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East Greenbush
Central School District
AIS/RTI Plan
1 (AIS/RTI Plan)
Table of Contents
Page
2 Committee Membership, Meeting Dates
3-6 Introduction and Mission Statement
7 Service Delivery Model Tier 1
8 Service Delivery Model Tier 2 English Language Arts
9 Service Delivery Model Tier 2 Math
10 Service Delivery Tier 2 Monitoring
11 Service Delivery Model Tier 3 English Language Arts
12 Service Delivery Model Tier 3 Math
13-14 Instructional Support Team
15 Reporting and Recording Data
16 Needs and/ Goals
Appendices
18-24 A – Definitions
25-28 B – Tier 1 Strategies for Differentiation
29 C – Tier 2 Strategies for Differentiation
30 D – Tier 3 Strategies for Differentiation
31-38 E – Instructional Support Team Forms
39 F – Notice of Need for Services (K to 5)
40 G – Notice of Discontinuation of Services (K to 5)
41-42 H – Notice of Need for Services (6 to 8)
43 I – Notice of Discontinuation of Services (6 to 8)
44 J – Notice of Need for Services (9 to 12)
45
Additional
Resources
K – Notice of Discontinuation of Services (9 to 12)
L- Common Core Aligned Progress Monitoring Reading and Math (K-8)
2 (AIS/RTI Plan)
Committee Membership
Cara Talmadge Assistant Principal Goff
Joanne Allen Reading Specialist/Dept. Chair Goff
Margie Isbester Reading Specialist Goff
Karen Anderson-Green Special Education Teacher Goff
Trish Thorman AIS Math Specialist Goff
Maureen Singer School Psychologist Genet/Goff
Carol Willis Reading/Math/Dept. Chair Genet
Barbara Law Reading Specialist DPS
Laurie Owens Reading Specialist Bell Top
Megan Bouchard Reading Specialist Red Mill
Christine Conley Reading Specialist Green Meadow
Melissa Dupont Reading Specialist Columbia H.S.
Sue Rys School Psychologist Columbia H.S./Goff
Tom O’Hara Administration District
Ralph Lyons Assistant Superintendent District
Meeting Dates
October 10, 2013
November 22. 2013
December 18, 2013
January 23, 2014
May 9, 2014
3 (AIS/RTI Plan)
ACADEMIC INTERVENTION SUPPORT/ RESPONSE TO INTERVENTION PLAN
The East Greenbush Central School District’s Academic Intervention Services (AIS)/Response to Intervention
Plan (RTI) was developed to meet the requirements of the Section 100.2 (ee) revision to Part 100 of the
Commissioner’s Regulations adopted by the Board of Regents in July of 2000. This regulation requires school
districts to provide Academic Intervention Services to students who score below State proficiency levels on the
Common Core and other State Assessments and/or students who are at risk of not achieving NYS Learning
Standards and Common Core Learning Standards.
The RTI program will continue to be implemented at the K-5 grades with the addition of a Reading Skills class
at grade 6. In addition an AIS model of service will continue to be delivered in grades 6-12. In accordance with
the Amendment of the Commissioner of Education pursuant to the Education laws sections 101.207, 305, 309,
and 3204 (paragraph 97) of subdivision of section 100.2 of the Regulations of the Commissioner of Education
the East Greenbush Central School District will implement a program that meets the guidelines set forth above:
A school district may provide a Response to Intervention (RTI) program in lieu of
providing Academic Intervention Services (AIS) to eligible students provided that:
The RTI program is provided in a manner consistent with subdivision (ii) of section
100.2 of the Regulations.
The RTI program is made available at grade levels and subject areas (reading/math)
for which the students are identified as eligible for AIS.
All students who are otherwise eligible for AIS shall be provided such AIS services
if they are not responding to the RTI program.
The K-6 Response to Intervention Program and the 6-12 Academic Intervention Service Program will be
implemented in the manner described by the New York State Education Department. The East Greenbush
Central School District’s AIS and RTI Plans are divided into subsets (K-6) and (6-12).
Introduction to the K-8 Response to Intervention Program
Response to Intervention (RTI) is the practice of providing high-quality instruction/intervention matched to
student needs and using learning rate over time and level of performance to make important educational
decisions about individual students. (NASDSE, 2006)
Response to Intervention represents an educational strategy designed to close achievement gaps for all students,
including students at-risk, students with disabilities, and students that are English Language Learners by
preventing smaller learning problems from becoming insurmountable gaps. RTI has also been shown to lead to
more appropriate identification and development of interventions for students with learning disabilities. Each
day educators make important decisions about students’ educational programs, including decisions as to
whether a student struggling to meet the standards set forth for all students might need changes in the nature of
early intervention and instruction or might have a learning disability. Determining whether a student has a
learning disability must be based on data-based information that leads to the determination that a student’s
learning difficulties are not the result of the instructional program or approach. RTI is an effective and
instructionally relevant process that informs these decisions.
4 (AIS/RTI Plan)
The New York State Education Department (NYSED) has established a regulatory framework for RTI in
relation to school-wide screening, minimum components of RTI programs, parent notification, and use of RTI
in the identification of students with learning disabilities. The Regents policy establishes RTI as a school-wide
system of organizing instruction and support resources to deliver high quality instruction to meet the diverse
needs of all learners.
Response to Intervention begins with high quality research-based instruction in the general education setting
provided by the general education teacher. Instruction is matched to students’ needs via provision of
differentiated instruction in the core curriculum areas and supplemental intervention delivered in a multi-tiered
format with increasing levels of intensity and targeted instruction. As a result of school-wide screening and
progress monitoring, students who have not mastered critical skills or who are in danger of not making
satisfactory progress are identified for supplemental intervention. If adequate progress is not made after the
student receives the most intensive level of instruction intervention, it may be determined that a referral for a
comprehensive evaluation to determine eligibility for special education services is warranted.
Reading in the early grades is a primary focus of the RTI process, as this is the area in which most of the
research available and the curriculum area in which most students are identified with learning difficulties.
However, the process of data-based decision-making and the principles of RTI can apply to other content areas,
as well as to behavioral issues that may impact learning.
There are several areas of regulatory requirements in which screening assessments and the provision of
appropriate instructions are outlined reflecting the principles of RTI. It is the integration of these requirements
that forms New York’s policy framework for school districts to use systematic effective educational practices.
These regulations, which are included in Appendix A, include:
Part 117-School-wide screening requirements,
Part 200-Requirements for written BOE Administrative Policies and Practices,
Part 100-Required Components of a RTI Program, and
Part 200-Requirements for Procedures for Determining if a Student has Learning Disability.
5 (AIS/RTI Plan)
Quality Indicators for Appropriate Instruction
Research/evidence-based instruction that has shown to be effective is provided to all students.
Scientific researched-based reading instruction includes an uninterrupted (k-5) block of 90 minutes of daily
explicit and systematic instruction in phonemic awareness, phonics, vocabulary development at all grade
levels, reading fluency (including oral reading skills) and reading comprehension strategies.
Scientific research-based math instruction includes instruction in problem-solving, arithmetic skill/fluency,
conceptual knowledge/number sense and reasoning ability.
Curriculum is aligned to Common Core and State Learning Standards and grade level performance
indicators.
Instruction is provided by qualified personnel and trained staff.
Differentiated instruction is utilized to meet a wide range of student need.
Instructional strategies/programs are implemented with fidelity.
Instruction is culturally and linguistically responsive to the language and learning needs of students whose
first language is not English.
East Greenbush Central School District Response to Intervention-Instructional Strategies
All students’ grades K-8 are provided with scientifically based instruction in reading. Scientific research-based
reading instruction K-5 includes an uninterrupted block of 90 minutes of daily explicit and systematic
instruction in phonemic awareness, phonics, vocabulary development at all grade levels, reading fluency
(including oral reading skills) and reading comprehension strategies. This uninterrupted instruction is provided
for all students. There are students within each cohort of the total population of students that have difficulty
with the concepts contained within reading and mathematic instruction. For these students, screening is
necessary.
Screening is an assessment procedure characterized by brief, efficient, and repeated monitoring of age-
appropriate academic skills (ie. identifying letters of the alphabet or identification of high frequency words), or
behaviors. Screenings are conducted for the purpose of initially identifying students who are “at-risk” for
academic failure and who may require closer monitoring and/or further assessment.
Section 117.3 of the Regulations of the Commissioner of Education requires that students who score below the
state designated proficiency levels be monitored periodically through screening and ongoing assessments of
reading and mathematical competencies.
Screenings of all students K-5 will be conducted three times per academic year (fall, winter, spring) to help
ensure the early identification of students potentially at-risk and the areas in which they may experience
difficulties.
