Response to Intervention (RtI) in General, Remedial and Special Education

1
Response to Intervention (RtI) in General,
Remedial and Special Education
Daniel J. Reschly dan.reschly_at_vanderbilt.edu Ore
gon School Administrators Eugene, OR September
19, 2005
2
What To Do With Egbert??

• 1st Grade, falling behind in reading
• Slow progress compared to peers
• Likely to miss benchmarks related to passing 3rd
  Grade reading test
• Distractible, inattentive, disruptive
• Sound Familiar
• WHAT HAPPENS NEXT? Driven by Federal Legislation

3
Progression of Federal Education Legislation
1960s 2000s Assistance
Results __________________________ ESEA EHA Goa
ls NCLB/ 2000 Rdg
1st Process Results Number Served Goals
4
NCLB Long-term Goals

• By 2013-2014, all students will reach high
  standards, at a minimum, attaining proficiency or
  better in reading and mathematics.
• By 2005-2006, all students will be taught by
  highly qualified teachers.
• All students will be educated in learning
  environments that are safe, drug free, and
  conducive to learning.
• All students will graduate from high school.

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Scientifically-based Interventions

• Strong internal validity, did the intervention
  actually make a difference
• Rigorous experimental designs
• Random assignment
• Subjects described in detail
• Contrasting intervention conditions

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Not Scientifically-based

• Absent experimental designs-no control group no
  random assignment
• Simple pre post-test designs
• Theoretically-driven, but no data
• Claims not supported by data
• Claim that it is impossible to conduct
  experimental investigations
• Claims from small N studies, no control group,
  data not published in refereed journals

7
Policy Analysis Influences

• Snow, C. E., Burns, M. S. Griffin, P. (Eds.)
  (1998). Preventing reading difficulties in young
  children. Washington DC National Academy Press.
• Teaching children to read An evidence-based
  assessment of the scientific research literature
  on reading and its implications for reading
  instruction http//www.nichd.nih.gov/publications/
  nrp/smallbook.pdf
• Minority Disproportionality Report, National
  Academy of Sciences/National Research Council
  Panel Report
• http//www.nap.edu/catalog/10128.html
• LD Summit Researchers Recommendations (Bradley et
  al., 2002)
• Presidents Commission on Excellence in Special
  Education (2002) report, http//www.ed.gov/inits/c
  ommissionsboards/whspecialeducation/reports.html

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What Next for Egbert?

• Chapter I tutoring
• Pull out, brief
• Poor results
• Little benefit despite billions spent
• Poor instruction, little progress monitoring,
  rare changes in instruction based on results
• Billions spent, dubious benefits

9
What Next for Egbert?

• Pre-referral Intervention
• For most, meaningless step
• Behavioral Definition? 15
• Data prior to intervention? 10
• Written Plan? 15
• Progress monitored/changes? 5
• Compare pre to post 10

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PROBLEM SOLVING CHART
Does the damn thing work?
Yes
No
Dont mess with it!
Did you mess with it?
You Idiot!
Yes
No
No
Will you catch hell?
Hide it!
Yes
Does anyone else know?
No
Yes
You poor slob!
Ignore it
Can you blame somebody else?
No
Yes
NO PROBLEM
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Refer Egbert for Special Education Consideration

• Comprehensive Evaluation-Battery of Tests,
  common battery?
• Assessment largely outside of the natural context
• Dubious generalizations from test behavior to
  classroom
• Eligibility assessment unrelated to intervention
• Team decision-making
• Egbert not eligible at 1st, 2nd, or 3rd grade
• WAIT TO FAIL EFFECT

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Categories Meaningful?

• OR
• MR 0.4 (NJ) to 3.0 (WV) 7Xs 0.6
• ED 0.1 (AR) to 2.0 (MN) 20Xs 0.8
• LD 2.7 (KY) to 9.3 (RI) 3Xs 5.7
• Sp/L 0.8 (HI) to 3.8 (WV) 5Xs 2.8
• OHI 0.1 (MS) to 2.1 (RI) 21Xs 1.0
• All 9.7 (CO) to 17.9 (RI) 2Xs 12.0
• What Accounts for the Differences?? Also
  differences between LEAs within states
• 2002-2003, age 6-17, school enrollment, Table
  AA-13, www.IDEAdata.org

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Foundations for Policy Changes What Does Work?
Sp Ed Placement??

