RtI Tools & Forms

Forms listed below are designed to help schools analyze RtI-specific data, track degree of RtI implementation, and organize their RtI process into a school or district plan. Some data forms include webcasts that more fully describe how to complete each form.

Data Forms

RtI Core Design Team

New York State Response to Intervention Technical Assistance Center

Use this form to record your RtI Core Design Team members and their positions. These members could include, but are not limited to, principal, other administrative positions, literacy coach, reading teacher, interventionist/AIS provider, general education teacher, special education teacher, ESL teacher, psychologist, speech pathologist, and parent.

Benchmarking Data Tools

Benchmark Tracking Form - AIMs Web

New York State Response to Intervention Technical Assistance Center

This tool documents the average benchmark score of specific student populations by grade level, early literacy measure, and benchmark period. It’s purpose it to help schools determine if students are improving over time on general outcome measures that are considered key indicators of overall reading achievement. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete Benchmark Tracking Form.

https://vimeo.com/user42030491/benchmark 

Benchmark Tracking Form - DIBELs NEXT

New York State Response to Intervention Technical Assistance Center

This tool documents the average benchmark score of specific student populations by grade level, early literacy measure, and benchmark period. It’s purpose it to help schools determine if students are improving over time on general outcome measures that are considered key indicators of overall reading achievement. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete Benchmark Tracking Form.

https://vimeo.com/user42030491/benchmark 

 

Benchmark Tracking Form - easyCBM

New York State Response to Intervention Technical Assistance Center

This tool documents the average benchmark score of specific student populations by grade level, early literacy measure, and benchmark period. It’s purpose it to help schools determine if students are improving over time on general outcome measures that are considered key indicators of overall reading achievement. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete Benchmark Tracking Form.

https://vimeo.com/user42030491/benchmark 

Rate of Improvement Form (AIMSWEB)

New York State Response to Intervention Technical Assistance Center

This electronic tool answers the question: What is the average Rate of Improvement (ROI) for student groups between two benchmark periods? This tool allows schools to calculate ROI among different student subtypes, by grade level and literacy measure and compare their student’s growth to normative growth rates. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete Rate of Improvement Form.

https://vimeo.com/user42030491/roi

 

Rate of Improvement Form (DIBELS)

New York State Response to Intervention Technical Assistance Center

This electronic tool answers the question: What is the average Rate of Improvement (ROI) for student groups between two benchmark periods? This tool allows schools to calculate ROI among different student subtypes, by grade level and literacy measure and compare their student’s growth to normative growth rates. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete Rate of Improvement Form.

https://vimeo.com/user42030491/roi

Risk Level Status Form - AIMSweb

New York State Response to Intervention Technical Assistance Center

This electronic tool answers the question: What percentage of students scored within the low-, some, and at-risk levels across benchmark periods? It’s purpose is to help schools evaluate the impact of their RtI process by examining the percentage of different student populations students scoring at different risk levels by grade and early literacy measure from one benchmark period to the next. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete the Risk Level Status Form.

https://vimeo.com/user42030491/risk

 

Risk Level Status Form - DIBELs

New York State Response to Intervention Technical Assistance Center

This electronic tool answers the question: What percentage of students scored within the low-, some, and at-risk levels across benchmark periods? It’s purpose is to help schools evaluate the impact of their RtI process by examining the percentage of different student populations students scoring at different risk levels by grade and early literacy measure from one benchmark period to the next. Click on the "View Website" to access the electronic tool

A short video tutorial provides directions on how to complete the Risk Level Status Form.

https://vimeo.com/user42030491/risk

Risk Level Status Form - easyCBM

New York State Response to Intervention Technical Assistance Center

This electronic tool answers the question: What percentage of students scored within the low-, some, and at-risk levels across benchmark periods? It’s purpose is to help schools evaluate the impact of their RtI process by examining the percentage of different student populations students scoring at different risk levels by grade and early literacy measure from one benchmark period to the next. Click on the "View Website" to access the electronic tool

A short video tutorial provides directions on how to complete the Risk Level Status Form.

https://vimeo.com/user42030491/risk

Tiered Intervention Form

New York State Response to Intervention Technical Assistance Center

Using this electronic tools allows schools the ability to determine: How many students moved to a less or more intensive tier between benchmark periods? The tool tracks the percentage of multiple student populations at each tier by grade level from one benchmarking period to the next. Click on the "View Website" to access the electronic tool. 

A short video tutorial provides directions on how to complete the Tiered Intervention Form.

https://vimeo.com/user42030491/tiered

 

 

RtI Forms & Templates

NYS RtI TAC Assessment Audit

New York State Response to Intervention Technical Assistance Center

A comprehensive assessment system will involve multiple and varied types of evaluative tools designed to provide information that guides and informs instruction. The RtI Assessment Audit is a review of assessment practices implemented by a school in the area of literacy across grade levels. Conducting a RtI Assessment Audit serves several purposes:

1. Identifies the different types of assessments used in the area of literacy
2. Clarifies the purpose (screening, progress monitoring, diagnostic, and outcome) of each assessment tool
3. Identifies the construct being assessed (e.g.. concepts of print, comprehension, fluency, etc..), 
4. Identifies training needs of staff members relative to the administration and interpretation of targeted assessments;   
5. Provides an opportunity for a school to identify redundancies or gaps in the assessment process.

Section 100.2(ii), added to Part 100 of the Commissioner’s Regulations, set forth minimum requirements for using an RtI process to determine a student’s response to research-based intervention. One of the minimum requirements outlined requests districts to establish a plan and policies for implementing school-wide approaches and pre-referral interventions [8 NYCRR section 100.2(ii)]. The Response to Intervention Plan Template for Individual Districts provides guidance for documenting your district’s RtI framework and implementation process.

Section 100.2(ii), added to Part 100 of the Commissioner’s Regulations, set forth minimum requirements for using an RtI process to determine a student’s response to research-based intervention. One of the minimum requirements outlined requests schools to establish a plan and policies for implementing school-wide approaches and pre-referral interventions [8 NYCRR section 100.2(ii)]. The Response to Intervention Plan Template for Individual Schools provides guidance for documenting your school's RtI framework and implementation process.

RtI Action Plan

New York State Response to Intervention Technical Assistance Center

After completing the NYS RtI Readiness Survey with your entire school staff and analyzing the results, the RtI Core Design Team will use this form to identify specific RtI indicators that need attention or modification. 

 

RtI Tiered Descriptor

New York State Response to Intervention Technical Assistance Center

The NYS RtI Tiered Descriptor Form allows schools to list programs the school is currently using, the interventionist, frequency of the program, and the duration at tiers 1, 2, and 3.

RtI Survey Tools

The New York State Self-Assessment Tool for RtI Readiness and Implementation was developed by consortium members of the NYS Response to Intervention Technical Assistance Center (NYS RtI TAC) in collaboration with personnel from the New York State Education Department P-12, Office of Special Education. As a self-assessment tool, it is intended to:(1) assist individual schools/districts in evaluating their current level of RtI readiness and implementation and 2) formulate an RtI Implementation plan that will address RtI indicators that require improvement or development. It offers an opportunity for the school community to engage in reflective conversations around the topic of RtI.

This tool is intended for use by a school’s or a district’s RtI Design Team for the purposes of:
1. summarizing and analyzing the results from the NYS Self-Assessment Tool for RtI Readiness and Implementation
2. prioritizing RtI elements or features in terms of importance or priority
3. using results to construct an implementation plan that will guide the RtI process in their respective schools/districts

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