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Tiered/Universal Design Lesson Plan Template

Classroom ________________________________                                                                      Date ______________

                   Tier 1 General or Universal instruction for all Learners
Activity: ____________________________ Standard Addressed: _________________________________________

Goal/Outcome of lesson: (use terms like express, receive, show, solve, select, generate etc. to allow access to learning by all students)
__________________________________________________________________________________________________

Evidence Based Instructional Guide Used. Include lesson or page number (ex. Houghton Mifflin, Kid Writing,
Everyday Mathematics, etc.):
__________________________________________________________________________________________________________

Description of how Activity/Instruction/Lesson will be taught through multiple ways of Representation: during
Whole Group/small group/guided reading/small group math/workshop group. List materials that will be used.

Visual/Verbal and            Auditory: i.e. orally           Kinesthetic/Tactile:        Affective:                   Technology
non verbal:                  state/chant or sing             I.e. demonstrations, sign   I.e. role playing,           options:
I.e. use charts, graphs,     directions, sing songs with     language or gestures,       connecting to student        I.e. Overhead projector,
pictures, watch video        content, read aloud             hands on manipulatives.     interest areas, cross age    ELMO, books on tape or
clips or photographic        books.                                                      peer tutoring.               computer.
slideshow.


Adaptations/accommodations/modifications that are needed:

___________________________________________________________________________________________________________

Description of how children will be able to practice skill and meet outcomes of the lesson through multiple
ways of Engagement: Workshops/Small group/Individual Center Activities for acquisition of skill. List materials.

Visual/Verbal and            Auditory:                       Kinesthetic/Tactile:        Affective:                   Technology
non verbal:                  I.e. listen to text / content   I.e. use a game format,     I.e. work in small groups,   options:
I.e. draw/illustrate/write   read or sung aloud, listen      build a model, use pieces   with a partner or alone,     I.e. use computer
idea/concept on paper,       to/ retell directions or        or objects to sequence,     build student interest and   software or interactive
design a poster/chart,       steps of lesson, oral Q&A       provide manipulatives,      choice into centers, etc.    websites, books on tape ,
provide a visual model       etc.                            etc.                                                     allow to use
for practice, etc.                                                                                                    overhead/ELMO etc.



Adaptations/accommodations/modifications that are needed:

___________________________________________________________________________________________________________

Description of how children will be assessed or are able to show what they have learned through multiple
ways of expression: Product/Learning Check/Open Response/checklist or Exit Slip. List examples to be used.

Visual/Verbal and            Auditory: I.e.                  Kinesthetic/Tactile:        Affective: I.e.              Technology
non verbal: I.e.             Sing, tell through              I.e. Puppet show, fill in   Role play presentation,      options: I.e.
Write, draw a picture or     answering questions, give       bubbles on answer grid,     act out play, group          Software that would
mural, make a chart or       an oral report, etc.            point to pictures, use      demonstration, etc.          track mastery of skill,
graph, portfolio, etc.                                       materials to represent                                   tape recording of answer
                                                             answers (manipulatives)                                  to problem, etc.
                                                             etc.


Adaptations/accommodations/modifications that are needed:


Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI                                              Page 1
Tiered/Universal Design Lesson Plan Template


                Tier 2 Instruction - Targeted and Temporary
 Targeted outcome/practice skill: ____________________________________________ Date ____________
Design instruction to meet the skill deficits/strengths found in after initial screening or assessment with identified
children. Tier 2 can also support the needs of gifted/advanced children who need extension of skills. Meet in small,
planned groups or through individual child initiated center activity to increase engagement and support skill
mastery. Systematically collect data to monitor progress. Analyze data to determine how to alter instruction.
This instruction should be embedded within regular daily activities if possible. This tier is intended
to supplement, not replace Tier 1 instruction.

(Highlight one) Small group/ Reading group/ Math group/ Center/ Choice time.

     Teacher            Group       Time       Child name         Child name         Child name        Child name

                       Group 1
                        (1-4)

                      Group 2
                        (1-4)

Systematic instruction to be used to practice skill:



Materials needed for instruction:




Progress monitoring tool/Data collection method to be used (attach):




Adaptations/accommodations/modifications needed:



Data Driven Decision Making/ how will the instruction be modified for non
responder/When will Tier 3 instruction begin if skill is not mastered?




Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI                      Page 2
Tiered/Universal Design Lesson Plan Template


              Tier 3 Instruction- Intensive and Intentional
Center/choice time of day-embed instruction within child’s choice of activity when
possible to promote engagement.

 Skill to be acquired         Individual Child               Teacher          length of session




Systematic instruction to be used (ex. direct instruction through discreet trials,
errorless learning etc.):




Materials needed for instruction:




Progress monitoring tool/Data collection to be used (attach):




Adaptations/accommodations/modifications needed:

________________________________________________________________________________________

Data Driven Decision Making/ Next step/ what are plans if skill is not acquired?
(Change the method of direct instruction/collaborate with special ed. Staff/go to
support team etc.)



