Phonological Awareness (Blevins, Rosner and Words their Way)

1. Fishbone Analysis Phonological Awareness (Blevins, Rosner and Words their Way) Alphabetic Principle (Core Phonics, Words their Way, LETRS Morphological Awareness) Morphology: Name: ________________ # of phoneme errors on spelling test: Alphabet Skills: Reading and Decoding: Spelling Skills: Rosner Auditory Analysis: Rhyme: Oddity Task: Oral Blending: Oral Segmentation: Phonemic Manipulation: # of Orthographic errors on spelling: Reading ORF Rate: Reading Level: ORF Accuracy: Oral Language Vocabulary: Color naming RAN: Site Words: Reading Vocabulary: Executive Functioning Skills: Reasoning Skills: Other: Vocabulary and Comprehension (DRA/SRI, Core Vocabulary and Critchlaw) Fluency (ORF, Fry and RAN)

2. Executive Functioning Concerns Root Causes of Reading Difficulty yes Name: _____________________________ Is there evidence to suggest difficulty with executive functioning? 1. Student has the ability to sustain focus when basic skills are automatic • Prioritize the concerns • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ no Reasoning Concerns Is there evidence to suggest difficulty with reasoning ? yes 2. Student is able to learn through various methods (mastery, inquiry) no Basic Reading Phonological Concern Reading Comprehension Concerns Basic Reading Orthographic Concern yes Is there evidence to suggest problems with phonological processing? yes Is there evidence to suggest difficulty with Language Processing ? yes Is there evidence to suggest problems with orthographic processing? 3. no no Create the Treatment Plan no Is there evidence to suggest difficulty with processing speed? no Reading Fluency Concerns yes

3. Handwriting (Handwriting without Tears Screener) Alphabetic Principle: Spelling (Core Phonics, Words their Way) Name: ________________ Memory: Orientation: Placement: Sentence: Developmental Stage of Spelling: # of Orthographic errors on spelling: # of Phonologic errors on spelling: Formation: Size: Neatness: Speed: Posture: Pencil Grip Alphabet Skills: Reading and Decoding: Spelling Skills: Writing Writing CBM CWS: Writing Content: Writing Organization: Writing Style and Fluency: Language Usage: Parts of Speech: Subject/Predicate Identification: Sentence types : Sentence Identification: Syntax CLOZE: Other: Written Composition (Writing CBM with Rubric ) Grammar (Writing CBM CWS, Grammar Assessment)

4. Executive Functioning Concerns Root Causes of Writing Difficulty yes Name: _____________________________ Is there evidence to suggest difficulty with executive functioning? 1. Student has the ability to sustain focus when basic skills are automatic • Prioritize the concerns • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ no Reasoning Concerns Is there evidence to suggest difficulty with reasoning ? yes 2. Student is able to learn through various methods (mastery, inquiry) no Sentence Level Grammar Concerns Handwriting Concerns Written Composition yes Is there evidence to suggest problems with sentence level syntax? yes Is there evidence to suggest difficulty with handwriting? yes Is there evidence to suggest problems with written composition? 3. no no Create treatment plan no Is there evidence to suggest difficulty with spelling? no Spelling Concerns yes

5. Number Sense (Math their Way; quantity discrimination cbm; missing number cbm ) Operations (Math their Way;) Name: ________________ Quantity Discrimination CBM: + & - Concept Level: + & - Connecting Level: + & - Symbolic Level: + * - Visualization Level: Missing Number CBM: Counting by Rote Memory: One-to-One Correspondence: Instant Recognition: Conservation of Number: Counting Backwards: Estimation of Objects: Numeral Recognition: Numeral Forms : Regrouping + & - Concept Level: Regrouping + & Connecting Level: Regrouping + & Symbolic Level: Regrouping + & - Concept Level: Regrouping + & Connecting Level: Regrouping + & Symbolic Level: Multiplication Concept Level: Multiplication Connecting Level: Multiplication Symbolic Level: Place Value Concept Level: Place Value Connecting Level: Place Value Symbolic Level: MBSP Correct Digit CBM (k-6; use 6th grade for 6-12): MBSP Applications (k-6): Color naming RAN: Mathematics Navigator Screener (6-12): Pattern Block Design: Other: Fluency (Monitoring Basic Skills Progress; Rapid Automatic Naming ) Reasoning and Problem Solving (Monitoring Basic Skills Progress; Pattern Block Design; Mathematics Navigator Screeners)

6. Executive Functioning Concerns that impact Procedural Math Root Causes of Math Difficulty yes Name: _____________________________ Is there evidence to suggest difficulty with executive functioning? 1. Student has the ability to sustain focus when basic skills are automatic • Prioritize the concerns • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ • ______________________________ no Reasoning Concerns that impact problem solving Is there evidence to suggest difficulty with reasoning ? yes 2. Student is able to learn through various methods (mastery, inquiry) no Math Fluency Concerns Number Sense Concerns Concepts and Application Concerns yes Is there evidence to suggest difficulty with processing speed yes Is there evidence to suggest difficulty with number sense? yes Is there evidence to suggest problems with concepts and application? 3. no no Create treatment plan Is there evidence to suggest difficulty with conceptual understanding of operations ? no no Computation Concerns yes

7. Value Streaming of Current Services Map out the current delivery of services the student receives in chronological order. Be detailed in streaming out the current process. Ask the question; Does this service support the concerns found in the root cause? If not then consider eliminating the services and increasing time on the services that support the root cause. Root Cause: ________________________________________________________ Indirect Services Direct Services key Task adds value Data Tasks the student completes Work flow duplicate