Response to Intervention andthe Identification of SpecificLearning Disabilities
Daniel J. Reschly
The use of response-to-intervention (RTI) to identify children and youth with specific learningdisabilities (SLDs) is described with multiple illustrations. Essential components of the RTI processare specified at multiple tiers of intervention, each essential to valid SLD identification. The RTIgoals are prevention in general education, early identification and intervention, and intensive treat-ment of children with severe and chronic achievement and behavioral challenges. Identificationof SLD is described as a series of stages culminating in a comprehensive evaluation that meetsrequirements of the federal Individuals with Disabilities Education Act. During the comprehensiveevaluation, the need for screening in at least 12 domains is stressed, followed by an in-depth as-sessment in domains in which the possibility of educationally related deficits exists. Advantages ofRTI-based SLD identification are discussed. Key words: problem solving, progress monitoring,response to intervention, SLD identification
CONTROVERSY has existed in the iden-tification of specific learning disabilities
(SLDs) from the inception of the diagnosticconstruct in the 1960s to the present. No con-sensus exists still today. In fact, thought andpractice are perhaps even more diverse thanat any time in the past 50 years. Other arti-cles in this special issue deal with the historyof identification policy and practices and vari-ous alternatives to SLD identification. This ar-ticle is devoted to one of the contemporaryalternatives, identification of SLD through theresponse-to-intervention (RTI) process. TheRTI process has multiple variations and some-what different purposes. In the first section,the basic structure and premises of RTI are
This article is an extensive rewrite and updating ofReschly and Bergstrom (2009).
The author has indicated that he has no financial andno nonfinancial relationships to disclose.
Corresponding Author: Daniel J. Reschly, PhD, 1402Lille Ct., Franklin, TN 37067 ([email protected]).
DOI: 10.1097/TLD.0000000000000003
discussed. This is followed by a considera-tion of policy and practice. Finally, the advan-tages and disadvantages of SLD identificationthrough RTI are contrasted with other currentalternatives to SLD identification.
The concepts of unexpected low achieve-ment and discrepancy from some expectedlevel of performance are fundamental to theSLD construct. The application of RTI toSLD identification preserves these basic con-cepts by defining SLD with the familiar no-tion of duel discrepancy, which involves bothdiscrepancy from normal levels of achieve-ment and discrepancy from expected levels ofprogress, given intensive instruction. This ar-ticle describes how RTI is used to implementthese traditional SLD identification conceptsby focusing on student progress.
RESPONSE TO INTERVENTION
Although problem-solving methods as fore-runners of RTI were developed severaldecades ago and applied to a wide arrayof human problems (Bergan, 1977; Deno &Mirkin, 1977), the term response to interven-tion emerged in the late 1990s to early 2000sto describe multitiered reading interventions
40 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014
(Lyon et al., 2001; Vaughn, Linan-Thompson,& Hickman, 2003) and behavior interventions(Horner & Sugai, 2000). The concept, how-ever, is ancient, because humans have used re-sults to decide on the adoption, continuation,modification, and discontinuation of practicesfor thousands of years. What is new todayin educational system RTI applications arethe solid scientific foundations for academicand behavioral interventions, improved mea-surement precision, formal decision rules, en-abling policy and legal supports, and applica-tion to a wide range of decisions includingidentification of SLDs.
Response to intervention is a process fordesigning and delivering interventions inhuman services settings that is based on fourfundamental principles (Batsche et al., 2005;Brown-Chidsey & Steege, 2010; Gresham,2007; Reschly & Bergstrom, 2009; Tilly,2008). The process must be implementedwith fidelity at all levels and must representthe principles as follows:
1. Scientifically based academic instruc-tion and behavior interventions matchedto student needs and implemented withgood fidelity over a time period that isreasonable to expect gains to meet per-formance expectations.
2. Progress monitoring that is sufficientlyfrequent and sensitive to match the de-gree of students’ needs and the inten-sity of the intervention, with resultsused to compare progress with goals andmake changes in goals or instruction/intervention as indicated by progressdata.
3. Data-based decision making about thedegree of students’ needs and the in-tensity of educational services requiredto meet those needs based on studentprogress toward benchmark goals forperformance.
4. Multitiered or levels of intervention thatvary in intervention intensity matched tostudent needs.
The term response to intervention appearsto be evolving into the term, multitier sys-tem of supports (MTSS), which is essentially
equivalent. For most purposes, RTI and MTSSare virtually identical in theory and practice;however, in the context of SLD identification,RTI is used most often and therefore is usedin this chapter. Systems implementing MTSSor RTI depend on several tiers of interven-tions that vary in instructional intensity andmeasurement precision. At all tiers, the majorgoal is to improve performance to benchmarklevels (defined later).
MULTIPLE TIERS: PURPOSES ANDPRACTICES
The number of tiers varies in differentRTI/MTSS systems, with a three-tier systembeing the most common model. The tiers typ-ically are organized loosely around differenteducational interventions delivered in (a) gen-eral classrooms in general education, (b) sup-plemental instruction or intervention alongwith general education classroom instructionin general education, and (c) long-term in-terventions that may involve other programssuch as special education in addition to gen-eral education. Identification of SLD may oc-cur in connection with decisions about spe-cial education eligibility. A common three-tiermodel is illustrated in Figure 1.
Tier I general education: Primaryprevention
Tier I is the general education classroom/program in which all or nearly all childrenparticipate. The primary purpose of Tier I isto deliver high-quality academic instructionand positive behavior programs that enablechildren to meet benchmark expectations.Both the academic instruction and positivebehavior programs are expected to be scien-tifically based, meaning that they are basedon multiple research studies yielding positiveresults (see later discussion). The primarypurpose in Tier I is prevention of academicand behavior problems, with a secondarypurpose of early identification and treatmentof students who appear to be falling belowbenchmarks. As noted in a National Research
More intense, longer term interventions of > 1 year that may or may not involve special education
All students
10% – 15% of students
10% – 12%
Figure 1. Multitiered system with tiers varying in intervention intensity and measurement precision.MTSS/RTI model with three tiers. MTSS = multitier system of supports; RTI = response to intervention.
