2015-2016
Revised August 2015
1
RIT INTERNSHIP HANDBOOK
TABLE OF CONTENTS
Introduction/Program Description
2
RIT School Psychology Program Goals and Objectives
3
Overview of Internship Guidelines
4
Securing an Internship
Site Selection
Supervisory Responsibilities of the District
Supervisory Personnel
4
Mid-Year Intern Evaluation
7
Internship Requirements
Internship Agreement
Core Internship Plan and Site-Specific Activities
Daily/Weekly Logs
Cumulative Summary of Activities
Formative Evaluations (2)
Evaluation of Supervisor (2)
Praxis Exam (pass)
Internship Seminar and Reflections
Intern Products (Assessment, Counseling, Case Study, Inservice)
Application for Graduation
1200 hour Certification Form
Finishing the Internship Year
Becoming Certified as a School Psychologist
APPENDIX
A. Formative Evaluation of Interns
B. Internship Agreement
C. Core Internship Plan
D. NASP Blueprint Domains
E. Weekly Hour Log
F. Monthly Intervention Log
G. Supervisor Evaluation of Intern
H. Student Evaluation of Internship Site and Supervisor
I. Intern Case Study: Portfolio Part II
J. Inservice Evaluation Rubric
M. 1200 Hour Certification Form
7-10
10
10
12
13
14
16
22
24
25
26
34
35
39
40
2
THE SCHOOL PSYCHOLOGY INTERNSHIP
A Handbook of Guidelines and Procedures
School Psychology Program
Rochester Institute of Technology
Rochester, NY 14623
The purpose of this handbook is to provide guidelines for persons participating in the school
psychology internship experience at Rochester Institute of Technology, including students, field
supervisors, and school site administrators.
Introduction: Program Description
The RIT School Psychology MS/AC program embraces the scientist-practitioner framework for
the preparation of students to become professional school psychologists. The scientistpractitioner 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 solution-focused 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.
3
RIT School Psychology Program 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.
4
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.
Overview of Internship Guidelines
The Internship in School Psychology is the part of the training program providing students and
supervisors a chance to evaluate a student's knowledge and skills in a controlled but applied
setting. It is an opportunity for the school psychology candidate to develop a professional
identity and sensitivity to working with culturally diverse students as the candidate moves
toward assumption of full responsibilities as a school psychologist. The internship is an
integration of all previous training experiences by means of practical application in schools and,
in some cases, additional educational and mental health settings.
By the end of the internship experience, students will have provided evidence of entry-level
competency in the program objectives listed above. Competency in program objectives will be
achieved by engaging supervised activities as outlined in the Core Internship Plan (CIP; see
Appendix) and additional activities developed by the student and field supervisor.
As per NASP guidelines, the internship is provided at the end of the formal training period and
occurs on a full-time basis over a period of one academic year (10 months; minimum 1200 hours
with at least 600 hours in a school setting). Six (6) graduate credits are awarded upon completion
of the internship.
The internship experience is a cooperative venture among several agencies. However, primary
responsibilities rest with Rochester Institute of Technology’s training program and the public
schools. Other cooperating participants may be from a variety of field agencies. Open lines of
communication among all those involved in the internship are essential to provide maximum
benefit to interns. It is expected that the internship will be comprehensive and well balanced in
roles and functions in school psychology.
Securing an Internship
RIT school psychology students have primary responsibility for securing their own internship
placements. As soon as the student has accepted the internship the student notifies the university
based internship coordinator of his/her internship selection. The student will request that the
school district sign the Internship contract and then faculty will sign the contract and return a
copy to the school district. RIT policy is that once the student has committed to an internship
site the student must not break the contract with the school district.
RIT faculty will assist prospective interns in securing their placements in several ways, including
but not limited to:
1. Holding a joint meeting between second-year practicum students and current interns
during the fall semester to discuss strategies for securing a quality internship.
5
2. Requiring second-year students to develop a portfolio of their academic and
professional work, including a current resume and personal statement. Faculty will
review portfolio items submitted during students’ second year of study.
3. Providing information with respect to past and current internship positions held by
RIT students. This information can be found in a binder in the School Psychology
Student Lounge.
4. Forwarding current internship postings to all prospective interns on an ongoing basis.
5. Providing information about out-of-state internships for students interested in
relocating.
6. Consulting with students who are having difficulty procuring an internship
placement. Students must be willing to relocate when the internship sites are not
available in the Greater Rochester area.
A.
Site Selection
The primary consideration in intern placement is the adequacy of a school system as an
intern training site, although the needs of the local system must also be taken into
consideration. The RIT internship program should not be seen as a primary means for the
local district to gain assistance with psychometric work.
The following considerations provide general criteria for intern placement.
1 . There should be one individual in the school district who is directly responsible for
the supervision of the intern. The on-site supervisor shall be responsible for no more
than two (2) interns at any given time. The on-site supervisor should be a statecertified school psychologist or a licensed psychologist, and preferably hold National
Certification in School Psychology (NCSP). Psychiatrists, social workers, counselors,
or psychologists may assist with the supervision in the case of agency placements.
The expertise and experience of the supervisor will be an important consideration in
intern site selection.
2. Adequate facilities for supervisors and interns are important, to ensure maximum
efficiency in testing, interviewing, and other intern activities. Office, secretarial, and
other professional support must be provided. The school system should provide
professional materials and reimburse the intern for mileage and other professional
expenses. RIT policy requires that all interns be given a stipend by their employing
school district.
B.
Specific Supervision Responsibilities of Local Districts
It is assumed that the most highly qualified person available will serve in the capacity of
