Table of Contents
Program Mission…………………………………………………………. Page 2
Program Goals……………………………………………………………
Background and History of the
RIT School Psychology Program………………………………………...
Page 3
RIT School Psychology Faculty………………………………………….
Page 4
Page 4
What Exactly is Practicum?........................................................................ Page 5
Practicum Sequence……………………………………………………… Page 5
Field-Based Practicum Supervisor Responsibilities……………………... Page 6
University-Based Practicum Supervisor Responsibilities………………..
Page 7
Practicum Student Responsibilities………………………………………
Page 8
Assessment for Practicum Students……………………………………… Page 8
RIT School Psychology Proposed Plan of Study..……………………….
Appendix A
Optional Activities for RIT Practicum Students…………………………. Appendix B
NASP Competencies & Levels of Intervention………………………….. Appendix C
Field Experience I Plan and Evaluation…….………………………….
Appendix D
Field Experience II Plan and Evaluation…………................................
Appendix E
Advanced Practicum I Plan and Evaluation……………………………..
Appendix F
Advanced Practicum II Plan and Evaluation…………………………….. Appendix G
Student Evaluation of Practicum Placement and Supervisor…………….
Appendix H
University Evaluation of Student………………………………………...
Appendix I
Practicum Log/Timesheet………………………………………………... Appendix J
Practicum Agreement…………………………………………………….
Appendix K
Reciprocity Agreement…………………………………………………... Appendix L
Page 2
Welcome
Thank you for assisting in a crucial part of RIT’s school psychology program! As a practicum
supervisor, you provide a School Psychology graduate student with unforgettable experiences with
children, parents, and teachers. This service is invaluable, and one of the reasons why students
choose our program.
The practicum experience has been designed to provide our graduate students with skills consistent
with our mission and program philosophy, and is consistent with the domains of the School
Psychology Blueprint for Training and Practice III (See Appendix C).
The RIT School Psychology MS/AC program embraces the scientist-practitioner framework for the
preparation of students to become professional school psychologists. The scientist-practitioner
school psychologist is a professional who has developed an empirical understanding of human
behavior in order to apply a wide breadth of knowledge in assessment, intervention, cultural
diversity, research, curriculum and instruction, technology, and ecological influences on child and
adolescent behavior. The scientific basis results in a highly skilled practitioner who has a thorough
understanding of educational and psychological research and practice and is capable of independent
decision making, serves as an advocate for children and families, and uses strength-based solutionfocused problem solving in order to help children succeed in their school environment. All students
are expected to demonstrate high standards of competence in their professional interactions with
children, parents, and school personnel. The School Psychology Program stresses that interventions
with and evaluations of children and youth emerge from a comprehensive, flexible, ecological
perspective that draws form fields of study such as psychology, biology, education, and sociology.
From a multicultural perspective, the program stresses the understanding of, respect for, and
responsiveness to the unique needs of children and their families.
The RIT school psychology program’s training model incorporates a reciprocal relationship
between coursework and fieldwork whereby theories, techniques, and relevant literature presented
in courses are supplemented by field experiences. As students gain greater depth of knowledge of
school psychology through the course curriculum, field experiences become increasingly
comprehensive. During their first year of study, students learn a variety of methods of gathering
reliable and valid data (e.g., observations, interviews, standardized assessment, report writing) and
practice gathering data in their field experiences using these methods. Concurrently, first year
students interact with a variety of school personnel in their field placements to experience the
operations and organizations of school systems and the role and function of the school psychologist.
During their second year of study, students learn how to use collected data to develop, implement,
and evaluate interventions. Second-year field experiences provide students with opportunities to
apply and evaluate academic and behavioral interventions, consult with teachers and parents,
counsel children and adolescents, and conduct psychoeducational evaluations, all under close
supervision. During their third year of study (internship year), students continue to develop their
professional skills, maintaining a scientific orientation while adhering to a high level of
professional and ethical standards in order to function as an independent school psychologist.
Revised 8/2015
Page 3
RIT School Psychology Goals
Goal 1: Students will develop a professional identity as a school psychologist whose conduct is
consistent with NASP and APA ethics codes, and Best Practices.
a. Students will demonstrate professional and interpersonal characteristics known to foster the
trust and respect of those with whom the student encounters in his or her professional roles.
b. Students will consider the influence of individual differences and cultural diversity factors
on development, behavior, and functioning in all areas of practice.
c. Students will demonstrate relevant knowledge and provide services consistent with legal
regulations and ethical standards in school psychology.
d. Students will participate in the activities related to state and/or national professional
organizations (e.g., NASP, NYASP, CEC, etc.)
Goal 2: Students will develop competency in the application of the scientific method and its
resultant body of knowledge.
a. Students will demonstrate competence in the critical review and evaluation of the
psychological and educational research literature.
b. Students will apply principles of research design, data analysis and data interpretation to
school-related problems and original research.
c. Students will acquire content knowledge of psychological foundations relevant to children’s
development and schooling.
Goal 3: Students will develop competency in data-based decision making and accountability.
a. Students will have knowledge of varied methods of assessment in education (e.g., normreferenced, curriculum-based, direct behavior, ecological) and the psychometric properties
for various purposes (e.g., screening, intervention development, progress monitoring).
b. Students will develop competency in selecting, administering, scoring, interpreting, and
integrating psychological assessment data in response to a defined referral concern.
c. Students will become skilled at translating assessment and data collection to conceptualizing
and evaluating the implementation of and response to interventions.
Goal 4: Students will develop competency in collaborating with families and school
professionals in providing effective academic and mental health services to children at
individual and systemic levels.
a. Students will participate meaningfully on teams charged with developing and implementing
effective school-wide practices that promote academic success and mental health in
children.
b. Students will engage parents in ongoing collaboration with the school in providing effective
services to their child(ren).
c. Students will contribute meaningfully to the development, implementation, and evaluation
of effective interventions for students identified as needing additional academic support.
d. Students will contribute meaningfully to the development, implementation, and evaluation
of effective interventions for students identified as needing additional behavioral and/or
social-emotional support.
Revised 8/2015
Page 4
Program Background
The Rochester Institute of Technology (RIT) offers a three-year program of graduate study in
school psychology at the specialist level. The program is 66 semester credits and culminates in a
Master of Science degree and an Advanced Certificate. The RIT school psychology program is
fully accredited through the New York State Department of Education and approved by the
National Association of School Psychologists. Upon graduation from the school psychology
program, students receive provisional certification by the New York State Department of Education.
A Master of Science degree in school psychology through the College of Liberal Arts was first
established at RIT in 1986, as it was deemed consistent with RIT’s mission of providing educational
programs for career development. By 1994, the school psychology program became fully approved
by the National Association of School Psychologists. Presently, the school psychology program is
housed within the Department of Psychology in the College of Liberal Arts.
RIT School Psychology Faculty
Suzanne Bamonto, Ph.D.,
Associate Professor
Graduate Program Director, Psychology Department
Paula Chase, M.S., A.C.
Lecturer
Practicum and Internship Coordinator
Scott P. Merydith, Ph.D.
Professor
Jennifer Lukomski, Ph.D., NCSP
Professor
Vincent Pandolfi, Ph.D.
Associate Professor
Revised 8/2015
Page 5
What Exactly is Practicum?
Practicum is an opportunity for RIT’s school psychology students to gain hands-on experience in
the schools as they progress through their coursework at RIT. From the first day of classes, students
are assigned field supervisors who are school psychologists in local school districts or agency
settings. Through practicum, students learn how schools function as organizations, the various roles
of school psychologists and other school personnel, the issues and needs of children and their
families, how research and theory learned in class applies to the practice of school psychology, and
most important, students apply what they are learning. This field experience is part of what makes
RIT’s school psychology program unique, as many training programs only offer one or two
semesters of direct experience in schools.
