ESL

(English as a Second Language)

Handbook

May, 2010

Table of Contents
ESL Staff List ...

Iowa Code.

Program Overview

Program Goals..

ESL Standards..

ESL Staff Responsibilities

Identification Procedures.

I-ELDA Proficiency Levels.

General ESL Program Guidelines

ESL Record Keeping & Parent Notification

Program Model.

Coordination of Curriculum.

Parent Communication.

Transition and Exit Procedures

Assessments.

10

ELLs and Special Education.

10

Appendix:
A-1: Suggested Accommodations.

12

A-2: ELL Student Progress Report...

13

A-3: Elementary ELL Communication Tool

14

A-4: Secondary ELL Communication Tool..

15

A-5: ELL-Special Ed Service Checklist...

16

A-6: ESL Program Transitional and Exit Criteria Checklist

17

A-7: ELL/Special Education Student Exit Checklist...

18

See ESL folder on the building server for a copy of GUIDELINES FOR THE INCLUSION
OF ENGLISH LANGUAGE LEARNERS (ELLs) IN K-12 ASSESSMENTS and Educating
Iowas English Language Learners: A Handbook for Administrators and Teachers.

ESL Staff
Suzie Pearson

Wallace Principal

Merima Pasalic
Lisa Mueller

Wallace ESL Teacher

Wallace & Timber Ridge ESL Teacher

Cheryl Henkenius

Timber Ridge Principal

Maureen Fry

Timber Ridge ESL Teacher

Mary Haden

Timber Ridge ESL Teacher

Joy Palmer

Wallace and Timber Ridge Dean of Students

Linda Hansen
Melissa Grinstead

Summit Principal
Summit and Middle School ESL Teacher

Brian Carico

Middle School Principal

Bruce Hukee

High School Principal

Emily Nymyer

High School ESL Teacher

2010-2011 School Year

District Central Office Staff

Clay Guthmiller
Bruce Amendt
Debra Cale

District Superintendent
Director of Academic Services
Reading/Language Arts/ESL Coordinator

English as a Second Language Program

Johnston Community School District
Iowa Non-English Speaking Legislation:
Chapter 280.4, Uniform School Requirement Iowa Code
This section of the Code requires that transitional bilingual education or English as a second
language programs be provided for students whose primary (first) language is one other than
English, until the student demonstrates a functional ability to understand, speak, read and
write the English language.
Section 670.57 of the Department of Education Administrative Rules sets the standards for
these programs.
District Program Overview
The English as a Second Language Program (ESL) provides English Language Learners
(ELL) with an opportunity to acquire proficiency in listening, speaking, reading and writing
English. The ESL Program promotes a positive learning environment in which each
students first language, culture and ethnic heritage is valued. The ESL teachers work with
students whose first language is a language other than English and who qualify for ESL
services through a testing and referral process. There are specific strategies, methodologies
and curriculum used to help students acquire English.
Program Goals
1. To educate ELL students to the same standard of excellence as all students in the
school district.
2. To teach listening and reading English skills with an emphasis on comprehension in
both social and academic settings with emphasis on academic rich language.
3. To teach speaking and writing English skills with an emphasis on quality production
in both social and academic settings with emphasis on academic rich language.
4. To instill positive self-concepts and attitudes toward school in ELL students.
5. To assist ELL students and their families in functioning and understanding within
their school and community.
6. To promote pride in ELL students cultural and linguistic backgrounds.
English as a Second Language Standards
Standard 1: English language learners communicate for social, intercultural and
instructional purposes within the school setting.
Standard 2: English language learners communicate information, ideas, and concepts
necessary for academic success in the area of language arts.
Standard 3: English language learners communicate information, ideas, and concepts
necessary for academic success in the area of mathematics.
4

Standard 4: English language learners communicate information, ideas, and concepts

necessary for academic success in the area of science.
Standard 5: English language learners communicate information, ideas, and concepts
necessary for academic success in the area of social studies.
The Johnston Community School District recognizes the following facts:
1. Language acquisition is an intellectual process; even the youngest learners do not
simply pick-up a language.
2. Language acquisition takes time. It can take six to nine years for an English Language
Learner to achieve the same level of academic proficiency as a native English speaker.
3. Effective education for English Language Learners calls for comprehensive provision
of excellence in education based on the latest research, standards, and known best
practices in the area of English as a Second Language.
ESL Staff Responsibilities

