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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!