Council report, “There is substantial evidencewith regard to both behavior and achieve-ment that early identification and interventionis more effective than later identificationand intervention.” (Donovan & Cross, 2002,p. 6). The following sections describe severalkey components to prevention and earlyidentification and treatment.
Universal screening and progress mon-itoring are applied to all children, usingmethods that are time-efficient and accuratein identifying students at risk for possible ed-ucational and behavioral problems. Universalscreening is most prominent for screeningearly reading development, where simplefluency measures requiring from 3 to 5min per child are used as part of Tier I inRTI/MTSS systems. Universal screening inreading (i.e., involving all students) typicallyoccurs three times per year: in the first monthof school, near the middle of the year, and inthe last month of school. Universal screeningin behavior involves a similar process thathas the same purposes (Horner et al., 2009;
Horner & Sugai, 2000; Walker, Severson, &Seeley, 2010). Additional progress monitor-ing may be conducted with a few childrenin each classroom to look more closely atresponses to instructional changes beforeconsideration of Tier II services. Currentlyavailable procedures can be used as early asthe first month of kindergarten to identifyyoung children with underdeveloped pre-and early reading skills such as alphabetknowledge, phonemic awareness, and initialsound fluency (AIMSweb, 2013; Good &Kaminski, 2011). These early measures havestrong correlations with third-grade wordreading and comprehension (Roberts &Vaughn, 2007); that is, they identify thelikelihood of individual children reading ade-quately by the end of Grade 3, an extremelyimportant educational goal (“Early Warning!,”2011; National Reading Panel, 2000).
Prediction is, however, relatively uselessfor the individual student. In RTI/MTSS sys-tems, the goal is to disconfirm predictionsthrough Tier I interventions in the general
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education classroom and, if needed, at Tiers IIand III. The trajectories of many children be-low benchmarks can be changed with earlyidentification and interventions. The absenceof early screening means that educators oftenwait for children to fail badly enough to beidentifiably by other less sensitive proceduressuch as teacher referral, frequently past theage when early reading interventions are mosteconomical and effective (National ReadingPanel, 2000). This wait-to-fail strategy is notin the best interests of children or school sys-tems.
Benchmarks are used in RTI/MTSS systems,but the concept has a slightly different con-notation compared with its common use, in-dicating a high or exemplary level of perfor-mance. Benchmark in this context means theminimum level of performance to have an 80%chance of passing a high-stakes, third-gradereading or mathematics assessment, or, in thecontext of behavior, patterns of behavior thatdo not disrupt normal classroom and schoolprocesses or interfere with the rights of
others excessively. In academics, benchmarksare below national achievement means or me-dians.
In addition to identifying children belowbenchmarks needing more intense instruc-tion, universal screening is used to deter-mine whether the classroom academic andbehavioral instruction is effective. The crite-rion is the amount of growth and the pro-portions of students performing at or abovebenchmarks toward educational success. Ex-cessive numbers of children performing be-low benchmarks and slow growth rates aresymptoms that typically indicate curriculumor instruction deficiency, often both. The datafrom an unpublished Evaluation Project I con-ducted with a school district are summarizedin the charts in Figure 2. They illustrate thephenomenon of markedly different classroomoutcomes in early reading attributable to cur-riculum and instructional differences. Theseare real data from real classrooms.
The expectation is that 80%–85% of all stu-dents in the classroom will meet benchmarks.
Figure 2. A, Initial sound fluency fall to winter kindergarten whole language instruction (benchmark =25). B, Initial sound fluency fall to winter kindergarten DI and SBRI (benchmark = 25). C, Correct phonemesegmentation fluency winter to spring kindergarten whole language instruction (benchmark = 35). D,Correct phoneme segmentation per minute winter to spring kindergarten: DI and SBRI (benchmark =35). DI = direct instruction; SBRI = scientifically based reading research.
Classrooms vary significantly, however, inmeeting this criterion. The time-series anal-ysis graphs in Figure 2 show results for eachchild and the entire class. This is, arguably,the most effective method to analyze univer-sal screening and progress monitoring resultsat Tier 1. The results in Figure 2 are fromtwo adjacent kindergarten classrooms in thesame elementary school building serving chil-dren, all of whom are African American andeligible for free or reduced-cost school lunch.Figure 2A reflects the fall-to-winter resultsobtained by children in a classroom taughtby an inexperienced teacher who is apply-ing the constructivist, balanced literacy (es-sentially whole-language) instructional meth-ods emphasized in her recently completedteacher training program. Many of the chil-dren are below benchmark, and most showslow progress. These results might be rational-ized and perhaps dismissed as about what canbe expected by citing the economic and otherdisadvantages experienced by these childrencompared with middle-class children.
This pernicious rationalization, however,becomes less tenable when the results inFigure 2B are considered. Here, we see thesame initial pattern of low performance onthe initial sound fluency measure. In thisclassroom, however, the experienced teacherused direct instruction and scientifically basedreading research (SBRI) principles to assist thechildren to make good progress, and, as Figure2B shows, more than 80% are at or bench-mark or above. Not all children in Figure 2B,despite excellent instruction, were at bench-mark. Special concerns existed with Student1, who started at a very low level and made al-most no progress. Some concern existed alsowith Students 11 and 18. Student 1 was placedimmediately in a Tier II supplemental instruc-tional program.
The effects of good instruction are cu-mulative as are, unfortunately, the effectsof poor instruction. These effects can beseen clearly in Figures 2C and D. The stu-dents in the whole-language classroom con-tinued from winter to spring to make slowprogress, and more than half remained be-
low the benchmark. In sharp contrast, thestudents in Figure 2D continued to make ex-cellent progress and all were at or above thespring semester benchmark, except for onestudent who joined the class about halfwaythrough the semester. Particularly notewor-thy is Student 2 in Figure 2D, who was Student1 in Figure 2B. This student made excellentprogress through the general classroom pro-gram plus supplemental instruction in Tier II.The results in Figure 2 are limited, but they arefrom real classrooms. There are many class-rooms just like these two classrooms withequally disappointing and inspiring results.
Scientifically based instruction principlesand curricula are critical to RTI successand valid identification of SLD. The afore-mentioned results raise two questions rel-evant to the use of RTI to identify SLD.First, how do we implement universal screen-ing throughout all classrooms in the UnitedStates? Through universal screening, morechildren who are below benchmarks are iden-tified. In a traditional system without screen-ing, many and perhaps most of childrenreading below benchmarks would not beidentified until a later grade. In fact, that iswhat happened prior to universal screeningand RTI when most children who ultimatelyreceived a diagnosis of SLD were not referredand classified until third or fourth grade, atime when interventions are more expensiveand less effective. The case for early screen-ing and early intervention is compelling; yet,the majority of school districts in the UnitedStates still do not implement this practical andeffective practice.
The second question is how do we imple-ment high-quality curricula and instructionbased on well-validated, evidence-basedprinciples much more widely in the UnitedStates? First, such instruction with universalscreening and progress monitoring reducessignificantly the number of children belowacademic benchmarks. Current curricula andinstructional practices often do not imple-ment these principles, and the preparation ofteachers generally does not stress SBRI anddirect instruction (Greenberg & Walsh, 2008;
44 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014
National Mathematics Advisory Panel, 2008;National Reading Panel, 2000; Walsh, 2013).The fact is that schools do not have sufficientresources to serve all of the children whofail to receive high-quality SBRI in Tier II,and teams certainly cannot diagnose all ofthese students as having SLD and serve themin special education. Results at Tier I have aprofound impact on Tier II, and the numberof students who may then go on toward moreintense interventions and consideration ofSLD identification. The danger of incompleteimplementation of Tier I, such as onlydoing universal screening without significantchanges in instruction, is that many morechildren will be identified as below bench-mark, overwhelming the resources at Tier IIand potentially at Tier III as well.
Tier II strategic interventions:Secondary prevention
Some students do not respond sufficientlyeven to the most effective Tier I instructionand curricula. For, perhaps, 10%–15% of stu-dents with greater needs, a second level oftime-limited, more-intense intervention is es-tablished in RTI/MTSS. The second tier is de-livered within the general education programand is part of early identification and interven-tion with academic and behavior problems.
Tier II interventions are delivered in a vari-ety of ways, depending on whether a student’sneeds are academic, behavioral, or both andon the nature of the interventions. Two ap-proaches are prominent in the literature andpractice: problem solving and standard pro-tocol (Burns, Appleton, & Stehouwer, 2005).Some erroneously suggest a dichotomy, or aneither-or relationship, between these two op-tions. In fact, both are used in many individualcases depending on student needs.
Problem solving involves an iterative pro-cess of defining concerns, analyzing currentconditions, including prior knowledge andcurrent interventions, designing interventionsthat are implemented with progress moni-toring, and evaluating results (Bergan, 1977;Bergan & Kratochwill, 1990; Deno & Mirken,1977; Tilly, 2008; Upah, 2008). The problem-
solving methods are applied at Tier II to de-velop individual and, in some cases, small-group interventions delivered in general ed-ucation around academic and/or behavioralconcerns.
Standard protocol interventions focusingon academic or behavioral skill growth are asecond general kind of Tier II intervention(Roberts & Vaughn, 2007; Torgesen, 2002;Torgesen et al., 1999; Vaughn et al., 2003).Standard protocol interventions focusing onspecific skill sets are delivered in groupsof about three to five children because re-search on tutorial interventions indicates thatsmall-group interventions are just as effectiveas individual interventions (Elbaum, Vaughn,Hughes, & Moody, 2000). Standard protocolinterventions are most often used in read-ing, although some standard protocol inter-ventions exist in classroom-related behavior(e.g., Crone, Hawken, & Horner, 2010). Inthe Vaughn et al. approach, the interven-tion was delivered daily over approximately20 weeks in 35-min pull-out sessions. Eachof the five critical components of readingwas taught each day, with greater emphasison weak areas. Principles of SBRI were im-plemented including instruction that is sys-tematic and explicit with frequent studentresponding and feedback (National ReadingPanel, 2000; Snow, Burns, & Griffin, 1998).Progress monitoring and graphing of individ-ual student progress against goals were doneat least once per week, with formative eval-uation rules applied. A significant proportionof the poor readers included in the Vaughnet al. standard protocol intervention made suf-ficient gains to remain in general educationwithout further support, thus very likely im-proving overall achievement in the school andreducing the need for expensive special edu-cation programming.
First, both approaches achieve strongly pos-itive results in research trials and practice sit-uations (Burns et al., 2005). The Burns et al.meta-analysis indicated a median effect size of+1.1 across 24 studies for both approachesto Tier II interventions. It is also importantto note that effect sizes varied from +6.71 to
+0.18, suggesting that simply adopting RTItiers is not sufficient. The interventions inthe tiers must be empirically validated, im-plemented with good fidelity, and revised asneeded through formative evaluation proce-dures.
For many students, both standard proto-col and problem-solving interventions areneeded. The standard protocol interventionmay be the most efficient and effective meansto address the academic problem, whereas in-terventions developed through problem solv-ing often are the most effective means toaddress off-task, disruptive behaviors that in-terfere with learning in the general educa-tion classroom and in small-group tutorial ses-sions (Morgan, Farkas, Tufis, & Sperling, 2008;Torgesen et al., 1999). Most standard proto-col reading interventions now include a pointsystem with backup reinforcers to improvetask engagement, because in previous stud-ies with equivocal results, behavior often in-terfered with efficient learning and improvedprogress (Torgesen et al., 1999; Vaughn et al.,2003). Moreover, problem-solving interven-tions to address disruptive and off-task behav-ior in the general education classroom are es-sential to generalization of achievement gainsfrom the tutorial sessions.
