School Psychology
Training Program
Practicum
Handbook
2012-2013
Donald L. Stovall, Psy.D. & Todd A. Savage, Ph.D., NCSP
University-Based Practicum Supervisors
2012-2013 UWRF School Psychology Practicum Handbook Page 1
Summer 2012
Greetings and welcome to your practicum year! As you are aware, SPSY 771 & 772:
Comprehensive School Psychology Practice (Practica I & II) serve as the vehicles for
you to begin to synthesize and integrate the knowledge related to the field you have
constructed through your coursework, as well as opportunities for you to apply your
knowledge in real-world settings under the supervision of seasoned, practicing school
psychologists. You may be experiencing a number of feelings as you enter the practica
experiences: excitement, anxiety, eagerness, urgency, fear, etc. These feelings are
normative and it is important for you to pay attention to them and to manage and channel
them to your benefit as you prepare to take on the role of the school psychologist during
your internship. Be aware, too, you will be receiving much support and guidance from
several experienced sources, including your field-based and university-based supervisors,
throughout your practicum. We invite you to rely on your supervisors and to take
advantage of their expertise as you develop your skills and abilities this year.
In conjunction with your practicum syllabus, this handbook provides much information
and many tools you will need to navigate your practicum experience. Please, keep it
handy and consult it as necessary throughout the practicum year. Your ability to meet the
requirements contained herein will be critical not only in terms of your own academic
and professional development, but in your matriculation to the internship experience in
the very near future, as well. The requirements are designed in accordance with NASP
and other federal and state training standards and successful completion of them will
stand you in good stead in the coming years.
We extend many good wishes to you as you embark on your practica. Do not hesitate to
contact us as indicated below should you have questions or needs for clarification.
Sincerely,
Donald L. Stovall, Psy.D.
University-based Faculty Practicum Supervisor
Office: (715) 425-3291
Fax: (715) 425-3242
E-mail: [email protected]
Todd A. Savage, Ph.D., NCSP
University-based Faculty Practicum Supervisor
Office: (715) 425-3243
Fax: (715) 425-3242
E-mail: [email protected]
2012-2013 UWRF School Psychology Practicum Handbook Page 2
TABLE OF CONTENTS
The Practicum Experience 3
Practicum Requirements 5
Practicum Calendar 10
Liability Insurance Requirement 11
Grading 12
Appendices
Appendix A: Practicum Case Documentation Forms 13
Appendix B: Practicum Activities Hours Log 19
Appendix C: Practicum Field-based Supervision Log 22
Appendix D: Performance-based Rubric (Teaming & Collaboration) 24
Appendix E: Performance-based Rubric (Group Counseling) 27
Appendix F: Performance-based Rubric (In-service) 30
Appendix G: In-service Participant Evaluation Form 33
Appendix H: Practicum Field-based Supervisor Evaluation Form 35
Appendix I: Guidelines for Summary and Reflection Activities 40
Appendix J: Field-Based Supervisor Interview 42
Appendix K: In-Class Case Presentation Format 44
Appendix L: Assignment Criteria for Grading: Book Review & Critique 47
Appendix M: Diversity Values and Dispositions Evaluation 49
Appendix N: Professional Work Characteristics Form 54
Appendix O: Intervention Case Study Example: Kara 57
Appendix P: Intervention Integrity Rating Form 66
Appendix Q: Intervention Case Study Appraisal Rubric 71
Appendix R: Readiness for Internship Form 73
2012-2013 UWRF School Psychology Practicum Handbook Page 3
UWRF SCHOOL PSYCHOLOGY TRAINING PROGRAM
THE PRACTICUM EXPERIENCE (2012-2013)
The Comprehensive School Psychology Practice Practicum I (SPSY 771) and Practicum
II (SPSY 772) courses are designed to provide candidates with their first opportunities for
intensive supervised, field-based experiences. The overarching philosophy undergirding
this practicum experience is candidates will have access to varied experiences through the
delivery of a comprehensive range of services with diverse student, family, and
professional populations. Through the practica experiences, school psychology
candidates will complete and document a minimum of 600 clock hours spent in
practicum activities, which translates to approximately 20 hours per week over the course
of an entire academic year. That is, practicum candidates are expected to engage in
practicum experiences until at least the end of the UWRF spring semester, as cooperating
districts are operating under this understanding. So, regardless of when candidates accrue
600 practicum hours, be it February or April of the practicum year, they are expected to
continue accruing practicum hours at their assigned practicum sites, again, until at least
the end of the UWRF spring semester of the practicum year. Given the intensive time
demands and commitment that practicum requires during the 3rd
year of training,
candidates must reduce any other full-time work responsibilities during this time (e.g.,
sabbatical, job share, time reduction). Practicum-related expectations and other
coursework during the 3rd
year often involve a time commitment similar to a full-time
work experience.
Third-year practicum experiences are supervised by both a university-based school
psychology faculty member and a field-based, licensed school psychologist. Numerous
public school practicum sites are located throughout western Wisconsin, eastern
Minnesota, south-central Minnesota, and the Minneapolis-St. Paul metroplex, all within
commuting distance to the university. Given the guiding philosophy for the practicum
experience outlined in the paragraph above, each candidate will be assigned to at least
two different practicum settings during the practicum year. It is the belief of the school
psychology faculty that being exposed to at least two different sites allows the practicum
candidate the opportunity to experience how different districts, schools, and supervisors
function and approach the education process. Through the assignment of at least two
practicum settings, program candidates should be exposed to a comprehensive range of
service delivery opportunities. Although practicum candidates may express a preference
for practicum placements, the school psychology faculty is ultimately responsible for
making practicum placements. A critical concern for a practicum placement is that a
comprehensive range of school psychology service delivery opportunities is made
available to the candidate and that she or he is able to gain experience in serving a diverse
population (defined broadly). Additionally, faculty members also consider the strengths
and areas of growth practicum candidates demonstrate in terms of their emerging
professional identities and skills; such consideration assists faculty members in ensuring
a fit between practicum candidates, districts, and field-based supervisors. In the event it is
determined a particular placement is not meeting the specific needs of the candidate, it is
possible the faculty, in tandem with the appropriate cooperating professionals, will re-
assign the candidate to another supervisor or practicum setting.
2012-2013 UWRF School Psychology Practicum Handbook Page 4
It is critical for candidates to understand that an application must be made for admittance
to practicum. It is by no means a guaranteed experience to all who are admitted to the
UW-RF school psychology program. Candidate professional work characteristics are
evaluated by university faculty to determine readiness for the practicum (see Appendix G
in this handbook). In the event that the majority of faculty members rate a candidate as
not a good nominee for the practicum experience, the candidate will be denied a
practicum placement. A professional growth plan can be developed (see Appendix Y of
the UWRF school psychology program student handbook) that identifies steps to correct
concerns to be addressed prior to practicum placement or the candidate may be advised to
discontinue the school psychology program altogether. Practicum assignments are made
by the university-based practicum supervisor(s). Candidate preferences for a location are
considered, but the ultimate placement is made by the university-based practicum
supervisor(s). The following details outline additional practicum placement procedures:
(1) The school psychology candidate must demonstrate evidence of academic
competence to be admitted to practicum. This evidence shall consist of
submission of a current university transcript at the time of practicum
application, documenting a cumulative grade point average of no less than 3.0,
and achievement of the Master of Science in Education (M.S.E.) degree.
(2) The school psychology candidate must demonstrate evidence of having
acceptable professional characteristics and interpersonal skills to be admitted
to practicum. This evidence shall consist of submission of Professional Work
Characteristics Appraisal Forms from appropriate faculty members (including
all school psychology faculty members) at the time of practicum application
(see Appendix K in the UWRF school psychology program student
handbook). Advisor review of portfolio progress, using the portfolio rating
rubric (see Appendix U in this handbook) will also be considered when
assessing candidate readiness for practicum.
Practicum-application procedures will be reviewed and materials distributed in the spring
semester of each year. Applications for practicum will be processed by the end of the
semester and placements for the following year will be announced near the end of spring
semester, or in some cases, the beginning of summer session. Candidates who do not
have the necessary prerequisites for practicum will not be permitted to engage in the
supervised field experience. Additionally, all candidates must purchase and maintain
enrollment as a NASP student member and in the Forrest T. Jones professional liability
insurance plan as required by the UWRF school psychology program throughout their
entire tenure in the program. Failure to purchase and maintain NASP student
membership and/or the Forrest T. Jones professional liability insurance will result in
the candidate being either prevented from entering the practicum experience or
dropped from the practicum experience.
Once the candidate has been approved to engage in the practicum sequence, she or he
must fulfill the specific practicum requirements outlined in the section that follows.
2012-2013 UWRF School Psychology Practicum Handbook Page 5
PLEASE, NOTE: Many school districts require an additional criminal background check
prior to the practicum placement. The school psychology faculty may approve and place
candidates at practicum sites, but the site always has the option not to approve a
candidate for placement based on the outcome of the background check.
Once the candidate has been approved to engage in the practicum sequence, she or he
must fulfill the specific practicum requirements outlined in the section that follows.
SUMMARY OF UWRF SCHOOL PSYCHOLOGY PROGRAM
PRACTICUM REQUIREMENTS
I. Hours. Each practicum candidate will engage in the practicum portion of the
program for a minimum of 600 hours distributed evenly across one academic
year; of these 600 hours, at least 300 must be spent in direct service with
clients. Observation of general and special education classrooms at both the
elementary and secondary levels should be conducted as part of these hours
and portions of the practicum experience must be devoted to working with
students in each of the following age-level groupings: pre-kindergarten,
elementary, and secondary. Please, note practicum requirements may not be
completed during summer break months. The practicum must be completed
within one year, except under extraordinary circumstances and at the
discretion of the university-based practicum supervisor. Practicum hours also
include the DIBELS screenings required of the practicum candidate three
times during the year in the River Falls School District. More information in
regard to the DIBELS expectations will be provided at the outset of the fall
semester. Regardless, the hours must be documented in the logs provided in
the practicum handbook, which is available online, and signed by the field-
based supervisors before submission to the university supervisor.
II. Cases. The practicum candidate must complete a minimum of 20 individual
student cases during the practicum experience. These cases may include the
following: (1) development of interventions that involve academic needs,
social needs, behavioral needs, or cognitive needs, (2) design, implementation,
and evaluation of interventions for students in general and special education
placements; (3) collaborative design, implementation, and evaluation of
consultations with families, teachers, or other professionals (4) direct service
through individual counseling or through the facilitation of student support
groups; (5) indirect service through some type of consultation delivery model;
(6) involvement in program planning and development; (7) participation in
research and data collection; (8) participation in the data-based decision-
making process, with emphasis on strategies for positive growth and change.
Of these 20 cases, a minimum of five (5) cases must be completed within each
of the following age designations: (a) infancy through age 5 years, 11 months;
(b) students aged 6-12 years; and (c) students aged 13 years and above;
additionally, at least five (5) cases must be based on a consultation process
2012-2013 UWRF School Psychology Practicum Handbook Page 6
employed to address issues raised by teachers or families related to a child.
All cases should be based on students demonstrating a variety of exceptional
needs (including giftedness) or issues to be addressed in both general and
special education settings. Documentation, through case study or other means,
of work with students from diverse cultural or linguistic backgrounds (i.e.,
English-language learners) is also required. Documentation of the completion
of these cases will occur through the signing of the Case Documentation
forms available in the practicum handbook by the field-based supervisor.
Finally, each candidate is required to complete two systematic intervention
case studies (single subject design; one student each semester) during the
practicum year (one during the fall semester and one during the spring
semester) based on the Intervention Case Study rubric (see the practicum
handbook for these forms) that includes four sections: 1) problem
identification, 2) problem analysis, 3) intervention, 4) evaluation. These cases
studies will be culled from the pool of 20 cases outlined above and they must
be based on students from diverse backgrounds. The candidate must also
complete an Intervention Integrity Rating form (See the practicum handbook
handbook) for each of these cases, as well. An example of a well-written
intervention case-study write-up can be found in both the School Psychology
Student Handbook and the practicum handbook, both of which can be found
on line. *NOTE: These case intervention studies may serve as an artifact
in the programmatic portfolio to meet the following NASP domains: 1, 2,
3, 4, 5, 6, 7, and 8.
