MTSSMulti-Tiered Support Systems

Handbook and Resource Guide 2020-2021

Table of Contents:

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What is MTSS 2

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Georgia’s View 3

What You Need to Know - Law 4

MTSS and Special Education 4-5

The WHY? 6

The Role of PLCs 7

Tier 1 8

Tier 2 8

Tier 3 9

Transitioning Students 9-10

MTSS Process 11-12

Progress Monitoring 13

Teaming Structures 13-15

Meetings 16

Referrals 16

Reports 16

Interventions 17

Folders and Paperwork 17-18

MTSS Student Form 1 19-26

Flowchart 27

Social History Form 28-29

Structured Observation Form 30-32

Resources 33-35

What is MTSS?MTSS is the acronym for Multi Tiered System of Support. This means that MTSS is like a large umbrella, and under it is RtI (Response to Intervention) and PBIS (Positive Behavioral Intervention and Supports) working together for students. MTSS is not a path to Special Education, on the contrary, it is designed to improve student learning

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and thus, keep students in the regular education classroom. The MTSS framework is designed to help schools systematically use data and problem solving to allocate educational resources to improve learning for all students. In order for MTSS to work, we all must be focused on providing a rigorous curriculum, encouraging parental involvement, and promoting collaboration and teamwork.

What is the Goal of MTSS?● Improve student achievement● Act proactively rather than reactively● Make data-based decision● Provide early interventions to struggling students● Implement effective communication for all stakeholders● Provide support to teachers through resources and training

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● Reduce special education referralsWhat are the academic goals?

● Increase the number of students that meet or exceed state standards● Increase graduation rate● Eliminate achievement gaps● Eliminate retention and failures

What are the behavioral goals?● Increase academic engagement● Increase social and behavioral competence● Decrease the number of discipline referrals● Decrease the number of suspensions/expulsions

Georgia’s View on MTSSUntil now, Georgia was the only state to have a four-tiered pyramid. Now, Georgia operates within a three-tiered, multi-level prevention system.

Students will receive services at all levels, depending on their needs. When all compo nents are implemented, research shows results include strengthened Tier I instruction with 80% of students responding to core curriculum. Georgia's Tiered System of Supports for Students is expected to become one of the primary guiding frameworks for a continuous, data-based, school improvement process,

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supporting academic, social emotional and behavioral achievement of all students to prepare them to be successful high school graduates.

The essential components of Georgia’s framework are aligned with the nationally vetted Multi-Tiered System of Supports (MTSS) including: Screening, Progress Monitoring, Multi-Level Prevention System, and Data-Based Decision Making. Georgia added Infrastructure as a fifth component to ensure schools can develop a systematic and preventive educational system that can easily be personalized for every child. The following are critical elements of Infrastructure: Leadership, Effective Teaming, Professional Learning, and Family & Community Engagement.

What You Need to Know:

Every Student Succeeds Act (ESSA) requires the use of evidence-based interventions and suggests that schools and districts implement a tiered system of supports.

House Bill 740 requires local school systems to use multi-tiered system of supports and reviews prior to expelling or assigning a student in preschool through third grade to out-of-school suspension for more than five consecutive or cumulative days during a school year.

High-Leverage Practices:

The success of a Tiered System of Supports for Students is dependent upon the use of High-Leverage Practices (HLPs). HLPs are a set of practices that are necessary to support student learning, and that should be learned and implemented by all teachers.

Evidence-Based Practices:Evidenced-based practices (EBPs) are effective educational strategies supported by evidence and research. Strategies are generally considered effective instructional and behavioral practices rather than a set of prescribed instructional procedures, systematically implemented. When HLPs s are coupled with EBPs, they provide a continuum of supports that result in a rapid response to academic and behavioral needs.

MTSS and Special Education:

Multi-tiered System of Support (MTSS), formerly known as RTI grew from efforts to improve identification practices in special education. Simply put, it is a process of systematically documenting the performance of students as evidence of the need for additional services after making changes in classroom instruction.