Figures 3 and 4 illustrate the interventionand data-based decision-making processesused in Tier II in example cases of studentswith reading problems. At Tier II, time-seriesanalysis individual graphs are used to guidedecision making. Figures 3A and B depict hy-pothetical children with reading difficultiesin the first grade. In Figure 3A, a successfulTier II intervention is depicted leading to thedecision to return the child to general edu-cation with no additional or supplemental in-terventions. An unsuccessful intervention isdepicted in Figure 3B.
Both these students are in a school thathas adopted an RTI system including uni-versal screening of all children using age-appropriate, curriculum-based measures inreading. Both children were below bench-mark levels in the spring of kindergarten andin the fall of first grade. Additional classroom
interventions were implemented for both,and progress monitoring was increased totwice per month during the fall semester. De-spite the greater instructional intensity andmore frequent progress monitoring with for-mative evaluation in the general educationclassroom, the children were significantly be-low the winter first-grade benchmark in oralreading fluency. The first student also hadlower rates of on-task behavior and engagedin a moderate level of disruptive behavior. Nobehavior issues were reported for the secondstudent.
An individual graph was established for thefirst student (Figure 3A). The essential fea-tures of the graph were the ordinate (verticalaxis) reflecting levels of oral reading fluencyand the abscissa (horizontal axis) representingtime in weeks. A reference line is entered onthe graph representing the benchmark levelin oral reading fluency for students in the mid-dle of first grade to early second grade (20weeks). The initial level is 24 words correctper minute. The slope of the benchmark lineis based on the average rate of growth for first-grade students of 1.5 words correct per week.The goal for the student is set at an ambitiousgrowth level of 2 words correct per week,which allows the student to reach the bench-mark level after 20 weeks. The rationale is thatthe student is receiving the more intense TierII intervention that will, if effective, producea more rapid growth rate.
The student is then placed in a Tier II stan-dard protocol reading intervention with be-havior intervention to increase task engage-ment and reduce disruptive behavior in thegeneral education classroom and tutorial ses-sions. The graph for the first student illus-trates data-based decision making based onweekly progress monitoring. First, the ini-tial growth over the first 2 weeks of inter-vention meets the goal of 1.5 words correctgrowth per week; therefore, the same instruc-tional and curricular procedures are contin-ued. Results over the next 3 weeks do notmeet the goal. Applying the formative evalu-ation rule of making changes in interventionsthat produce insufficient results over two or
46 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014
Figure 3. A, Successful Tier II reading intervention. B, Unsuccessful Tier II intervention. From a tablein “Response to Intervention,” by D. J. Reschly and M. K. Bergstrom, 2009, In The Handbook of SchoolPsychology (4th ed., pp. 434–460), New York: Wiley. Copyright 2009 by the John Wiley & Sons, Inc.Adapted with permission.
three data points, the intervention is changedboth to better meet the child’s needs and toimprove the results. The vertical line indicatesthe change at Week 5.
Instruction and behavior intervention con-tinue, as does progress monitoring. Over thenext few weeks, the rate of progress meetsthe goal and then exceeds the goal for 3 con-secutive weeks. Again applying the formativeevaluation decision-making rules of makingchanges if the results either fail to meet or ex-ceed the goal for 3 weeks, the goal now is in-creased from 2 to 2.5 words correct per week,a new goal line is established (not shown inFigure 3A) and a vertical line is entered atWeek 15 to signify a change in the goal. In-struction and behavior intervention continue.
By Week 20, the results indicate that thechild has caught up with the benchmark interms of level of performance and rate ofprogress. At this point, the Tier II interven-tion is reduced in intensity through fewersessions per week, with progress monitoringcontinued through the 24th week. The child’sprogress continues over the next 4 weeks ator above the benchmark level, and the TierII intervention is discontinued. The behaviorplan is also reduced in intensity; however,weekly progress monitoring is continued forat least another 4 weeks to ensure that be-havioral progress continues as well, leadingto the decision-making stage discussed in thenext section.
A second Tier II intervention with insuffi-cient results is depicted in Figure 3B. Againa standard protocol reading intervention wasimplemented, with weekly progress moni-toring. The students’ initial growth met thegoal, but by Week 3, results were insufficientto meet the goal. Intervention changes weremade at Weeks 5, 9, 13, and 17. Despite theseinstructional enhancements, the studentdepicted in Figure 3B failed to meet thegoal, and at the end of the 20 weeks, thestudent was still well below the benchmark.The child made progress (growth rate of ∼1word correct per week) but not at a rate tocatch up with the benchmark. On the basisof these results, there is a significant gap in
level of performance and rate of progress.Moreover, continuation of the same rate ofprogress would require many more monthsand perhaps years for the student to meet thebenchmark, a basic level of performance de-fined previously. Furthermore, the resourcesneeded to support a long-term interventionof this nature typically are beyond whatcan be provided in general education. TierIII is considered when students likely needintense instruction and significantly moretime to reach benchmarks based on the rateof progress achieved in Tier II.
Decision making at Tier II
Decisions are made on the basis of the re-sults obtained through the Tier II interven-tion(s). All decisions are data based, usingprogress monitoring data and performance to-ward goals related to benchmarks. The deci-sion choices are as follows:
1. Discontinuation and return to the gen-eral education classroom full-time if theresults meet benchmarks, with gradualdiscontinuation over 3–4 weeks of theTier II supports and progress monitor-ing.
2. Discontinuation and consider Tier IIIbecause the results were insufficient tomeet benchmarks despite implementa-tion of an evidence-based interventionthat was revised several times to im-prove results. Many children in well-established RTI/MTSS systems undergoa comprehensive evaluation at this pointto determine disability status and specialeducation need.
3. Continuation of the intervention for afew more weeks because the results areapproaching benchmarks levels, and afew more weeks likely will be sufficientto meet benchmarks.
