October 26, 2012

Down syndrome IEP - 4 year old

Date IEP - May 2012

Well, the big boy is 4 years old. He did great with his goals last year. Time for a new IEP. Again, there are no academic goals, still out-of-district placement. See a previous explanation here. However, you can get an idea of how academic goals might look like for a 4 years old by scrolling down to our parental input to goals - we have there a section on educational development.

Compared to last year, two more speech and language goals were added and the speech service was increased from 2x30min to 2x45min per week.

Here are sections of the actual IEP.

Necessary accommodations:
  • The student will be provided with preferential and supported seating (if necessary) during large and small group times to help maximize his attention to task, while accounting for his low muscle tone. 
  • Picture schedules of the entire classroom day and specific activities (bathroom, lunch, hanging up belongings will be used to make the student a more independent preschooler while increasing his understanding of the classroom expectations. 
  • First/Then boards will be used to help the student independently make transitions, learn the classroom routine as well as to break down tasks into small steps. 
  • Small groups (1-2) of peers with teacher direction will be used to continue to foster his social skills. 
  • Language scripts (2-3 word phrases/signs) will be modeled for the student to increase his use of language socially. 
  • A visual timer will be used during group and individual activities to gradually increase attention and duration of less desired/more difficult tasks. 
  • A total communication approach will be used including ASL signing and spoken language. 
  • The following will be used to increase his participation and understanding of the curriculum being introduced: visual supports, extra time for processing language, and repeated instructions. 
  • Model appropriate sentence structures. 
  • Expand utterances by modeling longer sentence structures. 
  • Directly teach vocabulary. 
  • Provide models of appropriate social skills. Provide ample opportunities to practice social skills with peers. Use of adult play partners to attract and mediate peer interactions.

There is no modification of the preschool curriculum needed at this time. It will be helpful for teachers to provide the student with multiple presentations of the curriculum using a variety of different methods to see how the student learns best within the daycare setting.

The student will benefit from a total communication approach that will provide him with alternative means (picture paired with print, print, signs) to participate in daily discussions, communicate his wants and needs, and to socially interact with others.

Specific Goals

Goal # 1 Specific Goal Focus: Speech and Language 
The student will demonstrate developmentally appropriate expressive language skills to support functional communication within academic and social contexts in 4 out of 5 opportunities with fading prompts and cues to none.

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student  will use the present progressive verb ending -ing during structured activities in 4 of 5 provided opportunities with 0-1 prompts per use. 
  • The student  will use plural -s ending during structured activities in 4 of 5 provided opportunities with 0-1 prompts per use. 
  • The student  will use articles 'a' and 'the' in short phrases or sentences during structured activities in 4 of 5 provided opportunities with no more than I prompt per use. 
  • The student  will use pronouns, starting with the earliest developing pronouns (it, this, that) during unstructured activities or play in 4 of 5 provided opportunities with no more than I prompt per use.
  • The student  will answer (what, who, and where) questions and make comments about past events and/or after reading a book with 70% accuracy given 0-1 prompts per answer. 
  • The student  will formulate basic wh-questions with the correct inflection and prosody during structured language activities with 70% accuracy given moderate cues. 
  • The student will use combinations of four words or understandable representations (e.g. word approximations or signs) within a play activity to request specific objects or to describe what is happening, in 4 out of 5 measured opportunities with moderate cueing.

Goal # 2 Specific Goal Focus: Speech and Language
The student will demonstrate understanding of developmentally appropriate language concepts of quantity, similarity, and relative location within his school

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will demonstrate understanding of 4 of the following 5 quantity concepts (none, all, some, one and two) in 70% of opportunities with moderate assistance. 
  • The student will demonstrate understanding of the concepts 'same' and 'different' for pictured vocabulary with 70% accuracy. 
  • The student will demonstrate understanding, followed by use of the locative concepts/spatial prepositions (under, in front of, next to, on) in 4 of 5 opportunities. 
  • The student will sort nouns by their function with 80% accuracy starting with things we wear, followed by things for play. 
  • The student will demonstrate the understanding of temporal concepts (e.g. now. next, before. after) with 70% accuracy and moderate cues.

