Pre-Referral Process
Prior to completing a Concern Form, the teacher:
- Discusses the concerns with the student
- E-mails the parents explaining the concerns
- Implements basic interventions and collects data for two to four weeks
If the student is already on the Student Support caseload, the teacher contacts the Student Support Team (SST).
If the student is not on the SST caseload, the teacher completes a Concern Form.
Process for follow up on Concerns by the Student Support Team (SST)
Upon receipt of the Concern Form, the SST schedules a meeting with the teacher(s) to discuss the concerns.
Before the meeting the SST contacts other teachers to find out if the concern is in other classes.
At the first meeting, the teacher brings documentation of the effectiveness of strategies and interventions attempted thus far.
Together the SST and the referring teacher(s) formulate an Individual Learning Plan (ILP) or a Classroom Accommodation Plan (CAP) to be implemented over the next six weeks at which time they meet again to review evidence and discuss results.
If the plan is successful, the team:
- Informs all relevant teachers and continues to implement the plan.
- Communicates with the parents.
If the Plan is not successful, the SST meets with the teacher to complete a Referral Form.
- The principal is informed.
- The plan and data are reviewed.
The SST and the teacher formulate a new Plan to implement and document for an additional six weeks.
At the end of the six-week period the teacher meets with the SST again.
If the Plan is not successful, the SST in collaboration with the teacher decides to: (1 of 3 options)
- Implement an additional intervention
- Create an academic probation contract
- Make a referral for accessing External Expertise
PYP Student of Concern Form – This form is used to seek some consultation/support from a counselor or learning support team member for some strategies that you could try in your classroom as part of the pre-referral stage. Most teachers should start here first to request an observation of a student or some ideas for interventions and strategies that might be successful with students. Some students of concern might never reach the referral stage because the interventions are successful. Homeroom teachers, Mandarin teachers, EAL teachers, single-subject teachers, and TAs are encouraged to complete this form. This form is less formal than the referral form.
PYP Student Support Referral Form – This form is used when submitting an official referral for a student. This form will be used for a student that you have already been trying some strategies/interventions within classrooms and tracking some data. Homeroom teachers, in general, will fill these out. By this stage, other teachers in other classes and members of the Student Support team can provide their feedback about a student’s strengths and challenges. In general, students being referred through this form might need Tier 2 or greater support. This referral can also start the process of preparing for an external psycho-educational assessment.



