This document appears to be a reading assessment form used to evaluate a student's reading comprehension, fluency, and engagement. It contains questions about the book being read, how challenging it is, a summary of events so far, a reading sample, predictions, and questions about reading habits. The form also includes areas to note the student's strengths and areas for improvement, and space to outline an instructional plan based on the assessment.

1. Name ______________________________ Date __________________ Text _____________________________________________________________
Why did you pick TITLE/COVER PICTURES GENRE SERIES SUBJECT AUTHOR FRIEND/PARE OTHER
this book? MATTER NT/TEACHER
Is this book easy, challenging, or just EASY JUST RIGHT CHALLENGING
right?
Performance Criteria 4 3 2 1
What do you think of the book so Opinion is detailed and makes Opinion is general and/or has Teacher must search for opinion, Unable to form coherent and
far? connection to text and reader. vague back-up. or S. says, “I just do.” informed opinion.
Tell me what’s been going on so Re-tell mentions all important Re-tell may leave out one thing Re-tell is heavily scaffolded by Has no idea how to re-tell in
far. (or what it’s about if elements in sequence and in and/or may be spotty. Is able to teacher. May go blank on response to teacher prompt. Has
finished). detail. Is able to answer teacher answer teacher questions in teacher questions, or have to no clue in response to teacher
questions in specific manner, using general manner. “search” for answers. questions.
Text supported text.
Teacher scaffolded
(Pick a part and have the student Reader is fluent with no errors or Reader relies on only one strategy Reader has to be provided word- Reader shows no sign of word-
read to you.) chooses from many strategies to to self-correct (sounding out) solving strategies by teacher, but solving strategies even after
self correct.) then corrects. teacher prompt.
Sound out Pictures Meaning
No errors TP G(ave)
What do you think is going to Reader gives detailed prediction Reader gives detailed prediction Reader’s prediction is limited or Reader’s prediction is implausible
happen next in the story? or inference based on text and/or or inference based primarily on inference is vague. or inference is off.
(prediction) background knowledge. background knowledge.
OR
What do you think about. . . ?
Are you reading at home? How’s Reader gives specific information Reader has a general idea about Reader is prompted as a reader Reader has trouble being a reader
that going? Does anyone read to leading to a reading life outside where they’re going and who they only through teacher direction. even with teacher direction.
you at home? What is next for of school and/or a detailed one are as a reader.
you as a reader? (Books on deck? inside school.
Subjects interested in?)
STRENGTHS: WISHES:
INSTRUCTIONAL PLAN: