STUDENT SUPPORT TEAM REFERRAL PROCESS 05-06

 

 

 

INITIAL REFERRAL

 

_____   Identify learning and/or behavior difficulties experienced by the student

_____   Contact the parent and conference with them regarding difficulties (minimum of two contacts must be documented) Document on   Instructional Strategies Plan Form

_____   Establish and implement instructional and behavioral modifications and Document on Instructional Strategies Plan Form

_____   Complete a Corrective Action Plan if concerns are related to behavior

_____   Document 20 days of behavior in an Anecdotal Log if concerns are related to behavior

_____   Complete the Communication Checklist if concerns are related to speech/language

_____   Have the Parental Permission Form signed

_____   Have parent complete the Student Information Form

_____   Request Vision/Hearing Screening

_____   Complete the SST Initial Referral Form

_____   Complete Focus of Concerns Form

_____   Copy the following items for the folder: birth certificate, attendance report, any school/county/state assessment information, student information sheet, work samples, discipline records, report card, conference notes

 

 

 

 

 

EXISTING FOLDER

 

_____   Identify learning and/or behavior difficulties experienced by the student

_____   Contact the parent and conference with them regarding difficulties (minimum of two contacts must be documented) Document on Instructional Strategies Plan Form

_____   Establish and implement instructional and behavioral modifications and Document on Instructional Strategies Plan Form

_____   Complete a Corrective Action Plan if concerns are related to behavior

_____   Document 20 days of behavior in an Anecdotal Log if concerns are related to behavior

_____   Complete the Communication Checklist if concerns are related to speech/language

_____   Request Vision/Hearing Screening

_____   Update the following items for the folder: birth certificate, attendance report, any school/county/state assessment information, student information sheet, work samples, discipline records, report card, conference notes

 

DATE _______________________

SIGNATURE OF 1^ST REVIEWER ___________________________________

SIGNATURE OF 2^ND REVIEWER __________________________________