Dear Parents & Guardians,
Recent federal and state educational initiatives have promoted models for accountability and school
improvement centered around the use of evidence-based problem-solving practices. The Response to
Intervention (RtI) model is designed to ensure all students have access to effective instruction. In Illinois,
schools are accountable not only for instruction in core academic skills but also for social-emotional
learning (SEL) of students. Thus, RtI requires systems for addressing academic, social-emotional, and
behavioral concerns.
Social and emotional difficulties can make it very challenging for students to learn and perform well in
school. We are doing a number of things this year, with extra funds from a grant, to support our students
and teachers. By promoting social and emotional well-being in our students, we can help reduce barriers
to learning and make sure that students are performing to the best of their ability. This year at (enter
school name), we will be screening students for social-emotional and behavioral concerns as part of a
comprehensive, preventative approach to addressing student needs early, before the concerns get more
severe.
The entire ninth grade class (or student body) is invited to participate in the screening. We will use the
information we collect to identify students who might benefit from additional supports. The screening will
involve your student completing a brief questionnaire that asks about signs of stress, sadness, worry,
anger, loneliness, irritability, motivation, and attention difficulties. If your student has a high score on this
questionnaire, our school psychologist or school social worker will contact you by letter or by phone. In
some cases, he or she will then meet with your student one-on-one to gather more information and to
determine what types of supports might be most helpful. The psychologist or social worker will contact
you to explain any services we recommend and ask your written permission before your student actually
begins receiving any services, such as participating in a skill-building group or individual counseling.
If you have questions or would like to look at the questionnaire we will be using, please contact (insert
principal name & phone number) or (insert psych/social worker name & phone number). The screening is
scheduled to take place during the fall semester. If you DO NOT want your student to participate in the
screening, please fill out the form at the bottom of this page and either mail or have your student return it
to (insert designated person) by September 10, 2012. If you do not return the form or email your request,
your student will be eligible to participate. Thank you for your consideration.
Sincerely,
Principal
-------------------------------------------------------------------------------------------------------------------------I DO NOT want my child to participate in the social-emotional and behavioral screening.
Student: ________________________________ Guardian: _______________________________
_______________________________________
Guardian Signature
Return to the (person) by September 10, 2012.
__________
Date