Students are expected to spend one full school day (6 hours) per week at their practicum site (a total
of 15 days per semester). When a student is unable to attend on a scheduled day, the student notifies
the field placement supervisor in advance and schedules a make-up day. In addition, the RIT School
Psychology program requires that students attend weekly on campus seminars, online discussions,
and practicum lectures.
Typically the first-year Field Experience students will be placed in a different setting each semester.
It is expected that second-year Advanced Practicum students will spend the entire year in the same
placement. Therefore, each student should experience three different field settings during their first
two years of study.
Over the course of the two year period, great care and consideration is made in placing students in a
variety of settings (i.e., rural, urban, suburban ), with a range of ages (i.e., preschool, elementary,
middle school, and high school students), as well as with a continuum of services (regular
education, resource, self-contained, hospital, residential).
Fortunately, the Rochester and Western New York area offers an excellent range of school settings
for practica experiences. In the course of training, RIT students gain experience at all educational
levels with a diverse pupil population relative to cultural-ethnic background, disability, and SES.
RIT practica students rotate through these placements and emerge with a better sense of problem
solving opportunities, and the challenges facing today’s educational system.
Practicum Sequence
Field Experience I: Professional School Psychology Foundations
In their first semester of practicum, students become acquainted with how school systems are
organized and operate. They observe the school psychologist's many roles and functions. Most
students in the first rotation are placed in a suburban or rural school district. The activities they
become involved in correspond with their fall coursework. Over the first year, students conduct
classroom observations and, tutor students, participate in pre-referral strategies, conduct limited
assessments (e.g., achievement testing and selected cognitive subtests), and consult with teachers.
Revised 8/2015
Page 6
Field Experience II: Professional School Psychology Foundations
In their second semester of practicum, students broaden their hands-on experiences and deepen their
skills. They are encouraged to be proactive and take initiative. Corresponding with more advanced
coursework, students begin to do Curriculum Based Measurement, prevention programming,
functional behavior analyses and more comprehensive evaluations using a variety of assessment
techniques. They are also able to compare and contrast their first semester experience with their
second semester experience.
Advanced Practicum I and II: Issues in Diversity
The second year of practicum is the culminating field experience prior to the student’s internship
year. This is where students apply their knowledge and skills to the field in a more integrative, as
well as independent level. The two overriding expectations for this experience are for students to
take initiative and for them to become more independent. Under the supervision of the field
supervisor, students’ will deepen the level of their assessment skills and their role in direct-indirect
interventions.
Sensitivity to the diverse cultural student populations that we have in the Greater Rochester Area is
crucial. Many of the students in this third practicum will be working with inner city youth of
Rochester, as well as with special programs administered by BOCES personnel.
For this advanced practicum experience students can administer, score, and interpret (with
supervision) a wide range of tests (cognitive, achievement, and social-emotional). They are also
able to do curriculum based measurement and progress monitoring. The program expects that
students do one or the other form of assessment (e.g., Standardized or CBM), or a combination of
both during their Practicum Three experience. Students will also present students’ performance to
parents, and/or multidisciplinary teams and be more actively involved in home/school collaboration.
In addition, students will be expected to conduct a FBA and BIP, and independently implement
other interventions (academic as well as social emotional). Students are expected to counsel
(individual or group) and facilitate small group lessons (skill streaming or academic activities).
Another expectation is for students to conduct a mini inservice on a related topic either to the school
team, teachers, staff (e.g., bus drivers, cafeteria workers, student aides), parents, or PTA.
Field-Based Practicum Supervisor Responsibilities
The main responsibility of a field-based practicum supervisor is to oversee all site related activities
that the practicum student performs.
The Practicum Agreement (See Appendix K) needs to be signed at the beginning of each semester
by your practicum student and you, and reviewed by the two of you together. This means both of
you need to read, understand, and agree on it before you sign.
Activities a practicum student engages in depend on his or her level within the school psychology
program. For example, a second year student will be more adept with testing materials than a
Revised 8/2015
Page 7
beginning first year student. Knowing RIT’s school psychology Proposed Plan of Study (See
Appendix A) will help you become familiar with what students may have covered in classes. Please
review the Optional Activities for RIT Practicum Students (See Appendix B), as well as the
activities listed on each practicum experience’s practicum plan (See Appendices D, E, F, G). You
will find that practicum students become more independent over the three rotations as their skills
and knowledge develop, from shadowing you and doing classroom observations, to administering
tests, consulting, and counseling students under supervision.
During the first two weeks of each semester, you and your practicum student will discuss the
potential activities the student will experience. The student will then fill out the designated
Practicum Plan (See Appendices D, E, F, G). Students may add to the Practicum Plan throughout
the semester.
It is important for you as the practicum supervisor to know that class assignments are not the
student’s reason for being placed at a practicum site. If a conflict arises and a class assignment
cannot be completed at the practicum site, please inform the student and he or she is responsible for
making other arrangements.
At the end of each semester, an evaluation form regarding your practicum student's performance
(See Appendices D, E, F, G) needs to be completed. This evaluation gives us the chance to gain
information about the student’s skills as a psychologist in-training, and any other information that
you deem important for us to know. In addition, the Practicum Plan should be reviewed and signed,
and the completed activities initialized.
University-based practicum supervisors are available at all times. Please feel free to contact the
university practicum supervisor if you have any questions, concerns, or positive experiences
regarding your practicum student.
We do realize it takes your energy, dedication, time, and commitment to provide a truly beneficial
practicum experience for our graduate students. With this in mind, RIT would like to offer you a
tuition waiver to acknowledge your commitment and devotion to school psychology training and
the community at large. We offer practicum supervisors eligibility to have tuition waived for a
course at RIT within one year from the date of termination of the practicum student supervision
(See Appendix K for details).
University-Based Practicum Supervisor Responsibilities
The two primary responsibilities of the university-based practicum supervisor are to provide the
necessary support for the field-based practicum supervisor and the practicum student, ensuring a
positive experience for both, and to formally evaluate the practicum student’s progress. Through
reading the student's weekly journals, contacting the field supervisor, monitoring the student's logs,
and providing group supervision during the weekly seminar, the university supervisor is kept
abreast of practicum experiences.
Even when minor concerns arise regarding the practicum student’s conduct, the university-based
supervisor appreciates receiving a phone call or an e-mail. When necessary, the university-based
Revised 8/2015
Page 8
supervisor will meet with the field supervisor to problem solve regarding helping the student benefit
from the practicum experience.
Through evaluation forms completed each semester, the university-based practicum supervisor is
kept abreast of the field-based supervisor’s impressions of the student’s competencies. Faculty
members are especially eager to hear how the practicum student is doing with professional conduct
and personal presentation. Site visits are optional and are made on an individual basis. The
university-based practicum supervisor will contact the field-based supervisor to see if he or she
desires a site visit.
The university-based practicum supervisor is also responsible for developing practicum sites and
placing students in their sites.
Student Responsibilities
Practicum students are required to keep a weekly log of their practicum hours (See Appendix I),
documenting what they did while at their sites. This is our way of ensuring that their experience is
valuable. The log needs to be reviewed and signed by you each time a student attends practicum to
ensure its validity and to make sure the student is keeping accurate records.
In addition, students write weekly reflection papers highlighting their experiences. At the end of
each placement, students also fill out an evaluation form rating their practicum site and supervisor
(See Appendix G).
Practicum students are responsible for keeping track of all required paperwork and providing you
with the necessary forms. The student will sit down with you to discuss the Practicum Plan for the
semester and to review this plan at the end of the semester.
