Canton City Schools
Reading Deficit Checklist
(to be completed with assigned RtI Coach)
Reading Deficit Area:
Phonemic Awareness
☐Blending and Segmenting
☐Sentence Segmentation
☐Syllable Blending
☐Syllable Segmentation
☐Phoneme Blending
☐Phoneme Segmentation
☐Onsets
☐Rimes
☐Rhyming Identification
☐Rhyming Utility
☐Alliteration Identification
☐Alliteration Utility
☐Beginning Sounds
☐Ending Sounds
☐Middle Sounds
☐Long Vowel vs. Short Vowel
☐Hard/Soft sounds
☐Double Consonants
☐Multisyllabic Words
☐Syllable Types (Closed/Open)
Vocabulary
☐Words in Context (Context Clues)
☐Word Meaning (Prefix, Suffix, Root Words,
Compound Words, Multiple Meaning Words)
☐Contractions
☐Synonym/Antonym
☐Homophone/Homograph
☐Parts of Speech
Phonics
☐Letter Recognition
☐Sight Words/ High Frequency Words
☐Letter Sounds
☐CVC Words
☐CVCC Words
☐Morpheme Structures (common syllables, compound words,
affixes)
☐Syllable Patterns / Common Syllables
☐Compound Words
☐Word Families
☐Variant Correspondence (Choose at least one):
☐R-Control Vowels
☐Vowel digraphs (2 vowels go walking, the first one
does the talking)
☐Consonant digraphs (1 sound with 2 letters)
☐Diphthongs (2 vowels make 1 sound, ex. hay,
boy, low)
☐Blends
☐Inflectional Endings
☐Affixes (Prefixes and Suffixes)
☐Silent Letters
Revised 5-06-13
Fluency
☐High Frequency Words/Phrases
☐Oral Reading (Choose at least one area)
☐Accuracy
☐Expression
☐Automaticity
☐Speed/Rate
☐Intonation
☐Phrasing
☐Word Parts
☐Common Syllables
☐Other: Click here to enter text.
Comprehension
☐Sequencing
☐Character Traits
☐Story Elements
☐Author’s Purpose
☐Reference Material
☐Theme
☐Compare Contrast
☐Cause/Effect
☐Fact/Opinion
☐Genre
☐Text Structure (Narrative, Expository and Non-Fiction)
☐Main Idea/Details
☐Inferences/ Drawing Conclusions
☐Monitor for Understanding
☐Story Structure (Plot diagram, Beginning/middle/end)
☐Text Questions
☐Summary/ Re-tell
☐Classifying Information (Graphic Organizers)
☐Predictions
☐Prior Knowledge
☐Determining Importance
☐Synthesizing
Writing Deficit Area:
☐Fine motor skills
☐Capitalization
☐Punctuation
☐Spelling
☐Indenting
☐Writing in different forms for different
purposes
☐Writing a summary
☐Writing a re-tell
☐Writing a main idea
☐Supporting a main idea with 3 details
☐Organizing ideas for coherence
☐Sequences events
☐TTQA
☐2 point questions
☐4 pt. questions
☐Other: Click here to enter text.
Revised 5-06-13
Canton City Schools
Math Deficit Checklist
(to be completed with assigned RtI Coach)
Number, Number Sense and Operation
☐Addition Facts
☐Subtraction Facts
☐Multiplication Facts
☐Division Facts
☐Multi-Digit Multiplication
☐Multi-Digit Division
☐Fractions
☐Money
☐Decimals
☐Percentages
☐Estimation
☐Other: Click here to enter text.
Measurement
☐Standard units
☐Metric Units
☐Perimeter/Area
☐Time/Temperature
☐Converting Units
☐Length / Weight/Volume
☐Other: Click here to enter text.
Geometry and Spatial Sense
☐Shapes
☐Lines/Segments/Rays/Point/Plane
☐Angles
☐2-D and 3-D Figures
☐Transformation/Symmetry
☐Other: Click here to enter text.
Patterns, Functions and Algebra
☐Sorting/Classifying and Ordering
☐Extending and Filling in Patterns
☐Open Sentences/Variables
☐Other: Click here to enter text.
Data Analysis and Probability
☐Reading and interpreting graphs
☐Constructing charts/tables/graphs timelines
☐Describe data using mean, median, mode and
range.
☐Probability
☐Sort and Classify by attributes
☐Identify a set of possible outcomes
☐Other: Click here to enter text.
Mathematical Process
☐Problem Solving Strategies (organized list, guess
and check)
☐Solve multi-step problems
☐Use pictures, numbers, or words to represent
problem situations and solutions.
☐Explain a mathematical concept using a 2- or 4point response.
☐Word Problems
☐Other: Click here to enter text.
Revised 5-06-13
Canton City Schools
Behavior Deficit Checklist
(to be completed with assigned RtI Coach)
Behavior Deficit:
☐Understanding student/teacher roles
☐Respecting others’ space
☐Listening Skills/Inattention
☐Requesting permission
☐Requesting assistance
☐Requesting clarification
☐Participating in class
☐Decision Making
☐Accepting responsibility
☐Transitioning activities
☐Working cooperatively in a group
☐Interrupting
☐Respecting adults
☐Respecting peers
☐Controlling anger
☐Adapting to change
☐Bullying
☐Anxiety
☐Oppositional Defiance
☐Ignoring distractions
☐Hyperactivity
☐Unprepared for class
☐Lack of organizational skills
☐Unsatisfactory homework
☐Out of seat
☐Talking without permission
☐Impulsiveness
☐Dishonesty
☐Gossip
☐Aggression
☐Refusal to work
☐Unmotivated to learn
Revised 5-06-13