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“We must be conscientious about not labeling or siloing students according to their needs. Similarly, tiers are not placements or designations that follow students throughout their academic careers. As an example, a student may receive tier 1 supports in a classroom, tier 2 reading supports during an intervention block and tier 3 counseling services for social emotional support regardless of whether or not the student has an IEP, a 504, or a behavior plan. A student who receives these supports is not a “tier 2” or a “tier 3” student, but at that point in time, has access to reading support in tier 2 and social emotional support in tier 3 mitigates barriers that may prevent the student from accessing supports in tier 1. Alternatively, a student with an IEP may receive robust accommodations and support while receiving tier 1 instruction in the classroom and attend the same tier 2 reading support as Created by Dr. Kristan Rodriguez & Dr. Katie Novak with the Massachusetts Department of Elementary & Secondary Education their classmates. In a well designed MTSS system, students receive the supports they need when they need them, from the staff members who are best able to support them, regardless of whether or not they have a documented education plan. It is important to note that tier 3 is not synonymous with special education. In fact, students with disabilities may not need tier 3 support while students not identified as having a disability may require those supports. It is also critical to understand that MTSS does not function as a step ladder. A student may need intensive tier 3 support without first accessing tier 2 supports. For example, if a student suffers a traumatic event, individual counseling daily may be needed. We do not tell her to try attending weekly group sessions to see if those work first. If the child is in crisis, we must provide her with the level of support required regardless of a defined disability or a predetermined sequence of scaled supports.”

“It is essential that special education staff play a pivotal role in all aspects of the MTSS framework. While MTSS is not a special education initiative, it supports all students, including students with disabilities. Therefore special education staff should play an integral role in the design and development of the multi-tiered system of support.”

https://ocde.us/MTSS/Documents/MTSS%20Special%20Education%20Insert%20(1).pdf

The WHY?There are two vital questions we need to ask ourselves when we seek to implement something new: Why do we need to change what we are doing? Will this positively impact students?

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For far too long, we have worked in silos. Each teacher trying to figure out what to do with academic problems and behaviors that they may or may not have encountered before. Now, with MTSS, teachers come together and acknowledge that students are a shared responsibility. With PLCs, PBIS, MTSS meetings, and all of the built in support, we are building a network of specialists that can help and support our efforts in teaching.

When teachers start to share the burden, they may have many feelings. Some feel like they don’t want to release control, some feel that the paperwork is too cumbersome, some feel that it is just “something else.” In fact, it is all of the best research practices coming together for the first time in an organized, communicative, community based program designed to help every child on the spectrum.

So what does this mean for teachers? First, we carry on with our research based classroom practices. We teach the curriculum. We have an orderly and inviting classroom where relationships are valued. This includes small group remediation when students struggle, small group enrichment for advanced students, working with behavioral specialists and our PBIS team to improve our classroom routines and procedures, etc. Making sure that the CORE teaching a student receives is the very best possible. Making sure that our lessons are research based, aligned to the curriculum, correctly scaffolded, correctly delivered, classroom routines and procedures are in place for smooth teaching and transitions, and making sure differentiation is taking place for students. The core is the classroom teacher’s responsibility and they should be able to say that 80% of their students are succeeding in the core. When students are struggling in some area or need advancement, going to PLCs and seeking the advice and input of other teachers, trying new ideas and interventions, and working to improve the classroom is necessary. When more help is needed, moving on to the MTSS team to try additional interventions and support is vital. Having a team to work with and support teachers is a “why.” Adding additional support as you move to Tier 2, progress monitoring and bringing the information back to the team to discuss and evaluate, and then deciding to continue the interventions, stop the interventions or move on to Tier 3 is the next step. If Tier 3 is necessary, having the team to bring in different individuals with specialties and TIME to help add another layer of support for students is vital. To have additional support for us and our students. To have additional resources for us and our students. To make sure that no student falls through the cracks. To ensure that we are providing the best CORE instruction that is available. All of these reasons are our “why.”

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Remember, some reasons to consider change: 80% of students are not succeeding with core instruction, not seeing growth after using interventions, students are struggling with academics OR behavior, gifted students are bored or not achieving as expected.

We must do what is right and research based for our students. If we are implementing something new, we must make sure that it will positively impact students. If we are not using something, if it is not research based, or it has been ineffective, get rid of it! Even more importantly in any new endeavor is administrator and teacher buy in. Administrators must support, implement, monitor and evaluate and teachers must support, implement, monitor and evaluate.