The ESL teachers, in communication with other school personnel, are responsible for
identification of English Language Learners (ELL).
Teachers will use the identification and placement processes outlined in this handbook.
The ESL teachers will maintain student rosters for building and district administration.
The ESL staff will be responsible to oversee the language acquisition process of the ELLs
and provide formal language instruction in speaking, listening, reading, and writing and
comprehension of the English language.
The ESL teachers will assist in determining if an ELL is entitled to other or additional
programs and services. (i.e. Extended Learning Program, Special Education)
ESL staff will work with classroom and content area teachers to provide appropriate
accommodations, modifications, and differentiated instruction and assessment for ELLs.
The ESL and core classroom teacher will promote pride in all students cultural and
linguistic backgrounds.
The ESL and core classroom teacher will work together to involve families in the
educational process and the community.
A member of the administrative staff of the JCSD will be responsible for collecting and
maintaining student rosters for all buildings and grade levels. Administrative staff will
serve as I-ELDA coordinator for all grade levels.
Identification Procedures

Students who may need ESL services are identified by:

1. Enrollment documentation of home language use.

2. There is a Home Language Survey on file in the students native language (when
available) that indicates that the students first language is a language other than
English.
Placement Procedures
Students will receive ESL services when:
1. There is an IPT assessment on file for the student that indicates eligibility.
2. Parents have been notified using the Notification of English Language Program
Placement form.

English Language Learner Composite Proficiency Levels From I-ELDA

Level 1 - Pre-functional indicates that the student is: Beginning to understand short
utterances. Beginning to use gestures and simple words to communicate. Beginning to
understand simple printed material. Beginning to develop communication skills in writing.
Level 2 Beginning indicates that the student can: Understand simple statements,
statements, directions and questions. Use appropriate strategies to initiate and respond to
simple conversation. Understand the general message of basic reading passages. Compose
short informative passages on familiar topics.
Level 3 Intermediate indicates that the student can: Understand speech delivered in
school and social settings. Communicate orally with some hesitation. Understand
descriptive material within familiar contexts and some complex narratives. Write simple texts
and short reports.
Level 4 Advanced Intermediate indicates that the student can: Identify some of the
main ideas and relevant details of discussions or presentations on a wide range of topics.
Actively engage in most communicative situations familiar to him or her. Understand the
context of most text in academic areas with support. Write some multi-paragraph essays,
journal entries, personal/business letters, and creative texts in an organized fashion with
errors.
Level 5- Advanced indicates that the student can: Identify many of the main ideas and
relevant details of discussions or presentation on a wide range of topics. Actively engage in
many communicative situations, familiar or unfamiliar. Understand the context of many
texts in academic areas with support. Write many multi-paragraph essays, journal entries,
personal/ business letters, and creative texts in an organized fashion with some errors.
Level 6 Full English Proficiency indicates that the student can: Understand and identify
the main ideas and relevant details of extended discussions or presentation on familiar and
unfamiliar topics. Produce fluent and accurate language. Use reading strategies the same as
their English speaking peers to derive meaning from a wide range of both social and
academic texts. Write fluently using language structures, technical vocabulary, and
appropriate writing conventions.

General ESL Program Guidelines

1. All students admitted to the ESL Program will follow the identification and placement
procedures outlined above. This will assure that the proper individuals have been
consulted and that parents and teachers have been contacted.
2. Following the completion of identification and placement procedures, the ESL teacher,
along with the classroom teacher, will determine the appropriate level of service for each
student.
3. ESL students in grades K-5 will be assigned to the school with the ESL Program Site.
High School, Middle School and Summit students will be served in their buildings.
4. ESL instructional groupings will be determined based on the learning needs of the
students being served.
5. Students in the ESL Program will be assessed annually using the I-ELDA data to
determine progress, future leveling and service.
6. ESL teachers will meet classroom teachers to discuss each students level of English
acquisition using I-ELDA data, the Language Acquisition Chart: Guidelines for
Differentiating Instruction and Assessment and any other data or information needed.
ESL Record Keeping and Parent Notification
Every student in the ESL Program should have a record on file containing the following:
A. Home Language Survey
B. Copy of IPT
C. Parent Program Notification Form
D. Program Refusal Waivers, if applicable
E. Student Progress Report
F. I-ELDA results & other program assessments used to determine ESL status
G. Copies of Transition and/or Exit Notification Letters
ESL records should be kept on file by the ESL teacher in the ESL classroom. At the end of
each school year or upon the students transfer to a different school, the records should be
kept in a separate file folder and/or binder and put inside the students cumulative record.
Program Model
Elementary Programming: K-5 students will be served at ESL program sites. This will
allow for the best use of resources, allow for grouping of ELL students with similar needs,
provide additional time for instruction, and allow for a more interactive and engaging
environment.
Pullout The pullout model is typically used only for those students who are non-English
proficient. Students spend part of the school day in a core classroom, but are pulled out
for a portion of each day to receive instruction in English as a second language.

Collaborative or Push-in: In the collaborative model the ESL teacher is pulled into the
core classroom where he/she provides instruction to whole classes and small groups using
methods that reflect best practice for ELLs.

Secondary Programming: 6-12 students will be served at their building.

ESL Class Period This model is generally used in secondary school settings. Students
receive ESL instruction during a regular class period and receive course credit. They
may be grouped for instruction according to their level of English proficiency.
Coordination of Curriculum
Classroom and ESL teachers must collaborate and coordinate curriculum for all ELLs.
This includes:
1. Intentional and periodic communication and collaboration between ESL and
classroom teachers.
2. Collectively determine appropriate academic materials.
3. Provide support in differentiation.
4. Share strategies and adoption of materials.
5. Sharing of materials.
6. General education teachers provide curriculum materials and assessments to ELL
ahead of time for proactive measures.
7. Provide opportunities for pre and/or re-teach.
8. Support motivation and engagement issues.
9. Use and communicate student progress reports, achievement documentation and
performance assessments to indicate student progress.
Parent Communication
All information is to be provided in a language that the parent understands, to the extent
practicable (See 3302[c]). To meet this requirement, the Iowa No Child Left Behind Parent
Communication Center (formerly the Iowa Translation Library) is available as an on-line
resource at http://www.transact.com to provide necessary documents in 23 languages.
Furthermore, parents are to be given information regarding how they can:
Be involved with their childs education (Sec. 3302[e][1][A])
Help their children to learn English, achieve academically, and meet the academic
content and achievement standards expected of all students (Sec. 3302[e][1][B])
It is recommended that this outreach be carried out through regular meetings, which parents
are to be informed of. During these meetings, parent questions, concerns, and
recommendations can be addressed. (Section 3302[e][2]) For a comprehensive list of parent
communications required under NCLB in addition to those mandated by Title III, visit
www.transact.com.
Johnston Community School District will notify students parents of:
The reason for placement in a program for English Language Learners.
The students level of language proficiency, the assessment used to determine
proficiency, and their level of academic achievement.
The method of instruction used in the childs educational program.
8

How the program will meet the needs and build on the academic strengths of the
child.
How the program will go about teaching the child English and preparing him/her to
meet academic standards for promotion and graduation.
Exit requirements for the program.
Information regarding parental rights.

Transition and Exit Procedures for the ESL Program

The Johnston Community School Districts English as a Second Language program will
work to transition and exit students from the program who meet the following criteria:
(see Appendix 5 for exit sheet)
Checklist for Transition of ELLs
A composite score of a 5 or 6 on the Iowa English Language Development
Assessment (I-ELDA)
Student is at or near the expected reading level
Recommendations of ESL teacher classroom teachers
At or near proficiency on district-wide assessments
Opinion of parents
Note: These students continue to take the I-ELDA even when they are in the
transition stage
Checklist for Exiting ELLs
A composite score of a 6 on the Iowa English Language Development Assessment (IELDA)
The student must also meet at least 3 of the 4 following criteria:
Student is at the required reading level
Student is showing evidence of success in the core classroom including good
participation, average grades, homework completion, few accommodations made
At or near proficiency on district wide assessments
ESL support no longer needed
Has demonstrated success during the transition stage
o In the transitional stage two weeks to two years
It is also recommended, but not required, that parental input is obtained.
Checklist for Re-entering ELLs
If during the transition process or after exiting a student begins to fail he/she may be reentered into the ESL program. The decision to re-enter a student should include:
Meeting with parents
Meeting with all appropriate school staff, including classroom teachers, counselors,
administrators, and any special staff, such as at-risk, that can give insight into the
students performance and abilities
Discussion of other programs that might be available to assist the student
After the above steps have been taken, a student may be re-entered into the ESL program
when:
All of the Entry Criteria from page 2 have been met
There is a recent IPT on file
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Assessments for English Language Learners

English Language Learners should be included in district-wide testing as directed by the
Iowa Department of Education. At this time, MAP, ITBS/ITED, Phonological Awareness
Profile, Benchmarking, 8th grade BRI, 10th grade Portfolio, Six Traits of Writing, and Science
assessments should be given to every ELL who has been in the United States longer than 12
months. Math tests should be given to every ELL student.
Additionally, all ELLs will be tested annually using a state and NCLB approved test to
measure their English language proficiency. Currently the Iowa English Language
Development Assessment (I-ELDA) is used.
The Iowa Department of Education manual, Guidelines for the Inclusion of English
Language Learners in K-12 Assessments, should be used as a reference to clarify questions
regarding testing ELLs. When testing ELLs, appropriate accommodations can be made.
ITBS/ITED Administration manuals are good sources to help in making decisions about the
types of accommodations that are appropriate for each student. Guidelines for the Inclusion
of English Language Learners in K-12 Assessments also contain good suggestions for types
of accommodations to use with ELLs.

English Language Learners and Special Education

ELLs may receive assistance from special education. However, during the decision-making
and problem solving process, some important questions about the students language and
educational background need to be answered.
1. Is the student having difficulties primarily because he/she does not speak/understand
the language of instruction?
2. Is the student having difficulties primarily because he/she has not had similar
opportunities to learn as peers to whom he/she is being compared?
If the answer to these questions is No, the classroom teacher and ESL teacher should work
with other staff to rule out language and acculturation as reasons for the students need for
assistance. To rule out language and acculturation, reviews, interviews, observations, and
tests should take place.
Review records:
to find out students home language.
to find out the number of years the student has attended school.
to find out the frequency of school changes.
to find out how many years of ESL or other English Language instruction the student
has had.
to find the number of years the child has attended school in an English speaking
school.
to find out how the student performed when instructed in his/her primary language.
to find work samples and compare them to those of peers with similar educational and
linguistic background.

10

Interview:
parents, guardians, siblings, caregivers, and the student. Ask them questions arising
from the review items.
the student about his/her understanding of English. Ask if he/she is able to speak and
understand peers when speaking English.
the ESL teacher regarding the students performance compared to other ELL students.
classroom teachers regarding the students performance compared to other ELL
students. Ask about the students rate of acquisition of rules and expectations.
Observe:
the student in different settings. Note the language the student uses to communicate
with English speaking peers, ELL peers, teachers, and family.
the student and compare to culturally and socio-linguistically similar peers in the
regular and ESL classroom.
the instruction to see if effective teaching strategies for ELL students are used and
attempts are made to modify instruction for the student.
Test:
the student on grade level when possible. Results should be compared with results of
average students in the general population.
the student in the native language to whatever extent possible. If there is significant
discrepancy, a native language test should be sought. Compare the results to
culturally and socio-linguistically similar peers.
the student to determine language proficiency.
NOTE:
During the referral process, ELL documentation/data should be used. A general
education intervention should be implemented with a systematic progress monitoring
system to measure the intervention effects.
Interpreters should be used during testing process if needed.
ELL teachers must be included in the referral process and coordination of
programming should occur when students are staffed.
Heartland AEA will help fund translators for the initial IEP meeting.
Special considerations will be given to an ELL who is also identified for special
education services. The district has established an exit checklist for ELL Special
Education students who will not be able to exit ESL services due to a learning
disability. Data must support that the ELLs learning disability is not impacted or
resulted from any language barriers. See Appendix 6.