• Treatment/Intervention aEffect Size
• EMR/Sp. Ed. Placement (IQ 60-75) -.14
• Slow Learner/Sp. Ed. IQ 75-90 -.34
• SLD and E/BD Sp. Ed. .29
• Traditional Placement Practices???
• Weak Relationships to Outcomes
• Note Effect size is expressed in SD units,
  analogous to a z-score

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IDEA 2004 Statute Re LD Identification

• Re SLD, the local educational agency shall not
  be required to take into consideration whether
  the child has a severe discrepancy between
  achievement and intellectual ability
• The LEA may use a process which determines if a
  child responds to scientific, research-based
  intervention
• RTI

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IDEA 2004 Proposed Regulations Re LD
Identification 300.307 Specific learning
disabilities

• (a) General. State must establish criteria and
  LEA must use state criteria
• (1) State can prohibit use of severe discrepancy
  between achievement and intellectual ability
  (severe discrepancy)
• (2) State cannot require use of severe
  discrepancy
• (3) State must permit the use of a process that
  determines if the child responds to scientific,
  research-based intervention (Response to
  Intervention or RtI)
• (4) State may permit the use of other
  alternative research-based procedures

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IDEA 2004 Proposed Regulations Re LD
Identification

• 300.308 Group members. No significant changes
• 300.309 Determining the existence of a specific
  learning disability.
• (a) The group described in 300.308 may
  determine that a child has a specific learning
  disability if
• (1) The child does not achieve commensurate with
  the childs age in one or more of the following
  areas, when provided with learning experiences
  appropriate for the child's age
• Adds Reading fluency to the existing 7 areas

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300.309 Determining the existence of a specific
learning disability continued

• (2)
• (i) The child fails to achieve a rate of learning
  to make sufficient progress to meet
  State-approved results in one or more of the
  areas identified in paragraph (a)(1) of this
  section when assessed with a response to
  scientific, research-based intervention process
• or

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300.309 Determining the existence of a specific
learning disability continued

• or
• (ii) The child exhibits a pattern of strengths
  and weaknesses in performance, achievement, or
  both, relative to intellectual development, that
  is determined by the team to be relevant to the
  identification of a specific learning disability,
  using appropriate assessments consistent with
  300.304 and 300.305 and

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300.309 Determining the existence of a specific
learning disability continued

• NEW AND SIGNIFICANT
• (b must consider, as part of the evaluation
  described data that demonstrates that
• (1) Prior to, or as a part of the referral
  process, the child was provided appropriate
  high-quality, research-based instruction in
  regular education settings, consistent with
  section 1111(b)(8)(D) and (E) of the ESEA,
  including that the instruction was delivered by
  qualified personnel and
• (2) Data-based documentation of repeated
  assessments of achievement at reasonable
  intervals, reflecting formal assessment of
  student progress during instruction, was provided
  to the child's parents.

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Multi-Tiered Academic Interventions of Increasing
Intensity and Measurement Precision

• Academics (Empirically validated instruction)
• Level I General Education All students
• Level II Standard Protocol and Problem Solving
  Small group and individualized interventions with
  eligibility determination if response is
  insufficient
• Level III Special education More intense
  services brought to student

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Multi-Tiered Academic Interventions of Increasing
Intensity and Measurement Precision

• Behavior-Empirically validated
• Level I General Education School wide positive
  discipline
• Level II Standard Protocol Treatments and
  Problem Solving Classroom organization and
  management and targeted individual interventions
  in general education. Eligibility determination
  if necessary.
• Level III Special education More intense
  services brought to the students

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Tier I Primary Prevention

• Scientifically-based instruction
• Curricula-content
• Teaching methodology
• Periodic Assessment of Progress
• Screen all students, begin in mid-kindergarten 3
  times per year
• More intense instruction and monitoring for
  students below class medians
• Connect results to benchmarks, additional
  assistance to non-predictors
• Emphasis on Prevention

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Tier I cont.

