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Riverdale Teacher/Parent/Student TAG Referral Form
Please complete the Student characteristic Profile below, and then check off any additional characteristics demonstrated by this student in the classroom. Please provide comments and examples whenever possible; specific information is extremely helpful as the TAG Committee proceeds with the identification process.
Student Characteristic Profile
Use the scale below to estimate the student’s intellectual and academic ability as well as their creativity and motivation to learn:
1. Never
2. Seldom
3. Occasionally
4. Frequently
5. Almost Always
6. Always
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* Indicates required question
Student Name and Grade
*
Your answer
Person Filling out Form
*
Your answer
Interests: Intense (sometimes unusual) interests. Unusual or advanced interest in a topic or activity; self- starter; pursues an activity unceasingly, beyond the norm.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Motivation: Evidence of relentless curiosity and desire to learn. Persistent in pursuing/completing self-selected tasks may be culturally influenced; evident in school or non-school activities.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Inquiry: Questions, experiments, explores. Asks unusual questions for age; plays around with ideas; extensive exploratory behaviors directed towards eliciting information about materials, devices or situations.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Insight: Quickly grasps new concepts and makes connections; senses deeper meanings. Exceptional ability to draw inferences; appears to be a good guesser; is keenly observant; heightened capacity for seeing unusual and diverse relationships; integration of ideas and disciplines.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Humor: Conveys and picks up on humor well. Keen sense of humor that may be gentle or hostile; large accumulation of information about emotions; capacity for seeing unusual relationships; unusual emotional depth; openness to experiences; sensory awareness.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Communication Skills: Highly expressive (with words, with numbers, with symbols). Unusual ability to communicate (verbally, nonverbally, physically, artistically, symbolically); uses particularly apt examples, illustrations, and elaborations.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Memory: Large storehouse of information (on school or non-school topics). Needs only 1-2 repetitions for mastery; has a wealth of information about school or non-school topics; pays attention to details; manipulates information.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Reasoning: Logical approaches to figuring out solutions. Ability to make generalizations and use metaphors and analogies; can think things through in a logical manner; critical thinker; ability to think things through and come up with a plausible answer.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Problem-Solving: Effective (often inventive) strategies for recognizing and solving problems. Unusual ability to devise or adopt a systematic strategy for solving problems and to change the strategy if it’s not working; creates new designs; inventor.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Imagination/Creativity: Produces many ideas. Highly original. Shows exceptional ingenuity in using everyday materials; is keenly observant; has wild, seemingly silly ideas, fluent and flexible producer of ideas; highly curious.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Comments/Examples
Your answer
READING/LA: Using/understanding advanced vocabulary
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Reading interest, fluency, and ability
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Reading more difficult books than peers
*
1. Never
2. Seldom
3. Occassionnally
4. Frequently
5. Almost Always
6. Always
READING/LA: Reading high level non-fiction
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Possessing a large storehouse of information about a variety of topics
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Recognizing author’s or speaker’s point of view, mood, or intentions
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Expressing him/herself through a variety of communicative skills
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Enjoying independent study and researching areas of interest
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Paying attention to details; elaborating
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
READING/LA: Being a keen and alert observer; usually “seeing more” or “getting more” out of a story, film, etc.
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Learns math concepts quickly
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Organizes data to discover patterns or relationships
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Enjoys trying to solve difficult problems
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Solves problems intuitively (May not be able to explain why the solution is correct)
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Is interested in numbers and quantitative relationships; sees usefulness of application of mathematics
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Visualizes spatially, creates visual images of problems
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Needs little practice to master new math concepts
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Develops unique associations; uses original methods for solutions
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Recalls relevant information or concepts in solving problems
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
MATH: Analyzes problems carefully: considers alternatives, not necessarily accepting first answer
*
1. Never
2. Seldom
3. Occassionally
4. Frequently
5. Almost Always
6. Always
Use this checklist to indicate any additional qualities and behaviors ___________ exhibits in the classroom.
Developmentally Advanced
Exhibits unique learning styles, grasping ideas all at once rather than step-by-step.
Learns at a faster pace, solves problems rapidly.
Curious; tends to ask complex questions.
Provides complicated answers with detailed explanations showing greater depth of understanding of topics than students their age.
Uses appropriate and original examples and/or is able to produce unusual analogies to illustrate points.
Comprehending abstract ideas with minimal concrete experiences*
Showing intuition; having “leaps of understanding*”
COMMENTS/EXAMPLES
Your answer
In comparing this student to others in their grade/class, would you say they learn, in mathematics, at a:
*
Faster Rate
Same Rate
Slower Rate
In comparing this student to others in their grade/class, would you say the learn, in language arts, at a:
*
Faster Rate
Same Rate
Slower Rate
In comparing this student to others in their grade/class, would you say their level of knowledge in mathematics is:
*
Higher Level
Same Level
Lower Level
In comparing this student to others in their grade/class, would you say their level of knowledge is in language arts:
*
Higher Level
Same Level
Lower Level
Can this student perform “over and above your expectations when given the opportunity in mathematics:
*
Higher Level
Same Level
Lower Level
Can this student perform “over and above your expectations when given the opportunity in languages arts:
*
Higher Level
Same Level
Lower Level
EXECUTIVE FUNCTIONING: Pays attention
*
Never
Seldom
Occassionally
Frequently
Almost Always
Always
EXECUTIVE FUNCTIONING: Organizes, plans and prioritizes at school
*
Never
Seldom
Occassionally
Frequently
Almost Always
Always
EXECUTIVE FUNCTIONING: Starts tasks and stays focused on them until completion.
*
Never
Seldom
Occassionally
Frequently
Almost Always
Always
EXECUTIVE FUNCTIONING: Self monitoring (keeps track of what they are doing)
*
Never
Seldom
Occassionally
Frequently
Almost Always
Always
SOCIAL/EMOTIONAL: How do you feel this student is doing socially and emotionally?
*
Your answer
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