III. Case parameters: The assignment of cases is made by the field-based
supervisor, who should ensure the proper permission to assess/observe/work
with a student has been procured from the appropriate family member or legal
guardian. Throughout the process, it is the ethical responsibility of each
practicum candidate to present she or he as being a school psychologist in-
training, ensuring she or he informs families, legal guardians, school
personnel, the students with whom she or he is working, and other affiliated
persons of such a designation. All formal reports the candidate creates must be
reviewed, approved, and co-signed by the field-based supervisor.
Each student evaluated by the practicum candidate should be observed in
various settings as part of the data-based decision-making process. School
psychology practicum candidates should confirm proper permission has been
obtained to assess a student. Furthermore, the practicum candidate should
interview the appropriate persons attached to the case, including teachers,
families, and other educational or community-based professionals as a part of
the data-based decision-making process. Also, as a part of the data-based
decision-making process, the candidate student should participate actively in
multidisciplinary staffings, to share results and recommendations with
teachers, families, and other specialists. In cases where individual follow-up
conferences (e.g., with families) are needed, the practicum candidate, in
2012-2013 UWRF School Psychology Practicum Handbook Page 7
conjunction with her or his field-based supervisor, should insure that such
conferences are scheduled and executed in a timely fashion.
IV. In-service presentation: The practicum candidate must prepare and participate
in at least one in-service presentation most likely during the spring semester
portion of the practicum experience, though it could be accomplished in the
fall semester, should the opportunity present itself. Both the field-based and
university-based supervisors should approve the topic of the in-service. This
presentation may be either an individual effort by the practicum candidate or a
portion of a larger presentation made in conjunction with other professionals.
The presentation must include a formal assessment or evaluation piece
completed by the session participants. The candidate must then write a 3-5
page reflection piece that summarizes the session, overall, the candidate’s
perceived strengths and areas of growth related to the presentation, in
particular, and the evaluations completed by the session participants. The
candidate should also outline how she or he intends to address their areas of
growth in this domain.
V. Group experience. The practicum candidate must organize and conduct a
minimum of one student or family group during the practicum year that meets
regularly for a specified period of time. Co-facilitation of a group with an
experienced staff member is preferred for candidates with no previous
experience in conducting group counseling or family education sessions.
Outcomes data must be collected and reported as a part of this process.
VI. Legal/ethical issue case summary: Each semester, the practicum candidate
must write and submit one case summary and reflection piece that addresses a
legal or ethical issue encountered during the practicum experience. Parameters
for this case study are provided the practicum handbook, which is available
online.
VII. Crisis prevention/intervention activities summary. Each semester, the
practicum candidate must write and submit documentation of participation in
some type of crisis prevention/intervention activity that occurred during the
practicum experience. Such activities could include reviewing the
school’s/district’s crisis prevention/intervention manual, participating on a
crisis prevention/intervention team, assisting in the implementation of a bully-
proofing program, etc. Parameters for this activities summary are provided in
the practicum handbook, which is available online.
VIII. RtI activities summary. Each semester, the practicum candidate must write and
submit documentation of participation in some type of RtI process or related
activity that occurred during the practicum experience. Such activities could
include participating in the school- or district-wide RtI process, attending
workshops or other professional development offerings related to RtI, etc.
2012-2013 UWRF School Psychology Practicum Handbook Page 8
Parameters for this activities summary are provided in the practicum
handbook, which is available online.
IX. Field-based face-to-face supervision. Each practicum candidate will meet
individually on a weekly basis with his or her field-based supervisor for a
minimum of one (1) hour of face-to-face supervision related to all practicum
activities. These hours must be documented in the appropriate log contained in
the practicum handbook and which need to be signed by the field-based
supervisor.
X. University-based face-to-face supervision. During the fall semester, each
practicum candidate will meet individually with his or her university-based
supervisor on a once per month basis for ½ hour of face-to-face supervision of
all practicum activities.
XI. Group seminars. Throughout the practicum year, each candidate will
participate in two regularly-scheduled university-based group seminars per
month for group supervision and content delivery.
XII. Two field-based supervisor assessments. It is the responsibility of each
practicum candidate to make all necessary arrangements for the field-based
supervisor to assess two (2) total (1 per semester) multidisciplinary meetings,
in-service presentations, or group sessions conducted by the practicum
candidate. The field-based supervisor will rate the candidate’s performance
according to the appropriate performance-based rubric available in the both
the UWRF School Psychology Student Handbook and the practicum
handbook, both of which are available online. These formal assessments are
above and beyond the expected, ongoing supervision activities between the
candidate and her or his field-based supervisor. *NOTE: A field-based
supervisor assessment pertaining to an activity in which parents are
involved may be used as an artifact in the programmatic portfolio under
NASP domain #7.
XIII. Four university-based supervisor assessments. It is the responsibility of each
practicum candidate to make all necessary arrangements for the university-
based supervisor to assess four (4) total (2 per semester), including two (2)
multidisciplinary meetings, one (1) in-service presentations, and one (1) group
session conducted by the practicum candidate. The university-based
supervisor will rate the candidate’s performance during the observation
according to the appropriate performance-based rubric contained in the
UWRF School Psychology Student Handbook and the practicum handbook,
both of which are available online. *NOTE: A university-based supervisor
assessment pertaining to an activity in which parents are involved may be
used as an artifact in the programmatic portfolio under NASP domain #7.
2012-2013 UWRF School Psychology Practicum Handbook Page 9
XIV. Field-based supervisor evaluations. The field-based supervisor will complete
an evaluation of the practicum candidate’s performance at mid-term and at the
end of the semester; the evaluation form is contained in both the UWRF
School Psychology Student Handbook and the practicum handbook. Thus, by
the end of the practicum experience, candidates will have a total of four (4)
evaluations completed by field-based supervisors (2 mid-term evaluations, 2
end-of-the-semester evaluations). These evaluations will be reviewed and
discussed with each candidate by both the field and university-based
supervisors through an informing conference, which could take place over the
phone. *NOTE: The summative (i.e., final) field-based supervisor
evaluation from SPSY 772 (i.e., spring 2013) is a necessary artifact to be
included in the programmatic portfolio to meet the following NASP
domains: 1, 2, 3, 4, 5, 6, and 10.
XV. Documentation logs. The practicum candidate will maintain monthly logs of
hours (see Appendix B in the practicum handbook) that document the range of
activities and services in which the candidate engages, in addition to the
specific number of hours engaged in individual activities and the total number
of hours engaged in all practicum-related activities. This log will be submitted
to the university-based supervisor once per week for review. Candidates are
expected to achieve a minimum level of 20 hours per week devoted to
practicum that includes an average of 1 hour per week of face-to-face
supervision with the field-based supervisor.
XVI. Book reviews: Each semester, the candidate must write and submit a book
review and critique based on texts selected by the university-based faculty
supervisors. Parameters for these book reviews are outlined in the practicum
syllabus as well as in Appendix L of the practicum handbook, which is
available online.
XVII. Annual programmatic self-assessments. At the end of the spring semester, the
candidate must complete and submit the annual programmatic self-assessment
measures, including the Diversity Values and Dispositions self-rating form
(see the UWRF School Psychology Student Handbook and the practicum
handbook for these forms). Candidates must also have their field-based
supervisors complete the Professional Work Characteristics Form (see the
UWRF School Psychology Student Handbook and the practicum handbook
for this form) and include the completed forms in the Programmatic Portfolio
each semester. *NOTE: The Professional Work Characteristics forms
completed by the field-based supervisor at the end of SPSY 772 (i.e.,
spring 2013) can be included as an artifact in the programmatic portfolio
under NASP domains #7 and #10.
XVIII. Programmatic portfolio. At the end of each semester of practicum, the
candidate must submit an updated programmatic portfolio that includes
reflections and artifacts in each of two sections: NASP domains and the WI
2012-2013 UWRF School Psychology Practicum Handbook Page 10
DPI Pupil Services area. Guidelines for this portfolio are contained in the
UWRF School Psychology Student Handbook, which is available online.
XIX. Ethical obligations. Each practicum candidate is expected to engage in all
practicum activities in strict accordance with the ethical principles established
by the National Association of School Psychologists and the American
Psychological Association. The 2010 NASP ethical standards can be found at
<http://nasponline.org/standards/2010standards/1_%20Ethical%20Principles.
pdf >.
XX. Miscellaneous. If needed, the university-based supervisor will meet with the
field-based supervisor and practicum candidate at times other than those
regularly-scheduled meetings to discuss the practicum placement or other
issues of concern.
XXI. Field-Based Supervisor Interview. During the fall semester, the candidate will
conduct an interview with one of her or his field-based supervisors regarding
the cooperating school district based on the interview protocol provided in the
practicum handbook. The candidate will be expected to present the results of
the interview in the practicum seminar as assigned. The parameters for this
interview can be found in the practicum handbook.
XXII. Case Presentations. Several times throughout the year, the candidate will
conduct case presentations during seminar based on actual cases from the field
and according to the case presentation guidelines found in the practicum
handbook.
XXIII. Readiness for Internship. By the time the candidate reaches the final eight
weeks of the SPSY 772 practicum experience, she or he must submit
completed Readiness for Internship forms (see either the UWRF School
Psychology Student Handbook or the practicum handbook for this form) from
two field-based practicum supervisors and her or his university-based
practicum supervisor. These forms will be reviewed by the school psychology
program faculty in tandem with the other myriad practicum data to determine
whether the candidate may matriculate to the required internship experience.
PRACTICUM CALENDAR
Due to the nature of the calendars established by the various cooperating public school
districts, the practicum candidate should expect to begin their practicum experience prior
to the beginning of the UWRF fall semester. The candidate may also be expected to
return to their practicum sites in January prior to the beginning of the spring semester.
Finally, cooperating districts and field-based supervisors expect the practicum candidate
to finish out the experience on a date that coincides with the end of their academic year,
which, in most cases, will extend 1-3 weeks beyond the end of the UWRF spring
semester. As such, practicum candidates with receive an “I” grade for SPSY 772 that will
2012-2013 UWRF School Psychology Practicum Handbook Page 11
be converted to the appropriate letter grade once candidates have completed their hours
and submitted documentation of such to their university-based supervisor.
LIABILITY INSURANCE REQUIREMENT
As part of the candidate’s entire tenure in the UWRF school psychology program, she or
he must obtain professional liability insurance for school psychologists in-training.
Having such insurance is necessary before the student can participate in the required
practica experiences. Liability insurance through the Forrest T. Jones company is the
required coverage by the UWRF school psychology program and it is available at a
discounted rate through the National Association of School Psychologists, which requires
one to be a member of the professional organization in order to take advantage of the
insurance benefit. Information about NASP membership is available at the NASP
Website (www.nasponline.org) while information about the liability insurance program is
available at the Forrest T. Jones Website (www.ftj.com). Failure to purchase and
maintain NASP student membership and the Forrest T. Jones professional liability
insurance will result in the candidate being either prevented from entering the
practicum experience or dropped from the practicum experience.
2012-2013 UWRF School Psychology Practicum Handbook Page 12
GRADING
The following rubric will be used in determining candidates’ practicum grade at the end of each semester:
Category 4 3 2 1 Level
Professional Work
Characteristics
Routinely
demonstrated
professionalism, including, but not
limited to:
organization, dress, punctuality,
dedication, ability to
accept feedback and other interpersonal
skills (e.g., patience,
respect).
Often demonstrated
professionalism
including, but not limited to:
organization, dress,
punctuality, dedication, ability to
accept feedback and
other interpersonal skills (e.g., patience,
respect).
Sometimes
demonstrated
professionalism including, but not
limited to:
organization, dress, punctuality,
dedication, ability to
accept feedback and other interpersonal
skills (e.g., patience,
respect).
Rarely demonstrated
professionalism
including, but not limited to:
organization, dress,
punctuality, dedication, ability to
accept feedback and
other interpersonal skills (e.g., patience,
respect).
Timely and proper
completion of NASP
and UWRF program
requirements
ALL requirements
were submitted by
the due dates in the syllabus. This
includes timely
submission of course packets and
materials to the
instructors
Some, but not all,
requirements were
submitted by the due dates in the syllabus.
Candidate struggled
to complete
requirements by the due dates in the
syllabus.
Field Supervisor
Evaluations
Routinely evaluated as excellent or a well-
above average
practicum candidate in terms of knowledge
and performance
competency.
Typically evaluated as a solid or
developing practicum
candidate in terms of knowledge and
performance
competency.
Typically evaluated as a practicum
candidate of average
or adequate knowledge and
performance
competency.
Typically evaluated as a below-average or
struggling practicum
candidate in terms of knowledge and
performance
competency.
Book review &
critique
>90 points earned on
the book review and
critique according to the book review
scoring rubric
80-89 points earned
on the book review
and critique according to the book
review scoring rubric
70-79 points earned
on the book review
and critique according to the
book review scoring
rubric
< 69 points earned on
the book review and
critique according to the book review
scoring rubric
Course portfolio
>90 points earned on
the course portfolio
according to the portfolio scoring
rubric.
80-89 points earned
on the course
portfolio according to the portfolio scoring
rubric.
70-79 points earned
on the course
portfolio according to the portfolio
scoring rubric.
< 69 points earned on
the course portfolio
according to the portfolio scoring
rubric.
TOTAL
Grading Rubric Total Guide:
>17 = A; 15-16 = B; 13-14 = C; 11-12 = D; < 10 = F
2012-2013 UWRF School Psychology Practicum Handbook Page 13
Appendix A
2012-2013 UWRF School Psychology Practicum Handbook Page 14
UWRF School Psychology Training Program Practicum Case Documentation Forms
UWRF Practicum Case Requirements
Case # Case
Type*
Early
Childhood
(n = 5)
Elementary
(n = 5)
Secondary
(n = 5)
Consultation
(n = 5)
Field-based
Supervisor’s
Initials &
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
*Key: A = assessment (e.g., cognitive, academic, personality)
ACI = academic intervention
BI = behavior intervention (e.g., development of behavior intervention plan)
IC = individual counseling
GC = group counseling
CC = consultation/collaboration
RP = research or program evaluation
Documentation of In-service Presentation
Date of
In-service
Presentation
Title of In-Service Presentation Field-based
Supervisor’s
Signature &
Date
University-based
Supervisor’s
Signature &
Date
2012-2013 UWRF School Psychology Practicum Handbook Page 15
ASSESSMENT AND INTERVENTION EXPERIENCE
How much experience with different types of assessment and intervention activities
are you accruing as a result of engaging in the practica experiences? Please, report
actual clock hours in direct service to clients. Hours should not be counted in more than
one category. Experiences involving information gathering about the client but not in the
actual presence of the client should be recorded in the “Support Activities” table found
elsewhere in this document.
Type of Activity Total # of Hours Spent
Face-to-Face with Clients
In This Activity
Total # of Different
Individuals Served
Through This Activity
Cognitive Assessment
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Academic Assessment
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Social/Emotional/Behavioral
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Academic Intervention
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Behavior Intervention
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Consultation/Collaboration
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Individual Counseling
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Group Counseling Total # of Different
Groups Run
-Early childhood (0-5.11)
-Elementary (6-12.11)
-Secondary (13+)
Program Evaluation
2012-2013 UWRF School Psychology Practicum Handbook Page 16
SUPPORT ACTIVITIES
This section involves describing the practicum activities in which you engaged that
supported your assessment and intervention experiences. This section includes
activities in which you engaged outside of the actual test administration and individual
and/or group counseling sessions conducted with clients. In addition, it includes the
activity of participating in didactic training held at your field-based site and on the UW-
RF campus related to your practica experiences.
Activity Total # Total # of Hours Spent in
the Activity
Case conferences
Case management, case
consultation
Didactic training/seminars
Progress notes/Records
Review
Assessment scoring,
interpretation, and report
writing
Video-audio-digital
recording review
Total
2012-2013 UWRF School Psychology Practicum Handbook Page 17
CLIENT PROFILES
Race/Ethnicity Number of Different Clients Seen
Assessment Intervention
African American/Black/African origin
Asian American/Asian origin/Pacific
Islander/Hawaii native
Latino-a/Hispanic
American Indian-Native American/Alaska
native/First Nation Canadian
European origin/Caucasian
Bi-racial/Multi-racial
Other (Specify: )
Sexual Orientation (This information may
not be known for all clients; please, indicate
only when known)
Number of Different Clients Seen
Assessment Intervention
Heterosexual
Lesbian
Gay
Bisexual
Exceptionalities Number of Different Clients Seen
Assessment Intervention
Physical/orthopedic disability
Blind/visually impaired
Deaf/hard of hearing/hearing impaired
Developmental disability (including cognitive
disabilities and autism spectrum disorders)
Serious mental illness (e.g., primary psychotic
disorders, major mood disorders that interfere
significantly with adaptive functioning)
Learning disability
Gifted
Other (Specify: )
Gender Number of Different Clients Seen
Assessment Intervention
Female
Male
Transgender
Other (Specify: )
Language Number of Different Clients Seen
Assessment Intervention
English-language learners
2012-2013 UWRF School Psychology Practicum Handbook Page 18
TEST ADMINISTRATION
What is your experience with the following instruments? Please, indicate all
instruments used by you in your assessment experiences completed during your practica
experiences. You may include any experience you have had with these instruments other
than practice administrations. Indicate the number of tests you administered and scored
in the first column. In the second column, indicate how of those tests you administered
and scored in Column I that were subsequently interpreted in a report you wrote.
Test # Administered
& Scored
# of Reports
Written
Achenbach Child Behavior Checklist
Adaptive Behavior Assessment System-Second Ed.
Barkely-Murphy Checklist for AD/HD
AIMS-Web
Bayley-III
BASC-2
Bender-Gestalt
BVAT
Conner’s Scales
DIBELS
Differential Abilities Scale-Second Edition
KABC-II
Projective measures
Stanford-Binet Intelligence Scales-Fifth Edition
Systematic observation/time sampling
UNIT
Vineland-II
VMI
WAIS-IV
Wechsler Memory Scale-Third Edition
WIAT-II
WISC-IV
WJ-III: Cognitive
WJ-III: Achievement
Woodcock-Muñoz Batería-Third Edition (NU)
Woodcock-Muñoz Language Survey-Revised
WPPSI-III
Other (Specify: )
Other (Specify: )
INTEGRATED REPORT WRITING
Client Population # of Integrated Reports Written
Child/Adolescent
Adult
2012-2013 UWRF School Psychology Practicum Handbook Page 19
Appendix B
2012-2013 UWRF School Psychology Practicum Handbook Page 20
UWRF School Psychology Training Program Practicum Activities Hour Log
PRACTICUM LOG - 2012-2013
AUG SEPT OCT NOV DEC JAN FEB MAR APR MAY Total Hours
ACTIVITIES
Interventions
Dyadic collaboration 0.0
Intervention Teaming 0.0
Intervention Implementation 0.0
Intervention Measurement 0.0
Misc. Intervention practices 0.0
Diverse Ethnicity/Culture
Consultation - Other 0.0
Counseling
Group 0.0
Individual 0.0
Diverse Ethnicity/Culture
Norm-Referenced Assessment
Preschool (3.0-5.11) 0.0
Elementary (6.0-12.6) 0.0
Middle (12.7-14.6) 0.0
High (14.7 and above) 0.0
Diverse Ethnicity/Culture
Alternative Assessments
Curriculum-Based Measurement 0.0
Criterion-Referenced 0.0
Diverse Ethnicity/Culture
Observation
Preschool (3.0-5.11) 0.0
Elementary (6.0-12.6) 0.0
Middle (12.7-14.6) 0.0
High (14.7 and above) 0.0
Diverse Ethnicity/Culture
Interviewing
Teacher 0.0
Parent/Care Giver 0.0
Student 0.0
Diverse Ethnicity/Culture
Report Writing 0.0
Child Study/M-Team 0.0
Case Staffing 0.0
Case Management 0.0
Miscellaneous
Crisis Intervention 0.0
In-Service (Giving) 0.0
In-Service (Attending) 0.0
2012-2013 UWRF School Psychology Practicum Handbook Page 21
Professional Development 0.0
Orientation 0.0
Organizational Time 0.0
Parent Conference 0.0
Program Evaluation 0.0
Program Planning 0.0
Research 0.0
Screening 0.0
Supervision (field) 0.0
Supervision (university) 0.0
Travel 0.0
Other:____________________ 0.0
Other:____________________ 0.0
Other:____________________ 0.0
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.0
_________________________________________________ _______________
Field-based Supervisor’s Signature Date
_________________________________________________ _______________
University-based Supervisor’s Signature Date
2012-2013 UWRF School Psychology Practicum Handbook Page 22
Appendix C
2012-2013 UWRF School Psychology Practicum Handbook Page 23
UWRF School Psychology Training Program Practicum Field-based Supervision Log
UW-RF School Psychology Practicum
Weekly Field-based Supervision Hours 2012-2013
Candidate Name:_________________________ _________________
Field-based Supervisor Name:__________________________
Week 1
Week 2 Week 3 Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Week 12 Week 13 Week 14
Week 15
Week 16
Week 17
Week 18
Week 19
Week 20
Week 21
Week 22 Week 23 Week 24
Week 25
Week 26
Week 27
Week 28
Week 29
Week 30
Week 31
Week 32 Week 33 Week 34
Week 35
Week 36
Week 37
Week 38
Week 39
Week 40
Total Field Supervision Hours: 0
Mean Field Superv. Hours Per Week:
_________________________________________________ _______________
Field-based Supervisor’s Signature Date
_________________________________________________ _______________
University-based Supervisor’s Signature Date
2012-2013 UWRF School Psychology Practicum Handbook Page 24
Appendix D
2012-2013 UWRF School Psychology Practicum Handbook Page 25
UWRF School Psychology Training Program Practicum Assessment: Performance-Based Rubric (TEAMING & COLLABORATION)
Candidate name & observation site: _________________________________________________
Description of activity observed: ___________________________________________________
Observer name and date: _________________________________________________________
Category 4 3 2 1 Level Interpersonal
skills and
communication
Routinely demonstrated effective interpersonal skills
(e.g., strong listening, patience,
and respect). Communicated information very clearly and
enthusiastically. Showed
dedicated interest in audience
understanding.
Usually demonstrated effective interpersonal skills
(e.g., strong listening,
patience, and respect). Information usually
explained and followed up
upon effectively.
Sometimes demonstrated effective interpersonal
skills (e.g., listening,
patience, and respect). Was able to communicate
information adequately,
but at a basic level.
Rarely demonstrated effective interpersonal
skills (e.g., strong
listening, patience, and respect). Struggled to
communicate information
effectively.
General problem-
solving
collaboration
Routinely solicited and helped
synthesize information from others. Interjected own ideas
assertively without being
domineering. Demonstrated clear preference for win-win
strategies and positive
approaches to problem solving.
Usually demonstrated ability
to interject own ideas and synthesize information from
others. Not yet viewed as a
clear problem-solving leader, but shows strong
foundational skills.
Sometimes used
information provided by others in team. Was
sometimes able to
collaborate effectively, but sometimes too
passive or aggressive
with own ideas.
Rarely utilized
information from other group members during
decision making. Was
excessively passive or aggressive with own
ideas.
Intervention
enhancement
A clear leader in helping develop appropriate goals and
interventions. Demonstrated
excellent awareness of varied interventions or instructional
methodologies.
Demonstrated helpful awareness and effort in
assisting development of
goals and interventions.
Provided some help in developing goals and
interventions. Ideas were
somewhat helpful, but viewed as basic.
Rarely or did not help develop goals or
interventions. Did not
recognize the need to link data to interventions or
modifications.
Diversity values
and dispositions
Routinely was respectful (valuing other perspectives,
listening actively, exhibiting
empathy, pacing the meeting), inclusive (thinking of others),
open, collaborative, and
cooperative. Adapted practice effectively and appropriately as
necessary to meet the needs of
others.
