Intervention strategies
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- SOCIAL
- FAMILY
- INTERVENTION STRATEGIES
ACADEMICPoor Grades (D’s & F’s) History of Detentions, Low Achievement Test Scores Suspensions, or Expulsions (MAP, TerraNova) Daydreams, Sleeps in Class Low Test Scores or Other Off Task Behavior Marked Change in Academic Performance Gives Up Easily Late or Incomplete Assignments Special Education/Gifted Poor Reading Skills Previous Drop-out Overage for Grade Placement (retained) Classroom Work Reflects Poor Attendance Morbid Themes Tardy to School/Class Other : ___________________ Discipline Problems Comments: PERSONALConsidered or Attempted Suicide Exhibits Immature Behavior Appears Worried, Tense, Unhappy, Frequent Health Complaints Depressed or Apathetic Major Illness or Medical Defiant Attitude, Argumentative Problems Lies Frequently Diagnosed ADD/ADHD Doesn’t Accept Responsibility for Actions Job Working More than 20 Hrs. ______ Expresses Dislike for School Per Week Consistently Negates Self and Others Pregnant or Teen Parent Attention-Seeking Appearance Married Marked Change in Appearance or Affect Victim of Abuse (sexual, verbal, Poor Grooming, Hygiene physical or emotional) _______ Appears to Make Poor Choices Lives Away from Parental Home Suspected Drug/Alcohol Use Other:___________________ Comments: SOCIALPoor Peer Relationships Difficulty with Authority Figures Trouble Making Friends Spends a Lot of Time Alone/ Poor Social Judgment Poor Social Interaction Frequent Disruptive Social Behavior Victim of Prejudice/Harassment Verbal or Physical Aggressive Behavior No Co-curricular Interests Dropped from Sports or Inappropriate Language or Gestures Suspected Sexual Activity Juvenile Office/Law Enforcement Involvement Co-curricular Activities _______ Marked Change in Peer Group/Social Behavior Reacts w/Anger Disproportionate to Situation Other: ____________________ Comments:
Family Unit Legal IssuesDifficulty Contacting Parent DFS Involvement Lack of Parental Involvement at School Custody Issues Non-English Speaking Home Emancipated Minor Multiple Families Living in Home Homeless Health Issues Evidence of Financial Difficulty Major Health Issues in Family Frequent Family/School Moves Death of a Relative or Friend Marked Change in Family Structure Attempted Suicide of a Relative Parents Did Not Complete High School or Friend Other: ____________________ Comments:
Check the box and write the date on the blank line of the intervention strategy(ies) you have used with this student.School Interventions Outside Agency BASE (A+ Tutoring) Beacon School Behavior Management Community Service Org. CATCH Counseling Services Classroom Modifications Div. Of Family Services Dimensions Jasper County Juvenile Div. English as a Second Lang. Law Enforcement Homebound Instruction Ozark Center Individual Testing Satellite School Intelligence Testing Observations Other Peer Tutoring Active Parenting Rainbows Attendance Policy Reading Plus Home Visits Reading Retention Program Parent/Child Library Prog. Retention Review Parent Involvement Prog. Screenings Parent-Teacher Conf. Summer School Parenting for Prevention SUCCESS Team Progress Reports to Parents Teacher Tutoring Staff Briefings Title I/Inclusion
Group Guidance Hot Line Procedures Individual Guidance Intervention Comments: CARL JUNCTION R-1 SCHOOL DISTRICT AT-RISK CHECKLIST & INTERVENTION STRATEGIES (7-12) Student’s Name: ____________________________________Grade: __________________________ Date:______________________________ Person Completing Form:
ACADEMICPoor Grades (D’s & F’s) History of Detentions, Low Achievement Test Scores Suspensions or Expulsions (MAP, TerraNova) Daydreams, Sleeps in Class Low Test Scores or Other Off Task Behavior Marked Change in Academic Performance Gives Up Easily Late or Incomplete Assignments Special Education/Gifted Poor Reading Skills Previous Drop-out Overage for Grade Placement (retained) Classroom Work Reflects Poor Attendance Morbid Themes ____ Tardy to School/Class Other : Discipline Problems Comments: PERSONALConsidered or Attempted Suicide Exhibits Immature Behavior Appears Worried, Tense, Unhappy, Frequent Health Complaints Depressed or Apathetic Major Illness or Medical Defiant Attitude, Argumentative Problems Lies Frequently