supervisor. The supervising school psychologist must have, at minimum, a masters + 30
credit equivalent (or the Ed.S.), Ph.D., Psy.D. , or Ed. D. degree and three years of
6
experience. The supervisor is seen as an exceedingly important professional model, as
well as one who is responsible for the administrative welfare of the intern.
The intern is believed to provide a sufficient amount of service to the school district to
justify the release of two hours per week of an internally employed supervisor from
regular duties or case load. If a qualified internal supervisor is not available from the
school district, the program director will assist in locating a qualified supervisor who
could be employed by the school district for that specific purpose. However, it is the
school district's responsibility to obtain a supervisor acceptable to the program faculty.
Any fees for supervision must be paid by the school district.
C.
Supervisory Personnel
Two persons have primary responsibility for internship supervision. They are the RIT
Internship Coordinator (the school psychology trainer) and the field supervisor (the
on-site supervising school psychologist).
1.
The Internship Coordinator is the field representative of the School Psychology
program at RIT. This person is the liaison between schools and agencies, the
School Psychology Program Director, and other School Psychology Program
faculty members. The responsibilities of the Internship Coordinator include the
following:
a. Provide internship guidelines for both the intern and the supervising
psychologist and ensure that these arrangements are mutually agreeable to the
supervisor, the intern, and the School Psychology program faculty.
b. Discuss the intern's work with the supervising psychologist and other
appropriate persons in the school district or agency.
c. Plan visits in advance and inform the intern and supervising psychologist of
the nature and extent of the planned visit. At least one visit per year will be
made by the Internship Coordinator. For internship sites outside of reasonable
driving distance from RIT, a telephone conference will be arranged in lieu of
an in-person visit.
d. Designate the final grade for the internship experience for university records.
This grade should be determined by mutual agreement with the supervising
psychologist at the internship site. See the Supervisor Evaluation of Intern
form located in the Appendix, p. 26.
e. Critically evaluate the professional logs of the intern. If areas of student
improvement are needed, it is the responsibility of the coordinator to attempt
implementation of these improvements with the student and the supervisor.
f. If questions of professional ethics arise, the coordinator is expected to respond
appropriately and, if necessary, to seek the advice of School Psychology
Program colleagues.
7
2.
The Field Supervisor approved by the RIT School Psychology Program faculty
must be certified as a School Psychologist (or licensed as a Psychologist) in the
state where the student is seeking to be placed as an intern. Other personnel may
work in a supervisory capacity for internship settings other than that of school
systems (e.g., psychiatric social workers, psychiatrists, clinical psychologists,
special educators) but they must be members in good standing with their
respective professional organizations and certified by approving state agencies.
The supervising specialist who assumes the responsibility for directing and
supervising the school psychology trainee should be an individual of proven
excellence in this field. He/she should be capable of guiding the graduate student
successfully through the internship experience.
The Field Supervisor is expected to fulfill the following responsibilities:
a. Coordinate the internship program with the public school administrators or
agency directors and the RIT program.
b. Provide an orientation period for interns at the beginning of an intern
experience.
c. Hold a minimum of two (2) hours per week of evaluative conferences with
each intern.
d. Field Supervisors should provide interns with as many activities described as
are essential for an effective internship experience.
e. Release intern to participate in university-based supervision once a month for
four hours.
Grade evaluation of the intern is a joint effort between the internship coordinator and the
field supervisor, and is based on competency in activities listed, effectiveness in relating
to school staff, and development toward independence as a professional school
psychologist. The supervisor will be asked to complete written evaluations of the intern at
the end of each RIT Semester. The supervisor’s recommendation is weighted heavily in
determining the intern’s grade for the Semester and year.
Mid-Year Intern Evaluation
Each intern’s progress will be reviewed formally by the RIT School Psychology Program
faculty at the end of the fall semester. Interns will be evaluated using the Formative
Evaluation of Interns Rubric (see Appendix A, p.13).
Internship Requirements
1.
Internship Agreement
Upon program approval of the internship site and the school psychology student’s
eligibility to commence an internship, the intern and school district will complete an
Internship Agreement. The forms are located in Appendix B, p. 14 of this handbook.
8
This agreement outlines the terms and conditions of the relationship between the intern,
the school district, and the RIT program. The school district must fill in the stipend
amount and name and address of the district. The contract should then be signed by the
school administrator responsible for hiring school psychology interns (often the Pupil
Personnel Services director), the field supervisor, and the intern. Once this is complete,
the intern must obtain signatures from the RIT School Psychology Program director and
the Internship Coordinator. One copy of the Agreement must be in the student’s RIT file.
It is recommended that the interns keep a copy for themselves and provide a copy for the
school district. The Internship Agreement must be on file prior to the commencement of
internship duties.
2.
Core Internship Plan (CIP) and Site-Specific Activities
During September, interns will consult with field supervisors and develop site-specific
activities further addressing training goals. A copy of the entire plan is due to the
Internship Coordinator no later than the beginning of October, and should include the
following information:
A cover page that includes the intern’s and field supervisor’s name, credentials, address
and contact information, and a signature page that the intern, field supervisor, and
internship coordinator will sign.
A schedule of the intern’s employment hours and exact building assignments, and the
school district calendar including vacation days, inservice meetings, etc.
A general overview of the intern’s role and responsibilities. Ideally, the intern would
gain some experience at each level of the school system from preschool (if available) to
high school.
Required activities for CIP (see Appendix C, p.18).
Additional site-specific activities (written behaviorally) to address the unique experiences
and opportunities offered by the particular internship site. Each site-specific activity