6 (AIS/RTI Plan)
Mission Statement
The East Greenbush Central School District Academic Intervention Providers believe that all students must be
provided with academic assistance necessary to achieve proficiency in the NYS Common Core Learning
Standards. This plan has been designed to provide effective and efficient interventions to all East Greenbush
Central School District students.
***AIS services for Special Education and English Language Learners will be available to students on the same
basis as non-disabled students provided that the AIS services are consistent with the student’s individualized
education plan and level of English proficiency. This service must be in addition to mandated IEP minutes and
services.
7 (AIS/RTI Plan)
Multi-Tier Service Delivery for English Language Arts and Math
Tier 1 Instruction
Core instruction takes place in the general education classrooms and includes all students. Instruction is
currently aligned with the NYS Common Core Learning Standards. The components of core Language Arts
instruction are phonemic awareness, phonics instruction, vocabulary, academic vocabulary, fluency,
comprehension and writing. The core instruction (Tier 1) includes differentiation based on the abilities of all
students.
K-5 Elementary
At this level the Fountas & Pinnell universal Benchmark screening is given to all students three times a year
(fall, winter, spring). Teachers identify groups in their classes based on a student’s skills in order to
differentiate instruction to meet the needs of all learners. Differentiated learning activities (e.g. mixed
instructional grouping, use of learning centers, peer tutoring) are utilized to address individual needs.
6-8 Middle School
At this level the NYS ELA and Math Exams are used as the universal screening. Differentiated learning
activities such as mixed instructional groupings and materials, use of student- driven learning centers, and
peer tutoring are utilized to address individual needs.
9-12 High School
At this level universal screening consists of the NYS ELA and Math 8 scores for 9th
grade, overall ELA and
Math achievement for grades 10-12, and the grade 11 NYS Exam. Classroom teachers monitor students’
performance and refer as needed.
***Please see Appendix B for Tier 1 Strategies for Differentiation
8 (AIS/RTI Plan)
Tier 2 Instruction
Tier 2 is the secondary level of intervention intended for students that do not respond to core instruction at the
Tier 1 level, and who are mandated by NYS Exam scores. This instruction is provided in addition to, and not in
place of, core instruction. Tier 2 interventions focus on areas of student need or weakness that are identified
from the results of the universal screening in combination with various other literacy and math assessments. The
interventions vary by curriculum focus, group size, frequency, and duration based on individual student needs
and responsiveness.
Tier 2 English Language Arts
K to 2nd
Grade 3rd
thru 5th Grade 6
th thru 8
th Grade 9
th thru 12
th Grade
Entrance
Criteria
Kindergarten
Screening Data
F & P Assessment
Teacher
recommendation based
on tier 1 data
IST recommendation
Score less than
proficient as
determined by SED
on NYS exam
F & P Assessment
IST Recommendation
Score less than
proficient as
determined by SED
Score less than the 35th
percentile on WRMT-3
Teacher
recommendation based
on tier 1 data
Score less than
proficient as determined
by SED
Score less than 35th
percentile on WRMT-3
Teacher
recommendation based
on tier 1 data
Providers
Classroom Teachers
AIS Reading Teachers
ESL Teachers
Special Education Teachers
Other Highly Qualified Staff
Location
Classroom
Literacy Labs
Any alternate location to be determined by the school
Group size 5 students recommended 6 students recommended 8 students recommended 8 students recommended
Frequency
Minimum of 90 minutes
per week in addition to
ELA block
Minimum of 90 minutes
per week in addition to
ELA block
Every other day for 40
minutes
Every other day for 40
minutes
Duration Length of time varies. Progress monitoring occurs frequently and if progress is not noted the IST will
reconvene to adjust intervention
Programs
See Appendix C
See Appendix C
Common Core Coach
English Language Arts
Scholastic
Scope/Action
Magazine
English 9 – 11 core
curriculum
Scholastic
Scope/Action
Magazine
Progress
monitoring
Curriculum Based
Assessment
Reading Street
Assessment
Specific Intervention
Assessment
Curriculum Based
Assessment
Reading Street
Assessment
Specific Intervention
Assessment
Common Core
Benchmarks
Test of Silent Oral
Word Reading Fluency
Power School Data
Oral reading fluency
Maze based on oral
reading fluency level
CARS
Curriculum Based
Assessment
Power School Data
Specific Intervention
Assessment
Exit
Criteria
Student is performing
at grade level as
evident from collected
data
Student is performing
at grade level as
evident from collected
data
Mandated NYS cut
point
35th percentile or
greater in total reading
on the WRMT – 3
Mandated NYS cut
point Performing at grade level
35th percentile or
greater in total reading
WRMT – 3
Student is performing
at grade level
9 (AIS/RTI Plan)
Tier 2 Math
K to 2nd
Grade 3rd
thru 5th
Grade 6th
thru 8th
Grade 9th
thru 12th
Grade
Entrance
Criteria
Teacher
recommendation based
on tier 1 data
Score less than
proficient as
determined by SED on
NYS exam
Teacher
recommendation based
on tier 1 data
Score less than
proficient as
determined by SED on
NYS exam
Teacher
recommendation based
on tier 1 data
Score less than
proficient on NYS
exam
Teacher
recommendation based
on tier 1 data
Providers
Classroom Teachers
AIS Math Teachers
ESL Teachers
Special Education Teachers
Other Highly Qualified Staff
Location Classroom
Math Labs
Any alternate location to be determined by the school
Group size 5 students
recommended
6 students
recommended
8 students
recommended
8 students
recommended
Frequency
Students will receive
AIS services as needed
Minimum of 20
minutes per week in
addition to classroom
mathematics
instruction
Every other day for 40
minutes
Every other day for 40
minutes
Duration Length of time will vary. If no progress is being noted after 8-12 weeks, IST will reconvene to determine
what program adjustments can be made to ensure more progress.
Programs EnVision Math EnVision Math EnVision Math
Progress
monitoring
EnVision Math
Diagnosis and
Intervention System
Focus Math
EnVision Math
Diagnosis and
Intervention System
Focus Math
Unit pre and post
Assessment
Aligned Common
Core teacher generated
assessments
Unit pre and post
Assessment
Aligned Common
Core teacher
generated
assessments
Exit
Criteria
Student is performing
at grade level as
evident from collected
data.
Student is
performing at
grade level as
evident from
collected data.
Mandated NYS
cut-point
Student is
performing at
grade level as
evident from
collected data.
Mandated NYS
cut-point
Student is performing
at grade level as
evident from collected
data.
65 or better than on
State Regents Exams
10 (AIS/RTI Plan)
Tier 2 Monitoring
For those students who do not qualify for Tier 2 intervention, but have not met the mandated NYS cut-point,
progress within the content area classes will be monitored as follows:
K-5 – Monitoring will be the responsibility of the classroom teacher.
6-12 – Monitoring will be the responsibility of the AIS Tier 2 providers.
Students that are monitored will receive quarterly progress reports, or reports 3 times per year (grades k-5).
Note: In order for a student not mandated for AIS to be considered for a Tier 2 intervention, the Tier 1 teacher
(classroom/content area teacher) makes a request for the student to be evaluated by the school IST team. The
request needs to be accompanied by a minimum of 3-4 weeks of data supporting the referral (see Appendix B, C
and E).
11 (AIS/RTI Plan)
Tier 3 Instruction
Tier 3 provides targeted intervention intended for those students that do not respond to instruction at Tier 1 and
2. The third tier of this model creates intensive instructional interventions to increase an individual student’s
rate of progress. This Tier provides greater individualized instruction in an individualized or small group
session. These services are considered supplemental instruction and are not intended to replace Tier 1
instruction.
Tier 3 English Language Arts
K to 2nd
Grade 3rd
thru 5th
Grade 6th
thru 8th
Grade 9th
thru 12th
Grade
Entrance
Criteria Lack of progress on Tier 2 Intervention – need for additional intervention
Providers
Classroom Teachers
AIS Reading Teachers
ESL Teachers
Speech/Language Teachers
Special Education Teachers
School Psychologist
Other Highly Qualified Staff
Location
Classroom
Guidance Office
Literacy Labs
Any alternate location to be determined by the school
Group size 3 students
recommended
4 students
recommended
up to 2 students
recommended
2 students
recommended
Frequency
Five times per week
for a minimum of 30
to 60 minutes per
session in addition to
classroom instruction
Five times per week
for a minimum of 30
to 60 minutes per
session in addition to
classroom instruction
Every day for 40
minutes
Every day for 40
minutes
Duration
Length of time will vary. If no progress is being noted after 8-12 weeks, IST will reconvene to
determine what program adjustments can be made to ensure more progress. Minimum of 10 – 30
weeks.
