Page _____ of _____
PLACER COUNTY SELPA
PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE
Student Name Dixon, Virginia
Date of Birth 5/20/2002
IEP Date: 3/6/2017
Strengths/Preferences/Interests
Parent Input: Ginny is cheerful and understands most of what is said to her. She likes playing with toys including dolls, her ipad
for videos, the park, pool, and movies.
(EC 3/2/2017)
Teacher's Comments: Ginny's Strengths, Preferences, and Interests include:
>basic computer skills
>able to navigate and find things on an ipad
>enjoys walks, scooter boards, kicking soccer balls with peers and staff
>enjoys looking at magazines and books
>watching Youtube videos on the computer
>can communicate what she wants or needs with words, icons, choice boards, and the speech generating
devices that we use in this class
>can follow a visual schedule and comply with most of the basic classroom rules
>she is able to sort, assemble, and disassemble some of the work box activities that are used in this class
>works for dolls, time on her ipad, Youtube videos on the computer, verbal positive reinforcement
(TSM 2/27/2017)
Concerns of parent relevant to educational progress
Ginny is on a grain free diet with no sugar and only organic vegetables and grass fed meats. Dairy is raw, non-pasteurized.
Please only give her food from home. She would also like to know if Ginny did get something that she was not supposed to have.
(EC 3/2/2017 call from teacher)
SBAC
English/Language Arts Overall
Standard Exceeded
Reading
Standard Met
Standard Nearly Met
Above Standard
At or Near Standard
Below Standard
Writing
Above Standard
At or Near Standard
Below Standard
Speaking and Listening
Above Standard
At or Near Standard
Below Standard
Research/Inquiry
Above Standard
At or Near Standard
Below Standard
Math Overall
Standard Exceeded
Concepts and Procedures
Problem Solving and Data Analysis
Communication Reasoning
CAA (Scores Not Available for
2015)
Standard Exceeded
Standard Met
Standard Nearly Met
Above Standard
At or Near Standard
Below Standard
Above Standard
At or Near Standard
Below Standard
Above Standard
At or Near Standard
Below Standard
Standard Met
CA Standards Test
Science
Adv.
Proficient
Basic
Below Basic
Far Below Basic
CMA
Science
Adv.
Proficient
Basic
Below Basic
Far Below Basic
Adv.
Proficient
Basic
Below Basic
Far Below Basic
CAPA
Science
CELDT
Standard Nearly Met
Standard Not Met
Standard Not Met
Standard Not Met
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Listening
Speaking
Reading
Writing
Physical Education Testing (grades 5, 7 & 9):
Other Assessment Data (e.g., curriculum assessment, other district assessment, etc.) Parent declined CAPA testing, 5/10/13.
Hearing Date:( 3/3/2016 )
Pass
Fail
Other CNC
Vision Date: ( 3/3/2016 )
Pass
Fail
Other CNC
Preacademic/Academic/Functional Skills
Teacher's Comments
Ginny started with us here at Del Oro High School on Dec. 1st 2015. She is almost always happy, but can be stubborn and hard
to transition from one activity or location to another.
Currently, Ginny rides to and from school on the school bus.
She has been able to transition from the bus much better this year with a reward system for following directions. She is at school
from 8:30 AM to 3:00 PM on Tuesdays - Fridays. Monday is an hour shorter
for staff development and meetings. PLC days.
At school, Ginny:
>hangs her backpack and coat on the hooks below her cubbie with some help if needed.
>puts her communication folder in the basket on the teacher’s desk. Sometimes needing a prompt
>puts her lunch in the refrigerator
>goes and sits in her seat and does her morning workbook with help
>goes on the morning walk to the Stadium and she does one or two laps with the class
>has brunch which is brought from home
>participates in the Pledge, Calendar, and Roll. Ginny puts days, weather, or other things up on the calendar,
when asked and uses a speech generating device for the names of the other students, and saying good
morning to them
>works in Stations on her IEP goals and the common core standards using the Unique Learning System
that is used here
>works for breaks, her ipad, dolls, or short Youtube videos
>transitions back to work after a break, but sometimes a toy may be hard to give up, but
putting a hand out and saying, "my turn" has worked and she knows that she can work for it again
>at lunch, she eats what is sent from home, but does not always finish everything. What she does not eat is
usually sent back home unless there is not much left of it.
