Student Name: ______________________________ CURRENT STUDENT PERFORMANCE REPORT: SUBJECT TEST/QUIZ AVERAGE BENCHMARK SCORES HOMEWORK COMPLETION? CLASSWORK SOLs English Math Science Social Studies ** How do the student's grades compare to others in the class? _______________________ __________________________________________________________________________ Has the student been through the Instructional Support Process? Yes No Grading Interventions attempted: No spelling or handwriting penalty Instruction Organization Extra practice on lessons Simplify, repeated instructions Peer tutoring Review directions Academic Intervention (SGL, small group, Guided notes PM homework help) Agenda check Computer assisted instruction Preferential seating Varied instructional modes (multi-sensory Color coded materials learning styles) Assign a buddy to check agenda Materials Behavior Management Copies of at home Positive reinforcement Graphic organizers provided Incentive program Audiovisual aids Written behavior contract High-interest reading materials assigned Manipulatives Post and review rules Calculator for math Immediate consequences delivered Computer for word processing Consistent enforcement of rules Testing Recorded behavioral changes Study guide for tests Progress reports sent to parents Extra time for tests Counseling Retake tests Frequent Parent Contact Extra credit options _______________________________ ______________________________ Please list any additional pertinent information below (or on back) as needed: INVITATION TO SPECIAL EDUCATION REFERRAL MEETING Student Name _______________________________ Date ________________ This is to notify you that a team meeting has been scheduled for the above student. Your participation and attendance at this meeting are very important. This meeting must be scheduled at a mutually
Student Name: ______________________________ CURRENT STUDENT PERFORMANCE REPORT: SUBJECT TEST/QUIZ AVERAGE BENCHMARK SCORES HOMEWORK COMPLETION? CLASSWORK SOLs English Math Science Social Studies ** How do the student's grades compare to others in the class? _______________________ __________________________________________________________________________ Has the student been through the Instructional Support Process? Yes No Interventions attempted: Instruction Extra practice on lessons Peer tutoring Academic Intervention (SGL, small group, PM homework help) Computer assisted instruction Varied instructional modes (multi-sensory learning styles) Materials Copies of at home Graphic organizers provided Audiovisual aids High-interest reading materials Manipulatives Calculator for math Computer for word processing Testing Study guide for tests Extra time for tests Retake tests Extra credit options Grading No spelling or handwriting penalty Organization Simplify, repeated instructions Review directions Guided notes Agenda check Preferential seating Color coded materials Assign a buddy to check agenda Behavior Management Positive reinforcement Incentive program Written behavior contract assigned Post and review rules Immediate consequences delivered Consistent enforcement of rules Recorded behavioral changes Progress reports sent to parents Counseling Frequent Parent Contact _______________________________ ______________________________ Please list any additional pertinent information below (or on back) as needed: INVITATION TO SPECIAL EDUCATION REFERRAL MEETING Student Name _______________________________ Date ________________ This is to notify you that a team meeting has been scheduled for the above student. Your participation and attendance at this meeting are very important. This meeting must be scheduled at a mutually
special_education_referral_8_3_16.docx