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.

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 to identify 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).

Progress monitoring

Progress monitoring is a critical part of the RTI framework to determine students' response to the chosen intervention and their rate of improvement.  Skills that the students have not mastered are identified and instruction can be modified to target those skills. IDA, based on the IES Practice Guide, Assisting Students Struggling with Reading: Response to Intervention (RTI) and Multi-Tier Intervention in the Primary Grades states that progress can be monitored weekly, but no less than once per month (see IDA's fact sheet 'Universal Screening - K-2 Reading').

Early screening and progress monitoring measures

The International Dyslexia Association suggests these measures for early screening and progress monitoring for reading by grade; each grade is on a separate tab in the table (from the IDA Fact Sheet "Universal Screening - K-2 Reading").

Regarding the monitoring of oral expressive and receptive language, the IDA Fact Sheet notes that "The assessment of oral expressive and receptive language (including vocabulary, syntax, and comprehension) provides key information in an individual’s reading profile and is predictive of reading outcomes. Unfortunately, there are limited measures at the K-2 level to assess these areas for screening purposes. Without such screening measures, testing for expressive and receptive language is usually done in diagnostic evaluations" (Gersten et al., 2008).

Recommended early screening and progress monitoring measures for reading (by grade)

Kindergarten

Early screening measures

  • phonological awareness including phoneme segmentation
  • blending, onset, and rime
  • rapid automatic naming including letter naming fluency
  • letter-sound association
  • phonological memory, including non-word repetition

Progress monitoring measures

  • phonemic awareness measures, especially measures of phoneme segmentation
Grade 1
Grade 2

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 SLD/Dyslexia Assessment Resource Guide by the Connecticut State Department of Education (2017), and the Alabama Dyslexia Resource Guide (Appendix A) by the Alabama State Department of Education (2016).  Other jurisdictions have also published Dyslexia Handbooks, some of which have screening recommendations - see "Dyslexia in Other Countries" on our website.

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.

Tim Odegard and others at Middle Tennessee State University have published Dyslexia within RTI:
A guide for identifying and providing instruction to students with characteristics of dyslexia in grades K - 3 which includes suggestions for specific early screening and progress monitoring measurements and tools for different grades.