Programs Leveled Literacy
Instruction
Leveled Literacy
Instruction
Wilson Language
Read 180
SRA Corrective
Reading
Wilson Language
SRA Corrective
Reading
Progress
monitoring
Fountas & Pinnell
Curriculum Based
Measurement
Oral Reading
Fluencies
Fountas & Pinnell
Curriculum Based
Measurement
Curriculum Based
Assessment
Intervention Based
Assessment
Curriculum Based
Assessment
Intervention Based
Assessment
Exit
Criteria
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
12 (AIS/RTI Plan)
Tier 3 Math
K to 2nd
Grade 3rd
thru 5th
Grade 6th
thru 8th
Grade 9th
thru 12th
Grade
Entrance
Criteria
Teacher
recommendation
based on tier 1 data
Score less than
proficient on NYS
Math exam as
determined by SED
Teacher
recommendation
based on tier 1 data
Score less than
proficient on NYS
Math exam as
determined by SED
Teacher
recommendation
based on tier 1 data
Score less than
proficient on NYS
Math exam
Teacher
recommendation
based on tier 1 data
Providers
Classroom Teachers
AIS Math Teachers
ESL Teachers
Speech/Language Teachers
Special Education Teachers
School Psychologist
Other Highly Qualified interventionists
Location
Classroom
Guidance Office
Math Labs
Any alternate location to be determined by the school
Group size 3 students
recommended
4 students
recommended
3 students
recommended
2 students
recommended
Frequency
Recommended five
times per week for a
minimum of 30
minutes per session
Recommended five
times per week for a
minimum of 30
minutes per session
Every day for 40
minutes
Every day for 40
minutes
Duration
Length of time will vary. If no progress is being noted after 8-12 weeks, IST will reconvene to
determine what program adjustments can be made to ensure more progress.
Programs EnVision Math EnVision Math EnVision Math
Progress
monitoring
EnVision Math
Diagnosis and
Intervention System
Focus Math
EnVision Math
Diagnosis and
Intervention System
Focus Math
Curriculum-Based
Assessment
Curriculum-Based
Assessment
Exit
Criteria
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
Student is
performing at grade
level as evident from
collected data.
13 (AIS/RTI Plan)
Instructional Support Team (IST)
The Instructional Support Team (IST) at each building is comprised of the building principals/designee and
service providers (which may include the school psychologist, occupational therapist, academic intervention
teacher, speech/language teacher, special education teacher, ESL teacher, and other teaching staff as
appropriate) will meet with classroom teachers to discuss students’ performance. Although teams will consider
benchmarks and cut points, they will also consider other factors, including the results of informal assessments
such as running records, along with any other information that the team needs to develop an intervention.
***Please see Appendix B, C and E for a list of appropriate supporting data and referral form.
Process for request to IST
Elementary: If a student displays problems in academic, social, emotional, physical-medical or any combination
of the above mentioned areas, the following steps will be taken:
A. Referral is made to the Instructional Support Team
B. Principal sends notice of upcoming Instructional Support Team meeting to all team members
C. Referral form is distributed to all team members at least 3-5 days in advance of the meeting
D. Team members meet and accomplish the following:
Issue is described
Relevant data is discussed (test scores, report cards, documentation from external sources, if
applicable, classroom performance etc.)
If behavioral in nature, desired goals and outcomes are established
Instructional Support Team discusses already established interventions, and existing resources
utilized
Instructional Support Team brainstorms interventions (to include, but not limited to scientifically
based interventions) to assist student in obtaining desired goal(s)
Team assigns a liaison as a contact person to assist and follow-up
Instructional Support Team sets up a reconvene date to review progress and effectiveness of
intervention
If a learning disability is suspected, the Instructional Support Team will recommend trials of RTI.
Support team members will work cooperatively with teachers to observe implementation of
intervention. If data collected indicates a learning disability, a referral to the CSE will follow.
Middle and Secondary: If a student is displaying problems in academic, social, emotional, physical-medical or
any combination of the above mentioned, the following steps will be taken:
A. Referral is made to Instructional Support Team
B. Principal sends notice of upcoming Instructional Support Team meeting to all team members
C. Referral form is distributed to all team members at least 3-5 days in advance of the meeting.
D. Team members meet and accomplish the following:
Issue is described
Relevant data is discussed (test scores, report cards, documentation from external sources, if
applicable, classroom performance etc.)
If behavioral in nature, desired goals and outcomes are established
Instructional Support Team discusses already established interventions, and existing resources
utilized
14 (AIS/RTI Plan)
Instructional Support Team brainstorms interventions (to include, but not limited to scientifically
based interventions) to assist student in obtaining desired goal(s)
Team assigns a liaison as a contact person to assist and follow-up
Instructional Support Team sets up a reconvene date to review progress and effectiveness of
intervention
If a learning disability is suspected, the Instructional Support Team will recommend trials of RTI.
Support team members will work cooperatively with teachers to observe implementation of
intervention. If data collected indicates a learning disability, a referral to the CSE will follow.
15 (AIS/RTI Plan)
Reporting and Recording Data
Parent Notification
Parents will receive the following notifications, as generated by RTIM Direct
1. A commencement of service letter by October 15th
or the appropriate point
2. Progress reports:
K-5 o Three times a year in conjunction with general education report cards
6-12 o Suggested notification four times a year in conjunction with general report cards and
o Four mid quarter progress comments on mid-term reports
3. Discontinuation letter upon completion of intervention
Conferences with teachers are arranged as needed.
Data Collection
Tier 1
Data for all modifications and differentiation of content performed in the regular classroom will be maintained
by the content area or classroom teacher.
Tier 2 and 3
Data for tier 2 and 3 will be tracked via the RTIm Direct online system. Tier 2 or 3 interventions will be input
into the system. Details of the intervention will include:
Provider
Beginning and ending date of the intervention
Frequency of intervention
Frequency of monitoring
Method of collecting and presenting data
Progress reports
16 (AIS/RTI Plan)
Goals
1. Local universal screening district wide
2. Updated RTIm training for all AIS providers
3. RTIm direct housekeeping
a. Updating letters and reports to RTIM Direct database
b. Investigate possibility of automatically adding State exam scores to RTIM database
c. Create standard method to input F&P Benchmark scores
4. Professional Development for best practices, screening, progress monitoring
5. Re-evaluate qualifying criteria for SpEd summer school reading instruction program
6. Increase Math AIS staff at the elementary level with emphasis on early intervention K-2 mathematics
7. Summer Curriculum writing District Wide to ensure consistency and continuity of Progress Monitoring
and CBM utilized and aligned to Common Core Learning Standards K-8
8. Review of instructional programs for writing implementation K-8 to ensure consistency and alignment
K-8
17 (AIS/RTI Plan)
APPENDICES
Page
18 A – Definitions
25 B – Tier 1 Strategies for Differentiation
26 C – Tier 2 Strategies for Differentiation
27 D – Tier 3 Strategies for Differentiation
28 E – Instructional Support Team Forms
43 F – Notice of Need for Services (K to 5)
44 G – Notice of Discontinuation of Services (K to 5)
45 H – Notice of Need for Services (6 to 8)
46 I – Notice of Discontinuation of Services (6 to 8)
47 J – Notice of Need for Services (9 to 12)
48
49
K – Notice of Discontinuation of Services (9 to 12)
L- Common Core Aligned Progress Monitoring Reading and Math (K-8)
18 (AIS/RTI Plan)
Appendix A - Definitions of Services
Elementary K-5
Push –In
Students receiving push-in services will have an additional instructor in their designated academic class to
clarify concepts, and work with students independently and/or in small groups.
Pull-out
Students receiving pullout services are provided additional small group instruction to strengthen skills necessary
for all students’ success.
Monitor
Students being monitored will be observed and evaluated for need for additional support in appropriate content
areas. Instruction for students will be provided by the classroom teacher in alignment with the state standards
and an AIS staff members will monitor student progress in the content area.
Goff Middle School 6-8
Push –In
Students receiving push-in services will have an additional instructor in their designated academic class to
clarify concepts, and work with students independently and/or in small groups.
Literacy Lab
Labs will be used to provide students with additional, small group instruction to reinforce concepts taught
during class and strengthen foundational skills necessary to achieve Common Core Learning Standards. Labs
are generally 40 minutes and are scheduled during the students’ day.
Monitor
Monitoring services are the least intensive services provided at the middle school level. Generally, these
students are monitored via PowerSchool by an AIS service provider and through conversations with the regular
classroom teachers. Although this is not a formal instructional period, students may be observed and evaluated
if additional services are deemed appropriate.
