1

IPP Assignment Template

Individualized Program Plan Assignment
Template

Group Assignment Confirmation Form: I confirm that I am aware of the entire contents
of this group assignment and that I have reviewed all group members’ contributions to
the assignment. I also acknowledge that each group member will be awarded the same
mark for this group assignment.

Group Member Names Laboratory Section

Number
Sean Lewis B 07

IPP Template

Individualized Program Plan

Student Information

Student Name: Dustin Johnson

Date of Birth: April 20, 2005
Current School: River Valley School
Current Grade: 5
Name of Guardian 1: Mr. Johnson (first name unknown)
Name of Guardian 2: Mrs. Kate Johnson

Administrative Information

Alberta Special Education Code: 54 (Learning Disability) and 44 (Severe Medical Disability)
School Year Current IPP is Active For: September, 2014 to June, 2015
Primary/Homeroom Classroom Teacher for Current IPP: Mr. Hoppins
Special Education Coordinator: Mrs. Lesley

School History

•Fun Times Preschool (Preschool)

•Crescent Heights Elementary (Kindergarten to Grade 1)

Medical Conditions that Impact Schooling

• Dustin wears glasses for farsightedness (i.e., close-up activities like reading)
• Dustin has specific learning disorder that impacts reading in word reading and accuracy. In addition, it impacts his
written expression in grammar, punctuation, clarity and organization.
• Dustin has been diagnosed with a mild range of Attention Deficit/Hyperactivity Disorder - Hyperactive/Impulsive
Type
 2
IPP Assignment Template
• Dustin has Persistent (Chronic) Motor or Vocal Tic Disorder with motor tics only
• Dustin’s hearing was recently evaluated with no concerns reported
• Dustin received physiotherapy for Torticollis until 2013

Assessment Data (Specialized Assessment Results)

Date Tests/Assessment Results

2007 Speech assessment Dustin’s receptive language abilities (i.e., how well he could understand)
were in the expected range; however, his expressive language abilities
(i.e., how well he could communicate his needs and wants) were slightly
delayed. Minor articulation difficulties were also identified. Dustin
received speech-language intervention throughout preschool for these
concerns.
Conner’s behaviour rating Report identifies discrepant results on ADHD and recommends a full
June 2013
scales by family psychological evaluation for ADHD.
physician.
Psycho Educational • Report affirms Low Average FSIQ; Average verbal
May 2014.
Assessment (WISC-IV, comprehension; Average perceptual reasoning; Low Average working
Fourth Edition Integrated memory; Average processing speed.
WISC-IV, VMI, NEPSY- • Report affirms Low Average to Average WIAT-III composite scores;
II, CPT II, Conners-3, Low Average reading composite; Low Average writing composite; Low
WIAT-III, P.I.C.S.-6) by Average to Average math composite; Low Average to Average math
Dr. Steven Jones, fluency composite.
Registered Psychologist • Report provides a diagnosis of ADHD - Hyperactive/Impulsive Type,
Mild Range; Specific Learning Disorder with impairment in reading;
Specific Learning Disorder with impairment in written expression;
Persistent (Chronic) Motor or Vocal Tic Disorder with motor tics only.

Current Level of Performance and Achievement

Report Cards
Dustin’s Kindergarten report cards indicate Good (3) achievement of grade level expectations in reading and math.
Some difficulty with following routines and expectations were noted.
Grade 1 report cards indicate that oral reading fluency was Not Meeting (1) level expectations. Difficulty
demonstrating appropriate listening behaviour was Elementary IPP Case Study: Dustin Johnson 4 also noted.
Grade 2 report cards indicated continued difficulty in reading fluency and deriving meaning from text but
improvement to Basic (2). Grade 2 report cards also indicated a difficulty in the area of writing Not Meeting (1).
Specifically, organizing written ideas, using proper capitalization and punctuation, and spelling were noted as areas of
concern.
Grade 3 report cards indicated that overall grade level expectations were met in all areas Basic (2); however, some of
Dustin’s writing skills remained at the Not Meeting (1) level, requiring moderate levels of support. Specifically, the
use of writing conventions such as capitalization and punctuation were identified as areas requiring support.
Grade 4 report cards indicated that overall grade level expectations were met in all areas at the Basic (2) level with the
exception of English Language Arts. Dustin’s English Language Arts was at the Not Meeting (1) level with moderate
levels of support required (e.g., writing conventions such as capitalization and punctuation, organizing written work,
writing stamina). Teacher comments indicate a need for frequent motor breaks and redirection to remain on-task.
Curriculum-Based Measurement
In the fall of Grade 4, Dustin participated in a small-group written expression intervention with the Special Education
 3
IPP Assignment Template
Coordinator. Mrs. Lesley completed regular progress monitoring as part of the intervention. At the beginning of the
intervention, Dustin scored in the bottom of the Low Average range in Total Words Written, Correctly Spelled Words,
and Correct Writing Sequences on a Curriculum-Based Measurement-Written Expression probe. Although Dustin
made gains throughout the intervention and improved his own personal scores, he scored in the top of the Low
Average range at the end of the intervention.