Tier II models and applications differ on anumber of characteristics depending on therelative emphasis on problem-solving versusstandard protocol–guided interventions andthe ultimate purpose of early identificationand treatment versus identification of SLD.In one version, called smart RTI, the main
48 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014
aim seems to be identification of strugglingstudents as SLD as soon as possible through arelatively brief intervention (4–6 weeks) anddecisions based on prediction of likelihoodto reach benchmarks (Fuchs, Fuchs, & Comp-ton, 2012). A potential major flaw with thisapproach is the relatively low number of datapoints used both to predict outcomes and toshift children from general to special educa-tion. Recent research indicates that more datapoints are needed to establish a stable trendline, an essential prerequisite to accurate data-based decision making at Tiers I and II (Christ,Zopluoglu, Monaghen, & Van Norman, 2013;Shapiro, 2013). Smart RTI also seems to ignoreresults from Vaughn et al., which show thatsome children respond to reach benchmarkslevels after 10–20 weeks of Tier II interven-tion after being low responders in an initial10-week period. Smart RTI is an example ofthe existing variations and primary purposesof RTI/MTSS.
Tier III: Intensive, long-termintervention
Tier III is reserved for those students whodo not respond sufficiently to Tier II and wholikely need intensive, long-term intervention.In some cases, Tier III involves continuationof the same level of resources over a longertime period (anticipated to be a year or more)and/or the utilization of additional resources.In Tier III, progress monitoring occurs at leastweekly related to goals with formative evalua-tion decision rules. Placement criteria in TierIII should always be accompanied by exit cri-teria defining the level of progress (usuallystated in terms of state benchmarks and/or be-havioral expectations) that will trigger move-ment to lower tiers.
Contrary to some misconceptions, Tier IIIdoes not exclusively involve special educa-tion. Special education eligibility and pro-gramming may or may not be involved withTier III. First, some Tier III students need moreintensive interventions but not the speciallydesigned instruction that is the hallmark ofspecial education. For example, many chil-dren and youth with internalizing problems
do not need special education to reach aca-demic benchmarks, but they do need mentalhealth services to improve emotional regula-tion competencies. For some students withintense and persistent needs, other general ed-ucation programs may be available and moreappropriate. Special education will be consid-ered for many, but not all students with in-tense and persistent learning and/or behaviorproblems.
SPECIAL EDUCATION ELIGIBILITY ANDSLD DIAGNOSIS IN RTI/MTSS SYSTEMS
Information from Tiers I and II is essential,but not sufficient, to meet the legal require-ments both to determine special educationeligibility and to diagnose SLD. If specialeducation is considered subsequent to Tier II,a comprehensive evaluation is required thatmeets the legal standards established in staterules and the Individuals with DisabilitiesEducation Act (IDEA, 2004, 2006). Theprincipal legal requirements concerningspecial education eligibility determinationestablished in IDEA and adopted by statesappear the Code of Federal Regulations (CFR)at 34 C.F.R. § 300.301 through 34 C.F.R.§ 300.306 in the section, Evaluations andReevaluations. All special education per-sonnel involved with staffing teams makingeligibility decisions should be intimatelyfamiliar with these requirements. Many of therequirements appeared first in the Educationof All Handicapped Children Act (1975, 1977)and have not changed over the last 35 years.
The legal requirements just cited establisha two-pronged criterion for special educationeligibility that should have equal weight indecision making:
� First, an educational disability must bediagnosed using classification criteria es-tablished by the state education agency(SEA). States must serve the children andyouth represented in the 13 disability cat-egories described in IDEA at 34 C.F.R.§ 300.8, but SEAs have wide discretionin determining the number of disabilitycategories, the names of the categories,
and the classification criteria. (Reschly &Hosp, 2004)
� Second, the disability, if one exists, mustcause adverse impact on the child’s ed-ucation and the child must need specialeducation, that is, specially designed in-struction and, if necessary to provide anappropriate education, related services aswell.
Both criteria are equally important. Thereare children who have a disability but donot need special education and some childrenwho need special education but do not meetthe classification criteria for a disability.
The essential role of effective instructionin the general education classroom and TierII before eligibility determination is furtheremphasized in legal provisions at 34 C.F.R.§ 300.306 forbidding the determination thatthe child is eligible if the determinant factorin eligibility is “lack of appropriate instruc-tion in reading, including the essential com-ponents of reading instruction” (as defined inthe No Child Left Behind Act of 2002; seeprior discussion of reading), or “lack of ap-propriate instruction in math,” or “limited En-glish proficiency.” These requirements focusattention on the content of the general ed-ucation curriculum (e.g., does it provide in-struction in the five reading content areas—phonemic awareness, phonics, vocabulary,reading fluency, and comprehension?) andthe appropriateness of the instruction. Thecurriculum content and instructional appro-priateness might logically be interpreted asthe degree to which children are on course tomeet benchmark expectations, a critical TierI question in RTI. If more than 15%–20% ofstudents are not on course to meet bench-marks, it is logical to implicate the quality ofthe curriculum and instruction as contribut-ing significantly to the low achievement.
Comprehensive evaluation
Students considered for special educationare entitled to a full and individual, compre-hensive evaluation that identifies educationaland behavioral needs. A critical regulation un-changed since 1977 specifies, “The child is as-
sessed in all areas related to the suspected dis-ability including, if appropriate, health, vision,hearing, social and emotional status, generalintelligence, academic performance, commu-nication status, and motor abilities” (34 C.F.R.§ 300.304(b)(4)).
This and other regulations suggest that ex-tensive information over multiple domainsshould be gathered and considered in de-termining disability eligibility, educationalneeds, and special education placement. Sig-nificantly, this legal requirement allows pro-fessional judgment about the domains to beassessed. The regulation does not mandate as-sessment in all the areas listed; rather, it hasthe qualification, if appropriate. The require-ment should be interpreted as requiring con-sideration of many domains (perhaps ≥12)through screening, followed by, when appro-priate, in-depth assessment within specific do-mains (Reschly, 2005, 2008). If screening sug-gests the possibility of an educationally relateddeficit in the domain, then in-depth assess-ment is required. If screening indicates a lowprobability of an educationally related deficit,then in-depth assessment is wasteful and irrel-evant to the goals of the evaluation.