19 (AIS/RTI Plan)
Columbia High School 9-12
Push–In English Class or Primary Instruction
These services allow students at the high school to be in small classes and/or give them extended time to master
the materials before taking the appropriate Regents Exam. Students receiving push-in services will have an
additional instructor in their designated academic class to clarify concepts, and work with students
independently and/or in small groups. In English, the essence of the intervention is to place students into a
smaller learning environment that is tailored to the students need and allows for more teacher contact time.
These courses are available to students in ninth and tenth grade.
AIS Lab
AIS labs at the high school are for students currently enrolled in English 9-11 and are designated for students
who need additional support in these courses. Labs meet every other day for forty minutes and are designed to
help the students be successful in both the class and the corresponding regents exam.
Monitor
Monitoring services are the least intensive services provided at the high school level. Generally, these students
are monitored via PowerSchool by an AIS service provider and through conversations with the regular
classroom teachers. Although this is not a formal instructional period, students may be observed and evaluated
if additional services are deemed appropriate. If a student being monitored is not being successful, placement in
the LRC will be discussed. If this is still unsuccessful a change in schedule may be necessary in order to receive
a greater level of intervention.
20 (AIS/RTI Plan)
Section 100.2 General School Requirements
(ee) Academic Intervention Services.
1. Requirements for providing academic intervention services (AIS) in kindergarten to grade two.
Schools shall provide academic intervention services to students in kindergarten to grade two when
such students:
i. are determined, through a district-developed or district-adopted procedure that meets State
criteria and is applied uniformly at each grade level, to lack reading readiness based on an
appraisal of the student, including his/her knowledge of sounds and letters; or
ii. are determined, through a district-developed or district-adopted procedure applied uniformly
at each grade level, to be at risk of not achieving the State designated performance level in
English language arts and/or mathematics. This district procedure may also include diagnostic
screening for vision, hearing and physical disabilities pursuant to article 19 of the Education
Law, as well as screening for possible limited English proficiency or possible disability pursuant
to Part 117 of this Title.
2. Requirements for providing academic intervention services in grade three to grade eight. Schools shall
provide academic intervention services when students:
i. score below:
a. the State designated performance level on one or more of the State elementary
assessments in English language arts, mathematics or science, provided that for the 2010-
2011 school year only, the following shall apply:
1. those students scoring at or below a scale score of 650 shall receive academic
intervention instructional services; and 2. those students scoring above a scale
score of 650 but below level 3/proficient shall not be required to receive academic
intervention instructional and/or student support services unless the school
district, in its discretion, deems it necessary. Each school district shall develop
and maintain on
file a uniform process by which the district determines whether to offer AIS
during the 2010-2011 school year to students who scored above a scale score of
650 but below level 3/proficient on a grade 3-8 English language arts or
mathematics State assessment in 2009-2010, and shall no later than the
commencement of the first day of instruction either post to its Website or
distribute to parents in writing a description of such process; b. the State
designated performance level on a State elementary assessment in social studies
administered prior to the 2010-2011 school year; provided that beginning in the
2010-2011 school year, at which time a State elementary assessment in social
studies shall no longer be administered, a school shall provide academic
21 (AIS/RTI Plan)
intervention services when students are determined to be at risk of not achieving
State learning standards in social studies pursuant to clause (iii) of this paragraph;
ii. are limited English proficient (LEP) and are determined, through a district-developed or
district-adopted procedure uniformly applied to LEP students, to be at risk of not
achieving State learning standards in English language arts, mathematics, social studies
and/or science, through English or the student's native language. This district procedure
may also include diagnostic screening for vision, hearing, and physical disabilities
pursuant to article 19 of the Education Law, as well as screening for possible disability
pursuant to Part 117 of this Title; or
iii. are determined, through a district-developed or district-adopted procedure uniformly
applied, to be at risk of not achieving State standards in English language arts,
mathematics, social studies and/or science. This district procedure may also include
diagnostic screening for vision, hearing, and physical disabilities pursuant to article 19 of
the Education Law, as well as screening for possible limited English proficiency or
possible disability pursuant to Part 117 of this Title.
3. Requirements for providing academic intervention services in grade nine to grade twelve. Schools
shall provide academic intervention services when students:
i. score below:
the State designated performance level on one or more of the State intermediate
assessments in English language arts, mathematics or science; and/or
a. the State designated performance level on a State intermediate assessment in social studies administered
prior to the 2010-2011 school year; provided that beginning in the 2010-2011 school year, at which time
the State intermediate assessment in social studies shall no longer be administered, a school shall
provide academic intervention services when students are determined to be at risk of not achieving State
learning standards in social studies pursuant to clause (iii) of this paragraph; and/or
b. the State designated performance level on any one of the State examinations in English language arts,
mathematics, social studies or science that are required for graduation.
ii. are limited English proficient (LEP) and are determined, through a district-developed or
district-adopted procedure uniformly applied to LEP students, to be at risk of not
achieving State learning standards in English language arts, mathematics, social studies
and/or science, through English or the student's native language. This district procedure
may also include diagnostic screening for vision, hearing, and physical disabilities
pursuant to article 19 of the Education Law, as well as screening for possible disability
pursuant to Part 117 of this Title; or
iii. are determined, through a district-developed or district-adopted procedure uniformly
applied, to be at risk of not achieving State learning standards in English language arts,
22 (AIS/RTI Plan)
mathematics, social studies and/or science. This district procedure may also include
diagnostic screening for vision, hearing, and physical disabilities pursuant to article 19 of
the Education Law, as well as screening for possible limited English proficiency or
possible disability pursuant to Part 117 of this Title.
4. Description of academic intervention services.
i. By July 1, 2000, a school district shall develop a description of academic intervention
instructional and/or student support services to be provided in schools to students in need
of such services pursuant to paragraphs (1), (2) and (3) of this subdivision. The
description shall include any variations in services in schools within the district, and shall
specifically describe:
The district-wide procedure(s) used to determine the need for academic intervention
services;
a. academic intervention instructional and/or student support services to be
b. provided pursuant to paragraph (5) of this subdivision; whether instructional services and/or
student support services are offered during the regular school day or during an extended
school day or year; and
c. the criteria for ending services, including, if appropriate, performance levels that
students must obtain on district-selected assessments.
ii. The description of academic intervention services shall be approved by each local
board of education by July 1, 2000. In the New York City School District, the New York City
Board of Education may designate that the plans be approved by the chancellor or his designee
or by community school boards for those schools under their jurisdiction. Beginning July 1, 2002
and every two years thereafter, each school district shall review and revise its description of
academic intervention services based on student performance results; except that this
requirement shall not apply to student performance results for the 2010-2011 school year, which
shall be excluded from such review.
iii. In lieu of a separate description of academic intervention services, the district may incorporate
the description of academic intervention services into a comprehensive district education plan. In
this instance, the preparation date for the description of academic intervention services shall
conform to the date of the preparation of the comprehensive district education plan.
iv. Based on performance criteria established by the commissioner, certain school
districts may be required to submit their description of academic intervention
services for specific schools to the department for review and approval.
5. Provision of academic intervention services. i. School districts may use time available for
academic intervention instructional and/or student support services during the regular
school day.
23 (AIS/RTI Plan)
ii. School districts may provide students with extended academic time beyond the
regular school day and school year.
iii. In public schools, academic intervention instructional and/or support services shall
be provided by qualified staff who are appropriately certified pursuant to Part 80 of
this Title. iv. Beginning September 1, 2000, academic intervention instructional
and/or student support services shall commence no later than the beginning of the
semester following a determination that a student needs such services. Services
shall continue until a student's performance: . meets or exceeds the State designated
performance level on the next State assessment; or a. is shown to be likely to meet
or exceed the State designated performance level on the next State assessment
through achievement on the district-selected assessments of the levels specified in
the district description of academic intervention services pursuant to paragraph (4)
of this subdivision.
6. Parental notification and involvement.
i. Notification of commencement of services. The parent or person in parental relation to a student
who has been determined to need academic intervention services shall be notified in writing by
the principal. Such notice shall be provided in English and translated, when appropriate, into the
native language or mode of communication of the parent. The notice shall include a summary of
the academic intervention services to be provided to the student, the reason the student needs
such services and the consequences of not achieving expected performance levels.
ii. Notification of the ending of academic intervention services. Parents or persons in
parental relation shall be notified in writing when academic intervention services
are no longer needed. Such notice shall be provided in English and translated,
when appropriate, into the native language or mode of communication of the
parent.
iii. Ongoing communication with parents or persons in parental relation. Parents or
persons in parental relation to students receiving academic intervention services shall be
provided with:
An opportunity to consult with the student's regular classroom teacher(s), and other professional staff
providing academic intervention services, at least once per semester during the regular school year; a.
reports on the student's progress at least once each quarter during the regular school year by mail,
telephone, telecommunications or other means, in a language or mode of communication understood by
the parents or person in parental relation; and b. information on ways to work with their child to improve
achievement; monitor their child's progress; and work with educators to improve their child's
achievement.