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Appendix 1

Suggested Accommodations for English as a Second Language Students

Pacing
Extend time requirements
Advance communication with ESL
teacher for difficult assignments and
projects
Environment
Seating near the center of the room
Presentation of Subject Matter
Emphasize critical information
Pre-teach vocabulary-share
vocabulary lists with the ESL teacher
Make and use vocabulary files
Reduce the reading level of
assignment
Use complementary text at the
appropriate reading level
Have the text read to the student by a
peer tutor or the ESL teacher
Materials
Allow student to use a bilingual
dictionary
Use supplementary text and materials
when needed
Directions
Give directions in small distinct steps
Restate directions in simplified
language
Use written directions
Have directions restated by a peer
Use visual cues and demonstrations
when possible

Assignments
Shorten assignments
Lower difficulty level
Provide the ESL teacher a written
copy of the assignment
Give students alternative or modified
assignments when the demands of the
class conflict with the students
linguistic abilities
Allow peer assistance when
completing assignments in class
Testing Adaptations
Read the test to the student
Allow the student to take or re-take
the test with the ESL teacher
Modify the questions
Modify the amount of information
and vocabulary the student is required
to master
Extend time frame for test taking
Social Interaction Supports
Use peer advocacy
Use peer tutoring
Structure activities to create
opportunities for social interaction
Use cooperative learning groups
Parent Communication
Use a first language report card
provided by the ESL teacher
Use a translator for conferences
Ask ESL teacher for translated field
trip forms etc.

Self-Management
Visual daily schedule
Visual reminder of ESL time
Help with use of assignment book
Request ESL reinforcement
Check often for understanding

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Appendix-2

Student Name: ______________________________

ELL Student Data Report

Home Language Survey
Date

Qualifies
YES

or

Comments
NO

IPT Placement Report & Current Placement Report

Tests
Date
Assessment for
Placement
Level of
Proficiency
IPT-Oral
IPT-Reading
IPT Writing

Current Placement
Proficiency Level

NES, NER, NEW- Non-English Speaker, Reader, Writer

LES, LER, LEW - Limited English Speaker, Reader, Writer
FES, FER, FEW - Fluent English Speaker, Reader, Writer

**IPT (Idea Proficiency Tests) tests used for the placement in ESL Program

I-ELDA Individual Progress Report: (English Language Development Assessment) state

required assessments for English proficiency
List assessment date in gray boxes.

Reading
Writing
Listening
Speaking
Comprehension
Composite
Scores: 0-6
The ELDA assessment enables Iowa to meet the following Title III NCLB requirements:
provide an annual assessment of English proficiency and show annual progress
in acquisition
include all LEP (Limited English Proficiency) students in English
language proficiency assessments
obtain independent measures of listening, speaking, reading, writing
report a measure for comprehension
measure school environment + academic skills
align assessments with state ELP standards.
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Appendix-3

Elementary ELL Communication Tool

Student Name:
Teacher:
ITBS Reading Comprehension:

Year:

Grade:

MAP Reading Comp: Fall:

Language Level:
Spring:

ELDA Reading:
Speaking:
Listening:
Y = Yes, S = Sometimes, N = Not Yet
Mid
T1
Mid
T1
T2

Writing:
T2

Mid
T3

Listening:

Listens attentively
Follows directions
Responds to questions

Speaking:

Pronounces words clearly

Expresses ideas
Speaks willingly in English
Uses correct English grammar

Reading:

Uses concepts of print

Identifies letters
Identifies letter sounds
Reads with fluency
o
o
o

Reads with understanding

o
o
o
o
o
o
o
o

Rate
Accuracy
Prosody (expression and phrasing)
Uses schema (organizes and uses background knowledge)
Infers
Determines Importance
Visualizing
Questioning
Synthesis
Summarize
Use fix-it strategies

Understands and uses correct vocabulary

o
o
o

Science vocabulary
Social Studies vocabulary
Math vocabulary

Writing:

Writes words
Writes complete and accurate sentences
Writes with strong ideas (narrow topic)
Writes with organization
Writes with appropriate word choice
Writes with voice
Writes with sentence fluency
Writes with correct conventions
Writes with correct grammar

Behaviors:

Treats self and others with respect

Able to stay on task

Math:

Able to read and understand directions

Able to read and understand word problems

Comments:

14

T3

Appendix-4

Secondary ELL Communication Tool

Student Name:
Teacher:
ITBS/ITED Reading Comp:

Year:

Grade:

Language Level:

MAP Reading Comp: Fall:

Spring:

ELDA Reading:
Speaking:
Listening:
Y = Yes, S = Sometimes, N = Not Yet

1
Listening:
Listens attentively
Follows directions
Responds to questions
Speaking:
Pronounces words clearly
Expresses ideas
Speaks willingly in English
Uses correct English grammar
Reading:
Uses concepts of print
Identifies letters
Identifies letter sounds
Reads with fluency
o
o
o

Rate
Accuracy
Prosody (expression and phrasing)

Reads with understanding

o
o
o
o
o
o
o
o

Writing:

Uses schema (organizes and uses background

knowledge)
Infers
Determines Importance
Visualizing
Questioning
Synthesis
Summarize
Use fix-it strategies

Understands and uses correct vocabulary

o
o
o

Science vocabulary
Social Studies vocabulary
Math vocabulary

Writing:
Writes words
Writes complete and accurate sentences
Write with strong ideas (narrow topic)
Writes with organization
Writes with appropriate words choice
Writes with voice
Writes with sentence fluency
Writes with correct conventions
Writes with correct grammar
Behaviors:
Treats self and others with respect
Able to stay on task
Comments:

15

Appendix-5

ELL Special Education Service Review Checklist

Please use the review checklist when considering placement and services of ELL students into special
education. This list is designed to provide consistency across the district. IEP service discussions need to
be individualized according to each students individual language and academic needs.

Who is
responsible?

What action will be

taken?

ESL teachers must be part of the STAT meetings

and know what data to collect prior to these
meetings. These data can be collected from the
ESL or classroom teacher, depending on who is
initiating the STAT meeting.
During this STAT meeting determine a list of
tools and assessments that will be used to
determine student needs.
As a team, define the strategies & skills that
need to be priority areas in order to meet the
students learning needs.
After entitlement, establish protocol for collecting
student performance data that will be used in
developing the IEP.
Clarify who will collect those data. Those data
should be used in determining types of support
services for ELL/special ed student.
Throughout the IEP process, clearly define the
roles of the ESL & special education teachers.
This can occur in the IEP meeting or in a collaborative planning
session between all parties involved. The definition of the roles
needs to be documented and shared wit the building administrator.

Academic content is taught by the classroom

teacher, unless otherwise designated in the IEP.
Supplemental support is provided by the special
education &/or ESL teacher, as determined by
the STAT or IEP process.
Determine the amount of collaboration needed
between ELL, special ed, and general ed
teachers. Must consider the language needs of
the student as you determine the services for the
child. The collaborative discussion must include
information on the students progress from data
collected.
As the team considers transitioning &/or exiting
ELL students who are also identified as special
ed, the district guidelines in the handbook must
be followed.

16

Appendix-6

Johnston English as a Second Language

Program Transitional and Exit Criteria
The Johnston Community School Districts English as a Second Language Program will work to
transition and exit students from the program who meet the following criteria :
Transitional Checklist
Requirements:
Composite Score of a 5 or 6 on the IELDA
Student is at or near required reading level
Recommendations from ESL and
classroom teachers
At or near proficiency on district wide
assessments
Opinion of parents

District Data:
Students reading level is _________.
I-ELDA Scores:
Reading Score _____

Writing Score _____

Speaking Score _____

Listening Score _____

Composite _____

Date ______

Exit Checklist
ELL must demonstrate proficiency on the first bullet and meet four of the five criteria that follow.
Requirements:
District Data:
Composite Score of a 6 on the I-ELDA
Students reading level is _________.
Student is at required reading level
I-ELDA Scores:
Student is showing evidence of success in
Reading Score _____
Writing Score _____
the core classroom
At or near proficiency on district wide
Speaking Score _____
Listening Score _____
assessments
Has demonstrated success during the
Composite _____
Date ______
transition stage
ESL support no longer needed
**It is also recommended the opinion of the classroom teachers and parents be obtained.

