Response to Intervention (RTI) Preventing and Identifying LD



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Response to Intervention (RTI) Preventing and Identifying LD Douglas Fuchs and Lynn S. Fuchs Vanderbilt University 1

Presentation Outline 1. Changes in Federal Law 2. Experimental Studies in Reading and Math 2

1. Changes in Federal Law 3

Across Methods: Signature Characteristic of LD Unexpected and Specific Learning Failure The child with unexpected learning failure (or underachievement) is perceived by parents and teachers as generally competent. The learning difficulty is surprising and puzzling. Specific learning failure suggests neurological dysfunction and processing deficits, which are presumed to cause severe problems in reading, writing, or math. 4

IQ-Achievement Discrepancy In regulations accompanying Education of All Handicapped Children Act (1975), underachievement has been operationalized as IQ-achievement discrepancy. 5

Criticisms of IQ-Achievement Discrepancy IQ tests do not necessarily measure intelligence. IQ and academic achievement are not independent; so, difference scores are unreliable. In the case of word reading skill deficits, few meaningful differences between IQ-achievement discrepant poor readers and IQ-achievement consistent poor readers. Children must fail before they can be identified as LD. 6

Number of Students Served with Learning Disabilities Under IDEA by Age 1999-2000 School Year 350,000 300,000 250,000 200,000 150,000 100,000 50,000 0 36,369 87,436 160,840 239,255 286,719 306,533 310,787 302,604 289,168 267,153 239,305 199,628 112,987 24,796 5,602 1,784 136 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 7

The Prominent Alternative: Defining LD in Terms of Severe Low Achievement RTI LD as nonresponders to validated instruction (unexpected underachievement). Assumption: If a child does not respond to instruction that is effective for the vast majority of children, then there is something different about the child causing the nonresponse. RTI eliminates poor instructional quality as a viable explanation for learning difficulty. 8

Two Purposes of RTI To reorient service delivery to provide early intervention To provide an alternative method of LD identification 9

Newest IDEA Cites Two Methods for LD Identification 1. IQ-Achievement Discrepancy 2. RTI 10

Typical RTI Procedure Tier 1 (Primary Prevention) All children receive the universal, core instructional program. All children are tested once in the fall. At-risk students are identified for Tier 2 intervention on the basis of low performance. Tier 2 (Secondary Prevention) For at-risk students, a second tier of prevention is implemented using standard research-validated tutoring protocols. Student progress is monitored throughout intervention, and students are re-tested following intervention. Growth/performance is dichotomized as responsive or unresponsive. Tier 3 (Tertiary Prevention) Those who do not respond receive a multidisciplinary team evaluation and are identified for individualized programming in special education (LD, BD, MR). 11

CONTINUUM OF SCHOOL-WIDE SUPPORT Primary Prevention: Universal Core Program for All Students ~5% ~15% Tertiary Prevention: Individualized Programs for Students who Do Not Respond to Standardized Intervention Secondary Prevention: Standard, Research-Based Tutoring for At-Risk Students ~80% of Students 12

Advantages of RTI Approach Provides assistance to needy children in timely fashion. It is NOT a wait-to-fail model. Helps ensure that the student s poor academic performance is not due to poor instruction. Assessment data are collected to inform the teacher and improve instruction. Assessments and interventions are closely linked. 13

2. Experimental Studies in Reading and Math 14

National Research Center on Learning Disabilities (NRCLD) Vanderbilt University and University of Kansas OSEP Grant #H324U010004 Vanderbilt Experimental RTI Studies Collaboration among Doug Fuchs, Lynn Fuchs, and Don Compton 15

Experimental RTI Studies Preventing and Identifying Learning Disability Reading and Math Studies (initiated in subsequent years, so samples do not overlap) Across Reading and Math Studies 3 Purposes 1. Examine efficacy of 1 st -grade preventative tutoring 2. Assess LD prevalence and severity, with and without Tier 2 tutoring and as a function of identification method 3. Explore pretreatment cognitive abilities associated with development Random assignment to 1 st -grade study conditions Longitudinal follow up to assess development of long- term difficulty 16

In This Presentation, Focus on Purpose #1 1. Examine efficacy of 1 st -grade Tier 2 tutoring (2. Assess LD prevalence and severity ~ with/without Tier 2 tutoring ~ as a function of identification method) (3. Explore the pretreatment cognitive abilities associated with development) 17

Presentation Organization Math RTI Study Reading RTI Study Concluding Thoughts 18

The Prevention and Identification of Math Disability Lynn Fuchs, Don Compton, Doug Fuchs, Kim Paulsen, Joan Bryant, and Carol Hamlett Vanderbilt University National Research Center on Learning Disabilities OSEP Grant #H324U010004 19

RTI Research in Math Compared to reading, much less is known about math, even at 1 st grade. No validated tutoring protocols exist at 1 st grade. The small body of work on math RTI (school psych literature) is limited to: _ Basic facts or simple computation _ Using brief, drill/practice intervention _ In few classrooms (unrepresentative of range of instructional quality) 20

Rationale This study: Addressed other curricular components Incorporated sustained tutoring Used random assignment Included larger samples Focused on how to operationalize response and define MD 21

Sample 41 1 st -grade teachers in 6 Title 1 and 4 non-title 1 schools Using Week 4 CBM Computation, 139 lowest performing (21% of 667 consented students) identified as at risk (AR) 139 AR randomly assigned to control or tutoring Not at risk (NAR): 528 remaining students with consent Of 528 NAR: _ All weekly CBM Computation _ 180 sampled for individual and group pre/posttesting posttesting _ Remaining 345 were only group pre/posttested posttested With attrition, samples sizes at end of 1 st grade: _ 127 AR: 63 control + 64 tutored _ 437 NAR: 145 individually/group tested + 292 group tested 22

Math (Pre/Post/FU) Measures _ Group: Fact Fluency, CBM Computation, Gr 1 Concepts and Applications, Story Problems _ Individual: WJ Applied Problems, WJ Calculation Math CBM for Progress Monitoring (Weekly) Cognitive Abilities (Pre) _ Language (WASI Vocabulary, WASI Similarities, Woodcock Diagnostic Reading Battery Listening Comprehension) _ Visuospatial (WASI Matrix Reasoning, WASI Block Design) _ Phonological (CTOPP Rapid Digit Naming, CTOPP Sound Matching) _ Processing Speed (WJ Psycho-Educational Battery-R Cross Out) _ Induction (WJ III Concept Formation) _ Working Memory (Working Memory Test Battery for Children Listening Recall) _ Attention (Social Skills Rating System 4 items) (Test sessions were audiotaped and coded for accuracy.) 23

Pretest Performance NAR > AR Tutored, AR Control _ WASI IQ _ WRMT WID and WA _ WJ Calculation and Applied Problems _ Fact Fluency _ Story Problems _ Grade 1 Concepts/Applications _ CBM Computation 24

Tutoring Small groups of 2-3 students 3 times per week outside classrooms Each session: _ 30 min of teacher-led instruction _ 10 min of student use of software, Math Flash, designed to improve automatic retrieval of math facts 25

Teacher-Led Instruction Concrete objects to promote conceptual learning 17 scripted topics (number sense, number concepts, numeration, place value, number combinations, story problems, 2-digit procedures without regrouping, missing addends) Computerized Practice on Number Combinations Each small group completed 48 sessions. All sessions audiotaped; ; tapes were sampled for coding; fidelity of implementation was strong. 26

Tutoring Efficacy Improvement Weekly CBM Computation Slope _ AR tutored = NAR > AR control WJ III Calculation _ AR tutored > NAR and AR Grade 1 Concepts/Applications _ AR tutored > NAR and AR control Story Problems _ NAR > AR tutored > AR control First-grade tutoring enhances outcomes. 27

Tutoring Efficacy Did tutoring decrease MD prevalence at end of 1 st grade? Yes, across identification options, tutoring substantially decreased prevalence. Example Final Low Achievement (<10 th percentile) on Gr 1 Concepts/Applications, prevalence went from 9.75% without tutoring to 5.14% with tutoring. ~ 2.5 million fewer children identified MD At end of 2 nd grade, MD prevalence was still twice as high in the untutored group. 28

29

In Sum, Results Demonstrate efficacy of 1 st -grade tutoring Indicate that RTI can reduce MD prevalence, at least through end of 2 nd grade. Other finding illustrate how options for designating MD affect prevalence and severity. 30

The Prevention and Identification of Reading Disability Doug Fuchs, Don Compton, Lynn Fuchs Joan Bryant, Loulee Yen, Marie Smith Vanderbilt University National Research Center on Learning Disabilities OSEP Grant #324U010004 31

Purposes 1. Examine the efficacy of 1 st -grade preventative tutoring in reading 2. Assess RD prevalence and severity, with and without preventative tutoring and as a function of identification method 3. Explore pretreatment cognitive abilities associated with reading development Again, In This Presentation, Focus on Purpose #1 32

Districts, Schools, and Teachers 2 school districts in Tennessee (urban Metro- Nashville and suburban Williamson County) 8 Title 1 and 8 non-title 1 elementary schools 42 first-grade teachers assigned randomly within schools to PALS (n( = 21) and No- PALS (n( = 21); in this presentation, we collapse PALS and No-PALS classes into Tier 1 instruction 33

Identifying At-Risk Students In the 42 classes, all students screened on: _ RLN (CTOPP) _ CBM Word Identification Fluency _ Teacher judgment The 6 lowest students per class on one or both measures, also judged as such by the teacher, were designated low study entry. 34

Study Conditions In each class, the 6 low study entry were rank ordered and split into top and bottom strata. Within each stratum, children were randomly assigned to: _ Fall Tutoring (n = 84) _ Spring Tutoring (n =84) -- if unresponsive to general education _ Control (n = 84). In this presentation, we focus on Spring Tutoring and Control conditions (not the Fall Tutoring condition). 35