should be accompanied by a list of NASP domains it addresses (see Appendix D, p. 22).
3. Daily Logs
Each intern will maintain a log which reflects the intern’s daily schedule of appointments
and activities (see Appendix E, p. 24). Times and activities (assessment, consultation,
counseling, meetings, etc.) need to be listed clearly. The log is intended to summarize, in
brief, the intern’s day-to-day activities. Field supervisors should review and initial the
logs each month. Interns will turn in their logs of the previous month at each class
meeting. It is suggested that interns keep logs in loose leaf notebooks that can be
supplemented from month to month. The log will be reviewed by supervisors for
evaluation and planning purposes, by the intern as a self-evaluation and planning tool,
and by the Internship Coordinator for accountability purposes.
9
NOTE: Interns must log all hours spent in internship-related activities throughout the
contracted internship period, even after the required 1200 hour minimum has been
achieved.
4. Monthly Intervention Log
Interns will document their professional activities, including assessment, counseling, and
intervention on an ongoing basis. A form for documenting these activities can be found in
Appendix F on p. 25. These updated forms are to be turned in monthly to the RIT
Internship Coordinator.
5. Semester Formative Evaluations
Interns and supervisors will complete evaluations and submit them to the Internship
Coordinator prior to the end of each RIT academic Semester. Evaluations will include:
a. Summary of IPP goals and objectives achieved to date.
b. Supervisor evaluation of intern.
c. Intern evaluation of supervisor and internship site.
6. Site Visits
The Internship Coordinator will meet with the intern and the site supervisor at least once
over the course of the year. Site visits for long-distance internships may be conducted via
telephone. Additional site visits may be requested by the intern, the field supervisor or
the Internship Coordinator as needed.
7. Praxis School Psychology Exam
Interns need to sit for the Praxis School Psychology subject exam before the end of the
internship year. This exam is required by NASP for the National School Psychology
Certification (NCSP). Interns should provide a copy of the score report to the School
Psychology Program office as evidence of having taken the exam.
8. Internship Seminar
An important component of university supervision, students on internship will attend one
Internship Seminar class per month. During this 4-hour meeting, students will share
internship experiences and complete assignments developed to enhance the learning
experience of the internship. Additional course requirements are outlined in the syllabus.
9. Intern Products
Interns will need to update their portfolios with a case study. The case study is an
extensive project the intern will undertake during the year. This project will be developed
in collaboration with, and approved by, the intern’s academic advisor. See Appendix I, p.
35 for evaluation rubric for the case study.
10
In addition to the case study, interns will submit written products throughout the year to
demonstrate their evolving competency in key school psychology roles. Products may
include assessment reports, counseling summaries, intervention reports, and/or inservice
materials and evaluation. Further details on required intern products will be given on the
first day of the Internship Seminar. See Appendix J, K and L, p. 39, 40, 41 respectively
for evaluation rubrics of the products.
10. Dignity for All Students Act (this is not an internship requirement but is needed to
become NYS Certified)
“In June 2012, the Legislature enacted Chapter 102 of the Laws of 2012, which amended the
Dignity Act to include a requirement that school professionals applying for a certificate or license
on or after July 1, 2013 complete training on the social patterns of harassment, bullying and
discrimination. The New York State Board of Regents approved the guidelines and curriculum for
this training at their May 2013 meeting. School psychologists seeking certification after July 1,
2013 will be required to take a six hour training course on “Harassment, Bullying, and
Discrimination Prevention.” Three hours of this course may be taken via online presentation and
three hours must be taken in a face-to-face presentation”.
For more information, please visit: http://www.highered.nysed.gov/tcert/certificate/dasaapplicant.html
Finishing the Internship Year
In addition to all required items outlined above and in the Internship Seminar Syllabus (e.g.,
logs, evaluation forms, journal articles), interns need to submit the following items to the School
Psychology Program office prior to graduation.
•
Application for Graduation – separate forms to be completed for each degree expected
(M.S., A.C.), and given to the School Psychology Program secretary no later than the
end of January of the graduation year.
•
1200 Hour Certification Form – interns must complete this form as soon as they have
logged 1200 internship hours. This form must be signed by the field supervisor and
returned to the School Psychology Program office. Degrees will not be certified by
RIT without this form. Please see Appendix M, p. 44 for a copy of the form.
Completion of the required 1200 hours does not automatically terminate the intern’s obligation
to their site. Most internships will involve more than 1200 hours. Interns are bound to fulfill
their contracted obligations to their sites by continuing to perform their internship duties until the
last day of the school district’s calendar as specified on the internship contract. It is RIT
program policy not to allow interns to request early termination of their contract in order to
commence employment outside of their internship district. It is permissible, however, for the
internship district to request early termination for the purpose of employing the student as a
regular salaried school psychologist, after the intern has completed 1200 hours and prior to the
end of the contracted internship period.
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Becoming Certified as a School Psychologist
RIT School Psychology Program graduates are eligible for certification at the national and state
levels. NYS certification is required to perform the duties of a school psychologist employed by
a school district or agency in New York. National Certification is optional in New York State,
but may render a job candidate more attractive to prospective employers.
For New York State certification, apply online through the New York State Teacher Certification
website (http://www.highered.nysed.gov/tcert/teach/index.html). Interns can open their files
toward the end of the internship year. The application will be processed when RIT certifies that
all degree requirements have been met. This typically occurs in mid-July.
Graduates wishing to seek employment outside of New York State must research the
certification requirements for the state in which they seek certification. The Internship
Coordinator is available to assist graduates in locating such information if needed.
