Rti Surveys and forms

Appendix 3. Intervention Provider Survey for the Evaluation of Response to Intervention Practices

for Elementary School Reading

What is the purpose of this study?

This study is part of the congressionally-mandated national evaluation of the Individuals with Disabilities Education Improvement Act (IDEA, Public Law 108-446) and will address the following questions:

• What are the effects on academic achievement of providing intensive reading interventions to elementary school children who have been identified as at risk for reading difficulties compared with children just above the cut point for providing intervention?

• How do academic outcomes, including reading achievement and special education identification, vary with elementary schools' adoption of Response to Intervention practices for early grade reading?

• How do Response to Intervention practices for early grade reading vary across schools?

How is the study team defining Response to Intervention?

Response to Intervention (RtI) is a multi-step approach to providing early and more intensive intervention and monitoring within the general education setting.

In principle, RtI begins with research-based instruction and behavioral support provided to students in the general education classroom, followed by screening of all students to identify those who may need systematic progress monitoring, intervention, or support. Students who are not responding to the general education curriculum and instruction are provided with increasingly intense interventions through a "tiered" system, and they are frequently monitored to assess their progress and inform the choice of future interventions, including possibly special education for students determined to have a disability.

IDEA permits some federal special education funds to be used for "early intervening services" such as RtI, and also permit districts to use RtI to inform decisions regarding a child's eligibility for special education.

Who is administering this study?

This study is being supported by the Institute of Education Sciences (IES) at the U. S. Department of Education as authorized by the U. S. Congress under Section 664 of IDEA. MDRC, SRI International, and RG Research Group developed plans for the study under contract ED-04-CO-0111/0003 with IES, and Survey Research Management is administering the teacher survey.

What is the purpose of this survey?

This survey seeks information to describe reading intervention services, sometimes called Tier 2 or Level 2 interventions and Tier 3 or Level 3 interventions.

1. Reading intervention can be in one or more areas of reading (that is, phonemic awareness, phonics, fluency, vocabulary, reading comprehension) and refers to targeted or intensive reading intervention for students.

2. Reading interventions are provided to students somewhat below grade level benchmarks (sometimes called Tier 2 or Level 2 students) or far below grade level benchmarks (sometimes called Tier 3 or Level 3 students), including students with disabilities.

3. Reading interventions may occur in addition to core reading instruction and employ print materials used by an instructor and student, or electronic computer based materials used primarily by the student.

Who should complete this survey?

Answer the three questions below to help you determine if you should complete this survey.

1. Do you teach small groups of students in grades 1, 2, or 3?

 Yes  No

2. Are some of these groups of students somewhat below or far below grade level reading benchmarks?

 Yes  No

3. Do you provide reading intervention services to these small groups?

 Yes  No

If you answered yes to all three questions above, please proceed. If you answered no to any question, then you do not need to continue this survey.

Will the information provided through this survey be kept confidential?

All information gathered for this study will be kept confidential and will only be used for research purposes. The information collected about schools and students for this study will be used only for statistical purposes and may not be disclosed or used, in identifiable form, for any other purpose except as required by law (Public Law 107-279, Section 183).

What are the instructions for this survey?

Please answer the questions based on your experiences. There are no expected answers, so please be thoughtful and honest as you respond. Your participation is important and appreciated, and confidential.

The survey is broken into two short sections:

A. Practices Used with Reading Intervention Groups

B. Professional Background and Experience

THANK YOU IN ADVANCE FOR COMPLETING THIS SURVEY!

According to the Paperwork Reduction Act of 1995, no persons are required to respond to this voluntary collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1850-New. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4537. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Jonathan Jacobson, U.S. Department of Education, Institute of Education Sciences, 555 New Jersey Avenue, NW, Suite 500J, Washington, D.C. 20208, or email jonathan.jacobson@ed.gov.

SECTION A: PRACTICES USED WITH READING INTERVENTION GROUPS

Questions A1 through A15 ask about various intervention groups. Intervention group refers to students who have been identified for targeted or intensive small group reading interventions because they are somewhat below or far below grade level benchmarks.

An intervention group should be regularly scheduled to meet with you before, during or after the school day for several weeks, months, school year. The intervention group should continue to meet until a decision is made to change the composition of the group or to change the child’s instruction, but would not be considered small group reading instruction that typically occurs during class-wide reading instruction.

For each regularly scheduled intervention group you worked with during the most recent full school week, please answer each question in the table below to describe how you teach and organize their reading intervention.

If you worked with more than three groups, please copy pages 2-5 and provide this information for each group with students in grades 1, 2, or 3.