>on days that she went in the car for Community Based Instruction, she could earn fries, chicken nuggets, and small soda for
following directions. This was discontinued per mom's request.
>After lunch is book time. A book from the library is read while she is able to look at the pictures. She may get snacks (nuts or
crackers from home) for staying in her seat and listening to book.
>After book time the class goes to the tennis courts for P.E. Ginny has enjoyed the scooter board and has ridden the adult
tricycle from time to time.
>on Adapted Physical Education (APE) days, Mike Jenson meets or takes Ginny to the tennis courts where they work on her
IEP goals
>Following that, she has a snack (from home) and a drink. Water, or another drink provided by mom.
>Then it is art or the vocational workboxes. She is able to do many of them, but prompts and reinforcement help to keep her
going. Again, breaks, toys, and videos for getting her work done.
>At the end of the day, clean up and stacking chairs before getting ready to go home.
So far, Ginny has been able to follow the schedule with few problems. She seems to be having a good time and she seems to
like the positive reinforcement for staying on task and earning her rewards for completing her work.
PROGRESS ON CURRENT GOALS:
Ginny’s current goals and benchmarks were written here after she had been here for about two months for her Annual IEP.
Mastery of goals are determined by and based upon observation, data collection and assessment completed by members of the
multidisciplinary team working with Ginny. Ginny’s progress on each goal is noted below.
GOAL #3: when given a picture of a digital or analog clock set to the hour, Ginny will be 80% accurate in matching it to the other
on 4 of 5 trials as recorded by staff.
Goal not met. Currently she is at 47% accuracy and Non-compliance is common.
GOAL #4: when matching coins to a value up to 50 cents, Ginny will be 80% accurate on 4 of 5 trials as recorded by staff.
Goal not met. Non-Compliance and aggression on this goal 4 out of 5 days. Once a week is in the 25% accuracy range.
Page _____ of _____
GOAL #5:when matching the first letter of a work in a field of three, Ginny will be 80% accurate on 4 of 5 trials as recorded by
staff.
Goal not met, but showed improvement all year. Currently in the 67% accuracy range when she will do it.
GOAL #6:when matching 10 pairs of different socks, Ginny will be 80% accurate on 4 of 5 trials as recorded by staff.
Goal Met. Currently Ginny is at 85.3% accurate and was 100% on Wednesday at Secret Ravine.
GOAL #7: when given 10 plastic nuts and bolts, Ginny will be able to put them together matching color and shape at 80%
accuracy on 4 of 5 trials as recorded by staff.
Goal not met. Too many things for this goal to be met. She matches the color at almost 100% each time and there are five
different colors.
There are five different shapes. She is 60 - 75 % accurate on shape.
Screwing them together is almost all hand over hand.
AREAS OF NEED
From last year's goals, some strengths and weaknesses have been found. New ideas to make gains will be tried.
One area of need is finding and matching the first letter of a word. The past goal of finding the first letter of a word in a field of
three was only 67% accurate. Another, more functional way to do the same would be to file the word in a card file by first letter.
This could be a useful skill later and helps her be more aware of the first letter of the word.
Currently when filing words by first letter in a card file, Ginny is 80% accurate on 0 of 5 trials with one verbal prompt as recorded
by staff.
Another Functional Academic goal that was not successful last year could be revisited in a new way to see if it is easier for her
to master it.
Currently when sorting real coins, Ginny is able to sort real coins into the correct containers at 80% accuracy with one verbal
prompt on 0 of 5 trials as recorded by staff.