To become a Nationally Certified School Psychologist (NCSP), download the application packet
from the NASP website (http://www.nasponline.org) and follow the application instructions.
After completing their 1200 hours, interns will receive a letter from the School Psychology
Program director certifying their completion of program requirements and anticipated
graduation. This letter may be included with employment application materials as proof of
employment eligibility while interns await their state certification forms.
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APPENDIX
A. Formative Evaluation of Interns
13
B. Internship Agreement
14
C. Core Internship Plan
16
D. NASP Blueprint Domains
22
E. Weekly Hour Log
24
F. Monthly Intervention Log
25
G. Supervisor Evaluation of Intern
26
H. Student Evaluation of Internship Site and Supervisor
34
I. Intern Case Study: Portfolio Part II
35
J. Inservice Evaluation Rubric
39
K. 1200 Hour Certification Form
40
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RIT School Psychology Program
Formative Intern Review
The School Psychology Program faculty reviewed your progress toward competence as an independent school
psychologist. Based on your products and evaluations submitted thus far, we have assigned ratings in the following
areas:
Student Name: _______________________ Graduation Year: ______ Date: __________
Area
Completion of
Internship
Activities
Comprehensiven
ess of Internship
Experience
Supervision
Requirements
and Participation
Taken the Praxis
II?
Field Supervisor
Input
Thesis
Case Study
Strengths:
Areas to address:
Rating
Needs Improvement
(1)
Is not on target for
completing all required
activities during the
year
Activities are limited
to few roles and/or
student populations
Inconsistent attendance
at meetings and/or in
managing course
requirements
Has not registered for
the Praxis II or has not
achieved a score of
660
Received ratings of 1
or 2 from supervisor
Insufficient progress
toward thesis
completion
Insufficient progress
toward case study
completion
Adequate (2)
Outstanding (3)
Is on target for
completing all required
internship activities
this year
Adequate balance of
roles and student
populations
Satisfactory attendance
at meetings, self-reliant
in managing course
requirements
Is likely to complete
all expectations ahead
of schedule
Registered for the
exam or taken it and
are awaiting results
Received adequate
ratings (3 or better)
from supervisor,
Consistent progress
toward thesis
completion
Self-initiated
consistent progress
toward case study
completion
Rich experience in a
diversity of roles and
student populations
Exemplary
contributions to
supervision, shows
passion in sharing
resources with
classmates
Taken and passed the
exam
Received highest
ratings from supervisor
Thesis completed
Case study completed
14
INTERNSHIP AGREEMENT
AGREEMENT BETWEEN DESIGNATED SCHOOL DISTRICT AND THE GRADUATE
PROGRAM IN SCHOOL PSYCHOLOGY AT 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. RIT seeks to meet the National Association of School Psychologists
(NASP) Standards in its contract with school districts, and recognizes the important contribution made by school
districts in which our interns are placed. As stated in Standard 6.5 of NASP Standards for Training and
Credentialing in School Psychology "At least 600 clock hours of the 1200 hour internship experience shall occur in
a school setting and shall provide a balanced exposure to regular and special education programs". In order to
maintain the educational excellence desired by both parties 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:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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 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 for all interns.
Making contact with field placement supervisors at least twice during the school year and making on-site
visits if necessary.
Evaluating the school district as an appropriate internship placement.
Providing evaluation forms and Institute calendar to the field placement supervisor.
Determining the Semester grade for the student, 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 and the collegiate supervisor.
Terminating the student's internship placement when either the student or the school district is in gross
violation of responsibility for the internship.
Responsibilities of the School District
Participating school districts, through their assigned field placement supervisors, will have primary responsibility
for the following:
1.
2.
3.
4.
5.
6.
7.
Ascertaining that the field-based internship supervisor is responsible for no more than two interns at any
one time.
Assuring that the intern participates in the full range of tasks and activities of the school psychologist.
Meeting with the student during the initial two weeks of the placement to draw up a plan addressing the
goals of the internship. This plan should include the following:
a.
a general overview of the role and responsibilities of the intern
b.
needs of the district to be met by the intern in areas of assessment, counseling, consultation,
participation in staffings, etc.
c.
schedules including the district calendar (vacation days, in-service meetings, etc.), and the
intern's daily schedule (hours, school building assignments, etc.)
Identification of the field placement supervisor prior to accepting an internship student. Field-based
internship supervisors must hold a valid credential in school psychology.
Provision of at least two hours per week of direct supervision for each intern with the field-based
internship supervisor.
Designation of work space for the internship student before the field placement begins.
Provision of a formal orientation of the intern to the school district, its goals, policies and functions.
15
8.
9.
10.
11.
Assistance of students in their integration of knowledge, skills and attitudes learned in the classroom with
field-based practices.
Close supervision of the internship student to insure that educational objectives are being met.
Immediate contact with the RIT faculty member responsible for the internship when there are problems in
student adjustment or performance.
Preparation of a written Semester evaluation of student learning and performance. Field-based internship
supervisors must share evaluations with the intern 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, adolescents and families whom we serve, and the larger community.
This agreement will be reviewed yearly and may be altered or modified by mutual consent.
Dates of Service: The internship period shall be September through June and shall follow the calendar of the
school district of employment. During this period the intern will be in the field placement five days each week.
The school district will allow the student to attend half or full day on-campus seminars once per month from
September to May. Vacation periods will follow the local school calendar.
Payment for Services: A Stipend of $__________ will be paid to the intern by the local school district. In the
event of termination of the placement, the intern shall be paid an amount proportional to the amount of time spent
in the placement.
PLEASE PRINT INFORMATION REQUESTED BELOW:
________________________________ (School District Name)
________________________________ (School District Street Address)
________________________________ (School District City, State, Zip)
________________________________ (School District Phone #)
___________________________________
Director of Pupil Personnel Services
_____________________________
Signature/date
___________________________________
(Field-based Internship Supervisor)
_____________________________
Signature/date
___________________________________
(Student Intern)
_____________________________
Signature/date
Suzanne Bamonto Graney, Ph.D.
Director, School Psychology Program
_____________________________
Signature/date
___________________________________
Internship Coordinator
_____________________________
Signature/date
Date agreement is completed/filed:
20__-20__ Academic Year
_____________________________
16
Core Internship Plan
(name of student)
(school district)
(student contact information)
(Supervisor’s name and credentials)
(supervisor contact information: address, phone number, email)
I have reviewed the following plan:
____________________________
School Psychology Intern
____________________________
Field Supervisor
____________________________
RIT Internship Coordinator
17
I.
Schedule of Employment and Building Assignments
II.
Overview of Roles and Responsibilities
18
III.
Core (Required) Activities
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 Activity
RIT Program Goal 1: Professional Identity
Be a regular, contributing member of
the Instructional Support Team (or its
equivalent)
Be a regular, contributing member of
the school’s crisis team
Articulate how cultural factors affect
the education of individual students and
the learning environment in the district
Attend at least 4 faculty meetings
Attend all psychology department
meetings or alternative
Attend at least one Board of Education
meeting
Attend at least one PTA (or equivalent)
meeting
Know the full continuum of special
education and mental health services
available within the district
Read the faculty handbook and become
aware of the school’s crisis intervention
plan
Know what mental health services are
available to students and their families
in the local community
Attend at least one extracurricular
school function (e.g., sporting event,
plays, concerts)
Attend an Open House in at least one
school
Maintain membership in NASP
ICS
DA
TA
R
X
SB
X
X
CAS WSL
X
X
X
X
X
X
X
X
X
X
X
X
DB
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Lev
19
Create a pamphlet for parents and
students about the role of a school
psychologist
Utilize site-specific e-mail and calendar
programs
Utilize site-specific information
management systems, e.g., SchoolTool,
MarcoPolo, PowerSchool, IEP Direct,
AIMSweb
RIT Program Goal 2: Research-Based
Practice
Conduct at least one in-service,
workshop, or information meeting for
school personnel or parents
Attend at least one in-service or
workshop offered by the district
Observe highly skilled regular
education and special education
teachers, write a summary of
observation to discuss with supervisor
Research effective interventions at least
once per Semester
Write at least one article related to child
or adolescent well-being and
disseminate through web page or school
newsletter
Participate in school-wide initiatives to
promote positive social behavior such
as character education and PBIS
Read at least 3 scholarly articles related
to school psychology practice
Develop a method for monitoring the
effectiveness of at least one program
offered in the district
Attend at least one conference and/or
workshop designed for school
psychologists and related professionals
RIT Program Goal 3: Assessment
Complete at least 10 comprehensive
evaluations, at least 5 of which are
initial referrals.
Conduct at least 5 Functional Behavior
Assessments
Complete structured classroom
observations as components of
evaluations
X
X
X
X
X
X
ICS
DA
TA
X
R
DB
SB
CAS WSL
Lev
X
X
X
X
X
X
X
X
X
X
X
X
X
X
ICS
DA
TA
R
DB
X
X
SB
CAS WSL
X
X
X
X
Lev
20
Conduct interviews with parents,
teachers, students, or others as part of
the evaluation process
Administer curriculum based measures
to elementary- or middle- school
students (possibly develop local norms)
Research and disseminate information
about the validity and reliability of tests
currently used in the district
RIT Program Goal 4: Interventions
Create at least 5 Behavior Intervention
Plans
Collaborate individually with teachers
regarding academic and/or behavioral
issues
Participate in the creation of 504
Accommodation Plans
Participate in the development of IEPs
Create a series of social skills lessons
and teach at least one lesson in a
classroom
Conduct individual counseling with at
least 5 students
Facilitate or co-facilitate at least one
counseling group (minimum 6 sessions)
Develop at least one intervention plan
with parents that involves a strong
school to home collaboration
Routinely collect baseline and progress
monitoring data to determine the
effectiveness of academic and
behavioral interventions
Develop academic interventions
Participate in team meetings/planning
X
X
ICS
DA
TA
X
X
R
DB
X
SB
CAS WSL
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Lev
21
Additional Activities (site-specific)
Develop additional goals and objectives related to your specific school district and role. Identify
which NASP domains are addressed by performing these additional activities. Use additional
paper if necessary.
Done Activity
ICS
DA
TA
R
DB
SB
CAS WSL
Lev
22
NASP Domains and Descriptions
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 become more effective when parents and other primary caregivers are
partners in intervention design and implementation.
23
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
24
RIT School Psychology Weekly Hour Log
Name:__________________________
Dates:__________________________
Monday
Tuesday
Wednesday
Thursday
Friday
Area I. Professionalism
Supervision with Field Supervisor
Supervision with University Supervisor
Professional Development
CSE Meeting
IEP Meeting
504 Meeting
Faculty Meeting
PTA
School Board Meeting
Administrative
Other:
Area II. Consultation
Consultation w/ Teachers
Consultation w/ Administrative Staff
Consultation w/ Other School Staff
Child Study/Pre-referral meetings
Parent consultation
Classroom Observations
Inservice Presentation
Other:
Area III. Assessment
Child Interview
Parent Interview
Teacher Interview
Pre-Assessment Observation
Review of Records
Test Administration and/or Scoring
Report writing
CBM
Functional Behavior Assessment
Other:
Area IV. Intervention
Individual Counseling
Group Counseling
Crisis Intervention
Counseling Planning
Classroom Observations
Behavior Intervention Plan
Other:
Total Daily Hours
P Total=____________
E Total =__________
M Total=__________
H Total=__________
P=Preschool
E= Elementary
M=Middle School
H=High School
Total Weely Hours:
Hours This Month:
Hours This Year:
Intern Initals:
Supervisor Initals:
Comments:
Total
Student
Age
Consent
Received
Plan
Record
Review
Observ
-ation
Student name:______________________________
Area of
Concern
 Initial Referral Eval.
 Reevaluation
 Academic
 Behavioral
 Social skills Class

