Guardian Interview for RtI Plans in Alpine

Parent/Guardian Concerns Section of RtI Plan in Alpine Achievement
1. What concerns do you have about your child’s learning or school performance, or about
your child’s attention, concentration, impulsivity, and/or activity?
2. Do you have any concerns about how your child is doing in certain subjects at school?
3. What concerns do you have about how much your child is enjoying school compared to
his/her friends or classmates?
4. What problems does your child have completing his/her homework?
5. In what area(s) does your child have problems in school performance?
6. Subjects/Activities of difficulty
7. Additional details about your child’s difficulties.
8. Stressful Events (currently as well as at the onset of school problems)
9. Students Strengths
10. How does the child get along with peers? Which extracurricular activities is the student
involved in? How does he/she do?
11. Emotional issues
12. Medical concerns
13. Who previously evaluated the student? Was the student eligible for services? What
type of service did they receive? Was it discontinued? When and why?
14. What history is there of learning problems in the family?
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