Student Academic Support Plan

4th Grade

Elementary School
Student Name Grade Level Student Information Date of Birth Homeroom Teacher

Universal Assessment Information

Benchmarks M-Comp Date Score R-CBM Accuracy Date Score R-CBM Rate Date Score Date Maze Score Last Spring Fall Winter Spring Math Date Score Date Reading Score

AIMSweb

Benchmarks

STAR

Last Spring Fall Winter Spring Math Date RIT %ile Date Reading RIT %ile

Benchmarks

MAP

Fall Winter Spring

Areas of Concern
___ Not an area of concern at this time __ Phonemic Awareness __ Initial sound isolation __ Blending __ Segmenting Decoding __ Phonics __ Sounds for letters A-Z __ Letter combination sounds __ Word Identification __ High frequency words __ Automaticity __ Fluency __ Rate __ Accuracy __ Prosody __ Vocabulary __ Conversational __ Content __ Comprehension __ Summarizing __ Questioning __ Making Connections __ Visualization __ Text Structure __ Monitoring

Reading

___ Not an area of concern at this time

__ Operations & Algebraic Thinking __ Number & Operations in Base Ten __ Number Operations Fractions __ Measurement & Data

__ Geometry

Math

__ Use the four operations with whole numbers to solve problems __ Gain familiarity with factors and multiples __ Generate and analyze patterns

__ Generalize place value understanding for multi-digit whole numbers __ Use place value understanding and properties of operations to perform multidigit arithmetic __ addition __ subtraction __ multiplication __ division

__ Extend understanding of fraction equivalence and ordering __ Build fractions from unit fractions by applying and extending previous understandings of operations on whole numbers __ Understand decimal notation for fractions, and compare decimal fractions

__ Solve problems involving measurement and conversion of measurements from a larger unit to a smaller unit __ Represent and interpret data __ Geometric measurement: understand concepts of angle and measure angles

__ Draw and identify lines and angle, and classify shapes by properties of their lines and angles

Additional Information:

Student Academic Support Plan Elementary School Student Name ___ Tier I (Core) ___ Tier II (Supplemental) ___ Tier III (Intensive)

Area of Concern: ______ Reading ______ Math Target area: Research Based Core Program Core Support Descriptor Small group instruction Leveled instruction Explicit instruction Engaging activities Scaffolding of instruction Additional practice opportunities Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Progress Monitoring Tool Name of Probe(s) Target Area # of times to be progress monitored

Area of Concern: ______ Reading ______ Math Target area: Research Based Core Program Core Support Descriptor Small group instruction Leveled instruction Explicit instruction Engaging activities Scaffolding of instruction Additional practice opportunities Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Start Date: Research Based Intervention Targets: Setting # of sessions per week Length of session Small group ______ One-on-one Progress Monitoring Tool Name of Probe(s) Target Area # of times to be progress monitored