RTI Folder.pub - Anderson County School District 4
RTI Folder.pub - Anderson County School District 4
RTI Folder.pub - Anderson County School District 4
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Response to Intervention (<strong>RTI</strong>)<br />
Students who are having difficulties in<br />
school can be referred to the school’s<br />
Response to Intervention team by parents,<br />
teachers, and other school personnel<br />
for further intervention and assistance.<br />
The <strong>RTI</strong> process has three<br />
phases which are outlined in this<br />
folder. The forms are enclosed and can<br />
be found on the intranet under Curriculum<br />
and Instruction.<br />
Interventionist: ____________________________________________<br />
Intervention Guidelines<br />
The purpose of the intervention team is collaboratively problem<br />
solve to develop an intervention for the specific student.<br />
The intervention may have ancillary benefits for others, including<br />
the teacher or other students; however, the intervention’s<br />
focus is the individual student who has been referred.<br />
The intervention should be based upon scientifically based<br />
research methods and/or peer-reviewed methods that are<br />
known to be effective when applied.<br />
An intervention is a current action that differs from the activities that normally occur in the student’s<br />
general education program. It is a written plan based on an individual student problem, which includes<br />
the following basic components:<br />
1. A clear statement of the problem;<br />
2. A problem analysis that uses data to confirm the initial concern;<br />
3. Development of a specific research-based intervention based on the problem analysis; and<br />
4. Baseline data.<br />
Progress Monitoring Data<br />
<strong>RTI</strong> Forms<br />
<strong>RTI</strong> 1 - 1 Teacher Concerns Sheet<br />
<strong>RTI</strong> 1 - 2 Initial Referral Sheet<br />
<strong>RTI</strong> 1 - 3 <strong>School</strong> History<br />
Parent Invitation to Attend <strong>RTI</strong> meeting<br />
<strong>RTI</strong> 1 - 4 Parent Concerns Sheet (2 pgs)<br />
<strong>RTI</strong> 1 - 5 Student Intervention Plan (<strong>Folder</strong> p. 2)<br />
Minutes of <strong>RTI</strong><br />
<strong>RTI</strong> 2 - 6 Parent Permission for Screening<br />
<strong>RTI</strong> 2 - 7 Vision, Hearing & Speech/Lang. Screening<br />
Date Intervention Freq/Duration Progress Monitoring<br />
Tool<br />
Target Area _______________<br />
Results/Observations<br />
Name _________________________________ Grade _________ Teacher ____________________<strong>School</strong> ________________ <strong>School</strong> Year ________
<strong>RTI</strong> PHASE ONE<br />
When a student in your class is having difficulties. . .<br />
A. Teacher completes the following steps: B. Teacher contacts parent and administrator/designee to<br />
Date:<br />
set up initial meeting for Phase One to discuss concerns.<br />
(Parent Invitation)<br />
Teacher completes Concerns Sheet (<strong>RTI</strong>1-1).<br />
C. Have parent complete Parent Concerns Sheet (<strong>RTI</strong> 1-<br />
Teacher completes Forms (<strong>RTI</strong>1-2).<br />
4). This could be sent home, completed via telephone,<br />
or completed at the meeting/<br />
Teachers checks with previous teachers, if applicable.<br />
Teacher reviews cumulative folder and completes<br />
school history (<strong>RTI</strong> 1-3).<br />
Teacher inserts work samples and other documentation<br />
to Phase One Forms.<br />
<br />
<br />
D. Teacher, administrator and parent review all forms and<br />
develop Student Intervention Plan at the meeting.<br />
Also, complete Minutes of <strong>RTI</strong> Meeting.<br />
E. Teacher implements student intervention plan for a<br />
minimum of fifteen (15) school days.<br />
STUDENT INTERVENTION PLAN
If the student continues to have difficulties. . . . .<br />
<strong>RTI</strong> Phase Two<br />
Date: Teacher contacts student Intervention Team Chairperson (ITC) with request for Phase 2.<br />
ITC coordinates a meeting with parent and required participants-referring sources, administrator/designee, at<br />
least one school intervention team member and guidance counselor. (Invitation)<br />
Review Student Intervention Plan. Bring copies of DIBELS, Grades, MAP Scores, and Anecdotal records, discipline<br />
reports. Complete Minutes of <strong>RTI</strong>. (Minutes of <strong>RTI</strong>)<br />
Decide what we are going to do for the student:<br />
DATE: RECOMMENDATION NOTES<br />
Attendees<br />
Signatures<br />
Principal:<br />
<br />
<br />
Continue with current intervention.<br />
Change frequency or duration of intervention to:<br />
Teacher:<br />
Parent:<br />
<br />
Try new intervention:<br />
Other(s):<br />
<br />
<br />
<br />
Change to Phase ___________<br />
Goals reached. Discontinue interventions.<br />
Date of next meeting _______________<br />
<strong>RTI</strong> Phase Two<br />
If the team decides to continue with intervention and the student continues to have difficulties. . . . .<br />
Date: Teacher contacts student Intervention Team Chairperson (ITC) with request for another evaluation of Phase 2..<br />
ITC coordinates a meeting with parent and required participants-referring sources, administrator/designee, at<br />
least one school intervention team member and guidance counselor. (Invitation)<br />
Review Student Intervention Plan. Bring copies of DIBELS, Grades, MAP Scores, and Anecdotal records, discipline<br />
reports. Complete Minutes of <strong>RTI</strong>. (Minutes of <strong>RTI</strong>)<br />
Decide what to do for the student. See next table on back.
Attendees<br />
Signatures<br />
Principal:<br />
DATE: RECOMMENDATION NOTES<br />
Continue with current intervention.<br />
Change frequency or duration of intervention to:<br />
Teacher:<br />
Parent:<br />
Try new intervention:<br />
Other(s):<br />
Change to Phase ___________<br />
Goals reached. Discontinue interventions.<br />
Date of next meeting _______________<br />
<strong>RTI</strong> PHASE THREE<br />
Participants-parent, referring source, school<br />
intervention team, and administration.<br />
Review all screening and data documentation.<br />
Decide if further formal evaluation is needed ;<br />
OR Continue with present intervention plan ;<br />
OR Develop 504 plan.<br />
Record all information on Minutes of <strong>RTI</strong><br />
form.<br />
If the intervention team deems it appropriate, a referral and<br />
all supporting documentation (<strong>RTI</strong> Forms) should be sent<br />
to the school referral coordinator. Parents are provided a<br />
copy of the Listing of Parental Rights for Special Education.<br />
The following forms are completed and forwarded to<br />
the Special Services Office:<br />
Permission for Evaluation<br />
Notification of Referral and Evaluation<br />
Health and Development History<br />
Consent for Treatment<br />
Release of Information<br />
Evaluations are scheduled and completed within 60 calendar days.<br />
Staffings to be scheduled by the Special Services Office are held in order to determine if a student is eligible<br />
for special education and related services.<br />
At a minimum, the following <strong>District</strong> personnel must be in attendance at the initial staffing:<br />
Principal or designee<br />
Referring teacher<br />
Person knowledgeable about special education or related services<br />
<strong>District</strong> Office representative<br />
Parent (must be given an opportunity to participate)