Early Years MTSS
ProgramSelf-Assessment
Program/District: ______
Building: ______
Date of Self-Assessment Completion: ______
The purpose of this self-assessment is to gather information regarding the extent to which various components of Early Years MTSS are in place in your program.
Your team will work together to complete this assessment. Each group member is receiving a copy of the assessment; however, only one form should be returned per team.
Your team should discuss and reach agreement about the status for each item (Not Started, In Progress, Achieved, and Maintaining). In addition, the leadership team should provide comments/evidence for each item. We ask that all members of the team participate in this process.
Please submit yourteam’s self-assessment by
Questions regarding the assessment may be directed to
Corrie Mervyn
Program Based Leadership Team Members (Name & Position)
Person(s) Completing Report (Name & Position)
Directions:
In responding to each item below, please use the following response scale:
Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
For each item below, please write the letter of the option (N, I, A, M) that best represents your Program Based Leadership Team’s response in the column labeled “Status”. In the column labeled “Comments/Evidence”, please write any comments, explanations and/or evidence that are relevant to your team’s response. When completing the items on this assessment, the team should base its responses on the classrooms being targeted for implementation by the program.
Consensus: Comprehensive Commitment and Support / Status / Comments/Evidence1. District/Programlevel leadership is established and provides active commitment and support (e.g., meets to review data and issues at least twice each year).
2. TheDistrict/Program Leadership provides opportunities for training, support and active involvement (e.g., administrator is actively involved in Leadership Team meetings).
3. The staff support and are actively involved with Early MTSS (e.g., one of top program goals ).
4. A District/Program Leadership team is established and represents the roles of a preschool administrator/elementary administrator, teacher, parent )
5. Data are collected to assess level of commitment and impact of MTSS on faculty/staff.
6. All personnel have received an overview of the MTSS framework and its implications for change from a traditional instructional model.
7. Families are included in the planning and implementation of MTSS.
8. The MTSS plan is integrated with other program/ district initiatives (e.g integrated into K-12 initiatives).
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Infrastructure Development: Data Collection and Team Structure / Status / Comments/Evidence9. District/Program-wide universal screening data (e.g., PELI, BIR) are collected through an efficient and effective systematic process.
10. District/Program-wide data are presented to staff after each benchmarking session (e.g., staff meetings, team meetings,).
11. District/Program -wide data are used to evaluate the effectiveness of core academic programs.
12. District/Program-wide data are used to evaluate the effectiveness of core behavior programs.
13. Universal Screening Data (PELI) data are used in conjunction with other data sources to identify students needing targeted group interventions and individualized interventions for academics.
14. Behavior data (BIR) are used in conjunction with other data sources to identify students needing targeted group interventions and individualized interventions for behavior.
15. Data are used to evaluate the effectiveness (MTSS) of Tier 2
Intervention programs.
16. Individual student data are utilized to determine response
to Tier 3 interventions.
17. Special Education Eligibility determination is made using the MTSS model for the following programs: Early Childhood Developmentally Delayed (ECDD), Specific Learning Disabilities (SLD), Speech and Language Impaired (SLI), Autism Spectrum Disorder (ASD).
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Infrastructure Development: Data Collection and Team Structure (Cont’d) / Status / Comments/Evidence18. District/Program Leadership/staff staff havea process to select evidence-based strategies/practices for Tier 1.
19. District/Program Leadership/staff have a process to select evidence-based strategies/practices for Tier 2.
20. District/Program Leadership/staff have a process to select evidence-based strategies/practices for Tier 3.
21. District/Program Leadership/staff have a regular meeting schedule for problem-solving activities.
22. District/Program Problem Solving Teams evaluates target students’ needs for MTSS at regular meetings.
23. The District/Program Leadership team involves families.
24. The District/ProgramLeadership Team has regularly scheduled data day meetings to evaluate Tier 1, Tier 2, and Tier 3 data.