Policy on Assessment for Practicum Students
We realize that assessment is an integral component of the training process for a school
psychologist. We do not expect all settings to offer assessment exposure. However, if you have an
opportunity, we encourage you to expose your practicum student to the assessment process in your
setting.
We do not require, nor expect, practicum supervisors to provide our students with individual testing
cases. Students do have course requirements to test typically developing children, and can do so in
the practicum setting with permission. In some school districts, our practicum students find
children to test by contacting teachers or other school personnel who offer their own children for
that purpose. Other school districts have allowed students to write a letter of consent home to
parents (with an attached notice of consent from the school district) asking for willing participants.
However, these are not expectations that we make of practicum supervisors and school districts, and
we work with our students to find alternative testing arrangements if necessary.
First-year practicum students are not prepared to conduct initial assessments. If an assessment is
conducted as part of an instructional program for the purposes of progress monitoring, however, and
will not be used for classification or change of placement decisions, then students in Field
Revised 8/2015
Page 9
Experience II may be suitable assessors, as long as the students’ coursework has prepared them for
that particular measure.
We do believe that students who have completed all of the assessment courses (typically concluded
after the fall semester of the second year) are capable of conducting full evaluations under close
supervision from their practicum supervisor. It is our policy, however, that the assessment activities
be restricted to reevaluations with no more than two reevaluations per semester. Additionally,
parental consent needs to be obtained permitting a school psychology student in training to conduct
the evaluation.
Advanced Practicum students are also available to conduct curriculum based evaluations for
intervention purposes, as well as to develop and evaluate short-term academic interventions.
We hope this provides you with some clarification on the role of practicum students regarding
testing. If you have additional questions, please call us (585-475-6701).
Revised 8/2015
Page 10
Appendix A: RIT School Psychology Proposed Plan of Study
First Year
Fall
Field Experience I: Professional School
Psychology Foundations
Advanced Developmental Psychology
Interpersonal Intervention Skills
Academic Assessment
Statistics
SPSY 600
SPSY 610
SPSY 620
SPSY 630
SPSY 640
Spring
Field Experience II: Professional School
Psychology Foundations
Cognitive Assessment
Social-Emotional Assessment
Applied Behavior Analysis
Academic Intervention
SPSY 601
SPSY 631
SPSY 632
SPSY 650
SPSY 721
Second Year
Fall
Advanced Counseling
Advanced Practicum I: Issues in Diversity
Developmental Psychopathology
Advanced Consultation
Comprehensive Assessment Integration
SPSY 722
SPSY 701
SPSY 710
SPSY 720
SPSY 730
Ethical and Legal Issues
Biopsychology
Advanced Practicum II: Issues in Diversity
SPSY 603
SPSY 611
SPSY 702
Systems and Organizational Interventions
Research Methods
SPSY 723
SPSY 641
Spring
Third Year
School Psychology Internship
SPSY 750
Revised 8/2015
Page 11
Appendix B: Optional Activities for RIT Practicum Students
Child
1.
2.
3.
4.
5.
6.
Meet the buses and escort children
Shadow a student for a day (high school)
Attend home visits
Become a Big Brother/ Big Sister
Observe and practice rapport building
Facilitate an anti-bullying group
Classroom
1.
2.
3.
4.
5.
Acquire an understanding of curriculum at each grade level
Observe social skills and behavioral interactions within the classroom
Observe and note effective classroom management and effective teaching variables
Volunteer in the resource room
Observe and compare different classroom situations
a. Grades
b. Inclusion
c. Learning styles
d. Teaching styles
e. Behavior management/modification
f. Students approach to a given task
g. Team teaching
6. Help a teacher plan a lesson/day
7. Team teach a lesson (with preparation)
8. Perform/observe non-traditional roles (e.g. supporting intramural activities)
9. Attend a field trip
10. Make note of strategies encountered in a journal for future reference
11. Act as a classroom helper
Building
1.
2.
3.
4.
5.
6.
7.
Attend faculty meetings
Attend parent-teacher conferences
Attend parent-psychologist conferences
Attend open house
Attend extra-curricular events
Read building newsletter
Understand student health issues and precautions (e.g. how to deal with bodily fluids, such
as blood, etc.)
8. Learn about professional turf issues
Revised 8/2015
Page 12
District
1.
2.
3.
4.
5.
6.
Attend Board of Education meetings
Attend meetings of the district psychologists
Assist in the development of district research policies
Learn about transportation requirements/policies
Learn about budgeting and financial issues
Observe grade level meetings
a. Curriculum development
b. Needs assessment
c. Mental health needs
7. Attend Staff Development Day
8. Study District Initiatives
9. Read the district newsletter
10. Attend TCI, LSCI, or SKIP training
Community
1.
2.
3.
4.
Attend home visits
Attend special events that relate to the community
Investigate sources of student support
Visit community agencies and out-of-district placements that provide services to the district
a. Meet the service providers
b. Observe/interview
c. Observe students receiving services
5.
6.
7.
8.
Understand the services provided by community agencies
Attuned programs designed for professional development
Go to popular “hangouts” to find out about student life outside of school
Acquire an understanding of cultural/ethnic issues through:
a. Reading
b. Observation
c. Interviewing
9. Acquire an understanding of safety issues related to the school community
10. Attend SETRC training
11. Perform out-reach to children who are hospitalized
12. Attend conferences
13. Attend parent support groups – district and city
14. Work with teen mothers
15. Learn process of referral to community agencies
Revised 8/2015
Page 13
Appendix C: NASP Competencies and Levels of Intervention
NASP COMPETENCIES:
Interpersonal and Collaborative Skills:
School psychologists must show the ability to work constructively and collaboratively with
diverse individuals and agencies, to communicate well and to disseminate information
clearly to others, and to recognize the fact that soliciting input from others may be as
important as imparting knowledge or sharing expertise.
Diversity Awareness and Sensitive Service Delivery:
School psychologists must have the ability to recognize when, where, and how issues of
diversity are manifest and operating within a wide variety of levels, to adapt their practices
in response to the needs of those being served, and to become aware of their own personal
world views and biases. School psychologists must use this recognition and knowledge to
help schools effectively embrace and address issues of diversity.
Technological Applications:
School psychologists must have the ability to help students, parents, and teachers know how
and where to access technology, and how to evaluate its safety and value, as well as how to
use it to enhance classroom learning. School psychologists must also be able to use
technology to communicate, and to increase efficiency with data gathering and storage,
progress-monitoring, assessment, and record keeping.
Professional, Legal, Ethical, and Social Responsibility:
School psychologists must practice in a manner that meets all professional and legal
standards in order to enhance the quality of services and protect the rights of all parties. Not
only does this include issues involving students directly, but it demands that school
psychologists continue their education through professional development activities and
should be aware of, and not exceed, the limits of their personal competency.
Data-based Decision Making and Accountability:
School psychologists must be good problem solvers who collect information that is relevant
for understanding problems, make decisions about appropriate interventions, assess
educational outcomes, and help others become accountable for the decisions they make both
at the student and the system level. School psychologists must be well-versed in a variety of
assessment methods that relate to both prevention and intervention.
Systems-based Service Delivery:
School psychologists must understand how systems work, and must use this understanding
to help organize schools and classrooms in ways that promote learning and prevent
problems. School psychologists must provide leadership in developing schools as safe,
civil, caring, inviting places where there is a sense of community, respect, and high
expectations of excellence for all. School psychologists must also realize that interventions
Revised 8/2015
Page 14
become more effective when parents and other primary caregivers are partners in
intervention design and implementation.