MTSS requires everybody working together to help every child succeed.

The Role of PLCs

PLCs play a vital role in the MTSS process. The whole process begins with a problem in the classroom. It can be student behavior or achievement. A classroom teacher is responsible for differentiating for and working with students to help them achieve. This is the core. This includes pulling a student back for individual or small group assignments, coming up with a plan for student behavior, implementing additional interventions, etc. PLCs are designed to review school-wide and individual classroom data, design and implement lessons/interventions/research based strategies, and provide support from other teachers, instructional leaders, and specialty personnel. During PLCs, teachers can bring individual students to the group, and they will help the teacher design and implement a plan for intervention.

Schools should develop a plan for school-wide intervention time (Tier 2/3). PLC teams will use all of the information available to divide students into groups to be remediated during this daily, built in intervention time. The groups can change weekly/monthly depending on student needs. Information from screeners, MAP and one other, (EX: AimsWeb, Rigby, Reading Horizons), intervention data, current reading / phonics/ sight word levels, classroom grades, benchmark results, etc., will help to place students in the appropriate intervention.

After 6 weeks of gathering progress monitioring data from the interventions, the PLC team will turn the paperwork over to the School MTSS team. The MTSS team will make a determination onTier 3. The schools which have EIP (intervention teacher) services, will utilize these services for Tier 3 students. The services must be above and beyond

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what is going on in the regular education classroom. A student in tier 3 would continue to be pulled back in small groups by the classroom teacher, would continue to go to Tier 2 interventions during the school-wide intervention/enrichment time, and would receive services from the intervention teacher during an additional time during the day. This intensive plan should be reserved for approximately 5% of the population. If more than 5% of the population is requiring this intensive intervention, core teaching in the classroom must be observed and evaluated.

Tier 1Every student is in Tier 1. Tier 1 is core instruction. Tier 1 is anything you would do in your regular classroom, including small groups, differentiation and remediation. 80% of the school population should be in tier 1, that means that 80% of your classroom should be on grade level, a “C” or better. Schools where universal screening data do not reflect 80% of the student population meeting standards may require more instructional time than others in particular core curriculum areas.

Tier I (Green)▪FOCUS: ALL students▪INSTRUCTION: District curriculum and instructional practices that are evidence-based; aligned with state or district standards (including English Language Proficiency Standards); and incorporate differentiated instructional strategies that address learning preferences, cultural differences, and readiness levels within the group▪SETTING: General education classroom or other education setting within the school (push-in services)▪ASSESSMENTS: Screening, continuous monitoring for progress (formative assessments - before, during and after instruction), and outcome measures and/or summative assessments.

Questions to Guide Analysis of Tier 1 Effectiveness● What percent of students are meeting grade level expectations? What percent of

students are “on track” for promotion?● Is Tier 1 instruction for each grade-level content or subject area effective?● How effective has Tier 1 instruction been at increasing the growth of all students?

Are students making accelerated growth that will result in closing the learning gap?

● Does your Tier 1 formative assessment process accurately predict student performance on summative assessments?

So, let’s ask ourselves these questions:● What is it we want students to learn? (Curriculum)

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● How will we know if they have learned it? (Data)● What do we do if they didn’t learn it? (Differentiation and Remediation)● What do we do if they did learn it? (Enrichment)

Tier 1: Behavior (PBIS) - Positive Behavioral Interventions and Supports

● Universal screener● Positive environment where instruction can occur with minimal disruption● All students are engaged in learning● Systematic process used by everyone in the building designed to address the

unique behavioral and social-emotional needs of all students● Evidence-based practices; an integrated approach that clearly defines systems,

practices and the use of data to improve student outcomes● Basic expectations systematically taught, modeled, reinforced and monitored in

all settings every day● Systematic acknowledgments of positive or improved behaviors integrated into

every setting every dayKey Practices of PBIS

● Clear definitions of expected positive behaviors in all school settings for students and staff

