MARLBORO CENTRAL SCHOOL DISTRICT RTI COMPLIANCE SUMMARY 2016

Screening

TweakInterventionAsNeeded

Referral

Create&ExecuteIntervention

ProgressMonitor

Marlboro Central School District Board of Education Members, 2015-2016

• BillBell,President• RussellConley• SusanHorton,VicePresident• JamesKuha• FrankMilazzo• JoAnnReed• JeffWalker

MichaelBrooksSuperintendentofSchools

RobinHechtDirectorofCurriculumandInstructionRoseanneMeleDirector,StudentServices

Marlboro Central School District ELEMENTARY (K-5) RTI STEERING COMMITTEE

Elementary School PatriciaWalsh,Principal MarlboroElementarySchoolShaneequaCameron,AssistantPrincipal MarlboroElementarySchoolRobinHecht,Director,Curriculum&InstructionRosanneMele,Director,StudentServices

Marlboro Central School District SECONDARY (6-12) RTI STEERING COMMITTEE

Secondary School DebraClinton,Principal MarlboroMiddleSchoolDemianStanmyer,AssistantPrincipal MarlboroMiddleSchoolRyanLawler,Principal MarlboroHighSchoolBruceCortalano,AssistantPrincipal MarlboroHighSchoolRobinHecht,Director,Curriculum&InstructionRosanneMele,Director,StudentServices

Table of Contents Page BoardofEducationMembers 2RTISteeringCommittees 3-4TableofContents 5-6MCSDRTISummaryOverviewofProcess…MultipleMeasures 7School-WideSystemsforStudentSuccess: ARTIModel 8-9AProfessionalParallel 10AppropriateInstruction 11CommonCoreELAK-2Curriculum/CoreKnowledge 12PedagogicalShiftsDemandedbytheCommonCoreStateStandards(ELA/Literacy)13CrosswalkofCommonCoreInstructionalShifts: Mathematics 14ResponsetoInterventionGlossary 15-16RTI Elementary Schools 17RTIReferral&InterventionProcessK-5 18-19ProgressMonitoringFormK-5(MCSDK-5MultipleMeasure’sMatrix) 20TeacherActionPlan1&2: K-5 21ParentNotification(ElementaryLevel) 22RTIProcessParentNotificationLetters 23NotificationofClassroomAction 24NotificationofRTITeamMeetingRequest 25NotificationofRTITeamMeetingOutcomes 26RTITeacherInstructions 27RTITeamReferralForm: ElementaryLevels 28-31ClassroomInterventionsSummarySheet 32ResourcesforActionPlans&ResponsetoIntervention 33RTITeacherInstructions 34RTITeamFacilitatorScript 35RTITeamMeetingNotesandAttendance:RTITeamActionPlanK-5

ElementaryLevels 36-3940

RTI Secondary Schools: MMS-MS 41RTIReferralandInterventionProcess 42-43MMS-MSELAProgressMonitoringForm 44MMS-MSMATHProgressMonitoringForm

45MMS-MSTeacherActionPlan: K-12 46RTITeamIntroductoryTeacherLetter: SecondaryLevel/MS 47MMS-MSRTIReferralForm 48TierIIProcessingForm 49StudentServicesTeamReferral 50-52ClassroomInterventionSummarySheet 53

RTI Secondary Schools: MHS 54RTIReferral&InterventionProcess 55-56TeacherActionPlan: K-12 57RTITeamActionPlan: K-12 58ClassroomInterventionsSummarySheet 59RTITeamIntroductoryTeacherLetter: SecondaryLevel/MHS 60

Marlboro Central School District RTI Summary

Overview of Process

Marlboro Central School District restructured the process by which students receive intervention services.Using the Commissioner’s regulations section 100.2(ee)(7) and 100.2(ii)MCSD changed the RTI structure toprovidestudentswithinterventionwhenneeded. Thesystemisdesignedusingthreetiersofintervention. Thefirst tier is universal. All students are screenedwithmultiplemeasuresdescribedbelowand providedhighquality education, which may include differentiated instruction, inquiry-based learning, and meta-cognitiveexercises.Thesecondtierincludesclosemonitoringanddocumentationofastudent(seeactionplan)withinthe regularclassroomby the teacherof record. The third tier includesmoreaggressiveinterventionswhichdifferbygradelevel.“Forthe2016-17schoolyear,districtsshallidentifystudentstoreceivedAISthroughatwo-stepprocess.”Step1All students performing below the median scale score between a level 2/partially proficient and a Level3/proficientonagrade3-8EnglishLanguageArt(ELA)ormathematicsstateassessmentshallbeconsideredforAIS.Step2Upon identification of a student for consideration for AIS, districts shall then use a district-developedprocedurewithinthisdocumenttobeapplieduniformlyateachgradelevelandcontentarea,fordeterminingwhichstudentsshallreceiveAIS.Step3The district will consider a student’s scores on multiple measures of student performance and determinewhetherthestudentisrequiredtoreceiveAIS.

Multiple Measures by Grade Level Band

MeasuresforK-5

StateandLocalAssessments(i.e.StateELA/Mathexams,STARReading/Math,SLOData,CommonTasks,Benchmarks)MCSDCurriculumAssessments(i.e.MathModuleAssessment,ELAModuleAssessment,PLRA,Dial-4,ESGI)TeacherAssessments(i.e.OralReadingRecords,F&PReadingRecord,quizzes/tests,exittickets/CheckforUnderstanding,observationalnotes,writingsamples)ReportCardsandProgressReports

Measuresfor6-8

Statetestsscore CastleLearning ReportCardGradesSTARELA/Math SLOData(AllContentArea) CommonTasksProgressReports ModuleAssessment

Measuresfor9-12

ReportCardGrades CommonTasksSLOData(AllContentArea) ProgressReports

Instruction Matched to Student Need

A school district's process to determine if a student responds to scientific, research- based instruction shall

include instruction matched to student need with increasingly intensive levels of targeted intervention and

instruction for students who do not make satisfactory progress in their levels of performance and/or in their

rate of learning to meet age or grade level standards. [8NYCRR §100.2(ii)(1)(iii)]

School-Wide Systems for Student Success: A Response to Intervention (RTI) Model

Academic Systems Behavioral Systems

Tier 3/Tertiary Interventions 1-5% •Individual students •Assessment-based •High intensity

Tier 2/Secondary Interventions 5-15% •Some students (at-risk) •High efficiency •Rapid response •Small group interventions • Some individualizing

1-5% Tier 3/Tertiary Interventions •Individual students •Assessment-based •Intense, durable procedures

5-15% Tier 2/Secondary Interventions

•Some students (at-risk) •High efficiency •Rapid response •Small group interventions •Some individualizing

Tier 1/Universal Interventions 80-90% •All students •Preventive, proactive

80-90% Tier 1/Universal Interventions •All settings, all students •Preventive, proactive

Illinois PBIS Net work, Revised May 15, 2008. Adapted from “ What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/schoolwide.htm

Resource for graphic above - http://www.p12.nysed.gov/specialed/RTI/guidance/appropriate.htm

Tier 1 Core Instruction: Core instruction or primary intervention intended for all students in the general education classroom.