24 (AIS/RTI Plan)
7. Notwithstanding the provisions of this subdivision, a school district may provide a Response to Intervention
(RTI) program in lieu of providing academic intervention services (AIS) to eligible students, provided that:
i. the RTI program is provided in a manner consistent with subdivision (ii) of section 100.2 of this
Part;
ii. ii. the RTI program is made available at the grade levels and subject areas (reading/math) for
which students are identified as eligible for AIS;
iii. all students who are otherwise eligible for AIS shall be provided such AIS services if they are
not enrolled in the RTI program; and iv. for the 2010-2011 school year, the school district shall
submit to the Department, no later than December 15, 2010, a signed statement of assurance that
the services provided in the RTI program meet the requirements of this paragraph; and for each
school year thereafter, the school district shall submit to the Department no later than September
1st of such school year, a signed statement of assurance that the services provided under the
district's RTI program meet the requirements of this
25 (AIS/RTI Plan)
B – Tier 1 Strategies for Differentiation
Tier One Interventions
Suggestions and Recommendations for Teachers
Pre-teach
Re-teach
Student retells info in own words
Draw a picture
Write about it
Think and then plan with adult before starting
Preferential seating
Office folders
Decrease distracters
Monitor work completion
Check lists
Raffle tickets
Strike 3 board
Review with instruction
Guided practice
Contact parent/guardian/ Notes to parents
Contact related service or special area teachers
Talk with student – learning what you need….
More time
Model thinking/ problem solving
Modify assignment/ style or length/ decrease
numbers of problems or questions/ Modified
spelling list
Agenda reminders
Physically helping student to organize – write
HW, etc.
Kinesthetic approach tapping sounds and
syllables
Oral report supported with information
provided on dry erase board
Graphic organizer
Number lines
Highlight
Checking understanding before student begins
assignments/ Student repeat directions
Manipulations, charts, work mats, etc.
Modeling – Demonstration during instruction
Sensory strategies with guided support
Read tests aloud
Writing – prewriting/ drafts/ webs
Slanted binder for visual help
Re-clarification of directions
STAR volunteers/ parent volunteers
Small groups pulled to re-teach skills
Early support teacher
TA working with children in small group – same
lesson as large group
Choral reading – with buddy or independently
Spelling – circle the correct response already
spelled out
Physical proximity
One on one help
Redirection
Individual goals
Writing – decrease length of assignment
Peers (if applicable), Cooperative learning, Paired
activities, Peer teaching
Praise
Acknowledge name prior to giving directions
Dry erase board to assist with tracking information,
demonstrating new idea
Simplify directions one step at a time
Highlight important information
Color code
1:1 with student retells directions and plan
Consequences
Provide movements to support learning
Additional Accommodations
Physical Arrangement of Room
Seat student near teacher
Stand near student when giving directions or presenting lessons
Increasing the distance between desks
26 (AIS/RTI Plan)
Seat student near a positive role model
Avoid distracting stimuli (high traffic areas, window, heating system, fan, etc.)
Lesson Presentation
Writing key points on the board
Provide visual aides
Provide peer note taker
Make sure directions are understood
Break longer presentations
Provide written outline
Have student review key points orally
Use computer assisted instruction
Assignments/ Worksheets
Give extra time to complete tasks
Simplify complex directions
Hand worksheets out one at a time
Allow student to tape record assignments or homework
Provide study skills training/ learning strategies
Allow typewritten or computer printed assignments
Reduce homework assignments
Do not grade handwriting
Require fewer correct responses to achieve grade
Provide structured routine in written form
Shorten assignments
Break work into smaller segments
Have student do either other questions
Put fewer numbers of questions per page
Organization
Provide peer assistance with organizational skills
Provide student with extra set of books for home
Provide student with an assignment notebook
Send progress reports home
Request parental help with organization
Supervise writing of homework assignments
Set short-term goals for work completion
Behaviors
Provide frequent, immediate, positive feedback
Contract with the student
Increase the immediacy of rewards
Use nonverbal cues to stay on task
Give extra rewards and privileges
Behavior management system developed with assistance of psychologist and/or the social worker
Implement time out or beak procedures
Allow short breaks between assignments
27 (AIS/RTI Plan)
Teach student to use break card or how to take a break
Ignore minor inappropriate behavior
Supervise during transition times
Anticipate problems and use preventative strategies
Train anger control; encourage student to walk away; use calm strategies
Teacher
Provide reassurance and encouragement
Speak softly in a non-threatening manner if student is nervous
Focus on student talents and accomplishments
Make time to talk alone with student
Look for signs of stress build up and provide encouragement or reduced workload
Allow student an opportunity to “save face”
Choose your battles
Give student choices
Compliment positive behavior and work
Look for an opportunity for student to display leadership role in class
Use mild, consistent consequences
Encourage student to discuss feelings with teacher
Academic Skills
If Reading is weak:
Provide extra reading time
Use “previewing” strategies
Select text with less on a page
Shorten amount of required reading
Avoid oral reading tasks
If Oral Expression is weak:
Accept all oral responses
Substitute visual display for oral report
Encourage expression of new ideas
Pick topics easy for the student to talk about
If Written Language is weak
Accept non-written forms of reports
Accept use of typewriter or computer
Accept use of tape recorder
Do no assign large quantities of written work
Test with multiple choice or fill-in blanks
Give class notes with blanks left for student to fill in
If Math is weak:
Allow use of calculator – except when learning new skills
Allow use of graph paper to space numbers
Provide extra math time
Provide immediate corrective feedback and instruction by modeling the correct computational procedure
28 (AIS/RTI Plan)
Teach the steps needed to solve a particular math problem
Give clues to the process needed to solve the problem
Parent Involvement
Initial agenda
Provide consequences for bringing completed assignment notebook or progress note home
Inform teachers/counselors of medication changes
Get feedback from teachers/counselor to give to physician for check-ups
Call teacher for feedback
Supply school with medication and necessary medical forms
Parent education – ADD/ADHD
Parent training – behavior management
Provide positive reinforcement for points earned in behavior program at school
Break homework into smaller parts and give frequent breaks
Seek outside services, if needed
Additional accommodations
Student Responsibility
Complete assignment notebook and get teacher initials
Take medication as prescribed
Come to class prepared with supplies
Complete assigned work
Ask parent or guardian to help you organize
Request assistance when needed
Take needed materials home to complete work
Seek encouragement from an adult
Set deadlines for work completion
Prioritize assignments
Estimate time needed to complete work
Learn how ADD affects you
Tell your teacher how they can help you
Break assignments into smaller parts
Attend supervised after school homework help
29 (AIS/RTI Plan)
C – Tier 2 Strategies for Differentiation
Tier 2 Interventions
Supplemental Instruction
Small Group differentiated Instruction
Modified homework and classwork
District speech and language improvement
Building level counseling
Behavior contracts with increased parent communication
SRA Decoding
SRA Reading Comprehension
Edmark Reading
Classroom accommodations
District occupational therapy services
Individualized student behavior plan
Functional Behavioral Assessments
Fountas & Pinnell Leveled Literacy Intervention
Pearson My Sidewalks
Targeted Guided Reading
30 (AIS/RTI Plan)
D – Tier 3 Strategies for Differentiation
Tier 3 Interventions
Intensive Interventions
SRA Decoding Skills
SRA Comprehension
Wilson Reading
Counseling Groups
504 Accommodation Plans
Occupational Therapy Services
Physical Therapy Services
Speech and Language Services
Special Education via consultant teacher services
Special Education within a self-contained classroom
Edmark
Fountas & Pinnell Leveled Literacy Intervention (grades K-4)
My Sidewalks (Pearson) (grades K-5)
31 (AIS/RTI Plan)
Appendix E: Instructional Support Team Forms
East Greenbush Instructional Support Team – Initial Meeting Facilitator Guide
1. Review Teacher Concerns (5 minutes)
• Review information from the referral form and data packet
• Teacher discusses major referral concerns
2. Select Target Behaviors (10 minutes)
• Review baseline data collected prior to initial meeting
• Define the top 1-2 teacher concerns in easily observable, measurable terms
3. Inventory Students Strengths and Talents (5 minutes)
• Discuss areas of strength
• Record incentives that motivate the student
4. Set Goals (5 minutes)
• Using baseline data as a guide, goals should be:
o Observable • Determine at least two ways to monitor progress
o Measurable • Realistic
5. Design the Intervention Plan (25 minutes) • Identify WHAT the intervention is
• Identify WHERE & WHEN it will take place
• WHO is responsible for implementing & monitoring student progress
6. Parent Contact (5 minutes)
• Determine who will contact the parent or guardian
• Update parent contact information (name, address, telephone, etc.)
