Early screening and response to intervention (RTI)

Early screening

Early identification and effective interventions are critical to avoid the subsequent results of failure to learn to read – poor academic performance, low self-esteem, behavioural issues and other mental health problems. There is strong evidence that intensive reading interventions are most effective in pre-school, kindergarten or first grade (Ozernov-Palchik & Gaab, 2016; Ozernov-Palchik et al, 2016; What Works Clearinghouse, 2009), so early identification is critical.  For example, in a study of 172 children involved in small-group reading intervention, children who received intervention earlier, in 1st and 2nd grade, made gains in foundational word reading skills relative to controls almost twice that of children receiving intervention in 3rd grade (Lovett et al., 2017).

Early identification is also feasible. Several studies have shown that early measures of risk factors for dyslexia in children as young as three are predictors of reading difficulties in later years (Ozernov-Palchik & Gaab, 2016; Puolakanaho et al, 2007). Such risk factors include a family history of dyslexia and deficits in areas of phonological awareness, phonological memory, letter-sound knowledge, and rapid automatized naming.

In Ontario, early screening for dyslexia is not widely used and the ‘wait to fail’ model prevails in most schools, which results in children not being identified with reading challenges until they are in Grade 3, 4 or even later.  It is
not uncommon for a parent to be told that their child cannot receive extra support in reading until they are two years behind in performance.

Choosing a screener

It is important that a screening tool be well-researched and has been proven to be accurate, valid and reliable.  Following legislation requiring early screening in many U.S. states, various jurisdictions have published lists of recommended ‘early screener’ assessments, such as the Connecticut State Department of Education (2017), Alabama State Department of Education (2016) and the International Dyslexia Association (2017).   Nadine Gaab’s lab at Boston Children’s Hospital has compiled a spreadsheet with detailed information about various early screeners.  Decoding Dyslexia California has also published a summary of screening tools for Universal Screening for Reading Difficulties.

Response to intervention (RTI)

An RTI framework incorporates early screening and effective instruction and intervention (Catts et al., 2015); this is also called the "Tiered Approach to Instruction" (Robinson & Hutchinson, 2014; Ontario Ministry of Education, 2013). Instruction in the classroom (Tier 1) would be evidence-based Structured Literacy instruction, using differentiated instruction and universal design for learning (UDL). In this approach, early screening and frequent progress monitoring identifies students who are at risk or struggling; these students are then provided with small group, more intense instruction, again with evidence-based Structured Literacy instruction (Tier 2).  Students who struggle in Tier 1 and 2 are offered Tier 3, one-on-one, personalized instruction.  Full psycho-educational assessments are not required to access intervention. This is critical because students often do not receive the services they need while waiting for further assessment.  A full psycho-educational assessment can be used to fully assess the learning challenges of these students to better inform instruction and accommodations.

The critical point is that effective, Structured Literacy instruction must occur in all Tiers, including the general classroom (Tier 1).  All students, including those with dyslexia and other struggling readers, will benefit from this approach and effective implementation of Structured Literacy instruction in the classroom (Tier 1) can reduce the number of students requiring Tier 2 and Tier 3 services (Kilpatrick, 2015).