Often was respectful (valuing other perspectives,
listening actively, exhibiting
empathy, pacing the meeting), inclusive (thinking
of others), open,
collaborative, and cooperative. Adapted
practice adequately as
necessary to meet the needs of others.
Sometimes was respectful (valuing other
perspectives, listening
actively, exhibiting empathy, pacing the
meeting), inclusive
(thinking of others), open, collaborative, and
cooperative. Showed
some effort to adapt practice to meet the needs
of others.
Did not present as being respectful (valuing other
perspectives, listening
actively, exhibiting empathy, pacing the
meeting), inclusive
(thinking of others), open, collaborative, and
cooperative. Did not
adapt practice to meet the needs of others.
Data-based
decision-making
Collected valuable data for understanding problems.
Utilized multiple tools and
techniques (as needed) in gathering the data.
Recognized as a clear leader in
data collection, interpretation, and data-based decision
making.
Collected acceptable data for understanding problems.
Chosen tools and techniques
were sufficient, and data provided to team was
valuable in decision making.
Collected adequate data for understanding
problems, with room for
improved variability. Showed some effort to
connect data to
interventions.
Collected data were incomplete or
inappropriate for the
presenting problem. Did not effectively connect
data to interventions or
goals.
Professional, legal,
and ethical
responsibility
Clear and effective adherence
to due process guidelines in all decisions affecting students.
Maintained high ethical
standards.
Adhered to due process
guidelines in most decisions affecting students.
Maintained acceptable
ethical standards.
Adhered to due process
guidelines in most decisions affecting
students. Ethical
standards were adequate.
Neglected or failed to
recognize some due process guidelines.
And/or did not address
ethical issues appropriately.
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 26
Additional observation notes:
The completed rubric was reviewed and discussed with me and I had an opportunity to have my
questions answered about the evaluation of my performance through this observation.
________________________________________________________ ___________________
Practicum candidate signature Date
___________________________________________________ __________________
Supervisor signature Date
Rubric total guide:
22 – 24 Outstanding skill, knowledge, and effort observed. The candidate is emerging as an independent,
well-respected, and highly-motivated school psychologist.
18 – 21 Adequate skill, knowledge, and effort observed. Strong foundational skills in place. The
candidate is moving in the direction of becoming an effective and independent practicum-level
school psychologist.
15 – 17 Average skill, knowledge, and/or effort observed. Some strengths noted. Some areas will require
significant development to ensure the candidate develops as an effective school psychologist.
Strengths:
Areas for growth:
2012-2013 UWRF School Psychology Practicum Handbook Page 27
Appendix E
2012-2013 UWRF School Psychology Practicum Handbook Page 28
UWRF School Psychology Training Program Practicum Assessment: Performance-Based Rubric (GROUP COUNSELING)
Candidate name and observation site: _______________________________________________
Description of activity observed: ___________________________________________________
Observer name and date: _________________________________________________________
Category 4 3 2 1 Level Intervention &
counseling skills
A clear leader in assisting client(s)
develop appropriate
goals. Demonstrated
excellent awareness of
varied counseling
approaches.
Demonstrated helpful awareness and effort in
assisting client(s)
develop goals.
Provided some assisting client(s) in
developing goals.
Ideas were somewhat
helpful, but viewed
as basic.
Rarely or did not assist client(s)
develop appropriate
goals.
Interpersonal skills
and communication
Routinely demonstrated
effective interpersonal
skills (e.g., strong listening, patience).
Communicated very
clearly and enthusiastically.
Showed dedicated
interest in understanding.
Usually demonstrated
effective interpersonal
skills (e.g., strong listening, patience). Was
able to communicate
appropriately.
Sometimes
demonstrated
effective interpersonal skills
(e.g., listening,
patience). Was able to communicate
information
adequately, but at a basic level.
Rarely demonstrated
effective
interpersonal skills (e.g., strong listening,
patience). Struggled
to communicate information
effectively.
General problem-
solving
collaboration
Routinely solicited and
helped synthesize information from
client(s). Interjected
own ideas assertively without being
domineering.
Usually demonstrated
ability to interject own ideas and synthesize
information from
client(s).
Sometimes was able
to effectively solicit and synthesize
information from
client(s).
Rarely utilized
information from client(s) in problem
solving. Was
excessively passive or aggressive with
own ideas.
Diversity values and
dispositions
Routinely was
respectful (valuing other perspectives, listening
actively, exhibiting
empathy, pacing the meeting), inclusive
(thinking of others),
open, collaborative, and cooperative. Adapted
practice effectively and
appropriately as necessary to meet the
needs of others.
Often was respectful
(valuing other perspectives, listening
actively, exhibiting
empathy, pacing the meeting), inclusive
(thinking of others),
open, collaborative, and cooperative. Adapted
practice adequately as
necessary to meet the needs of others.
Sometimes was
respectful (valuing other perspectives,
listening actively,
exhibiting empathy, pacing the meeting),
inclusive (thinking of
others), open, collaborative, and
cooperative. Showed
some effort to adapt practice to meet the
needs of others.
Did not present as
being respectful (valuing other
perspectives,
listening actively, exhibiting empathy,
pacing the meeting),
inclusive (thinking of others), open,
collaborative, and
cooperative. Did not adapt practice to
meet the needs of others.
Professional, legal,
and ethical
responsibility
Maintained high ethical
standards and
professional approach.
Maintained acceptable
ethical standards and
professional approach.
Ethical standards and
professionalism were
adequate.
Neglected or failed to
recognize ethical and
professional responsibilities issues
appropriately.
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 29
Additional observation notes:
The completed rubric was reviewed and discussed with me and I had an opportunity to have my
questions answered about the evaluation of my performance through this observation.
________________________________________________________ ___________________
Practicum candidate signature Date
___________________________________________________ __________________
Supervisor signature Date
Rubric total guide:
18– 20 Outstanding skill, knowledge, and effort observed. The candidate is emerging as an independent,
well-respected, and highly-motivated school psychologist.
14 – 17 Adequate skill, knowledge, and effort observed. Strong foundational skills in place. The
candidate is moving in the direction of becoming an effective and independent practicum-level
school psychologist.
11 – 13 Average skill, knowledge, and/or effort observed. Some strengths noted. Some areas will require
significant development to ensure the candidate develops as an effective school psychologist.
Strengths:
Areas for growth:
2012-2013 UWRF School Psychology Practicum Handbook Page 30
Appendix F
2012-2013 UWRF School Psychology Practicum Handbook Page 31
UWRF School Psychology Training Program Practicum Assessment: Performance-Based Rubric (IN-SERVICE)
Candidate name and observation site: _______________________________________________
Description of activity observed: ___________________________________________________
Observer name and date: _________________________________________________________
Category 4 3 2 1 Level In-service
development
Developed an in-service presentation that
definitely addressed an
area of need for the
audience and that was
clearly empirically-
based in terms of its content.
Developed an in-service presentation that
addressed an established
area of need for the
audience and that
included content derived
from empirically-based literature specific to the
topic.
Some attempt was made to tailor the
presentation based on
the established needs
of the audience and
some effort went into
basing the content on information provided
in the empirical
literature.
The in-service presentation was
disconnected from
the established needs
of the audience
and/or its content was
not derived from empirically-based
literature.
Interpersonal skills
and communication
Routinely demonstrated
effective interpersonal
skills (e.g., strong listening, patience).
Communicated very
clearly and enthusiastically.
Showed dedicated
interest in meeting the needs of the audience
and adjusted approach
accordingly.
Usually demonstrated
effective interpersonal
skills (e.g., strong listening, patience). Was
able to communicate
appropriately. Showed interest in meeting the
needs of the audience
and attempted to adjust the approach
accordingly.
Sometimes
demonstrated
effective interpersonal skills
(e.g., listening,
patience). Was able to communicate
information
adequately, but at a basic level. Some
attempts made to
meet the needs of the audience and to
adjust the approach.
Rarely demonstrated
effective
interpersonal skills (e.g., strong listening,
patience). Struggled
to communicate information
effectively. No
interest in or attempts made to meet the
needs of the audience
and to adjust the approach as
necessary.
Diversity values and
dispositions
Routinely was respectful (valuing other
perspectives, listening
actively, exhibiting empathy, pacing the
meeting), inclusive
(thinking of others), open, collaborative, and
cooperative. Adapted
practice effectively and appropriately as
necessary to meet the
needs of others.
Often was respectful (valuing other
perspectives, listening
actively, exhibiting empathy, pacing the
meeting), inclusive
(thinking of others), open, collaborative, and
cooperative. Adapted
practice adequately as necessary to meet the
needs of others.
Sometimes was respectful (valuing
other perspectives,
listening actively, exhibiting empathy,
pacing the meeting),
inclusive (thinking of others), open,
collaborative, and
cooperative. Showed some effort to adapt
practice to meet the
needs of others.
Did not present as being respectful
(valuing other
perspectives, listening actively,
exhibiting empathy,
pacing the meeting), inclusive (thinking of
others), open,
collaborative, and cooperative. Did not
adapt practice to
meet the needs of others.
Professional, legal,
and ethical
responsibility
Maintained high ethical
standards and professional approach.
Maintained acceptable
ethical standards and professional approach.
Ethical standards and
professionalism were adequate.
Neglected or failed to
recognize ethical and professional
responsibilities issues
appropriately.
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 32
Additional observation notes:
The completed rubric was reviewed and discussed with me and I had an opportunity to have my
questions answered about the evaluation of my performance through this observation.
________________________________________________________ ___________________
Practicum candidate signature Date
___________________________________________________ __________________
Supervisor signature Date
Rubric total guide:
14 – 16 Outstanding skill, knowledge, and effort observed. The candidate is emerging as an independent,
well-respected, and highly-motivated school psychologist.
10 – 13 Adequate skill, knowledge, and effort observed. Strong foundational skills in place. The
candidate is moving in the direction of becoming an effective and independent practicum-level
school psychologist.
8-9 Average skill, knowledge, and/or effort observed. Some strengths noted. Some areas will require
significant development to ensure the candidate develops as an effective school psychologist.
Strengths:
Areas for growth:
2012-2013 UWRF School Psychology Practicum Handbook Page 33
Appendix G
2012-2013 UWRF School Psychology Practicum Handbook Page 34
UWRF School Psychology Training Program In-Service Participant Evaluation Form
Session Title:
Presenter:
Date:
Place:
Please, respond to the statements below according to the following scale:
1 = Disagree 2 = Neutral 3 = Agree
1. Session objectives were met. 1 2 3
2. I gained useful and helpful
knowledge from this session. 1 2 3
3. Knowledge I gained from this
session applies to me directly
in my work in the school setting. 1 2 3
4. The materials/handouts provided 1 2 3
were helpful and informative.
5. The presenter was knowledgeable
and professional. 1 2 3
6. Strengths of the session include:
7. Suggested improvements for the session include:
Thank you for your participation and for your feedback!
2012-2013 UWRF School Psychology Practicum Handbook Page 35
Appendix H
2012-2013 UWRF School Psychology Practicum Handbook Page 36
UWRF School Psychology Program Practicum Candidate Evaluation of Knowledge & Emerging Skills
Practicum candidate: _____________________________________________________________
Field-based supervisor completing this evaluation: _____________________________________
Evaluation cycle: _____ Mid-term _____ End-of-Semester
Semester: _____ Fall _____ Spring
Date: _________________________________________________________________________
RATING INSTRUCTIONS: Please, evaluate the practicum candidate’s knowledge and skill development by circling the
appropriate rating next to each question on the following pages. Item content is based on the 2010
NASP standards for graduate education of school psychologists (see:
http://www.nasponline.org/standards/2010standards/1_Graduate_Preparation.pdf for additional
details).
Use the scale provided while considering the practicum candidate’s progress relative to
expectations for all practicum level school psychologists-in-training. Please, note: The practicum
candidate should be rated on ALL items (i.e., do not indicate “NA”). If you are unsure about the
practicum candidate’s progress on an item, please discuss the item content with others who may
know.