● Clear definitions of problem behaviors● Regularly scheduled instruction and practice in desired social behaviors● A continuum of procedures for acknowledging and encouraging expected

positive and improved behaviors● A continuum of procedures for discouraging problem behaviors● Procedures for ongoing data-based monitoring and evaluation of all systems,

practices, and interventions● Family awareness and involvement

Tier 2Tier 2 involves those students who are not succeeding in the core, especially those performing below Those students who may be occasionally failing or barely passing classroom tests, doing poorly on homework, can’t seem to grasp new concepts, need extra help with work, more intensive interventions, extra time, etc. They may have intermittent behaviors that are causing a disruption to their education or the education of their peers. Intense academic interventions and/or behavior interventions are needed (above and beyond what you are doing in the regular classroom). These students should make up approximately 5-15% of the total population. High numbers of students needing Tier 2 or Tier 3 interventions may indicate deficits in implementation fidelity or a

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need for the school to provide additional preventive school-wide, grade-level, or classroom supports at Tier 1.

Tier II (Yellow) ▪FOCUS: Students identified through screening and other data sources who are in need of enrichment/acceleration or are at risk for poor learning and behavioral outcomes▪INSTRUCTION: Targeted to the area of need, supplemental instruction and/or intervention delivered to small groups; and with fidelity (i.e., consistent with the way it was designed)▪SETTING: General education classroom or other education setting within the school▪ASSESSMENTS: Progress monitoring, diagnostic

Tier 2:● Provided in addition to Tier 1 Core Instruction● Evidence-based programs and strategies matched to students’ needs as

determined by assessment data● Staff trained to implement programs and strategies and progress monitor effects● Programs and strategies implemented with fidelity● Fidelity checks of Tier 2 instruction● Flexible and creative scheduling● Adequate time● Human and fiscal resources for small group interventions● Trained teachers, instructional specialists and paraprofessionals (when trained)

○ Students with the greatest deficits need to be provided services by highly effective staff members whose data shows efficacy of their practice

● 30 minutes a day, 3-4 days a week● Small group with 3-5 students● Interventions target specific weakness● Weekly progress monitoring● Analysis of PM data to determine if the time, intensity or intervention program

needs to be changed to accelerate growth ● 6 weeks of intervention and progress monitoring● Use data to inform decision of continuing intervention, fading service, moving to

Tier 3.

Behavior:● Interventions tailored to needs● Interventions designed to accelerate the development of pro-social behavior

while increasing engagement in academics● Pre-teaching, teaching, and re-teaching of social skills● Behavior change strategies that focus on the underlying function driving the

behavior● Consistent with PBIS plan

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● Increased frequency of progress monitoring● Flexible movement between tiers

Tier 3

What it looks like in the classroom:

Tier 3 students are not performing. These students have continuously failed tests, homework, quizzes, they may have chronic behaviors that are impeding their learning or the learning of others. They are way below their expected target and need intensive interventions either academic, behavioral, or sometimes both. The interventions for tier 3 have to be above and beyond (different) from those used in tier 2. This is 1-5% of your total population.

Tier III (Red)▪FOCUS: Students who have not responded to primary or secondary level of prevention or who are in need of enrichment or acceleration (SST)▪INSTRUCTION: Intensive, supplemental instruction delivered to small groups (2-3) or individually, typically not the core teacher, highly trained in the content they will teach and the programs/strategies that will be delivered▪SETTING: Usually outside of primary classroom, within the school▪ASSESSMENTS: Progress monitoring (more frequent), diagnostic

Differences between Tier 2 and 3:● The frequency with which interventions occur● The duration and intensity of particular interventions, 30 minutes/5 days a week● The skill and expertise of the interventionist● The frequency of progress monitoring

Data indicating that a student is not responding adequately to Tier 3 interventions may show cause to suspect a disability.

http://www.rtinetwork.org/essential/tieredinstruction/tier3/distinguishing-between-tier-2-and-tier-3-instruction-in-order-to-support-implementation-of-rti

Tier 3 Behavior:● Interventions designed to provide intensive skill development to approximately

one to five percent of students who display chronic, severe misbehavior or social-emotional problems

● Intended to increase behavioral, social and psychological well-being, as well as academic engagement

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● Increased time, duration● Reduced group size or individual● Progress monitoring data - DAILY● Fidelity checks to determine if the intervention is implemented as described in the

behavior plan

What if a student is achieving?

When a student starts to improve, it is necessary to make sure that the student has the support they need to continue their educational journey. So what is the procedure to move a student back down the tiers?