Comments/notes:




Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI   Page 3
Tiered/Universal Design Lesson Plan Template


                        Additional Notes or Comments:




Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI   Page 4

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Tiered Lesson Plan Template

  • 1. Tiered/Universal Design Lesson Plan Template Classroom ________________________________ Date ______________ Tier 1 General or Universal instruction for all Learners Activity: ____________________________ Standard Addressed: _________________________________________ Goal/Outcome of lesson: (use terms like express, receive, show, solve, select, generate etc. to allow access to learning by all students) __________________________________________________________________________________________________ Evidence Based Instructional Guide Used. Include lesson or page number (ex. Houghton Mifflin, Kid Writing, Everyday Mathematics, etc.): __________________________________________________________________________________________________________ Description of how Activity/Instruction/Lesson will be taught through multiple ways of Representation: during Whole Group/small group/guided reading/small group math/workshop group. List materials that will be used. Visual/Verbal and Auditory: i.e. orally Kinesthetic/Tactile: Affective: Technology non verbal: state/chant or sing I.e. demonstrations, sign I.e. role playing, options: I.e. use charts, graphs, directions, sing songs with language or gestures, connecting to student I.e. Overhead projector, pictures, watch video content, read aloud hands on manipulatives. interest areas, cross age ELMO, books on tape or clips or photographic books. peer tutoring. computer. slideshow. Adaptations/accommodations/modifications that are needed: ___________________________________________________________________________________________________________ Description of how children will be able to practice skill and meet outcomes of the lesson through multiple ways of Engagement: Workshops/Small group/Individual Center Activities for acquisition of skill. List materials. Visual/Verbal and Auditory: Kinesthetic/Tactile: Affective: Technology non verbal: I.e. listen to text / content I.e. use a game format, I.e. work in small groups, options: I.e. draw/illustrate/write read or sung aloud, listen build a model, use pieces with a partner or alone, I.e. use computer idea/concept on paper, to/ retell directions or or objects to sequence, build student interest and software or interactive design a poster/chart, steps of lesson, oral Q&A provide manipulatives, choice into centers, etc. websites, books on tape , provide a visual model etc. etc. allow to use for practice, etc. overhead/ELMO etc. Adaptations/accommodations/modifications that are needed: ___________________________________________________________________________________________________________ Description of how children will be assessed or are able to show what they have learned through multiple ways of expression: Product/Learning Check/Open Response/checklist or Exit Slip. List examples to be used. Visual/Verbal and Auditory: I.e. Kinesthetic/Tactile: Affective: I.e. Technology non verbal: I.e. Sing, tell through I.e. Puppet show, fill in Role play presentation, options: I.e. Write, draw a picture or answering questions, give bubbles on answer grid, act out play, group Software that would mural, make a chart or an oral report, etc. point to pictures, use demonstration, etc. track mastery of skill, graph, portfolio, etc. materials to represent tape recording of answer answers (manipulatives) to problem, etc. etc. Adaptations/accommodations/modifications that are needed: Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI Page 1
  • 2. Tiered/Universal Design Lesson Plan Template Tier 2 Instruction - Targeted and Temporary Targeted outcome/practice skill: ____________________________________________ Date ____________ Design instruction to meet the skill deficits/strengths found in after initial screening or assessment with identified children. Tier 2 can also support the needs of gifted/advanced children who need extension of skills. Meet in small, planned groups or through individual child initiated center activity to increase engagement and support skill mastery. Systematically collect data to monitor progress. Analyze data to determine how to alter instruction. This instruction should be embedded within regular daily activities if possible. This tier is intended to supplement, not replace Tier 1 instruction. (Highlight one) Small group/ Reading group/ Math group/ Center/ Choice time. Teacher Group Time Child name Child name Child name Child name Group 1 (1-4) Group 2 (1-4) Systematic instruction to be used to practice skill: Materials needed for instruction: Progress monitoring tool/Data collection method to be used (attach): Adaptations/accommodations/modifications needed: Data Driven Decision Making/ how will the instruction be modified for non responder/When will Tier 3 instruction begin if skill is not mastered? Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI Page 2
  • 3. Tiered/Universal Design Lesson Plan Template Tier 3 Instruction- Intensive and Intentional Center/choice time of day-embed instruction within child’s choice of activity when possible to promote engagement. Skill to be acquired Individual Child Teacher length of session Systematic instruction to be used (ex. direct instruction through discreet trials, errorless learning etc.): Materials needed for instruction: Progress monitoring tool/Data collection to be used (attach): Adaptations/accommodations/modifications needed: ________________________________________________________________________________________ Data Driven Decision Making/ Next step/ what are plans if skill is not acquired? (Change the method of direct instruction/collaborate with special ed. Staff/go to support team etc.) Comments/notes: Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI Page 3
  • 4. Tiered/Universal Design Lesson Plan Template Additional Notes or Comments: Lesson plan reflects recommendations of Universal Design for Learning, DEC, KDE, and RtI Page 4