Example Intervention Log.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	V
1	Year	Teacher	Child's Goal	RtI Tier (1, 2, 3)	Intervention/Enrichment Focus	Specific Resource(s) Used	Progress Monitoring Tool & Frequency	Dates of Intervention	Fidelity	Attendance >5/Tri			Behavior >2 Majors/Tri			Medications			Check In/Check Out			Comments
2	Year	Teacher	Child's Goal	RtI Tier (1, 2, 3)	Intervention/Enrichment Focus	Specific Resource(s) Used	Progress Monitoring Tool & Frequency	Dates of Intervention	Fidelity	Tri 1	Tri2	Tri 3	Tri 1	Tri2	Tri 3	Tri 1	Tri2	Tri 3	Tri 1	Tri2	Tri 3	Comments

3	EXAMPLE 2015-16	EXAMPLE Mrs. Smith	Increase Benchmark by 3 levels by 2nd trimester	1	Comprehension	Story Map	AIMSweb MAZE 2x/week	11/22-2/15	95%				X			X (start)	X (changed)	X (end)	Mrs. Anderson			Loves to read about dinosaurs. Participation improves with frontloading.
4	2017-18	Banana/Kiwi	Name all consonant and short and long vowel sounds in isolation and use sound blending skills to decode 3 and 4 letter words with 95% accuracy on bi-weekly reading assessments	2	Phonics	Zoo Phonics	DIBELS NWF 1x/week	10/2/17 - 10/27/17	95%
5	2017-18	Banana/Kiwi	Decode 2 syllable words in isolation and in text, with 95% accuracy	3	Phonics	Sound Partners	DIBELS NWF 2x/week	11/6/17 - 12/6/17	90%
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100