1. 204
The Reading Teacher Vol. 65 Issue 3 pp. 204–208 DOI:10.1002/TRTR.01031 © 2011 International Reading AssociationR T
P E R S P E C T I V E S O N R T I
DIAGNOSIS
D
escriptions and advice about Response
to Intervention (RTI) implementations
often focus on assessment. In an earlier
column, Wixson and Valencia (2011)
described the multiple purposes for assessment in an
RTI system:
■ Screening
■ Diagnostics
■ Formative progress monitoring
■ Benchmark progress monitoring
■ Summative outcome assessment
Because RTI is an approach to identifying students
as learning disabled, it is important to attend to the
quality of the measurements used to make high-
stakes decisions about student placements. However,
RTI is also intended to reduce the number of
students who become identified as having a learning
disability by preventing reading difficulties. This is an
instructional problem and, as Scanlon and Anderson
(2010) noted, too little attention is given to “the nature
and qualities of the instruction that is offered” (p. 21).
All students deserve high-quality first instruction (we
will address this topic in an upcoming column).
However, good teaching requires thoughtful
assessment. Furthermore, some students continue to
struggle, even when they receive very good classroom
instruction. These students need more tailored
instruction that is responsive to their specific strengths
and areas of need. Screening measures designed to
identify struggling students are usually quite general or
sample only a snippet of skilled reading performance.
They rarely provide the specific information needed
to determine the most appropriate intervention or
instruction.
By itself, this would not be problematic. However,
many schools and districts have created RTI systems
that move straight from screening to instruction
without looking more closely at the individual
student, an approach called the direct route (Johnson,
Jenkins, & Petscher, 2010). Of course, when the
direct route decision is based on only one screening
instrument, there is quite a grave possibility of error
in classification (false negatives or false positives). As
well, these single measures do not provide enough
information to make good instructional decisions
about individuals or small groups of students
(Valencia et al., 2010).
This problem is exacerbated when the school adopts
a one-size-fits-all intervention, a practice sometimes
called standard protocol (Fuchs et al., 2003). Although
Fuchs and his colleagues were clear that a standard
protocol was to be employed with groups of students
with similar reading difficulties, a single screening
measure often invites only one possible response, and,
Marjorie Y. Lipson and Pam Chomsky-Higgins provide research and
professional development support to schools through the Vermont Reads
Institute at the University of Vermont, Montpelier, USA; e-mail mlipson@
vriuvm.org and pamela.chomsky-higgins@uvm.edu.
Jane Kanfer is a reading specialist at Milton Elementary School in
Vermont; e-mail JKanfer@mtsd-vt.org.
The department editors welcome reader comments. Karen K. Wixson
is dean of the school of education at the University of North Carolina
at Greensboro, USA; e-mail kwixson@uncg.edu. Marjorie Y. Lipson is
Professor Emerita at the University of Vermont, Burlington, USA; e-mail
mlipson@uvm.edu.
The Missing Ingredient in RTI Assessment
MarjorieY. Lipson
with Pam Chomsky-Higgins ■ Jane Kanfer
TRTR_1031.indd 204TRTR_1031.indd 204 11/7/2011 4:05:47 PM11/7/2011 4:05:47 PM

2. DIAGNOSIS: THE MISSING INGREDIENT IN RTI ASSESSMENT
www.reading.org R T
205
for many schools, the direct route leads to
just one instructional option.
A very large body of research is
emerging to confirm what good teachers
and specialists have always known: the
underlying roots of students’ reading
difficulties are diverse (Aaron et al.,
2008; Valencia & Buly, 2004). In addition,
it is becoming quite clear that instruction
focused on the wrong thing not only
does not help students, but it may
actually be harmful (Connor, Morrison,
& Katch, 2004). It should be a very high
priority for teachers and specialists
to gather specific information about
individual students to make appropriate
instructional decisions. So, we turn
our attention to an essential, but often
neglected, type of assessment: diagnosis.
Using Assessment
for Diagnostic Purposes
Because the word diagnosis is so often
associated with identifying disease or
its symptoms, we want to be clear that
we do not assume a medical model of
reading difficulties. Instead, we want
to promote the original meaning of
the word diagnosis, from the Greek to
discern the nature and cause of anything.
