Trailblazer
Elementary School
ACT Referral Procedure
(Advocates for Children of Trailblazer)
1.1. Obtain
an ACT referral form located in the office.
At the beginning of the year,
wait at least two weeks before referring a student.
When a new student enrolls
during the year, allow at least a two week adjustment
period before referring if you
have concerns. Please be sure that you contact the
parent in person or by phone to
discuss concerns
before beginning this process.
The procedure for the referral is as follows:
- a.
a.Complete the
ACT Referral Form, front side only. The Action Plan on the back
of the form will be completed
during the meeting. Include information from any staff member who is
in contact with the child.
- b. Return the completed form
to the ACT team Manager.
- c. The ACT team will review
data and prepare for the intervention meeting.
- d. Involved parties will be
notified of the time and date for the child’s intervention meeting.
Meetings will begin at _______on ______________.
The classroom teacher will be
responsible for notifying the parents of the ACT
meeting time and date.
2. All involved parties will
attend the ACT intervention meeting where an Action
Plan will be written. The
following may be discussed at the ACT meeting:
-
a.Behaviors of
concern
-
b.The extent
to which patterns have emerged
-
c.Alternative
hypotheses based on areas of expertise
-
d.Strengths/weaknesses
of student
-
e.Need for
assessment-formal or informal
-
f.Supports
available within the school community
-
g.Possibilities
for outside assistance
-
h.Next steps
-
i.Parties
responsible for follow-through
-
j.Timeline for
intervention strategies
k.
3. A follow-up date will be
tentatively scheduled at that time. Teachers always have the
option to schedule follow-up
intervention sessions as needed:
-
a.To determine
if new steps are necessary.
-
b.If
additional problems are identified.
c.
4. The ACT team Manager will
then complete the follow-up and place paperwork in the
child’s cumulative folder.
5. If NO follow-up meeting is
necessary, contact the ACT manager before the next
scheduled meeting.
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