• Focus:ALLstudents• Interventionist:Generaleducationteacher• Setting:Generaleducationclassroom• Grouping:Variableandflexiblegroupingformats• Curriculum:Scientific,research-basedreadinginstructionalignedtostatestandardsand

differentiatedbasedonstudentneedandability• Duration:Year-long• LengthofInterventionSessions:Involvesaminimumof90minutesofuninterruptedELAinstruction

perday• Assessment:UniversalScreening2-3timesperyear(Fall,Winter,Spring)plusacombinationof

informalmeasurestoinforminstructionandidentifystudentswhomaybeat-riskforreadingfailure• ProgressMonitoring:Studentswhoarejustbeloworafewpointsabovetherecommended

benchmarkscoreonuniversalscreeningmaybeprogressmonitoredonamonthlybasis

Tier 2 Core Instruction + Supplemental Intervention: Secondary intervention intended for 10-15% of students not making progress with core instruction

at Tier 1. • Focus:Studentsconsideredat-riskasdeterminedbyuniversalscreening,progressmonitoring,and

additionalvalidatedmeasuresofstudentperformance• Interventionist:Trained,skilledandknowledgeableschoolpersonnel• Setting:Variable,canoccurinand/oroutsideofgeneraleducationclassroom• Grouping:Small,homogenousgrouping(1:3–1:5)basedonsimilarinstructionalneeds• Curriculum:Supplemental,research-basedinstructiondesignedtoremediateskilldeficitsoftargeted

students;compliments/supplementscoreinstruction• Duration:Varies,basedonrateofprogressandperformanceofstudents;10-30weeksminimum• LengthofInterventionSessions:20-30minutes,3to4timesperweek

Note:inadditiontocoreinstructionatTier1• Assessment:Combinationofinformalandformalmeasurestoinforminstruction,identifyspecific

skilldeficitsrelativetoreading,anddetermineresponsetointervention• ProgressMonitoring:Twicemonthlytoexaminerateandlevelofperformanceforthepurposeof

determiningstudentresponsetosupplementalinstruction/intervention

Tier 3 Core Instruction + Customized Intervention: Tertiary instruction intended for about 1-5% of students who are not responding to instruction at Tiers 1 and 2.

• Focus:Studentsconsideredat-riskasdeterminedbyuniversalscreening,progressmonitoring,and

additionalvalidatedmeasuresofstudentperformance• Interventionist:Highlytrained,skilledandknowledgeableschoolpersonnel• Setting:Mostoftentakesplaceoutsideofgeneraleducationclassroom• Grouping:Small,homogenousgrouping(1:1–1:3)• Curriculum:Supplemental,customized,intensive,systematic,research-basedinstructionthattargets

readingareasofgreatestneed;compliments/supplementscoreinstruction• Duration:Varies,aminimumof10-30weeks• LengthofInstructionalSessions:30-60minutes;fivetimesperweek

Note:inadditiontocoreinstructionatTier1• Assessment:Combinationofinformalandformalmeasurestoinforminstruction,identifyspecific

skilldeficitsrelativetoreading,anddetermineresponsetointervention• ProgressMonitoring:OnceperweektoexaminerateandlevelofperformanceforTheabovedescriptionsweretakenfromwww.nysrti.org

Research Based Analogy

A Professional Parallel

Asmore educators areadopting someversion of RTim in theirschools, it has been observed that what we professionaleducators are trying to do in schools is very similar to howphysicianshavebeenprovidingmedical servicesforalong time.Although not a perfect analogy, there is a definite parallelbetweentheseroles.

AProfessionalParallel….. TIER1 TIER2 TIER3 Annualcheck-ups; Strategicsupple- IntensiveCare:Team Standardtreatment; mentalcare: ofdoctors,nurses, Regularphysician Specialistand etc. Regularphysician Screeningdata Diagnosticdata Monitoringdata INCREASING:Time,Intensity,DataCollection,Expertise

Physicians keep in mind the STANDARDS of health and wellness, and work hard to help their patients maintain or achieve these standards. They collect appropriate DATA to inform their profes- sion decisions, and they use their knowledge and skills to provide appropriate and effective INTERVENTIONS as necessary to support their patients' physical well being. As professional educators, we are called to do the same thing but we use academic standards and work to help students achieve “academic health and wellness”!

Appropriate Instruction A school district's process to determine if a student responds to scientific, research-based instruction shall include appropriate

instructiondeliveredtoallstudentsinthegeneraleducationclassbyqualifiedpersonnel.Appropriateinstructioninreadingmeans

scientific research-based reading programs that include explicit and systematic instruction in phonemic awareness, phonics,

vocabularydevelopment,readingfluency(includingoralreadingskills)andreadingcomprehensionstrategies.

[8NYCRR§100.2(ii)(1)(i)]Appropriateinstructionbeginswiththecoreprogramthatprovides:

• highquality,research-basedinstructiontoallstudentsinthegeneraleducationclassprovidedbyqualifiedteachers;• differentiatedinstructiontomeetthewiderangeofstudentneeds;• curriculumthatisalignedtotheStatelearningstandardsandgradelevelperformanceindicatorsforallgeneraleducation

subjects;and• instructionalstrategiesthatutilizeaformativeassessmentprocess.

Appropriate Instruction in Reading

Appropriateinstructioninreadingmeansexplicitandsystematicinstructioninphonemicawareness,phonics,vocabularydevelopment,readingfluency(includingoralreadingskills)andreadingcomprehensionstrategies.[8NYCRR100.2(ii)and200.4(c)(2)(i)]

Forhighqualityearlyliteracyinstruction,thecorereadingprogramshouldminimallybescheduledforanuninterrupted90minuteblockofinstructiondaily.

Appropriate Instruction in Mathematics

Appropriate instruction in mathematics includes instruction in problem-solving,arithmetic skill and fluency, conceptualknowledge/numbersenseandreasoningability.TheMarlboroCentralSchoolDistrictK-5CorePrograminEnglishLanguageArts(ELA)providehighquality,research-basedinstructiontoallstudentsingeneraleducationclassesbyqualifiedteachersusingtheCommonCoreLearningStandardsandNewYorkState’sCommon Core Curriculum; Module/F&P Reading Program is used in primary grades to address the skills strand components.Common Core State Standards and New York State’s Common Core Mathematics Curriculum are utilized for instruction in K-5Mathematics.ThepedagogicalshiftsdemandedbytheCommonCoreStateStandardsinEnglishLanguageArtsandMathematicsareincludedinthisdocumentalongwiththeThreePillarsoftheK-2ELACommonCoreCurriculum.

Common Core ELA K-2 Curriculum Core Knowledge SkillsStrand Listening&LearningDomains Guided/IndependentReading

-addedforNYS

Foundational InteractiveReading GuidedReading–Skills SharedReading LeveledTextsPrintConcepts WrittenResponse IndependentReadingPhonological Listening FluencyAwareness VocabularyPhonics DiscussionVocabulary

©2012CoreKnowledgeFoundation. ThisworkislicensedunderaCreativeCommonsAttribution-Non-Commercial-ShareAlike3.0UnportedLicense. www.creativecommons.org/licenses/by-nc-sa/3.01

www.engageNY.org

Pedagogical Shifts Demanded by the Common Core State Standards

TherearesixshiftsinELA/LiteracyGrade3-5thattheCommonCorerequiresofusifwearetobetrulyalignedwithitintermsofcurricularmaterialsandclassroominstruction.

ShiftsinELA/LiteracyShift1 BalancingInformational

&LiteraryTextStudentsreadatruebalanceofinformationalandliterarytexts.

Shift2 KnowledgeintheDisciplines

Studentsbuildknowledgeabouttheworld(domains/contentareas)throughTEXTratherthantheteacheroractivities

Shift3 StaircaseofComplexity Studentsreadthecentral,gradeappropriatetextaroundwhichinstructioniscentered. Teachersarepatient,createmoretimeandspaceandsupportinthecurriculumforclosereading.

Shift4 Text-basedAnswers Studentsengageinrichandrigorousevidencebasedconversationsabouttext.

Shift5 WritingfromSources Writingemphasizesuseofevidencefromsourcestoinformormakeanargument.

Shift6 AcademicVocabulary Studentsconstantlybuildthetransferablevocabularytheyneedtoaccessgradelevelcomplextexts.Thiscanbedoneeffectivelybyspiralinglikecontentinincreasinglycomplextexts.