Tier 3-Students who have showed progress for 8 weeks consistently ( two meetings must be held), are able to move back down to Tier 2. The intensity of the intervention continues but the frequency may, if the group decides, be lowered. Students who are moved down to Tier 2 are held in Tier 2 for at least 12 weeks (two meetings must be held). If a student shows continued improvement and adequate progress toward their individual goals, they may move to Tier 1. Remember, MTSS is a process. All students are in MTSS and every student must be monitored for success.

Tier 2-Students who are in Tier 2 can be moved down to Tier 1 when they show consistent positive results for 12 weeks with consistent interventions. When they are moved down to Tier 1 the teacher must monitor them for 6 weeks and hold an exit meeting with the MTSS team after the six week period.

Tier Practice Reference

2 Use explicit and systematic instruction Gersten et al (2009)

2 Groups of 3 to 5 students Elbaum et al (2000)

2 Provide instruction in up to 3 foundational reading skills Gersten et al (2009)

2 &3 Focus on underlying, foundational skills for math and reading

Gersten et al (2009)

2 & 3 Progress should be continuously monitored until at least 8 data points are available for reliability

Christ (2006)

3 Use an intervention with at least 3 components that are different from Tiers 1 and 2

Swanson and Sschse-Lee (2000)

3 Potential intervention components include (a) highly Burns et al (2008)

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targeted, (b) provides and appropriate level of challenge, (c)explicitly teaches a specific skill, (d) allows many opportunities to respond, and (e) provides immediate corrective feedback for an individual student

MTSS ProcessUniversal Screeners

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Universal Screeners should be used for math, reading and behavior. Screening is conducted to identify or predict students who may be at risk for poor learning outcomes. Universal screening assessments are typically brief, conducted with all students at a grade level, and followed by additional testing or short-term progress monitoring to corroborate students' risk status.

AcademicMAP will be given at the beginning of each school year to help identify any additional students who may need to be placed into the MTSS process. Cut offs for these will be determined by grade span but will generally be students falling under the 30-35%tile.

Behavior JCCS will use a universal screener for behavior. It can be done either on paper or digitally. In addition to the universal screener, each school will monitor student discipline data and once a student reaches 3 office discipline referrals within a school year the student should be placed in Tier II within the MTSS system. All schools will use the Check In Check Out model.

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○ Data Decision Rules

Data decision rules are formal procedures that inform

our actions around data. We set data decision rules

to provide a framework for our teams and

practitioners to interpret data. Some data decision

rules can be extracted directly from research and they

are presented here in that way. There are some times

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however, when schools and districts will need to

design their own rules based on best practice and

their unique circumstances.

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Monitoring Progress with Interventions Part 1Video Link https://www.youtube.com/watch?v=zlauXlQ5N34&feature=youtu.be

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○ Monitoring Progress with Interventions Part 2

Video Link https://www.youtube.com/watch?v=qppccxgr5-M&feature=youtu.be

○ Monitoring Progress with Interventions Part 3

Video Link https://www.youtube.com/watch?v=qF9xH1_ZVGo&feature=youtu.be

○ Monitoring Progress with Interventions Part 4

Video Link https://www.youtube.com/watch?v=Cy4Pg9locqk&feature=youtu.be

○ Monitoring Progress with Interventions Part 5

Video Link https://www.youtube.com/watch?v=LY5pmHRKtts&feature=youtu.be

IndicatorsGrades K-2Primary Indicator - MAP Percentile Score, GKIDSAt or Above 75-99 - ExceedsOn Watch - 50-74 - MeetsIntervention - 25-49 - On WatchUrgent Intervention - 0-24 - Intervention

Secondary Indicators may include: (specify for each)● Below Grade Level Lexile on MAP● Standards Based Report Card (specify)● Behavior (5 or more incidences in 9 wk period)● Attendance (specify #)● LEXIA Data for Reading ● Reading A-Z Levels for Reading ● Reflex Math Data for Math ● Exact Path Data for Math

Grades 3-12Primary Indicator - MAP Percentile ScoreAt or Above 75-99On Watch - 50-74Intervention - 25-49Urgent Intervention - 0-24