Enhancing the Development of Cognitive and Academic Skills:
School psychologists must participate in the development of challenging, but achievable,
cognitive and academic goals for all students, and must recognize the need to adjust
expectations and avenues of assessment for individual students. School psychologists must
also be able to apply learning theory and cognitive strategies to the instructional process, to
communicate these effective strategies to students, parents, and other school personnel, and
to help monitor the integrity of interventions and instructional practices.
Enhancing the Development of Wellness, Social Skills, and Life Competencies
School psychologists must help schools attend to the general health, mental health, and
welfare of students in order to ensure effective academic development. They can
accomplish this by helping to design prevention and intervention programs that promote
wellness and resiliency. Also, school psychologists must have minimal competency in a
variety of crisis situations, and must know where and how to access further resources if they
are needed. Finally, school psychologists must participate in the development of
challenging, but achievable behavioral, affective, and adaptive goals for all students to
encourage conflict-resolution and pro-social behavior.
LEVELS OF INTERVENTION:
Universal
Systems-level programs directed at all and designed to meet the academic and socialemotional needs of the vast majority of students. These include, for example, the use of
evidence-based approaches to reading and math instruction or the implementation of
positive school-wide discipline program to reduce problems with behavior management.
Targeted
Address specific academic or social-emotional skill or performance deficits. This may
include a Title I reading intervention to supplement classroom reading instruction, or
redesigning environments to help coach students in social interactions.
Intensive
Used with children who have chronic or more severe difficulties. This may incorporate an
interagency component that brings home, school, and community together to address more
challenging needs.
Revised 8/2015
Page 15
Appendix D: Field Experience I Plan and Evaluation
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
FIELD EXPERIENCE I PLAN
Name: _____________________________________
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
FIELD EXPERIENCE I PLAN
NASP COMPETENCIES
ICS – Interpersonal and Collaborative Skills
DA – Diversity Awareness and Sensitive Service Delivery
TA – Technological Applications
R – Professional, Legal, Ethical, and Social Responsibility
DB – Data-based Decision Making and Accountability
SB – Systems-based Service Delivery
CAS – Enhancing the Development of Cognitive and Academic Skills
WSL – Enhancing the Development of Wellness, Social Skills, and Life Competencies
LEVEL – Level of Intervention… circle when completed
(1 – Universal, 2 – Targeted, 3 – Intensive)
DONE
Description of Activity
1. Tour school building
2. Observe and interview related
service professionals and school
principal
3. Curriculum Based Measurement
(e.g. DIBELS) and/or progress
monitoring
4. Observe/co-facilitate group or
individual counseling sessions
ICS
DA
TA
X
X
R
DB
SB
X
X
X
X
X
X
X
CAS
WSL
LEVEL
1
2
3
1
2
3
1
2
3
X
X
Revised 8/2015
1
2
3
Page 16
5. Administer Achievement (I) and
Cognitive (II) subtests with
direct supervision
6. Develop age/grade norms
through observations and
interviews with students
7. Perform record reviews and
discuss record content with
supervisor
8. Perform classroom observations
and present to supervisor
1
2
3
X
1
2
3
X
X
X
X
1
2
3
X
X
X
X
X
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
9. Attend CSE, IST, PPS, and/or
parent meetings
X
X
10. Visit alternative placement
locations
X
X
11. Attend PTA meeting
X
X
X
12. Review school’s crisis plan
X
X
X
Other activities:
Supervisor’s Initial Review
Approval ___________________________ Date ______
Supervisor’s Final Review
Approval ___________________________ Date ______
Revised 8/2015
Page 17
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
FIELD EXPERIENCE I EVALUATION
Name: _____________________________________
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
FIELD EXPERIENCE I STUDENT EVALUATION
Please use the following rating scale in evaluating the student at a novice level on characteristics
listed below.
N/A – Not applicable or not observed: Not an appropriate item for a practicum student at this
setting.
1 – Unsatisfactory: Student’s skill reflects insufficient mastery in this area. Student needs
additional development of this skill.
2 – Needs Improvement: Plans should be made to assure student gains extra practice in this area.
3 – Satisfactory: Student’s skill in this area is adequate at a novice level. Student should
continue to practice this skill under professional supervision.
4 – Competent at a novice level: Student is relatively independent in this skill.
Interpersonal and Collaborative Skills
1. Presents with a professional appearance
N/A
1
2
3
4
2. Demonstrates good judgment and common sense
3. Communicates and listens effectively
4. Relates well to students
5. Establishes effective collaborative relationships with
teachers and other school personnel
6. Shows respect for all school professionals, parents,
Revised 8/2015
Page 18
and students
7. Demonstrates enthusiasm
8. Approaches others in a warm, outgoing manner
9. Displays initiative and resourcefulness
10. Is receptive to constructive feedback
11. Articulates own strengths and weaknesses
12. Actively engages in professional discourse
13. Is concerned with quality of work
14. Is adaptive and flexible
15. Shows evidence of continued self-evaluation
Diversity Awareness and Sensitive Service Delivery
1. Achieves comfortable interactions with students,
families, staff, and other professionals of differing
ethnic backgrounds
2. Seeks culturally relevant information when working
with students and families
3. Demonstrates active learning about different cultures
N/A
1
2
3
4
N/A
1
2
3
4
4. Demonstrates acceptance for others’ values and
viewpoints
5. Shows concern, respect, and sensitivity for the needs
of students
6. Demonstrates an awareness of own world views and
biases
7. Shows sensitivity to sources of bias when selecting
and administering assessment measures
Professional, Legal, Ethical, & Social Responsibility
1. Observes scheduled hours and appointments in a
punctual manner
2. Is prompt in meeting requests, and follows through
when additional action is needed
Revised 8/2015
Page 19
3. Completes work in a neat, thorough, and accurate
way
4. Manages time efficiently
5. Keeps supervisors informed of unusual events and
activities, as well as routine matters in their school(s)
6. Uses information from supervisor in an appropriate
manner
7. Demonstrates an awareness of competency level, and
does not accept responsibilities beyond this level
8. Follows standardized procedures when administering
assessment measures
9. Maintains confidentiality when appropriate
10. Understands and follows district policies
11. Adheres to the NASP Standards for Professional
Ethics
12. Makes up missed time due to illness or other
conflicts
Technology
N/A
1
2
3
4
N/A
1
2
3
4
1. Uses computer scoring programs effectively, with
supervision
2. Uses assistive devices and appropriate systems in
order to communicate with students and families
3. Uses internet resources effectively
Assessment (Formal, CBM)
1. Understands the nature of a referral and the purpose
of assessment
2. Follows standardized procedures when administering
subtests
3. Performs record reviews and classroom observations
appropriately
4. Discusses student performance in a meaningful and
thorough manner – reflecting understanding
5. Discusses possible recommendations and
intervention strategies that follow from assessment
results
Revised 8/2015
Page 20
Intervention (Academic, Social, & Emotional)
N/A
1
2
3
4
1. Discusses the goals of interventions
2. Tutors students in effective, appropriate manner
Please provide comments regarding the student’s strengths and weaknesses, and descriptions of how
to strengthen the areas where there are weaknesses:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
Other comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
The signature of the field supervisor below attests to the fact that the student has completed all
assigned cases as appropriate and has completed the practicum according to all guidelines and
requirements at this point.