Last year, Ginny was able to match the socks, but has not learned how to put them together so that they will stay together.
Currently when given matched socks, Ginny is able to put them together so that they will stay together at 80% accuracy on 0 of
5 trials with one verbal prompt as recorded by staff.
Last year, Ginny was asked to match color, shape, and twist them together as a workbox activity goal. She was only able to
match the color at a high level of accuracy. Breaking this down this year.
Currently when matching 6 different shapes (large square, triangle, circle, and small square, triangle, and circle) Ginny is 80%
accurate with one verbal prompt on 0 of 5 trials as recorded by staff.
Currently when given the differently colored and shaped nuts and bolts, Ginny is able to twist them together with 80% accuracy
with one verbal prompt on 0 of 5 trials as recorded by staff.
(TSM 3/2/2017)
Communication Development
Page _____ of _____
SLP Comment, 3/2017: Ginny is a multi-modal communicator who expresses herself using picture icons, communication boards,
infrequent true words, and non-symbolic communication strategies such as proximity, facial expression, body movements, object
manipulation and non-speech vocalizations. She shows little interest in static communication boards, however a personalized
core board and an icon placemat is accessible to Ginny at her desk and modeled by staff. Ginny has access to loose icons that
she uses to request preferred objects such as candy and iPad. She uses a 32-cell voice output communication device during a
calendar/roll activity each morning but requires maximum gestural prompting or hand over hand assistance due to lack of
attention toward the device. Ginny uses true words on an inconsistent basis to request objects and actions, request help, and
greet others. She independently uses the carrier phrase "I want" to signal her desire for a toy, drink etc, says "hi" to others, and
requests help. With prompting or modeling Ginny can say a variety of words such as more, all done, water, juice, etc. She did
not meet her current communication goal to use at least 15 verbs in functional utterances. She imitates and uses independently
verbs: eat, drink, go, stop, play, sit, and walk but she is highly inconsistent and does not combine verbs with other words to form
sentences. She has been inconsistent in her ability and willingness to match verb icons to photos of self and others engaged in
physical actions, and rarely points to verbs on a communication board. Receptively, Ginny identifies common objects when
named and follows familiar instructions with variable accuracy depending on her motivation to participate. Ginny is a social girl
who enjoys interacting with staff and peers by smiling, making eye contact, and being in close proximity. Her speech production
tends to be quite clear when she is motivated to use spoken language. KH
Gross/Fine Motor Development
Adapted Physical Education, March 2017: Ginny has been participating with a small group of her peers from her class and she
is gradually
doing more and more. Ginny traditionally works on her gross motor skills in Adapted P.E. individually and in small groups with
her peers on the tennis courts. This is an improvement as she had been choosing to stay in the classroom instead of
participating with her peers. Also, Ginny has made progress on her Object Control Catching and Throwing Goals.
In summary, Virginia eventually attempts what is asked of her when prompted and reinforced with staff support. Based on her
present gross motor development, it is recommended that the IEP team continue Adapted Physical Education Services for
Virginia at this time.
Area of Need:
Ginny is able to kick a stationary or a slowly rolled 8.5" playground ball and/or a size 4 foam soccer ball a distance of 15' on the
ground or in the air between two cones placed 6' apart in 0 out of 5 attempts, in 2 out of 3 consecutive trial sessions from a
standing position. (Adapted P.E.//MJ)
________________________________________________________________
Teacher's Comments.
Ginny seems to have little or no trouble with the basic Gross and Fine Motor Skills. Limitations seem to be more in the fine motor
skills areas and may be lack of practice or motor planning.
