 Complete an Intervention Plan for each identified area of concern
Tier II
SAT Intervention Plan for Academics
Complete one SAT Intervention Plan for Academics for each area of academic concern.
Student:
Date of Plan
Initial
Reasons for referral:
Academic
Follow Up
Medical/Health
Behavior
NM Standards & Benchmarks Area:
Grade:
Percentage of skills mastered within grade expectancy:
Performance is:
above expectancy
within expectancy
below expectancy
A. FACTORS
Has attendance been a negative factor?
*Yes
Has parent been contacted regarding attendance?
No
Yes
No
Date of contact:
Has opportunity for appropriate instruction been a factor?
Has language proficiency been a factor?
*Yes
*Yes
No
No
*If identified as factor(s), must address through support plan prior to proceeding to Tier III.
Curriculum/instruction are based on peer-reviewed research:
Yes
No
Current curriculum of instruction: _______________________________
Principal
Confirmation:
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 Complete an Intervention Plan for each identified area of concern
B. ACADEMIC INTERVENTION PLAN
Baseline Data:
(Include program/instructional strategies, time, grouping, progress monitoring tool for
determining baseline and progress monitoring data)
Target Goal(s): (Including specific skills in measurable terms)
Progress Monitoring: How often will progress monitoring data be collected and graphed or
charted? By whom? What measure will be used?
Intervention Focus
Support Strategies
Program Emphasis
supplement core with re-teaching or
intervention component of core
replace current core program with
intervention program
other:
Intervention Focus
Support Strategies
Time (Opportunity
to Learn)
Person(s)
Responsible
Timeline
Person(s)
Responsible
Timeline
Person(s)
Responsible
Timeline
add supplemental instruction period
(specify time(s)/week)
other:
Intervention Focus
Support Strategies
Grouping for
Instruction
reduce group size down to 3 or fewer
students
provide individualized instruction
other:
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 Complete an Intervention Plan for each identified area of concern
C: PROGRESS MONITORING
Date of Progress
Monitoring
Progress Monitoring
Tool
Results
The SAT will meet again on _________/_________/_________ to review this plan
Status: Mastered, Progressing, Revised, Discontinued
*General Guidance:
If the student has 4 or more progress monitoring data points showing improvement, maintain the
intervention program.
If the student has 4 or more progress monitoring data points showing NO or minimal improvement,
change the intensity of the program (notify the parent of the intervention change). Data points are
determined through weekly progress monitoring. See Levels of Intensity Matrix.
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