RtI Permission Letter Example - School Administrators of Iowa

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Independence Community School District
East Elementary
1003 1st St W.
Office: (319) 334-7425
Fax: (319) 334-7427
Janette Hopkins, Secretary
Mary Jean Blaisdell, Principal
Date: _______________
Dear Parent/Guardian,
Currently East Elementary is offering the interventions outlined on the attached sheet (or backside).
Teachers use current achievement and/or progress monitoring data as well as classroom observation
to determine which students should be included in the interventions available. Due to limited
resources, the most needy students will be served first through the available interventions.
Interventions consist of 15-30 mins additional instruction with a certified teacher 3-5 times a
week/cycle. These sessions will take place during a time that will not disrupt your child’s learning in
the classroom. The interventions will typically last about 6-8 weeks, after which the progress
monitoring data from these interventions will be reviewed to determine if individual students will
return to Tier 1 (regular class only) instruction or continue to Tier 2 or 3 instruction (Supplementary
or Intensive).
Parents will be notified prior to the beginning of any intervention through a letter such as this and
will also receive a summary of the student’s progress and next recommendation through teacher
contact after the intervention is complete.
To learn more about RtI and interventions, please see the document included “Response to
Intervention: A Parent’s Guide” for a more detailed explanation of RtI.
Please review and sign the attached sheet and send back to school as quickly as possible. Questions
about why your student was recommended for this program should be directed to me at 334-7425.
Thank you,
(classroom teacher)
Signature needed
on other side
Your child has been recommended for the following Intervention(s):
Boost Up is a set of research-based school readiness activities at pre-K, kindergarten and primary
grades that produce a “booster” effect for gaining and retaining basic skills. Boost Up activities
increase brain development by increasing electrical activity in brain cells through sensory
stimulation, motor activities and emphasis on basic content mastery.
Group Time with Mrs. Honey and a small group of other students to work on:
_____________________________________________________________________________
Second Step is a small group in which children learn how to identify feelings, deal with emotions,
resist impulsive behavior, resolve conflict, solve problems, and understand the consequence of their
actions.
English Language Learning (ELL) is a set of activities designed to help students become proficient
in English as a second language.
Supplemental Reading/Math (circle which) is small group (3-5) instruction designed to focus on
specific skills in reading or math such as fluency, comprehension, word identification strategies,
vocabulary, number/letter identification, math fact fluency, addition or subtraction strategies,
problem-solving and/or time/money/measurement.
Intensive Reading/Math Instruction (circle which) is individual or very small group (1-2)
instruction designed to focus on specific skills in reading or math such as fluency, comprehension,
word identification strategies, vocabulary, number/letter identification, math fact fluency, addition or
subtraction strategies, problem-solving and/or time/money/measurement.
____________________________________________________________
*****************************************************************************
Please return whole sheet!!
_____ Yes my child has permission to participate in the above group(s) as checked.
_____ No my child does not have permission to participate in the above group(s) as checked.
_________________________________
(parent signature)
___________________________
(student’s name)
___________________________
(teacher’s name)
Please read other
side
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