iep form for julian

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Special Education Individualized Education Program (IEP) Student Name: Julian Date: March 1, 2017 School: Hartvigsen Grade: Elementary (age 12) Birthday: July 17, 2004 Primary Language at home: English Placement in Special Education  Review of evaluation results indicate that this child meets the criteria to receive special education services in
  Special Education Individualized Education Program (IEP) Student Name: Julian Date: March 1, 2017 School: Hartvigsen Grade: Elementary (age 12) Birthday: July 17, 2004 Primary Language at home: English Placement in Special Education    Review of evaluation results indicate that this child meets the criteria to receive special education services in the ______   Intellectual Disabilities_________________ category according to the Utah State Board of Education Rules and Regulations for Programs for the Disabled. Hospital and Home Residential School Special Day School Enrollment in Special Class (Part-time in regular class when appropriate) Part-time Instruction for Services (up to ½ day out of the regular classroom) Services within the general education classroom for the identified student with a disability: a.   To the teacher b.   To the student Current Physical Education Placement Special Day School: Julian does not participate in regular physical education. Instead, Julian participates in a special physical program and adapted swimming program for 3 times a week for forty minutes each session.    Location of Services: Hartvigsen    Dates when services will begin and end:   JANUARY 24, 2017 –  APRIL 21, 2017   Student  ’ s present level of performance (PLOP)      Based on the TGMD3 and Humphries’ Assessment of Aquatic Readiness ( HAAR), Julian is   deficient in: (1 Ball Skill) Overhand Throw. Julian only met 1 of the 4 criteria for a mature overhand   throw. (1 Motor Skill) HAAR Phase 5. Julian has only met 2 of the 6 guidelines for Phase 5 (able to   glide from the side of the pool to the instructor independently and will glide with a bent   leg kick to instructor independently.   Guidelines for HAAR assessment Phase 5 are as follows: o   Will float supine unassisted   o   Will glide from side of pool to instructor independently   o   Will glide with bent leg kick to instructor independently   o   Will glide with straight leg kick to instructor independently   o   Will come to instructor with straight leg kick and rudimentary arm movements   independently   o   Will come to instructor with straight leg kick and straight over arm movements   independently.   (1 Fitness Skill) Julian is deficient in cardiovascular endurance. He completed only one lap   in three minutes. Semester Goal #1:  Julian will meet 4 of the 4 criteria to demonstrate a mature overhand throw. Date Objective was mastered: Objectives: 1. Julian will meet 2 of the 4 criteria to demonstrate an overhand throw. 3/04/2017 2. Julian will meet 3 of the 4 criteria to demonstrate an overhand throw. Did not achieve. Still working.  3. Julian will meet 4 of the 4 criteria to demonstrate an overhand throw. Did not achieve. Too difficult.    Semester Goal #2: Julian will meet 5 out of the 6 guidelines of the HAAR assessment for independent movement through the water. Date Objective was mastered:  Objectives: 1.   Julian will float on his back unassisted for at least two seconds. Did not achieve. He’s at one second  2. Julian will glide with a straight leg kick to the instructor for at least three feet independently. Did not achieve. He’s still working on a bent leg kick   3. Julian will come to the instructor with a straight leg kick and rudimentary arm movements for at least four feet. Did not achieve. Too difficult. Semester Goal #3: Julian will increase his cardiovascular endurance as measured by swimming 2 laps in 3 minutes or less. Date Objective was mastered: Objectives: 1. Julian will participate in swimming activities for at least three minutes without stopping. 3/11/2017 2. Julian will participate in kicking activities for at least three minutes without stopping. 3/18/12017 3. Julian will complete at least 2 laps in three continuous minutes. Did not achieve. He swam one lap.  _______________________________________________________________________________________________________________ Specific Educational and/or Related Services: Adapted Physical Education Name of person responsible to provide services: Alex Walker Equipment Needed: ball, life jacket, flotation bars (for floating), target 20 ft. away, clock or timing device.
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