Referral and Intervention Flow Chart€¦ · Referral and Intervention Flow Chart Gassroom Teacher - Concems Classroom Level Notices student is-not rneetino orade level or dassrOOm

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/ Appendix BDenny Middle School: STUDENT ACADEMIC SUPPORTTEAM

Referral and Intervention Flow Chart

Gassroom Teacher - ConcemsClassroom Level Notices student is-not rneetino orade level or dassrOOm exoectations

Gassroom Teacher - Attempts InterventionsBegins various interventions and document efforts/outcomes usingStudent Intervention Log (Form 1). Contacts parent re: concerns .

•••Gassroom Teacher - Referral to Teaching Team

Completes Team Intervention Request (Form 2). Submits Team Leader who set datefor team discussion and follows up with counselor and other team members

tTeaching Team Level Initial Teacher Team Meeting

I Parent ReferralS/Requests ~Teaching Team meets to discuss student, Contact parent; invite

others, as needed. Determine strengths, needs, and supports.Resolved through TeacherReview Cumulative Rle (Form 4) and Teacher Input (Form 2).

Brainstorm and create teaching team plan using Teacher Team Team PlanIntervention Action Plan (Form 3). Set review date. Check bade in 10 school days

If successful, monitor

Implement Teacher Team Inteniention Action Plan ~ If not, reactivate referral,keep team members informed

Review Action Plan/Determine Next Steps (Form 3R)

Student Academic Support Team Level 1 I/-Student Academic Support Team

Case Presentation by Counselor Refer for 504 Plan~ Refer forEvaluation* Problem-solve to

To be completed Within Create SAST Intervention Plan (Form S) develop accommodations3S school days Assign Point Person. Set Review Date.

1 1/ 1 ,\

\ Re~ -\0 S\?-GImplement SAST Plan s\>cl~~ \"Ie,., ••.•.• \>"r>

Qualifies** DNQ Case Manager prepare Po-rc.ro\- Cor> \ "" c.-'" (. c-: \Place on IEP Reactivate SAST for review dateFollow upon Referral Process Update TeacherTeam

placement

1?~':

Review Intervention Plan (Form SR) I Successful IHold meeting with SAST participants I Monitor student, as neededWas plan successful in addressing student needs?

Update TeacherTeam

~UnsuccessfulProblem-solve •

Revise plan and review effectivenessRefer for programmatic remedies

I

•••

I Implement Revised Plan ISet new review date I

:-tf. at any time during the process, it becomes apparent that the student might better benefit from a specific remedy or direct referral for19, the SAST will recommend action accordingly.

-~ Students who have already been qualified for special education or S04 Accommodations are not excluded from the SAST referral process ifthey demonstrate the need for more intensive intervention services.

12/06

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DENNY INTERNATIONAL MIDDLE SCHOOL

STUDENT INTERVENTION TEAM

. Intervention Process Steps

Classroom Level

Step 1 - Teacher identifies struggling students in his/her classes and contactsparent/guardian about concern.

Step 2- With parent input, teacher employs various classroom interventions andreasonable accommodations documenting dates and results of those actions.

Teaching Team level~

Step 3 - Individual teacher (or person requesting intervention) submits request toTeam Leader. The Team Leader places the student on the Team Meeting agenda;distributes and collects Teacher Intervention Reports data from team members, informscounselor, and contacts the parent/guardian to tell them the students has been referredto the entire team.

Step 4 - Teacher Team Intervention Action Plan -This occurs at the subsequent teammeeting when data collected is used to develop an intervention action plan. Parents,counselor, and other support staff may be involved in developing the teacher teamaction planning, as appropriate. Counselor helps manage the process, gathers relevantschool-wide data as necessary, and informs building support team of the teacher teamaction plan.

Step 5 - Implement Teacher Team Intervention Action Plan for a recommendedminimum of ten days.

Step 6 - Review Teacher Team Intervention Action Plan at the conclusion of ten days.If the issues are not resolved, the team can elect to modify and adjust the plan or moveto support team referral through counselor. If the results are favorable, continue tomonitor student at team level and modify plan as needed .