PROVIDING FEEDBACK:
Feedback to the candidate should be provided about her or his development relative to
graduating intern expectations. Written comments on any particular strength or challenging
characteristic may be included in the box at the end of this form. Please, communicate with
other supervisors about the practicum candidate’s progress, as needed.
PASSING CRITERIA:
The Practicum Candidate’s Evaluation of Knowledge & Emerging Skills appraisal rubric
has 165 total points. Passing levels are as follows:
Semester Item Passing Level TOTAL rubric passing level Fall - Formative Minimum rating of 2 60% (100+)
Spring -Summative Minimum rating of 3 80% (132+)
Ratings of 2 (minimal) and 3 (average) are normative in the fall semester of practicum,
with growth expected thereafter. At the time of the fall formative evaluation and beyond,
a non-passing level TOTAL score may necessitate the development of a “Professional
Growth Plan” (see Appendix Y of the Program Handbook) or other new goals for the
candidate. Individual items that are not passed should be discussed and should guide new
goal setting.
2012-2013 UWRF School Psychology Practicum Handbook Page 37
RATING SCALE:
1: The practicum candidate has been significantly challenged by lack of knowledge or
skill in this area
2: Some knowledge or skill development
3: Average knowledge or skill development
4: Emerging knowledge or skill; nearing proficiency
5: Proficient; the intern has demonstrated highly developed knowledge or skill; similar to
other school psychology internship completers.
The practicum candidate…
1) DATA-BASED DECISION MAKING AND ACCOUNTABILITY
1) Is knowledgeable of various models and methods of assessment
for identifying strengths and needs 1 2 3 4 5
2) Is knowledgeable of various models and methods of assessment
for measuring progress and outcomes of services 1 2 3 4 5
3) Effectively applies data results to design, implementation and evaluation
of response to services 1 2 3 4 5
DOMAIN TOTAL =
2) CONSULTATION AND COLLABORATION
4) Is knowledgeable of varied methods of consultation, collaboration, and
communication 1 2 3 4 5
5) Communicates opinions and data to all appropriate parties in a supportive,
problem-solving fashion. 1 2 3 4 5
6) Demonstrates effective consultation and collaboration skills during design,
implementation, and evaluation of services and programs 1 2 3 4 5
DOMAIN TOTAL =
3) INTERVENTIONS AND INSTRUCTIONAL SUPPORT TO DEVELOP ACADEMIC SKILLS
7) Is knowledgeable about biological influences on academic skills and
instructional strategies 1 2 3 4 5
8) Is knowledgeable about cultural and social influences on academic skills and
instructional strategies 1 2 3 4 5
9) Demonstrates skills to implement and evaluate services that support
cognitive and academic skills 1 2 3 4 5
DOMAIN TOTAL =
4) INTERVENTIONS AND MENTAL HEALTH SERVICES TO DEVELOP SOCIAL AND LIFE
SKILLS 10) Is knowledgeable about biological, cultural, developmental, and social
influences on behavior and mental health 1 2 3 4 5
11) Is knowledgeable about behavioral and emotional impacts on learning
and life skills 1 2 3 4 5
12) Demonstrates skills to implement and evaluate evidence-based strategies to
promote social–emotional functioning and mental health 1 2 3 4 5
DOMAIN TOTAL =
2012-2013 UWRF School Psychology Practicum Handbook Page 38
5) SCHOOL-WIDE PRACTICES TO PROMOTE LEARNING
13) Is knowledgeable about school and systems structure, organization, and theory 1 2 3 4 5
14) Is knowledgeable about general and special education, technology resources,
and evidence-based school practices 1 2 3 4 5
15) Demonstrates skills to develop and implement practices that create and
maintain effective and supportive learning environments for children and others 1 2 3 4 5
DOMAIN TOTAL =
6) PREVENTIVE AND RESPONSIVE SERVICES
16) Is knowledgeable of principles and research related to resilience and risk factors
in learning and mental health 1 2 3 4 5
17) Is knowledgeable of multi-tiered prevention and evidence-based strategies 1 2 3 4 5
18) Demonstrates skills to promote services that enhance mental health, safety,
physical well-being, and effective crisis preparation, response, and recovery 1 2 3 4 5
DOMAIN TOTAL =
7) FAMILY-SCHOOL COLLABORATION SERVICES
19) Is knowledgeable of principles and research related to family systems, strengths,
needs and culture 1 2 3 4 5
20) Is knowledgeable of evidence-based strategies to support family influences on
children’s learning, socialization, and mental health 1 2 3 4 5
21) Demonstrates skills to design, implement, and evaluate services that facilitate
family and school partnerships 1 2 3 4 5
DOMAIN TOTAL =
8) DIVERSITY IN DEVELOPMENT AND LEARNING
22) Is knowledgeable of individual differences, abilities, disabilities, and other
diverse characteristics 1 2 3 4 5
23) Is knowledgeable of research related to diversity factors for children, families,
and schools, including factors related to culture and individual and role
differences 1 2 3 4 5
24) Demonstrates skills that promote effective functioning for individuals, families,
and schools with diverse characteristics, cultures, and backgrounds 1 2 3 4 5
DOMAIN TOTAL =
9) RESEARCH AND PROGRAM EVALUATION
25) Is knowledgeable of research design, statistics, measurement, varied
data collection and analysis techniques, and program evaluation methods 1 2 3 4 5
26) Uses various technology resources for data collection,
measurement, and analysis of problems to support effective practices 1 2 3 4 5
27) Demonstrates skills to evaluate and apply research as a foundation
for service delivery 1 2 3 4 5
DOMAIN TOTAL =
10) LEGAL, ETHICAL, AND PROFESSIONAL PRACTICE
28) Is knowledgeable of the history and foundations of school psychology and
multiple service models and methods 1 2 3 4 5
29) Is knowledgeable of the ethical, legal, and professional standards, and other
factors related to professional identity and effective practice 1 2 3 4 5
30) Demonstrates skills related to providing services consistent with ethical, legal,
and professional standards 1 2 3 4 5
DOMAIN TOTAL =
2012-2013 UWRF School Psychology Practicum Handbook Page 39
OVERALL POSITIVE IMPACT ON YOUTH, SCHOOLS, AND OTHER CONSUMERS
31) Has contributed to improving student academic learning or social, emotional, or
behavioral well-being 1 2 3 4 5
32) Has contributed to the success of other educators through consultation &
collaboration 1 2 3 4 5
33) Has contributed to parent knowledge, skill, and/or satisfaction with
their child’s education 1 2 3 4 5
SECTION TOTAL =
We have reviewed this evaluation together and have discussed steps to continue progress
toward goals. Items that are not rated at a passing level are being used to help develop
additional internship goals as needed.
________________________________________________________________________
Supervisor Signature/Date
________________________________________________________________________
Practicum Candidate Signature/Date
Additional Comments:
Evaluation Rating TOTAL Score: _________
Item content that needs development:
2012-2013 UWRF School Psychology Practicum Handbook Page 40
Appendix I
2012-2013 UWRF School Psychology Practicum Handbook Page 41
UW-RF School Psychology Training Program Guidelines for Summary and Reflection Activities
As outlined in the practicum syllabus, the candidate must produce and submit summaries
and reflections related to the following activities:
-Legal/ethical issue that arises during the practicum experience (one per semester, two
summaries total)
-Crisis prevention/intervention activities summary (one per semester, two summaries
total)
-RtI activities summary (one per semester, two summaries total)
-Reflection piece related to an in-service presentation conducted by the candidate (one in-
service presentation required, meaning one reflection piece in this domain)
Pertaining to the first three items listed above, the candidate should provide a 1-2 page
summary of the issue or activity, followed by 2-3 pages of reflection related to the issue
or activity. As for the write-up related to the in-service presentation conducted by the
candidate at her or his practicum site, the candidate should summarize briefly what kind
of presentation was conducted, what transpired during the presentation itself, the results
of the evaluations collected from the in-service participants through the presentation
process, and reflections by the candidate as to her or his strengths, areas for growth, and
methods to address her or his identified areas of growth. This piece should be 3-5 pages
total in length.
2012-2013 UWRF School Psychology Practicum Handbook Page 42
Appendix J
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FIELD-BASED SUPERVISOR INTERVIEW
Your assignment is to prepare a written summary of your practicum setting, and the role
of the school psychologist within your setting. You should interview your supervising
school psychologist so that you can discuss how the role of the school psychologist is
practiced within your setting. If possible, interview at least one other school psychologist
in the district to get his or her perception of the duties they believe are important for
school psychologists.
As part of your profile, you should discuss the several components. What is the profile of
the district? Here you can provide information about the number of students in the
district, number of students in special education programs, diversity statistics for the
district, including percentage of students of color, number of school psychologists.
Is the district changing, growing, or remaining stable? What are the primary duties the
school psychologist is expected to complete? Here talk about how does the school
psychologist view his or her role?
How many schools does the school psychologist serve? What does the school
psychologist mainly do? What does the school psychologist like about his or her job/role?
What does the school psychologist dislike about his or her job/role?
What recommendations would the school psychologist give to a new student, as far as
training emphasis or particular skills? Does your school psychologist have any thoughts
about the future of school psychology, and where the profession needs to go? How is the
district preparing for response to intervention?
Do school psychologists in the district serve in any specialty roles, such as Autism
Specialist, Due Process Coordinator?
Does the school psychologist participate on any committees, and if so, what do the
committees focus on?
How much contact does the school psychologist have with families? Do they believe they
have enough contact with families?
2012-2013 UWRF School Psychology Practicum Handbook Page 44
Appendix K
2012-2013 UWRF School Psychology Practicum Handbook Page 45
IN-CLASS CASE PRESENTATION FORMAT
The case can be a circumstance where you participated in an assessment for eligibility,
provided supportive counseling to a student, conducted an observation of a student,
facilitated the development of an intervention through a collaborative consultation
process, or participated in a group as a leader or co-facilitator. Other examples of a case
involve circumstances where you have provided support to a student through crisis
intervention, or worked with a teacher or parent as a consultant.
Information you should include in your presentation. Reason for services, description of
the student, review of information you collected, interpretation of the information or the
student's status, recommendations for the student, and how the information collected or
services provided were intended to help the student. In situations where you have
collected data, providing a summary of the data could be helpful to your peers. Please,
describe any positive changes for the student involved, and note cases where
diversity considerations played a prominent role.
Format for Case Discussion
Identifying Information/Demographics: Age, gender, cultural/ethnic background, or
other social factors that may be relevant (e.g., new to school).
Concerns: One or two sentence summary, a statement from the student about their needs,
or a parent or teacher description is recommended.
History of Concerns: Chronology and context of symptom development (how long, new
or long-lasting concern). Any relevant contributing or complicating environmental factors
(family stress etc.), previous treatment already tried for the presenting problem. List all
significant illnesses, injuries, surgeries, and birth complications/defects that would have a
direct bearing on student performance.
Current Health and Physical Status: Descriptions of health, identification of any
medicals for treatment of attention or other needs (e.g., depression, anxiety).
Treatment History: Discuss past interventions or current strategies used. Previous
assessment results and diagnoses, type of treatment, where treated, compliance with
treatment, and results.
Family History: To your knowledge, report on the history of any family members for a
DSM-IV disorder, or any family members (e.g., siblings, parents) that have a history of
special educational concerns. Other family dynamics include family constellation, recent
changes such as divorce or separation
Social History: A wide variety of information about the student falls into this category.
Peer relationships, enjoyed activities, participation in clubs or sports. Rating of peer
affiliation from strong connections to problematic connections.
2012-2013 UWRF School Psychology Practicum Handbook Page 46
Assessment: Summarize assessment results and provide relevant assessment data.
Intervention History: Types of services, impact of services.
Discussion and Plan: Discuss the synthesis of the information about the student and how
the information was connected to recommendations or strategies to benefit the student.
Discuss intervention recommendations and the rationale for these over other alternatives.
When possible, please describe any positive changes for the student involved.
Format for Group Presentation
Targeted Audience for the Group: social skills needs, study habits, behavior
management, self-esteem.
