Classroom management system (Tier 1) is not working

Use tracking sheet from the

for this behavior.
intervention to report
Student
does
notoncomplete
workprogress.
during independent
A. Fill in all
information
Form

A. I went STEP
to the websites
1
to find an Choose
intervention
that wouldand
work for my
classroom.implement
Student will be tracking the
an that she writes
number of words

each day. At the end of each

writing time, Cecilia will count the
number of words that she writes.
She will write the number of
words on the weekly chart. She
will graph the number of words
on the graph. She will then mark
that she has graphed the number
on her chart. At the end of the
week, student will meet with
teacher to see if she met her goal
(3 out of 5 days a week, Student
will write 5 more words each
day).

B. Tracking sheet for

intervention.
1. Chart for subject
completion and movement of
smiley faces.
2. Tracking sheet for student
to color the number of
smileys for that day.
3. Teacher tracks the number
of days per week with 5 or
more.

C. Contact Parents (needs

to be recorded on Form F)

F:
Name: Cecilia Jackson
Teacher: 4TH
Date entered: 5/15/15
Reason/ Need for Assistance
Recorddoes not
(Target Area): Student
write that much onthe
any given
assignment. She has the ideas
and CAN write if the teacher is
sitting near.
Objective Focus (Common Core
Standard): CCSS.ELALITERACY.W.4.2 Write
informative/explanatory texts to
examine a topic and convey ideas
and information clearly.
Who and What will occur; How
often: Student will be tracking
the number of words that she
writes each day. At the end of
each writing time, Cecilia will
count the number of words that
she writes. She will write the
number of words on the weekly
chart. She will graph the number
of words on the graph. She will
then mark that she has graphed
the number on her chart. At the
end of the week, student will
meet with teacher to see if she
met her goal (3 out of 5 days a
week, Student will write 5 more
words each day).
Indicator of Success (Use SMART
goal format): Student will
increase the number of words
written each day by 5 words for 3
out of 5 days a week.
Start Date of Intervention 5/18/15
Progress Check/Date*: Check
back date 6/24/15 to report
progress.
Parent Contact Date :11/5/14
Conferences, 4/22/15 Phone call
5/15/15 Email with plan, 6/24/15
Checked in with plan, still
working, informed parents via
email.
B. Try intervention.

STEP
2

STEP
3
Track data
on
tracking
Record on Form F in Progress
sheet
and
Check.
record
progress
Record: If the
goal is weekly,
then you must provide the
weekly data.
You can save the data
somewhere else and type it in
Form F once in awhile.

Date and progress: 5/22/15 =

Student met the goal for this
week. Student increased 5 or
more words 5 out of 5 days a
week. Will continue the plan.
5/29/15 = Student met the goal
for this week. Student increased
5 or more words 5 out of 5 days a
week. Will continue the plan.
6/5/15 Student did not meet the
goal for this week. Student
increased 5 or more words 1 day
this week. However, we only had
a straight writing day 2 days this
week. Will continue the plan.
6/12/15 Student met the goal
for this week. Student increased
5 or more words 5 out of 5 days a
week. Will continue the plan.
6/24/15 Student met the goal
for this week. Student increased
5 or more words 5 out of 5 days a
week. Will continue the plan.
Be sure to include if the
intervention is working and you
will continue or not in this
column.

STEP 4
Decision
Teacher must decide and
follow steps.
1. Is the plan working?
YES: Continue on STEP 3
Continue plan, , continue
data tracking, and
continue recording
progress in Form F in the
Progress Check column.
NO: Go back to STEP 1
Follow the steps again.
NOTES: Try at least 2
different interventions,
recorded on Form F before
moving to STEP 5.

Cecilias Writing Plan

Cecilia has a hard time getting words on her paper. She has great ideas and can write a lot of sentences if the teacher is sitting
near her.
Number of
words

CHART
Day
Monday
Tuesday
Wednesday

Graph
ed?

Date

Day
Monday
Tuesday
Wednesd
ay
Thursday
Friday

Thursday
Friday
Number of
words

CHART
Day
Monday
Tuesday
Wednesday
Thursday
Friday

Date

CHART

Graph
ed?

Graphe
d?

Number of
words

Graphe
d?

Date

CHART
Day
Monday
Tuesday
Wednesd
ay
Thursday
Friday

Number of
words

Date

Week of: ____________________________________

D
A
T
E

Monday
Tuesday
Wednesda
y
Thursday
Friday
Monday
Tuesday
Wednesda
y
Thursday
Friday
Monday
Tuesday
Wednesda
y
Thursday
Friday
Monday
Tuesday
Wednesda
y
Thursday
Friday
Monday
Tuesday
Wednesda
y
Thursday
Friday

TOTAL for week: __________________

PLAN:
Implement Plan: At the end of year writing time, Cecilia will count the number of words written. She will write the number on her
chart. She will then graph that number on the bar graph. The goal is that she will increase the number of words.

What goes on Form F?

Student
Name

Clas
s

Reason/
Need for
Assistance
Date
(Target
Entered
Area)
What is the
problem?

Cecilia
Jackson

4TH

5/15/15 Student
does not
write that
much on
any given
assignme
nt. She
has the
ideas and
CAN write
if the
teacher is
sitting
near.

Objective Focus
(Common Core
Standard)
What is the standard
related?

Who and What will occur; How

often

Indicator of
Success (Use
SMART goal
format)

What is the intervention?

Create a goal for the

plan/student using
numbers.

CCSS.ELA Student will be tracking the

LITERACY.W.4.2
number of words that she
Write
writes each day.
informative/expla At the end of each writing
natory texts to
time, Cecilia will count the
examine a topic
number of words that she
and convey ideas
writes.
and information She will write the number of
clearly.
words on the weekly chart.
She will graph the number of
words on the graph.
She will then mark that she
has graphed the number on
her chart.
At the end of the week,
student will meet with
teacher to see if she met
her goal (3 out of 5 days a
week, student will write 5
more words each day).

Student will
increase the
number of words
written each day
by 5 words for 3
out of 5 days a
week.

Date of
Intervention
(Start and
End)

5/18/15

Progress Check/Date*

Parent Contact
Date

Every so often, analyze data and report it here.

More often the better. Can keep information
somewhere else until you visit the form again.

Contact parents every

time you make a plan or
a change.

5/22/15 = Student met the goal

for this week. Student
increased 5 or more words 5 out
of 5 days a week. Will continue
the plan.
5/29/15 = Student met the goal
for this week. Student
increased 5 or more words 5 out
of 5 days a week. Will continue
the plan.
6/5/15 Student did not meet
the goal for this week. Student
increased 5 or more words 1
day this week. However, we
only had a straight writing day 2
days this week. Will continue
the plan.
6/12/15 Student met the goal
for this week. Student
increased 5 or more words 5 out
of 5 days a week. Will continue
the plan.
6/24/15 Student met the goal
for this week. Student
increased 5 or more words 5 out
of 5 days a week. Will continue
the plan.

11/5/14
Conferences
4/22/15 Phone
call
5/15/15 Email
with plan
6/24/15
Checked in with
plan, still
working,
informed
parents via
email.

Notes