TPBI2 team intervention plan.pdf
TPBI2 Team Intervention Plan
Child’s name:
Birth date:
Age:
Person determining intervention plan:
Date:
Relationship or role:
Projected month of reevaluation follow-up:
Contact person:
Phone:
Directions: Select the TPBA2 Domain Outcomes column OR the OSEP Global Outcomes column. Prioritize as a team (1, 2, 3, 4) one or more outcomes below based on their importance for the child in home and community (H/C) and school and/or child care (S/CC) settings. The priorities may be the same or different, depending on the child’s needs in each environment.
| TPBA2 Domain Global Outcomes | OSEP Child Outcomes | ||||||
|---|---|---|---|---|---|---|---|
| H/C | S/CC | H/C | S/CC | ||||
| Ability to move independently and effectively and to regulate and use sensory input for learning(Sensorimotor Development) | Positive social-emotional skills | ||||||
| Ability to effectively relate to others and control emotions and behavior(Emotional and Social Development) | Acquisition and use of knowledge and skills | ||||||
| Ability to understand and use verbal and nonverbal communication(Communication Development) | Appropriate behaviors to meet needs | ||||||
| Ability to understand ideas, solve problems, and learn(Cognitive Development) |
| The priority subcategories selected for intervention: | Rating | Age level |
|---|---|---|
For each of the subcategories identified above, the team should write a functional intervention target (IT) to address in intervention. The IT should include what functional skill or process the child will be able to do in daily activities and the context in which this will occur. Indicate whether the IT is for home and/or school (e.g., “Home and school: Maria will be able to feed herself nonslippery food with an adaptive spoon without adult assistance and manage to get 75% of the food into her mouth during each snack or meal”).
Team Intervention Plan TPBI
Functional ITs:
A. How home and community services will be provided:
By whom:
Frequency/intensity/duration:
Role of intervention facilitator(s):
Role of family members:
B. How school and child care services will be provided:
By whom:
Frequency/intensity/duration:
Role of intervention facilitator(s):
Role of educators/caregivers: