2 x 10 Implementation Planning Worksheet
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| Name of Program: | |
| Intervention Coordinator: | Member of Tier 2 team who coordinates this intervention |
Student Selection
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| How will students be selected? | Tier 2 team will review MIL for students with 2- 5 MIL incidences in a 8 week window. Also for teachers who reports a student as seeking adult attention or those needing a stronger student-teacher relationship. |
| How many students can be served? | Initially 1 student at a time for teachers and then can move up to 2 students if desired. |
| How will parents be notified/consent gained? | Parents will be contacted by the teacher via phone/email to invite student to participate and obtain parent consent and provide information on the intervention to parents. |
Implementation
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| Example goal for Student Progress Monitoring | As part of the 2x10 program, the student will meet established goal of a 20% decrease of inappropriate adult attention seeking in the tracking log for 4 out of 5 days. |
| When will the intervention occur during the day? | Teacher meets with student at any point in the day to have the two-minute conversation. Beginning of the day and natural transitions often work well. |
| How long will it last? | Two minutes per day for the conversation and one minute to progress monitor. |
| Who will provide intervention? | Classroom Teacher or Area Specific Staff (PE, Playground, Music) |
| Where will it occur? | Classroom or Specific Area dependent on the adult building the relationship. |
| How will implementation fidelity be monitored/tracked? | Teacher or area specific staff will log when daily conversations occur and will use intervention fidelity checklist to self-monitor fidelity weekly. |
Progress Monitoring
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| How will student progress be monitored (PM)? | 2 x 10 form, office referrals, grades, attendance and other school data |
| How frequently will PM occur? | Teacher will review progress towards goal weekly with student. Tier 2 team will monitor overall progress every two weeks. |
| Who is responsible for PM? | Teacher
is responsible for student feedback.
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| When will the PM data be looked at by the team? | As part of Tier 2 team reviews every two weeks. |
| What is the average length of time in program? | 10 days initially and 20 days in a second round is needed. |
| How will the team determine if a student is ready to be exited? | Meeting goal of 80% on tracked across a 10 day period. |
| What will the team do if a student is not making progress? | Adjust goals for student, modify reinforcer plan, check for implementation fidelity |
Communication
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| What will parent and teacher communication look like?
| Parents and teacher will be in close communication for this intervention with teachers or area staff providing recognition and acknowledgement for progress. |