Ginny is able to:
>assemble and disassemble some of the easier vocational workbox tasks
>manipulate and carry large and small objects without dropping them
>run, jump, and walk over uneven terrain without difficulty
>ride the adult tricycle
(TSM 3/2/2017)
_________________
Occupational Therapy Comment 3/2017:
Ginny demonstrates a right hand preference. Ginny employs a static tripod grasp with a finger wrap. She is able to use a pincer
grasp to pick up small items and pointer finger to point at objects. She requires hand-over-hand assistance to trace her name in
all capital letters. She requires minimal to moderate assistance to complete a 24-piece puzzle. She requires moderate
assistance to engage a zipper on her jacket laid out on the table; however this is inconsistent and it depends on her attention
span/distractibility. She enjoys the iPad and demonstrates the ability to swipe and activate small areas on the screen. Ginny's
sensory diet is embedded into her daily schedule. She participates on walks, rides an adapted trike and in physical education
with the classroom. She frequently has fidgets with her. //AL, OTR/L
Social Emotional/Behavioral
Behavior Specialist Comment 3/2017
Virginia has a current Behavior Intervention Plan (BIP) dated 2/25/16 in place to address the following:
1. Aggression: defined as Ginny slapping, pinching, grabbing, hitting or pushing others. Throwing items at others. Includes
attempts.
2. Socially stigmatizing behaviors: defined as Ginny touching herself in the breast, groin or buttocks area on the outside or inside
of her clothing or touching others without permission. Ginny taking others food without permission or picking food items off the
ground and putting them in her mouth.
Page _____ of _____
3. Non-compliance episode: defined as Ginny not following an instruction by the second time given. May be paired with
dumping/swiping items off surfaces. An episode is over when Ginny is following the staff instruction.
At this time it is recommended that the definition of non-compliance episode be updated to the following:
Non-compliance episode: defined as Ginny not following an instruction by the second time given. May be paired with
dumping/swiping items off surfaces and/or aggression. An episode is over when Ginny is engaged and following the staff
instruction for a minimum of 30 seconds.
Current rates of Behavior:
Data from January and February 2017 (23 data days) indicates the following rates of behavior:
Aggression: 75 occurrences; 3.26/day
Socially Stigmatizing Behaviors: 141 occurrences; 6.13/day
Non-compliance episode: 35 occurrences; 1.52/day, with a duration range of 1-23 minutes per episode
Progress on Goal(s):
“By March of 2017, Ginny will ask for a break in order to escape or delay non-preferred task demands instead of engage in noncompliance or aggression as evidenced by a decrease in these behaviors from an average of 8.3 per day to less than 4 per day
as measured by special education staff data across 2 consecutive weeks.”
**Goal Not Met. Data from 1/30/17 to 2/10/17 indicates that aggression and non-compliance are at a combined average of
5/day.
Virginia has decreased her occurrence of aggression and non-compliance however there has been an increase in her rate of
socially stigmatizing behavior; a goal has been drafted for this area of need.
AREA OF NEED: Currently, to assist Virginia in reaching her post- secondary goals, in trigger conditions e.g., in the bathroom,
presence of food on ground) Virginia is able to utilize a replacement skill (e.g., engage with fidget, busy her hands (incompatible
behavior)) rather than engage in socially stigmatizing behavior at an average rate of 6.13/day as observed and measured by
staff collected data.
The updated areas of the BIP include: the definition of non-compliance episode, frequencies of behavior, and the addition of
physical prompting/assistance as a predictor of behavior. Upon agreement of these updates by the IEP team all staff who work
with Virginia should continue to receive training and consultation of the BIP to ensure fidelity. //SB, M.A.
Vocational
Teacher's Comments.
Vocational workbox activities include sorting activities, assembly, and disassembly mostly. Most if not all of these are new to her.
With support and positive reinforcement for completing tasks, she will learn and master these tasks in time.
Ginny is able to:
>sort brushes and combs
>sort shapes and colors if choices are 3 or less
>assemble and disassemble tooth brush holders, but support is needed to complete a set number of them
>stringing blocks or other wooden shapes together with shoe string
So far, matching colors seem to be the easiest for Ginny. Shapes are more difficult, and assembly of things that she has had no
experience with is all hand over hand. Three new goals have been written to help improve these skills.