CrosswalkofCommonCoreInstructionalShifts:Mathematics

Marlboro Central School District Response to Intervention (RTI) Glossary

BaselineData:Informationcollected,priortotheuseofanintervention,tobeusedasacomparisontodatacollectedduringandafteranintervention.ContinuousProgressMonitoring:AccordingtoNoChildLeftBehind(NCLB),studentprogressismonitoredatleastthreetimesperyear(ormoreasneededanddocumentedinRTIm)inordertomakeinformeddecisionsregardingstudentprogressasaresultofinstruction.CurriculumBasedMeasurement(CBM):Astandardizedmethodoftrackingandrecordingstudentprogressintargetedareas.DifferentiatedInstruction:AccordingtoRTI,thismustserveasthefoundationofallinstruction.LeveledInstructionforAll(LIA):Targetedinstructionusingdatatorescueskills. Forexample,toobtainthegrowthweseekinstudents,teachersneedtoassessandanalyzeforcurrentperformancelevelandputintoactionaplanthattargetstheskillsneededtoreachthegoal,i.e.:beforeteachingaunit,theteachertakestheassessmenttoidentifythesubsetofskillsneededtomastertheunit. Theteachercreatesastudentchecklistoftheidentifiedsubskills. Next,theteachergivesaquickassessment(temperaturecheck)oneachsubskill(+/-).Finally,theteachercreatesgroupsbasedonthesubskillsthatneedrescuing.Whenthisapproachisfollowedforallstudents–belowlevel,on level,abovelevel-leveledinstructionforalloccurs.EarlyIntervention:AccordingtoNCLB,inadditiontothecorereadingprogram,provisionsoftargetedinterventionsaremadeintheearlygradeswhicharecarefullystructuredanddesigned.HighQualityInstruction:AccordingtoNCLB,allchildrenshouldbereceivingatleast90minutesperdayofdifferentiatedinstructioninreading,mathandscience,byahighlyqualifiedteacher.IndividualswithDisabilitiesEducationAct(IDEA):ThepermitstheuseofanRTIprocessratherthananI.Q.assessmentforidentifyingstudentswhomayhaveaLearningDisability.

ProgressMonitoringduringInterventions:According to NCLB, student progress is monitored frequently in order to fine-tune instruction.When dataindicates a lackof progress,necessarysteps are taken to adjust the typeof interventionused, and/or timeallottedforitsemployment.Research-BasedInstruction:AccordingtoNCLB,allreadinginstructionshouldbevalidatedbyresearchofhowchildrenlearntoreadandbestinterventionsforstrugglingreaders.ResponsetoIntervention(RTI):Aprocesswhereastudent’sresponsetoappropriate,highquality,evidence-basedinstructionandinterventionisdocumentedacrosstieredlevelsofservices.Tier1Interventions:The provision of general screening and group interventions that usually represent the core instructionalprogramandtakeplaceintheclassroom.Tier2Interventions:IfstudentsdonotmakeadequateprogressinTier1,moreintensiveservicesandtargetedinterventions,usuallyinsmallgroupsettings,areprovidedinadditiontotheinstructioninthegeneralcurriculum.Tier3Interventions:Students in this tier would receive the most intensive, very small group instruction (i.e. 2-3 students perteacher). They are workingwith themost highly trained individuals professionals in the area of need (e.g.reading/literacyspecialists,contentareatrainedteachers).UniversalDesignforLearning(UDL):Provides a framework for all students to succeed by providing multiple pathways for learning. This isaccomplished through an instructor’s use of:multiplemeans of representation (variousways of presentinginformation),multiplemeansofexpression(variousvenuesforstudentstopresentinformation),andmultiplemeansofengagement(differentiatedinstruction).UniversalScreening:AccordingtoNCLB,toolssuchasCurriculumBasedMeasurement(CBM)probesordirectassessmentareusedtoidentifystudentswhomaybe“atrisk”forfallingbelowstateorgradelevelstandards.Thisisalsousedtoconcludestudentprogressasaresultofinstruction.

MARLBORO CENTRAL SCHOOL DISTRICT RESPONSE TO INTERVENTION

ELEMENTARY SCHOOL

Thecentralquestionisnot:“Whataboutthelearneriscausingtheperformancediscrepancy?”

Itis:“Whatabouttheinteractionofthecurriculum,instruction,

learner,andlearningenvironmentshouldbealteredsothatthechildwilllearn?”

KenHowell(UniversityofOregon,2007)

RTIReferralandInterventionProcessK-5

□StudentisidentifiedbyteacherusingRTIMultipleMeasuresMatrix(UniversalScreeningandMonitoring)(FormA)

• Baselinedataiscollectedonallstudents• Goalsaredeterminedforallstudents.

DateCompleted__________

□TeachergeneratesActionPlanforStudentsinNeed(FormB)• Determineclassroominterventions/actionstotargetspecificgoalsusingdata• Actionplaniswrittenbytheclassroomteacherwhomayseeksupportfrominterventionist(s)• Parentisinformedbyclassroomteacherofactionplan(FormC)

DateCompleted__________

□ActionPlansareImplemented(FormB)• Fidelitytotheplanisdocumented• Student’sprogressismonitoredregularlyclassroominterventionsummarysheet(FormG)• Assessmenttomeasureachievementoftheofthegoalisgivenin4weeks

□TeachergeneratesActionPlan2forstudentsinneed(FormB)

□ActionPlansareImplemented(FormB)• Fidelitytotheplanisdocumented• Student’sprogressismonitoredregularlyclassroominterventionsummarysheet(FormG)• Assessmenttomeasureachievementoftheofthegoalisgivenin4weeks

Ifthegoalsaremet,theinterventionprocessendsandstudentismonitoredcloselyfor4-6weeks.IfgoalsarenotmetaftertwoActionPlancycles,referthechildtotheRTITeamforreview.TheclassroomteachercompletesRTIReferralFormbeforemeetingandtheClassroomInterventionsSummarysheet(FormG);theteachermayseeksupportfromaninterventionisttocompletetheseforms.Theclassroomteachersubmitsthecompletedformstotheschool’sRTITeamChairtobeputontheRTITeam’smeetingagenda.

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RTI Referral and Intervention Process K-5

Student is identified by teacher using RTI Multiple Measures Matrix (Universal Screening and Monitoring) (Form A)

• Baselinedataiscollectedonallstudents• Goalsaredeterminedforallstudents

Teacher generates Action Plan for Students in need (Form B)

• Determineclassroominterventions/actionstotargetspecificgoalsusingdata• ActionPlaniswrittenbytheclassroomteacherwhomayseeksupportfrominterventionist(s)• Parentisinformedbyclassroomteacherofactionplan

Action Plan is implemented (Form B)

• Fidelitytotheplanisdocumented • Student’sprogressismonitoredregularly(FormG)• Assessmenttomeasureachievementofthegoalisgivenin4weeks

Ifgoalsarenotmet,theclassroomteachergeneratesActionPlan2.TeacherloopsbackthroughtheprocessbeginningatStep1.

Ifthegoalsaremet,theinterventionprocessendsandstudentismonitoredcloselyfor4-6weeks.

IfgoalsarenotmetaftertwoActionPlancycles,referthechildtotheRTITeamforreview.TheclassroomteachercompletesRTIReferralFormandtheClassroomInterventionsSummarysheet;(FormG)theteachermayseeksupportfromaninterventionisttocompletetheseforms.Theclassroomteachersubmitsthecompletedformstotheschool’sRTITeamChairtobeputontheRTITeam’smeetingagenda.

FormAMarlboro Central School District Grades K-5 Multiple Measures Matrix (Progress Monitoring) (This form

is to be completed for all students and becomes an artifact.) StudentName: GradeLevel:

TeacherName:______________________

EnglishLanguageArts(ELA)orMathematics 1 2 3 4 Below

GradeLevelApproachingGradeLevel

ProficientatGradeLevel

ExceedingGradeLevel

State/LocalAssessments

MCSDCurriculumAssessments

TeacherAssessments

ProgressReportsand/orReportCards

LEGEND1checkingreyarea=Monitor 2checksingreyarea=Check&Connect3checksingreyarea=Push-inServices 4checksingreyarea=Push-in/Pull-outServicesDATE:____________________

FormBMarlboro Central School District TEACHER Action Plan for:

Grade: Date:

Circle One: Action Plan 1 Action Plan 2 (This form is to be filled out for all students found in the gray area of the ‘Progress Monitoring Form.’)

LEARNINGTARGET(S)ORGOALSTATEMENT(S):

Intervention Plan: DescriptionofInstructionalStrategiesorMethods DeliveryMode

(Setting/Frequency)Data/Assessment

ParentNotificationofActionPlan:calledon: andsentletteron:

Parent Notification (Elementary Level)

A school district's process to determine if a student responds to scientific, research-based instruction shall include written notification to the

parents when the student requires an intervention beyond that provided to all students in the general education classroom that provides information

about:

(a) the amount and nature of student performance data that will be collected and the general education services that will be provided pursuant to the

structure and components of the RTI program selected by the school district;

(b) strategies for increasing the student’s rate of learning; and

(c) the parents’ right to request an evaluation for special education programs and/or services. [8NYCRR §100.2(ii)(1)(vi)]

Procedures for Parent Notification:

WhenstudentsparticipateintheRTIprocess,therearespecificparentnotificationrequirements.ParentsmustbenotifiedinwritingandinalanguageormodeofcommunicationtheyunderstandiftheirchildneedsaninterventionbeyondthatwhichisprovidedtoallstudentsintheclassroomintheRTIprocess.TeacherActionPlans1&2(FormC)

Priortoastudentbeingbroughttotheschool’sRTIteam,parents/guardiansarenotifiedbytheclassroomteacherregardinghisorherconcerns (academic/behavioral)about thestudent. This initial contactmaybedone inperson,orby telephone and by letter (Form D). Parent contact is documented on the Classroom Interventions Summary Sheet(FormG.)

When services are needed, parents/guardians are notified by a formal letter from the building principal via astandard letter generated through RTIm-Direct explaining the intervention(s) and the reason(s) why the student isreceiving the intervention(s).(Form E) After an interventionist creates the student’s intervention in RTIm-Direct, asummaryoftheinterventionmaybeprintedwiththestandardletter. Thissummaryprovidestheparent/guardianwiththetypeofintervention,thestartdate,themode,frequency,period,durationandprovider. TheRTItier,reasonsfortheserviceandconsequencesfornotachievingtheperformancelevelarealsolistedontheinterventionsummaryform.

Aprogressreportforeachinterventionfromeachproviderissenttothestudent’sparent/guardianat7-weeksand14-weeks(withthereportcard). Providersreportonhowthestudentisperformingintheacademicorbehavioralarea with the intervention(s). In the narrative, providers may include progress monitoring data such as instructionalreadinglevel,highfrequencywordknowledge,fluencyrate,letterandsoundknowledge,andmathfluencybasedonthestudent’sintervention(s).

Eachtimetheschool’sRTIteammeetsonastudent,theparentistobenotified(seeparentnotificationletters:RTIteammeetingrequestandRTIteammeetingoutcome)bytheclassroomteacher.Thisincludesfollow-upmeetings.

In the event a student is referred for an evaluation to determine if the student has a learning disability, the parent will have received appropriate data- based documentation of repeated assessments of achievement at reasonable intervals, reflecting formal assessment of student progress during instruction. (8NYCRR §200.4(j)(1)(ii)(b))

RTI Process Parent Notification Letters Action Plan Notification

RTI Team Meeting Request RTI Team Meeting Outcome(s)

Note: Parentnotificationisrequired.Theselettersshouldbeusedinordertocreatea“papertrail”ofparentnotificationoftheRTIprocess.

Form C MARLBORO CENTRAL SCHOOL DISTRICT

21 Milton Turnpike, Suite 100 Milton, NY 12547

J Michael Brooks Robin Hecht S Superintendent of Schools Director Curriculum & Instruction ( (845) 236-5802 (845) 236-5812 F FAX (845) 795-5904 FAX (845) 795-5906 email: michael.brooks@marlboroschools.org e-mail: robin.hecht@marlboroschools.org

NOTIFICATION OF CLASSROOM ACTION PLAN

Dear :

We continually strive to support the learning of every child at Marlboro Elementary School. To meet theindividual needs of every child, we monitor academic and behavioral progress with various assessments regularlythroughouttheyear.

Ifachilddoesnotmakesatisfactoryprogresstowardgrade-levelexpectations,aplanofactioniscreatedbythe

child’s teacherteam. Theplanofaction,oractionplan,consistsof interventions toaddresstheareasofconcernandtargetedgoalsthatareusedtomonitortheeffectivenessoftheinterventions.

Thisletteristonotifyyouthatyourchildhasanactionplantoaddressthefollowing:

LearningTarget InstructionalStrategiesorMethods

Also,youareanimportantpartofyourchild’sinstructionalteam. Youcanhelpby:HomeSupport Materialsprovided

Yourchildwillbemonitoredcloselyforthenext3-5weekstodeterminewhetherornothe/sheisachievingthe

targetedgoals.Theintentionoftheactionplanistosetyourchildbackontherighttracktowardsuccess. Iwillnotifyyouin3-5weeksoftheoutcomeofthisplan. Ifyouhaveanyquestionsofconcerns,pleasecontactme.

Sincerely,

Form D

MARLBORO CENTRAL SCHOOL DISTRICT 21 Milton Turnpike, Suite 100

Milton, NY 12547 J Michael Brooks Robin Hecht S Superintendent of Schools Director Curriculum & Instruction ( (845) 236-5802 (845) 236-5812 F FAX (845) 795-5904 FAX (845) 795-5906 email: michael.brooks@marlboroschools.org e-mail: robin.hecht@marlboroschools.org

NOTIFICATION OF RTI TEAM MEETING REQUEST

TotheParents/Guardiansof :

Asyouknow,actionplansweredevelopedinanefforttohelpyourchildprogresstowardgradelevel

expectations. I have implemented the action plans consistently, but (insert child’s name) is not makingadequateprogresstowardthegoalsweset.

ThisletteristonotifyyouthatIhaverequestedameetingwiththeRTI(ResponsetoIntervention)team

todiscussandplanfurtherinterventions. Theteamiscomprisedofschool-widestaffmembershavingexpertiseinacademicand/orbehavioralinstruction. ThepurposeoftheRTIteammeetingistodeterminethenextstepsforyourchildtoachievesuccess.

IwillnotifyyouaftertheRTIteammeetingstoletyouknowtheirrecommendations. If youhaveany

questionsorconcerns,pleasecontactmeatschool.

Sincerely, Form E

MARLBORO CENTRAL SCHOOL DISTRICT 21 Milton Turnpike, Suite 100

Milton, NY 12547 J Michael Brooks Robin Hecht S Superintendent of Schools Director Curriculum & Instruction ( (845) 236-5802 (845) 236-5812 F FAX (845) 795-5904 FAX (845) 795-5906 email: michael.brooks@marlboroschools.org e-mail: robin.hecht@marlboroschools.org

NOTIFICATION OF RTI TEAM MEETING OUTCOMES

Dear :

This letter is tonotify you that theMarlboroCentral SchoolDistrict’s RTI (Response to Intervention)Teammet on to review your child’s progress and the stepstakentointerveneinareasofneedandtoplanthenextstepsforyourchildtomeetgrade-levelexpectations.

TheRTITeamrecommendationsareasfollows:

Also,IhaveattachedtheRTITeam’sActionPlandetailingtheintervention(s)yourchildwillreceiveasaresultofthemeeting.Ineedtomeetwithyoutodiscusstheserecommendationsfurther.Pleasecontactmeatschooltosetupadayandtimethatisconvenientforyou.

Sincerely,

RTI TEACHER INSTRUCTIONS:

1. The Classroom Teacher completes the ‘RTI Referral Form’ after cycling through twoAction Planswithoutgoalshavingbeenmet(seeflow chart).

2.The‘RTIReferralForm’issubmittedtotheRTI Team Chairperson along with the ‘Classroom InterventionsSummarySheet.’

3.The‘Classroom Interventions Summary Sheet’ becomes anartifact. (FormG)

FormFMarlboro Central School District

RTI Team Referral Form: Elementary Levels

Directions:PleaseanswerthequestionsbelowsothatwewillbebetterpreparedattheRTITeamMeetingtocreateanactionplantoaddressyourconcerns.

Student’sName:_________________________________________________________________ReferringTeacher(s):______________________________________________________________DateofBirth:_________________Grade:___________DateofReferral:___________________

Hasthestudenteverbeenretained? Ifso,when ?Isthestudentreceivingorhavetheyeverreceivedanyofthefollowingsupports? _________AISMath _________AISELA _________SpecialEd–Weretheypreviouslytestedandfoundineligible?Ifso,when____? _________504 ________Counseling _________BehavioralPlan _________StudentInterventionPlan

DominantLanguage&SecondaryLanguage: o EnglishLanguageLearner(ELL)

Attendance(asofdateofreferral):____________________________/Tardy________________

Medicalorhealthconcernsforstudent:

Parent/Guardiancontactdate(s):seeattachedTier1SummarySheet(FormG)Numberofdisciplinaryreferralstodate: Sourceofreferrals: Classroom_____Lunch/Recess______Hallway______Bus_______Numberofsuspensiondaystodate: ****************************************************************************************

1a.Whatcanthestudentdo? Pleaselist3-4skillsand/ortalentsthatthestudentdisplaystosomedegreeofcompetencyorspecificinterests/incentivesthatthestudentfindsmotivating.

1.

2.

3.

4.

1b.Whatwouldyoulikethestudenttodo?Describethespecificconcernspromptingthisreferral(seeactionplans)e.g.,abilitytodecodewordsincontextvs.inisolationorre-readtogainmeaning;areasthestudentneedstoimprovetobesuccessfulinschool.

StudentConcern1.

StudentConcern2. 2a.Whatdoyoubelieveistherootcausewhythestudentisnotshowingadequategrowth?2b.Arethereanysocialoremotionalfactorsthatmaybenegativelyimpactingthestudent’sperformance?

3.PresentLevelofPerformanceUsingthestudent’sassessmentdatafromtheMultipleMeasuresMatrix,(FormA)provideatleasttwostatementsthatsupportyourspecificconcernsforthestudent.(e.g.,thestudent’sSTARscoreforfallwas andthegradelevelnormis orthestudent’sscoresontheF&Pfallwas_____andmostcurrent______.

4.Iftheproblemisprimarilybehavioral,usethechartbelowtodefinethespecificproblem. DisciplineHistory

Thecondition(s)underwhichthebehaviorusuallyoccurs:

Specificdescriptionoftheproblembehaviorthatimpactslearning:

Listthefrequency,intensity,anddurationoftheproblembehavior:

Example:Reactionoccurswhenthestudentisaskedtoreadapieceoftextmorethanoneparagraph.

Studentrefusestoreadit,talkstohisorherpeersandthenargueswiththeteacherwhenredirected.

Thishappensatleast75%ofthetimeandusuallyescalatestothestudenthavingtoberemovedfromclass.

5.Aretheresettingsorsituationsinwhichtheproblemislesssevereorminimized?

6.PleaseattachTeacherActionPlans1&2(FormB)andClassroomInterventionsSummarySheet(FormG)forevidenceofinterventionsattempted.

7.Pleaselistmembersofyourschoolstaffwhomyouwouldliketoreceiveaninvitationtothemeeting:****************************************************************************************

*PleaseattachaMultipleMeasuresMatrix (FormA)documentingthestudent’sformativeandsummativeassessments. (Suchasreportcards,statetestscores,NYSCommonCoreCurriculumassessments,STAR,F&P,PLRAscoresassessments)

------------------------------------------------------------------------------------------------------------Reminder:Pleasebringanydatathatpertainstothestudent’sacademicorbehaviorconcernstotheRTITeammeeting.(Seechecklistbelow)

RTITeamMeetingDOCUMENTATIONCHECKLIST

Documentsrequired:

ClassroomTeacher:

o MultipleMeasureo ActionPlano ClassroomInterventionsSummarySheeto AttendanceRecordo Studentworksampleso SampleAssessments[i.e.RunningRecord,ModuleAssessments]o CopyofReferralForm

Interventionists–bringallthatapply:

o RTIm-DirectProgressNotes,ServiceLogs(AISteacher)o Speech&LanguageReporto ReportfromSocialWorkero BehaviorPlano NYSESLATorLab-Rscores(ESLteacher)o HealthRecords

FormG

School Year

Marlboro Central School District

Classroom Interventions School

Summary Sheet Student:_ Teacher: Date: Summarizeimplementedclassroominterventions(actionplans).Usingthedatacollected,ratetheeffectivenessoftheseinterventions.

InstructionalStrategiesorMethods DataCollected(Assessments;WorkSamples)

EffectivenessofIntervention(Checkone)

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

Summarizehomeintervention. Usingthedatacollected,ratetheeffectivenessofthissupport.HomeSupport Materialsprovided EffectivenessofSupportatHome

SignificantImprovement Improved NoChange Regression SignificantRegression

ThisformistobecompletedandbroughttotheRTImeeting. Date(s)ofparentcontact:

Resources for Action Plans and RTI

1.) Online Resources

1.FoundedbyJimWrightasofsourceforfreeRTIresources: www.interventioncentral.org2.NationalCenteronResponsetoIntervention: www.rti4success.org3.RTIActionNetwork–aProgramoftheNationalCenterforLearningDisabilities

www.rtinetwork.org4.www.nysrti.org–NewYorkStateResponsetoInterventionTechnicalAssistanceCenter

2.) Print Format Resources

ThathelpwithactionplanwritingandunderstandingRTI:EducatorsasPhysicians:UsingRTIDataforEffectiveDecision-MakingbyJanHasbrouck,PH.DwithJ.R.Wilson,M.A.

1.RTIToolkit:APracticalGuideforSchoolsbyJimWright2.RTIFromAllSides: WhatEveryTeacherNeedstoKnowbyMaryHoward3.WhatReallyMattersforStrugglingReaders: DesigningResearch-BasedProgramsbyRichard

Allington4.TheLiteracyTeacher’s Playbook GradesK-2orGrades3-6:FourStepsforTurningAssessment

DataintoGoal-DirectedInstructionbyJenniferSerravallo

Thathelpwithinterventionsand/orsupports:

1.TheRTIDailyPlanningBookK-6: Tools&StrategiesforCollecting&AssessingReadingDataandTargetedFollow-UpInstructionbyGretchenOwocki

2.MovingForwardwithRTI:Reading&WritingActivitiesforEveryInstructionalSetting&TierbyMaryHoward

3.SolutionsforReadingComprehension: StrategicInterventionsforStrivingLearners(K-6)byLindaHoyt,KellyDavis,JaneOlson,andKellyBoswell

4.TeachAll,ReachAll:InstructionDesign&DeliverywithTGIF!BySusanMulkey5.TheContinuumofLiteracyLearning,GradesPreK-8;TeachingforComprehendingandFluency:

Thinking,TalkingandWritingAboutReading(K-8);andWhenReadersStruggle:TeachingThatWorksbyIreneFountasandGuySuPinnell

Also,theCCSSviewedasa“roughcontinuum”canalsobeusedtowritegoalstogrowstudents. Thestandardsgiveteachersasenseofwhattoexpect,byyear’send,ateachgradelevel. Eachnumberedstandardisdescribedalongaprogression–so,forexample,standardRI.1.1asksafirstgraderto“askandanswerquestionsaboutkeydetails in a text” and RI.2.1 asks a second grader to domorewith the similar skill: “ask and answer suchquestionsaswho,what,where,when,why,andhowtodemonstrateunderstandingofkeydetailsinatext.”

RTI TEACHER INSTRUCTIONS:

1.TheRTI TeamChairpersonuses the‘FacilitatorScript’andthe‘Agenda’tofacilitatethemeeting.

2.TheChairpersonadds theactionnotes on the‘Agenda’ formwhile the Team’sNote Taker/Recordercompletesthe‘RTIMeetingNotes’form.

3.These‘RTIMeetingNotes’becomeanartifactofthemeetingalongwith the ‘RTI TeamActionPlan.’ (FormH)

4.The‘RTITeamActionPlan’(FormH)iscompletedbythe referring teacher in conjunction with the RTImTeam during the meeting and shared with all teammembers and any interventionists involved with theplan.

MARLBORO CENTRAL SCHOOL DISTRICT

RTI Facilitator

Script Road Map WelcometoRTI! Ourpurposehereistogettotherootcauseoftheissuesthatareholding(nameofstudent)backfrombeingfullysuccessful.

As facilitator, it is imperative thatwe remain timely and respond in our conversations usingspecific details and data to support the claimswemake about the student, and I will workdiligently to keep our conversations focused in that direction. We will follow a structuredproblem-solvingmodelthatgoesthroughseveralstages.