Eligibility evaluations vary by state specialeducation system characteristics, especiallythe use of noncategorical identification forhigh-incidence disabilities (Tilly, Reschly, &Grimes, 1999). To date, most states continueto use categorical eligibility (Reschly & Hosp,2004). The 12 domains in which screeningshould occur for all children and youth arehealth, vision, hearing, general intellectualfunctioning, reading, math, language writtenand spoken, adaptive behavior, communica-tion, behavior, emotional regulation, and mo-tor. In-depth assessment is needed only inthose domains in which screening indicatespossible educationally related deficits. Thisapproach is illustrated in Table 1 for 4 of the12 domains.
For example, the school entrance physicalexamination, teacher observations, and nurserecords and notes are sufficient for nearly allchildren to screen for an educationally re-lated health deficit. However, consider the
Adaptive behaviorinterventions. ConsiderID eligibility and specialeducation eligibility.
Intelligence Achievement test results,teacher observations,and adaptive behaviorscreening results.
If no evidence of ID, stop.IF ID possible, proceedto in-depth assessment
Administration of acomprehensive test ofgeneral intellectualfunctioning, interpretedappropriately.
Determination of IDeligibility on theintelligence dimension.Consideration of specialeducation eligibility andplacement.
Note. CBM = curriculum-based measurement; ID = intellectual disability. Four domains are included in the table. Eightother domains should be evaluating using the same screening and decision-making process, followed by, if indicated,in-depth assessment. The other domains are vision, hearing, math, language written and spoken, communication,behavior, emotional regulation, and motor. From “Response to Intervention,” by D. J. Reschly and M. K. Bergstrom,2009, In The Handbook of School Psychology (4th ed., pp. 434–460), New York: Wiley. Copyright 2009 by the JohnWiley & Sons, Inc. Adapted with permission.
situation of a child observed by the teacherto have higher rates than most children ofneeding to go to the restroom, being thirsty,and variations in energy level. These aresigns of a possible diabetic condition. Thescreening information just described is not,of course, sufficient for a diagnosis. Giventhis screening information, an in-depth assess-ment is needed through a specialized medi-cal evaluation. Similar reasoning applies to allother areas. For example, consider a child re-ferred because of behavior issues for whomschool records and teacher classroom rat-
ings indicate reading at or above national agenorms. This student does not, of course, needan in-depth, diagnostic reading assessment.Screening first, followed by in-depth assess-ment as needed, is the basis for good educa-tional decisions and consistent with federalIDEA legal requirements.
The traditional practice of administeringan individual general intellectual functioningmeasure to nearly all referred children mustbe reconsidered (Fletcher, Coulter, Reschly,& Vaughn, 2004; Fletcher, Lyon, Fuchs, &Barnes, 2007; Fletcher & Reschly, 2005;
Reschly, 2004). First, RTI must be allowed bystates as a means to determine SLD eligibility(see later discussion). If IQ–achievementdiscrepancy and cognitive processing arereplaced by RTI, the next issue is to rethinkthe need for assessment of general intellectualfunctioning in disability determination. If RTIis used in a categorical disability system, allstudents should be screened for significant,educationally related deficits in generalintellectual functioning through examinationof group achievement test results, samplesof academic work, and teacher ratings. If theinformation from these sources suggests pos-sible intellectual functioning at a significantlysubaverage level, then and only then are tra-ditional measures of intellectual functioningrelevant to educational decision making. Tra-ditional intelligence tests are useful in thesecircumstances to rule out mild intellectualdisability and as an exclusion factor in thediagnosis of SLD. Behavior screening and, ifindicated, in-depth assessment can rule outemotional disturbance. Other possible causesof the poor achievement that persists despitesystematic interventions can also be ruled outthrough screening and, if indicated, in-depthassessment. Adoption of RTI and problemsolving in the identification of disabilities,especially SLD, should reduce IQ testing inschools by about 90% (Ikeda et al., 2007;Marston, 2002; Reschly, 2005).
SLD diagnosis with RTI/MTSS
In evaluating the appropriateness ofRTI/MTSS to identify SLD, with a comprehen-sive evaluation as described earlier, the overallproblem of SLD identification must be consid-ered. As noted, more than 35 years ago, afterreporting the results of an initial evaluation ofthe intellectual ability–achievement discrep-ancy method, Danielson and Bauer (1978)commented, “One wonders if a technicallyadequate solution to the problem of LD iden-tification exists.” (p. 175). The same cautionexists today. The choices are not between per-fect SLD identification methods but betweenmethods with varying degrees of inadequa-cies. The RTI/MTSS approach to SLD identifi-
cation is superior to other methods for a vari-ety of reasons, which are presented later.
Instructional relevance
The RTI/MTSS approach focuses explicitlyon the goals from the school curriculum, us-ing measures directly related to those goals.The goals are based on the community con-sensus of what is important for children andyouth to learn.
Scientifically based interventions
Scientifically based or evidence-based inter-ventions are the foundations for all interven-tions at Tiers I, II, and III. The interventionsvary in intensity at each tier, with intensitydefined as the degree of instructional explicit-ness, measurement precision, and group size.Data-based decision making using instruction-ally relevant measures that are sensitive tosmall increments in academic and behaviorgrowth is the foundation for RTI/MTSS. De-cisions are based on tangible reflections ofprogress relevant to important academic andbehavioral outcomes.
Improvement of special educationservices
A major and infrequently cited benefitof RTI/MTSS is the improvement of specialeducation services to children through thedevelopment of information that informs thedesign and implementation of the individ-ual educational program (IEP). Time-seriesanalysis graphs are developed at Tier II thattypically are useful in designing the IEP and inmonitoring progress after special educationservices are implemented. Despite nearly 30years of research indicating the benefits ofprogress monitoring and formative evaluationto children (and teachers; Fuchs & Fuchs,1986; Kavale, 2007), the vast majority ofcurrent special education IEPs and programsdo not use time-series analysis graphs withprogress monitoring and formative eval-uation. These programming componentsenhance special education results and aremore likely to be implemented after identi-fication of SLD through RTI/MTSS because
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they come more or less naturally from theidentification process and procedures.
