Area Education Agency 6

INTENSIVE INSTRUCTION PLAN

Student Name: Todd Date of Birth: Start Date for Instruction: Building/District: Grade: PK

Team Members and Role: Name Role Name Role SLP Parents School Psychologist Teacher Teacher Summarize parent input and participation: Bill and Sally Doe brought Todd to Grant Wood AEA’s Child Check on September 8th 2006 with communication concerns (speech, following directions, language, development).

List all team meeting dates with brief summary of results: 9/15/2006 – Team met at Doe residence to further assess Todd’s developmental skills. Todd was found to be delayed in the areas of: speech, language, cognitive development, play skills, and behavior. Team began intensive instruction twice a week in the home. 9/28/2006 – Team met at ABC Preschool. AEA staff observed Todd in his classroom environment and met with his classroom teachers. Intensive Instruction will now be provided in the classroom environment.

Current Student Performance and Focus of Instruction: What is/are the ….

specific areas of instructional focus? Expressive and Receptive Language

student’s current level of performance? Preschool Language Scale – 4 Total Language Standard Score = 51 Classroom Communication Profile Checklist = 11 points 15-20 expressive vocabulary words Mean Length of Utterance (MLU) = 1.3 words

expected level of performance? What comparison was used? Preschool Language Scale – 4 Average Total Language Standard Scores = 85-115 Classroom Communication Profile Checklist Average = 54 points 40 month olds average expressive vocabulary words = 300-500 words 40 month olds MLU = 3.0-3.7 words

difference between current level and expected level of performance? Preschool Language Scale -4 standard score = discrepancy of more than 34 points Classroom Communication Profile Checklist Average = discrepancy of 43 points Expressive Vocabulary words = discrepancy of more than 280 words MLU = discrepancy of more than 1.7 words per utterance

student’s strengths in this instructional area? Adequate hearing and vision,

Grant Wood AEA Intensive Instruction Form 7/06 1 multiple sources of data to support development of this plan? Parent report, Child Check Screening, Speech and Language sample, Observation, Teacher report, Preschool Language Scale-4, Classroom Communication Profile Checklist, Expressive Vocabulary Checklist

other factors that may impact the student’s performance? Lack of joint attention and engagement with adults and peers

Goal: Todd will increase his overall performance average on the classroom communication profile by 15 points from his baseline of 11.

If area of instructional focus is behavior, the goal must specify alternative behavior skills to be taught. Define the specific behaviors that will and will not be measured (examples and non-examples). Todd will be taught to follow simple one step directions in the classroom and to use language to make requests, fulfill wants and needs, interact with adults and peers, and answer questions. Examples include: Todd sitting during circle time when he is handed a “sit” picture card and given a verbal instruction. Non-examples include:

Instructional Plan and Decision Making Process:

Strategies and Materials Frequency/Length of Time Person(s)/Role(s) Visual Cues/Pictures Tuesdays and Thursdays Responsible Hand-over-hand assistance for 30-90 minutes between 9- Modeling/repetition 11:30am. Wait Time

Data Collection Strategy Decision Making Plan

Person/role responsible for data collection: Frequency of data review:

Method of data collection: Decision making rule: Language Sample ___ Four Point Decision Making Rule Classroom Communication Profile _X_ Trendline Analysis ___ Other (explain) Frequency of data collection: 1-2 times per week 30 – 90 minutes Monitoring Plan Data collection conditions: Preschool setting, large group and one-on-one Method to monitor implementation of the plan: instruction Person(s) responsible:

Document the change(s) to the instructional plan in the above boxes and on the performance monitoring chart.

Instructional Status and Team Recommendations: Date: 11/20/06

Was the instructional plan implemented and monitored as intended? Yes

Grant Wood AEA Intensive Instruction Form 7/06 2 What is the student’s level of performance following implementation of the instructional plan? 12 points as measured on the classroom communication profile

What is the discrepancy between this performance and the expected level? Include rate of acquisition information when appropriate.

___Less discrepant __X__More discrepant _____Same ____Insufficient data

Team recommendation(s) (check all that apply):

____ Discontinue intensive instruction plan ____ Revise instruction from intensive to supplemental ____ Continue the intensive instruction plan ____ Revise the intensive plan ___X_ Consider need for special education through a Full and Individual Evaluation

If follow-up steps or activities are needed, briefly summarize here. A meeting will be held to discuss educational options for Todd. The team recommends special education services with IEP goals for speech/language, following routines and directions, and engagement/interaction skills.

Grant Wood AEA Intensive Instruction Form 7/06 3