Student Strengths
• Energetic
• Great sense of Humor
• Interest in sports and outdoors
• Helpful around the classroom
• Sensitive to the needs of others
• Enjoys helping
• Works hard to follow school rules
Student Areas of Need
• Student currently requires several verbal reminders to follow school rules and routines
• Student could improve with various components of writing including letter formation, spacing, spelling, and use of
proper capitalization and punctuation
• Student could improve at reading
• Student could develop relaxation techniques to focus and feel less restless in class
• Student could benefit independent work periods
Required Classroom Accommodations .
• Benefits from being given jobs that involve motor components
• Responds well to motor breaks and verbal cues built into the regular routine
• Given extra time to complete written tasks
• Allowed to complete fewer practice questions
• Student is evaluated orally frequently
• Student has access to a scribe
• Student has access to a fidget tool
Long-Term Goal #1:
Dustin will improve his grammar and punctuation skills to a satisfactory grade 5 level by June 30, 2015

Short-Term Objectives Assessment Procedures Progress Review

By the end of first semester Dustin Teacher verification of assignments. December 30, 2015
will be able to begin all of his written
sentences with capital letters and
finish them with the appropriate
punctuation.

Dustin will be able to write Teacher grading and verification of March 30, 2015
paragraphs with no more than three assignments.
punctuation or grammatical errors in
a single sentence.

Dustin will be able to complete Teacher grading and verification of June 30, 2015
 4
IPP Assignment Template
written assignments with an average assignments.
of less than one grammar or
punctuation error per sentence.

Strategies to Support Objectives:

1. Use of a writers’ checklist or mnemonic for editing his written work and accurately using proper capitalization and
punctuation.
2. Dustin can use word processing software to type his assignments to view corrections in real-time.
3. Extra class time allotted for Dustin to generate ideas and write a plan for his written piece, writing the piece, and
checking his work for proper syntax, grammar and so on.

Long-Term Goal #2:

Dustin will independently complete 75% of his in-class assignments at a satisfactory level for grade 5 English classes
in a one-month period.

Short-Term Objective Assessment Procedure Progress Review

Dustin will work independently in an Self-monitoring of completed December 30, 2015

assigned “quiet corner” for at least 30 assignments (with teacher
minutes without verbal reminders to verification)
stay on task for 5 consecutive English
periods

Dustin will work independently in an Self-monitoring of completed March 30, 2015

assigned seat among his classmates assignments (with teacher
for at least 30 minutes without verification)
needing reminders to stay on task for
5 consecutive English periods

Dustin will satisfactorily and Self-monitoring of completed June 30, 2015

independently complete at least 75% assignments (with teacher
of in-class assignments for a two- verification)
week period in English

Strategies to Support Objectives:

1. Strategic seating arrangements
2. Behaviour contract that includes teacher support will be provided twice during each writing task: Once at the
beginning and again at the end.

Planning for Transition

• Dustin should continue to develop skills with assistive technologies for success in future grades
• Dustin should also continue to develop organizational skills and working memory by utilizing lists, visual calendars,
etc.
• Student should be provided with brain and body breaks during transitions so as to ensure attention at next activity
• Going forward Dustin might benefit from coaching on how to explain his motor tics to peers
 5
IPP Assignment Template
• Although not necessary at this time, formalized treatments are available for motor tics and options can be discussed
with a family physician or registered psychologist

Year-End Summary

*Not required for the assignment.

*IPP template modified from Alberta Education (2006). Alberta Education (2006).
Individualized program planning (IPP) ECS to grade 12: Working through the IPP
process.