• Low performing students
• Assess progress monthly
• Establish additional learning opportunities using
  specialized materials and instruction
• In general education classroom
• Grouping students
• Tutoring by paraprofessionals
• Train parents when appropriate

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Tier I Case Example Behavior

• Egbert middle of Ktg.
• Teacher observation of behavior
• Eggie is aggressive toward other children and,
  occasionally, toward adults
• Disrupts classroom activities, large and small
  group settings
• Now What?
• Ensure effective classroom organization and
  management Rules, expectations, examples,
  consistent application, etc.
• Focus attention on positive behaviors, ignore
  (when possible) negative behaviors
• Clear consequences for aggressive behavior toward
  others (inclusion time out)

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Reading Benchmarks
Big Idea of Literacy CBM Measure
Indicator of Risk-KTG Letter Naming Fluency
Phonemic Awareness Initial Sound Fluency Phoneme Seg Fluency
Alphabetic Principle Nonsense Wd Fluency
Accuracy and Fluency with Text Oral Rdg Fluency (ORF)
Comprehension ORF and Retell Fluency
Vocabulary Word Use Fluency
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Reading Benchmarks (DIBELS)
Age/Grade Measure Fluency (FL) Criterion
Winter KTG Letter Naming Fl Initial Sound Fl 25 sounds per minute (pm)
Spring KTG Phoneme Seg 35 sounds pm
Winter 1st gr. Spring 1st gr. Spring 2nd gr. Spring 3rd gr. Nonsense WD Oral Rdg Fluency Oral Rdg Fluency Oral Reg Fluency 50 sounds pm 40 wds pm 90 wds pm 110 wds pm

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Tier I Case Example Academics

• Egbert middle of Ktg.
• Screening data, Eggie below benchmarks for Ktg in
  letter-sound recognition
• Now What?
• Classroom instruction for all children
  emphasizing phonemic recognition skills
• Increase assessment once per month for Eggie and
  others similar to him
• Additional small group instruction in the
  classroom with continued monitoring

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Tier I Case Example Behavior

• Egbert middle of Ktg.
• Teacher observation of behavior
• Eggie is aggressive toward other children and,
  occasionally, toward adults
• Disrupts classroom activities, large and small
  group settings
• Now What?
• Ensure effective classroom organization and
  management Rules, expectations, examples,
  consistent application, etc.
• Focus attention on positive behaviors, ignore
  (when possible) negative behaviors
• Clear consequences for aggressive behavior toward
  others (inclusion time out)

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Tier I Screening in General Education
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3rd Grade Classroom Example

• Did not pass Passing Scores

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Results of Tier I

• Prevention Effect
• Measure progress monthly for children below
  benchmarks
• Many children below Curriculum Based Measurement
  Reading benchmarks respond to general education
  classroom interventions.
• Non-responders?
• Tier II interventions provided

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Tier II Secondary Prevention

• Academics Standard protocol treatments
• Small group, pull out, similar needs
• More intense instruction and monitoring
• 5-component reading interventions, with emphasis
  on weak components
• 10-20 weeks of intervention
• Not individualized, may not deal with behavior
• Early identification-early intervention

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Tier II cont. Academics

• Direct instruction, explicit teaching
• I do it We do it together You do it with
  feedback You do it to automaticity
• Focus on skills in weak areas, alphabetic
  principle, fluency, vocabulary, comprehension
• All components included and taught explicitly
• Progress monitoring weekly, graphed, formative
  evaluation
• 20 weeks of explicit instruction
• Decisions based on level and rate of learning in
  relation to benchmarks

34
Tier II cont. Behavior

• Eggie Classroom disruptive behaviors and
  aggression continue at unacceptable levels
• Targeted individualized interventions
• Formal behavior observations using a structured
  protocol
• IL (location), Noisy, Attending, PN (physically
  negative) plus other aggression
• Time sampling plus event recording
• Peer comparisons