	Group #1	Group #2	Group #3
A1. What time of day does the instruction occur? MARK ONE.	AM PM Both AM and PM	AM PM Both AM and PM	AM PM Both AM and PM
A2. In what location does the instruction occur? MARK ALL THAT APPLY.	General education classroom Interventionist classroom Other (please specify: _________________)	General education classroom Interventionist classroom Other (please specify: _________________)	General education classroom Interventionist classroom Other (please specify: _________________)
A3. What is the grade level of students in the group? MARK ALL THAT APPLY.	 K  1  2  3  4  5  6	 K  1  2  3  4  5  6	 K  1  2  3  4  5  6
A4. At what time during the day is the group scheduled for intervention? MARK ALL THAT APPLY.	During the core reading block At a time other than the core reading block but within the school day Before school After school	During the core reading block At a time other than the core reading block but within the school day Before school After school	During the core reading block At a time other than the core reading block but within the school day Before school After school
A5. What is the reading level of the students? MARK ALL THAT APPLY.	At or above grade level reading benchmark in reading Somewhat below grade level reading benchmark Far below grade level reading benchmark	At or above grade level reading benchmark in reading Somewhat below grade level reading benchmark Far below grade level reading benchmark	At or above grade level reading benchmark in reading Somewhat below grade level reading benchmark Far below grade level reading benchmark
A6. How many times during the week, do you meet with this group? MARK ONE.	 1  2  3  4  5  More than 5	 1  2  3  4  5  More than 5	 1  2  3  4  5  More than 5
A7. During your last typical meeting with this group, how many minutes of reading instruction did you provide? MARK ONE.	Up to 30 minutes 31-46 minutes 46-60minutes 61-75 minutes 76-90 minutes 91-105 minutes 106-120 minutes 121-135 minutes 136-150 minutes More than 150 minutes	Up to 30 minutes 31-46 minutes 46-60 minutes 61-75 minutes 76-90 minutes 91-105 minutes 106-120 minutes 121-135 minutes 136-150 minutes More than 150 minutes	Up to 30 minutes 31-46 minutes 46-60 minutes 61-75 minutes 76-90 minutes 91-105 minutes 106-120 minutes 121-135 minutes 136-150 minutes More than 150 minutes
A8. How many students were assigned to the group ? MARK ONE.	 1  2  3  4  5  6  7  8  9 or more	 1  2  3  4  5  6  7  8  9 or more	 1  2  3  4  5  6  7  8  9 or more
A9. How many of the students in the group have an IEP ? MARK ONE.	 0  1  2  3  4  5  6  7  8  9 or more	 0  1  2  3  4  5  6  7  8  9 or more	 0  1  2  3  4  5  6  7  8  9 or more
A10. How many students in the group were Limited English Proficient or English Language Learners? MARK ONE.	 0  1  2  3  4  5  6  7  8  9 or more	 0  1  2  3  4  5  6  7  8  9 or more	 0  1  2  3  4  5  6  7  8  9 or more
A11. What components of reading were emphasized for this group? MARK ALL THAT APPLY.	Phonemic awareness Phonics Vocabulary Fluency Reading comprehension	Phonemic awareness Phonics Vocabulary Fluency Reading comprehension	Phonemic awareness Phonics Vocabulary Fluency Reading comprehension
A12. What reading programs and/or reading series were used with this group? MARK ALL THAT APPLY.	Early Reading Interventions (ERI) Fundations Great Leaps Guided Reading Interventions from core reading series (for example, Triumphs, Soar to Success) Leveled Literacy Intervention (Fountas-Pinnell) Leveled Reader Series (for example McGraw-Hill, Pearson) Orton-Gillingham PALS Phonics for Reading Read Naturally Read Well Reading A-Z Reading Mastery Reading Recovery Voyager Passport Wilson Reading Words Their Way Other (please specify: _________________)	Early Reading Interventions (ERI) Fundations Great Leaps Guided Reading Interventions from core reading series (for example, Triumphs, Soar to Success) Leveled Literacy Intervention (Fountas-Pinnell) Leveled Readers Series (for example, McGraw-Hill, Pearson) Orton-Gillingham PALS Phonics for Reading Read Naturally Read Well Reading A-Z Reading Mastery Reading Recovery Voyager Passport Wilson Reading Words Their Way Other (please specify: _________________)	Early Reading Interventions (ERI) Fundations Great Leaps Guided Reading Interventions from core reading series (for example, Triumphs, Soar to Success) Leveled Literacy Intervention (Fountas-Pinnell) Leveled Readers Series (for example, McGraw-Hill, Pearson) Orton-Gillingham PALS Phonics for Reading Read Naturally Read Well Reading A-Z Reading Mastery Reading Recovery Voyager Passport Wilson Reading Words Their Way Other (please specify: _________________)
A13. Are any of the reading interventions primarily delivered by a computerized instructional system?	Yes No	Yes No	Yes No
A14. How many weeks ago did you last measure the performance of students in this group?	 Never  This week  1 week  2 weeks  3 weeks  4 weeks  5 weeks  6 weeks  More than 6 weeks	 Never  This week  1 week  2 weeks  3 weeks  4 weeks  5 weeks  6 weeks  More than 6 weeks	 Never  This week  1 week  2 weeks  3 weeks  4 weeks  5 weeks  6 weeks  More than 6 weeks
A15. Under what circumstances would the decision be made to move a student to another group during the school year? MARK ALL THAT APPLY.	Student’s responsiveness to an intervention indicates a change should be made Time has expired for a time limited intervention Disciplinary issue Make room for a different student Students remain in the group for the year	Student’s responsiveness to an intervention indicates a change should be made Time has expired for a time limited intervention Disciplinary issue Make room for a different student Students remain in the group for the year	Student’s responsiveness to an intervention indicates a change should be made Time has expired for a time limited intervention Disciplinary issue Make room for a different student Students remain in the group for the year

