RTI: Response to Intervention

Often when people say "RTI" (Response to Intervention) you might hear a chorus of groans followed by a lot of opposition.  However, those are often the responses obtained because there is not a clear understanding of its purpose and how it is supposed to be implemented.  If implemented properly it is a vital approach to identify children who have a true neurological learning disability from those who just need extra help, support, or remediation of specific skills.

Ten years ago when I was working in public schools this was the new "thing".  Prior to a special education referral some type of intervention was to be attempted in order to differentiate those with a true learning disability from those without since special education services are for those children with a specific disability, which requires specialized instruction and often times a more restrictive learning environment.  

After meeting with some educators and parents I was reminded of how misunderstood this process is and because of that it is being implemented incorrectly.  This process should be an opportunity to remediate specific areas of deficit in order to measure how the child responds to that specific intervention.  Response should be quick IF the intervention is specific and accurately addressed in the designed intervention.  If an intervention is NOT providing the expected result the intervention team should regroup and determine why.  Maybe the intervention is not specifically matched to the skill identified as needing intervention.  Maybe there is a foundation or prerequisite skill that is weak and therefore interfering with the child's "response".  Maybe the intervention is not being provided frequently enough to result in a measurable change.

When I am asked to review the interventions being provided or review RTI process for school here are some of the issues I have identified that are interfering with the effectiveness of this process.

1. There is not a specific team of professionals identified to interpret screening data and aid in designing interventions.   Effective and efficient teams should consist of a specific group of professionals in the school building who are responsible for assisting classroom teachers in administering and interpreting universal screenings.  Universal screenings are screenings used to identify the effectiveness of classroom intervention and/or how well the children are responding to a specific lesson.  For instance if a universal screening is administered and several children are identified at-risk then an adjustment may be needed in the current curriculum.  Maybe the current curriculum is not addressing a certain skill to the degree that class needs.  If that is the case the teacher can reteach the lesson or provide extra practice.  Maybe there is a small group of children in the class that need extra help on that specific skill prior to moving on to the next.
2. There is not a specific process outlined or monitored and/or the process is not efficient because team members cannot meet regularly to discuss data or intervention plans.   Often times a person or group of educators is identified as part of an intervention team or some schools have a designated interventionist.  This is an excellent start but if a specific process is not outlined with timelines for progress monitoring the process is not effective nor is it efficient.  In addition to a process there needs to be a system for collecting data and monitoring the child's response to the interventions designed.  There also needs to be a process for this information to follow the child as he or she progresses through school so interventions can build on each other and progress in a hierarchy.  Without a paper trail of data teachers often provide the same interventions over and over not knowing what was tried previously thus making the process last much longer than expected.
3. Interventions are not specific to the needs of the child or they are not monitored or adjusted frequently enough based on the child's response.  If the screening and assessment data is not accurately interpreted it is difficult to identify specific interventions that are strategic and incremental.  One reason this is a problem is because there is not a clear understanding in the difference between an intervention and an instructional technique.  Guided reading is NOT an intervention.  It is an instructional approach for teaching reading and when done correctly can be a very effective form of instruction.  However, guided reading is too broad and covers a variety of skills simultaneously.  For children struggling to learn to read there is often a specific skill that needs to be addressed.  A good guided reading lesson will address decoding, vocabulary, fluency, and comprehension to name a few.  The child may not be success flu in this classroom instruction because he or she needs more strategic intervention in decoding and simply reading a book does not systematically address the foundation skills needed.  In addition, the foundation skills needed to be a fluent decoder should be addressed differently depending on the age and grade level of the child.  The question should be WHY is the child not successful with this type of classroom instruction.  It should not be an opportunity to do more of the same instruction but in a different location or in a smaller group.  
4. Interventions are outlined and children go through the intervention for a specific amount of time regardless of the identified deficits or regardless of how the child is responding.  This is often the case when the team is more focused on the amount of time the intervention should last as opposed to the intervention itself.  Sometimes schools will choose a specific intervention often a specific program and all children will go through the same program regardless of their profile of strengths and weaknesses.  Reading Recovery is often used like this in my area.  The child enters the program and continues in the scripted program for the designated 12 week period regardless of how effective it is for that specific child.  Some schools will purchase fluency intervention programs and do fluency drills with children regardless of the deficit areas.  As a result I often see fluent yet inaccurate readers who still cannot comprehend to the level needed because they are conditioned to read fast instead of reading to comprehend.  These fixed intervention programs are provided consistently by well meaning educators but when children do not respond as expected there are no other options in place nor do the interventionist have the knowledge or skill level to make adjustments and therefore rendering the intervention ineffective.
5. Interventions are being provided but there is not documentation to review the appropriateness or effectiveness of the intervention, which makes it very difficult when trying to determine if adjustments need to be made.  Some schools have very little documentation of the interventions provided.  These schools rely only on the results of the screening and progress monitoring results, which gives some kind of documentation, but it does not let us know if the intervention provided matched the areas of need or if it was provided to the level of intensity needed.  Sometimes the intervention proves effective but the child needs it provided at a greater intensity and frequency to get the desired results.  This determination can only be made if there is specific documentation regarding what was done and for how long.  Some schools are overly focused on documenting correctly and charting progress they overlook how to provide the meat of the information, exactly what they are doing during each intervention session.

This is certainly not an all inclusive list but just a few of the issues I have witnessed.  As a therapist it is easier for me to implement a RTI program because it is very similar to speech and language therapy.  As a SLP I have to interpret test data, identify specific measurable goals, and then design activities that target these goals during each therapy session.  I must measure the effectiveness of the intervention/activity and the child's response after each session.    Depending on the child's response I have to design an appropriate intervention for the following therapy session.  Maybe the child struggled and I need to adjust how I am intervening with a specific concept.  Maybe the child responded beautifully and I need to increase the level of difficult of the intervention for the following session.  

Unfortunately RTI has gotten a bad reputation not because it is an ineffective program but because we are not implementing it correctly simply because we don't understand it's purpose.  If you are interested in learning more about the RTI process or how to make this a more effective process for your school please contact me at [email protected].  Often times there are steps that can be taken that can make a tremendous difference not only in the effectiveness of the program but also in the performance of the children!!!
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