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Tier II Behavior cont

• Behavioral Intervention
• Precise Definition-Observable Behavior
• 2. Valid/Reliable Measure in the Natural Setting
• 3. Validate the Existence of the Problem
  Estimate the Severity (Age Norms/Peer
  Comparisons)
• 4. Intervention Goals in Terms of the Target
  Behavior
• 5. Analysis of Antecedent (including prior
  knowledge), Situational, and Consequent
  Conditions

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Tier II Behavior cont

• Behavioral Intervention, cont.
• 6. Intervention Plan Based on Principles of
  Behavior Change or Instructional Design
• 7. Systematic Implementation, Treatment
  Integrity, Frequent Monitoring of Progress
• 8. Formative evaluation-revisions as needed
• 9. Evaluate effects after 20 weeks
• 10. Systematic Plan for Maintenance and
  Generalization of Behavior Change

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Effects of Tier I and Tier II

• Potentially identifies more students in general
  education with reading problems through universal
  screening
• Reduces number of students with very poor reading
  and increases number of students meeting
  benchmarks, but
• Non or insufficient response rate of 3-5
• Generalizations of improved performance to
  classroom without pull out support
• What Next?

38
Limitations of Tier II in LD Identification

• Small group interventions, NOT individualized
• Does not meet requirements for a full and
  individual evaluation
• Academic focus, probably ignores behavior
• Multi-factored assessment required
• Exclusion factors must be assessed

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Foundations for Policy Changes What Does Work?
ABA, DI, CBM

• Treatment Effect Size
• Applied Behavior Analysis. 1.00
• CBMGraphingFormative
• Evaluation .70
• CBMGraphingFormative
• EvaluationReinforcement 1.00
• Comprehension Strategies gt1.00
• Many other effective instructional and behavior
  change principles

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PS-RTI Challenges

• Fidelity of Treatment, steps and decision making
• Paradigm Shift Change thinking and priorities
  about services
• Continuing education needs of practitioners
• No bright lines to separate eligible from
  non-eligible students

42
Prevention-Early Intervention

• LEA can use 15 of federal IDEA funds to support
  prevention and early identification-treatment
• Purpose minimize over-identification and
  unnecessary sp ed referrals
• Provide academic and behavioral supports
• Supports professional development and provision
  of interventions including early literacy
  instruction
• Scientifically-based
• Golden opportunity for schools!!

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SEA/LEA Choices RELD Identification

• IF Tier I and Tier II are done well and are
  insufficient THEN WHAT???
• Four Options Implications and Value
• Cognitive assessment, processes, pattern of
  strengths and weaknesses??
• IQ-achievement discrepancy?? Revised?
• Intense, individualized problem solving
• Nothing-child is eligible based on Tier II
  results

44
What Is A Specific Learning Disability?

• Many plausible answers
• Social and political reality in need of a
  foundation in theory and research
• Definition (psychological processes) ignored for
  30 years in federal regulations on identification
  of LD. Why?
• Research for 30 years on LD identification and
  student characteristics
• State policies and practices

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LD Is Relative to Context and Expectations

• Large differences in achievement levels depending
  on context and expectations
• Key feature LD is very low achievement compared
  to peers that, associated with other behaviors,
  provokes referral
• Many persons with low ach not referred,
  especially girls with reading problems
• LD is real in the sense of low relative
  achievement, often complicated by mildly
  disruptive classroom behavior, that places
  children and youth on a negative educational
  trajectory

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Origins of IQ-Achievement Discrepancy

• 1975 Congress passed mandatory special education
  legislation, LD included
• Processing definition adopted
• Processing measures and interventions repudiated
  in research published in early to mid 1970s
• Huge concerns about over-identification and
  consistency prevalence estimates varied from 2
  to 32
• Congress mandated the development of LD
  classification criteria OR 2 cap imposed
• Deadline of December 31, 1977

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Origins of IQ-Achievement Discrepancy continued

• Enormous disagreement in the field in 1975-1977,
  gt1000 letters to BEH
• No consensus on LD identification
• Rutter Yule studies-2 groups of poor readers
• Severe discrepancy between achievement and
  intellectual ability
• Best alternative to a very difficult problem
• Marker for LD, but never thought to be the
  essence of LD
• Problems recognized immediately (Danielson
  Bauer, 1978)

48
Implementation of Severe Discrepancy Overall
Trends

• Increasingly adopted by states in 1970s and 1980s
• Little consistency regarding method to determine
• Little consistency regarding magnitude of
  discrepancy
• Considerable evidence of frequent nullification

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Implementation of Severe Discrepancy State
Policies and Practices

• Reschly Hosp (2004)
• 48 of 50 states (exceptions-IA and LA)
• Standard score or SD differences 10 states
• Regression methods or some variation 20 states
• Idiosyncratic, uninterpretable methods or no
  stated method in 18 states

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Implementation of Severe Discrepancy State
Policies and Practices

• Criterion for severe discrepancy (how large?)
  (Reschly Hosp, 2004)
• 30 of 48 states provide guidance to LEAs
• Determined the magnitude of the required
  discrepancy if the IQ100
• States vary from 15 to 30 points (still verifying
  some states)
• No statistically significant relationship between
  magnitude of discrepancy and LD prevalence

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Control of PrevalenceKY 2.85 to RI 9.43
www.ideadata.org Table AA13
Mean5.8, SD1.19
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Discrepancy Method Criticized

• IQ-Achievement Discrepancy
• Unreliable-especially stability over short time
  intervals and different pairs of tests
• Questionable Validity
• Expensive
• CAUSES HARM THROUGH DELAYING TREATMENT TO AGE
  9-11

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Ability-Achievement Discrepancy What Next?

• Strong proponents exist (Kavale, Scruggs and
  Mastropieri)
• Essential marker of LD, necessary but not
  sufficient
• Implementation fidelity is the main problem
• Revise to overcome weaknesses
• Better than nothing, a flawed bright line is
  better than no line

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Ability-Achievement Discrepancy Conclusions

• Rejected by LD Summit Researchers
• Must overcome research indicating
• Questionable validity and reliability
• Wide variations in how applied
• Enormous variations in prevalence
• Harmful, wait to fail effects in early grades
  when intervention is most likely to be effective
• Absence of prevention or early identification-earl
  y intervention effects

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Processing Basis for LD Identification

• Terminology
• Basic psychological processes related to learning
• Neuropsychological intact and non-intact areas,
  or strengths and weaknesses
• Learning Styles
• Information processing modality (visual-auditory)
• Cognitive processing (simultaneous-successive-
  plus others)

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Origins of Processing in LD Identification

• Original definition, Kirk et al.,
• Adopted in Federal legislation in 1967 and in EHA
  in 1975, 1977 IDEA 2004
• Dominant definition in states
• Conforms to essence of LD according to many LD
  experts
• Theory driven
• Claims of positive benefits always precede
  research examining the claims

57
Applications of Processing Constructs in LD
Identification and Treatment

• LD Identification A child with LD displays a
  pattern of cognitive strengths and weaknesses
  that account for the inefficient learning and
  poor achievement
• LD Intervention-Process Training Interventions
  are designed to improve cognitive weaknesses,
  with the assumption that improved achievement
  will follow.
• LD Intervention-Aptitude by Treatment
  Interaction Instructional content and
  methodology matched to cognitive (neurological)
  strengths

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Applications of Processing Constructs in LD
Identification

• LD Identification
• Focus on pattern of strengths and weaknesses
• Assumption that LD is caused by or is related
  to cognitive weaknesses that interfere with
  efficient learning
• Clinical insight integrate test scores with
  clinical observations and other data sources to
  offer insightful answers to referral questions.
• Greater profile variability seen as indicator of
  LD

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Processing Constructs in LD Identification State
Policies and Practices

• Most states use Federal LD definition (82)
• Most states ignore processing disorder in
  classification criteria (37/50 or 74)
• The 13 states do NOT provide explicit guidelines
  or criteria to guide identification of processing
  deficit
• Unrelated to LD prevalence
• Trend toward diminishing state specification of
  processing disorder in LD classification,
  1980-2005

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Processing in LD Identification Research Results

• No unique pattern associated with LD
• High base rates for processing strengths and
  weaknesses
• Test scatter is normal and more tests, more
  scatter
• Nearly all (if not all) children with low
  achievement with have processing deficits (as
  will normal children)
• Profile reliability is questionable