Study Conditions (Cont d) We collected weekly WIF data: 9 waves in the fall and 9 waves in the spring. We identified the subset of students who were unresponsive to Tier 1 general education, using dual discrepancy on fall WIF slope and level. Tier 1-unresponsive students to fall general education instruction: _ Spring Tutoring: n = 40 _ Control: n = 24 36

Study Conditions (Cont d) We administered a battery of standardized reading tests at fall, mid-year, end of grade 1, end of grade 2. Unresponsive students comparable by condition on: _ IQ _ Vocabulary _ CTOPP Rapid Digit Naming, Elision, Memory for Digits _ WRMT WID and WA _ TOWRE Sight Word and Phonemic Decoding _ Teacher Ratings of Effort and Distractibility They were: _ ~ 2/3 SD < mean on WIF local norms _ ~ 2/3 SD < national norms on IQ, Vocabulary, Phonological Processing _ 1/3 to 2/3 SD < national norms on reading measures _ Teachers mean effort rating ~ 60% _ Teachers mean distractibility rating between sometimes and very often 37

Tutoring Groups of 2-4 students Validated treatment protocol _ Letter-sound correspondence, decoding words, sight word recognition, fluency-building, and partner reading, with point system for motivation _ 9 wks, 4x per wk, 35-45 min per session Fidelity _ All sessions audiotaped _ Tapes of sessions #14 and #28 checked for all tutors against a 79-item checklist _ Inter-rater agreement on coding of tapes was 96% across sessions and tutors _ > 95% tutor fidelity across sessions and tutors 38

Measures Screening _ CTOPP Rapid Letter Naming, CBM-WIF Progress Monitoring _ Weekly CBM-WIF Fall _ CTOPP (Elision, Memory for Digits); 4-subtest WASI; WRMT-R (WI, WA); Woodcock Diagnostic Reading Battery (Listening Comprehension); Cognitive battery also administered. Mid-Year _ WRMT-R (WID, WA); TOWRE (Sight Word Reading, Phonemic Decoding) End-Year and End Grade 2 _ WJ (Passage Comprehension); WRMT-R (WID, WA), TOWRE (Sight Word Reading, Phonemic Decoding); Woodcock Diagnostic Reading Battery (Listening Comprehension); Social Skills Rating System (SSRS; short form); Teacher Rating of Reading Effort 39

Tutoring Efficacy Progress Monitoring Data Spring Tutored and Control exhibited similar growth from fall to mid-year, prior to tutoring (slope 1). Spring Tutored group showed greater growth than control from mid-year to end-year, during tutoring (slope 2). 40

Tutoring Efficacy: Standardized Reading Measures For 3 or 4 measures (all but Sight Word Efficiency): interaction between condition and time, whereby _ Contrast from pretest to mid-year was comparable for Spring Tutored and Control _ Contrast from mid-year to posttest was significant, with Spring Tutored outperforming Control. Effects maintained at end of grade 2. 41

Word ID 45 40 35 30 Raw Score 25 20 15 10 5 Tutor Control 0 Entrance Pre-Intervention Post-Intervention Follow-up 42

Word ID 45 40 35 30 Raw Score 25 20 15 10 5 Tutor Control 0 Entrance Pre-Intervention Post-Intervention Follow-up 43

Word Attack 16 14 12 Raw Score 10 8 6 4 2 Tutor Control 0 Entrance Pre-Intervention Post-Intervention Follow-up 44

Sight Word Efficiency 45 40 35 30 Raw Score 25 20 15 10 5 0 Tutor Control Entrance Pre-Intervention Post-Intervention Follow-up 45

Decoding Efficiency 14 12 10 Raw Score 8 6 4 2 0 Tutor Control Entrance Pre-Intervention Post-Intervention Follow-up 46

Tutoring Efficacy Did tutoring decrease RD prevalence at end of 1 st grade? Defining RD = 1 st -grade WID slope <.75 SD below normative mean slope Yes: RD rates significantly lower in Spring Tutored (43.5%) than Control (81.8%) 47

In Sum, Results Demonstrate efficacy of 1 st -grade tutoring in the spring semester for students unresponsive to Tier 1 general education Indicate that RTI can reduce RD prevalence, at least at end of 1 st grade. Other findings illustrate how options for designating RD affect prevalence and severity. 48

Concluding Thoughts Across Math and Reading RTI is a promising practice for preventing LD. Less is known about RTI for identification. _ Across math and reading, findings indicate that prevalence and severity of LD changes depending on how response is operationalized. _ This could lead to varying identification rates across states and districts, creating heterogeneity of category similar to traditional definitions. _ So, guidance on how to standardize response is needed. In addition, guidance is needed about what constitutes intervention within RTI and how to measure quality of that intervention is required. 49

Other NRCLD Activities: Collaboration between VU and KU Survey research on state practices (VU) Technical assistance on RTI (KU) Identification and description of RTI model sites (KU) 50

For Additional Information Contact: Flora Murray flora.murray@vanderbilt.edu Vanderbilt University 328 Peabody College Department of Special Education Nashville, TN 37203 (615) 343-4782 51