Goal # 3 Specific Goal Focus: Speech and Language
The student will increase the use of age appropriate pragmatic skills to support functional communication in the classroom. therapy setting, and in social contexts in 4 out of 5 opportunities with fading prompts and cues to none.

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will initiate an interaction with a peer at least once per session by first gaining the peers attention through eye contact plus verbal or sign communication then making a clear on-topic request or comment using adequate vocal volume given no more than one prompt for gaining attention and one prompt for speaking. 
  • The student will respond to a peer's communication bid, by turning, making eye contact and using clear verbal or sign communication in 4 of 5 measured opportunities with fading prompts and cues to none. 
  • The student will demonstrate appropriate tum-taking in conversation with a peer, taking at least 3 turns or last­ing for at least 2 minutes using verbal or sign communication, in 4 out of 5 opportunities.

Goal # 4 Specific Goal Focus: Speech and Language
The student will improve his speech intelligibility by producing targeted sounds in single words and phrases in 9 out of 10 opportunities with fading

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will produce /v, f/ in the initial position with 70% accuracy and moderate cues. 
  • The student will produce phonemes /t,d/ in all positions at the word level with 70% accuracy and moderate cues. 
  • The student will produce phonemes /k,g/ in all positions at the word level with 70% accuracy and moderate cues. 
  • The student will produce /n/ in the initial position of words with 70% accuracy and moderate cues.
  • The student will produce /s/ in the initial position of words with 70% accuracy and moderate cues.

Goal # 5 Specific Goal Focus: Gross motor 
The student will demonstrate improved gross motor skills to participate in age appropriate preschool activities as demonstrated by achievement of the following objectives and measured by physical therapy provider over the last month of the marking period.

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will both ascend/descend 10 stairs alternating feet with railing assistance as needed in 3 out of 4 trials. 
  • The student will jump down from a step with two foot takeoff and landing in 3 out of 4 trials. 
  • The student will throw a ball a distance of 5 feet with an overhand throwing motion in 2 out of 4 trials.
  • The student will kick a rolled ball 5 feet in 3 out of 4 trials. 
  • The student ill balance on I foot for up to 5 seconds in 2 out of 4 trials. 
  • With upper extremity support the student will hop on his preferred foot 2 consecutive times in 2 out of 4 trials. 

Goal # 6 Specific Goal Focus: Fine Motor 
The student will complete a variety of fine motor/visual motor activities including manipulatives (puzzles, scissors, stringing beads) during small group activities as measured by the following objectives.

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will grasp preschool-sized marking tools (markers, crayons, pencils, paintbrushes) with a functional grasp to make horizontal and vertical lines in 75% of measured trials. 
  • The student will string 5 small-medium beads on a string in 75% of measured trials. 
  • The student will hold scissors (children's scissors or children's loop scissors) in a functional position to make 2-inch snips in 75% of measured trials. 
  • The student will unzip his lunch bag and open a Ziploc bag to obtain a snack in 75% of measured trials. 
  • The student will imitate or independently draw circles in 75% of measured trials.

Goal # 7 Specific Goal Focus: Activities of Daily Living 
The student will demonstrate improved self-help skills to increase independence within the school setting as measured by the following objectives.

Benchmark/Objectives: What will the student need to do to complete this goal?
  • The student will rotate his cup to drink independently from an open cup with minimal spilling in 75% of trials.
  • The student will use a spoon/fork to eat a snack/meal with minimal spilling in 75% of trials.
  • In preparation for outside transitions, the student will put on his shoes independently in 75% of trials.
  • Thee student will pull up his pants with minimal assistance or verbal cueing in 75% of trials.
  • Using a keying pull if necessary, the student will use one hand to stabilize coat and the other hand to zip when donning his coat in 75% of measured trials. 


Service Delivery
Speech Therapy - 2x45min/week
Physical Therapy - 2x30min/week
Occupational Therapy - 2x45min/week

== END OF IEP ==

And here you can find the letter we sent before the IEP meeting detailing our concerns and goals for my son. Not quite sure about how to organize this info. Hopefully is not too confusing. For our parental input to all IEPs so far, go here.

