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Intensive Intervention Implementation Review Log

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National Center on Intensive Intervention Intensive Intervention Implementation Review Log—1
4651_12/15
Intensive Intervention Implementation Review Log
Purpose: This log can be used by intervention providers or planning teams to review, document, and improve implementation of the
data-based individualization (DBI) process for the group of students they serve. To monitor implementation for an individual student,
see the Student-Level Data-Based Individualization Implementation Checklists and Data-Based Individualization Implementation Log:
Daily and Weekly Intervention Review.
Teacher, Interventionist, or Team: __________________________________________________________________
Date of Review: __________________________________________________________________________________
Instructions: For each question below, please mark the best answer according to the anchors provided. “You” may refer to the person
or team completing the form or to the person assigned the relevant task in each student’s plan. Explanations and other notes may be
recorded at the end of the form. Review your answers and notes to identify a) aspects of implementation that need to be strengthened
and b) strategies or resources to address these needs.
1
The form can be completed as many times as deemed necessary to determine if
implementation improves.
Monitoring Plan Implementation and Students’ Progress
In this section, review the implementation of each student’s current intervention and progress monitoring plan, as well as students’
progress.
Question No Partially Yes
Anchors
1. Did you collect information on the
implementation of all components of each
student’s intensive intervention plan?
☐1 ☐2 ☐3
1 =
No
, not collected for any student.
2 = Collected on some students.
3 = Yes, collected on all students.
1
See the National Center on Intensive Intervention website (http://www.intensiveintervention.org/) for more information on and resources to support DBI
implementation.
National Center on Intensive Intervention Intensive Intervention Implementation Review Log—2
Question No Partially Yes Anchors
2. Did you collect ongoing progress monitoring
data for all students receiving DBI?
☐1 ☐2 ☐3
1 = No, not collected for any student.
2 = Collected on some students.
3 = Yes, collected on all students.
3. Did you collect progress monitoring data at least
weekly, according to each student’s plan?
☐1 ☐2 ☐3
1 = No, not collected.
2 = Collected but not regularly or as frequently as
planned.
3 = Yes, collected regularly according to plan (at least
weekly).
4. Did the data indicate a need for adaptation for
any students?
2
If the answer is “No,” answer “N/A” for the
remaining questions.
☐1 ☐2
☐N/A
1 = No adaptations needed.
2 = Yes, adaptations are needed.
N/A = No new adaptations were needed during this
review period.
Adapting Plans
Complete this section only if the team answered “Yes” to all or nearly all of the questions in the previous section.
Question
No Partially Yes
Anchors
5. Did you identify potential adaptations for
students who needed them?
If the answer is “No,” answer “N/A” for the
remaining questions.
☐1 ☐2 ☐3
☐
N/A
1 =
No
, needed adaptations not yet identified for any
students.
2 = Identified only for some students who need
adaptations.
3 = Yes, identified for all students.
N/A = No new adaptations were needed during this
review period.
2
Consider implementing an adaptation to an academic intervention when the trend line for progress monitoring data is lower than the goal line, or if the four
most recent data points (e.g., four weeks) fall below the student’s goal line. Adaptations may need to occur more frequently for behavior interventions, depending
on the nature of the problem behavior.
National Center on Intensive Intervention Intensive Intervention Implementation Review Log—3
Question No Partially Yes Anchors
6. Did you use the data to identify potential
adaptations?
☐1 ☐2 ☐3
☐
N/A
1 =
No, adaptations were made without using data.
2 = Data use was inconsistent.
3 = Yes, data were consistently used to guide
adaptations.
N/A = No new adaptations were identified during this
review period.
7. Did you implement the intended adaptations?
☐1 ☐2 ☐3
☐N/A
1 = No, identified adaptations were not implemented
for any student.
2 = Identified adaptations were implemented
inconsistently or only for some students.
3 = Yes, identified adaptations were consistently
implemented for all students.
N/A = No new adaptations were identified during this
review period.
Please note any relevant information to explain the above ratings, including information on the appropriateness of the progress
monitoring data (e.g., sensitivity to change) and the quality of implementation of the intervention plan and adaptations.
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Completed 27 April 2021

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