.~~

Building Support Team level

Step 7 - Counselor does a Case Presentation of to Building Support Team. SupportTeam engages in problem solving and brainstorming. Consider all alternatives andresources available to address the student's problem. Assign a Case Manager.

Step 8 - Develop and implement Building Support Team Action Plan. Counselor updatesteacher team on action plan and interventions. Case Manager may meet with teacherteam.

Step 9 - Case Manager reviews Support Team Action Plan and gives a Progress Reportto support team and teacher team, and together they determine next steps such asprogrammatic remedies, special education evaluation, 504 Plan, change of placement.

10/2005

J FORMl

Denny Middle SchoolStudent InterventionLog

Student Name --------------------Teacher Name I--~~~------~-----

Date Not~s,aboutStudentInterventions tried/comments(fli~sheetf()Tcboices ),"

.'

. '.,

I

-,

IcA (HEre...

s-t-cp IG

Strateqies and Ideas for Classroom Interventions

1. Changes in Format

! 1b Provoe c:!o=>~ ooduttered woO: pages 10! ~ kx p3SShie visual- ~~ prct!':11S

2. Changes in Input

i 2a ' Shortefl reading assiqnmeots: 2b RecrCi1D rncffila.'\:)n into smaIie! chunks,2c H3't'e \ests cc cIireclicw1S read exaI yi 2d ?roV.je '!II'!i1:lB:1 i1strudioos

2e Use ~, vi.ieo, f-""" ~

2f Provoe concrete Ieam:ing wi .2g Repeat ca1 d<riy vefb<j and Mitten

I i1strtY.::tions (dled\ jo( ~

2h PrO'AdeYefbal direction.at each step2i F'roYrle sma1 qroup i"tstructioo2j lJrldefine key wads il directicns

! 2k f.Jow I!me kx ~-eef tmomg,

i:

3a limit Cheamount !he student must copy from~ r:xoveshead

3b AJow fcfigef IHre fa( studeofs 't'efbai responsesdue 10 slow . speed

3c st"iOOro assiglment 'Mth sane conceptsrLe.oddJ~

3d />Jtl::M rn student to write it preferred methodf~ '~). ,.curstVe

3e Nmtke when avaaabIe3f Provide .2

3g Mtowuseof calculator to check work

4. Behavioral·Strategies

4a Talk with student about the4b Give s!udent exi'a4c Coritact ~ <iscuss attadUr.g home

esfOCsChooI4d P:osiIi\ote noEsIcaIs home4e ~ U ~ r:x small group4f PrcMde routile schedule, expectalioos, and

4g AI!:YfI student to standi move when needed4h DevelOp a nonWlfbat signal MIh sWdent 10

redirect attenfionIfocus to task

5. How the student is asked tocomplete assignments

Sa5b Witt guided ~ (1:1 wl1eochef, tutor,

( JeartJp.and cmicutum5c wiIh dassffiates .5d IJsil9 . ~5e Using organizafiooaI planner (checked by

Teacher and ParentSf Devek>pcontract with student for work

5Q Pro'fide brealcs

6. Scope of Curriculum

6a Review ~ daiy

6b . RepeaU ReYieWI Dri

6c Short. ~ ood repealed practice sessions

6d Short. frequent. <nJ repeated practice

Due Date: _ Please return to: _

DENNY MIDDLE SCHOOL

SWDENT INTEVENTION TEAMSTEP 4: TEACHER TEAM INTERVENTION REPORT

Student: Grade: Team Leader: _

Request Initiated By: Relationshipto Student: _

L Academics: Pleaserate the student on the following major skill areas.Reading: Below............... At AboveWriting: Below............... At ~ AboveMath: Below............... At AboveLanguage: Below............... At AboveMotor Skills: Below............... At Above

Grade LevelGrade LevelGrade LevelGrade LevelGrade Level

IL Student Characteristics: Pleasecheck those that apply to this student.

