Intervention Decision Framework

7 min read Psychoeducational Profiles
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Intervention Decision Framework

Cognitive Profile to Intervention Matching

This framework helps educators match student cognitive profiles to evidence-based interventions.

READING DIFFICULTIES

Decision Tree: Reading Struggles

Step 1: Identify the Breakdown Point

Student struggles with reading
         │
         ├─── Can they decode words accurately?
         │         │
         │         ├─── NO → Phonological Processing Issue
         │         │         → Go to: Decoding Interventions
         │         │
         │         └─── YES → Can they read fluently?
         │                       │
         │                       ├─── NO → Fluency Issue
         │                       │         → Go to: Fluency Interventions
         │                       │
         │                       └─── YES → Can they comprehend?
         │                                     │
         │                                     ├─── NO → Comprehension Issue
         │                                     │         → Go to: Comprehension Interventions
         │                                     │
         │                                     └─── YES → May be motivation/engagement
         │                                               → Go to: Engagement Strategies

Decoding Interventions (Phonological Processing Weakness)

Tier 2 Interventions: 1. Wilson Reading System - Structured literacy for grades 2-12 2. Orton-Gillingham Based Programs - Multisensory phonics 3. Fundations - K-3 phonics and spelling 4. SIPPS (Systematic Instruction in Phonological Awareness, Phonics, and Sight Words)

Key Instructional Features: - Explicit, systematic phonics - Multisensory (visual, auditory, kinesthetic, tactile) - Cumulative and sequential - Diagnostic teaching (assess and adjust)

Accommodations While Building Skills: - Text-to-speech for content learning - Audiobooks - Reduced reading load - Extended time

Fluency Interventions (Accuracy OK, Rate/Prosody Weak)

Evidence-Based Approaches: 1. Repeated Reading - Same passage 3-4 times until fluent - Track words per minute progress

  1. Paired Reading
  2. Student reads with fluent partner

  3. Partner provides support as needed

  4. Readers Theater

  5. Rehearsed oral reading with purpose

  6. Builds prosody and expression

  7. Fluency-Oriented Reading Instruction (FORI)

  8. Teacher models, echo reading, partner reading, independent practice

Goal: 50+ correct words per minute by end of 1st grade, increasing ~10-15 wcpm per grade

Comprehension Interventions (Decodes OK, Understanding Weak)

Strategy Instruction (Grades 3+): 1. Reciprocal Teaching - Predicting, questioning, clarifying, summarizing - Gradual release to student-led

  1. QAR (Question-Answer Relationships)
  2. Right There, Think and Search, Author and Me, On My Own

  3. Teaches where to find answers

  4. Graphic Organizers

  5. Story maps for narrative
  6. Main idea webs for informational

  7. Compare/contrast charts

  8. Think-Alouds

  9. Teacher models thinking during reading
  10. Gradually transfer to students

Consider Underlying Issues: - Vocabulary weakness? → Explicit vocabulary instruction - Working memory? → Chunked text, note-taking supports - Background knowledge gaps? → Pre-teaching concepts

MATHEMATICS DIFFICULTIES

Decision Tree: Math Struggles

Student struggles with math
         │
         ├─── Do they understand number concepts?
         │         │
         │         ├─── NO → Number Sense Issue
         │         │         → Go to: Number Sense Interventions
         │         │
         │         └─── YES → Can they perform procedures accurately?
         │                       │
         │                       ├─── NO → Procedural Issue
         │                       │         → Go to: Procedural Interventions
         │                       │
         │                       └─── YES → Can they apply to word problems?
         │                                     │
         │                                     ├─── NO → Problem-Solving Issue
         │                                     │         → Go to: Problem-Solving Interventions
         │                                     │
         │                                     └─── YES → Fluency/Automaticity issue?
         │                                               → Go to: Math Fluency Interventions

Number Sense Interventions (Foundational Weakness)

Evidence-Based Approaches: 1. Quantity Discrimination - "Which is more?" activities - Estimation jars - Number line placement

  1. Subitizing Practice
  2. Quick recognition of small quantities

  3. Dot patterns, finger patterns, dice

  4. Part-Part-Whole Understanding

  5. Decomposing numbers multiple ways
  6. Number bonds, ten frames

Programs: - Number Worlds - Building Blocks - Math Recovery

Key Principle: Use manipulatives extensively before symbols

Procedural/Calculation Interventions

Approach: Concrete-Representational-Abstract (CRA)

  1. Concrete Stage
  2. Physical manipulatives (base-10 blocks, fraction tiles)

  3. Student manipulates objects

  4. Representational Stage

  5. Draw pictures of the manipulatives

  6. Tally marks, circles, bar models

  7. Abstract Stage

  8. Numbers and symbols only
  9. Only move here when representation is solid

For Specific Operations:

Operation Concrete Tools Visual Model
Addition Counters, unifix cubes Number line, part-part-whole
Subtraction Counters, take-away Number line, comparison bars
Multiplication Arrays, groups of objects Area model, repeated groups
Division Equal sharing, arrays Repeated subtraction, area
Fractions Fraction tiles, circles Number line, bar models

Problem-Solving Interventions (Procedures OK, Application Weak)

Schema-Based Instruction: 1. Teach problem types (change, compare, combine, equal groups) 2. Map problems to schemas 3. Use schema to set up equation 4. Solve and check

Attack Strategies: - CUBES: Circle numbers, Underline question, Box key words, Evaluate steps, Solve and check - UPS Check: Understand, Plan, Solve, Check

Visual Supports: - Graphic organizers for problem types - Strip diagrams / bar models - Acting out problems

Math Fluency Interventions (Knows concepts, slow recall)

