LISA Academy Public Charter Schools
Family's Guide to Special Education
ACT Aspire / DLM
Online Resource Guide
Section 504 Guide
Myths about Dyslexia
Signs of Dyslexia and Strengths
OG in 3D Program
Level 2 screening referral
*This referral is for a Level 2 screening for the characteristics of dyslexia. This screening does not diagnose Dyslexia.
Choose LISA Academy Campus
North Elementary (Grades K to 5)
North Middles School / High School (Grades 6 to 12)
Springdale (Grades K to 8)
West Elementary (Grades K to 5)
West Middle School (Grades 6 to 8)
West High School (Grades 9 to 12)
Arkansas Hybrid (Grades K - 12)
Rogers/Bentonville (Grades K - 7)
Is the student currently receiving dyslexia intervention?
Indicates required field
Is the level 2 screening being requested bt the dyslexia committee?
Parent Contacted Prior to Referral
Name of Student
Place a check beside each behavior observed in the classroom.
Difficulty learning and remembering the names of the letters in the alphabet.
Difficulty sequencing the alphabet orally or in writing.
Difficulty associating letters with sounds, such as the letter t with the /t/ sound.
Difficulty with recognizing and generating rhyming patterns.
Difficulty pulling words apart into individual sounds. (ex. mat /m/ /a/ /t/)
Difficulty with blending sounds to form words.
Very slow in acquiring reading skills.
Makes guesses on unfamiliar words in reading.
Problems keeping place on page when reading.
Deficient word attack skills.
Failure to understand what he / she reads.
Difficulty using the correct short vowels in spelling words.
Has trouble spelling words correctly in a sentence.
Makes spelling errors that involve changing the order of letters within a word.
Difficulty with finding the right word to say and / or seems to hesitate when trying to answer a question.
Spelling, reading, writing skills are below what you would expect in view of perceived intellectual ability.
Reasons for Referral
(for staff use only) upload all the documentation required by the dyslexia staff guide
Max file size: 20MB
Upload any recent evaluations and / or student work (if you are unable to upload this required information, please give hard copies to the dyslexia interventionist on your campus)
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