1. Phonological Awareness (Blevins, Rosner and Words their Way) Alphabetic Principle (Core Phonics, Words their Way, LETRS Morphological Awareness) Vocabulary and Comprehension (DRA/SRI, Core Vocabulary and Critchlaw) Fluency (ORF, Fry and RAN) Rhyme: Oddity Task: Oral Blending: Oral Segmentation: Phonemic Manipulation: Alphabet Skills: Reading and Decoding: Spelling Skills: Morphology: # of Orthographic errors on spelling: Site Words: ORF Rate: ORF Accuracy: # of phoneme errors on spelling test: Color naming RAN: Reading Level: Oral Language Vocabulary: Name: ________________ Executive Functioning Skills: Reasoning Skills: Other: Rosner Auditory Analysis: Reading Vocabulary: Reading Fishbone Analysis

2. Is there evidence to suggest difficulty with executive functi oning? Is there evidence to suggest difficulty with Language Processing ? Is there evidence to suggest difficulty with reasoning ? Root Causes of Reading Difficulty Student has the ability to sustain focus when basic skills are automatic Is there evidence to suggest difficulty with processing speed? Student is able to learn through various methods (mastery, inquiry) yes no 1. 2. 3. Is there evidence to suggest problems with phonological processing? Is there evidence to suggest problems with orthographic processing? yes no yes no yes no yes no yes no Prioritize the concerns 1.______________________________ 2.______________________________ 3.______________________________ 4.______________________________ 5.______________________________ 6.______________________________ Executive Functioning Concerns Reasoning Concerns Reading Comprehension Concerns Reading Fluency Concerns Basic Reading Phonological Concern Basic Reading Orthographic Concern Create the Treatment Plan Name: _____________________________

3. Handwriting (Handwriting without Tears Screener) Alphabetic Principle: Spelling (Core Phonics, Words their Way) Written Composition (Writing CBM with Rubric ) Grammar (Writing CBM CWS, Grammar Assessment) Memory: Orientation: Placement: Sentence: # of Orthographic errors on spelling: # of Phonologic errors on spelling: Writing CBM CWS: Parts of Speech: Subject/Predicate Identification: Sentence types : Sentence Identification: Syntax CLOZE: Writing Content: Writing Organization: Writing Style and Fluency: Language Usage: Name: ________________ Other: Writing Formation: Size: Neatness: Speed: Posture: Pencil Grip Developmental Stage of Spelling: Alphabet Skills: Reading and Decoding: Spelling Skills:

4. Is there evidence to suggest difficulty with executive functi oning? Is there evidence to suggest difficulty with handwriting? Is there evidence to suggest difficulty with reasoning ? Root Causes of Writing Difficulty Student has the ability to sustain focus when basic skills are automatic Is there evidence to suggest difficulty with spelling? Student is able to learn through various methods (mastery, inquiry) yes no 1. 2. 3. Is there evidence to suggest problems with sentence level syntax? Is there evidence to suggest problems with written composition? yes no yes no yes no yes no yes no Prioritize the concerns 1.______________________________ 2.______________________________ 3.______________________________ 4.______________________________ 5.______________________________ 6.______________________________ Executive Functioning Concerns Reasoning Concerns Handwriting Concerns Spelling Concerns Sentence Level Grammar Concerns Written Composition Create treatment plan Name: _____________________________

5. Number Sense (Math their Way; quantity discrimination cbm; missing number cbm, NZ Math Interview ) Operations ( Math their Way; New Zealand Math Interview ) Reasoning and Problem Solving (Monitoring Basic Skills Progress; Pattern Block Design; Mathematics Navigator Screeners ) Fluency ( Monitoring Basic Skills Progress; Rapid Automatic Naming ) MBSP Correct Digit CBM (k-6; use 6 th grade for 6-12): Subitizing: Color naming RAN: MBSP Applications (k-6): Mathematics Navigator Screener Logical Responses : Evidence of inductive/deductive reasoning skills: Pattern Block Design With Guides Without Guides + & - Concept Level: + & - Connecting Level: + & - Symbolic Level: + & - Visualization Level: Place Value Regrouping + & - Concept Level: Regrouping + & Connecting Level: Regrouping + & Symbolic Level: Place Value Concept Level: Place Value Connecting Level: Place Value Symbolic Level : Multiplication: Division: Fractions: Proportions and Ratios: Name: ________________ Executive Functioning Skills: Reasoning Skills: Other: Cardinality: Conservation of #: One to One Correspondence: Estimation of Object: Number ID: Number Form : Quantity Discrimination : Reasoning Skills:

6. Is there evidence to suggest difficulty with executive functi oning? Is there evidence to suggest difficulty with number sense? Is there evidence to suggest difficulty with reasoning ? Root Causes of Math Difficulty Student has the ability to sustain focus when basic skills are automatic Is there evidence to suggest difficulty with conceptual understanding of operations ? Student is able to learn through various methods (mastery, inquiry) yes no 1. 2. 3. Is there evidence to suggest difficulty with processing speed Is there evidence to suggest problems with concepts and application? yes no yes no yes no yes no yes no Prioritize the concerns 1.______________________________ 2.______________________________ 3.______________________________ 4.______________________________ 5.______________________________ 6.______________________________ Executive Functioning Concerns that impact Procedural Math Reasoning Concerns that impact problem solving Number Sense Concerns Computation Concerns Math Fluency Concerns Concepts and Application Concerns Create treatment plan Name: _____________________________

7. Value Streaming of Current Services Map out the current delivery of services the student receives in chronological order. Be detailed in streaming out the current process. Ask the question; Does this service support the concerns found in the root cause? If not then consider eliminating the services and increasing time on the services that support the root cause. Root Cause: ________________________________________________________ Indirect Services Direct Services Task Data key Tasks the student completesWork flow adds value duplicate