Page 79 - The Individual Education Plan (IEP) - A Resource Guide, 2004

Sample 3
Individual Education Plan
IEP
REASON FOR DEVELOPING THE IEP
x
Student identified as Student not formally identified but requires special education program/services, exceptional by IPRC including modified/alternative learning expectations and/or accommodations
STUDENT PROFILE
Name: Student C
School: OntarioSchool
Student OEN/MIN: 345678910
Current Grade/Special Class: 5
Most Recent IPRC Date: 21/05/2004
Exceptionality: Behaviour
IPRC Placement Decision (check one) Regular class with indirect support Regular class with resource assistance Regular class with withdrawal assistance
Gender: Male Date of Birth: 04/19/1994
Principal: B. Principal
School Year: 2004-2005 Date Annual Review Waived by Parent/Guardian:
x Special education class with partial integration Special education class full-time
ASSESSMENT DATA
List relevant educational, medical/health (hearing, vision, physical, neurological), psychological, speech/language, occupa- tional, physiotherapy, and behavioural assessments.
Information Source
Date
Summary of Results
Psychological report
21/11/2002
Report provides diagnosis of oppositional defiant disorder
Educational assessment
15/06/2004
Literacy and numeracy skills grade-appropriate
Medical assessment
09/04/2000
Report provides diagnosis of ADHD
STUDENT’S STRENGTHS AND NEEDS
Areas of Strength
Areas of Need
Kinesthetic learning style
Attention skills
Gross and fine motor skills
Social skills
Receptive language (reading)
Anger-management skills
Expressive language (speaking/writing)
Memory skills
Health Support Services/Personal Support Required Yes (list below) x No 1
Appendix B: Samples of Completed IEP Forms 77