• Share the intervention plan with parent(s)/guardian
7. Review the Intervention Plan (5 minutes)
• Make sure all parties understand the intervention plan
• Set follow-up meeting date
32 (AIS/RTI Plan)
EGCSD IST Initial Meeting Minutes Form
Name: __________________________ Grade _____________
Date: ___________________________ Teacher: _________________________________
DOB: __________________________ AIS/Special Ed Teacher: ____________________
Parent/Guardian: ______________________________
Student’s Current Attendance Record (to date): Days Absent: _____ Days Tardy: _____
Team Members Roles
Facilitator: _____________________________ Time Keeper: __________________________
Note taker: _____________________________ Case Liaison: __________________________
Step 1. Assess Teacher Concerns (5 minutes)
The facilitator reviews information from the referral sheet including concerns (5 minutes)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Step 2. Inventory Student Strengths, Talents, and Reinforcers (5 minutes)
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________
Step 3 Review Baseline Data (5 minutes) – baseline data, cumulative folder review, behavior report cards or
referrals
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
33 (AIS/RTI Plan)
Step 4 Select TARGET Teacher Concerns (5 to 10 minutes)
Define the top 1-2 concerns in observable terms (the top two difficulties that most interfere with the
student’s functioning in the classroom)
If it’s a behavioral concern, include relevant information about frequency, duration, and/or intensity of
behavior. (E.g. can use Teacher Behavior Report Card from interventioncentral.com, direct observations,
referrals, write-ups, etc.).
If it’s an academic concern, include data regarding student fluency and accuracy of skills of concern (E.g.
curriculum based assessment, work and homework completion, etc.).
1. Targeted Concern Reasons/Functions for Behavior
Behavioral Academic
Lacks necessary skills
Has limited motivation
Seeks attention from adults
Reacting to teasing/bullying
Tries to escape from work
demands or setting
Seeks access to privileges or
rewards
Seeks sensory stimulation (e.g.
playing with objects
Other
_____________________
_____________________
_____________________
_____________________
Lacks necessary skills
Has limited motivation
Struggling academically
in current instructional
placement
Needs drill and practice
Other
_____________________
_____________________
_____________________
2. Targeted Concern Reasons/Functions for Behavior
Behavioral Academic
Lacks necessary skills
Has limited motivation
Seeks attention from adults
Reacting to teasing/bullying
Tries to escape from work
demands or setting
Seeks access to privileges or
rewards
Seeks sensory stimulation
(e.g. playing with objects
Other
_____________________
_____________________
_____________________
_____________________
Lacks necessary skills
Has limited motivation
Struggling academically in
current instructional
placement
Needs drill and practice
Other
_____________________
_____________________
_____________________
34 (AIS/RTI Plan)
Step 5A: If an academic concern - set observable, measurable, and realistic goals
Tool (e.g., F & P, Reading Street Assessment, Oral
Reading Fluency, Comprehension, Math Fluency, Word
Lists, timed writing composition, etc.)
Baseline
Goal
Step 5B – If it is a behavioral concern – set Behavior Goals
Tools (e.g., frequency of behavior, direct observations,
referrals, teacher behavior report card –
www.intervention central.com)
Baseline
Goal
Step 6A – Planning/ Brainstorming (15 to 20 minutes) - record all intervention ideas discussed during
meeting. These ideas may be revisited at a later time.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
35 (AIS/RTI Plan)
Step 6B Design an intervention Plan – Describe the intervention and any resources necessary for its
implementation.
Concern 1- with treatment integrity in mind be specific and provide as much detail as possible
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Start date: ___________ End date: ______________ Length of intervention: _______________
When/Where will the intervention take place?_____________________________________________
Who will be responsible for carrying out the intervention plan? ______________________________
_________________________________________________________________________________
What (if any) special instructional or behavioral program material/resources or training is needed for this
intervention? __________________________________________________________________
At what date and time will the contact person check with the teacher to see how the intervention is
going:_____________________
Concern 2- with treatment integrity in mind be specific and provide as much detail as possible
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
_________________________________________________________________
Start date: ___________ End date: ______________ Length of intervention: _______________
When/Where will the intervention take place?_____________________________________________
Who will be responsible for carrying out the intervention plan? ______________________________
_________________________________________________________________________________
What (if any) special instructional or behavioral program material/resources or training is needed for this
intervention? __________________________________________________________________
At what date and time will the contact person check with the teacher to see how the intervention is
going:____________________
36 (AIS/RTI Plan)
Step 7 – Method of Monitoring Progress (5 minutes) – i.e., Math CBA, F & P, Observation, Oral Reading
Fluency, Math Fluency, Writing CBM, etc.
Method of measuring the response to intervention: (Attempt to use the same method of collecting progress
monitoring data as was used for baseline collection in Step 5):
_________________________________________________________________________________
_________________________________________________________________________________
Who will monitor: ________________________________________________
How often will progress be monitored (frequency of monitoring): ____________________________
Method of measuring response to intervention – please check only those that are addressed in intervention
Step 8 – How will the meeting information be shared with parents/guardian(s) (5 minutes)
Who will share the meeting information with the parent/guardian: ____________________________
Step 9 – Review the intervention and monitoring plans (5 minutes)
The recorder reviews the main points of the intervention and monitoring plans with the team.
The team selects a meeting date and time for follow up meeting.
Please note – date should be selected 8 to 12 weeks from the start of the intervention. Next meeting date:
_________________
If requested or designated – the contact person will establish a date and time to meet with the teacher to
discuss intervention and progress: ________________________________
37 (AIS/RTI Plan)
EGCSD INSTRUCTIONAL SUPPORT TEAM REFERRAL FORM
Student: _____________________________ Grade: ________________________________
Teacher: ______________________________ Date: ______________________________
DOB: ______________________________ Age: ______________________________
Guardian: ____________________________ Phone: (h)____________ (w) ___________
Reason for Referral (Primary Concern):
______ Academic ______ Behavioral ______Emotional ______ Medical ______ Social
How and when was the parent or guardian notified of the referral (parent contact must occur prior to the
referral): _________________________________________________________________________
What are the student’s strengths, talents, or specific interests?
1. ________________________________
2. ________________________________
3. ________________________________
Describe your specific concerns. List any academic, language, motor, social, emotional, behavioral, or
medical issues that negatively impact learning.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Describe the student’s academic performance
AG = above grade G = grade level BG = below grade level
_____ math computation _____ math concepts/ math reasoning
_____ word attack skills/ reading decoding _____ spelling w/in written work
_____ reading comprehension _____ vocabulary understanding
_____ spelling on a test _____ readiness skills
_____ listening comprehension _____ writing
In what settings/situations does the issue occur MOST often? _________________________________________________
___________________________________________________________________________________________________________
In what settings/situations does the issue occur LEAST often? _________________________________________________
___________________________________________________________________________________________________________
38 (AIS/RTI Plan)
Previous Testing Information: psych, speech, medical, OT/PT, outside evaluations, other
Type of Testing Date Results
Interventions (What interventions have been implemented to resolve this issue? How did they
work?)
Intervention Start/End Date Person(s) Responsible Outcome
Describe any outside factors that may be negatively affecting the student’s progress:
Specifically, what type of assistance would you like to receive from the Support Team? Do you want a Case
Liaison assigned to meet with you to consult about the intervention and progress monitoring?
What would be the best day(s)/time(s) for someone to observe the student having the difficulties that you
describe above?
Please list any other teachers or support staff that work with this student who should be invited to attend an IST
meeting (i.e., AIS staff, Early Intervention, Occupational Therapy):
Please attach any additional pertinent information such as the student’s most current report card, schedule,
and attendance record and return with referral.
39 (AIS/RTI Plan)
Appendix F – Notice of Need for Services (K to 5)
Date:
Student Name:
Dear Parent(s)/Guardian(s):
Your child has been recommended to receive Academic Intervention Services (AIS) in the academic areas
indicated below. Next to each academic area is the name of the AIS provider who will work with your child.
AIS provider who will be working with your child:
___ Reading _______________________________
___ Math _________________________________
The decision to provide your child with AIS was based on the following criteria:
____ Teacher recommendation
____ Formative data (district assessments)
____ NYS ELA Assessment (grades 3-5)
____ NYS Math Assessment (grades 3-5)
The overall goal of providing your child with AIS is to give him/her the support needed to perform at or above
grade level. Services may be provided in the classroom and/or in small group settings outside of the classroom.
You will receive AIS reports in conjunction with report cards that will communicate his/her progress. Ongoing
evaluation of your child will determine the need to continue or discontinue AIS support. If at any time during
the year you have any questions or concerns, please contact your child’s AIS provider or classroom teacher.
