Putting Research Into Practice Three-Tier Approach Holds Promise in Helping Children Read and Write School Matters
School Matters  |   September 01, 2003
Putting Research Into Practice
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Development / School-Based Settings / Language Disorders / Reading & Writing Disorders / Speech, Voice & Prosody / School Matters
School Matters   |   September 01, 2003
Putting Research Into Practice
The ASHA Leader, September 2003, Vol. 8, 8. doi:10.1044/leader.SCM2.08172003.8
The ASHA Leader, September 2003, Vol. 8, 8. doi:10.1044/leader.SCM2.08172003.8
A three-tier model that links research to practice and assessment to intervention holds promise for helping all children read and write. This model also could create collaborations among speech-language pathologists, psychologists, and teachers in implementing language-based instruction for preventing and treating reading and writing disabilities.
The tiers are the result of nearly 15 years of research at the University of Washington (UW) by Virginia Berninger, a professor of school psychology, and her colleagues that is funded by the National Institute of Child Health and Human Development. Combining longitudinal studies on reading and writing—and the connection between the two—with instructional research and brain-imaging studies, Berninger developed a model to transform struggling students into functional readers and writers as quickly as possible.
“These kids know that they’re not catching on in reading and writing,” Berninger said. “And as kids who are poor readers and writers get older, they become angry and act out or become sad and withdraw.”
The Three Tiers
At a Schools 2003 session on “Helping Every Child Become a Reader and Writer: A Three-Tier Model of Assessment-Intervention Links,” Berninger shared her approach:
  • Tier1—screen children in kindergarten to second grade to identify and provide early intervention

  • Tier2—assess and modify the general education curriculum and monitor students’ progress

  • Tier3—diagnose and treat children who fail to respond to the first two tiers and offer special education services to those with persistent difficulties

Each tier is linked to the Process Assessment of the Learner (PAL) Test Battery that can be used in conjunction with WIAT II, or another achievement measure, and the PAL Research-Supported Reading and Writing Lessons.
The first tier offers early screening to catch poor readers and writers before they fall further behind. A large-scale study cited in Keeney and Keeney (1966) showed that when reading problems are identified in first or second grade, 85% will be brought up to grade level, but when reading difficulties are identified in fifth through seventh grade, only 10%–15% will read on grade level.
To help at-risk readers, instruction should be aimed at multiple components and levels of language that are taught close in time. In first grade, for example, the alphabetic principle (which phonemes correspond to one- and two-letter spelling units) can be taught to automaticity in isolation, applied strategically to word context, and then used to self-regulate fluent reading of text in books for meaning—all during a 20-minute lesson.
“We need to teach all of these components within a short time period and teach orthographic awareness of one- and two-letter spelling units in written words that correspond to phonemes as explicitly as phonological awareness of the phonemes in spoken words,” Berninger said.
In the second tier of assessment and intervention, clinicians should assess whether students are receiving all necessary components of the curriculum, adding missing components and modifying components that are not effective. In the Washington schools, a statewide pilot showed tier two assessment and intervention greatly reduced—by 73%—the number of children who needed special education services in later grades.
At the third tier stage, those children who have persistent difficulty with reading and writing should be assessed to determine why they are struggling, whether they qualify for special education services, and how general education can provide the explicit, systematic instruction they require.
A Look Into the Brain
Berninger explored the definition and etiology of dyslexia and its link with dysgraphia, while differentiating dyslexia from language learning disability (LLD). All these disorders benefit from explicit phonological, orthographic, and morphological awareness in literacy instruction, but children with LLD need even more intensive instruction in morphological and syntactic awareness than do children with dyslexia, who may have a strength in morphological processing despite their problems with written words.
Family genetics and brain-imaging studies conducted by Berninger’s research team confirm findings of other researchers that dyslexia is a brain-based genetic and neurological disorder. In a series of studies in which dyslexics and age- and IQ-matched able readers are imaged before and after the dyslexics receive treatment, the UW team showed that dyslexics’ brains are responsive to instruction. Dyslexics differ from controls before—but not after—treatment in efficiency of neural metabolism and amount of blood flow during phonological processing in left frontal regions and in the amount of blood flow in the word-forming centers in the rear brain while processing morphological, phonological, or orthographic word forms.
“Dyslexics have brain differences that can be modified through treatment,” Berninger said. “These differences may not always be cured, and some individuals require explicit instruction throughout schooling to process and produce written language.”
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September 2003
Volume 8, Issue 17