Professional Documents
Culture Documents
Student Information
ELL History
Native language Years in USA Review of educational background
Less than 2 years in English-speaking school If yes, indicate the most recent test scores:
Aprenda Reading Aprenda Math CELLA LAB Haitian/Creole Assessment
Additional Total Score Subtest Score Subtest Score Subtest Score Subtest Score Subtest Score Subtest Score
Assessment Data
SAT 10 Total
Total
Total
Total
Reading Performance
Area of concern Level Explanation/description (leave blank if not a concern)
Reads grade level materials with appropriate fluency
Is able to comprehend grade level passages and texts
Assessment results align with students reading skills
Other: enter skill area
Reading deficit areas (check all that apply)
Phonological Awareness Phonics Fluency Vocabulary Comprehension
gross differences single consonants accuracy unable to decode recall of pertinent facts
rhyme digraphs speed known vocabulary due identifying main idea
to poor phonics skills
syllables blends word auto- prediction/inference
short vowels maticity limited vocabulary summarizing
alliteration
onset and rime long vowels limited English limited background
language skills knowledge
phonemic segmentation vowel digraphs
phonemic synthesis diphthongs learning/applying
syllables comprehension
phonemic manipulation strategies
silent e
r-controlled vowels
poly-syllabic words
Mathematics Performance
Area of concern Level Explanation/description
Solves computational problems at grade level
Solves word problems at grade level
Test results align with students mathematics skills
Other: enter skill area
Mathematics deficit areas (check all that apply)
Content Knowledge Problem Solving Processing
addition/subtraction facts reading level addition/subtraction fluency
multiplication/division facts vocabulary multiplication/division fluency
fractions symbols/diagrams step sequendcing
decimals multi-step problems process retention
spatial relationships reasonableness of answers completion speed
other
other enter skill area
Page 2 of 4
Pages 3 and 4 of this document are to be completed during the meeting.
Problem definition
Goal
Intervention description
Preparation
Building background
Comprehensible input
Strategies
Interaction
Practice / application
Lesson delivery
Review / assessment
Page 3 of 4
MEASUREMENT SYSTEM
How will progress be monitored?
Assessment type/name
Assessment frequency
Data collector
MEETING PARTICIPANTS
Name of Attendee Signature Role
Administrator
Teacher
Parent
ESOL Contact
ESOL Specialist
The team will meet on the above date to review student progress data. Based on the evidence presented at the
meeting, the team will decide on future action.
Maintain the current differentiation plan to meet the needs of the student as progress is evident.
Discontinue the differentiation plan because the goal has been met or the problem has been resolved.
Revise or modify the current differentiation plan or create a new plan because the student's needs are
not being met.
Consider increasing supports through the RtI problem-solving process. Complete the Comprehensive
Student Review Form and refer the student to the school-based RtI problem-solving team.
MEETING PARTICIPANTS
Name of Attendee Signature Role
Administrator
Teacher
Parent
ESOL Contact
ESOL Specialist
Page 4 of 4