Questions A16 through A17 ask about what typically occurs for most small groups of students in each tier you teach.

A16a. Typically, how is progress monitoring data used for students somewhat below grade level benchmark in reading, sometimes called Tier 2 or Level 2 students? MARK ALL THAT APPLY.

 To determine if instruction should be changed

 To determine if student’s group placement should be changed

 To determine if special education pre-referral process is appropriate

 To determine if special education referral process is appropriate

 Not applicable

A16b. Typically, how is progress monitoring data used for students far below grade level benchmark in reading, sometimes called Tier 3 or Level 3 students? MARK ALL THAT APPLY.

 To determine if instruction should be changed

 To determine if student’s group placement should be changed

 To determine if special education pre-referral process is appropriate

 To determine if special education referral process is appropriate

 Not applicable

A17a. In a typical month, for students in Tier 2 or Level 2, approximately how often do you measure student progress, using any of the following types of reading outcome and skill measures?

Times per month…

 Oral reading fluency  0  1  2  3  4  5  6 or more

 Curriculum-embedded test  0  1  2  3  4  5  6 or more

 Phonics  0  1  2  3  4  5  6 or more

 Word lists  0  1  2  3  4  5  6 or more

 Running records  0  1  2  3  4  5  6 or more

 Phonemic awareness  0  1  2  3  4  5  6 or more

 Other (please specify: _______________) 0  1  2  3  4  5  6 or more

 Other (please specify: _______________) 0  1  2  3  4  5  6 or more

A17b. In a typical month, for students in Tier 3 or Level 3 approximately how often do you measure student progress, using any of the following types of reading outcome and skill measures?

Times per month…

 Oral reading fluency  0  1  2  3  4  5  6 or more

 Curriculum-embedded test  0  1  2  3  4  5  6 or more

 Phonics  0  1  2  3  4  5  6 or more

 Word lists  0  1  2  3  4  5  6 or more

 Running records  0  1  2  3  4  5  6 or more

 Phonemic awareness  0  1  2  3  4  5  6 or more

 Other (please specify: _______________) 0  1  2  3  4  5  6 or more

 Other (please specify: _______________) 0  1  2  3  4  5  6 or more

A18. Do you meet with a school level (or grade level) team--for example, school psychologist, speech language pathologist, reading specialist, etc.--that evaluates the progress of struggling readers and makes decisions about reading interventions?

 Yes  No (skip to question B1)

A19. At the last typical school-level (or grade-level) meeting, who attended this meeting in addition to yourself? MARK ALL THAT APPLY.

• Reading specialist

• Reading interventionist

• Reading coach

• Special education teacher

• ELL or ESL teacher

• General education teacher(s)

• Social Worker/Guidance counselor

• School psychologist

• Speech language pathologist

• School administrator

• Paraprofessional or instructional assistant

• Staff from the district office

• Other adult not listed here
  (please specify: _________________)

A20. How frequently does this school-level (or grade-level) team meet ? MARK ONE.