Oth
 Initial Referral Eval.
 Reevaluation
 Academic
 Behavioral
 Social skills Class

Other ______________
 Initial Referral Eval.
 Reevaluation
 Academic

Behavioral

Social skills Class

Oth
 Initial Referral Eval.
 Reevaluation
 Academic

Behavioral

Social skills Class

Oth
 Initial Referral Eval.
 Reevaluation
 Academic
 Behavioral
 Social skills Class

Oth
 Initial Referral Eval.
 Reevaluation
 Academic

Behavioral

Social skills Class

______________
Oth
 Initial Referral Eval.
 Reevaluation
 Academic

Behavioral

Social skills Class

Oth
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
 Initial Referral Eval.
 Reevaluation
 Academic
 Behavioral
 Social skills Class

Other ______________
 Crisis
 IEP
 Non- mandated
Counsel.
 Individual Counseling
 Group Counseling
Type of Intervention
Month:____________________
Progress
Monitoring
Parent
Mtg./
Outcome
25
26
RIT SCHOOL PSYCHOLOGY PROGRAM
SUPERVISOR EVALUATION OF INTERN
Name of Student:_____________________________________________
Date:_________________________
Internship Semester: _____________________
District:__________________________________________
Supervisor:______________________________
Supervisor’s Title:__________________________________
This evaluation contains two parts. The first part is an assessment of the intern’s professional work characteristics,
and the second is an evaluation of specific competencies gained over the internship experience. Please evaluate the
intern according to the rating scales provided for each section.
Section 1: Professional Work Characteristics Evaluation
Please rate the intern’s demonstration of the qualities below using the following rubric. Please add clarifying
comments below each item.
1 – Rarely or never demonstrates attribute. A rating of 1 reflects serious concerns about the intern’s
effectiveness in this area, and indicates the need for competency plan addressing the characteristic(s) in question.
2 – Occasionally demonstrates attribute. Intern is in the beginning stages of developing competence in this area,
but further supervised experience is needed to develop this characteristic.
3 – Consistently demonstrates attribute at a novice level. Intern demonstrates the characteristic at the expected
level with minimal supervision.
4 – Exemplary demonstration of attribute. Intern demonstrates the characteristic at an independent level.
N/A – Insufficient opportunity to observe
_____________________________________________________________________________________________
Respect for Human Diversity
1
2
3
4
N/A
Commitment to child advocacy
Avoids group or class attributions
Inspires, rather than admires, diversity
Comments:
Communication Skills (one-way)
Sensitive to nonverbal communication
Listens, reframes, clarifies
Elicits and utilizes feedback
Comments:
1
2
3
4
N/A
27
Effective Interpersonal Relations (two-way)
Shows interest in others
Avoids divisive statements or actions
Actively seeks resolution
Comments:
1
2
3
4
N/A
Ethical Responsibility
Employs an outcomes orientation
Uses evidence-based practices
Adheres to NASP/APA Ethical Guidelines
Comments:
1
2
3
4
N/A
Adaptability
Handles crises well
Is resourceful and persistent
Accepts new challenges
Comments:
1
2
3
4
N/A
Initiative
Expresses divergent views
Assumes leadership
Actively engages in professional discourse
Comments:
1
2
3
4
N/A
Dependability
Follows through with commitments
Stable performance and time management
Concerned with quality; avoids short-cuts
Comments:
1
2
3
4
N/A
28
Section 2: Intern Competency Evaluation for Training and Professional Practice
Please rate the intern’s demonstration of the skills and competencies below using the following rubric. Please add
clarifying comments below each performance area.
1 – Minimal or No Competence. A rating of 1 reflects serious concerns about the intern’s effectiveness in this
area, and indicates the need for a plan addressing the skill(s) in question.
2 – Adequate Competence with Supervision. Intern is in the beginning stages of developing competence in this
area, but further supervised experience is needed to develop this skill. Acceptable level for practicum student or
beginning intern. Below expectations for advanced intern or novice school psychologist.
3 – Novice-Level Competence. Intern demonstrates the skill at a level expected of an entry-level school
psychologist.
4 – Independent Competence. Intern demonstrates the skill in an exemplary manner, or at a level expected of an
experienced school psychologist.
N/A – Insufficient opportunity to observe
_____________________________________________________________________________________________
Performance Area 1: Interpersonal and Collaborative Skills
Demonstrates good judgment and common sense
1
2
3
4
N/A
Meets difficult situations with self-control
1
2
3
4
N/A
Communicates and listens effectively
1
2
3
4
N/A
Disseminates information clearly and professionally
1
2
3
4
N/A
Relates well to students
1
2
3
4
N/A
Establishes effective collaborative relationships with parents
1
2
3
4
N/A
Establishes effective collaborative relationships with teachers and other
school personnel
1
2
3
4
N/A
Shows concern, sensitivity and respect for all school professionals, parents,
and students
1
2
3
4
N/A
Demonstrates enthusiasm for work
1
2
3
4
N/A
Approaches others in a warm, outgoing manner
1
3
3
4
N/A
Is receptive to constructive feedback
1
2
3
4
N/A
Appropriately mediates and resolves conflicts
1
2
3
4
N/A
Is adaptive and flexible
1
2
3
4
N/A
Comments:
29
Performance Area 2: Diversity Awareness and Sensitive Service Delivery
Demonstrates an awareness of own worldviews and biases
1
2
3
4
N/A
Seeks culturally relevant information when working with students and
families
1
2
3
4
N/A
Actively seeks to learn about different cultures
1
2
3
4
N/A
Shows acceptance of others’ values and viewpoints
1
2
3
4
N/A
Shows concern, respect, and sensitivity for individual differences
1
2
3
4
N/A
Assists in the integration of all students into instructional programs
1
2
3
4
N/A
Keeps families’ cultures, backgrounds and individual learning
characteristics in mind when developing interventions
1
2
3
4
N/A
Is sensitive to sources of bias when selecting and administering assessment
measures
1
2
3
4
N/A
Achieves comfortable interactions with students, families, staff, and other
professionals of differing cultural backgrounds
1
2
3
4
N/A
Works effectively with interpreters
1
3
3
4
N/A
Uses computer scoring programs effectively
1
2
3
4
N/A
Uses AIMSweb or other programs to participate in progress monitoring
1
2
3
4
N/A
Uses assistive devices and appropriate systems in communicating with
students and families (when warranted)
1
2
3
4
N/A