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Implementation: Three-Tiered Intervention System and Problem-Solving Process / Status / Comments/Evidence25. The District/Programhas established a three-tiered system of servicedelivery.
a. Tier 1 Academic Core Instruction/Curriculum clearly identified.
b. Tier 1 Behavioral Core Instruction/Curriculum clearly identified.
c. Tier 2 Academic Supplemental Instruction/ Strategies clearly identified.
d. Tier 2 Behavioral Supplemental Instruction/ Strategiesclearly identified.
e. Tier 3 Academic Intensive Strategiesare evidence-based.
f. Tier 3 Behavioral Intensive Strategies/Programs are
evidence-based.
26. Teams (e.g., District/Program/Classroom Problem-SolvingTeams,) implement effective problem solving procedures including:
a. Universal screening and other assessment data have been reviewed to determine the percentage of students currently proficient overall and within each sub-group, and a gap analysis has been completed.
b. Replacement behaviors are clearly defined.
c. Problem analysis is conducted using available data and evidence-based hypotheses.
d. Intervention plans include evidence-based (e.g., research-based, data-based) strategies.
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Implementation: Three-Tiered Intervention System and Problem-Solving Process (Cont’d) / Status / Comments/Evidencee. Intervention support personnel are identified and scheduled for all interventions.
f. A system is in place to continually verify that interventions are implemented with fidelity.
g. MTSS is evaluated through systematic data collection.
h. Changes are made to intervention based on student response.
i. Families are routinely involved in implementation ofMTSS process and interventions.
j. Families are provided information on the MTSS process, including an overview of the MTSS framework, tiered instruction, types of programs used, and tips to support their children and school to implement the MTSS strategy. The overview includes timelines, explanations of interventions, and expectations.
k. Families are notified and requested to participate in the three-tier process as soon as their children begin tiered supports.
l. Families are involved in their problem solving, progress monitoring, and goal setting.
m. Families are routinely involved in implementation of interventions.
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Implementation: Monitoring and Action Planning / Status / Comments/Evidence27. A strategic plan (implementation plan) exists and is used by the District/Program Leadership Team to guide implementation of MTSS.
28. The District/Program Leadership Team meets at least twice each year to review data and implementation issues.
29. The District/Program Leadership Team meets at least twice each year with the District Leadership Team to review data and implementation issues.
30. Changes are made to the implementation plan as a result of programand district leadership team data-based decisions.
31. Feedback on the outcomes of the MTSS Project is provided to program-based staff and families at least yearly.
Scale:Not Started (N) — (The activity occurs less than 24% of the time)
In Progress (I) — (The activity occurs approximately 25% to 74% of the time)
Achieved (A) — (The activity occurs approximately 75% to 100% of the time)
Maintaining (M) — (The activity was rated as achieved last time and continues to occur approximately
75% to 100% of the time)
Professional Development (Consensus, Infrastructure, Implementation) / Status / Comments/Evidence32. All staff involved in the implementation of MTSSreceivestraining in effective use of data for instructional decision-making.
33. All staff involved in the implementation of MTSSreceives training in assessment tools used for universal screening (ie PELI, BIR) and progress monitoring.
34. All staff involved in the implementation of MTSSreceivestraining in research-based intervention strategies.
35. All staff involved in the implementation of MTSS receives training in collaborating with and involving families.
36. Key district and program staff are identified for enhanced training in specific components of MTSS to build capacity and to ensure sustainability of MTSS.
37. To facilitate application of data analysis skills, program schedule time for staff to review data following universal screening.
38. The District/Program provides a variety of opportunities (e.g., printed materials, public meetings) for families to learn about the three-tiered intervention model using an MTSS process.
39. The program professional development calendar provides sufficient time and flexibility for professional development in the components of MTSS.
Additional Comments/Evidence:
* Adapted from the Florida Problem Solving/Response to Intervention Project and the IL-ASPIRE SAPSI v. 1.6
Center for School Evaluation, Intervention and Training (CSEIT)
Loyola University Chicago1