• More often than once per week

• Once per week

• Once every 2 weeks

• Once every 3 weeks

• Once every 4 weeks

• Once every 5 weeks

• Once every 6 weeks

• Once every 7 weeks

• Once every 8 weeks

• Once every 9 weeks

• Once every 10 weeks

• Once every 11 weeks

• Once every 12 weeks

• Less often than every 12 weeks

A21. How are reading data usually used during school-level team, sometimes grade level, meetings? MARK ALL THAT APPLY.

• To determine if individual students are making satisfactory/adequate progress

• To identify individual students who need a reading intervention

• To determine if adjustments are needed in the core reading instruction/curriculum

• To determine if individual students should be moved to a different reading group

• To determine if individual students should be moved to a different classroom for reading

• To determine if individual struggling readers need a change in their instruction

• To decide if any individual students should be referred for special education

• Other (please specify: _________________)

SECTION B: PROFESSIONAL BACKGROUND AND EXPERIENCE

Questions B1 through B7 ask about your professional background and experience.

B1. What is your title in the school?

 Reading intervention/specialist  Special Educator  Classroom Teacher
 Speech Language Pathologist  Paraprofessional  ELL Teacher

 Other (specify _____________)

B2. Including the current year, how many years have you been an educator?

	Enter # of years below…
Total number of years as an educator	____ # Years
Number of years at this school	____ # Years
Number of years with current job title	____ # Years

B3. What is the highest educational degree that you hold ? MARK ONE.

• High School

• Associate’s

• Bachelor's

• Master's

• Doctorate or Professional Degree

B4. Which of the following describes the teaching certificate/endorsement you currently hold ? MARK ONE.

• Regular or standard state certificate or advanced professional certificate

• Probationary certificate (issued after satisfying all requirements except the completion of a probationary period)

• Provisional or other type of certificate given to persons who are still participating in an alternative certification program

• Temporary certificate (requires some additional college coursework, student teaching and/or passage of a test before regular certification can be obtained)

• Waiver or emergency certificate (issued to persons with insufficient teacher preparation who must complete a regular certification in order to continue teaching)

• I do not have any of the above certifications

B5. Please indicate which educational areas you hold state certification or licensure in, and what grade span (for example, K-6) this certification or licensure is for MARK ALL THAT APPLY..

	Area of Certification/Endorsement	Grade Span
	I do not hold certification/endorsement
	Elementary Education	________
	Early Childhood Education	________
	Secondary Education	________
	Special Education	________
	Arts/Music	________
	English Language Arts	________
	ESOL/Bilingual/ESL Education	________
	Reading	________
	Foreign Languages	________
	Mathematics	________
	Computer Science	________
	Natural Sciences	________
	Social Sciences	________
	Other (please specify: ________________)	________

B6. During the last 12 months, including the summer, in how many of each of the following types of professional development activities in reading have you participated? Please count each activity only once. What is the total number of hours you spent in these activities?

• First write in the number of activities of each type in which you have been engaged over the last 12 months.

• Then, write the total number of hours you spent in these activities. Mark 0 if you participated in none.

	Enter below the # of
	Times over the last 12 months	Total Hours over the last 12 months
a. Attended short, stand-alone training or workshop in reading (half-day or less)	# ____	# ____
b. Attended a longer institute or workshop in reading (more than half-day)	# ____	# ____
c. Attended a college course in reading (include any courses you are currently attending)	# ____	# ____
d. Attended a conference about reading (might include multiple short offerings)	# ____	# ____
e. Received coaching related to reading instruction	# ____	# ____
f. Received mentoring related to reading instruction	# ____	# ____
g. Acted as a coach related to reading instruction	# ____	# ____
h. Acted as a formal mentor related to reading instruction	# ____	# ____
i. Participated in a professional learning community (PLC)	# ____	# ____
j. Other (e.g. participated in a teacher study group, network, or collaboration supporting professional development in reading, participated in committee or task force related to reading, visited or observed reading instruction in other schools)	# ____	# ____

B7. During the last 12 months, how much of an emphasis did these topics receive in the professional development activities that you attended. MARK ONE RESPONSE ON EACH ROW.

	Did not occur	Occurred-Minor emphasis	Occurred Moderate emphasis	Occurred Major emphasis
How to administer benchmark test				
How to use reading data to adjust core instruction				
How to use reading data to evaluate school progress				
How to use graphed data to determine relative progress of students				
How to organize small group instruction				
How to analyzing and interpret student achievement data				
How to administer assessments				
How to interpret and use reading assessment data to guide instruction				
How to diagnose reading difficulties				
How to choose reading intervention(s)				
How to use reading intervention(s)				
Strategies for teaching reading to ELL students				
Strategies for teaching reading to special education students				

April 3, 2012 Revised Interventionist Survey Page 5