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Secondary Indicators may include: (specify for each)● Milestones Scores in Reading & Math● Below Grade Level Lexile on MAP● Grades - Summative Assessment Data - less than 70% mastery ● Behavior(5 or more incidences in 9 week period)● Attendance (specify # of days)● LEXIA Data for Reading (WPES)● System 44 or Read 180 Data for Reading ● Reading A-Z Levels for Reading (WPES)● Exact Path Data for Math (WPES)

Progress Monitoring - All teachers will progress monitor their students regularly.Academic Tier 2 and 3 students will be progress monitored using a research based assessment such as EasyCBM (reading and math), Reading Horizons (reading) and the AimsWEB+ assessment system ( reading, math). For those students at Tier II and Tier III this must be done, at a minimum, weekly.

BehaviorTier 2 and 3 students will be progress monitored daily through data collected with the Check-In/Check-out process or through their individual behavior plan. This data will be collected within Infinite Campus in the RTI tab. Please review the CICO process here: https://www.interventioncentral.org/behavior_management_check_in_check_out

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MTSS Teaming Structures:

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*Taken from Teaming Structures NCMTSS http://www.livebinders.com/play/play?id=2052295#anchor

District MTSS Team MTSS CoordinatorExecutive Director of Teaching & LearningExecutive Director of Student ServicesExecutive Director of Student Support ServicesDistrict PsychologistInstructional Coaches

School MTSS Team*School MTSS Coordinators - School Coordinators will be principals. The school team will also consist of at least one math and one reading teacher from each grade level, the instructional coach, the counselor, the nurse, and PEC teachers. School teams will meet weekly to review student data and any tier 2 and 3 referrals.

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Monthly District-wide MTSS MeetingsMembers of each school’s MTSS team will meet monthly with the district MTSS team to go over procedures, policies and participate in professional growth activities.

Monthly District Team MTSS Site VisitsMembers of the District MTSS Team will schedule one day per month at each school to review data with the School MTSS team and conduct a random review of student files.

Making Referrals for Students

MTSS teams cannot make referrals to the district Psychologist without taking the student through the MTSS process. Referrals received by the District Psychologist, that have not gone through the correct process will be referred back to the school MTSS Team. *An expedited process is available for students exhibiting characteristics of the most significantly disabled. Please contact the Special Education Director for more information.

Tier II & Tier III Student Reports

MTSS requires progress monitoring. At tier 2 this may consist of a combination of evidences. Included should be classroom grades, classroom test grades, progress monitoring results, reports from any programs being used, and anecdotal information about the whole child. At tier 3, a different intervention must be utilized ON TOP OF tier two interventions. This intervention must be progress monitored as well and all other pertinent information gathered. If progress monitoring results are not submitted to the team, it cannot, by definition, be considered tier 2 or 3.

Each school shall maintain an accurate list of ALL students in the MTSS process. This will be kept in a Google Sheets provided by the district.

Academic/Behavior InterventionsJCCS

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Jasper County Charter System will use an intervention matrix with research based academic and behavioral interventions. Each school in Jasper County will use the Intervention Matrix provided to enter additional academic and behavioral interventions being used. All interventions must be research based and progress monitored.

MTSS Folders and Paperwork

FOLDERS:● Tier 3 will have two prongs, 2 divider folders. ● 6 sections:

○ Parent Contacts (letters, signature pages, consent forms etc.)○ Completed tier forms/checklists, meeting notes, meeting attendance. ○ Screening data/MAPs data/other relevant testing information. ○ Reading PM Data/Graphs/Student Work samples○ Math PM Data/Graphs/Student Work samples○ Other important documents. Medical forms, hearing/vision, etc. This

could also be a section where information needed to complete an evaluation to determine the need for special education services goes if necessary.

● Folders will remain in intervention teacher of record’s room. Tier 2 folders will remain with HR teacher and travel with students to classes where interventions will occur OR they could be housed with the teacher implementing the interventions. If the student is receiving support in both reading and math, the folder’s location can be determined at the discretion of the teachers.

● Folders should be brought to ALL SST/MTSS meetings up to date. ● Folders will be checked for completeness on a rotating schedule by the MTSS

School Lead or admin. Folders will also be checked by visiting members of the District MTSS Team.