Asthestudent’steacher,youarethemostimportantparticipantinthismeeting. Together,wewill:

• Setspecificstudentgoalsforimprovement• Brainstormideaswithinacollaborativeforum• Designaninterventionplanwithstrategiestohelpyourstudentimprove.

Atthecloseofthemeeting,ournotetaker, _,willsummarizethenotesconcerning the intervention planwe developed. The noteswill be entered into RTIm,will beavailable to team participants and may be shared with others who were not here todayincluding the student’s parent(s). However, we ask that everyone here keep theconversationsthat takeplaceat thismeetingconfidential.

Let’sbeginwiththefirstitemonouragenda.

Marlboro Central School District

Response to Intervention Team Meeting Notes: Elementary Level

Student’sName:ReferringTeacher: Date:

Step1a:Whatcanthestudentdo?(List3-4skillsortalentsthatthestudentdisplaystosomedegreeofcompetency,aswellasthoseincentivesthatmotivatethestudent.Thisinformationcanbevaluableduringinterventionplanningtoidentifystrategiesthatwillmotivatethestudenttoparticipate.)

Step1b:Whatwouldyoulikethestudenttodo?(Listoneormoreareaswhichthestudentneedstoimprovetobesuccessfulinschool-AREASOFCONCERN;e.g.,abilitytodecodewordsincontextvs.inisolationorre-readtogainmeaning.)

Step2:ReviewPresentLevelofPerformance(SeeMultipleMeasuresMatrix)(FormA)

Step3:ListInterventionsAttempted(SeeClassroomInterventionsSummarySheet(FormG)and/orActionPlans)(FormB)

Step4:DeviseRTITeamActionPlan(FormH)Step4a:SelectTargetTeacherConcerns(Definetheprimaryconcern(s)inobservableterms.Identifytherootcause(anyunderlyingskillsdeficitsorreasonsthatbestexplainthestudent’sdifficulties).Behaviorproblemsshouldincluderelevantinformationaboutfrequency,duration,and/orintensityofbehavior.)

Step4b:SetAcademicand/orBehavioralOutcomeGoalsandMethodsforProgress-Monitoring(Foreachselectedconcern,setambitiousbutrealisticgoalsforimprovementthatarelikelytobeattainedwithin6-8instructionalweeksandselectmethodstomonitorstudentprogressduringtheintervention.)

Ø AcademicGoalStatement:Thestudentwillachieve

(levelofproficiencydescribesinmeasurableterms)in

(specificskillarea)bythetargetdateof .Thisgoalwillbemonitoredby

(personresponsibleformonitoringthestudentgoal)ona basisusingthefollowingmeasure(s): .

(frequency:daily,weekly) (progress-monitoringtools)Ø BehavioralGoalStatement:Thestudentwillincrease/decrease

(definitionofbehavior)when

(conditionsinwhichthebehaviorislikelytoappear)toachievethegoalof

(describegoalinobjective/measurableterms)bythetargetdateof . Thisgoalwillbemonitoredby ona basisusingthefollowingmeasure(s):

(personresponsibleformonitoringthestudentgoal) (frequency:daily,weekly)

.(progressmonitoringtool)

Step4c:DevelopInterventionPlan(Selectoneinterventionthataddresseseachoftheselectedconcerns;spelloutthe interventioninaseriesof stepssothattheperson(s)designedto implementtheplancandosocorrectlyandefficiently. Includeanyspecializedmaterialsortrainingtoimplementtheintervention.)

è DescriptionofIntervention:

è StartDate:

è Setting:

è Frequency: Duration:

è Whowillbeprovidingtheintervention?Supplementalactivitiesrecommendedbytheteam(inadditiontoprimaryintervention):

VisionScreening Observation

HearingScreening Speech/LanguageScreening

OTScreening ADDScreening–Connor’sScale

Counseling Other Step5: ReviewtheInterventionPlan(s):

• Setdateforfollow-upRTITeammeeting onthestudent.(Generally, follow-upmeetings arescheduled6-8instructionalweeksfromthestartdateoftheintervention.)

Nextmeetingdate:

• ThenotetakerrecordsmainpointsoftheinterventionsandmonitoringplansintoRTImwiththeteam.

AttendanceatRTITeamMeeting

StudentDiscussed: DateofMeeting:

Name Position1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

FormH Marlboro Central School District RTI Team Action Plan for:

Elementary K – 5

Grade: Referring Teacher(s): Date:

GoalStatement(s):

InterventionPlan:DescriptionofInstructionalStrategiesorMethods DeliveryMode

(Setting/Frequency)Data/Assessment

Interventionist:

Interventionist:

Follow-UpMeetingDate:

MARLBORO SCHOOL DISTRICT RESPONSE TO INTERVENTION MIDDLE

SCHOOL

RTIReferral&InterventionProcessSecondary

□StudentisidentifiedbyteacherusingRTIMultipleMeasuresMatrix DateCompleted:_______

□ClassroomTier1Interventionsaredeterminedandimplementedthroughdocumentationtodevelopabaselineofstudent’sleveloffunctioning. DateCompleted:_______

□Parentsarecontactedbyteacher/teamtoshareconcernsandgaininsightonstudentfunctioning. DateCompleted:_______IfstudentrespondsfavorablytoTier1interventioncontinueinterventionuntilstudenthasstabilized.DocumentprogressusingClassroomInterventionSummarySheet DateCompleted:_______IfstudentdoesnotrespondfavorablytoTier1interventionalreadyattempted.(initialreferraltoRTIm) DateCompleted:_______

□Teacher/teamcompletedRTIreferralandsubmitstoappropriateguidancecounselortodiscussconcernsandmoveforwardwithRTIprocess(ameetingdatewillbeset).Paperworkforwardedtonon/coreteachersforinput.TeamwillbeadvisedastothedateforRTIteamtomeetregardingstudentwithinaweekofreceivingcompleteddocument. DateCompleted:_______

□RTIteamschedulesanappointmenttimetomeetwiththeteacher/teamduringtheirteamtime.Teacher/teamshouldhaveatleastoneofthefollowing: Documentationofparentcontactorinitialbaselinedata. Exampleofstudent’sworkrelatedtoIntervention. Explanationofclassroom-interventionsalreadytried. Documentationsrelatingtotheinterventionandresults.DateCompleted:_______

□RTIteaminconjunctionwithteacher(s),designsspecificinterventiontobeimplemented.Minutesaretakenandinterventionplanisdeveloped.Clockstartsontheinterventiontimeperiodof4-6weeks,followupmeetingdateisestablished. DateCompleted:_______

□Teacher/teamimplementsinterventionandcollectsdataonstudentresponse.Completeprogressmonitoringdocuments. DateCompleted:_______Ifstudentrespondsfavorablytointerventioncontinuewithintervention.Ifstudentdoesnotrespondfavorablytointervention.Secondreferrallevel.

□MeetingwillbedeterminedforRTItoreconvenetodiscussdataaftersubmissionofdocument.

□RTIdesignsnewintervention,orreferschildontofurthertesting,ormakesreferraltoCSE.Thirdreferrallevel. DateCompleted:________

Teacher/team suspects ssue:

RTI Referral & Intervention Process

Teacher/teamsuspectsissue.ClassroomInterventionsaredetermined&implementedthrudocumentationtodevelopabaselineof

student’sleveloffunctioning.

Parentsarecontactedbyteacher/teamtoshareconcernsandgaininsightonstudentfunctioning. Studentrespondsfavorablytointervention.

Continueinterventionuntilstudenthasstabilized.

Studentdoesnotrespondfavorablytotier1interventionalreadyattempted. (InitialreferraltoRTI)Teacher/teamcompletesRTIreferralandsubmitstoappropriateguidancecounselortodiscussconcernsandmoveforwardwithRTIprocess(ameetingdatewillbeset). Paperworkforwardedtonon/coreteachersforinput.

TeamwillbeadvisedastothedateforRTIteamtomeetregardingstudent.

Guidancecounselor,alongwiththeteam,fillsoutremaininginformationonreferralform.