_________________________________
Practicum Student Signature
_________________________________
Field Supervisor Signature
_________________________________
University Supervisor Signature
Revised 8/2015
Page 21
Appendix E: Field Experience II Plan and Evaluation
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
FIELD EXPERIENCE II PLAN
Name: _____________________________________
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
FIELD EXPERIENCE II PLAN
NASP COMPETENCIES
ICS – Interpersonal and Collaborative Skills
DA – Diversity Awareness and Sensitive Service Delivery
TA – Technological Applications
R – Professional, Legal, Ethical, and Social Responsibility
DB – Data-based Decision Making and Accountability
SB – Systems-based Service Delivery
CAS – Enhancing the Development of Cognitive and Academic Skills
WSL – Enhancing the Development of Wellness, Social Skills, and Life Competencies
LEVEL – Level of Intervention… circle when completed
(1 – Universal, 2 – Targeted, 3 – Intensive)
DONE
Description of Activity
1. Assist with evaluations,
administering cognitive and
achievement measures under
close supervision
2. Curriculum Based Measurement
(e.g. DIBELS) and/or progress
monitoring
3. Utilize curriculum-based
assessment procedures in
decision making
4. Conduct FBA and develop BIP
5. Conduct formal consultation
with a teacher regarding
ICS
DA
X
X
TA
R
DB
SB
CAS
X
X
X
1
2
3
X
X
X
X
1
2
3
X
X
X
X
1
2
3
X
X
X
X
X
WSL
X
Revised 8/2015
LEVEL
1
2
3
1
2
Page 22
behavior and/or academic
interventions
6. Develop a data-based academic
intervention plan for an
individual student
7. Consult with teachers regarding
behavioral interventions
3
X
X
X
X
X
X
8. Consult with teachers regarding
academic interventions
X
X
X
9. Observe and interview related
service professionals
X
X
10. Participate in CSE meetings
and/or parent informing sessions
X
X
X
X
11. Perform record reviews and
structured class observations
X
X
X
12. Visit alternative placement
locations
X
13. Participate in problem-solving
team
X
15. Attend at least one PTA meeting
16. Examine school crisis plan and
interview a member of the crisis
team
Other activities:
X
X
X
X
X
X
X
14. Tour school, review school
policies and procedures
1
2
3
X
X
X
X
X
X
X
X
X
X
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
Revised 8/2015
Page 23
1
2
3
1
2
3
1
2
3
1
2
3
Supervisor’s Initial Review
Approval ___________________________ Date ______
Supervisor’s Final Review
Approval ___________________________ Date ______
Revised 8/2015
Page 24
Name: _____________________________________
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
FIELD EXPERIENCE II EVALUATION
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
FIELD EXPERIENCE II STUDENT EVALUATION
Please use the following rating scale in evaluating the student at a novice level on characteristics
listed below:
N/A – Not applicable or not observed: Not an appropriate item for a practicum student in this
setting
1 – Unsatisfactory: Student’s skill reflects insufficient mastery in this area. Student needs
additional development of this skill
2 – Needs Improvement: Plans should be made to assure student gains extra practice in this area.
3 – Satisfactory: Student’s skill in this area is adequate at a novice level. Student should continue to
practice this skill under professional supervision.
4 – Competent at a novice level: Student is relatively independent in this skill.
Interpersonal and Collaborative Skills
N/A
1
2
3
1. Presents with a professional appearance
2. Meets difficult situations with self-control
3. Demonstrates good judgment and common sense
4. Communicates and listens effectively
5. Disseminates information clearly
6. Relates well to students
7. Establishes effective collaborative relationships and
communicates well with parents
8. Establishes effective collaborative relationships with
teachers and other school personnel
9. Approaches others in a warm, outgoing manner
10. Displays initiative and resourcefulness
Revised 8/2015
4
Page 25
11. Is receptive to constructive feedback
12. Articulates own strengths and weaknesses
13. Initiates changes when appropriate
Diversity Awareness and Sensitive Service Delivery
N/A
1
2
3
4
N/A
1
2
3
4
N/A
1
2
3
4
1. Achieves comfortable interactions with students,
families, staff, and other professionals of differing
cultural backgrounds
2. Seeks culturally relevant information when working
with students and families
3. Demonstrates active learning about different cultures
4. Demonstrates an understanding of working with
interpreters
5. Demonstrates an awareness of own worldviews and
biases
6. Shows sensitivity to sources of bias when selecting and
administering assessments
Professional, Legal, Ethical, and Social Responsibility
1. Observes scheduled hours and appointments in a
punctual manner
2. Is prompt in meeting requests, and follows through
when additional action is needed
3. Completes work in a neat, thorough, and accurate way
4. Manages time efficiently
5. Keeps supervisors informed of unusual events and
activities, as well as routine matters in their school(s)
6. Uses information from supervisor in an appropriate
manner
7. Demonstrates an awareness of own competency level,
and does not accept responsibilities beyond this level
8. Follows standardized procedures when administering
assessments
9. Maintains confidentiality when appropriate
10. Understands and follows district policies
11. Adheres to the NASP Standards for Professional Ethics
12. Makes up time missed due to illness or other conflicts
Technology
1. Uses computer scoring programs effectively
Revised 8/2015
Page 26
2. Uses assistive devices and appropriate systems in
communicating with students and families (when
necessary)
3. Uses Internet resources effectively
Assessment
N/A
1
2
3
4
N/A
1
2
3
4
1. Identifies the nature of a referral and the purpose for
assessment
2. Accurately completes record reviews and preconsultation interviews
3. Identifies a variety of appropriate assessment tools
and/or strategies for use with particular cases (tests,
observations, interviews, rating scales, curriculumbased procedures, etc.)
4. Uses an ecological approach to assessment
5. Discusses student performance in a meaningful and
thorough manner, reflecting understanding of the
student within the context of the setting or situation of
concern
6. Discusses appropriate intervention strategies that follow
from assessment results
Intervention (Academic, Social/Emotional)
1. Clearly describes goals of interventions
2. Selects interventions based on child needs and known
efficacy
3. When co-leading groups, demonstrates skill in utilizing
group counseling techniques
4. Demonstrates skill in utilizing individual counseling
techniques
5. Uses effective instructional techniques when tutoring or
providing skill development (academic or social)
6. Uses effective instructional techniques in facilitating
small group lessons
7. Uses appropriate assessment techniques to monitor
intervention effectiveness and adjusts the interventions
accordingly
8. Participates in crisis interventions appropriately
Revised 8/2015
Page 27
Please provide comments regarding the student’s strengths and weaknesses, and descriptions of how
to strengthen the areas where there are weaknesses:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
Other comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
The signature of the field supervisor below attests to the fact that the student has completed all
assigned cases as appropriate and has completed the practicum according to all guidelines and
requirements at this point.
_________________________________
Practicum Student Signature
_________________________________
Field Supervisor Signature
_________________________________
University Supervisor Signature
Revised 8/2015
Page 28
Appendix F: Advanced Practicum I Plan and Student Evaluations
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
ADVANCED PRACTICUM I PLAN
Name: _____________________________________
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
ADVANCED PRACTICUM I PLAN
NASP COMPETENCIES
ICS – Interpersonal and Collaborative Skills
DA – Diversity Awareness and Sensitive Service Delivery
TA – Technological Applications
R – Professional, Legal, Ethical, and Social Responsibility
DB – Data-based Decision Making and Accountability
SB – Systems-based Service Delivery
CAS – Enhancing the Development of Cognitive and Academic Skills
WSL – Enhancing the Development of Wellness, Social Skills, and Life Competencies
LEVEL – Level of Intervention… circle when completed
(1 – Universal, 2 – Targeted, 3 – Intensive)
DONE
Description of Activity
17. Assist with evaluations,
administering cognitive,
achievement, and socioemotional measures under close
supervision
18. Curriculum Based Measurement
(e.g. DIBELS) and/or progress
monitoring
19. Present test results to parents
ICS
20. Consult with teachers regarding
behavioral and academic
interventions
X
DA
TA
X
X
X
R
DB
SB
CAS
WSL
X
X
X
1
2
3
X
X
X
1
2
3
X
X
X
X
Revised 8/2015
LEVEL
1
2
3
1
2
3
Page 29
21. Facilitate small group lesson
X
22. Observe and interview related
service professionals
X
23. Conduct or assist with at least
one FBA
X
24. Participate in CSE meetings
and/or parent informing sessions
X
X
X
X
X
X
X
X
X
25. Perform record reviews and
structured class observations
X
X
X
26. Visit alternative placement
locations
X
27. Participate in problem-solving
team (e.g. IST/PAT/SSS
X
29. Attend at least one PTA meeting
30. Examine school crisis plan and
interview a member of the crisis
team
31. Participate in and review crisis
interventions with supervisor (as
they occur)
X
X
X
X
X
28. Tour school, review school
policies and procedures
X
X
X
X
X
X
X
X
X
X
X
X
X
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
Other activities:
Revised 8/2015
Page 30
1
2
3
1
2
3
1
2
3
1
2
3
Supervisor’s Initial Review
Approval ___________________________ Date ______
Supervisor’s Final Review
Approval ___________________________ Date ______
Revised 8/2015
Page 31
Name: _____________________________________
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
ADVANCED PRACTICUM I EVALUATION
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
ADVANCED PRACTICUM I STUDENT EVALUATION
Please use the following rating scale in evaluating the student at a novice level on characteristics
listed below.
N/A – Not applicable or not observed: Not an appropriate item for a practicum student at this
setting.
1 – Unsatisfactory: Student’s skill reflects insufficient mastery in this area. Student needs
additional development of this skill.
2 – Needs Improvement: Plans should be made to assure student gains extra practice in this area.
3 – Satisfactory: Student’s skill in this area is adequate at a novice level. Student should
continue to practice this skill under professional supervision.
4 – Competent at a novice level: Student is relatively independent in this skill.
Interpersonal and Collaborative Skills
1. Presents with a professional appearance
N/A
1
2
3
4
2. Meets difficult situations with self-control
3. Demonstrates good judgment and common sense
4. Communicates and listens effectively
5. Disseminates information clearly to stakeholders
6. Relates well to students
7. Establishes effective collaborative relationships and
communicates well with parents
8. Establishes effective collaborative relationships with
teachers and other school personnel
9. Shows respect for all school professionals, parents,
and students
Revised 8/2015
Page 32
10. Demonstrates enthusiasm
11. Approaches others in a warm, outgoing manner
12. Displays initiative and resourcefulness
13. Is receptive to constructive feedback
14. Articulates own strengths and weaknesses
15. Actively engages in professional discourse
16. Concerned with quality of work
17. Is adaptive and flexible
18. Shows evidence of continued self-evaluation
Diversity Awareness and Sensitive Service Delivery
1. Achieves comfortable interactions with students,
families, staff, and other professionals of differing
cultural backgrounds
2. Seeks culturally relevant information when working
with students and families
3. Demonstrates active learning about different cultures
4. Demonstrates acceptance for others’ values and
viewpoints
5. Shows concern, respect, and sensitivity for individual
differences
6. Demonstrates an understanding of working with
interpreters
7. Demonstrates an awareness of own world views and
biases
8. Shows sensitivity to sources of bias when selecting
and administering assessment measures
Professional, Legal, Ethical, & Social Responsibility
1. Observes scheduled hours and appointments in a
punctual manner
2. Is prompt in meeting requests, and follows through
when additional action is needed
3. Completes work in a neat, thorough, and accurate way
N/A
1
2
3
4
N/A
1
2
3
4
4. Manages time efficiently
5. Keeps supervisors informed of unusual events and
activities, as well as routine matter in their school(s)
6. Uses information from supervisor in an appropriate
manner
7. Demonstrates an awareness of competency level, and
does not accept responsibilities beyond this level
Revised 8/2015
Page 33
8. Follows standardized procedures when administering
assessment measures
9. Maintains confidentiality when appropriate
10. Understands and follows district policies
11. Adheres to the NASP Standards for Professional
Ethics
12. Makes up missed time due to illness or other conflicts
Technology
1. Uses computer scoring programs effectively
N/A
1
2
3
4
N/A
1
2
3
4
N/A
1
2
3
4
2. Uses AIMSweb or other programs to participate in
progress-monitoring
3. Uses assistive devices and appropriate systems in
order to communicate with students and families
4. Uses internet resources effectively
Assessment (Formal, CBM, FBA/BIP)
1. Identifies the nature of a referral and the purpose for
assessment
2. Identifies appropriate assessment tools for use with
particular cases
3. Uses an ecological approach toward assessment
4. Discusses student performance in a meaningful and
thorough manner – reflecting understanding
5. Discusses appropriate recommendations and
intervention strategies that follow from assessment
results
Intervention (Academic, Social, & Emotional)
1. Clearly describes the goals of interventions
2. Uses strengths and evidence-based interventions
3. When co-leading groups, demonstrates skill in
utilizing group counseling techniques
4. Demonstrates skill in utilizing individual counseling
techniques
5. Tutors students in effective, appropriate manner
6. Demonstrates skill in facilitating small group lessons
7. Follows the PBIS model
8. Uses progress monitoring for interventions
9. Participates in crisis interventions appropriately
Revised 8/2015
Page 34
Please provide comments regarding the student’s strengths and weaknesses, and descriptions of how
to strengthen the areas where there are weaknesses:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
Comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
The signature of the field supervisor below attests to the fact that the student has completed all
assigned cases as appropriate and has completed the practicum according to all guidelines and
requirements at this point.
_________________________________
Practicum Student Signature
_________________________________
Field Supervisor Signature
_________________________________
University Supervisor Signature
Revised 8/2015
Page 35
Appendix G: Advanced Practicum II Plan and Student Evaluations
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
ADVANCED PRACTICUM II PLAN
Name: _____________________________________
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
ADVANCED PRACTICUM II PLAN
NASP COMPETENCIES
ICS – Interpersonal and Collaborative Skills
DA – Diversity Awareness and Sensitive Service Delivery
TA – Technological Applications
R – Professional, Legal, Ethical, and Social Responsibility
DB – Data-based Decision Making and Accountability
SB – Systems-based Service Delivery
CAS – Enhancing the Development of Cognitive and Academic Skills
WSL – Enhancing the Development of Wellness, Social Skills, and Life Competencies
LEVEL – Level of Intervention… circle when completed
(1 – Universal, 2 – Targeted, 3 – Intensive)
DONE
Description of Activity
32. Administer, score, and interpret
full battery of testsreevaluations
33. Curriculum Based Measurement
(e.g. DIBELS) and/or progress
monitoring
34. Present test results to parents
ICS
DA
TA
X
R
DB
X
X
X
X
X
35. Counsel students individually
and/or in groups
X
X
X
36. Consult with teachers regarding
behavioral and academic
interventions
X
X
SB
CAS
WSL
LEVEL
X
X
X
1
2
3
X
X
1
2
3
X
X
X
Revised 8/2015
1
2
3
1
2
3
1
2
3
Page 36
37. Inservice to teachers/parents or
staff and/or write school
psychology related topic for
school newsletter
38. Facilitate small group lesson
39. Observe and interview related
service professionals
X
40. Conduct or assist with at least
one FBA
X
41. Participate in CSE meetings
and/or parent informing sessions
X
X
X
1
2
3
X
X
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
X
X
X
X
X
X
X
42. Perform record reviews and
structured class observations
X
X
X
43. Visit alternative placement
locations
X
44. Participate in problem-solving
team (e.g. IST/PAT/SSS)
X
46. Attend at least one PTA meeting
47. Examine school crisis plan and
interview a member of the crisis
team
Other activities:
X
X
45. Tour school, review school
policies and procedures
X
X
X
X
X
X
X
X
X
X
X
X
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
Revised 8/2015
Page 37
1
2
3
1
2
3
1
2
3
1
2
3
Supervisor’s Initial Review
Approval ___________________________ Date ______
Supervisor’s Final Review
Approval ___________________________ Date ______
Revised 8/2015
Page 38
Name: _____________________________________
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
ADVANCED PRACTICUM II EVALUATION
Practicum Site: ______________________________
Grade Range: _________
Circle:
Special Population ______________
Rural
Suburban
Urban
School Psychologist/Student Ratio: _____________
Supervisor: _________________________________
Highest Degree: (Circle One)
Masters
Masters/Advanced Certificate
Ed.S
Ph.D
Psy.D
ADVANCED PRACTICUM II STUDENT EVALUATION
Please use the following rating scale in evaluating the student at a novice level on characteristics
listed below.
N/A – Not applicable or not observed: Not an appropriate item for a practicum student at this
setting.
1 – Unsatisfactory: Student’s skill reflects insufficient mastery in this area. Student needs
additional development of this skill.
2 – Needs Improvement: Plans should be made to assure student gains extra practice in this area.
3 – Satisfactory: Student’s skill in this area is adequate at a novice level. Student should
continue to practice this skill under professional supervision.
4 – Competent at a novice level: Student is relatively independent in this skill.
Interpersonal and Collaborative Skills
1. Presents with a professional appearance
N/A
1
2
3
4
2. Meets difficult situations with self-control
3. Demonstrates good judgment and common sense
4. Communicates and listens effectively
5. Disseminates information clearly to stakeholders
6. Relates well to students
7. Establishes effective collaborative relationships and
communicates well with parents
8. Establishes effective collaborative relationships with
teachers and other school personnel
Revised 8/2015
Page 39
9. Shows respect for all school professionals, parents,
and students
10. Demonstrates enthusiasm
11. Approaches others in a warm, outgoing manner
12. Displays initiative and resourcefulness
13. Is receptive to constructive feedback
14. Articulates own strengths and weaknesses
15. Actively engages in professional discourse
16. Concerned with quality of work
17. Is adaptive and flexible
18. Shows evidence of continued self-evaluation
Diversity Awareness and Sensitive Service Delivery
1. Achieves comfortable interactions with students,
families, staff, and other professionals of differing
cultural backgrounds
2. Seeks culturally relevant information when working
with students and families
3. Demonstrates active learning about different cultures
4. Demonstrates acceptance for others’ values and
viewpoints
5. Shows concern, respect, and sensitivity for individual
differences
6. Demonstrates an understanding of working with
interpreters
7. Demonstrates an awareness of own world views and
biases
8. Shows sensitivity to sources of bias when selecting
and administering assessment measures
Professional, Legal, Ethical, & Social Responsibility
1. Observes scheduled hours and appointments in a
punctual manner
2. Is prompt in meeting requests, and follows through
when additional action is needed
3. Completes work in a neat, thorough, and accurate way
N/A
1
2
3
4
N/A
1
2
3
4
4. Manages time efficiently
5. Keeps supervisors informed of unusual events and
activities, as well as routine matter in their school(s)
6. Uses information from supervisor in an appropriate
manner
Revised 8/2015
Page 40
7. Demonstrates an awareness of competency level, and
does not accept responsibilities beyond this level
8. Follows standardized procedures when administering
assessment measures
9. Maintains confidentiality when appropriate
10. Understands and follows district policies
11. Adheres to the NASP Standards for Professional
Ethics
12. Makes up missed time due to illness or other conflicts
Technology
1. Uses computer scoring programs effectively
2. Uses AIMSweb or other programs to participate in
progress-monitoring
3. Uses assistive devices and appropriate systems in
order to communicate with students and families
4. Uses internet resources effectively
5.
Assessment (Formal, CBM, FBA/BIP)
1. Identifies the nature of a referral and the purpose for
assessment
2. Identifies appropriate assessment tools for use with
particular cases
3. Uses an ecological approach toward assessment
4. Discusses student performance in a meaningful and
thorough manner – reflecting understanding
5. Discusses appropriate recommendations and
intervention strategies that follow from assessment
results
Intervention (Academic, Social, & Emotional)
1. Clearly describes the goals of interventions
N/A
1
2
3
4
N/A
1
2
3
4
N/A
1
2
3
4
2. Uses strengths and evidence-based interventions
3. When co-leading groups, demonstrates skill in
utilizing group counseling techniques
4. Demonstrates skill in utilizing individual counseling
techniques
5. Tutors students in effective, appropriate manner
6. Demonstrates skill in facilitating small group lessons
7. Follows the PBIS model
8. Uses progress monitoring for interventions
9. Participates in crisis interventions appropriately
Revised 8/2015
Page 41
10. Demonstrates a theoretical orientation that
incorporates an ecological, solution-focused, and CBT
orientation.
N/A
1
2
3
4
Inservice Topic: __________________________
1. Presentation Style
2. Presentation Format
3. Presentation Content
The ultimate goal of the practicum experience is to (a)
prepare the student for the realities of practice in school
psychology, and (b) prepare the student for the internship
experience. The student is currently making progress
towards these goals.
Please provide comments regarding the student’s strengths and weaknesses, and descriptions of how
to strengthen the areas where there are weaknesses:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
Overall is the student ready for internship (circle)? YES
NO
Comments:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________
The signature of the field supervisor below attests to the fact that the student has completed all
assigned cases as appropriate and has completed the practicum according to all guidelines and
requirements at this point.
________________________________________________
Practicum Student Signature
Date
________________________________________________
Field Supervisor Signature
Date
________________________________________________
University Supervisor Signature
Date
Revised 8/2015
Page 42
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
EVALUATION
Appendix H: Student Evaluation of Practicum Placement and Supervisor
Student Evaluation of Practicum Placement and Supervisor
Name of Supervisor: ______________________________________________________
Name of District/Agency: __________________________________________________
Name of Student: ________________________________________________________
Field Experience
I
II
OR
Advanced Practicum I
II
In the space provided enter the number of the response which best describes your internship
experience. Please feel free to expand on any item by writing on the reverse side of this form.
STRONGLY AGREE
AGREE
UNSURE
DISAGREE
STRONGLY DISAGREE
=
=
=
=
=
5
4
3
2
1
1. My supervisor and I meet individually at least one hour per week. ___________
2. My supervisor is very accessible. ___________
3. The quality of supervision is excellent. ___________
4. My supervisor is interested in my meeting RIT program requirements. ___________
5. My supervisor is interested in my development of professional skills. ___________
6. My supervisor is interested in my providing services to the district/agency. ___________
7. My supervisor allows me the freedom to try out new strategies and skills. ___________
8. My coursework at RIT prepared me for practicum. ___________
9. My practicum supervisor offers me skill development beyond the skills available through
coursework. ___________
10. I would recommend my practicum supervisor and this setting to other graduate students.
___________
Revised 8/2015
Page 43
11. Supervisor Strengths:
12. Supervisor Areas of Need:
13. Indicate additional experiences that you will need in order to progress toward your goals this
semester.
14. How can the RIT faculty help you meet your goals in your field placement?
15. How well have you met your goals to date?
Comments:
Note: Students and supervisors should refer to Standards for Training and Field Placement
Programs in School Psychology (NASP).
