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7/28/2019 Individual Assessment Plan
http://slidepdf.com/reader/full/individual-assessment-plan 1/5
ASSESSMENT AND EVALUATION OF EXCEPTIONAL CHILDREN
INDIVIDUAL ASSESSMENT PLAN
INDIVIDUAL ASSESSMENT PLAN
Name: School
Birthdate: Age: Grade:Assessment Coordinator: Date of IAP:Reason for Referral:
Assessment Goals Assessment Questions Assessment Procedures Person(s)Responsible
Date/ Time
• Document the medical,developmental, family,and educational history
of Jasmine.• Determine the changes
in behaviour of the childand factors that possiblycontributed to thosechanges.
• Determine the otherprofessional servicesprovided to the child.
1. Find out the basicinformation of the child inthe following area:
A. General InformationB. Medical HistoryC. Developmental HistoryD. Family HistoryE. EducationF. BehaviourG. Other ProfessionalHelp
1. Parents/guardians of the child willfill up the Case History Record (to beprovided by the school).
2. Interview with parents / guardiansto validate the data provided in theCHR of the child.3. Interview with the student
1. SPED teacher2. Teacher Aide3. Parents/ Guardian
4. Former Teacher
Case History Record- Due on July17, 2012
Interview with parents andstudents- July 20, 2012, 2:00PM
Interview with a former teacher:July 20, 2012, 4:00PM
• Determine the strengthsand weaknesses of thechild in the area ofcommunication.
1. What is the child’scurrent level ofperformance in thefollowing domains:
A. CommunicationA.1. Oral languageA.2. Written Language
1.Observation Record2. Review of Anecdotal Record3. Teacher Made Checklist in Oraland Written Language vis-à-vis thedevelopmental milestone for oral and written language4. Review record of written outputs(portfolio assessment)5. Interview with parents/students6. Interview with the school’s speechtherapist
1. SPED teacher2. Teacher Aide3. Parents4. Speech Pathologist
School Assessment:July 24,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
Interview with resident school’sspeech therapist July 20,2012,1:00PM
This document contains confidential information. No part of this document may be reproduced, stored in a retrieval system, photocopied, recorded or otherwise
without permission form parents/guardians and school administrators.
7/28/2019 Individual Assessment Plan
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ASSESSMENT AND EVALUATION OF EXCEPTIONAL CHILDREN
INDIVIDUAL ASSESSMENT PLAN
• Determine the strengthsand weaknesses of thechild in the area ofadaptive functioning.
B. Adaptive FunctioningB1. Self-ManagementB2. Self-DirectionB3. Leisure skills
B4. Home/School LivingB5. Community UseB6. Health SafetyB7. Work readiness
1.Observation Record2. Review of Anecdotal Record3. Teacher Made Checklist onAdaptive Functioning
4. Interview with the parents/guardianand the student
1. SPED teacher2. Teacher Aide3. Parents
School Assessment:July 24,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
• Determine the strengthsand weaknesses of thechild in the area ofpsychomotordevelopment.
C. Motor FunctioningC1. Fine-motorC2. Gross-MotorC3. Balance and Body
Coordination
1.Observation Record2. Review of Anecdotal Record3. Teacher Made Checklist on Fineand Gross Motor Skills vis-à-vis theDevelopmental Milestone onPsychomotor Development.4. Review record of outputs (portfolio
assessment)5. Interview with the parents/guardianand the student6. Interview with occupationaltherapist
1. SPED teacher2. Teacher Aide3. Parents4. Occupational
Therapist
School Assessment:July 24,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
• Determine the strengthsand weaknesses of thechild in the area ofcognitive development.
D. CognitiveD1. ReasoningD2. ComprehensionD3. Other areas
1.Observation Record2. Review of Anecdotal Record3. Administration of teacher madetest attuned to the school’scurriculum and grade level of thechild.
4. Teacher made checklist vis-à-visthe cognitive developmentalmilestone5. Interview with Parents
1. SPED teacher2. Teacher Aide3. Parents
School Assessment:July 24,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
This document contains confidential information. No part of this document may be reproduced, stored in a retrieval system, photocopied, recorded or otherwise
without permission form parents/guardians and school administrators.
7/28/2019 Individual Assessment Plan
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ASSESSMENT AND EVALUATION OF EXCEPTIONAL CHILDREN
INDIVIDUAL ASSESSMENT PLAN
• Determine the strengthsand weaknesses of thechild in the area of socio-emotional development.
• Identify the behaviour/sthat hinders academicachievement andsocialization with otherpeople.
E. Socio-emotionalE1. AttentionE2. Relationship with
peers
family members, etc.E3. Home/ Classroombehavior
1.Observation Record2. Review of Anecdotal Record3. Teacher made Behavior Checklist/Rating Scale
4. Review of the child’s behaviouralperformance with the use of abehaviour chart ( with two weeksreported data)5. Interview with parents/ guardian6. Interview with a former teacher7. Interview with a classmate of thechild.
1. SPED teacher2. Teacher Aide3. Parents/ Guardian4. Former Teacher
School Assessment:July 24,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
Interview with a former teacher:July 20, 2012, 4:00PM
• Determine the currentlevel of performance ofJasmine in Mathematics.