Identifying Information/Demographics: Ages, gender, cultural/ethnic background of
the participants, or other social factors that may be relevant.
Goals of the group: What do you hope to accomplish with the group? Build friendships
skills? Lessen anxiety of participants while in a school setting?
Number and length of sessions: Include discussion about follow-up with students after
session ends.
Co-facilitator and your relationship with: How will you and your co-facilitator, if any,
relate and work with each other?
Treatment History: Have member of the group participated in services before? What is
the make up of students who have and IEP compared to those who do not have an IEP?
Describe the Curriculum you plan to use: A standardized curriculum? One that has
been adapted, and if so, what changes were made? Is their homework? What
mechanisms are in place to check for transfer of skills learned in group to skills in other
settings such as the classroom or home?
Assessment: How will you assess or judge whether or not the students have benefited
from the group? Describe any pre or post treatment measures.
Discussion and Plan: Discuss your perceptions about the group and the participant’s
response to group activities. It is not necessary that the group has been completed. When
possible, please, describe any positive changes for the student involved.
.
2012-2013 UWRF School Psychology Practicum Handbook Page 47
Appendix L
2012-2013 UWRF School Psychology Practicum Handbook Page 48
ASSIGNMENT CRITERIA FOR GRADING
Book Review and Critique (100 points each)
In order to provide the candidate an opportunity to demonstrate her or his ability to become a more
reflective school psychologist, to apply skills of culturally-responsive professional process, to examine
alternative viewpoints or multiple perspectives, and to construct meaning from messages communicated in
the writings of a researcher and author, candidates will complete a book review and critique for the texts
listed below. Additionally, the candidate must come to class the afternoon book discussions are listed on
the syllabus prepared with questions pertaining to each book that will be asked much like a book club.
Fall 2012: Gay, G. (2010). Culturally-responsive teaching: Theory, research, & practice (2
nd ed.). New York: Teachers
College Press.
Spring 2013: Delpit, L., & Dowdy, J. D. (Eds.). (2008). The skin that we speak: Thoughts on language and culture in the
classroom. New York: The New Press.
Yang, K. K. (2008). The latehomecomer: A Hmong family memoir. Minneapolis, MN: Coffee House Press.
Each book review and critique should be cited and referenced according to American Psychological
Association (6th
edition) criteria, typed, and double-spaced. The text of each review and critique should
be limited to no more than 10 pages in length. The format of each manuscript should include a cover
page, abstract, introduction, summary, discussion, implications, and reference page. In the development of
each critique, the candidate should incorporate the following:
-An examination of the common themes, topics, and ideas
-Reactions and reflections from you, the book reviewer
-Implications and conclusions of text related to you and your professional development
-A discussion of how the ideas posited by the authors relate to other materials presented in class
-Relevance to school psychology preparation programs
Grading: 90-100 points Meets and/or exceeds all stated criteria in an effective manner
1. Summary discussion of text themes, topics, ideas
2. Examines links to shaping of professional development
3. Discusses relevance to the field of school psychology
4. Presents reactions and reflections
5. Reference page
6. APA format, typed, double-spaced
7. Uses correct grammar, spelling, and mechanics of writing
80-89 points Meets most stated criteria in an effective manner
70-79 points Meets some stated criteria in an effective manner
0-69 points Meets few stated criteria in an effective manner
2012-2013 UWRF School Psychology Practicum Handbook Page 49
Appendix M
2012-2013 UWRF School Psychology Practicum Handbook Page 50
UW-RF School Psychology Training Program Diversity Values and Dispositions Evaluation
Candidate name: ________________________________________________________________
Date: _________________________________________________________________________
Using the scale below, please, rate the extent to which you believe the practicum
candidate has demonstrated the following diversity values and dispositions throughout
the field-based component of her or his practicum experience. Choose the corresponding
number for each category.
1.....2…..3…..4…..5
not at all a great deal
Being Respectful
Valuing other’s experiences, contributions, and expertise 1.....2…..3…..4…..5
Valuing diversity and cultural differences, in general 1.....2…..3…..4…..5
Listening 1.....2…..3…..4…..5
Empathizing 1.....2…..3…..4…..5
Engaged in active learning 1.....2…..3…..4…..5
Thinking of others and our impact on others 1.....2…..3…..4…..5
Pacing the learning process 1.....2…..3…..4…..5
Being Inclusive
Demonstrating a willingness and desire to relate to
and to work with all people (e.g., clients) 1.....2…..3…..4…..5
Considering others (e.g., when making decisions) 1.....2…..3…..4…..5
Including people in the process of learning,
research, service, etc. 1.....2…..3…..4…..5
Willing to challenge one’s own beliefs that classify
a group of persons as pejorative in some way 1.....2…..3…..4…..5
2012-2013 UWRF School Psychology Practicum Handbook Page 51
Being Collaborative and Cooperative
Working cooperatively and effectively with others 1.....2…..3…..4…..5
Being responsive to others 1.....2…..3…..4…..5
Demonstrating an interest and ability to learn from others
about their experiences of culture and diversity 1.....2…..3…..4…..5
Engaging in dialogues, rather than debates, regarding
multiculturalism and diversity issues 1.....2…..3…..4…..5
Working together, to understand one another 1.....2…..3…..4…..5
Being Open
Being open to new ideas and learning in general 1.....2…..3…..4…..5
Engaging in perspective-taking 1.....2…..3…..4…..5
Demonstrating flexibility 1.....2…..3…..4…..5
Being receptive and responsive to feedback 1.....2…..3…..4…..5
Seeking help when needed 1.....2…..3…..4…..5
Taking risks to promote professional growth/development 1.....2…..3…..4…..5
Engaging in self-disclosure that is relevant to professional
effectiveness 1.....2…..3…..4…..5
Being Inquisitive
Showing interest and a curiosity about people and
their diverse cultural life experiences 1.....2…..3…..4…..5
Seeking additional knowledge and experiences related
to diversity and multicultural issues 1.....2…..3…..4…..5
Demonstrating a desire to learn about others 1.....2…..3…..4…..5
Scientifically-minded (applying ethical/professional
standards and scientific findings) to diversity/multicultural
issues 1.....2…..3…..4…..5
2012-2013 UWRF School Psychology Practicum Handbook Page 52
Self-aware and Introspective
Awareness of personal and professional strengths 1.....2…..3…..4…..5
Awareness of personal and professional areas of growth 1.....2…..3…..4…..5
Demonstrating an awareness of one’s biases/prejudices
and ignorance 1.....2…..3…..4…..5
Reflecting on one’s impact on others and the tasks at
hand 1.....2…..3…..4…..5
Reflecting on how one is affected by others 1.....2…..3…..4…..5
Engaging in critical thinking (e.g., different perspectives) 1.....2…..3…..4…..5
Evaluating one’s feelings, decisions, actions, and how
one relates to others 1.....2…..3…..4…..5
Culturally-Aware
Learning about, understanding, and accepting people
from a variety of diverse and cultural backgrounds 1.....2…..3…..4…..5
Providing culturally-relevant services to people based
on theoretical and research knowledge 1.....2…..3…..4…..5
Being aware of how one’s own cultural background may
impact her or his assessment practices, consultation
interactions, or interventions with persons from diverse
backgrounds 1.....2…..3…..4…..5
Being aware of how different cultures view what is
normal, acceptable, and okay 1.....2…..3…..4…..5
Understanding the process and interpersonal dynamics
necessary to be effective with persons from diverse
backgrounds 1.....2…..3…..4…..5
Demonstrating an interest in and a commitment to
conducting research on multicultural and diversity issues 1.....2…..3…..4…..5
Using appropriate research methods with diverse
populations 1.....2…..3…..4…..5
2012-2013 UWRF School Psychology Practicum Handbook Page 53
Socially-Just
Engaging in active support and advocacy to promote
equality and justice for underserved, oppressed, and/or
marginalized groups of people 1.....2…..3…..4…..5
Involved in the development of research programs
related to social justice issues 1.....2…..3…..4…..5
Committed to service and community efforts for diverse
populations 1.....2…..3…..4…..5
Aware of power and privilege dynamics on various levels 1.....2…..3…..4…..5
Actively addressing institutional barriers 1.....2…..3…..4…..5
Professional Growth and Improvement Demonstrating a desire to learn and improve one’s
knowledge base, research, and service skills 1.....2…..3…..4…..5
Seeking actively feedback regarding one’s performance 1.....2…..3…..4…..5
Willingness to abandon nonproductive strategies in an
attempt to self-correct 1.....2…..3…..4…..5
Applying the ethical and professional standards of the
profession to one’ work 1.....2…..3…..4…..5
Applying scientific findings to professional work 1.....2…..3…..4…..5
*Permission to use and to adapt this measure was granted by the primary author, Dr. Kathleen Bieschke.
March 2008
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Appendix N
2012-2013 UWRF School Psychology Practicum Handbook Page 55
UW-RF School Psychology Training Program Professional Work Characteristics Appraisal
Candidate: _______________________________________________________________ Rater: ___________________________________________________________________ Year in Program: 1st 2nd 3rd (Practicum) or 4th (Intern) Date: ______________ Please, rate the candidate on each item using the scale below. Comments on any particular strength or weakness and recommendations, if any, may be written at the end of the form.
Characteristic Rating (circle one)
Initiative – initiates activities when appropriate; does not wait to be asked or told when to begin an anticipated task.
NA 1 2 3 4 5
Dependability – can be counted on to follow through on a task once a commitment to it has been made; reliably completes assignments in a timely manner.
NA 1 2 3 4 5
Time Management/Work Organization – organizes work and manages time effectively.
NA 1 2 3 4 5
Problem-Solving/Critical Thinking – thinks critically; effectively analyzes problem situations and conceptualizes alternative approaches and solutions.
NA 1 2 3 4 5
Respect for Human Diversity – respects racial, cultural, socioeconomic, religious, gender-related, sexual orientation, and other human differences; demonstrates the sensitivity and skills needed to work with diverse populations.
NA 1 2 3 4 5
Oral Communication – expresses self orally in an organized and clear manner.
NA 1 2 3 4 5
Written Communication – writes in an organized, clear manner. NA 1 2 3 4 5
Attending/Listening Skills – attends to important communications; listens attentively.
NA 1 2 3 4 5
Effective Interpersonal Relations – relates effectively to colleagues, faculty, supervisors, and clients.
NA 1 2 3 4 5
Teamwork – works well with others; collaborates effectively with others on assignments/projects.
NA 1 2 3 4 5
Adaptability/Flexibility – adapts effectively to the demands of a situation; is sufficiently flexible to deal with change.
NA 1 2 3 4 5
Rating Scale NA No opportunity to observe/don’t know 1 Needs substantial improvement to be at level appropriate for year in program 2 Needs some improvement to be at level appropriate year in program 3 Exhibits average level for year in program 4 Exhibits level that is above average for year in program 5 Exhibits level that is exceptionally strong for year in program
2012-2013 UWRF School Psychology Practicum Handbook Page 56
Comments/Recommendations
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Characteristic Rating (circle one)
Responsiveness to Supervision/Feedback – is open to supervision/feedback and responds to such appropriately.
NA
1 2 3 4 5
Self-Awareness – shows realistic awareness of personal strengths and weaknesses and impact this has on professional functioning and relationships with others.
NA
1 2 3 4 5
Professional Identity/Development – appears to identify with the profession of school psychology; conducts oneself as a professional; concerned with own professional growth.
NA
1 2 3 4 5
Independent Functioning – functions with minimal supervision or independently, when appropriate.
NA
1 2 3 4 5
Data-Based Case Conceptualization – able to use data/information to conceptualize cases and generate hypotheses and possible solutions; uses evidence to evaluate outcomes.
NA
1 2 3 4 5
Systems Orientation – understands that schools, families, and organizations are systems; recognizes and effectively utilizes rules, policies, and other characteristics of systems.