● Tier 2 will have standard two pocket folders with 3 prongs. These can also be red.

○ All forms, graphs and parent contact should be dated and in chronological order with the most recent on top.

○ The folder will house the following sections: ■ Parent contacts, meeting notes, Tier forms.■ Student work samples (if appropriate), PM data, and graphs

divided by subject.

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● If using electronic monitoring, paper records should be available within their folders for easy access at SST/MTSS meetings. These need to be updated and refreshed at least every 9 weeks and before any SST/MTSS meetings.

○ Work samples: All work samples should be pertinent to current goals/objectives. Some skills that may require work samples may include math calculations, writing, etc., anything where seeing their work, beyond data points or graphs, would be beneficial to determining growth.

Jasper County Charter SystemMTSS Student Initial Intervention Form

*Initiate during PLCs for students with consistent deficits

Student Name: Grade: Date of Birth: Age: Gender:

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Student ID#: (GTID) Address: Referring Person(s)/Team: Teacher:

Parent/Guardian: Relationship:1. Mother 2. Father

Phone #: Academic Year:

Results of current vision screening: ______ Results of current hearing screening: ________ _______________________Date of 1st Meeting with PLC:(Come up with intervention strategies) _______________________Date of 2nd Meeting with PLC: (Outcomes, additional interventions)_______________________Date of 3rd Meeting with PLC:(Decision - Successful? MTSS Team?)

Student Strengths (Check all that apply)

*To be filled out by Classroom Teacher

• Positive attitude • High expectations for self. • Transitions easily

• Hard worker • Organized • Takes pride in appearance

• Trustworthy • Good sense of humor • Athletic

• Works well in groups • Cooperates • Musically talented

• Works well independently • Responsible • Artistically inclined

• Respectful of authority • Creative • Other:

• Motivated • Has leadership qualities

1. Problem Identification: Reason for student referral (include all relevant data: Behavioral or Academic).

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Please check area(s) of concern.

Grades

Behavior

Social

Attendance

Medical/Medicine

Other: (Ex: Speech)

*Parent Contact: (2 minimum) Please date each contact.Other:

Notes: (Please indicate pertinent information, grades, discipline or attendance data, etc.)

Phone calls, date: ___Emails, date: ___Conferences, date: __Letters, date:___

* During the conversation with the parent, please ask about the child’s social/emotional history. If the parent discloses to you, send home a Social Developmental History form. (Found on the website) 2. Problem Hypothesis: Why do you think the student is experiencing these difficulties? Please be as thorough as possible. (Function of the Behavior)

Is there a family history that may be relevant? (parent history or siblings already placed in a program)

Directions: The PLC team, along with the classroom teacher, will complete parts 3-5 of the Initial Referral Form and will submit to the MTSS Chair (Principal). 3. (Tier 2 - PLCs) Date: __________________

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*Include a minimum of 6 data points for evidence of effectiveness. Graph your data to show effectiveness. (Behavior - website Ex: http://www.sped.sbcsc.k12.in.us/ppm/behavior/datacollection.html, PBIS WORLDBOOKRefer to resources such as the book Positive Discipline, A Teacher’s A-Z Guide or the Behavior Flipchart. Remember to access our Intervention Matrix. Academics - website example: http://www.jimwrightonline.com/pdfdocs/cbmresources/cbmgraphs/math_40_12.pdf. If the intervention is working, you do not need to change the intervention, the process is working. If the intervention is not facilitating growth/achievement, you must move on after 2 weeks to another research-based intervention. Attach all paperwork. (It is very rare that continuing an intervention for extra time helps if it hasn’t in 2 weeks)

Intervention(s)/Duration (2 weeks) Effectiveness (What did the data show when you graphed it?)

4. (Tier 2 - PLCs) Date:_________________*If behavior, use PBIS Worldbook for intervention.

Intervention(s)/Duration (2 weeks) Effectiveness (What did the data show when you graphed it?)

5. (Tier 2 - PLCs) Date: __________________

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Intervention(s)/Duration (2 weeks) Effectiveness (What did the data show when you graphed it?)