_____________________________ _____________________________
Principal AIS provider
East Greenbush Central School District
()Elementary
40 (AIS/RTI Plan)
Appendix G – Notice of Discontinuation of Services (K to 5)
Student: ___________________________
Dear Parent/Guardian:
September 2014
As you are aware your child has previously received AIS services in the areas listed below. However, based on
his/her proficiency performance on either state assessments or through their work in the classroom it has been
determined that your child is no longer are in need of these services.
Prior Service: _______________________________________ Reason for Discontinuation:_________
Assessment Name: ____________________ Assessment Score: ____________________
_______ Recommendation of teacher/administrator.
Reason for recommendation: ________________________________________________
Although your child is no longer receiving AIS services in the area indicate, it is important to remember the
work habits and dedication that brought your child to this point. Please encourage your child to continue to seek
out extra help as needed, and remain in contact with his/her teachers to ensure that progress continues to be
made. If you have any questions or concerns, please call your child’s AIS provider.
Sincerely,
__________________ ____________________
Building Principal Reading/Math Specialist
East Greenbush Central School District
()Elementary
41 (AIS/RTI Plan)
Appendix H – Notice of Need for Services (6 to 8)
Date_________
Dear Parent/Guardian of __________________________,
The New York State Board of Regents has mandated that schools provide Academic Intervention Services (AIS) to
students who score below the state-designated performance level on state assessments and/or who are at risk of not
achieving the state learning standards. These standards are assessed at various grade levels during your child’s
education. Your child qualifies for and is being recommended for AIS to better prepare him/her to meet these
standards and build the foundation to be successful academically at both Howard L Goff Middle School and,
eventually, at Columbia High School.
We have designed a comprehensive AIS program that will help students achieve their best academically. The
program’s various levels of services are designed to specifically fit your child’s needs.
Your child has been scheduled for the services indicated below. These services are already a part of his/her
schedule.
ELA: _______Monitor Progress _________ Push-In __________ Literacy Lab
The levels of services are described in more detail below.
Monitor
Monitor an AIS intervention. A student receiving this service has his/her academic progress closely monitored by
both the ELA and AIS teachers. If it is deemed that the student in not making satisfactory progress, a change in
services will be considered. Parents will receive quarterly progress reports and will be notified should a change in
the level of AIS service be needed.
Push-In
Students receiving push-in services will have an additional instructor in their appropriate academic class.
Literacy Lab
Literacy lab is a 40 minute period offered in addition to the classroom instruction. It provides students small group
instruction to strengthen skills necessary to be successful with grade level work.
If you have any questions regarding these services, please contact your child’s AIS teacher. We look forward to
working together to provide an excellent year of academics for your child!
Sincerely,
____________________ _______________________
AIS Teacher Principal
East Greenbush Central School District
HOWARD L. GOFF MIDDLE SCHOOL
42 (AIS/RTI Plan)
East Greenbush Central School District
HOWARD L. GOFF MIDDLE SCHOOL
Date_______
Dear Parent/Guardian of______________________________,
The New York State Board of Regents has mandated that schools provide Academic Intervention Services (AIS) to
students who score below the state-designated performance level on state assessments and/or who are at risk of not
achieving the state learning standards. These standards are assessed at various grade levels during your child’s
education. Your child qualifies for and is being recommended for AIS to better prepare him/her to meet these
standards and build the foundation to be successful academically at both Howard L Goff Middle School and,
eventually, at Columbia High School.
We have designed a comprehensive AIS program that will help students achieve their best academically. The
program’s various levels of services are designed to specifically fit your child’s needs.
Your child has been scheduled for the services indicated below. These services are already a part of his/her
schedule.
Math: _______Monitor Progress _________ Push-In __________ Math Lab
The levels of services are described in more detail below.
Monitor
Monitor an AIS intervention. A student receiving this service has his/her academic progress closely monitored by
both the math and AIS teachers. If it is deemed that the student in not making satisfactory progress, a change in
services will be considered. Parents will receive quarterly progress reports and will be notified should a change in
the level of AIS service be needed.
Push-In
Students receiving push-in services will have an additional instructor in their appropriate academic class.
Math Lab
Math lab is a 40 minute period offered in addition to the classroom instruction. It provides students small group
instruction to strengthen skills necessary to be successful with grade level work.
If you have any questions regarding these services, please contact your child’s AIS teacher.
We look forward to working together to provide an excellent year of academics for your child!
Sincerely,
____________________ _______________________
AIS Teacher Principal
43 (AIS/RTI Plan)
Appendix I – Notice of Discontinuation of Services (6 to 8)
East Greenbush Central School District
HOWARD L. GOFF MIDDLE SCHOOL
September 2014
Student: ___________________________
Dear Parent/Guardian:
As you are aware your child has previously received AIS services in the areas listed below. However, based on
his/her proficiency performance on either state assessments or through their work in the classroom it has been
determined that your child is no longer in need of these services.
AIS Service: _______________________________________
Reason for Discontinuation:
Score on state assessment
Assessment: _____________ Score:_______________
Recommendation of teacher/administrator
Reason for recommendation: _______________________________
Although your child is no longer receiving AIS services in the area indicated, it is important to remember the
work habits and dedication that brought your child to this point.
Please encourage your child to continue to seek out extra help as needed and remain in contact with his/her
teachers to ensure that progress continues to be made. If you have any questions or concerns, please contact
your child’s counselor at 207-2476.
Sincerely,
_______________________ _______________________
Building Principal Reading/Math Specialist
44 (AIS/RTI Plan)
Appendix J – Notice of Need for Services (9 to 12)
Date_________
Dear Parent/Guardian of __________________________,
The New York State Board of Regents has mandated that schools provide Academic Intervention Services (AIS) to
students who score below the state-designated performance level on state assessments and/or who are at risk of not
achieving the state learning standards. These standards are assessed at various grade levels during your child’s
education. Your child qualifies for and is being recommended for AIS to better prepare him/her to meet these
standards and build the foundation to be successful academically at Columbia High School.
We have designed a comprehensive AIS program that will help students achieve their best academically. The
program’s various levels of services are designed to specifically fit your child’s needs.
Your child has been scheduled for the services indicated below. These services are already a part of his/her
schedule.
ELA: _______Monitor Progress _________ Push-In __________ Literacy Lab
The levels of services are described in more detail below.
Monitor
Monitor an AIS intervention. A student receiving this service has his/her academic progress closely monitored by
both the ELA and AIS teachers. If it is deemed that the student in not making satisfactory progress, a change in
services will be considered. Parents will receive quarterly progress reports and will be notified should a change in
the level of AIS service be needed.
Push-In
Students receiving push-in services will have an additional instructor in their appropriate academic class.
Literacy Lab
Literacy lab is a 40 minute period offered in addition to the classroom instruction. It provides students small group
instruction to strengthen skills necessary to be successful with grade level work.
If you have any questions regarding these services, please contact your child’s AIS teacher. We look forward to
working together to provide an excellent year of academics for your child!
Sincerely,
____________________ _______________________
AIS Teacher Principal
East Greenbush Central School District
COLUMBIA HIGH SCHOOL
45 (AIS/RTI Plan)
Appendix K – Notice of Discontinuation of Services (9-12)
East Greenbush Central School District
COLUMBIA HIGH SCHOOL
September 2014
Student: ___________________________
Dear Parent/Guardian:
As you are aware your child has previously received AIS services in the areas listed below. However, based on
his/her proficiency performance on either state assessments or through their work in the classroom it has been
determined that he/she is no longer in need of these services.
AIS Service: _______________________________________
Reason for Discontinuation:
Score on assessment
Assessment: _____________ Score:_______________
Recommendation of teacher/administrator
Reason for recommendation: _______________________________
Although your child is no longer receiving AIS services in the area indicated, it is important to remember the
work habits and dedication that brought your child to this point.
Please encourage your child to continue to seek out extra as needed and remain in contact with your child’s
teachers, to ensure that progress continues to be made. If you have any questions or concerns, please contact
your child’s counselor at 207-2020.
Sincerely,
_______________________ _______________________
Building Principal Reading Specialist
Appendix L – Common Core Aligned Progress Monitoring Reading (K-8) and Math (K-5)
Sample Progress Monitoring for Reading K-5 Student ______________________ Date __________________ Independent Level ____ Teacher (s)/Team _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
Instructional Level ____ Independent Level ____ Reading Level Goal ______
The Reader can: Please list areas of strengths mastered by the student.
Skill Needs: List areas to be re-taught to the student.
Instructional Plan: What are the identified skills that need to be strengthened? What modality of instructions will be utilized to implement skill set?
Timeline and Progress Monitoring: What is the timeframe for re-teaching? When and how will you check on progress?