NA
1 2 3 4 5
Rating Scale NA No opportunity to observe/don’t know 1 Needs substantial improvement to be at level appropriate for year in program 2 Needs some improvement to be at level appropriate year in program 3 Exhibits average level for year in program 4 Exhibits level that is above average for year in program 5 Exhibits level that is exceptionally strong for year in program
2012-2013 UWRF School Psychology Practicum Handbook Page 57
Appendix O
2012-2013 UWRF School Psychology Practicum Handbook Page 58
Intervention Case Study Example: Kara
Problem Identification
Kara turned in an average of 50% of her assignments per week. Her teacher indicated in order for
Kara to achieve a higher level of academic competency, it was important for her to complete at
least 95% of her assignments. The teacher noted Kara seemed to be alone quite a bit and asked to
leave the classroom frequently to use the bathroom. On occasion, the teacher observed Kara
"staring into space." When encouraged to participate in group activities, she would comply. The
teacher wondered if Kara was either depressed or had some sort of medical problem to account
for her behavior.
The classroom teacher indicated a set of six school-wide behavioral goals have been established
through the Positive Behavioral Supports methodology. In addition, her class has established its
own interpretation of these goals. One of the goals is to have students complete and turn in all
assignments. A review of the teacher's grade book for this fifth-grade class indicated students
turned in a mean of 80% of their assignments.
Skill analysis. An analysis of completed assignments verified the papers turned in had very few
errors. Furthermore, the fact that sometimes Kara did turn in her assignments to the designated
box on the teacher's desk indicated she knew the procedure for turning in her assignments. A
review of Kara's test results in the teacher's grade book indicated she typically understood the
academic content because the grades that she received were generally a "C" or above. On class-
wide curriculum-based measures for reading fluency, math, writing, and spelling, Kara performed
at or above the 50th percentile in comparison to her peers in the class.
Performance analysis. Kara is a fifth-grade student who has recently moved into the district. Her
mother stated she had remarried last year and Kara and her mother moved into the home of the
new husband and his three children. Kara is now the second-youngest sibling of the four children.
The youngest child attends the same school and she has been struggling academically for several
years.
A review of the records from Kara's previous school indicate Kara's performance was average or
above in all academic areas. Kara passed both the hearing and vision screenings. A review of the
teacher's grade book showed Kara turned in most assignments on Wednesdays and Thursdays.
An interview the Kara's mother indicated she helps all four of her children with their homework.
Each child was required to spend at least 1/2 hour sitting at the kitchen table each night
completing homework or, if there was no homework, reading a book. She was concerned about
Kara due to her change in behavior since the recent divorce and marriage. Kara seemed to be
more sullen and she did not participate in family activities much. She was previously a very
organized youngster, who took pride in having a clean and orderly room. Recently, however, she
seems to have lost interest in many things. In addition, she often returned from her weekend visits
with her father looking tired and unhappy. However, when her mother questioned her about her
2012-2013 UWRF School Psychology Practicum Handbook Page 59
visits with her father, Kara always indicated they were "fine." Kara's weekend visits typically
occurred three out of four weekends a month. When asked about the teacher's concern regarding
Kara's health, her mother indicated she had noticed Kara’s eating patterns had changed recently
and she seemed to want to sleep more than she had previously. However, the issue of a medical
problem was one that had not been considered.
Kara stated she was not happy with her new school and her new family. She said the work was
"too hard" and she especially did not like her younger sister because she was "dumb." Her affect
during the interview seemed relatively depressed and it was difficult to engage Kara
in conversation.
A class-wide intervention/prevention strategy had been established by the teacher to increase the
number of assignments that students turn in. The teacher stated the entire class reviews the six
school-wide behavioral goals daily, including the goal to turn in all assignments. She then tracks
on a chart, the number of daily assignments turned in compared to the number of assignments
given. The teacher reviews this chart with each student weekly. Students who fall behind in their
assignments are encouraged to complete the work at home.
Three in-class observations were conducted and recorded in narrative form in order to obtain a
full picture of Kara's performance. In summary, it appeared Kara tended to enter the classroom at
the beginning of each day demonstrating behavior patterns that predicted whether she would turn
in her assignments. For example, when she entered the classroom quietly and appeared tired she
would typically fail to turn in her assignments. On the other hand, when she entered the
classroom, engaged in conversation with her peers and did not appear tired, she would turn in her
assignments. More often than not, Kara sat alone and failed to engage in social activities and
conversations with her peers. The classroom teacher confirmed that these patterns were typical
for Kara.
Problem Analysis
A meeting was convened to review the results of the data-gathering efforts thus far with the
classroom teacher and the student's parent. Four hypotheses were generated and a plan for testing
each hypothesis was developed. The first hypothesis was Kara was not turning in her assignments
on Mondays, Tuesdays, and Fridays because she forgot to do so as a result of her concern about
spending the weekend with her father. The second hypothesis was Kara was not turning in her
assignments because she was seeking attention from her mother who has, since her new marriage,
split her attention between four siblings. This has changed since Kara and her mother lived
together and all of her mother's attention was focused on Kara. In addition, as a result of this life
change, Kara may have felt left out because she believed she is different than her siblings and
peers because she is the only one with a Mexican heritage. The third hypothesis was Kara was not
turning in her assignments because she forgot to do so as a result of being tired and, perhaps,
physically ill. She seemed to be going to the bathroom frequently, often looked tired and
sometimes seemed confused. The final hypothesis was Kara was not turning in her assignments
because she was not motivated to do so. Although the teacher keeps a chart on assignment
completion, Kara may not have been checking this chart on a regular basis. Furthermore, the chart
2012-2013 UWRF School Psychology Practicum Handbook Page 60
itself may not have been motivating enough for her, and that there was a need to ensure Kara
participated in the monitoring to determine if this had an impact on her assignment completion.
The first hypothesis was tested to determine the relationship between Kara's rate of turning in
assignments and whether she spends the weekend with her father. Kara was observed on
Mondays, Tuesdays, and Fridays during weeks when she spent time with her father and when she
did not spend time with her father. The number of assignments turned in was monitored and so
was her affect and social interaction. The actual difference in the rate of assignments she turned
in was not significantly different for Fridays. However, the assignments continued to remain low
on the Mondays and Tuesdays after she visited with her father compared to those same days when
she did not visit with her father. Kara continued to appear fatigued and have poor affect on those
Mondays and Tuesdays, as well. Therefore, this hypothesis was not rejected. However, the
hypothesis was modified to eliminate Fridays.
The second hypothesis was tested to determine if there was a relationship between the amount of
time her mother spends with Kara and the rate of turning in assignments. Kara's mother agreed to
keep track of the amount of time that she spent individually with her daughter for two weeks. In
addition, an attempt was made to vary the times. She contacted the classroom teacher daily with
her report of time spent the night before. The classroom teacher noted the number of assignments
turned in on the assignment completion chart. These data over the course of the two weeks were
analyzed and it was determined there was no correlation between the two variables. Therefore,
this hypothesis was rejected.
The third hypothesis was tested by determining if Kara had a medical problem that affected her
rate of turning in assignments. Kara was diagnosed with diabetes by her pediatrician and began
monitoring her blood sugar and controlling her diet. Her rate of turning in assignments increased
somewhat. However, her affect and rate of interacting with her peers seemed to continue to vary.
Mondays and Tuesdays continued to be days Kara's affect and socialization were somewhat low.
Therefore, a follow-up hypothesis was tested after confirming with Kara's father he had not been
careful about the food she was eating during her weekend visits with him. This hypothesis was
Kara's mood and thus the rate of turning in her assignments on Monday and Tuesday were
affected by unmodified food consumption, based on requirements for treating diabetes, when she
visited with her father on the weekend. Kara's father did monitor and limit her food consumption
on the weekend and there was a dramatic change in Kara's affect and social interaction on the first
Monday and Tuesday after he began. Therefore, this hypothesis was accepted.
The fourth hypothesis was tested to determine whether self-monitoring of her assignments would
motivate Kara to turn in her assignments. Kara kept track of each assignment she turned in for 2
weeks. The classroom teacher met with Kara each day to review her assignment completion chart
and to determine the amount of agreement between Kara's recording and the teacher's recording
of assignment completion. During the first three days (i.e., Monday, Tuesday, and Wednesday)
that the plan was implemented, the number of completed assignments increased. However, after
day three the rate reverted to approximately the original rate. It could not be determined if this
hypothesis should be rejected or not due to the lack of long-term data. Therefore, although the
hypothesis was not accepted, the teacher agreed to continue to work on this with Kara. The data
2012-2013 UWRF School Psychology Practicum Handbook Page 61
would be monitored weekly to determine the impact of this self-monitoring
assessment/intervention.
Although her academic skills were within the average range or higher than those of her peers,
her behavior had been characterized by variable moods, a lower rate of engagement with peers
and a lower rate of turning in assignments. She also had a noticeably different appearance from
her siblings in the family and from her peers in the class. Her new siblings had fair skin and hair,
while Kara had dark hair and dark skin. Most of her peers in the class were Caucasian or
African American, while Kara was of Mexican heritage. Kara's primary language was English,
but she was fluent in Spanish, as well. The results from hypothesis testing suggested her rate of
turning in assignments was impacted primarily by her health conditions, interviews and
observations did not indicate her perception of her social status had an impact on her behavior.
Intervention
Data obtained from hypothesis testing indicated Kara's rate of turning in assignments increased
when her food consumption and sugar level were monitored and controlled at home and at her
father's house. Therefore, the intervention included three monitoring charts for (1) sugar level, (2)
food consumption, and (3) turning in assignments. The goals for this complex intervention were
to assist Kara to monitor her sugar levels; to reduce the amount of "junk food" she eats, especially
when she spends the weekend with her father, and to increase her rate of turning in assignments.
The school psychologist, teacher, student's parent, and student discussed and formulated the
intervention plan. Kara's goal was to turn in 95% of her assignments per week. This was
anticipated initially to occur rapidly due to the fact the hypothesis was medically based. Since the
problem is medically based, it will be important to ensure Kara continues to track her food and
sugar level throughout her life. Although the hypothesis regarding motivation was not accepted
previously, it was anticipated that motivation to monitor blood sugar levels and food consumption
on a continuous basis will vary over time. So the intervention is expected to remain in place with
the addition of an incentive system, until fading is used to reduce Kara's need for the intervention
and she demonstrates she is self-sufficient in controlling her food intake and sugar level.
The school psychologist provided training for the classroom teacher and Kara's parents for
implementing the self-monitoring methods (Shapiro, Durnan, Post (2002) and Skibiskey
Levinson, 2002). Self-monitoring has been demonstrated to promote independence (Connell et
al., 1993; Trammel, Schloss, & Alper, 1994), which is the long term goal of the intervention. The
methods were tailored to the situation and to the needs of the family and the classroom teacher. A
check for treatment integrity was built into the checklists. Failure to complete the checklist
indicated lack of integrity to the intervention.
The charts for maintaining sugar level and food consumption were completed by Kara and
checked by her parents on a daily basis. The work completion chart was completed by Kara at the
end of each day, and it was verified by the classroom teacher. See the charts below. Each Friday,
the results of the week were shared between home and school via email. The teacher and Kara
reviewed her charts for each day of the week on Friday, and the teacher sent an email message
2012-2013 UWRF School Psychology Practicum Handbook Page 62
back to both parents regarding the similarities across the three charts. The incentive was then
selected by Kara and the team from the established list and implemented as appropriate.
This intervention was considered by the teacher and Kara's mother to require a higher level of
intensity, since the completion and review of the charts, as well as the development and
implementation of incentives required daily attention by Kara, her parents, and the classroom
teacher. However, the team agreed this level of intervention delivery and the response to the
intervention did not require special education services.
Although Kara was not pleased about needing to monitor her sugar level and food consumption,
she agreed that it was necessary. Kara's family and classroom teacher also agreed the intervention
was likely to be the least intrusive, most effective plan to deal with her health and rate of turning
in assignments.
Assignments Checklist
Monday Tuesday Wednesday Thursday Friday
How many assignments did I turn in today?
How many assignments did my teacher
have listed on the board today?
Did I reach my goal (95%)? Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
My teacher agreed with my ratings today.
Sugar Level Checklist
Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Each time I check my sugar level
and it was okay I make a mark
here.
Each time I check my sugar level
and it was not okay I make a
mark here.
My sugar level was good all day
todav (Ratinq 3).