Currently when given matched socks, Ginny is able to put them together so that they will stay together at 80% accuracy on 0 of
5 trials with one verbal prompt as recorded by staff.
Currently when matching 6 different shapes (large square, triangle, circle, and small square, triangle, and circle) Ginny is 80%
accurate with one verbal prompt on 0 of 5 trials as recorded by staff.
Currently when given the differently colored and shaped nuts and bolts, Ginny is able to twist them together with 80% accuracy
with one verbal prompt on 0 of 5 trials as recorded by staff.
(TSM 3/2/2017)
Adaptive/Daily Living Skills
Teacher's Comments.
Ginny is helped with toileting, but for behavior and support mostly
Ginny is able to:
Page _____ of _____
>carry her backpack from the bus to the classroom and hang it independently
>clean up her table after meals and putting the placemat where it goes independently
>ask to use restroom (usually will say pee pee) independently and almost never has an accident
>help in the classroom with cleaning and putting away things
>independently picks up trash and throws it in the trash while on walks
In Adaptive/Daily Living Skills Ginny was able to match her socks. A possible new goal could be for her to put them together so
that they would stay together.
Currently when given matched socks, Ginny is able to put them together so that they will stay together at 80% accuracy on 0 of
5 trials with one verbal prompt as recorded by staff. (TSM 3/2/2017)
Health
3/14/17 Nursing Note: As reported by Mother, Ginny has undergone some significant diet changes with her now consuming a
Grain free diet, with no added sugar, organic if possible, and grass fed meats and raw dairy. No medications changes reported.
T. Castro, RN
3/7/16 Nursing Note: Virginia has been diagnosed with Autism. She does not have any significant health history reported.
Virginia has a reported allergy to Amoxicillin. Virginia is current and up to date on her immunizations with the exception of her
7th grade Tdap booster of which there is a waiver in place. She does not take any daily medications and she does not have any
history of seizure activity. Virginia weighs 130lbs and measures 5’3” placing her at 23.3 (84th %) a healthy weight on the Body
Mass Index. RN was unable to condition student for hearing or vision screening. However, student presents with functional
vision, both distance and near, and hearing both inside and outside of the classroom. Students health is reported as stable.
There are no noted or reported health concerns at this time. T. Castro, RN
For student to receive educational benefit, goals will be written to address the following areas of need:
Academic, Communication, Adaptive Daily Living Skills, and Social Emotional/Behavioral.
Page _____ of _____
PLACER COUNTY SELPA
SPECIAL FACTORS
Student Name Dixon, Virginia
Date of Birth 5/20/2002
Does the student require assistive technology devices and/or services?
Rationale
No
IEP Date: 3/6/2017
Yes
Adapted materials, Augmentative communication device, visual schedule, visual supports ("I'm working for" card with icons to
choose from), token chart, communication board, and touch screen computer.
Does the student require low incidence services, equipment and/or materials to meet educational goals?
(if yes,specify)
No
Yes
Considerations if the student is blind or visually impaired: No
Considerations if the student is deaf or hard of hearing: No
If the student is an English Learner, complete the following section:
Does the student need primary language support?
No
What will be the language of instruction for the student?
Yes
If yes, how will it be provided?
Who will provide ELD services to student?
General Education
What type of classroom setting will the student attend?
English Language Mainstream
Structured English Immersion
Alternative Program (primary language instruction)
Special Education
Comments:
No Yes 1. Aggression: defined as Ginny slapping, pinching,
grabbing, hitting or pushing others. Throwing items at others. Includes attempts.
2. Socially stigmatizing behaviors: defined as Ginny touching herself in the breast, groin or buttocks area on the outside or inside
of her clothing or touching others without permission. Ginny taking others food without permission or picking food items off the
ground and putting them in her mouth.
3. Non-compliance episode: defined as Ginny not following an instruction by the second time given. May be paired with
dumping/swiping items off surfaces and/or aggression. An episode is over when Ginny is engaged and following the staff
instruction for a minimum of 30 seconds.
