Michael F. Shaughnessy Senior Columnist EdNews.org
Eastern New Mexico University

Peggy McCardle, Ph.D., MPH is Chief of The Child Development & Behavior Branch of the Center for Research for Mothers & Children at the National Institute of Child Health and Human Development. Her " snail mail " address is 6100 Executive Blvd., Suite 4B05 in Rockville, Maryland 20852-7510. In this interview, she discusses the concept of " Response to Intervention" a new paradigm regarding intervention to help students with possible learning disabilities.

1) Recently there has been much discussion about employing a "response to intervention" model to identify "learning disabled " children. What is your role in this picture?

There has been a extensive discussion of how Response to Intervention, or RTI, relates to the option presented in the Individuals with Disabilities Education Act (IDEA) 2004 reauthorization, and is about education practice and identification of students with learning disabilities for special education services.There is also a need for research on using RTI to identify students with various types of learning disabilities – including, specifically, reading disabilities. The NICHD has a longstanding interest in the how to identify and classify learning disabilities, in the neural and genetic bases of learning disabilities, and in the design and testing of interventions based on this information. This, in fact, was the focus of a Request for Applications for Learning Disabilities Research Centers (LDRC) in 2005; four centers were funded. NICHD has funded LRDC for the past 8 years, and this competition resulted in continuing the funding for one existing center and in funding three new centers.They will be researching these issues over the next five years (2006-2010).

2) How much time should a teacher spend attempting different strategies before the child is finally diagnosed or labeled as "learning disabled"?

Well, that depends. Researchers have demonstrated that providing explicit, high quality instruction to students can significantly reduce the number of students who are not reading or reading poorly, and who would thus be referred for special education. Teachers should always be monitoring how well students are learning over time.If a teacher has provided explicit instruction and most students have learned the particular aspects of reading being taught, and then she or he has tried differentiating instruction to the needs of a particular student and that student is still struggling, then it's definitely time to look more deeply into why a student is not learning. At that point, the teacher should ask the team of professionals who work with the teacher for help in assessing the student's abilities and difficulties.

3) Many children with learning disabilities have other problems- low frustration tolerance, depression, anxiety, low self esteem etc. How does response to intervention assist in these realms?

The International Reading Association (IRA) recently hosted a series of meetings with representatives of thirteen different organizations representing teachers, school psychologists and social workers, parents of children with learning difficulties, and others, to address the role of the team of professionals who work with children in schools and how those roles may change for schools implementing RTI. Representatives from the Institute of Education Sciences and the NICHD were part of this group, and I think the group really broke some new ground – they formed a highly collaborative working group and produced a document that IRA and the other organizations will distribute that should be very helpful to schools implementing RTI. They published it this month (Nov. 2006) and it's called "New Roles in Response to Intervention: Creating Success for Schools and Children" (available on the web at http://www.reading.org/resources/issues/focus_rti_library.html#roles).

But to answer your specific question, which I think is indirectly addressed in that document, because it discusses the roles of the various team members. RTI is a team effort, with the classroom teacher having the central role but being supported collaboratively by all the other professionals on the team. Thus, the teacher could discuss the student's behavior and learning progress (which is likely related) with a school psychologist or counselor, a special educator, or other team member. That might give some great ideas on how to work with that student. The teacher might ask one of these colleagues to observe the student in class, to get a clearer picture of the behavior and ideas about how to work with the student. And the teacher and that colleague/team member might then draft a plan to address the behavior, which the teacher could then implement.

4) There have been some concerns about "treatment integrity" that is, asking teachers to keep records, provide the intervention, or supervise educational assistants, on top of everything else they have to do. Are we expecting too much from teachers?

Well, we all know teachers work really hard and have little time for extra tasks. But I would guess that in some form or other most teachers are keeping records of how their students are doing already. Good teachers are able to differentiate instruction to meet student needs, so if that is what you mean by providing intervention, again I think a lot of teachers are already doing that. A reading coach or mentor should ideally be available to brainstorm and problem solve with the teacher on those cases, too. I think we do expect an awful lot from teachers, and they merit all the help and respect we can give them.

Now, about NICHD and how we relate to all this – and by treatment integrity I am guessing you're talking about what I and our researchers refer to as treatment fidelity. When researchers are testing an intervention they have developed,they usually include some measure of how faithfully the teacher follows the training for delivering that intervention. Are they doing it the way it was designed or not? Treatment fidelity is important because we need to know whether it's the intervention/ instruction that is making the difference if we find a difference, and that it wasn't just a particularly charismatic teacher or some other factor that accounts for the differences. Then there are studies of scaling up specific interventions from e.g. small group to whole class, or from a few classes to an entire school or district.