Diagnosed ADD/ADHD Doesn’t Accept Responsibility for actions Job Working More than 20 Hrs. Expresses Dislike for School Per Week Consistently Negates Self and Others Pregnant or Teen Parent Attention-Seeking Appearance Married Marked Change in Appearance or Affect Victim of Abuse (sexual, verbal, ____ Poor Grooming, Hygiene physical or emotional) Appears to Make Poor Choices Lives Away from Parental Home Suspected Drug/Alcohol Use Other: Comments: SOCIALPoor Peer Relationships Difficulty with Authority Figures Trouble Making Friends Spends a Lot of Time Alone/ Poor Social Judgment Poor Social Interaction Frequent Disruptive Social Behavior Victim of Prejudice/Harassment Verbal or Physical Aggressive Behavior No Co-curricular Interests Inappropriate Language or Gestures Dropped from Sports or Suspected Sexual Activity Co-curricular Activities Juvenile Office/Law Enforcement Involvement Reacts w/Anger Disproportionate Marked Change in Peer Group/Social Behavior to Situation Other:
Comments: FAMILYFamily Unit Legal IssuesDifficulty Contacting Parent DFS Involvement Lack of Parental Involvement at School Custody Issues Non-English Speaking Home Emancipated Minor Multiple Families Living in Home Homeless Health Issues Evidence of Financial Difficulty Major Health Issues in Family Frequent Family/School Moves Death of a Relative or Friend Marked Change in Family Structure Attempted Suicide of a Relative Parents Did Not Complete High School or Friend Other:
Comments: INTERVENTION STRATEGIESCheck the box and write the date on the blank line of the intervention strategy(ies) you have used with this student.School Interventions Guidance 504 Plan Counselor Referrals Assignment Sheets Dropout Contact Attendance Meetings Group Counseling BASE (A+ Tutoring) Hotline Procedures Carl Junction Unlimited Individual Counseling Detention Individual Testing English As a Second Language Gifted/Talented Program Outside Agencies Homebound Instruction Adolescent Treatment Center In-School Suspension Beacon School Inclusion Community Service Org. KIDD Group Counseling Services Parent Contacts Division of Family Services Parent-Teacher Conferences Jasper County Juvenile Div. Parents as Teachers Job Corp Progress Reports Private Counseling Centers Referral to Special Services Satellite School Special Seminars Vocational Rehabilitation Summer School Teacher-Student Conferences Other Interventions: Teacher Tutoring Credit Recovery Vocational Services Late Start Tutoring Intervention Comments: COUNSELING REFERRAL LIST
R  esources & Referrals
Missouri Migrant Education Program 305 E. Cleveland Monett, MO 417/235-6534 Fax 417/235-8094 District: Carl Junction R-1 Head Start: Head Start of Carl Junction 301 South Broadway Carl Junction, MO 64834 417/649-0745 Ext. 2764 District Preschool: Cheryl Costley Early Education Center 301 South Broadway Carl Junction, MO 64834 417/649-5709 Parents As Teachers: Cheryl Costley Early Education Center 301 South Broadway Carl Junction, MO 64834 417/649-5709 GED/ESL Classes: Cyndy Giebler Carl Junction Unlimited 134 South Main Carl Junction, MO 64834 417/649-5731 5:30-8:30 Monday & Tuesday District Contact: Dr. Jim Cummins Assistant Superintendent 206 South Roney Carl Junction, MO 64834 417/649-7026 School Nurses:Carl Junction R-1 Stacey Whitney-K1 South 417/649-0745 Ext. 2108 Martha Tate-K1 North 417/649-5761 Ext. 2226 Sheryl Sterns-Primary 2-3 417/649-7034 Ext.2204 Amberlee Kendrick-Int. 417-649-7011 Ext. 2313 Bridget Price-JH/HS 417-649-7246 Ext. 2504 County: Jasper Public/County Health Dept.: Jasper County Health Dept. 321 East 4th Joplin, MO 64801 417/623-6122 WIC, 417/623-1928 Division of Family Services: Jasper County DFS 601 Commercial Joplin, MO 64801 417/629-3050 Local Clinic: The Community Clinic 701 South Joplin Joplin, MO 64801 417/624-5500 Freeman Maternity Clinic 3401 McIntosh Circle Drive Joplin, MO 64804 417/347-8566 Family Planning Clinic 302 South Joplin Joplin, MO 64801 417/781-4788 Head Start Central Office 1200 North Main Joplin, MO 64801 417/781-4497 Legal Aid: Legal Aid of Western MO 417/782-1650 MISC: National Aids Hotline Immigration Lawyer: 1-800-342-AIDS/English Suzanne Gladney 1-800-344-SIDA/espanol 920 Southwest Blvd. Kansas City, MO 64108 816/474-9868 
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