__ completes work__ well organized__ attentive; curious

follows directions__ accepts limits__ works well independently

tolerates frustration__ copeswell with failure

self-startercomfortable as a leader

__ participates in class discussionsshares with others

__ well-liked by classmates__ stands up for self; self-advocates

~ __ . ignores teasing_ appropriate hallway behavior

__ appropriate cafeteria or lunch break behavior__ has good attendance__ has support system at home__ displays good judgement and common sense__ seems self-directed; self-manager__ has goals or works toward goals__ expressesideas well verbally__ willing to engage in problem-solving

is able to recognize anothers' perspective__ is capable of showing empathy__ resp%l2Swell to adults__ is wil/lnglo try new things; open-minded__ . has good self esteem

Student Strengths: Behavioral Issues:upset by changes in routineabrupt mood changes

__ frequently non-compliance or procrastinates__ often oppositional__ frequent crying__ frequent physical complaints'__ frequent lying__ "borrows" w/o asking permission; steals__ inappropriate responsesto normal situations__ pervasive mood of unhappiness/depression__ low self esteem or negative self concept__ suspected drug or alcohol abuse__ attempts at friendships alienates others__ keeps to self - a "loner"__ excessively fearful of social situations

anxious in new situations or tasks__ sexually inappropriate behavior__ ' fits of anger or explosive__ destroys property__ verbally aggressive__ physically aggressive__ history of assaultiveness/flohts

self-abusive behavior__ frequent use of foul language

distracts or bothers other studentsexcessivemotion in structured situationseasily distracted/ poor concentrationfrequently off-taskfrequently absent or tardy

III, Behaviors Interfering with Learning: Pleasecheck all that apply.Remembersbasic facts one day, but can't recall them a few Seemsnot to be interested in any classroom activities

days later Is easily distracted by peripheral noise or movementsFrequentlyrequires instructions to be repeated Is often overactiveRequiresan unusual amount of redirection to remain on task Does things that distracts other studentsProducesadequately in one-on-one situation, but not in group Refusesto try classroom activitiesFunctions best when time and activities are highly structured Frequently wastes time in classIs unusually dependent upon the teacher or other students Often loses books and materialsDoes not ask for help when needed Homework is not completed or tumed inHas a short attention span Afraid to make a mistakeCompleteswork hastily and impulsively Performs adequately in class but fails testsIs disorganized and/or messy Has difficulty with pencil-and-paper tasks

__ Takes longer than others to finish work Frequent absenteeism affects grades__ Appears tired; sleeps in class Doesnot complete make-up work

~_ Appears preoccupied; daydreams Socializestoo much during class

OVER

Denny Middle School 10/2005

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Iv. Interventions Attempted: Check the interventions that you have tried. Reflect results as (E)ffective or (I)neffective.

Academic InterventionsObjective stated at start of lessonIndividualized directions/check understanding. ,Breakdown of tasks into smaller stepsModified material for lower grade level skillsComputer assisted instructionHands-on activities (manipulatives)Taped instructions or lesson (content)Hand-outs rather than blackboard workProviding practice timeExtending timelines / shortened assignmentsOral discussionto confirm comprehensionModified testing methods (oral vs written)Pacingoutput / frequent breaks / timersAudio-visual instructlonal methodsHelp with organizational skillsUst assiqnrnents/scheduleon boardClarification of grading criteriaPeer pairing/ peer assisted learningSmall group instructionAcademic controct:ing.Consultation with support personnel

II. Parent/Home Contacts:

Oates Results Behavioral Interventions Dates

Preferential seating/rearrange desksProvide routine scheduleOarification of classroom rulesIncreased choicesPraise/encouragementIgnoring non-threatening inappropriate behaviorImmediate reinforcement of appropriate behaviorRewards for sustaining appropriate behaviorWithholding rewards

----Use of logical consequencesUse of a study carrel to reduce distractionsModeling desired attitude and behaviorTeach and role-play desired behaviors---- Effort reports - daily or weeklyTime-out in classroom

---- Time-out in another classroomAssigned lunch detentionStudent-teacher conference

----Behavioral contractingConsultation with support personnel

Results .,-

Date: Person Contacted: Method of Contact:Comments/Notes: --

}

Date: Person Contacted: Method of Contact:Comments/Notes:

Date: Person Contacted: Method of Contact:Comments/Notes:

VI. Intervention Outcomes: Please elaborate on effectiveness of attempted interventions (what worked, what didn't)-:'~•..,..-.;.•.•.•.

VII. Additional Comments: Please write any additional information you would like to share.

Signature: Date Submitted: _

Denny Middle School 10/2005