As you do things on a larger scale, things often get adapted or altered, and researchers have studied fidelity to intervention to determine how much you can tweak an instructional program or intervention before it is no longer effective. That's important information for teachers to know. It's also important for administrators to know as they consider not only which programs or curricula to purchase but also the training and support teachers may need to most effectively use that program or curriculum. Teachers have to be pretty creative, but if we let them know the parameters that it's ok to change and those where you might lose effectiveness if you change them, then they have that in their repertoire and can use their creativity to better advantage. The Institute of Education Sciences actually funds more of this type of scale-up research than NICHD does, now, but we all have an interest in fidelity to instruction or intervention.

5) I gotta tell you, I used to teach in New York, in Nebraska and in other states. What I have learned is that students do not attend school regularly. They are sick, absent, have to go to the doctor, have to go to the dentist, and then there are field trips, sports events, assemblies and the like. How are teachers going to be able to provide "intervention" in a consistent fashion, so as to procure reliable, valid results?

Right, many of us with classroom experience are familiar with this challenge. But that question's really out of our arena here at NICHD. You're really talking about school organization and scheduling. At the NICHD, we focus, in the research that we fund, on how children learn, what goes wrong when students don't learn,how all this relates to brain development, the role of environment and heredity (the genetics of learning disabilities), and which intervention methods work best for which students under what conditions. Our branch studies all aspects of child and adolescent development, so we support research on cognitive, social and emotional development, early learning and school readiness, health behaviors, and math and science cognition and learning. But we don't really study issues like the one you raise. They are practical issues that our researchers have to consider in developing interventions and instructional approaches, but we don't have great solutions for them.

6) Some indicate that the IDEA definition of "learning disability" flies in the face of Response to Intervention. Others feel that Response to Intervention is very much a very legitimate part of the Student Assistant Team Process. What is your take on this?

Well, as I said earlier, we are funding work on RTI and how to define, identify, and classify learning disability.And some of our funded researchers who were already immersed in work on the classification of learning disabilities were on that Presidential Commission that produced the report on which I believe the IDEA language is based. I think looking for other options than the IQ-achievement discrepancy makes a great deal of sense, since it's been pretty convincingly demonstrated, repeatedly, that the discrepancy model doesn't identify all students with learning disabilities.

7) If a child had a learning disability in spelling that was perhaps caused by repeated inner ear infections as a child, would a response to intervention model help? Or should the child get an audiological evaluation?

Any child who has had repeated ear infections should have had their hearing tested. But I'm not so sure you can say a child has a problem in spelling because of the ear infections. In a response to intervention model, any child who is not progressing should receive more intensive instruction.However, if this more intensive instruction doesn't yield the expected results and if the subsequent small group or one-on-one work does not yield results, then the student should be referred for a complete assessment. As the intensity is increased, I would hope the RTI team is being consulted. And again, any time you think a student is not hearing, they should be referred at least for a hearing screening.So I guess I'm saying yes to both – RTI can help but get the student's hearing tested if you suspect a hearing problem.

8) If a child does not respond to legitimate intervention, could it be that they are borderline or even high mild mental retardation?

Of course that could be one possibility, but there are many others. That's why any child who doesn't respond to the more intensive and individualized instruction should be referred for a complete assessment. It's important to realize that RTI does not eliminate the complete, multidisciplinary educational assessment that is used to diagnose an educational problem. It's just that if we provide all children with explicit, high quality reading instruction to begin with, and try to intensify and differentiate instruction for those who don't get it with the whole group the first time through, we should have more students reading and have fewer referrals for these assessment and fewer students in special education.

9) Should educational assistants be allowed to do the response to intervention, or it this a domain that only a "highly qualified "teacher should be able to do?

RTI is not just one item.There are probably things that the teacher could trust a well trained assistant to do, under his or her supervision, but all students should be taught to read by a highly qualified teacher!

10) What question have I neglected to ask?

Your coverage of the issue of RTI seems to have been pretty thorough. I would emphasize that there are teams out there in schools who have been implementing a tiered approach to intervention for a few years already, so while it's new to some it's not a totally new idea. So there are teams we can learn from. The International Dyslexia Association participated in the role definition group that IRA pulled together this year, but they also just published a special convention issue of their own publication, Perspectives on Language and Literacy (Nov., 2006, Vol 32. No. 5) that has three articles on RTI. One is something you have not asked about – parents and their role.

There are questions a parent should ask and some pretty clear information about what RTI is that parents should find helpful. There is also a meeting summary document about how schools might build capacity to deliver RTI, in that issue, which has some nice information about schools that have been doing an RTI approach already and what their experiences have been. It might be very helpful to your readers.