• Determine the differentfactors that influence theperformance of Jasminein Mathematics.
1. What is the child’scurrent level ofperformance in
Mathematics?2. What are the factorsaffecting the child’sperformance inMathematics?
1.Review of anecdotal Record2. Work Sample analysis (reviewrecord)
3. Teacher-made test in Math (basedon grade level and attuned in theMath curriculum on the said gradelevel)4. Teacher made checklist on Mathcompetencies for the said gradelevel.5. Interview with the parents/guardianand the student
1. SPED teacher2. Teacher Aide3. Former Teacher
4. Parents/Guardian
School Assessment:July 25,20128:00AM- 5:00PM
School Assessment:July 25,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
Interview with a former teacher:July 20, 2012, 4:00PM
• Determine the currentlevel of performance ofJasmine in Languageand Reading.
• Determine the differentfactors that influence theperformance of Jasminein Language andReading.
1. What is the child’scurrent level ofperformance in English –Reading / Language?2. What are the factorsaffecting the child’sperformance in Languageand Reading?
1.Review of anecdotal record2. Review record on the Reading andLanguage performance of the child.3. Oral Reading Test4. Reading Comprehension Test5. Scholastic6. Interview with speech therapist(school-based)7. Interview with the parents/guardianand the student
1. SPED teacher2. Teacher Aide3. Former Teacher4. Parents /Guardian
School Assessment:July 25,20128:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
Interview with a former teacher:July 20, 2012, 4:00PM
• Determine the current 1. What is the child’scurrent level of
1. Review of Anecdotal Record2. Work Sample Analysis
1. SPED teacher2. Teacher Aide
School Assessment:July 25,2012
This document contains confidential information. No part of this document may be reproduced, stored in a retrieval system, photocopied, recorded or otherwise
without permission form parents/guardians and school administrators.
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ASSESSMENT AND EVALUATION OF EXCEPTIONAL CHILDREN
INDIVIDUAL ASSESSMENT PLAN
level of performance ofJasmine in writing.
• Determine the differentfactors that influence the
performance of Jasminein Writing?
performance in Writing?2. What are the factorsaffecting the child’sperformance in Writing?
3. Completion of teacher made worksheets and writing exercises inthe Writing Workbook4. Interview with the parents/guardian
and the student
3. Former Teacher4. Parents/Guardian
8:00AM- 5:00PM
Interview with Parents/students:July 20,2012, 2:00PM
Interview with a former teacher:July 20, 2012, 4:00PMOverview:On July 5, 2012, the child was enrolled in the learning center. The SPED teacher assigned to teach her and the parents agreed to conduct theassessment. However, the teacher should be given enough time for her to document the child’s behaviour and academic performance; thus, this IAP is proposed.
ASSESSMENT TIME FRAME
DATE ACTIVITIES PERSON/S RESPONSIBLEJuly 10 – July 25,
2012Observation Period-Documentation of the child’s performance at home and school- Screening
Teacher Aide, SPED Teacher, Parents/Guardian
July 17,2012 Completion of the Case History Record of the Child Parents/ Guardian in coordination with the SPED teacherJuly 20, 2012 Interview with parents, other professionals (OT, Speech Therapist),
former teacherParents, OT, Speech Therapist, former teacher of the child,teacher aide
July 24, 2012 Assessment of the child vis-à-vis the different developmentaldomains/milestones
SPED Teacher, Teacher Aide, Occupational Therapist, SpeechTherapist, Parents/Guardian
July 25, 2012 Assessment in different academic subjects SPED Teacher, Teacher Aide, Former TeacherJuly 26 – 30 Consolidation and interpretation of assessment results SPED Teacher, Teacher AideJuly 31, 2012 Accomplished Assessment Report SPED Teacher
August 1, 2012 Meeting with Parents for the discussion of the IEP of Jasmine SPED Teacher, Teacher Aide, Occupational Therapist, SpeechTherapist, Parents/Guardian
August 2-6,2012 IEP Development (good for one school year) SPED teacher, teacher aide, Occupational Therapist, SpeechTherapist, Parents/Guardian
August 7,2012 Approval of the IEP of the child Parents / GuardiansAugust 7- March
2012Implementation of the IEP with progress monitoring and periodicevaluation.
SPED teacher, teacher aide, Occupational Therapist, SpeechTherapist, Parents/Guardian
March 2012 Evaluation and revision of the IEP SPED teacher, teacher aide, Occupational Therapist, SpeechTherapist, Parents/Guardian
For parental use: This assessment plan has been explained to me. I understand the need for assessing my child and the procedures to be used. Igive my approval.
This document contains confidential information. No part of this document may be reproduced, stored in a retrieval system, photocopied, recorded or otherwise
without permission form parents/guardians and school administrators.
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ASSESSMENT AND EVALUATION OF EXCEPTIONAL CHILDREN
INDIVIDUAL ASSESSMENT PLAN
_______________________________ Parent’s Signature
______________________________ Date
This document contains confidential information. No part of this document may be reproduced, stored in a retrieval system, photocopied, recorded or otherwise
without permission form parents/guardians and school administrators.