Uses internet resources effectively
1
2
3
4
N/A
Uses technology to maximize the effectiveness of inservice presentations
1
2
3
4
N/A
Assists teachers and other staff in using technology to perform relevant
tasks
1
2
3
4
N/A
Is able to apply technology creatively in solving problems (e.g., information
dissemination, data display, development of forms and observational
procedures, use of Excel in making data-based decisions)
1
2
3
4
N/A
Comments:
Performance Area 3: Technological Applications
30
Comments:
Performance Area 4: Professional, Legal, Ethical, and Social Responsibility
Observes scheduled hours and appointments in a punctual manner
1
2
3
4
N/A
Is prompt in meeting requests, and follows through when additional action
is needed
1
2
3
4
N/A
Keeps records reliably and accurately
1
2
3
4
N/A
Completes work in a thorough and accurate way
1
2
3
4
N/A
Written and verbal reports are accurate
1
2
3
4
N/A
Manages time effectively
1
2
3
4
N/A
Keeps supervisor(s) informed of unusual events and activities, as well as
routine matters in their school(s)
1
2
3
4
N/A
Uses information from supervisor appropriately
1
2
3
4
N/A
Does not accept responsibilities beyond own competency level
1
2
3
4
N/A
Articulates own strengths and weaknesses
1
2
3
4
N/A
Shows evidence of continued self-evaluation
1
2
3
4
N/A
Follows standardized procedures when administering standardized tests
1
3
3
4
N/A
Maintains confidentiality when appropriate
1
2
3
4
N/A
Makes up time missed due to illness or other conflicts
1
2
3
4
N/A
Comments:
31
Performance Area 5: Data-Based Decision Making and Accountability
Systematically collects information to identify the problem and determine
strengths and needs
1
2
3
4
N/A
Utilizes assessment information to plan services and make decisions
1
2
3
4
N/A
Utilizes data to evaluate the outcomes of services and interventions
1
2
3
4
N/A
Demonstrates understanding of, and fluency with, the problem-solving
process
1
2
3
4
N/A
Is able to use a variety of procedures (including tests, observations, and
interviews) to evaluate student cognitive functioning
1
2
3
4
N/A
Is able to use a variety of procedures (including tests, curriculum-based
procedures, observations, interviews, and permanent product reviews) to
evaluate student academic competence in relation to grade-level
expectations
1
2
3
4
N/A
Is able to use a variety of procedures (including tests, observations,
interviews, and permanent product reviews) to evaluate student socialemotional functioning and behavioral adjustment
1
2
3
4
N/A
Using a variety of procedures, routinely includes an evaluation of the
environment in which the student is experiencing difficulty
1
2
3
4
N/A
Is able to discuss the student’s performance in relevant areas thoroughly,
reflecting understanding of how relevant student characteristics are
interacting with the environmental demands of the school
1
2
3
4
N/A
Is able to tie together the results of multi-method assessments resulting in
appropriate recommendations and intervention strategies for the student
1
2
3
4
N/A
Is knowledgeable of the range of services offered to students within the
district
1
2
3
4
N/A
Routinely interacts and collaborates with professionals across the range of
services from general education to the most restrictive special education
placements
1
2
3
4
N/A
Demonstrates understanding of how services are provided to students, and
how students access services within the district
1
2
3
4
N/A
Seeks to overcome barriers to best practice as appropriate
1
2
3
4
N/A
Comments:
Performance Area 6: Systems-Based Service Delivery
32
Comments:
Performance Area 7: Enhancing the Development of Cognitive and Academic Skills
Links assessment data to the development of instructional interventions
1
2
3
4
N/A
Uses empirically-demonstrated instructional methods/interventions
1
2
3
4
N/A
Assesses likelihood of intervention implementation
1
2
3
4
N/A
Clearly describes the goals of interventions
1
2
3
4
N/A
Collects data to evaluate the outcomes of interventions
1
2
3
4
N/A
Utilizes intervention data to guide instructional decisions
1
2
3
4
N/A
Assess the integrity of intervention implementation
1
2
3
4
N/A
Comments:
Performance Area 8: Enhancing the Development of Wellness, Social Skills, and Life Competencies
Links assessment data to the development of social-emotional or behavioral
interventions
1
2
3
4
N/A
Utilizes an ecological approach when developing social-emotional or
behavioral interventions
1
2
3
4
N/A
Uses strengths and evidence-based interventions
1
2
3
4
N/A
Clearly describes the goals of social-emotional or behavioral interventions
1
2
3
4
N/A
Uses data to evaluate the outcomes of the interventions
1
2
3
4
N/A
Uses outcome data to adjust the interventions as appropriate
1
2
3
4
N/A
Deals effectively with crisis situations
1
2
3
4
N/A
Demonstrates skill in utilizing individual counseling techniques
Demonstrates skill in utilizing group counseling techniques
1
1
2
2
3
3
4
4
N/A
N/A
33
Evaluates the likelihood of intervention implementation
1
3
3
4
N/A
Assesses fidelity of implementation of social-emotional, behavioral, or
adaptive interventions
1
2
3
4
N/A
Participates appropriately in school-wide prevention programs (e.g., PBIS,
crisis prevention, etc.)
1
2
3
4
N/A
Comments:
Goals:
Given the above ratings of the intern’s current skills, please list three areas of strength and three goals for continued
professional training, in the order of their importance.
Strengths
Goals
1._________________________________
1.___________________________________
___________________________________
_____________________________________
2.__________________________________
2.____________________________________
____________________________________
_____________________________________
3.__________________________________
3.____________________________________
____________________________________
______________________________________
Spring Semester: In your opinion, is this student ready for entry-level work as a school psychologist? Y
Supervisor’s signature:______________________________
Date:________________________
Student’s signature:________________________________
Date:________________________
(The student’s signature indicates only that the evaluation has been discussed with student.)
N
34
Student Evaluation of Internship Placement and Supervisor
Name of Supervisor:
Name of District / Agency:
Name of Intern:
FALL _________
Spring__________
In the space provided, please enter the number of the response that 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
My supervisor and I meet individually at least two hours per week. ____
My supervisor is accessible. ____
The quality of supervision is excellent. ____