Parental input to IEP goals - 4 years old

Gross Motor SkillsOver the last year, The Student has made great progress in his gross motor skills. We are especially pleased that he seems to have gained strength in his upper body and core musculature. This remains an area of some concern and of constant work for us, especially given its importance and impact in all areas of development. We believe it is vital for The Student’s current and future academic success to improve his posture (both walking and sitting) and to improve his body coordination. We hope that, with appropriate support and help, The Student will continue his gains over the next year.

We expect that by the end of the 2012-2013 academic year The Student will refine his running and jumping skills, will learn to jump forward, to balance on one foot, to walk on a line, to throw balls overhead and catch bouncing balls, and to kick and intercept balls.

Fine Motor Skills
Over the last year, The Student has become increasingly more confident in his fine motor skills. He shows more patience and desire for fine motor activities, as well as more precision in performing these activities.

We expect that by the end of the 2012-2013 academic year The Student will be able to use adaptive scissors, string large beads, place small pegs in small holes, manipulate clay materials (rolling balls, snakes) and develop appropriate pre-writing skills (paint with wrist action, imitate/copy circle, cross). He will be able to unzip his lunch box, open a Ziploc bag and unscrews jar lids.

Self Help
We expect The Student will become increasingly more independent through self-feeding, self-dressing and undressing, potty training and improved personal hygiene practices. The Student will use an open cup for drinking, use the fork and spoon correctly, learn to put his pants/socks/shoes on, take off his shirt/sweeter, and use two hands to zip and unzip his coat.

Speech and Language
Over the last year, The Student has greatly expanded his speaking and listening vocabulary. He can make requests and comment on his environment. The use of sign language was instrumental in his speech development and supported him with (1) new word acquisitions, (2) use of longer sentences as a combination of spoken and signed words, and (3) clarification of less intelligible words. We believe it is essential to continue using sign language as an augmentative communication tool for The Student.

Expressive language
We expect that The Student will continue to expand his spoken vocabulary, use 3-word sentences consistently and have increasingly better speech intelligibility. The Student will pronounce his name correctly, use articles appropriately and use plural forms. He will use “I” and “you” in speech. He will use the “ing” form for common verbs. He will use k, g, f, t, d, and n sounds. He will use question inflection to ask for something.

Receptive language
The Student will follow 2 unrelated directions. He will continue to work on functional understanding/recognition of objects. He will understand the concept of past-present-future (now, next, later, before, today, yesterday, tomorrow). He will understand the concept of same and different. He will understand quantities (one, two, few, and many).

Communication
The Student will engage in longer interactive play sessions with an adult or peer. The Student will initiate and respond to peers’ interaction. The Student will answer questions about past events (what, when, who, where). The Student will answer questions and comment after reading a book. He will learn to formulate basic questions.

Educational Development
Over the last year, The Student has worked very hard to improve his pre-academic skills. He can recognize his name, the numbers from 1 to 10, the whole uppercase alphabet and most of the lowercase letters. He recognizes at least 10 colors and most body parts. He can count from 1 to 10 with support. He recognizes some shapes (circle, star, heart). He can sort objects by color. He has a sight vocabulary of at least 20 words.

We expect that by the end of the 2012-2013 academic year The Student will recognize and name most shapes. He will recognize the numbers from 1 to 20. He will be able to suggest words that start with specific letters. He will work on concepts related to size, quantity, direction and opposites. He will understand the concept of same-different. He will show awareness of time and understands the concept of past-present-future (now, next, later, today, yesterday, tomorrow). He will sort objects based on size, shape and function. He will increase his sight words vocabulary.

== END PRE IEP LETTER ==

And here is the actual letter we sent to our ETL after receiving their IEP proposal and before aproving the document. They agreed to most modifications, except additional speech therapy. At that point we partially rejected the IEP and requested a new meeting with the ETL and the speech therapist. It took a couple of months, but in the end we've got 30 more minutes of speech.

Parental input to proposed IEP

Dear ETL,
 
Attached to this letter are our initial comments on the proposed IEP draft which we received on May 13th 2012. Please make the corrections and modifications possible at this time and let us know when a new draft is ready, so we can act on it.
 
We appreciate the time and effort you and the team members have invested in the proposed IEP.
 
