Prescribing the Right Medication

When working with students that are in need of an academic intervention I think as if I were a doctor (of course without the pay)! Patients often ask doctors to screen them for diseases or illnesses. Screening tests are given, a diagnosis is made and then a treatment is prescribed to match the diagnosis. Treatment is give time to work. The doctor observes how well the treatment is working.  If the patient isn’t getting better the doctor may try a different dosage or change the frequency the medication is taken. Maybe the doctor needs to prescribe a different treatment/medication or maybe the illness was miss diagnosed. A doctor continually checks in to see how the progress of treatment is going and makes adjustments when needed.

As educators, we must think the same way! We need to diagnose student skill deficits, prescribe an intervention that targets the skill and continuously monitor to see how the progress of treatment is going.

The following are best practices to take to ensure interventions implemented constitute as an intervention (an implemented intervention plan that will achieve the most student growth).  Also, I have provided an example of a student (Student A) going through the intervention process.

Screening and Diagnoses:

Universal screeners are tools used to identify those at-risk students. Typically, universal screeners are administered to ALL students in the fall, winter and spring.  At times, further assessment is needed to pinpoint the specific skill deficit. Lincoln Street School uses the STAR assessment as their universal screener.

Example: Universal screen is administered and student A is  “flagged” as at-risk in reading fluency.

Prescribing a Treatment:

Once the specific skill deficit has been identified, a Tier II intervention targeting that skill will need to be “prescribed”. It is imperative to match the intervention to the student’s skill deficit. A teacher will need to determine the frequency (how often each week) and duration (length of minutes needed for each lesson) to implement the intervention. Most interventions have protocols to follow to maintain the fidelity. This would include the suggested frequency and duration of the intervention. Prior to implementation, a progress monitoring tool will need to be chosen. Progress monitoring allows an educator to:

– Assess a student’s performance prior to implementation of intervention

– Set end goal and determine expected growth rate

– Monitor student’s responsiveness to the intervention

After the baseline data (rate of performance prior to start of intervention) is collected a goal can be set and an end date chosen. The goal should be based on the expectation or rate of performance for that progress monitoring tool. For example, if using a running record Hasbrouck & Tindal have expected grade level word count per minute for fall, winter and spring.

Example: Student A was identified as needing a fluency intervention. The teacher will implement a Paired Reading Intervention. The intervention will last for 8 weeks (end date of December 29, 2014). The end goal is for the student to be reading 92-120 words per minute based on Hansbrouck & Tindal (winter for 3rd grade). A 1 minute timed running record will be used as the progress monitoring tool. After gathering baseline data, the teacher determined the students is reading 60 words per minute (WPM). Based on the baseline of 60 WPM and the end goal of 92-120 WPM the expected rate of growth is 8 words per 2 week period. The prescribed intervention will occur for 5 days a week for 5 minutes each day.

Observational Wait Time:

The prescribed intervention is given at a set frequency and duration. Frequency is how often the intervention occurs and duration is the number of minutes of intervention. Most researched based intervention have set protocols for duration and frequency. For more severe skill deficits, the intervention should be implemented more frequently.

After 2 weeks (two data points), the data should be reviewed for growth. A teacher needs to look at the data and ask “If the student continues at the current rate of growth will he/she meet the end goal?”

If the answer is no, then some possible adjustments will need to be made.

Further questions will need to be answered:

– Has the intervention been implemented with fidelity?

– Will adjusting the frequency, duration and/or group size increase the rate of growth so the end goal will be met?

– Is the intervention aligned with student’s skill deficit?

– Should a new intervention be implemented to target the same skill?

If the answer is yes, then continue implementing the intervention as designed.

If the answer is no, then the appropriate adjustments need to be made so the answer is then yes!

Example: Student A has completed two weeks of a Paired Reading intervention. The teacher completed a running record and noted the students rate was 70 WPM. The student’s baseline was 60 WPM.  That is a growth rate of 10 words per week (70 WPM – 60 WPM = 10 WPM). If the student continues at this rate for the 8 week intervention the end goal of 92-120 WPM will be achieved.

Continuous Check-Ins and Ending of Treatment:

Over the course of the implemented intervention bi-weekly progress monitoring occurs. This data will be used to note growth over time and to identify if adjustments need to be made to the intervention (frequency, duration, group size, etc). If the student makes adequate growth (as determined after each data point) over the course of the implemented intervention, then the student should meet the end goal. If the goal is met prior to the end date, then the intervention can be stopped. The student will need to be watched for any future concerns.

 

This educational “treatment” contains best practices/protocols when implementing an intervention. As stated in a prior post, RTI frameworks vary depending on the state, district and school. Therefore, some RTI frameworks may contain some differences, but in the end each plan must include:

– A universal screener

– An intervention with protocols

– Progress monitoring with end goal

Below is a completed intervention write-up for Student A. This detailed plan is not something that is necessarily needed to be completed on students receiving an intervention. It is meant to be used as a tool to better understand the process and best practices for implementing an intervention(an intervention so it constitutes as an intervention).

Intervention Plan

 

 

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