RTIteamschedulesanappointmenttimetomeetwiththeteacher/teamduringtheirteamtime.Teacher/teamshouldhaveatleastoneofthefollowing:

•Documentationofparentcontactorinitialbaselinedata.•Exampleofstudent’sworkrelatedtoIntervention.•Explanationofclassroom-interventionsalreadytried.•Documentationsrelatingtotheinterventionandresults.

RTIteam,inconjunctionwithteacher(s),designsspecificinterventiontobeimplemented. Minutesaretakenandinterventionplanisdeveloped.

•Clockstartsontheinterventiontimeperiodof1-6weeks.•Follow-upmeetingdateisestablished.

Teacher/teamimplementsinterventionandcollectsdataonstudentresponse.

Studentrespondsfavorablytointervention.Studentdoesnotrespondfavorablytointervention. Secondreferrallevel.

Continuewithintervention. RTIreconvenestodiscussdata.

RTIdesignsnewintervention,orreferschildontofurthertesting,ormakesreferraltoCSE.Thirdreferrallevel.

Middle School ELA Progress Monitoring Form

(ThisformistobefilledoutbytheRTITeamimmediatelyforeverystudent.)

StudentName:_ Grade/Team:

BelowGradeLevelinELA

ApproachingGradeLevel

inELA

GradeLevel

inELA

AboveGradeLevelinELA

NewYorkStateTest

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:_

Gr5:

Gr6:

Gr7: ReportCard

Grade

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

FallSTAR

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

SpringSTAR

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

CommonTask

ModuleAssessments

Legend1GreyCheck Monitor2GreyChecks CheckandConnect3GreyChecks Pull-outclass4GreyChecks Pullout,guidance,socialworker

Middle School MATH Progress Monitoring Form

(ThisformistobefilledoutbytheRTITeamimmediatelyforeverystudent.)

StudentName:_ Grade/Team:

BelowGradeLevelinMath

ApproachingGradeLevelinMath

GradeLevelinMath

AboveGradeLevelinMath

NewYorkStateTest

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7: ReportCard

Grade

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

FallSTAR

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

Gr5: Gr6:

Gr7:

SpringSTAR

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7:

Gr5:

Gr6:

Gr7: CommonTaskModule

Assessments

Legend1GreyCheck Monitor2GreyChecks CheckandConnect3GreyChecks Pull-outclass4GreyChecks Pull-out,guidance,socialworker

(Optional) Marlboro Central School District TEACHER Action Plan for:

Levels: K – 12 Grade: Date:

Circle One: Action Plan 1 Action Plan 2 (This form is to be filled out for all students found in the gray area of the ‘Progress Monitoring Form.’)

LEARNINGTARGET(S)ORGOALSTATEMENT(S):

Intervention Plan: DescriptionofInstructionalStrategiesorMethods DeliveryMode

(Setting/Frequency)Data/Assessment

ParentNotificationofActionPlan:calledon: andsentletteron:

(GuidanceGenerated)MarlboroCentralSchoolDistrict

21 Milton Turnpike, Milton, NY 12547 Tel: 845-236-5812 Fax: 845-794-7710

RTI TEAM

INTRODUCTORY TEACHER LETTER: MIDDLE SCHOOL Date:DearReferringTeacher/ReferringTeam:The purpose of the RTI team is to develop an intervention that will promote improvements in a student’s academicperformanceor behavior.Please complete the bottomportionof this form and send it to _____________,ChairpersonoftheRTIteam. ShewillthenhaveapreliminarymeetingwiththeRTITeamandaCaseLiaisonwillbeassignedtoyou.TheCaseLiaisonwillbeyourprimarysupportthroughoutthisprocess.TheCaseLiaison,alongwiththeguidancecounselor,willalsoarrangeforthecollectionofadditionalbackgroundinformation. AttheInitialRTITeammeeting,wewillbediscussingthestrategiesattemptedthusfarandwilldevelopanActionPlantoputthenewintervention(s)intoplace.Following the Initial RTIMeeting, the Case Liaisonwillmeetwith you again to ensure that you have all the resourcesnecessarytoimplementtheintervention(s)andtomonitoritseffectiveness.Thankyou,

TheMiddleSchool/HighSchoolRTITeam

Student’sName: Teacher/Team(listall): Grade: DateofBirth:_ Brieflydescribetheacademicand/orbehavioralconcernsyouhaveforthisstudent:

DatereviewedbyRTITeamChairperson: RTImemberassignments:

MarlboroCentralSchoolDistrictSecondaryDivision

PROCEDURESFORBUILDINGLEVEL

RESPONSETOINTERVENTIONREFERRALFORM

1.ReferringteacherobtainsformfromtheGuidanceOfficeandcompletesstudentinformation.2.ReferringteachercompletesformandreturnstoGuidance.3.Guidancewillattachstudentscheduleandreportcard.TheprincipalordesigneewillsetupaRTImeetingandnotifyallteachers.Student’sName:____________________________________DateofReferral:______________________Building:___________________________________________Grade:_______________ReferringTeacher:___________________________________Student’sDOB:_________________PreviousRTIMeeting(s):___________________________________________________________________Checkserviceschildreceived:Classified:Y□N□AISReading□AISMath□AISSpeech□ESOL□Counseling□504□Other□(Specify)_____________________________Iftransferred:FormerDistrict:________________________TransferDate:_________________________ParentalInvolvement(DatesofContact/Results):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

RTI Tier II Interview Processing Form Student/ID: Teacher(s):

ReferralDate: Received: RTIDOESNOTAPPLY: Reevaluatedate:

Pre Screening Interview B.A.S.E Components

BEHAVORIAL–(Discipline/attendance/tardiness/FBA/BIP)

ACADEMIC–(Identifydata–i.e.grades,subjects,regents)

SOCIAL/EMOTIONAL–(Home,school,outsideagenciesinterventions)

EFFICIENCY- (Strengths,modifications,learningstyles)

ActionPlanB A S E

MARLBOROCENTRALSCHOOLDISTRICTSecondaryDivision

PROCEDURESFORBUILDINGLEVEL

STUDENTSERVICESTEAMREFERRALFORM

StudentDescription:1.aReferringteacher,pleasedescribethereasonforreferralinspecificterms:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________*PleaseprovidetheSSTwithworksample,classassessments,commontasketc.1.bObservationChecklist(pleasecheckbehaviorsthatcauseconcern)1._____Behavior 8.______StudyHabits2._____Attendance 9.______Participation3._____LatetoClass 10.______CompletingHomework4._____OrganizationalSkills 11.______ConsistencyofWork5._____CompletingAssignments 12.______Disruptive6._____Effort/Attitude 13.______Distractible7._____FollowingOralDirections 14.______StudyHabits

Pre Screening Interview B.A.S.E Components

BEHAVORIAL–(Discipline/attendance/tardiness/FBA/BIP)

ACADEMIC–(Identifydata–i.e.grades,subjects,regents)

SOCIAL/EMOTIONAL–(Home,school,outsideagenciesinterventions)

EFFICIENCY- (Strengths,modifications,learningstyles)

ActionPlanB A S E

1.cStudents’strengthsandinterests:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________SpecificInterventionStrategies:2a.Whatmodificationsoradjustments(instructional/social)haveyoumadetoaddresstheproblem?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2b.Howhasthestudentrespondedtothesechanges?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

MARLBOROCENTRALSCHOOLDISTRICTSecondaryDivision

PROCEDURESFORBUILDINGLEVEL

STUDENTSERVICESTEAMREFERRALFORM SummaryofStudentServicesTeamMeeting: 3a.Majorneedsofstudent:

___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ 3b.RecommendationsofSST(Whatwillbedone?Bywhom?ByWhen?): ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ 3c.Afollow-upmeetingisscheduledfor:__________________________________________________ AttendingthisSSTMeeting(NameandPosition): ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________

School Year

CompletepaperorRTIm

Marlboro Central School District

Classroom Interventions School

Summary Sheet (This form is to be filled out and is to become an artifact.)

Student:_ Teacher: Date: Summarizeimplementedclassroominterventions(actionplans).Usingthedatacollected,ratetheeffectivenessoftheseinterventions.