Traditional SLD concepts
Much could be said about the flaws in thetraditional definition of SLD, particularly theinitial error of framing SLD in terms of pro-cesses; however, two concepts have beenpresent in nearly all discussions of SLD iden-tification (Fletcher et al., 2007). First, thereis the concept of unexpected low achieve-ment. The challenge is to determine unex-pected from what? The traditional solutionwas the discrepancy between intellectual abil-ity and achievement in designated areas (“Pro-cedures for Evaluating,” 1977). No one was re-ally happy with this solution (e.g., Kaufman,2004; Senf, 1978), although it survived untilsubstantial and replicated research clearly es-tablished flaws in the method and the harm tochildren of delaying initial diagnosis and treat-ment of SLD to later ages, the wait-to-fail effect(Stuebing, Barth, Molfese, Weiss, & Fletcher,2009).
Unexpected low achievement in RTII/MTSS diagnoses of SLD is based on inadequateresponse to high-quality instruction imple-mented over a substantial time period, guidedby progress monitoring and formative evalua-tion data-based decision rules. An inadequateresponse to these programming conditionsthat are well below benchmarks is an unex-pected result, hence part of the basic conceptof SLD.
Exclusion of other plausible causes of thelow achievement is the second foundationalconcept in the SLD diagnostic construct.Other plausible causes that are addressed andruled out are intellectual disability, emotionaldisturbance, sensory or motor impairments,cultural differences, economic disadvantage,and limited English proficiency (IDEA, 2006;34 CFR § 300.309(a)(2)). The exclusion fac-tors are assessed through screening for eachbefore RTI is initiated or during the RTI/MTSScomprehensive evaluation. Information forscreening is followed by in-depth assessmentif potential problems are indicated in a spe-cific domain.
POLICY AND LEGAL BASIS OF RTI/MTSSIN IDENTIFICATION OF SLD
The policy and legal bases for SLD identifi-cation through RTI/MTSS are well establishedin IDEA (2004, 2006; 34 C.F.R. § 300.309). Re-sponse to intervention is one of two methodsendorsed in the special regulations for SLD.The RTI/MTSS approach is explicitly men-tioned at 34 C.F.R. § 300.309,
The child does not make sufficient progress to meetage or State-approved grade-level standards in oneor more of the areas identified in paragraph (a)(1)of this section when using a process based on thechild’s response to scientific, research-based inter-vention.
States must permit the RTI/MTSS method,but other methods can be adopted includ-ing an alternative discussed later or research-based procedure(s) established by the state.In a recent, as yet incomplete, survey of statepolicy, all states require some form of RTIas part of SLD eligibility, but many furtherrequire additional procedures such as deter-mining strengths and weaknesses in cognitiveprocessing and/or the severe discrepancy be-tween intellectual ability and achievement. Aspermitted by IDEA regulations, some statesuse RTI/MTSS as the only method for the iden-tification of SLD (e.g., Colorado, Iowa, WestVirginia).
ALTERNATIVES TO RTI/MTSSIDENTIFICATION OF SLD
The principal alternative to determinationof SLD through RTI/MTSS is the IDEA reg-ulation regarding strengths and weaknesses;specifically,
The child exhibits a pattern of strengths and weak-nesses in performance, achievement, or both, rel-ative to age, State-approved grade-level standards,or intellectual development, that is determined bythe group to be relevant to the identification ofa specific learning disability, using appropriate as-sessments, consistent with §§300.304 and 300.305.(IDEA, 2006; 34 C.F.R. § 300.309)
The strengths and weaknesses method ofSLD identification is extremely loose, mean-ing that almost any measurement procedureproducing a pattern of strengths and weak-nesses that is determined by the staffingteam to be indicative of SLD can be ap-plied. In fact, only one state (Maine) cur-rently specifies specific criteria for cognitivestrengths and weaknesses (Oliver & Reschly,2004). The regulation on strengths and weak-nesses is used frequently by states to jus-tify the continued use of the traditional se-vere discrepancy between intellectual abilityand achievement in SLD identification. A crit-ical and often-misunderstood phenomenonis that large variations across cognitive pro-cess, achievement, and intellectual function-ing measures are normal and should be ex-pected. Moreover, strengths and weaknessesin these profiles have never been a uniquecharacteristic separating students with SLDfrom normally achieving children (e.g., Fuchs,Fuchs, & Deno, 1985). Strengths and weak-nesses across a profile of scores founder asindicators of disability due to large reliabilityproblems with difference scores and the er-roneous expectation that normally achievingchildren will have flat profiles across a full bat-tery of tests. To repeat, test profile scatter isnormal.
Much has been written about processingand SLD identification over the last 40 years.Some traditional SLD scholars and advocatescontinue to endorse a processing basis for SLD(e.g., see review by Fuchs, Hale, & Kearns,2011) while acknowledging,
Scientific evidence does not justify practitioners’use of cognitively focused instruction to acceler-ate the academic progress of low-performing chil-dren with or without apparent cognitive deficitsand an SLD label. At the same time, research doesnot support “shutting the door” on the possibilitythat cognitively focused interventions may eventu-ally [emphasis added] prove useful to chronicallynonresponsive students in rigorous efficacy trials.(p. 102)
In a later article, Kearns and Fuchs (2013)reported a meta-analysis that essentially
yielded negative results regarding theusefulness of cognitively focused instruction.
The history of processing constructs andSLD over the last 40 years is an excellentexample of faith triumphing over reality.The fundamental claim that SLD is causedby processing deficits and that a pattern ofprocessing strengths and weaknesses mustbe identified in SLD identification persistsdespite consistent disconfirming evidence,regardless of whether the processes areconceptualized as information processingmodalities (e.g., auditory, visual learners),cognitive style (e.g., simultaneous, sequentialprocessing), or cognitive processes (e.g.,memory, executive function, planning).Ample research substantiates the nearly uni-formly negative results regarding processingand interventions with children with SLD(e.g., Hammill & Larsen, 1974, 1978; Kavale,2007; Kearns & Fuchs, 2013; Mann, 1979;Pashler, McDaniel, Rohrer, & Bjork, 2009).
