplemental aids,
supports, modification, and/or accommodations required (if applicable) to access the general curriculum and make
progress toward meeting annual goals. If supplemental aids/services, modifications/accommodations and/or assistive
technology will be provided in special education classes, include in the table below.

Classroom Activities
No classroom activities have been added for this student.
If the student is in preschool, describe how the student is involved in the general education program.
Lucas participates in community outings with his family.

Supports for school personnel:

Describe consultation and/or training for school staff to meet the unique needs of the student.
Not applicable at this time

State and District-wide Testing:

For each subject tested in the child's grade, choose the method of assessment below. If "with accommodations" is
chosen for any subject, provide description of the accommodations for each subject in the right columns. Alternate
Assessment, if chosen, must apply to all tests taken.

District Tests
District Assessment: Not Participating

State Tests
No state tests have been added for this student.

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IEP Document
Alternate Assessment Justification
If the student is participating in any alternate assessment(s), explain why the regular testing method, standard
administration or with accommodations , is not appropriate, and why the selected is appropriate:
Not applicable at this time

Least Restrictive Environment Justification

If the student will be removed from nondisabled peers for any part of the day, explain why the services cannot be
delivered with nondisabled peers with the use of supplemental aids and services.

Lucas's impairments in social communication/interactions and RRBs impact his ability to communicate his wants and needs,
use language for social purposes, develop peer relationships, participate in adult directed activities, engage in age appropriate
play, and demonstrate his full range of knowledge and skills. These challenges impact Lucas's overall development and he
demonstrates delays in multiple areas. He requires a small setting with specially designed instruction from a special education
teacher with multiple opportunities to practice newly learned skills with peers working on similar goals in order for him to
be successful in his learning environment along with speech therapy, occupational therapy and transportation services.

Progress Reports:
Progress Reports on IEP goals will be issued in accordance with school report card schedule.
(If the IEP team determines that more frequent progress reports are needed, indicate the schedule below:)
A more frequent progress report is not needed at this time
Extended School Year Status:
ESY worksheet must be completed.
Is not eligible for extended school year based on current data
IEP TEAM PARTICIPANTS

The following individuals were present and participated in the IEP Team decision. (A Request to Excuse Required IEP Team
Member(s) has been obtained if any of the below participants are identified as excused. Note with an * any team member
who used alternative means to participate.)

Name Position Date

Trisha Lynn Dillon LEA Representative 11/30/2023
Ida Lynn Jackson Special Education Teacher 11/30/2023
Trisha Lynn Dillon Regular Education Teacher 11/30/2023
Sarah Neal Interpreter of Instructional Implications of 11/30/2023
Evaluation Results
Andreina Villalobos Mother 11/30/2023
Vicki Levon Lucas-Crowder Other Team Member 11/30/2023
Sarah Neal Other Team Member 11/30/2023
Louise Scott-Cole Other Team Member 11/30/2023

Explanation of team participants/absence of participants (if needed):

-Vicki Lucas-Crowder-Speech-Language Pathologist -Sarah Neal-Psychologist -Louise Scott-Cole-Occupational Therapist

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Student: Lucas Contreras Villalobos Student UID #: 3261689617 DOB: 12/15/2020
School: CECAS Grade: P2 Age: 2
Primary Eligibility: AU Secondary Eligibility:

ELIGIBILITY WORKSHEET – EXTENDED SCHOOL YEAR (ESY)

I. ESY Eligibility Determination

After the consideration of applicable data, the IEP Team has determined:

Yes No Cannot be Factors for Consideration

Determined at
this Time
The student regresses or may regress during extended breaks from instruction and
cannot relearn the lost skills within a reasonable time; or
The benefits a student gains during the regular school year will be significantly jeop-
ardized if he or she is not provided with an educational program during extended
breaks from instruction; or
The student is demonstrating emerging skill acquisition ("window of opportunity")
that will be lost without the provision of an educational program during extended
breaks from instruction.

Based on the information above:

Yes No Determination
The student is eligible to receive Extended School Year services.
The student is not eligible to receive Extended School Year services.
Eligibility cannot be determined at this time. The IEP Team will determine eligibility by .

II. ESY Program Description

Describe the ESY program for this student by indicating the type(s) of service (special education and/or related service) and
the number/length/location of session(s).

Type of Service ESY Sessions

Number Length Location

ESY Start Date:

ESY End Date:

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 Wake County Schools

Student: Lucas Contreras Villalobos Student UID #: 3261689617 DOB: 12/15/2020

School: CECAS Grade: P2 Age: 2
One-time Consent to Release Personally Identifiable Information and Access Public Benefits
from the North Carolina Division of Health Benefits (NC Medicaid)

Federal law encourages school districts to seek payment from public insurance programs for some health care
services provided at school. Under the Family Education Rights and Privacy Act (FERPA), your consent is required
for the school system to release information about your child to the North Carolina Division of Health Benefits (NC
Medicaid) in order to access your or your child's public benefits. You are entitled to a copy of any information the
school system releases to the state Medicaid program. You may inquire about this program or revoke your consent at
any time by contacting Dr. Susan Battigelli at (919) 694-0729.

Your decision to allow the school district to release this information and access your or your child's public benef-
its will not affect your child's educational program or Medicaid benefits. This consent form is completed for each
child receiving evaluations and/or services under any of the following plan types: Individualized Education Program
(IEP); Individualized Family Service Plan (IFSP); Section 504 Plan; Individualized Health Plan (IHP); or Behavior
Intervention Plan (BIP).

The funds collected from Medicaid in this school system will be used to:
provide valuable and necessary additional staffing to meet therapy needs of students, education for staff to learn new
therapeutic techniques, assistive technology equipment, and materials for individual student needs.

Please mark the appropriate statement, sign, and date at the bottom:
_________ I GIVE MY CONSENT for Wake County Schools to access my or my child's NC Medicaid benefits for
reimbursement of services provided through the plan(s) my child may receive. My signature does not give consent to
bill my private insurance company. The school system may release the following information to access these public
benefits:
· My child's name;
· Medicaid Number
· My child's date of birth;
· My child's service documentation including evaluations;
· The dates and times services are provided to my child at school;
· Reports of my child's progress, including therapist notes, progress notes and report cards.

I understand that my child will continue to receive educational services at no cost to me. I can revoke my consent at
any time and withdrawing my consent does not relieve the school district of its responsibility to ensure all required
services are provided at no cost to me.

_________ I DO NOT GIVE MY CONSENT for this information to be released. I understand refusing to consent
or revoking consent does not change the school district's responsibility to provide educational services at no cost to
me.

Child's Full Name: Lucas Contreras Villalobos

School: CECAS

Parent/Guardian's name (print): _____________________________________

Parent/Guardian's signature: _____________________________________

Signature Date: _____________________________________