Texas Literacy Initiative

Martha Medina, RTI Coordinator

TLI Teacher Specialists:

Patricia Cisneros Young

Laura Martinez

Roxanne Reyna

Ninfa Garcia, Ph.D.

Pace Cluster

Pace High Scho

ol

RTI PART 2: FORMS &

DOCUMENTATION

New

TLI will assist by providing intervention options for the TEACHER.

Parent Forms

BISD believes in providing Interventions to students who are not meeting standards

BISD believes in effective education for Each Child, we utilize the 4 Tiered approach, RtI

Based on cumulative data, your child has been referred for an intervention process, RtI

Questions to the parent regarding family, child behaviors, and/or Health concerns

The Parent acknowledges that the BISD has informed them of the RtI process and that the child will receive interventions.

RtI-1 FormInitial Student Referral to RtI

Process

For major behavior concerns, refer to Review 360

Most information may be found in the student’s Personal Records Folder

Academic and assessment data collection, select all that applies

New

Select Accommodations that have been given the student

If Very Effective, it may be an indicator that the student can perform better and that he/she may not have a learning problem

RtI-2 FormStudent Health

Information

Nurse will fill this form out for the student.

RtI-3A FormScreening for

Language Dominance

Teachers should keep in mind that language may be a barrier affecting student’s academic performance.

This is for all students.

RtI-3B FormStudent

Language Observation

Each teacher of the referred student needs to complete this check list

Only filled out for Bilingual students.

RtI-4 FormMinutes and Action Log

RtI Coordinator will complete this form to make sure all paperwork has been filled out.

Collection of Student

DataAchievement Scores ex. STAAR/ TELPAS/ STANFORD/ and etc…Grades ex. Current Grades Speed/ TPRI/ TEJAS LEE/TMSFAInput from Parents ex. Parent Information FormAttendance reports ex. Report from Data Entry

RtI-5 Individual Intervention

PlanElementary

New

New

RtI-5 Individual

Intervention Plan

Middle School

RtI-5 Individual

Intervention Plan

High School

You can provide any of these accommodat-ions for students. Only if they have an X under RtI Team.

RtI-6Signature

Form

Acknowledging that we have an instructional plan in place with adequate interventions for the child. And that it will be implemented with fidelity.

New

Observation needs to be documented for 18 weeks.

RtI-7Progress

Monitoring Record

RtI-14A FormSpeech

Language Dominance

Each teacher of the referred student needs to complete this check list

RtI-14B FormStudent Oral

Language Observation

Each teacher of the referred student needs to complete this check list

RtI-14C FormSpeech Parent

Interview

Parent Interview focuses on Birth Medical History and Developmental Background.

Additional Documentation Forms for

Speech

RtI-10 Form

Behavioral

RtI-11 Form

Behavioral

RtI-12 FormBehavioral

RtI-13 Form

Behavioral

RtI-9A Form

Dyslexia

RtI-9B FormDyslexia

RtI-14 Consent to Release Confidential Information

RtI-8A Form504

RtI-15 FormReferral for

Consideration of Special Education

RTI PRESENTATION

PART 2: RTI FORMS &

DOCUMENTATION

Texas Literacy Initiative

Martha Medina, RtI Coordinator

Teacher Specialists:

Patricia Cisneros Young

Laura MaRtInez,and Roxanne Reyna

Pace Cluster

THANK

YOU!