Outcome of Interventions: Continue Interventions___

MTSS Referral___

Tier 3 Referral to MTSS Team: When Tier 1 and 2 have been implemented with fidelity and research based practices have seen no significant improvements, students may be referred to the MTSS team after the PLC process has been completed. The MTSS team will utilize the MTSS Student Initial Intervention Form and all data gathered to make a determination on Tier 3. The classroom teacher will work with the interventionist to provide the team with progress monitoring data from Tier 3 interventions. *Only in special circumstances can students skip the PLC (Tier 2) portion of the process. Refer to the Special Education Director for more information.

*To be filled out by MTSS team MTSS Team Signatures:

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Teacher Signature(s): K-5Student went through the SST/RTI process ______Student was identified Developmentally Delayed _____Attended Pre-School _____Student tested out of PEC ____ Date: ________Previously retained____ If so, in grade ____Final average from previous grade: Math ______ Reading ______Year: ________ Math EOG:_____Reading EOG:______ Year: ________ Math EOG:_____Reading EOG:______ Year: ________ Math EOG:_____Reading EOG:______ Current MAPS data ____________________________________6-12Student tested out of PEC ____ Date: ________Previously retained____ If so, in grade ____Year: ________ Math EOC:_____Reading EOC:______ Science: __________Year: ________ Math EOC:_____Reading EOC:______ Science:___________Year: ________ Math EOC:_____Reading EOC:______ Science:___________Other subjects and grades: _______________________Current MAPS data________________________ *Please attach appropriate documentation (Report Card, Grades, attendance, intervention data, progress monitoring)

Plan for Intensive Intervention: ____ Academic _____ BehaviorWho:

Where:

Intervention(s):

How Often: (How many times a week and for how often)

Additional Supports:

Progress Monitoring dates:

Team “Check in” dates:

Expected Goal for EOY:

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Outcome/Effectiveness of Interventions: (Graph Data)

Action recommended: Further intervention______ Screening _______

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Jasper County Charter System Social History - Editable

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Jasper County Classroom Observation - Editable

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Resources:

ESSAhttps://www.ed.gov/ESSA

Georgia House Bill 740 http://www.legis.ga.gov/Legislation/20172018/171502.pdf

PBIShttps://www.pbisworld.com/

Rigorous Curriculumhttps://www.slideserve.com/gary/rigorous-curriculum-designhttp://blackbinder.com/uploads/2/7/9/2/2792870/rigorouscurriculumdesignch1.pdf

From Georgia DOE MTSS Website:

Family Guide and Resources:

● A Family Guide to Understanding MTSS English & Spanish ● Key MTSS Terms

Resources:● High-Leverage Practices ● Selecting Evidence-Based Tools for Implementing Intensive Intervention ● https://ies.ed.gov/ncee/wwc/ ● http://www.bestevidence.org/ ● National Center on Intensive Intervention Tools Chart ● MTSS vs. RTI ● Taxonomy of Intervention Intensity ● Evidence-Based Intervention Guide ● Positive Behavioral Interventions and Supports (PBIS) ● http://www.pbiscaltac.org/

Guidance and Rubrics

● 2019 - 2020 ELA/Reading EIP Rubrics● 2019 - 2020 Mathematics EIP Rubrics

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● 2019 - 2020 EIP Guidance

Guidance and Rubrics Archives

● 2018 - 2019 ELA/Reading EIP Rubrics ● 2018 - 2019 Mathematics EIP Rubrics ● 2018 - 2019 EIP Guidance ● 2017 - 2018 ELA/Reading EIP Rubrics ● 2017 - 2018 Mathematics EIP Rubrics ● 2017 - 2018 EIP Guidance ● 2016 - 2017 ELA/Reading EIP Rubrics ● 2016 - 2017 Mathematics EIP Rubrics ● 2016 - 2017 EIP Guidance

Rules

● 160-4-2-.17 EARLY INTERVENTION PROGRAM (EIP)

Additional Resources

● EIP Frequently Asked Questions (FAQs) ● EIP Brochure ● Sample of EIP Parent Letter ● SST Student Questionnaire ● SST Teacher Questionnaire ●

For Teachers:

K-12 Math Tier 1 & 2 Intervention Menu

Tootlkit: REL/ILS

Evidence Based PracticesPrefessional Practices

PBIS

Google Doc with MTSS Meeting INFO

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