Tier2Strategic

InstructionalRecordForm
Grade:5th/6thGradeDate:01/24/2011
1.

Indicators:Examinationofbenchmarkingdata(AIMsWeb,ComprehensionScreener,SpellingInventory),
pertinentclassroomdata(RunningRecords,Retellings,IDRForms),andStudentSortrevealsan
instructionalneedinthearea(s)ofcomprehension.

2.

InterventionandRationale:F&Plevels,ComprehensionScreenerandRetellingRubricsshowthisisthelargest
areaofdeficit.

3.

CriteriaforSuccess:
__WordsReadCorrect
X#CorrectonRetellingRubric
__%Accuracy(ERI)
__Other
IfOtherpleasespecify:______________________________________________________

4.

Goal:GiveninterventionofGuidedReadingfocusedoncomprehension,studentswillreceiveascoreof19pointson
theNonfictionRetellingRubricwhenreadinganindependentreadinglevelbook,byspringbenchmark.

5.

6.

Implementation:
StartDate

Interventionist

#Of
Min

HowOften

When
(Time)

Where

01/24/2012

Owen

30

5x/week

3:003:30pm

Rm.119

#Sessions
Completed
ToDate

02/28/2012

14

04/24/2012

45

05/22/2012

62

DecisionOn
Implementation
InitialPlacement
XContinue
__Modify
XContinue
__Modify
XContinue
__Modify

ProgressMonitoring:
What

Who

Frequency

RetellingRubric

Owen

2x/Month

Initial
XContinue
__Modify
XContinue
__Modify
XContinue
__Modify

7.

Results:

Students

Date

Above(AB)
At(A)
Below(B)Goal

Aleksandar
Bozin

02/28/12

ABA(B)

13pointsNonfictionLevelM

D(C)M

04/24/12

(AB)AB

24pointsNonfictionLevelN
AleksandarhasstartedmedicationforADHD.

D(C)M

05/22/12

AB(A)B

19pointsNonfictionLevelO

D(C)M

Data/Comments

ABAB
Andy
Kunda

DCM

02/28/12

(AB)AB

25pointsNonfictionLevelS

D(C)M

04/24/12

(AB)AB

23pointsNonfictionLevelU

D(C)M

05/22/12

(AB)AB

24pointsNonfictionLevelV

(D)CM

ABAB
Lysandra
Lazar

DCM

02/28/12

(AB)AB

24pointsNonfictionLevelT

D(C)M

04/24/12

AB(A)B

21pointsNonfictionLevelV

D(C)M

05/22/12

(AB)AB

24pointsNonfictionLevelV

D(C)M

ABAB
Tony
Balian

Discontinue(D)
Continue(C)
Modify(M)

DCM

02/28/12

AB(A)B

20pointsNonfictionLevelT

D(C)M

04/24/12

(AB)AB

22pointsNonfictionLevelV

D(C)M

05/22/12

(AB)AB

24pointsNonfictionLevelV

D(C)M

ABAB

DCM

Tier3Intensive
InstructionalRecordForm
StudentName:Vasilios(Billy)HasapisGrade:5thGradeDate:01/23/2012
PreviousIntervention(s)/Dates:20082009:SRAReadingMastery1stGradeandHeggerty1stGrade(Tier3:OctJune).20092010:GuidedReading
(AugJune),SRAReadingMastery1stGrade(Tier3:OctJune),SixMinuteSolution2ndGrade(Tier3:AprilJune).20102011:SRADecodingLevel
B1/B2,GuidedReadingandWordWork(Tier3:AugJune).20112012:SRADecodingLevelCandLexia(Tier3:OctJan).
2. Indicators:Examinationofbenchmarkingdata(AIMsWeb,ComprehensionScreener,SpellingInventory),pertinentclassroomdata
(RunningRecords,Retellings,IDRForms)andStudentSortrevealsaninstructionalneedinthearea(s)offluency.
3. RationaleforTier3Intervention:AIMsWebscoresshowthisishislargestareaofdeficit.
4. Goal:GiveninterventionofSRADecodingLevelCandLexia,studentwillreceiveascoreof100wpmwith5orfewererrorsona4thgradereading
passagebyspringbenchmark.
1.

Intervention:SRALevelC/Lexia

Interventionist:Garnick

Implementation
Date

01/23/2012

#OfMin.

GroupSize:5students

ProgressMonitoring
HowOften

SRA:30min
SRA:MonFri
Lexia:45mpw

When
(Time)

Progress
Monitoring
Tool

SRA:3:003:30pm

RCBM

Target
(Above,At,
Below)

#OfSessions
Completedto
Date

Discontinue,
Continue,or
Modify?

Rationale/Comments/Changestocurrentinterventions
(groupsize,duration,frequency)
WinterRCBM:70/6(4th%ile)

03/12/2012

Below

25

Continue

04/23/2012

At

45

Continue

05/21/2012

Above

62

Continue

SpringRCBM:100/0(11th%ile)