1st quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
2
nd
quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
3
rd
quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
1 (AIS/RTI Plan)
Sample Progress Monitoring for Reading 6-8 Student ______________________ Date __________________ Independent Level ____ Teacher (s)/Team _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
Instructional Level ____ Independent Level ____ Reading Level Goal ______
The Reader can: Please list areas of strengths mastered by the student.
Skill Needs: List areas to be re-taught to the student.
Instructional Plan: What are the identified skills that need to be strengthened? What modality of instructions will be utilized to implement skill set?
Timeline and Progress Monitoring: What is the timeframe for re-teaching? When and how will you check on progress?
1st quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
2
nd
quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
3
rd
quarter
Phonemic Awareness Fluency Decoding Comprehension Sight words Vocabulary Other (Specify)
2 (AIS/RTI Plan)
Sample Progress Monitor for Math K Student ______________________ Date __________________ Independent Level ____ Instructional Level ____ Teacher (s) _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
The student can: Please
list areas of strengths
mastered by the student.
Skill Needs: List areas to be re-taught to the student. Instructional Plan: What are the
identified skills that need to be
strengthened? What modality
of instructions will be utilized
to implement skill set?
Timeline and Progress Monitoring: What is the timeframe for re-teaching? When and how will you check on progress?
1st trimester
Numbers to 10
Two-Dimensional and Three-Dimensional
Shapes
Comparison of Length, Weight, Capacity, and
Numbers to 10
Number Pairs, Addition and Subtraction to 10
Numbers 10–20 and Counting to 100
Analyzing, Comparing, and Composing Shapes
Other (Specify)
2
nd
trimester
Numbers to 10
Two-Dimensional and Three-Dimensional
Shapes
Comparison of Length, Weight, and Capacity and
Numbers to 10
Number Pairs, Addition and Subtraction to 10
Numbers to 10-20, and Counting to 100
Analyzing, Comparing, and Composing Shapes
Other (Specify
3
rd
trimester
Numbers to 10
Two-Dimensional and Three-Dimensional
Shapes
Comparison of Length, Weight, and Capacity and
Numbers to 10
Number Pairs, Addition and Subtraction to 10
Numbers to 10-20, and Counting to 100
Analyzing, Comparing, and Composing Shapes
Other (Specify)
3 (AIS/RTI Plan)
Sample Progress Monitor for Math 2 Student ______________________ Date __________________ Independent Level ____ Instructional Level ____ Teacher (s) _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
The student can:
Please list areas of
strengths mastered by
the student.
Skill Needs: List areas to be re-taught to the student. Instructional Plan: What are the
identified skills that need to be
strengthened? What modality of
instruction will be utilized to
implement skill set?
Timeline and Progress Monitoring:
What is the timeframe for re-
teaching?
When and how will you check on
progress?
1st
trimester
Sums and Differences to 20
Addition and Subtraction of Length Units
Place Value, Counting, and Comparison of Numbers to 1000
Addition and Subtraction Within 200 with Word Problems to
100
Addition and Subtraction Within 1000 with Word Problems to
100
Foundations of Multiplication and Division
Problem Solving with Length, Money, and Data
Time, Shapes, and Fractions as Equal Parts of Shapes
Other (Specify)
2nd
trimester
Sums and Differences to 20
Addition and Subtraction of Length Units
Place Value, Counting, and Comparison of Numbers to 1000
Addition and Subtraction Within 200 with Word Problems to
100
Addition and Subtraction Within 1000 with Word Problems to
100
Foundations of Multiplication and Division
Problem Solving with Length, Money, and Data
Time, Shapes, and Fractions as Equal Parts of Shapes
Other (Specify)
3rd
trimester
Sums and Differences to 20
Addition and Subtraction of Length Units
Place Value, Counting, and Comparison of Numbers to 1000
Addition and Subtraction Within 200 with Word Problems to
100
Addition and Subtraction Within 1000 with Word Problems to
100
Foundations of Multiplication and Division
Problem Solving with Length, Money, and Data
Time, Shapes, and Fractions as Equal Parts of Shapes
Other (Specify)
4 (AIS/RTI Plan)
Sample Progress Monitor for Math 3 Student ______________________ Date __________________ Independent Level ____ Instructional Level ____ Teacher (s) _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
The student can: Please
list areas of strengths
mastered by the
student.
Skill Needs: List areas to be re-taught to the student. Instructional Plan: What are the
identified skills that need to be
strengthened? What modality of
instructions will be utilized to
implement skill set
Timeline and Progress Monitoring:
What is the timeframe for re-teaching?
When and how will you check on
progress?
1st
trimester
Properties of Multiplication and Division and Solving
Problems with Units of 2–5 and 10
Place Value and Problem Solving with Units of
Measure
Multiplication and Division with Units of 0, 1, 6–9,
and Multiples of 10
Multiplication and Area
Fractions as Numbers on the Number Line
Collecting and Displaying Data
Geometry and Measurement Word Problems
Other (Specify)
2nd
trimester
Properties of Multiplication and Division and Solving
Problems with Units of 2–5 and 10
Place Value and Problem Solving with Units of
Measure
Multiplication and Division with Units of 0, 1, 6–9,
and Multiples of 10
Multiplication and Area
Fractions as Numbers on the Number Line
Collecting and Displaying Data
Geometry and Measurement Word Problems
Other (Specify)
3rd
trimester
Properties of Multiplication and Division and Solving
Problems with Units of 2–5 and 10
Place Value and Problem Solving with Units of
Measure
Multiplication and Division with Units of 0, 1, 6–9,
and Multiples of 10
Multiplication and Area
Fractions as Numbers on the Number Line
Collecting and Displaying Data
Geometry and Measurement Word Problems
Other (Specify)
5 (AIS/RTI Plan)
Sample Progress Monitor for Math 4 Student ______________________ Date __________________ Independent Level ____ Instructional Level ____ Teacher (s) _______________
The student can: Please
list areas of strengths
mastered by the
student.
Skill Needs: List areas to be re-taught to the student. Instructional Plan: What are the
identified skills that need to be
strengthened? What modality
of instructions will be utilized
to implement skill set?
Timeline and Progress Monitoring:
What is the timeframe for re-teaching?
When and how will you check on
progress?
1st
trimester
Place Value, Rounding, and Algorithms for Addition
and Subtraction
Unit Conversions and Problem Solving with Metric
Measurement
Multi-Digit Multiplication and Division
Angle Measure and Plane Figures
Fraction Equivalence, Ordering, and Operations
Module 6: Decimal Fractions
Module 7: Exploring Multiplication
Other (Specify)
2nd
trimester
Place Value, Rounding, and Algorithms for Addition
and Subtraction
Unit Conversions and Problem Solving with Metric
Measurement
Multi-Digit Multiplication and Division
Angle Measure and Plane Figures
Fraction Equivalence, Ordering, and Operations
Module 6: Decimal Fractions
Module 7: Exploring Multiplication
Other (Specify)
3rd
trimester
Place Value, Rounding, and Algorithms for Addition
and Subtraction
Unit Conversions and Problem Solving with Metric
Measurement
Multi-Digit Multiplication and Division
Angle Measure and Plane Figures
Fraction Equivalence, Ordering, and Operations
Module 6: Decimal Fractions
Module 7: Exploring Multiplication
Other (Specify)
6 (AIS/RTI Plan)
Sample Progress Monitor for Math 5 Student ______________________ Date __________________ Independent Level ____ Instructional Level ____ Teacher (s) _______________
Grade ____ Teacher ___________ RTI SPED 504 (Circle any that apply)
The student can: Please list areas of strengths mastered by the student.
Skill Needs: List areas to be re-taught to the student.
Instructional Plan: What are the identified skills that need to be strengthened? What modality of instructions will be utilized to implement skill set?
Timeline and Progress Monitoring: What is the timeframe for re-teaching? When and how will you check on progress?
1st trimester
Place Value and Decimal Fractions Multi-Digit Whole Number and Decimal Fraction Operations Addition and Subtraction of Fractions Multiplication and Division of Fractions and Decimal Fractions Addition and Multiplication with Volume and Area Problem Solving with the Coordinate Plane Other (Specify)
2
nd
trimester
Place Value and Decimal Fractions Multi-Digit Whole Number and Decimal Fraction Operations Addition and Subtraction of Fractions Multiplication and Division of Fractions and Decimal Fractions Addition and Multiplication with Volume and Area Problem Solving with the Coordinate Plane Other (Specify)
3
rd
trimester
Place Value and Decimal Fractions Multi-Digit Whole Number and Decimal Fraction Operations Addition and Subtraction of Fractions Multiplication and Division of Fractions and Decimal Fractions Addition and Multiplication with Volume and Area Problem Solving with the Coordinate Plane Other (Specify)