Much more could be said about other alter-natives to RTI/MTSS for identifying SLD. Inter-ested readers are referred to two particularlyinsightful chapters in an edited volume thatdespite being 10 years old are excellent de-scriptions of current issues in using either se-vere discrepancy or pattern of strengths andweaknesses in cognitive processes to identifySLD. In short, both severe discrepancy andpatterns of strengths and weaknesses are se-riously flawed as identification methods andcontribute little or nothing to effective in-terventions (Fletcher et al., 2002; Gresham,2002). The RTI/MTSS approach is highly rec-ommended here, not because it is perfect butbecause it is better in accurately identifyingchildren and youth with SLD and creatingconditions for effective special education in-terventions than any of the alternative meth-ods of SLD identification.
CHALLENGES IN IMPLEMENTINGRTI/MTSS IN SLD IDENTIFICATION
The RTI/MTSS approach is complex,involving multiple levels of intervention in-tensity and measurement precision, delivered
54 TOPICS IN LANGUAGE DISORDERS/JANUARY–MARCH 2014
across general, remedial, and special educa-tion. Each of the key components at eachtier has a strong evidence base, involving, forexample, progress monitoring and formativeevaluation, direct and explicit instruction,scientifically based reading and mathematicsinstruction, and behavior interventions usingprinciples from applied behavior analysis(Mayer, Sulzer-Azaroff, & Wallace, 2011). Posi-tive results are reliably associated with each ofthese and other components. The more com-plex issue is whether these components canbe implemented with good fidelity as a sys-tem of intervention and decision making. Thesystem challenge is implementing not onlythe components with good fidelity but alsothe integrated decision making at all levelssimultaneously. Some evidence suggests thatthe system implementation is possible butnot automatic or necessarily easy (Ikeda et al.,2007).
Fidelity of implementation
The fidelity of RTI/MTSS must be evaluatedin the context of other alternatives to SLDidentification. Research on the fidelity of im-plementing the severe discrepancy methodof identifying SLD is instructive. Several stud-ies in different states established enormousproblems in the fidelity with which the se-
vere discrepancy method was implemented,with about one third to more than one halfof all students with a diagnosis of SLD notmeeting the state-adopted severe discrepancycriteria, even though the data came fromstates that at that time had explicit tablesto specify the discrepancy needed to meetthat part of the state SLD classification rules(Kavale & Reese, 1992; Mcleskey & Waldron,1991). Regardless of the SLD identificationmethod, significant resources will have to bedevoted to ensuring fidelity of implementa-tion, including preparation of key personnel,specification of key steps, monitoring imple-mentation, and evaluating decision making(Greenberg & Walsh, 2008; Steiner & Rozen,2004; Walsh, 2013; Zigmond, Kloo, & Stanfa,2011).
SLD identification trends
The national trend in identification of SLDis toward gradually lower proportions of theoverall school-age population. In Figure 4,this trend is depicted using data publishedin the National Digest of Educational Statis-tics (Snyder & Dillow, 2012). The last datapoint was determined by using data fromwww.ideadata.org and the projected nationaland state enrollment in P-12 public educa-tion. To serve as a contrast to the rather large
0
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2005–2006
2006–2007
2007–2008
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Sp/L
Figure 4. Prevalence of the Sp/L and SLD population 3–21 years of age as a proportion of theP-12 public school enrollment: 1977 to 2011–2012. Sp/L = speech–language-impaired; SLD = specificlearning disability. From Table 48 in “Digest of education statistics 2011 (NCES 2012-001),” by T. D.Snyder and S. A. Dillow, 2012. Copyright 2012 by the Institute of Education Sciences. Adapted withpermission.
fluctuations in SLD at selected points since1977, the proportions of children and youthidentified because of speech–language impair-ments are also represented. Overall, identifi-cation of students with disabilities, aged 3–21years, has changed from a high at 13.8% ofthe P-12 public school population in 2004–2005 to 13.0% in 2010–2011. The peak SLDidentification was at 6.1% of the P-12 publicschool population in 2000–2001, declining to4.7% in 2011–2012. The numerator reflectingthe SLD or speech–language-impaired (Sp/L)population 3–21 years of age somewhat ex-aggerates the prevalence of these disabilitiesin the public school population that generallydoes not include children and youth at 3, 4,19, 20, and 21 years of age. The trends areclear. The Sp/L population has been remark-ably stable, whereas the SLD population hasvaried considerably. The main point of thesedata in relation to the RTI/MTSS method ofdetermining SLD eligibility is that prevalencehas continued to decline in a trend that be-gan with the 2001–2002 school year and con-tinues as RTI/MTSS has become increasinglyprominent since 2005. It also should be notedthat the prevalence of other health-impaireddisability category has increased over thissame time period, but not as much as SLD hasdeclined.
CONCLUSION
The use of RTI to identify SLDs is intendedto fully integrate educational interventionsand measurement from general educationthrough special education. Multiple tiers dif-fering in intervention intensity, measurementprecision, and numbers of students partici-pating in each are implemented with multiplepurposes, including improving prevention,early identification and treatment, identifica-tion of SLD and other disabilities, and specialeducation services. Other SLD identificationmethods exist, but research on them indi-cates significant problems with reliabilityand validity, particularly regarding improvinginstructional programs for students whostruggle academically and behaviorally. Manychallenges with all SLD identification meth-ods exist, particularly the fidelity with whichthey can be implemented as intended. Thesechallenges are worth addressing in RTI/MTSSbecause of the benefits to children in theforms or earlier intervention, application ofevidence-based practices with progress mon-itoring and formative evaluation, and imple-mentation of an iterative process of definingproblems, analyzing conditions, intervening,adjusting interventions based on results, anddata-based decisions about outcomes.
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