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Huntsville City Schools Intervention

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Huntsville City Schools Intervention Powered By Docstoc
					                                            INTRODUCTION

Response to Instruction (RtI) integrates core instruction, assessment, and intervention within a multi-tiered
system to maximize student achievement and reduce behavior problems. Through the implementation of RtI,
schools identify and monitor students at risk, use problem-solving and data-based decision making to provide
research-based interventions and adjust the intensity of intervention based on the student’s response.

RtI interventions are intended for students who are not responding to core or strategic instruction and
interventions. A decision to move a student to research-based interventions is determined by a problem-solving
team (PST) after several documented individualized interventions in the classroom have resulted in limited
progress. Decisions regarding RtI intervention services are based on diagnostic assessments and progress
monitoring. Plans should be made by the team to review student progress on a regular basis in order to make
timely instructional decisions. Materials and strategies should be specialized research or evidence-based
interventions based on the needs of the students who will receive the interventions.

The ACC and Federal laws and regulations specify that parents of students receiving interventions must be
notified periodically of specific progress made by the student. The progress monitoring data discussed at the
monthly PST meetings along with PST recommendations should be shared with parents. A Parent Notification
of Intervention Letter should be sent to parents by the PST within one week of initiation of intervention. It is
suggested that an Intervention Progress Report be sent to the parent at regular intervals.

                         DIRECTIONS FOR COMPLETING SECTION I

   Referring teacher completes student information at the top of the page and enters the date of
    completion.

   Work Samples: Attach representative samples of classwork (teacher lead and independent student work)
    and homework assignments.

   Classroom Tests: Attach student tests (i.e., weekly and/or end-of-chapter/unit classroom tests).

   Behavior Assessment: Attach teacher’s anecdotal notes, discipline referrals, suspension letters, etc.

   Current Classroom Performance Indicators: Attach written projects, teacher’s notes related to non-
    written projects (i.e., exhibits, recitations).

   Current Grades/Averages: Attach a copy of the student’s current report card or progress reports or list
    scores.

   Cumulative Folder Summary: Attach a copy of the student’s most recent standardized assessment results
    or list scores.

   Other Information: Additional information from the referring teacher, other teachers, counselors, and
    administrators.

   Parent Input: Attach information provided by the parent/guardian to the referring teacher.
                                 2010 – 2011 RESPONSE TO INSTRUCTION
                          Problem Solving Team (PST) Student Intervention Plan Form

SECTION I.: DOCUMENTATION OF CONCERN(S) & DURATION OF INTERVENTION(S)
            [Completed by the teacher(s) of the class where the concern(s) exist(s)]

Student’s Name: _________________________ Sex:               Race: _________ Date: __________________
School:                     Code:       Grade:               Age: ____ Birth date: ____________________
Specific Concern(s):

Specific Screening/Benchmark Data:

Hearing Screening Date:_____________Pass______Fail______
Vision Screening (near) Date:________Pass____Fail___ Vision Screening (far) Date: ______Pass ______Fail

Teacher(s) Referring Student: _____________________________________________________________________

                       Evidence of Concern(s) and Duration of Classroom Intervention(s)
                                   (Attach documentation for each category.)
Evaluation Method                    Observation/Information                     Dates (From - To)
Work samples:
(classwork &
homework)
Classroom tests:


Behavior assessment:
(baseline data)

Current classroom
performance indicators:


Current
grades/averages:




Other information:


Parent input:
                          DIRECTIONS FOR COMPLETING SECTION II
Duplicate this page as needed. The information required in Section II should be completed by the PST team at
the initial meeting for the student, and a copy given to the referring teacher for implementation to begin the
following day.

   Record the date of initial team meeting on the referred student.
   Record the student’s name in the appropriate space.
   Record the teacher(s) responsible for implementation of research-based interventions.
   Identified Concern(s) to be Addressed: Check all of the categories to be addressed by the team. Choose
    as many concerns as applicable.
Types of Interventions: Check all of the categories that apply. The accommodations which were listed in the
BBSST Manual will not meet the scientific, research-based intervention requirements included in current laws and
regulations. As accommodations do not represent scientific, research-based interventions; they are not to be included in
the interventions considered by a PST. While accommodations do not improve student skills and are not considered to
represent scientific, research-based interventions, any teacher may elect to employ accommodations when they seem
appropriate for use with any student.