Sincerely,
xxxxxxxx

May 19th, 2013
Parental comments to the proposed IEP for The STUDENT
  • Student information (Page 1). The STUDENT is 4 years old.
  • Student Strengths (Page 2).
    • The STUDENT’s strengths, as mentioned here, are copied from the previous IEP and are outdated. Especially the note that reads “Recently he has begun verbalizing more sounds …” should be replaced with something along the lines of “The STUDENT is talking in single words and short sentences. He is very interested in communicating with both adults and peers. “
    • The 2012 speech therapy comments on The STUDENT’s strengths are missing.
  • Key Evaluation Results Summary (Page 2)
    • It should be mentioned in the text that the evaluation results described in the paragraph beginning with “According to Early Intervention and the Public School assessments …” are from 2011 evaluations. They do not reflect his current development in terms of his age level.
    • The 2012 Speech Therapy updates are missing.
  • Speech and Language Goals
    • The speech and language goals should be labeled/reorganized according to their focus as (1) Expressive, (2) Receptive and (3) Social Pragmatics Goals. The non-specialist members of the team (parents and teachers) need a clear organization of these goals in order to attempt caring them over in daily activities, to monitor progress and to have a meaningful communication with the therapist regarding specific strategies.
  • Goal 1. Speech and language
    • There should be an objective that addresses specifically the increase of the length of utterance. The STUDENT is already using sporadic 3-4 word sentences, but The STUDENT, parents and teachers need help in identifying strategies to encourage The STUDENT’s consistent use of longer sentences. We would like to add an objective formulated along these lines: “The STUDENT will use 4 word sentences within a play activity to request specific objects or to describe what is happening, in 4 out of 5 measured opportunities”.
    • For parents’ and teachers’ clarification, please specify the spontaneously (vs. imitatively) aspect of the expressive language objectives.
  • Goal 3. Speech and language.
    • The STUDENT should work on producing the “F” sound or an age appropriate approximation. The omission of the “F” sound is, in the opinion of the parents, highly detrimental to The STUDENT’s intelligibility.
    • The STUDENT should work on maintaining the interaction with a peer and staying in the conversation and on topic. We would like to add one objective formulated along these lines: “The STUDENT will demonstrate appropriate turn-taking in conversation with a peer, taking at least X turns or lasting for at least X minutes using verbal communication, in 4 out of 5 opportunities”.
  • Goal 4. Gross motor
    • The annual review proposed objective was going up/down a flight of stairs without railing assistance. The IEP goal says with railing assistance.
  • Goal 5. Fine motor
    • The STUDENT should continue working towards achieving the goal of imitating circular scribbles (previous IEP) and progressing to independent circular scribbles.
  • Goal 6. Activities of daily living.
    • The STUDENT should continue working on zipping his coat, using a hand to stabilize one end and the other to pull the zipper.
    • One of the cup drinking objectives could to be modified to mention the help needed for rotating the cup with more precision and for finishing his drink. The STUDENT is already taking independent sips from an open cup, when prompted verbally.
  • Service Delivery
    • PT services should be 2x30 minutes/week. The IEP shows only 1x30 minutes/week session.
    • 2x30 minutes/week speech therapy sessions do not reflect the considerations of the new IEP. While The STUDENT made progress over the course of the last IEP, he did not in any way outperform his IEP goals. As mentioned in the annual review, not all objectives were achieved, although he did make good progress towards them. We agree that 30 minutes/week/per goal proved to be an adequate amount of Speech therapy. A similar amount of service time should be allocated for the newly added social pragmatic goal, to give The STUDENT and his therapist the chance to make similar progress over the next year. We believe the speech service for the next year should be either 2x45 minutes/week or 3x30 minutes/week, at school’s discretion.
  • Additional Information
    • It was discussed during the IEP meeting, and agreed upon, using a more direct method of communication between the parents and therapists, in the form of a communication book, a calendar or some other type of daily form. We would like the IEP to explicitly mention the commitment of the team to using this mean of communication, rather than a vague mention of the parents’ desire for communication.
    • “Parents feel that The STUDENT would benefit from having his (not her) services … “.




  • 1 comment:

    1. Hi thank you so much for this . We have our first annual meeting for our daughter tomorrow. She will be 4 in August and your blog has been so helpful ! I found it googling 4 year old iep goals . :)

      Sara

      ReplyDelete