Revised 8/2015
Page 44
RIT SCHOOL PSYCHOLOGY
MS/AGC PROGRAM
Appendix I: University Based Practicum Evaluation of Student
UNIVERSITY BASED PRACTICUM EVALUATION
OF STUDENT
Name of student: ______________________ Field Experience: I II
Advanced Practicum: I II
University Based Supervisor: ______________________
Date: _______________
Review of Field Supervisor’s observations/evaluations:
Review of class participation/journals:
Review of openness to learning opportunities and motivation:
Review of Competencies as demonstrated in Practicum:
Interpersonal and Collaborative Skills
Diversity Awareness and Sensitive Service Delivery
1
2
3
4
Technical Applications
Professional, Legal, Ethical, and Social Responsibility
Data-based Decision Making and Accountability
Systems-based Service Delivery
Enhancing the Development of Cognitive and Academic Skills
Enhancing the Development of Wellness, Social Skills, and
Life Competencies
1 – Unsatisfactory
2 – Needs Improvement
3 – Satisfactory
4 – Competent
Areas of Strength:
Revised 8/2015
Page 45
Areas of Need:
Completion of Practicum Plan:
Revised 8/2015
Page 46
Appendix J: Practicum Log/Timesheet
Rochester Institute of Technology
Professional Practice Log
Practicum: _______
Week Total: _______
Semester Total: ______
Trainee Name: ____________________________________ Date: _______________
Practicum Site: ______________________________________
Signature(s) of Field Supervisor(s): __________________________________________
Date
Client
hours
Description of Activity
Supervisor Total
hours
hours
TOTALS:
Revised 8/2015
Page 47
Appendix K: Practicum Agreement
PRACTICUM AGREEMENT
SCHOOL PSYCHOLOGY PROGRAM
ROCHESTER INSTITUTE OF TECHNOLOGY
The School Psychology Program at Rochester Institute of Technology considers field instruction to be a vital
component of the student’s education. Practica are provided over the two year period which precede the Internship.
RIT seeks to meet the National Association of School Psychologists (NASP) Standards in its contract with school
districts and agencies, and recognizes the important contributions which field placements make in the preparation of
practicum students. In order to maintain the educational excellence desired by both field placements and university
program in this joint endeavor, specific statements of the responsibilities of both parties are outlined below:
Responsibilities of School Psychology Program at Rochester Institute of Technology
The RIT School Psychology Program will have primary responsibility for the following:
Limiting the RIT supervisor’s practicum seminar sections to no more than ten students.
Assuring that all students meet the highest standards of ethical and legal practice.
Adhering to the Standards for Training and Credentialing in School Psychology prepared by the National
Association of School Psychologists.
Selecting and screening of school districts, agencies and field-based supervisors for each placement.
Selecting and screening of students to be placed in the field, and determining the appropriateness of specific
placements for specific students.
Developing an integrative seminar class to be held on campus for all practicum students.
Arranging on-site visits between the collegiate supervisor and the field placement supervisor at least twice during
the school year. Additional on-site visits will be made as individual needs dictate.
Evaluating the school district or agency as an appropriate practicum placement.
Providing evaluation forms and Institute calendar to the field placement supervisor.
Determining the student’s grade for the three hours of practicum credit, based on the evaluation of the field
placement supervisor, the student’s performance in the seminar, submission of daily logs, and an evaluation
conference between the field supervisor, the collegiate supervisor, and the student.
Terminating the student’s practicum placement when either the student or placement is in gross violation of
responsibility for the practicum.
Responsibilities of the School District and/or Agencies
Participating school districts and agencies, through their assigned field placement supervisors, will have primary
responsibility for the following:
1.
2.
3.
4.
5.
6.
Ascertaining that the field-based practicum supervisor is responsible for no more than three practicum students
at any one time.
Assuring that the practicum student observes the full range of tasks and activities of the school psychologist,
and participates in those activities as appropriate.
Meeting with the student during the initial two weeks of the placement to draw up a plan addressing the goals
of the practicum. This plan should include the following:
a.
observation/learning opportunities available at the placement
b.
a general overview of the role and responsibilities of the practicum student
c.
needs of the placement that may be met by the practicum student
d.
schedules including the placement calendar (vacation days, in-service meetings, etc.), and the
student’s daily schedule (hours, assignments, etc.)
Identification of the field placement supervisor prior to accepting a practicum student. Field-based supervisors
must hold a valid credential in school psychology or a credential appropriate to the setting.
Provision of at least one hour of supervision per six hour period for each practicum student with the field-based
practicum supervisor.
Designation of workspace for the practicum student before the field placement begins.
Revised 8/2015
Page 48
7.
8.
9.
10.
11.
Provision of a formal orientation of the practicum student to the school district, or agency, its goals, policies
and functions.
Assistance of students in their integration of knowledge, skills and attitudes learned in the classroom with
field-based practices.
Close supervision of the practicum student to insure that the educational objectives are being met.
Immediate contact with the RIT faculty member responsible for the practicum when there are problems in
student adjustment or performance.
Preparation of a written evaluation of student learning and performance once per semester. Field-based
supervisors must share evaluations with the student prior to submission to the faculty at RIT.
Both parties recognize the interdependence of the School Psychology Program at Rochester Institute of Technology and
the local school district, and recognize that each will derive the greatest benefit by promoting the interests of both. Each
of the parties is therefore entering into this cooperative educational effort and agrees to interpret the provisions stated
above in such a manner as to best promote the interests of the profession of school psychology, the school district, the
children and adolescents whom we serve, and the larger community. This agreement will be reviewed regularly and
may be altered or modified by mutual consent.
PLEASE PRINT INFORMATION REQUESTED BELOW:
_______________________________ (School District Name)
_______________________________ (School District Street Address)
_______________________________ (School District City, State, Zip)
_______________________________ (School District Phone Number)
Dates of Service: The Practicum period shall be (check all that apply):
I_____
(Fall)
II____
(Spring)
III____
(Fall)
IV____
(Spring)
Dates:
From:____________________
Until:____________________
During this period the student will be in the practicum placement one full day each week. Vacation periods will follow
the local school calendar.
______________________________
Building or District Administrator
______________________________
Signature
____________________
Date
______________________________
Field-based Practicum Supervisor
______________________________
Signature
____________________
Date
______________________________
Practicum Student
______________________________
Signature
____________________
Date
______________________________
University Supervisor
______________________________
Signature
____________________
Date
Revised 8/2015
Page 49
Appendix L: Reciprocity Agreement
TUTION WAIVER FOR SCHOOL PSYCHOLOGY
INTERNSHIP AND PRACTICUM SUPERVISORS
In recognition of services as an Internship or Practicum Supervisor for the School Psychology
Program, Rochester Institute of Technology agrees to waive tuition for three (3) semester credits in
any given graduate or undergraduate course(s) at RIT. All courses taken as a form of reciprocity are
subject to course prerequisites, enrollment, and other restrictions, and are subject to state and federal
income taxes.
The waiver must be used by the Internship or Practicum Supervisor or another school district
employee within the school system listed below as designated by the Pupil Personnel Services
Director.
Date:
Waiver Expiration Date:
Field Supervisor Name:
School Name:
Address:
City, State, Zip:
SIGNATURES/APPROVALS:
_____________________________________
Suzanne M. Bamonto, Ph.D.
Graduate Program Director, Psychology Department
Student Name: ____________________________
(School district employee authorized to use waiver)
To be completed by registration:
Term: ______________ Credit Hours:_________
Course Title:___________________________
Distribution
SS#: _____________________
Course #:___________________________
Bursar Office Human Resources Office
School Psychology Dept.
Student
*Please contact Renee Walker, Administrative Assistant, Psychology Department
(585-475-7265) when you are ready to use your waiver.
Revised 8/2015