Does student's behavior impede learning of self or others?
If yes, specify positive behavior interventions, strategies, and supports 1. Ginny benefits from a structured classroom environment with
visual supports
2. When working with Ginny, have her token economy system with her and have her choose what she would like to work for (e.g.
ipad, dolls, toys)
3. If something is not available, give Ginny choices of what is available to work for. It may be helpful to show her an icon or the
actual item
4. The amount of work/compliance required for a token will be systematically increased to increase her work length and
independence
5. The amount of work required will also be based on Ginny's current attending level and behavioral state
6. Timers can be helpful to let her know how much more time she has with a task
7. Provide access to communication modalities at all times throughout her school day (core board, device, verbal, icons)
8. Provide specific social praise throughout the day in the absence of maladaptive behaviors
9. Provide transitions warnings, especially when going from a preferred activity to non-preferred (e.g. dolls to PE)
10. Use a DRI (differential reinforcement of an incompatible behavior) by providing a choice of fidgets throughout the day to keep
her hands busy
11. Use first/then language
12. State "my turn" when you need her to relinquish an item and let her know she can work for it again
13. Use concise firm language in the bathroom with clear directives to decrease bathroom non-compliance
14. Monitor proximity of other's food to decrease her being able to reach it
15. Praise all functional communication throughout the day
16. Gain attention first before giving an instruction. Short compliance checks can be used (e.g. touch your nose, give me a high
five)
17. Hard items that can be thrown should not be available unless monitored
Behavior Goal is part of this IEP
Behavior Intervention Plan (BIP) attached
Page _____ of _____
PLACER COUNTY SELPA
Offer of FAPE - SERVICES
Student Name Dixon, Virginia
Birthdate 5/20/2002
IEP Date: 3/6/2017
The service options that were considered by the IEP team (List all): The team considered a continuum of services including general
ed, general ed w/accommodations and modifications, 504, Specialized Academic Instruction on a comprehensive campus, in a
District Functional Skills program, and in a PCOE program. The team agreed that the least restrictive placement was the PCOE
program with Specialized Academic Instruction, Speech & Language, Behaviorist Services, Occupational Therapy, Adapted
Physical Education, and Transportation. All other less restrictive options cannot meet the student's needs.
In selecting LRE, describe the consideration given to any potential harmful effect on the child or on the quality of services that he or
she needs: The IEP team discussed the potential harmful effects including decreased access to instructional opportunities and
appropriate social interaction with typically-developing peers and the potential impact to Ginny's self-esteem. The team
determined that her substantial needs combined with the anticipated benefits of the proposed placement outweigh the potential
impact to Ginny's self-esteem.
Supplementary Aids, Services & Other Supports for school personnel, or for student, or on behalf of the student
Aids, Services, Program
Accommodations/Modifications,
and/or
Supports
Manipulatives for Math/Science
Start Date
Student
End Date
Frequency
Duration
Location
03/06/2017
03/05/2018
Daily
as needed
School
03/06/2017
03/05/2018
Daily
390 min
School
03/06/2017
03/05/2018
Daily
as needed
School
03/06/2017
03/05/2018
Daily
390 min
School
03/06/2017
03/05/2018
Daily
Personnel
Adult support/staff assistance
in all realms of school activities
(academic, social, sensory,
and communication)
throughout the school day.
Preferential/assigned seating
to avoid inappropriate
behaviors.
Communication supports
(visual schedule, icons, choice
boards, token charts, working
for cards and first / then cards)
Home/School communication
system. (Notes to Home, Notes
from Home)
Special Education Transportation
Student
Personnel
Student
Personnel
Student
Personnel
Student
Backpack
Personnel
No
Yes
SPECIAL EDUCATION and RELATED SERVICES
Service: Specialized Academic Instruction
Start Date: 3/6/2017
End Date: 3/5/2018
Provider: District of Service
Ind
Duration/Freq: 390 min x 1 Totaling: 390 min served Daily
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: To address goals and objectives related to Functional Academics, Independent Living Skills, Vocational Skills, Communication,
and Behavior. Will also include brunch, lunch and all breaks because adult supervision is required to maintain appropriate behavior.
