District Checklist

Evaluation of Response to Intervention Practices for Elementary School Reading (Site Recruitment)

Appendix 5 District Checklist Mature IES Evaluation RtI Practices

District Checklist

OMB: 1850-0872

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Appendix 5. District Protocol for Obtaining District Information about Mature RtI Schools and Determining Interest in

Participation in the Study

Evaluation of RtI Practices in Elementary School Reading


District Name:

Nominated School’s Name:

Name/Title of Nominator:

Name/Title of Administrator:

District Location:

Date:


As we indicated in our earlier letter to you, we’re beginning to recruit sites for a U.S. Department of Education study on Response to Intervention Practices in Elementary School Reading. As we shared, national experts had nominated ________________ school as a possible site for studying how RtI is addressing the educational needs of students who struggle with learning how to read. After contacting this school to learn more about their RtI practices and to gauge their interest in participating in this study, we found that they match our study requirements and are interested in participating if the district also agrees to participate in the study.


Therefore, we are contacting you again to discuss the study in more depth and to learn more about the district’s RtI policies and practices.


We’d like to ask you a couple of quick questions about _________________ school, the status of the implementation of RtI in other schools in the district; and about the standardized reading assessments required by the district. Are you the right person to talk to? (If no, get the name of the person who is knowledgeable.) Do you have about 30 minutes to talk with us about RtI in the district?


Our questions include:


  1. Do you agree that ______ school represents a mature implementation of RtI?

  2. Are there other elementary schools in the district that are considered to be as mature or even more mature in their implementation of RtI reading practices as _______________ school?


Follow-up asking for names of schools


  1. Are there other elementary schools in the district that have not started implementing RtI practices in elementary reading? If so which schools?


Follow-up asking for names of schools


  1. Are there other elementary schools in the district that began implementation after ______________ school and, in your view point, would be considered not as far along? If so, which ones? In what year did they begin implementation?

Follow-up asking for names of schools


  1. Did the district provide guidance or resources to support the school to implement RtI?

    1. If so, what kind of support did the district provide?

    2. Was this kind of district support provided to all of the elementary schools in the district at the same time? If not, how did the district stagger its support to the elementary schools to implement RtI practices?



  1. Across the district, what standardized reading tests are required to be administered to students in grades 1 through 5? Some of these tests may be required by the state or district. If you like, we can email this question to you in a spread sheet to more simply check off the boxes or you can tell me over the phone.



Name of Standardized Test

Performance measured by test (e.g., oral reading fluency, letter naming fluency, reading comprehension)

State or District Required


Years that this standardized test has been administered

and Year of 1st administration

1st grade





2nd grade





3rd grade





4th grade





5th grade








  1. Is it OK for us to call ______________ school(s) -- that are either not implementing RtI or are not as far along in their RtI implementation -- to learn more about their practices for assisting struggling readers? If yes, who would be the best person to talk to?


  1. Do you think that your district would be interested in participating in this study sponsored by the US Department of Education? If yes, could we call you at a later date to discuss this possibility?



Thank you very much for your time and assistance!

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File TitleAppendix 5
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