My sugar level was good most of
the day today (Ratinq 2).
My sugar level was not good
most of the dav todav (Rating 1).
My parent agreed with my ratings
today.
2012-2013 UWRF School Psychology Practicum Handbook Page 63
Food Checklist
Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Each time I eat something that is
on my "Okay List" I make a mark
here.
Each time I eat something that is
not on my "Okay List" I make a
mark here.
I ate only foods that were on my
"Okav List" today (Ratinq 3).
I ate a little food that was not on
mv "Okav List" today (Rating 2).
I ate a lot of food that was not on
mv "Okav List" today (Ratinq 1).
My parent agreed with my ratings
today.
Rating Comparison Checklist
Week Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
Did I reach my goal for turning in
assiqnments?
Suqar Ratinq (1, 2, 3)
Food Ratinq (1,2,3)
Evaluation
The success of the intervention was evaluated based on an A-B design, with A representing the
baseline and B representing the implementation of the described intervention. Although it would
not be a good idea to eliminate the components of the intervention in which her diet and sugar
were monitored and controlled, it was possible to keep track of the levels of implementation for
these factors. Thus, it was confirmed that the rate of turning in assignments was related to diet
and sugar levels, with better control of health components being related to higher rates of
turning in assignments.
2012-2013 UWRF School Psychology Practicum Handbook Page 64
Percent of Turning in Assignments Comparing Baseline to Goal
Comparison Chart
2012-2013 UWRF School Psychology Practicum Handbook Page 65
Kara's rate of turning in assignments during baseline was 50%. After four weeks of the intervention, her
rate increased to an average of 95%. The classroom teacher reported Kara's general affect and
socialization seemed to improve after the intervention was implemented. Kara reported she felt much
better when her sugar was under control, as a result of the change in her diet. However, she also indicated
it would probably be difficult to continue to do this for the rest of her life. Treatment integrity for the
intervention ranged from 70% to 100% during the entire intervention phase.
The parents, teacher and school psychologist team met at the conclusion of the four-week intervention
period and agreed the intervention was a success. However, all expressed concern Kara would need to
learn to self-manage her diabetes with the ongoing support of her family and her teachers. A strong
cautionary note was expressed by the team. The members felt the monitoring intervention should not be
considered an option, but instead is necessary for Kara to keep her good health. Generalization to all
times and settings continued to be a concern.
It is recommended periodic meetings between Kara's family and the classroom teacher be conducted each
year to ensure Kara's health and academic progress are well managed.
2012-2013 UWRF School Psychology Practicum Handbook Page 66
Appendix P
2012-2013 UWRF School Psychology Practicum Handbook Page 67
Intervention Integrity Rating Form
Use the following scale to help determine the integrity of the implementation of your
intervention. Consider the questions with the entire timeframe of the intervention in mind. This is
only a guide. You may develop your own integrity rating scale to better suit the specific
intervention being implemented.
1 = Never or rarely
2 = Sometimes or inconsistently
3 = Often or most of the time
4 = Always or almost always
Intervention Integrity Evaluation Guide:
The following is intended to be a guide only for the total score. Please, review scores for each
item carefully and use professional judgment at all times.
13-16 = Strong Intervention Integrity; Intervention Often or Always implemented properly
11-12 = Average or adequate Intervention Integrity; Intervention may have been implemented
properly at times but not ideal; Intervention results may be questionable
< 11 = Poor Intervention Integrity; Intervention results cannot be evaluated properly
The intervention was used as designed/developed
1 2 3 4
The agreed upon intervention materials were used
1 2 3 4
The agreed upon consequences/reactions were contingently delivered
(e.g., reinforcers, feedback, rewards, etc.) 1 2 3 4
The agreed upon charting of intervention progress was completed
(e.g., tally marks, self-monitoring, etc.) 1 2 3 4
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 68
Appendix Q
2012-2013 UWRF School Psychology Practicum Handbook Page 69
UWRF School Psychology Program Intervention Case Study Appraisal Rubric
Candidate: ___________________________________________________________________
Rater: _____________________________________________________________________________
Year in Program: 3rd
(Practicum) or 4th
(Intern) Date: __________________________
RATING INSTRUCTIONS:
While passing levels will vary by year in the program (see table below), all ratings should be
assigned with the expectations of a graduating intern in mind. Feedback to the candidate should
be provided about her or his intervention skills and awareness relative to graduating-intern
expectations. A non-passing level TOTAL score may necessitate the development of a
Professional Growth Plan (see Appendix Y of the UWRF school psychology program handbook)
or other new goals for the candidate.
The Intervention Case Study rubric has 57 total points. Passing levels vary by year in program,
as follows:
Year in Program TOTAL rubric passing level Practicum, Year 3 70% (40+)
Intern, Year 4 80% (47+)
Please, rate the candidate on each item using the scale below. Comments on any particular strength or
challenging characteristic may be written in the box at the end of the rubric.
RATING SCALE:
1: This intervention component is not clearly included or minimally described
2 or 3: This intervention component is adequately described or comprehensively described
(assignment of 2 or 3 will depend on maximum item score – varies by item).
2012-2013 UWRF School Psychology Practicum Handbook Page 70
Section 1:
Problem
Identification
3 2 1 LEVEL
1.1 Student’s behavior is defined
in the context of appropriate
grade and/or peer expectations
The student’s behavior is
operationally defined.
The student’s behavior is
identified by not operationally
defined.
1.2 The problem is
collaboratively defined.
The problem is not
collaboratively defined.
1.3 The discrepancy between
current and desired level of performance is explained.
The behavior is operationally
defined or quantified in terms of both current and desired
level of performance
The behavior is not operationally
defined in terms of both current and desired levels of
performance.
1.4 Baseline includes the student behavior and peer/grade
norms and expectations with
computed trend lines.
A baseline for the student is established using sufficient
data.
A baseline for the student behavior is not established or
has insufficient data.
1.5 The student behavior is identified as a skill deficit or
a performance deficit.
The student behavior is not identified as a skill or
performance deficit.
1.6 Parents/guardians and teachers are involved in the
problem-identification
process.
Parents/guardians and teachers are not involved in the problem-
identification process.
TOTAL
Section 2:
Problem
Analysis
3 2 1 LEVEL
2.1 Hypotheses are generated through collaboration with
teacher and/or parents.
One or more hypotheses are developed to identify the
functions that the behavior
serves and/or the conditions under which the behavior is
occurring (two or more of the
following factors: child factors, curriculum, peers,
teacher, classroom, home.)
Hypotheses are not developed or are developed in only one area
and/or hypotheses are not
measurable.
2.2 There are multiple sources of data that converge on each
proposed hypothesis.
There is evidence that appropriate data are collected
to confirm or reject the
proposed hypotheses. Appropriate data include one
or more of the following:
record review, interview, observation, testing, self-
report.
Appropriate data are not collected to confirm or reject the
hypotheses.
2.3 Hypotheses reflect an awareness of issues of
diversity (e.g., physical,
social, linguistic, cultural).
Hypotheses do not reflect an awareness of issues related to
diversity.
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 71
Section 3:
Intervention
3 2 1 LEVEL
3.1 Intervention is linked to observable,
measurable goal statement(s).
Intervention is not linked to
observable, measurable goal
statement(s).
3.2 Intervention selection is based on data from problem analysis and
hypothesis testing.
Intervention selection is not based on data from problem
analysis and hypothesis testing.
3.3 Intervention is evidence-based (e.g., research literature, functional
analysis, single case design
analysis).
Intervention is not evidence-based.
3.4 Intervention is developed collaboratively.
Intervention is not developed collaboratively.
3.5 Intervention reflects sensitivity to
individual differences, resources, classroom practices, and other
system issues. Acceptability of
intervention is verified.
Intervention does not reflect
sensitivity to individual differences, resources, classroom
practices, and other system
issues. Acceptability of intervention is not verified.
3.6 Logistics of setting, time, resources,
and personnel are included in the intervention plan.
Logistics of setting, time,
resources and personnel are not included in the intervention plan.
3.7 Intervention selection considers
unintended outcomes or limitations.
Intervention selection does not
consider unintended outcomes or
limitations.
3.8 Intervention is monitored and data
are provided to ensure that it is
implemented as designed (Intervention Integrity)
Intervention Integrity is not
monitored.
TOTAL
Section 4:
Evaluation 3 2 1 LEVEL
4.1 Charting includes student
performance trend lines
and/or goal lines.
Progress monitoring data are
demonstrated on a chart.
Progress monitoring data are not
demonstrated on a chart.
4.2 Progress monitoring data are
demonstrated to be effective
when compared to data generated from multiple
sources/settings.
Progress monitoring data are
demonstrated to be effective
when compared to baseline data.
Intervention is not demonstrated
to be effective through data
comparison.
4.3 Responses to Intervention
data are used to inform problem-solving and decision
making. Single-case design
was specified.
Data are used to inform
further problem solving and decision making (i.e.,
continuation of intervention,
modification of intervention, maintenance of intervention).
Data are not used to inform
further problem-solving and decision making.
4.4 Strategies for
transfer/generalizing outcomes to other settings are
documented as effective.
Strategies for
transfer/generalizing outcomes to other settings are
addressed.
Strategies for
transfer/generalizing outcomes to other settings are not
addressed.
4.5 Modifications for future interventions are considered
based upon collaborative
examination of effective data.
Effectiveness of intervention is shared through
collaboration with parents,
teachers, and other personnel.
Effectiveness of intervention is not shared or communicated.
4.6 Strategies for follow-up are developed and implemented.
Suggestions for follow-up are developed (e.g., continued
progress monitoring,
transition planning).
Suggestions for follow-up are not developed.
TOTAL
2012-2013 UWRF School Psychology Practicum Handbook Page 72
Summary Data for the Intervention
Comments/Recommendations:
______________________________________________________________________________
Supervisor/Date
CASE STUDY OVERALL RATING
Section 1 TOTAL ___/15
Section 2 TOTAL ___/8
Section 3 TOTAL ___/16
Section 4 TOTAL ___/18
RUBRIC TOTAL ___/57 P or F
Intervention Integrity Rating (separate form)
(80 to 100% is considered acceptable)
___%
Effect Size or % of Non-overlapping data points
<.20 = little or no effect
.20 = small effect
.50 = medium effect
.80+ = large effect
___
2012-2013 UWRF School Psychology Practicum Handbook Page 73
Appendix R
2012-2013 UWRF School Psychology Practicum Handbook Page 74
READINESS FOR INTERNSHIP: SUPERVISOR RATINGS
To help assess candidate readiness for internship, the following ratings must be requested from
two practicum field-based supervisors and the practicum university-based supervisor by April 1st
of the spring semester. The data collected will be used by candidates as they develop internship
goals. In some cases, the faculty may require the candidate to complete a more thorough
Professional Growth Plan or, in cases where significant improvement is required, a candidate
may be denied access to the internship altogether. Supervisors are asked to provide a candid
assessment of the practicum candidate below. Thank You.
Unacceptable Needs Some
Improvement
Adequate Above
Average
Exceptional Cannot
Rate
Initiative
Dependability
Verbal Communication
Written Communication
Flexibility/Adaptability
Cooperation/Collaboration
Independence
Emotional Stability
Leadership
Organization
Professional Ethics
Willingness to work
outside personal zone of
comfort (i.e., desire to
broaden experiences)
Respect for Diversity
Responsiveness to
Feedback
2012-2013 UWRF School Psychology Practicum Handbook Page 75
In your judgment, is this individual a good candidate for the internship experience? YES NO
Please, offer suggestions to help this candidate prepare for internship:
Candidate Name:
Supervisor Printed Name:
Supervisor Signature: Please, return this form to: Scott Woitaszewski, Wyman Education Building, UWRF, River Falls, WI 54022
FOR PROGRAM DIRECTOR USE ONLY:
By the end of the spring semester of practicum:
- PRAXIS exam has been taken at least once. Date:_______; Passing Date:_______
- Directed Research project completed. Date:_______
- Programmatic Portfolio Approved. Date:________
- NO incomplete grades from any program courses. Confirmation Date:_______