Service: Language and speech
Start Date: 3/6/2017
End Date: 3/5/2018
Provider: District of Service
Ind
Duration/Freq: 30 min x 1 Totaling: 30 min served Weekly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: Direct speech and language services to address expressive language goal and functional language development.
Service: Adapted physical education
Start Date: 3/6/2017
End Date: 3/5/2018
Provider: District of Service
Ind
Duration/Freq: 30 min x 2 Totaling: 60 min served Weekly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: To work on physical fitness goals and objectives individually and/or in a small group setting.
Page _____ of _____
Service: Occupational therapy
Start Date: 3/6/2017
End Date: 3/5/2018
Provider: District of Service
Ind
Duration/Freq: 30 min x 2 Totaling: 60 min served Monthly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: To work on goals to improve independent self care.
Service: Behavior intervention Services
Start Date: 3/6/2017
Provider: District of Service
Ind
Duration/Freq: 600 min x 1 Totaling: 600 min served Yearly
Grp
End Date: 3/5/2018
Sec Transition
Location: Separate classroom in public integrated facility
Comments: Behavior Intervention services are necessary in order to address maladaptive behaviors that interfere with Virginia’s learning and
disrupts the learning environment. Behavior services are typically provided within the class setting as appropriate for Virginia’s needs.
Services will be provided by the behavior specialist and/or behavior support assistant and will include collaboration with the teacher,
classroom staff, related service providers, and parents. Services will focus on training staff to implement the BIP with fidelity. Due to Virginia’s
fluctuating behavior needs, services may be provided at different frequencies throughout the year.
EXTENDED SCHOOL YEAR (ESY)
Yes
No
Rationale: Ginny has demonstrated severe regression of skills during extended school breaks and extra time is wasted re-
teaching of skills after an extended school break. The IEP team is in agreement that ESY is appropriate for Ginny.
Service: Specialized Academic Instruction
Start Date: 6/19/2017
End Date: 7/14/2017
Provider: District of Service
Ind
Duration/Freq: 240 min x 1 Totaling: 240 min served Daily
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: Participation in the upcoming Extended School Year (ESY) Program is recommended to maintain Ginny's current level of
progress toward meeting her annual IEP goals.
Service: Language and speech
Start Date: 6/19/2017
End Date: 7/14/2017
Provider: District of Service
Ind
Duration/Freq: 30 min x 2 Totaling: 60 min served Yearly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: All ESY sessions to be provided in group settings.
Service: Behavior intervention Services
Start Date: 6/19/2017
End Date: 7/14/2017
Provider: District of Service
Ind
Duration/Freq: 30 min x 1 Totaling: 30 min served Yearly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: Behavior intervention services are necessary in order to address maladaptive behaviors that impede Ginny's learning and may
cause her harm. Behavior services will be provided by the behavior specialist and/or the behavior support assistant. Services will include
collaboration with the teacher, classroom staff, DIS providers, and parents.
Service: Occupational therapy
Start Date: 6/19/2017
End Date: 7/14/2017
Provider: District of Service
Ind
Duration/Freq: 30 min x 1 Totaling: 30 min served Yearly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments:
Service: Adapted physical education
Start Date: 6/19/2017
End Date: 7/14/2017
Provider: District of Service
Ind
Duration/Freq: 30 min x 4 Totaling: 120 min served Yearly
Grp
Sec Transition
Location: Separate classroom in public integrated facility
Comments: Individually and/or in a small group setting.
Programs and services will be provided according to when student is in attendance and consistent with the district of service calendar and
scheduled services, excluding holidays, vacations, and non-instructional days unless otherwise specified.