To fill out the Student Intervention Matching (SIM) form, enter the student’s identifying information and universal screening classification at the top, rate each behavioral statement on the form’s scale based on what you have directly observed, then total the ratings for each intervention’s assigned item numbers. Any intervention whose three items sum to six or higher is considered a reasonable match for that student.1Alabama Regional Behavioral Support Services. Student Intervention Matching Form (SIM-Form) The form is a Tier 2 behavioral screening tool used within PBIS and MTSS frameworks, and because districts adopt it locally, the version in front of you may differ slightly from the one described here.
Before You Start
Have two things ready: the student’s universal screening results and your own direct observations of the student. The screening tells you whether the student was flagged for externalizing behaviors, internalizing behaviors, or both, and you will circle that classification in the header. The observations are what you will draw on when rating each statement. If you have only had the student for a short time, that matters — the form includes a “Don’t Know” option for a reason.1Alabama Regional Behavioral Support Services. Student Intervention Matching Form (SIM-Form)
Confirm which version your district uses. The standard SIM form is a single page of 21 behavioral statements rated on a four-point scale. The expanded version, called the Student-to-Intervention Matching System (SIMS), begins with a seven-item screener that routes you to a different tab depending on whether the student has an acquisition deficit or a performance deficit.2Shasta County Office of Education. Student-to-Intervention Matching System The steps below cover both.
Header Information
The top of the form asks for the student’s name, the name of the person completing the form, and the date. You also circle the student’s screening classification: Externalizing, Internalizing, or Both.1Alabama Regional Behavioral Support Services. Student Intervention Matching Form (SIM-Form) Districts sometimes add fields for grade level, teacher name, or student ID, but the core header is short. Do not guess at the externalizing or internalizing designation — pull it from the screening results.
SIMS Only: The Acquisition vs. Performance Screener
If you are using the SIMS, you complete a seven-item screener before any intervention matching. Each statement is rated 0 (Never), 1 (Some of the time), or 2 (Most of the time). The items alternate between skill gaps (“Student is unable to perform expected behaviors even when properly motivated”) and motivation gaps (“When the right incentive is in place, the student is able to behave and perform well”).2Shasta County Office of Education. Student-to-Intervention Matching System
Total the seven ratings. A score of ten or higher classifies the student as “Can’t Do,” an acquisition deficit, and sends you to the acquisition tab. A score of nine or lower classifies them as “Won’t Do,” a performance deficit, and sends you to the performance tab.2Shasta County Office of Education. Student-to-Intervention Matching System This classification matters. A student who has never been taught a self-regulation skill needs direct instruction; a student who has the skill but lacks motivation needs a different set of supports. Getting this step wrong points you at the wrong tab and the wrong interventions.
Rating the Behavioral Statements
From here the work is the same on either form: read each statement and rate how well it describes the student. On the standard SIM form, you rate the 21 items as Very True (3), True (2), Untrue (1), or Very Untrue (0), with a “Don’t Know” option.1Alabama Regional Behavioral Support Services. Student Intervention Matching Form (SIM-Form) On the SIMS performance tab, the scale is worded differently: Not at all (0), Slightly (1), Moderately (2), Greatly (3).2Shasta County Office of Education. Student-to-Intervention Matching System The numeric values map the same way.
Rate from what you have actually seen. If you cannot honestly assess an item, mark “Don’t Know” rather than filling in a guess. A rating pulled from assumption pushes the score in the wrong direction and can match the student to an intervention that doesn’t address what is really going on. Work through every item before you start totaling.
Scoring the Standard SIM Form
The bottom of the form contains a scoring grid. Each Tier 2 intervention is linked to three specific item numbers. Add the three ratings for each intervention. The seven interventions and their items are:
- School-home note system (SHN): Items 1, 6, 13
- Behavior contract (BC): Items 4, 16, 21
- Self-monitoring protocol (SM): Items 10, 12, 18
- Check-in/Check-out mentoring (CICO): Items 2, 9, 17
- Positive peer reporting (PPR): Items 3, 11, 20
- Class pass intervention (CP): Items 5, 8, 15
- Small group social-emotional training (SG-SET): Items 7, 14, 19
Any intervention scoring six or higher is a match.1Alabama Regional Behavioral Support Services. Student Intervention Matching Form (SIM-Form) A student can match to more than one intervention, and that is expected. When several cross the threshold, the team decides which to run first based on available resources and the student’s most pressing need.
Scoring the SIMS Acquisition Tab
If the SIMS routed you to the acquisition tab, scoring works differently. After rating that tab’s items, you first determine whether the deficit sits in emotional regulation or behavioral regulation. A score of twelve or higher on the initial acquisition items points to emotional regulation; eleven or lower points to behavioral regulation.2Shasta County Office of Education. Student-to-Intervention Matching System
Emotional regulation branches into three possible matches: anger/aggression management training, anxiety/depression-based curriculum, and trauma-focused curriculum. Behavioral regulation branches into two: executive functioning curriculum and social skills training.
The thresholds shift on this tab. For emotional regulation interventions, a summed score of six or higher is a match. For behavioral regulation interventions, the threshold is seven or higher.2Shasta County Office of Education. Student-to-Intervention Matching System Because these interventions are instructional, they typically run in small groups rather than through individual monitoring systems.
Common Mistakes That Throw Off the Score
A few habits reliably produce bad matches. Guessing on items you have not observed, rather than marking “Don’t Know,” is the biggest one. Entering a screening classification from memory instead of pulling the actual screening result is another. On the SIMS, rushing the seven-item screener and misclassifying “Can’t Do” as “Won’t Do” sends you down the wrong tab entirely, so every intervention match that follows is wrong. And when multiple interventions clear the threshold, picking one by habit rather than by team discussion wastes the information the form just gave you.
What the Form Is Not
A completed SIM form becomes part of the student’s education records, which means a parent can inspect it under FERPA and ask why specific items were rated the way they were.3Office of the Law Revision Counsel. 20 USC 1232g – Family Educational and Privacy Rights Rate from documented observation, not impression. The form is also not a step toward special education: IDEA does not require a student to go through MTSS before being referred for an evaluation, and a parent can request an initial evaluation at any time regardless of whether the SIM form has been completed.4Individuals with Disabilities Education Act. Return to School Roadmap – Child Find Under Part B Treating a completed SIM form as a prerequisite for a referral creates legal risk for the school.