Learning Difficulties Tracking Chart
Class: Teacher:
Learning Difficulties Tracking Chart
Student is Having Difficulties Learning Successfully in the Classroom
Student’s birth date: Gender:
Name:
Parents’ names & contact information:
Married? Divorced? If divorced what are the custody arrangements?
Other potentially relevant information:
Tier 1
Reasons for Concern:
o Academic
o Cognitive
o Social
o Behavioural
o Emotional
o Physical
Academic or Cognitive:
Date(s) of class instruction:
What was being taught?
Observations
Do you have a 1. sample of the work? Yes (attach) No (get one if at all possible) NA
2. Student profile
3. Student questionnaire
4. Parent questionnaire
5. Relevant challenges & strategies sheet if appropriate
6. Class profile
Comments:
Social, Behavioural, Emotional:
Date(s) of observations:
Situations structured unstructured:
Observations:
Comments:
Physical:
Date(s) of observations:
Situations:
Observations:
Comments:
Information from OSR
Individual Education Plan? YES? NO?
Key points? Or attach copy.
Parent Interview
Date:
Parents/Guardians present:
Parents’ comments
Next steps tried:
o more intensive instruction
▪ group instruction or work
▪ PEER TUTORING
▪ WORKING WITH
➢ VOLUNTEER
➢ EDUCATIONAL ASSISTANT
➢ SPECIAL EDUCATION TEACHER
➢ OTHER STAFF MEMBER
➢ PARENT
➢ OTHER
o DIFFERENTIATED INSTRUCTION OR REMEDIATION:
o TEACH LEARNING STRATEGIES:
o BEHAVIOUR MODIFICATION TECHNIQUES:
o ACCOMMODATIONS:
▪ EQUIPMENT:
▪ TIME
▪ SEATING PREFERENCE
Comments on next steps
Approximate Time Next Steps are Reviewed:
Successful? Not successful?
Reason and place in student’s Learning Profile:
Have you attached a sample of the work after the next steps were implemented?
Yes No NA
Other information & comments:
If not successful, date when child was flagged as at risk:
Parents informed: YES NO
Date informed
Their response?
Tier 2
Results of Tier One Require Further Investigation, Support & Action
Date of referral to In-School Support Team:
Date of Team Meeting:
Team Members Present:
Recommendations of Team Meeting:
For Teacher Action:
Further accommodations?
Modifications to Expectations?
Additional Interventions?
Further Assessment by Teacher?
For Other Professional’s (Names & Positions)
Action:
Further Assessment?
Additional Interventions?
Tier 3
Results of action on Tier 2 recommendations and reasons for moving to Tier 3
Do you have more work samples attached? Yes NA
Date Parents informed:
If team meeting is student referred for psycho-educational assessment? YES NO
If not, what was the reason:
What strategy is going to be employed instead?
Pedagogical or psychological reasons for the strategy?
If student is referred for psycho-educational assessment:
To whom is the student referred? Date of referral
Kind of Assessment
Expected Date of Assessment
Actual Date of Assessment
Date of Presentation of Assessment
Is there a working summary for teacher’s use? YES NO
Recommendations:
Recommendations for action outside the current classroom or materials?
Information attached? Yes No
Comments:
Date of implementation of those recommendations:
Date teacher plans to reassess e.g. next report card
Date for next psych-educational reassessment:
Teacher’s Personal Record:
What works well:
What needs improvement:
Reflections:
This tracking sheet was created as a personal tracking sheet for you as a teacher who will be undoubtedly working with many kids who need help. First it is to help you remember what you need to document everything to get students help as swiftly as possible. It is based closely on Education for All, especially p. 20 & 35. Secondly, it is to help you track and document what kind and how timely the help your students are getting outside the classroom and outside the school. Thirdly, it is to give you a tool to jot notes on your evaluations on how things are working for you and your students.
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