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Processing in LD Identification Research Results

• Poor consistency due to high subjectivity in
  profile interpretation
• No evidence that greater stress on cognitive
  processing will control LD prevalence (more
  likely to exacerbate over identification)
• Always new processes related to new theories
  with promise of improved results with new
  processes
• Intense debates between authors of new tests
  and processes vs researchers appeared in 1970s,
  1980s, 1990s, and 2000s

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Cognitive Processing in LD Interventions Process
Training Research 1970-2005

• Many processes, many claims, little research
• Rare positive results
• Even rarer demonstration of near transfer of
  gains No evidence of far transfer
• No evidence of achievement gains related to
  alleged processing gains
• No studies that meet standards for scientifically
  based research
• Claims of advocates virtually never confirmed in
  research by others

63
Use of Processing in Aptitude by Treatment
Interaction Matching

• Match Up Teaching Methodology to Aptitudes
  Avoid Dead Tissue (Reynolds, 1992)
• Many Applications in School Psychology and
  Special Education (e.g..., Neuropsychology,
  Learning Styles, Multicultural Teaching
  Methodology, Simultaneous vs Sequential,
  Information Processing Modality, Right Hemisphere
  -- Left Hemisphere, visual vs Auditory Learners)

64
Aptitude by Treatment Matching???

• Treatment/Intervention aEffect Size
• Modality Matched Instr. (Aud.) .03
• Modality Matched Instr. (Vis.) .04
• Simultaneous/Successive .??
• Right Brain/Left Brain .??
• Cultural Leaning Style .??
• NOTHING FOR KIDS
• FEEL GOOD ASSESSMENT

65
Results of ATI Research

• King of England describing his Danish
  brother-in-law There is nothing there.
• Cronbach, (1975). Once we attend to
  interactions, we enter a hall of mirrors that
  extends to infinity. (p. 119)
• Kavale (1999) No supportive data, but cannot kill
  Phoenix-like processing claims
• Vaughn and Linan-Thompson (2003), There is no
  empirical support for the use of modality-matched
  instruction or learning styles as a means to
  enhance outcomes for students with LD. (p. 142).

66
Digression Neuropsychology and Neuroscience

• Distinguish between neuropsychology and
  neuroscience
• Neuropsychology is dependent on psychometric
  profiles
• Difference scores are less reliable
• Scatter is normal
• Base rates for profile variations
• Flat profiles are atypical
• Nearly all have profile variations

67
Neuroscience Findings

• Instruction in decoding changes brain functioning
  on fMRI
• Neuroscience findings generally refute
  traditional neuropsychology with learning
  problems
• Neurological functioning more dynamic, less
  static
• Little practical application of fMRI to current
  school psychology practice
• No unique LD markers!!

68
Neuroscience

• Instruction in decoding changes brain functioning
  on fMRI
• Neurological functioning more dynamic, less
  static
• Little practical application of fMRI to current
  school psychology practice
• No unique LD markers!!

69
Digression fMRI Studies

• Science article fMRIs of boys and girls engaged
  in decoding-Girls used both hemispheres, boys one
• Implications??
• Do fMRI to find real LD?
• Abandon IQ and go to fMRIs
• Trade the hatchback for an 18 wheeler
• Cost issues 3m per machine, plus maintenance

70
Strengths of Cognitive Processing as a Key Factor
in LD

• Consistent with traditional (widely ignored)
  unvalidated LD definition
• Consistent with advocates feelings about
  essence of LD
• Preserves traditional clinical practice for many
  professionals

71
Problems with Cognitive Processing and LD
Identification and Intervention

• Absence of empirical evidence to support claims
• Clinical interpretationnot testable
• Identification? Must overcome the base rates for
  profile variations
• Treatment? Must show that processes can be
  trained AND that changes in processes produce
  better achievement
• Treatment? Must should statistically and
  practically significant ATI
• Flawed assumptions refuted to date in research

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Problem Solving and RtI

• Improves behavior and achievement outcomes in
  general, remedial, and special education
• Links diagnosis with treatment
• Facilitates application of scientifically-based
  interventions
• Self-correcting methodology
• Accountability enhanced