   Narrative of methods/strategies: Provide a narrative of the research-based methods and strategies used in
    the intervention plan. Include the number of days and amount of time that intervention will occur.
   Intervention Materials: List all materials necessary for the successful implementation of intervention.
   Planned Location: Record the setting in which the plan will be implemented
   Planned Method(s) of Monitoring Progress: Indicate how the student’s progress will be monitored by the
    team and the administrator.
   Intervention Goal: Planned Criteria (measurable) for Success/Termination of Intervention:
    Establish goals that would indicate progress or the lack thereof.
   Planned Beginning Date: Record the date on which interventions will begin. (This date should be the next
    school day following this meeting.)
   Planned Monitoring Date: Record the date on which interventions will be monitored.(This date should be
    at least monthly.)
SECTION II.                        DOCUMENTATION OF INTERVENTION PLAN                                  Date: ________________
                                           (Completed by Problem Solving Team)

Student's Name:
Teacher(s) Responsible for Intervention Implementation:

Identified Concern(s) to be Addressed (Choose one or more from the following):
 [ ] 01      Reading
 [ ] 02      Math
 [ ] 03      Behavior

                                             Intervention Plan
Types of Interventions: (Choose all that apply.)
Must include scientific, research-based instruction and intervention.
 [ ]   Reading: Word-Level Intervention
 [ ]   Reading: Comprehension Intervention
 [ ]   Math: Computation Intervention
 [ ]   Math: Reasoning/Problem Solving Intervention
 [ ]   Behavior Intervention
 [ ]   Other Intervention
*The accommodations which were listed in the BBSST Manual will not meet the scientific, research-based intervention requirements
included in current laws and regulations. As accommodations do not represent scientific, research-based interventions; they are not to
be included in the interventions considered by a PST. While accommodations do not improve student skills and are not considered to
represent scientific, research-based interventions, any teacher may elect to employ accommodations when they seem appropriate for
use with any student.

Narrative of methods/strategies: __________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Intervention Materials:                                                         __________        ______________

Planned Location: ____________________________________________________________________

Planned Method(s) of Monitoring Progress:




Intervention Goal: In _______ weeks, the student will


Planned Beginning Date:_______________________ Planned Monitoring Dates________________
_________________________________________________________________________________
                     DIRECTIONS FOR COMPLETING SECTION III

Duplicate this page as needed. The information in Section III should be completed by the PST at the
follow-up meetings to discuss and document the results of the interventions that were implemented.

   Date of Follow-up: Record the date the team meets again to discuss and document the results. This
    should occur at least monthly.

   Total Number of Days Implemented: Record the total number of days the plan was implemented.

   Outcome: Check one of the four categories that describe the outcome of the plan.

   Outcome Data and Results of Intervention: Give a brief narrative describing the outcome and results
    of the plan. The referring teacher should bring these results back to the team.

   Student Intervention Documentation: Provide evidence of the progress monitoring that occurred
    during the implementation of the plan.

   Recommendations for future action: Check one of the six categories that describe the team’s
    recommendations for future action. If ‘Other’ is checked, give a brief description.

   Signatures: Members of the Problem Solving Team sign under Section III (referring teacher,
    teacher responsible for intervention, and PST chair).

                                             SECTION IV

* If referring the student to special education for testing, a Functional Assessment of the Classroom
Environment (BASC) must be included with the Student Referral Form.
SECTION III. Intervention Plan Review:                      Initiation Date: __________
(Plan to be reviewed at least monthly)                      Date of Follow-up: __________
                                                            Completion Date:________________________
                                                            Total Number of Days Implemented: _________

Outcome (Select one of the following):
 [ ]   1 Concern(s) better
 [ ]   2 No change
 [ ]   3 Concern(s) worse
 [ ]   4 Withdrawn from school

Outcome Data and Results of Intervention (results brought back by the teacher):



         _________________________________________________________________
                                                                                                       _____________
See Student Intervention Documentation for Additional Outcome Information.

Recommendations for future action (e.g., release, continue interventions in another plan, try other specific
interventions, or refer for special education evaluation or to another program):
 [ ]      Release
 [ ]      Continue interventions
 [ ]      Try other specific interventions
 [ ]      Refer for special education evaluation                  [ ] SOS/BASC completed
 [ ]      Refer to another research –based program
 [ ]      Other: ________________________________________________________________________
Signatures:

Person(s) Responsible for Intervention (Teacher)                    Date


Person(s) Responsible for Intervention (Teacher)                    Date


Problem Solving Team Chair                                          Date

SECTION IV. IF REFERRING THE STUDENT FOR SPECIAL EDUCATION TESTING:
General education shall complete a functional assessment of the classroom environment using an observation system such
as the Behavior Assessment System for Children – (BASC – Student Observation System – SOS portion). General
education teacher of the student and the special education teacher (serving in an advisory capacity of the team) shall
complete the referral papers for the special education testing to begin, and it is recommended that the vision and hearing
screening be a part of this process.
Answer the following questions.
   1. Does the data support that the reason for referral has a direct impact on the student’s education performance, or for
       a preschool child, participation in age appropriate activities?
   2. Does the data support eh severity of the reason for referral?
   3. Does the data support the duration of the reason for referral?
   4. Does the data support the valid implementation of intervention(s) for the referral concern(s)? (e.g., appropriate
       target behavior, relationship of intervention to target behavior,, duration of intervention, integrity of implementation,
       data collection procedures?
   5. Does the data support the ineffectiveness of the intervention(s) for the referral concern(s)?
   6. Does the data include multiple sources of information about the reason for referral?

				
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