My supervisor is interested in my meeting RIT program requirements. ____
My supervisor is interested in my development of professional skills. ____
My supervisor is interested in my providing services to the district/agency. ____
My supervisor allows me the freedom to try out new strategies and skills. ____
My course work at RIT prepared me for this field of placement. ____
My field supervisor offers me skill development beyond the skills available through coursework.
____
I would recommend my field supervisor and this setting to other graduate students. ____
Overall what is your assessment of your current field supervisor and placement?
How can the RIT faculty help you meet your goals in your internship placement?
12. Any additional comments (use reverse if necessary).
35
Name:______________________ Graduation Year:______________ Date:_____________
RIT School Psychology: Portfolio Part II / INTERN CASE STUDY
NASP Standards require that all school psychologist candidates demonstrate the professional skills necessary to
deliver effective services that result in positive, measurable outcomes for clients. Fulfillment of this performancebased requirement is met through the successful completion of the Intern Case Study. The case study will describe
an actual case that has been completed by the intern using systematic and structured problem-solving procedures.
The following rubric will be used to evaluate the submitted case study.
Section 1: Problem Identification
Very Effective
Needs Development
 The student’s behavior is
operationally defined
 The student’s behavior is
identified, but not
operationally defined
 The problem is
collaboratively defined
 The problem is not
collaboratively defined
 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
levels pf performance
 The behavior is not
operationally defined in
terms of both current and
desired levels of
performance
 Baselines includes the
student behavior and
peer/grade norms and
expectations with computed
trend lines
 A baseline for the student
behavior 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 and/or
performance deficit
 The student’s performance
is not identified as a skill
and/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
1.1
 The student’s behavior is
defined in the context of
appropriate grade and/or
peer expectations, e.g. local
norms
Effective
1.2
1.3
1.4
36
Section 2: Problem Analysis
Very Effective
Effective
Needs Development
2.1
 Hypotheses are generated
through collaboration with
teacher and/or parent
 One or more hypotheses are
developed to identify the
functions that the behavior
serves and/or the conditions
under which the behavior is
occurring or has developed in
two or more of the following
areas: child factors,
curriculum, peers, teacher,
classroom, home
 Hypotheses are not
developed, hypotheses 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, and self
report
 Appropriate data are not
collected to confirm or
reject the hypotheses
 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 (e.g. physical,
social, linguistic, cultural)
2.3
Section 3: Intervention
Very Effective
Effective
Needs Development
3.1
 Intervention is linked to
observable, measurable goal
statement(s)
 Intervention is not linked to
observable, measurable goal
statement(s)
3.2
 Intervention(s) selection is
based on data from problem
analysis and hypothesis
testing
 Intervention(s) selection is
not based on data from
problem analysis and
hypothesis testing
3.3
 Intervention(s) is evidencebased (e.g., research
literature, functional analysis,
single case design analysis)
 Intervention(s) is not
evidence-based (e.g.,
research literature,
functional analysis, single
37
case design analysis)
3.4
 Intervention(s) is developed
collaboratively
 Intervention(s) is not
developed collaboratively
3.5
 Intervention(s) reflects
sensitivity to individual
differences, resources,
classroom practices, and other
system issues. Acceptability
of intervention is verified
 Intervention(s) does not
reflect sensitivity to
individual differences,
resources, classroom
practices, and other system
issues. Acceptability of
intervention is 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
 Treatment integrity is not
monitored
Section 4: Evaluation
Very Effective
Effective
Needs Development
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
38
4.3
 Response to intervention
data are used to inform
problem solving and
decision making. Single
case design was specified
(e.g., changing criterion,
parametric, component
analysis, multiple baseline,
alternating treatment)
 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 effectiveness
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
39
RIT School Psychology INTERNSHIP
Inservice Evaluation
Student Name: _______________________
Area
Rating
Date: __________
Needs Improvement
(1)
Adequate (2)
Description
Inconsistent and
Inadequate description of
inservice details
Materials
Inconsistent, poorly
presented materials
Date, Duration, Place,
Description and number
of Attendees, described
concisely
Adequate documentation
of Outline of inservice,
and practical handouts for
attendees
Self- Evaluation
Insufficient or unrealistic
or incomplete description
A realistic description of
what you did well and
what areas you would
change
Attendees’
Evaluation
Insufficient
documentation of
attendee’s evaluation of
inservice
Disorganized/ Inefficient
and ineffective use of
time
Adequate evaluation form
developed, and
completed by attendees
Presentation to
class
Comments:
Clear, organized, good
time management, not
rushed yet concise,
highlighted materials and
process.
Outstanding (3)
Resources and
materials go above and
beyond.
Well organized, practical
and empirically based
In addition to a realistic
description of #2, a
specific plan for how you
will address both what
you did well and the
areas of change.
Evaluation form
developed, completed
and formally analyzed
(graphed)
In addition to #2,
exemplary presentation
style, animated and
engaging.
40
Certification of 1200 Hours Completed
Name of Student:
________________________________________
Name of Field Supervisor: ___________________________________
Internship Placement: ______________________________________
Internship Dates: Starting: ___________ Ending: _______________
This is to certify that the above named student has completed a total of 1200 clock hours in a
internship under my supervision in accordance with requirements of the School Psychology
Program at Rochester Institute of Technology and the National Association of School
Psychologists.
___________________________
(signature of supervisor)
__________________
(date)