Teacher Signature:

Subject:

Date:

Parent contact date: _________

Based on the criteria checked above, the following student is dismissed from ESL services:
Student Name: ____________________________________ Date: _____________________
School: _________________________ Grade: ________ ESL Teacher: ___________________
Copy Sent to Cathy Robison on: ____________________

17

Appendix-7
6

Johnston Community Schools Checklist for ESL Exit for ELL Special Education Students
Very few ELLs who quality for special education services will not be able to pass the ELDA due to their learning
disability. In order for an ELL/Special Ed student to be exited from ESL services, many things must be considered.
As a district, we must be very confident that this students disability is due to an academic learning disability, and is
not the result of English language acquisition. It is recommended that students below 3rd grade not be considered for
this process. An ELL should be in the ESL program for at least 3 years and dual served for at least one year before
exiting is a consideration.

Student Name:

Grade:

ITBS Score
Reading

Math

Benchmarking Level:

School:

MIALT Score
Science

Reading

ELDA

Math

*PA Profile:

Speaking

Listening

Reading

Writing

Progress Report proficient areas:

*use report card criteria to determine proficiency.

1.
2.
3.
4.
5.

6.
7.
8.
9.

Questions
ELLisconsistentlynonproficient
accordingtoatleast3datapointsin
Math.
ELLisconsistentlynonproficient
accordingtoatleast3datapointsin
Reading.
ELLisconsistentlynonproficient
accordingtoatleast3datapointsin
Science.
ELLisconsistentlynonproficient
accordingtoatleast3datapointsin
writing.
ELLisreceivingsupplementalESLpull
outservices.Pleasedocumentthe
amountoftimestudentisreceiving
supplementalsupport.
ELLisreceivingservicesthroughapush
inmodel.Describethemodel.
ThecurriculumusedwiththeELLhas
beendifferentiatedaccordingtotheir
languageneeds.
ELLhasbeenprovidedwithacademic
andlanguagegoalsandhasnotbeen
abletoperformineitherarea.
Classroomteacherhasprovidedthe
necessarydifferentiatedinstructionto
adequatelymeettheacademicand
languageneedsofthestudent.

Yes

No

Provide Supporting Details

18

Questions
10. ELLperformancehasbeenevaluated
anddocumentedbyclassroomteacher,
ESLteacher,andateacherwithspecial
edbackground.
11. Despitecurriculum&instruction
differentiation,thestudentslearning
difficultiespersist.
12. Listotherprogramsoralternativesthat
havebeenexploredandimplemented
andhowoften.
13. ELLhasnotbeensuccessfulwiththeexit
requirementsfor_________years.
14. Studenthasdifficultiesinreading,
writing,andspeakinginfirstlanguage.
15. Describethereading&writing
difficultiesthisstudentisexperiencingin
firstlanguage.
16. Feedbackfromparentsindicatesthatthe
childexhibitsthesametypeoflearning
difficultiesintheirnativelanguage.
17. Basedonthedatacollected,ESLservices
donotsupporttheacademicprogressof
thisELL.
18. Aninterpreterhasbeeninvolvedinthe
entitlementtestingtoensureitisnota
languageissue.
19. TheELLsacademicneedscanbemet
throughspecialeducationservices
withoutthesupportofESLservices.
20. AsanESLeducator,youarecertainthat
thatthisstudentslowperformanceis
notduetoalanguageacquisitionissue.

Yes

No

Provide Supporting Details

Please return this completed and signed document to Bruce Amendts office. Upon the arrival of this form, it will be
sent to John Scott at the Iowa Department of Education for final approval. After the district receives final notification,
an update will be made to the ESL student roster and you will be notified.
DATE

Classroom Teacher Signature:

ESL Teacher Signature:
Special Education Teacher Signature:
Building Administrator Signature:
Parent Signature:

Date of District Notification: __________

Date of State Approval: ___________

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