HALL COUNTY SCHOOL SYSTEM ABC School

STUDENT SERVICES DEPARTMENT 2150 Book Pk

711 Green Street Gainesville GA

Gainesville, GA 30501

(770) 534 -1080

Student: John Q. Sample DOB 2-11-99 Gender Attendance:

Date 10-21-09 Grade Teacher Mrs. Smarts School Id. # XXXXX Meeting # 5

List meeting attendees:

Modification of Intervention 1 of 1 . Within 4 weeks
(for more than one goal, complete form for Multiple Goals – B2_Multiple)
The student will increase decrease.
letter identification letter/sound association decoding oral reading fluency reading comprehension sight word fluency written expression number sequencing number identification number one-to-one correspondence number counting number sense - quantities math reasoning math computation internalized emotion behavior social skills adaptive skills articulation communication - language motor skills (specific skill – This is the general target area of deficit)
retelling
from instructional 34 (level/measure) .
to independent 34 (level/measure)
(Click to add text)
as measured by .
LNF - DIBELSPSF - DIBELSISF - DIBELSNWF - DIBELSORFSight Word PercentagesRR - AccuracyMAZEBehavior Report CardMath Computation Fluency ProbesConcepts & Applications FluencyGKIDSSLP DataDRA short formWriting Rubric
(add text if needed)
Strategic intervention plan (describe intervention in detail i.e., SRA, Touch Math, CI/CO – Must be different from plan deemed to be unsuccessful):
Mrs. Smarts will continue to work with John on retelling in a level 34 book using the 4Ws strategy from the online RTI Literacy Notebook. However, she will also add the "Key Word Strategy" from the RTI Literacy notebook by having John write important words from the story on sticky notes as he reads. Mrs. Smart will model this for John, then help him choose the important words, gradually encouraging him to implement this strategy independently.
Who will implement this intervention? Mrs. Smarts
When will the first date of implementation be? 10-22-09
Where will this intervention take place? Mrs. Smarts' classroom, back table
for 15 minutes per day and 5 days per week
in addition to the regular curriculum.

Scheduled date for follow up Tier 2 meeting: 11-19-09

Signatures of Team Members:

______

______

______

END OF MEETING

Continue to Part 2 for follow up Tier 2 meeting.


Part 2 of 2: Examining Data in determining level of success of current intervention plan:

Documentation of follow-up meeting for goal above:

Today’s date: 11-19-09

List meeting attendees: Mrs. Smarts/classroom teacher, Mrs. Kind/instructional coach, Mrs. Knowsalot/5th grade teacher, Mr. Genius/5th grade teacher

Data collected during intervention plan above: John was given running record assessments on a level 34 book using the DRA short form. On 11-07-09, John scored in the independent range on the level 34 book and instructional on a level 38. Therefore, Mrs. Smarts began working with John on level 38 books during his intervention time. On 11-19-09 John scored in the independent range on a level 38, and showed improvement on all retelling sections of the continuum, moving from 2s to 3s on the continuum. He is now independent on a level 38 and instructional at a level 40. On the instructional level 40 John scored 2s in the retelling areas of the continuum. See attached running records.

Statement of Progress:

Intervention plan was implemented from 10-21-09 to 11-19-09. Intervention was: . Therefore, the RtI Committee has decided to .

Summary of Discussion (Use Form B3 for additional minutes if needed for handwritten notes):

John has made good progress using both the 4Ws strategy and the Key Words Strategy from the RTI Literacy notebook. The committee agreed that he should continue with these strategies at an increased level of difficulty since he is now independent on a level 38.

If any modification of the intervention plan is indicated above, fill out a Modification of Intervention Form (B2_Modification of Intervention).

The intervention has resulted in adequate progress; therefore, the intervention plan listed on the current Goal Form B2 will continue to be implemented just as stated on this form. However, the team needs to increase the new goal. The NEW goal is:

Goal 1 of 1 Within 4 weeks (only use one goal per form)
The student will increase decrease.
letter identification letter/sound association decoding oral reading fluency reading comprehension sight word fluency written expression number sequencing number identification number one-to-one correspondence number counting number sense - quantities math reasoning math computation internalized emotion behavior social skills adaptive skills articulation communication - language motor skills (specific skill – This is the general target area of deficit)
retelling characters and details
from instructional 40 (level/measure) .
to independent 40 (level/measure)
(Click to add text)
as measured by .
LNF - DIBELSPSF - DIBELSISF - DIBELSNWF - DIBELSORFSight Word PercentagesRR - AccuracyMAZEBehavior Report CardMath Computation Fluency ProbesConcepts & Applications FluencyGKIDSSLP DataDRA short formWriting Rubric
(add text if needed)

Date of next meeting to review progress of current plan again: 12-20-09

The intervention needs to be modified. A Modification of Intervention Form (B2_Modification of Intervention) will be completed and attached today. Date of next meeting to review progress of modified plan:

The student’s target area stated on this Goal Form B2 no longer appears to be an area of deficit. Student will no longer receive Tiers 2 interventions.

Team is recommending application to move to Tier 3. The intervention plan is being modified today. An Modification of Goal Form (B2_ Modification of Intervention) will be completed and attached today. Date of Tier 3 meeting will be determined after letter of approval is received via email from Student Services.

·  Is vision and hearing screening current? If not, who on the team will be responsible for having vision and hearing screening completed, documented and placed in file?

·  Who will send home B4 screening permission form and follow up if form is not returned?

T2_Modification of Intervention Form of B2 August_2009

Student Services, Hall County School System, Georgia