RtI Family and Community Engagement Module/Colorado Department of Education
June 2009
Partnering Survey and Needs Assessment
Our school is developing new ways to support our teachers and families in working
together. We are trying to coordinate home and school learning. This survey was
developed to gather data about family-school-community partnering beliefs and
practices from all stakeholders who support our students. Please answer questions from
the perspective of your specific role. The Beliefs and Needs section is for all
respondents. There are separate Practice sections for school/community staff and
family members – please only answer the section that is appropriate for you. A brief
Needs Assessment asks about what would be helpful to you. We welcome your
comments. All this information will be used to plan our partnering activities.
Please Check Information that Relates to Your Role with Students:
Educator: ____ Position: _______________________________________________
Family Member: ____ Student Grade Level(s): _____________________________
Community Resource: ____ Affiliation: ___________________________________
Name (Optional): ______________________________________Date: ____________
I would like to participate on a family-school community partnering committee at our
school. My contact information is as follows (name, email or phone or address):
Adapted from the following sources:
Vosler-Hunter, R.W. (1998). Changing roles, changing relationships: Parent-professional collaboration on behalf of
children with emotional disabilities. Portland, OR: Portland State University, Research and Training Center on Family
Support and Children’s Mental Health.
Bryan, J.B, & Pelco, L. ( 2006). School psychologist involvement in partnerships survey (SPIPS). Williamsburg, VA:
William and Mary School of Education.
National Center for Special Education Accountability Monitoring. Parent survey-special education. Version 2.0.
Retrieved May 9, 2008, from http://www.monitoringcenter.lsuhsc
Thanks to the family members, professionals, and graduate students who provided input as to this survey’s content.
RtI Family and Community Engagement Module/Colorado Department of Education
June 2009
FOR FAMILY MEMBERS AND SCHOOL STAFF/COMMUNITY RESOURCES
Disagree
Undecided
Agree
Strongly
Agree
1. Believe that families and schools share responsibility for a
student’s education.
2. Believe that students should see their teachers and families
working together in relation to their everyday school experiences
and learning.
3. Believe that schools and families each have areas of
expertise/information to share in supporting student success.
4. Believe teachers and family members should communicate
regularly about both positive events and concerns.
5. Believe that I have the skills/training to work as a partner in
supporting school success for students.
6. Believe that teachers and family members should share concerns
when either sees a student beginning to struggle or becoming
discouraged.
7. Believe that teachers and family members should each have
responsibilities for student planning and interventions when
concerns are identified.
8. Believe that students should be partners in home-school
communication and in intervention planning.
9. Am confident in my ability to develop and maintain family-school
partnerships in my specific role (as staff, family member, or
community resource).
10. Know about the Response to Intervention (RtI) process in my
school.
Strongly
Disagree
I…
N/A
Beliefs (What I Think…)
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
RtI Family and Community Engagement Module/Colorado Department of Education
June 2009
FOR FAMILY MEMBERS
N/A
Not at All
Rarely
Sometimes
Frequently
Very
Frequently
Practices (What I Do…)
1. Participate in problem solving with teachers when there are
academic or behavior concerns, then assist with setting goals and
developing a plan.
2. Have resources, training and support to help me with the
following: encouraging my child in school; providing resources, time
and space for homework; talking to my child about school and
learning.
3. Use information from home when I discuss my child’s progress,
needs, problems, and possible solutions with the school.
4. Know the following for my student’s school, classes and activities:
rules, how progress is reported, and homework expectations for
students and families.
5. Communicate regularly (two-way) with teachers for positive
reasons, routine matters, progress updates, and concerns if needed.
6. Share my student’s strengths, challenges, interests, and attitudes
about school with the teachers.
7. Ask teachers what I can do to support my student’s learning in our
home or through the community.
8. Have visits in my home from school staff.
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
9. Feel valued and respected by teachers and school staff.
0
1
2
3
4
5
10. Visit my child’s school.
0
1
2
3
4
5
11. Participate with teachers in the Response to Intervention (RtI)
problem-solving process.
0
1
2
3
4
5
I…
RtI Family and Community Engagement Module/Colorado Department of Education
June 2009
FOR SCHOOL STAFF AND COMMUNITY RESOURCES
N/A
Not at All
Rarely
Moderately
Frequently
Very
Frequently
Practices (What I Do…)
1. Include families in problem solving when there are academic or
behavioral concerns; then set mutual goals, monitor progress,
review and revise plan with families as needed.
2. Provide resources, training and support to help families with the
following: encouraging their child in school; accessing resources,
time and space for homework; talking to their child about school and
learning.
3. Use data points from multiple sources when I discuss a child’s
progress, needs, problems, and possible solutions.
4. Share with families the following: school, class, and activity rules;
how progress is reported; homework expectations for students and
families.
5. Ask each family to share about student’s strengths, challenges,
interests, and attitudes about school.
6. Communicate regularly (two-way) with families of all my students
for positive reasons, routine matters, progress updates, and
concerns if needed.
7. Ask parents what they need to actively support student learning in
the home and partner with the school or the community.
8. Visit families in their homes.
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
0
1
2
3
4
5
9. Reach out to families with cultural, language, gender,
socioeconomic, and learning differences.
10. Invite families to come to school.
0
1
2
3
4
5
0
1
2
3
4
5
11. Participate with families in the Response to Intervention (RtI)
problem-solving process.
0
1
2
3
4
5
I…
RtI Family and Community Engagement Module/Colorado Department of Education
June 2009
FOR FAMILY MEMBERS, SCHOOL STAFF, COMMUNITY RESOURCES
NEEDS ASSESSMENT (What Would Be Helpful to Me….)
I would like more information and/or training on the following topics:












RtI
Creating learning opportunities at home
Parenting classes
Teacher-family communication strategies
Family volunteering opportunities at home or school
Involving families in school decision-making
Teachers and families working together when a student is struggling
School-community partnering
Area community resources
Conflict resolution strategies for teachers and families
Homework strategies
Communication with other families
 Other – Please identify
The best time for me to attend workshops or trainings is:
 Weekday Mornings (Before School)
 Weekday Afternoons (After School)
 During School Day
 Weekday Evenings
 Saturdays
 Online
 Written Workbooks, Materials
Other – Please Identify
Please share any comments or questions regarding how our school can best support families,
teachers, and community resources working together in coordinating student school success.