For Basic Fact Fluency: 1. Explicit Strategy Instruction - Teach derived fact strategies (doubles, doubles plus one, make ten) - Don't just drill - teach thinking strategies

  1. Incremental Rehearsal
  2. Mix known facts with unknowns (8:2 ratio)

  3. Build automaticity gradually

  4. Timed Practice (carefully)

  5. Only after accuracy is established
  6. Student competes against self, not others
  7. Short intervals (1-2 minutes)

Technology Supports: - Reflex Math - Xtra Math - IXL Math (with targeted skill focus)

WRITING DIFFICULTIES

Decision Tree: Writing Struggles

Student struggles with writing
         │
         ├─── Is handwriting legible?
         │         │
         │         ├─── NO → Motor/Visual-Motor Issue
         │         │         → Go to: Handwriting/Keyboarding
         │         │
         │         └─── YES → Can they spell accurately?
         │                       │
         │                       ├─── NO → Spelling/Encoding Issue
         │                       │         → Go to: Spelling Interventions
         │                       │
         │                       └─── YES → Can they compose text?
         │                                     │
         │                                     ├─── NO → Written Expression Issue
         │                                     │         → Go to: Composition Interventions
         │                                     │
         │                                     └─── YES → May be motivation/topic

Handwriting Interventions

For Motor Difficulties: 1. Occupational therapy consultation 2. Explicit letter formation instruction 3. Handwriting Without Tears program 4. Alternative pencil grips

When to Prioritize Keyboarding: - If handwriting significantly impedes written expression - If student age 8+ and handwriting intervention not effective - Teach touch-typing explicitly

Spelling Interventions

Phonetic Spellers (sound it out but wrong): - Structured word study (Words Their Way) - Morphological instruction (prefixes, suffixes, roots) - Systematic spelling patterns

Dysphonetic Spellers (don't hear sounds): - Phonological awareness training - Elkonin boxes (sound boxes) - Multisensory spelling approaches

Written Expression Interventions

Self-Regulated Strategy Development (SRSD): - POW+TREE for opinion writing - POW+WWW for narrative writing - Explicit strategy instruction with mnemonic support

Scaffolding Supports: - Sentence frames and starters - Graphic organizers for planning - Paragraph templates - Dictation as a bridge

ATTENTION AND EXECUTIVE FUNCTION

Decision Tree: Focus/Organization Struggles

Student has attention/organization difficulties
         │
         ├─── Is it primarily sustained attention?
         │         │
         │         ├─── YES → Attention Regulation Strategies
         │         │
         │         └─── NO → Is it working memory?
         │                       │
         │                       ├─── YES → Memory Supports
         │                       │
         │                       └─── NO → Is it organization/planning?
         │                                     │
         │                                     ├─── YES → Executive Function Coaching
         │                                     │
         │                                     └─── NO → May be processing speed

Attention Support Strategies

Environmental: - Preferential seating (near teacher, away from distractions) - Reduce visual clutter - Noise-reducing headphones for focus work - Clearly defined workspace

Instructional: - Chunk work into segments (10-15 min for elementary, 20-25 for secondary) - Movement breaks between segments - Active engagement strategies (whiteboards, discussions, hands-on) - Immediate feedback

Self-Regulation: - Visual timers - Self-monitoring checklists - Goal setting for attention periods - Cue cards for self-redirection

Working Memory Supports

Reduce the Load: - Written (not just verbal) instructions - One step at a time - Checklists and to-do lists - Reference sheets always available

Strengthen Encoding: - Repetition and review - Multisensory input - Meaningful connections - Chunking related information

Executive Function Coaching

Organization: - Teach a specific organizational system - Color-coded materials - Regular binder/backpack checks - Assignment notebook with verification

Planning: - Break long-term assignments into steps - Backward planning from due date - Visual project timelines - Regular check-ins on progress

Time Management: - Estimate time before tasks - Use timers - Reflect on estimates vs. actual - Practice prioritizing

BEHAVIORAL INDICATORS → ROOT CAUSES → INTERVENTIONS

Behavior Observed Possible Root Cause Intervention Approach
Avoids reading aloud Decoding weakness Structured literacy, don't force oral reading
Rushes through work Anxiety, processing speed, impulsivity Teach self-checking, incentivize accuracy
"Forgets" multi-step tasks Working memory weakness Written checklists, one step at a time
Messy, disorganized work Visual-spatial weakness, motor issues Graph paper, templates, organizational systems
Trouble starting tasks Executive function weakness Clear first steps, task initiation prompts
Gives up quickly Frustration tolerance, learned helplessness Break into achievable chunks, celebrate progress
Inconsistent performance Attention, motivation, skill gaps Identify pattern, address root cause
Strong verbal, weak written Writing disability, processing speed Allow oral responses, typing, extended time
Strong written, weak verbal Language processing difference Processing time, written supports
Good one-on-one, struggles in class Attention, processing speed, anxiety Reduce distractions, proximity, check-ins

INTERVENTION INTENSITY GUIDE

Tier 1 (Universal - All Students)

  • High-quality core instruction
  • Differentiated activities
  • Universal screening to identify struggles
  • 80-85% of students succeed with Tier 1 alone

Tier 2 (Targeted - Some Students)

  • Small group instruction (3-6 students)
  • 20-30 minutes, 3-5 times per week
  • In addition to core instruction
  • Evidence-based intervention programs
  • Progress monitoring every 2 weeks
  • 10-15% of students need Tier 2

Tier 3 (Intensive - Few Students)

  • Individual or very small group (1-3)
  • 45-60 minutes daily
  • Highly individualized
  • May be delivered by specialist
  • Progress monitoring weekly
  • 3-5% of students need Tier 3
  • Consider evaluation for special education if not responding

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