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

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

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

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

5. Name: ________________
Number Sense (Math their Way; quantity discrimination cbm; missing number cbm )
Operations
(Math their Way;)
Name: ________________
Quantity Discrimination CBM:
+ & - Concept Level:
+ & - Connecting Level:
+ & - Symbolic Level:
+ * - Visualization Level:
Missing Number CBM:
Counting by Rote Memory:
One-to-One Correspondence:
Instant Recognition:
Conservation of Number:
Counting Backwards:
Estimation of Objects:
Numeral Recognition:
Numeral Forms :
Regrouping + & - Concept Level:
Regrouping + & Connecting Level:
Regrouping + & Symbolic Level:
Regrouping + & - Concept Level:
Regrouping + & Connecting Level:
Regrouping + & Symbolic Level:
Multiplication Concept Level:
Multiplication Connecting Level:
Multiplication Symbolic Level:
Place Value Concept Level:
Place Value Connecting Level:
Place Value Symbolic Level:
MBSP Correct Digit CBM (k-6; use
6th grade for 6-12):
MBSP Applications (k-6):
Color naming RAN:
Mathematics Navigator Screener (6-12):
Pattern Block Design:
Other:
Fluency (Monitoring Basic Skills Progress; Rapid Automatic Naming )
Reasoning and Problem Solving (Monitoring Basic Skills Progress; Pattern Block Design; Mathematics Navigator Screeners)

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

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
key
Task
adds value
Data
Tasks the student completes
Work flow
duplicate