InstructionalStrategiesorMethods DataCollected(Assessments;WorkSamples)

EffectivenessofIntervention(Checkone)

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

Summarizehomeintervention. Usingthedatacollected,ratetheeffectivenessofthissupport.HomeSupport Materialsprovided EffectivenessofSupportatHome

SignificantImprovement Improved NoChange Regression SignificantRegression

ThisformistobecompletedandbroughttotheRTImeeting. Date(s)ofparentcontact:

MARLBORO CENTRAL SCHOOL DISTRICT

RESPONSE TO INTERVENTION HIGH SCHOOL

RTIReferral&InterventionProcessSecondary

□StudentisidentifiedbyteacherusingRTIMultipleMeasuresMatrix DateCompleted:_______

□ClassroomTier1Interventionsaredeterminedandimplementedthroughdocumentationtodevelopabaseline ofstudent’sleveloffunctioning. DateCompleted:_______

□Parentsarecontactedbyteacher/teamtoshareconcernsandgaininsightonstudentfunctioning. DateCompleted:_______IfstudentrespondsfavorablytoTier1interventioncontinueinterventionuntilstudenthasstabilized.DocumentprogressusingClassroomInterventionSummarySheetDateCompleted:_______IfstudentdoesnotrespondfavorablytoTier1interventionalreadyattempted.(initialreferraltoRTIm) DateCompleted:_______

□Teacher/teacherscompletedRTIreferralandsubmitstoappropriateguidancecounselortodiscussconcernsand moveforwardwithRTIprocess(ameetingdatewillbeset).Paperworkforwardedtoteachersforinput. TeacherswillbeadvisedastothedateforRTIteamtomeetregardingstudentafterreceivingcompleted document. DateCompleted:_______

□RTIcommitteeschedulesanappointmenttimetomeetwiththeteacher/teachers.Teacher/teachersshould haveatleastoneofthefollowing: Documentationofparentcontactorinitialbaselinedata. Exampleofstudent’sworkrelatedtoIntervention. Explanationofclassroom-interventionsalreadytried. Documentationsrelatingtotheinterventionandresults.DateCompleted:_______

□RTIcommitteeinconjunctionwithteacher(s),designsspecificinterventiontobeimplemented.Minutesaretaken andinterventionplanisdeveloped.Clockstartsontheinterventiontimeperiodof4-6weeks,followupmeeting dateisestablished. DateCompleted:_______

□Teacher/teachersimplementsinterventionandcollectsdataonstudentresponse.Completeprogressmonitoring documents. DateCompleted:_______Ifstudentrespondsfavorablytointerventioncontinuewithintervention.Ifstudentdoesnotrespondfavorablytointervention.Secondreferrallevel.

□RTIcommitteetoreconvenetodiscussdataaftersubmissionofdocument.

□Datetobedetermined.

□RTIdesignsnewintervention,orreferschildontofurthertesting,ormakesreferraltoCSE.Thirdreferrallevel. DateCompleted:________

Teacher/team suspects ssue:

RTI Referral & Intervention Process

Teacher/teamsuspectsissue.ClassroomInterventionsaredetermined&implementedthrudocumentationtodevelopabaselineof

student’sleveloffunctioning.

Parentsarecontactedbyteacher/teamtoshareconcernsandgaininsightonstudentfunctioning. Studentrespondsfavorablytointervention.

Continueinterventionuntilstudenthasstabilized.

Studentdoesnotrespondfavorablytotier1interventionalreadyattempted. (InitialreferraltoRTI)Teacher/teamcompletesRTIreferralandsubmitsto appropriate guidance counselor to discussconcerns andmove forwardwith RTI process (ameetingdatewillbeset). Paperworkforwardedtonon/coreteachersforinput.

TeamwillbeadvisedastothedateforRTIteamtomeetregardingstudent.

Guidancecounselorandthereferringteacher,fillsoutremaininginfoonreferralform.

RTIcommitteeschedulesanappointmenttimetomeetwiththeteacher/teamduringtheirteamtime.Teacher/teamshouldhaveatleastoneofthefollowing:

•Documentationofparentcontactorinitialbaselinedata.•Exampleofstudent’sworkrelatedtoIntervention.•Explanationofclassroom-interventionsalreadytried.•Documentationsrelatingtotheinterventionandresults.

RTIteam,inconjunctionwithteacher(s),designsspecificinterventiontobeimplemented. Minutesaretakenandinterventionplanisdeveloped.

•Clockstartsontheinterventiontimeperiodof1-6weeks.•Follow-upmeetingdateisestablished.

Teacher/teamimplementsinterventionandcollectsdataonstudentresponse.

Studentrespondsfavorablytointervention.Studentdoesnotrespondfavorablytointervention. Secondreferrallevel.

Continuewithintervention. RTIreconvenestodiscussdata.

RTIdesignsnewintervention,orreferschildontofurthertesting,ormakesreferraltoCSE.Thirdreferrallevel.

n otific ionof ion lan alledon: sen le on

CompleteasneededRTIm Marlboro Central School District

TEACHER Action Plan for: Levels: K – 12 Grade: Date:

Circle One: Action Plan 1 Action Plan 2 (This form is to be filled out for all students found in the gray area of the ‘Progress Monitoring Form’.)

LEARNINGTARGET(S)ORGOALSTATEMENT(S):

Intervention Plan:

DescriptionofInstructionalStrategiesorMethods DeliveryMode(Setting/Frequency)

Data/Assessment

Follo - in Da

CompleteasneededRTIm Marlboro Central School District RTI Team Action Plan for:

Level K – 12

Grade: Referring Teacher(s): Date: (This form is to be completed by the RTI Committee, the RTI Chairperson will then distribute

to the interventionist(s) and it becomes an artifact.)

GoalStatement(s):

InterventionPlan:DescriptionofInstructionalStrategiesorMethods DeliveryMode

(Setting/Frequency)Data/Assessment

Interventionist:

Interventionist:_

School Year

TranscribetoRTIm

Marlboro Central School District

Classroom Interventions School

Summary Sheet (This form is to be filled out and becomes an artifact.)

Student:

Teacher:

Date:_ Summarizeimplementedclassroominterventions(actionplans).Usingthedatacollected,ratetheeffectivenessoftheseinterventions.

InstructionalStrategiesorMethods DataCollected(Assessments;WorkSamples)

EffectivenessofIntervention(Checkone)

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

SignificantImprovement Improved NoChange Regression SignificantRegression

Summarizehomeintervention. Usingthedatacollected,ratetheeffectivenessofthissupport.HomeSupport Materialsprovided EffectivenessofSupportatHome

SignificantImprovement Improved NoChange Regression SignificantRegression

ThisformistobecompletedandbroughttotheRTImeeting. Date(s)ofparentcontact:

(GuidanceGenerated)

MarlboroCentralSchoolDistrict21 Milton Turnpike, Milton, NY 12547

Tel: 845-236-5812 Fax: 845-795-5906

RTI TEAM

INTRODUCTORY TEACHER LETTER: HIGH SCHOOL DearReferringTeacher/ReferringTeam:ThepurposeoftheRTIteamistodevelopaninterventionthatwillpromoteimprovementsinastudent’sacademicperformanceorbehavior.Pleasecompletethebottomportionofthisformand send it to___________________________________. The Team Member Guidance willworkwithyouonyourreferralformas theywillallgiveyousupportthroughoutthisprocess.The Guidance Counselor will also arrange for the collection of additional backgroundinformation.YouwillbediscussingthestrategiesattemptedthusfarandwilldevelopanActionPlantoputthenewintervention(s)intoplace.FollowingtheActionPlan, theGuidanceCounselorwillmeetwithyouagain and followup toensure that you have all the resources necessary to implement the intervention(s) and tomonitoritseffectiveness.Thankyou,TheHighSchoolRTITeam**************************************************************************Student’sName:Teacher/Team(listall):_ Grade: Date: Brieflydescribetheacademicand/orbehavioralconcernsyouhaveforthisstudent:

DatereviewedbyRTITeamChairperson: RTImemberassignments:

TeacherLiaison:___________________________________________________