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  • Summary Report Template

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    This summary report provides information about a student for their current school year including personal details, academic performance, medical history, interventions tried, and classroom observations. It contains data on attendance, standardized test scores, reading and math levels, grades, writing samples, functional behavior assessments, and progress monitoring through the response to intervention process. The report was prepared by a staff member to evaluate the student's needs and progress.

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    This summary report provides information about a student for their current school year including personal details, academic performance, medical history, interventions tried, and classroom observations. It contains data on attendance, standardized test scores, reading and math levels, grades, writing samples, functional behavior assessments, and progress monitoring through the response to intervention process. The report was prepared by a staff member to evaluate the student's needs and progress.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    19 views4 pages

    Summary Report Template

    Uploaded by

    api-307642825
    This summary report provides information about a student for their current school year including personal details, academic performance, medical history, interventions tried, and classroom observations. It contains data on attendance, standardized test scores, reading and math levels, grades, writing samples, functional behavior assessments, and progress monitoring through the response to intervention process. The report was prepared by a staff member to evaluate the student's needs and progress.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 4

    WAYNESBORO AREA SCHOOL DISTRICT

    Fairview*Hooverville*Mowrey*Summitview
    SUMMARY REPORT
    Students Name:
    Grade:
    DOB:
    CA:
    Parents Name:
    Address:
    Phone Number:
    School:
    Teacher:
    Current Program:
    Permission Date:
    _____________________________________________________________
    REASON FOR REFERRAL
    ________________________________________________________________________
    BACKGROUND INFORMATION
    Parent CommentsClassroom Teacher Comments
    Specialist CommentsPreschool Experiences
    _____________________________________________________________
    MEDICAL INFORMATION
    History
    Diagnoses and Evaluations
    Medication
    Hearing and Vision Screening Results
    Services from Outside Agencies
    _____________________________________________________________
    SCHOOL DATA
    Attendance History
    Days Absent
    Days Tardy

    PSSA Scores
    Reading
    Math
    Writing
    Science

    3rd Grade

    Aimsweb
    Fall

    MAZE

    4th Grade

    ORF

    5th Grade

    OVERALL RATING

    Winter
    Spring
    Fountas and Pinnell
    Fall
    Winter
    Spring

    Level
    Accuracy

    Comprehension

    Fluency

    Level
    Accuracy

    Comprehension

    Fluency

    Comprehension

    Fluency

    Level
    Accuracy
    *Copies are attached.

    Study Island
    1st
    2nd
    3rd
    4th

    Reading

    Math

    Current Grades
    Subject
    1st
    2nd
    3rd
    4th
    Reading
    Writing
    Spelling
    Math
    Social Studies
    Science
    Health
    * Denotes that student receives additional supports in that subject.

    Writing Sample
    Winter
    Rating
    Focus Content-

    Organization-

    Style-

    Conventions-

    Spring
    Focus -

    Organization-

    Style-

    Conventions-

    Rating
    Content-

    *Copies of writing samples and a current piece of writing are attached.


    FBA
    *Copy is attached.
    PBSP
    *Copy is attached.
    _RTI
    Tier
    Number of Weeks Monitored
    Area of Progress Monitoring
    Current Interventions
    Program
    Length of Time

    Number of Times Weekly

    Comments if applicable
    *Copies of RtI graphs are attached.
    _____________________________________________________________
    PREVIOUS INTERVENTIONS
    _____________________________________________________________
    CLASSROOM OBSERVATIONS
    _____________________________________________________________
    IST INFORMATION
    Report prepared by:
    Date:

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