This report will be typed in Century Gothic 11 point font; double spaced with 1 inch

margins. Do not double space your name, date, and the report title. Hand in a hard
copy on December 5 at the final.

I. Learner Background
a. First name, grade
b. Family and school information
c. Interests, likes, dislikes
II. Assessment Information
a. Letter identification; Sounds known visually
b. Word recognition; include source (e.g. Dolch list)
c. Reading level (e.g., grade level, lexile level); instructional level use 5 error
rule
d. Words correct per minute (at what grade level)
e. Sounds known Auditorily
f. Spelling skills (auditory sequencing, auditory and visual memory)
g. Handwriting skills; handedness, spatial awareness, letter formation
sequencing
III. Needs and Goals
a. Based on part II., what does the learner need to learn; what do you plan
to teach
b. Goals that are specific and measurable (e.g., learn 10 new Dolch words
from the 2nd grade list; learn to identify words for all 6 syllable patterns)
IV. Progress Monitoring
a. Describe progress made regarding phonemic awareness & phonics
b. Describe progress made regarding reading fluency and comprehension
c. Describe progress made regarding writing (e.g., spelling, penmanship)
V. Next Steps
a. Write a summary paragraph describing what you would teach next if you
were to continue to work with this student.
Grading Rubric

_____/5 Content is comprehensive (see outline)

_____/5 Professional voice (objective language, no slang [learner, kid])

_____/5 Information is clear and concise

_____/5 Information is well organized

_____/5 Assessment information is specific

_____/5 Goals are measureable and observable

_____/5 Phonogram Checklist is filled out and attached

________/35 Total Points