According to Merriam-Webster, a
diagnosis is “an investigation or analysis
of the cause or nature of a condition,
situation or problem” (www.aolsvc
.merriam-webster.aol.com/dictionary/
diagnosis). Without very good diagnostic
information and/or a flexible formative
assessment system, our instructional
programs and student performance will
not improve, and RTI will simply be
an alternate route to special education
placement or to permanent membership
in Title I classrooms.
We have been collaborating with
many Vermont schools to improve
literacy success for all students and have
recently turned our attention to helping
schools adopt a systemic approach to
RTI. Pam and Marge started to work
at Jane’s school 2 years ago. This large
Vermont school was entering year 3 of
corrective action. Despite several years of
attention to literacy, too many students
were identified for special education,
and too few were benefitting from the
literacy instruction they received.
The reading teachers in the building
were knowledgeable and committed.
However, they were relying on a
conventional approach to services. Using
universal assessment data, they identified
students near the beginning of the year,
created a schedule for the students on
“their caseload,” and then pulled those
students from the classroom for the
remainder of the year. The nature of the
instruction provided varied from teacher
to teacher and was not well documented.
More troubling were the longitudinal
data suggesting that students who
participated in reading services (provided
by reading teachers or special educators)
were not gaining ground against their
peers. Although there were exceptions,
students typically continued to qualify for
reading services from year to year, and
their overall performance was below the
state standards.
During year 1 of our collaboration,
Jane and her colleagues began to
examine their available assessment data
much more closely. They moved from
global reading levels to looking at the
component areas of reading (e.g., word
recognition, fluency, comprehension),
and they constructed “typical profiles”
of student difficulties (see Figure for the
framework). The first profiles focused not
Figure Template for Analyzing Student Data and Creating Profiles
Intervention Plan for Literacy—Template
Student Profile: [Describe or name the type of profile—for example, Struggling Grade 1 Student or
Intermediate Comprehension Difficulty]
Intervention Focus: [Describe or name primary focus for intervention]
Area(s) of Primary Concern Evidence and Data Source
Phonological awareness
Letter ID
Sight vocabulary
Fluency
Decoding
Vocabulary
Comprehension
Motivation
Stamina
Writing about reading
Text level
Other
Goal(s) of the Intervention:
Describe the Intervention: [Include Information about:
• Duration
• Frequency
• Materials to be used
• Strategies, techniques, approaches, etc.
• Instructional framework
• Person responsible
• Relationship to classroom instruction]
Progress Monitoring: [How will instructional impact and effectiveness be
assessed?]
TRTR_1031.indd 205TRTR_1031.indd 205 11/7/2011 4:05:48 PM11/7/2011 4:05:48 PM

3. DIAGNOSIS: THE MISSING INGREDIENT IN RTI ASSESSMENT
206
The Reading Teacher Vol. 65 Issue 3 November 2011R T
on the students with the most severe (and
least frequent) types of difficulties, but on
the most common types of difficulties—
arguing that these would have the
broadest impact and might also provide
insights into classroom practices that
could be strengthened. These students
are not necessarily the so-called “bubble
kids,” those whose test results suggest
that they are very nearly proficient (or “on
the bubble”). Cynical practices that direct
teachers to focus on those students so
that schools can realize “improvement”
have been criticized roundly elsewhere
(Koretz, 2008). In some schools, the most
common profile might be students who
are close to proficiency; in others, it could
be other students.
The most common profile when
we started involved struggling grade
1 students who showed very limited
proficiency. We called this profile
“beginning struggling word learner,”
and the intervention focus was strategic
decoding. These were students who had,
with good instruction in kindergarten,
come to grade 1 knowing all or most of
the letter names and many/most letter
sounds. They typically knew a small
collection of high-frequency sight words.
However, they had not met the leveled
text standard for end of kindergarten
(Level B, guided reading level) and were
making very slow progress in letter-
sound blending and in problem solving.
These students were an early focus for
us because we knew that helping them
was pivotal in preventing reading failure
later on, especially because another
common profile in the school involved
students in grades 3 through 6 who had
acquired good decoding skills but whose
comprehension was weak. These students
were especially worrisome because their
performance actually declined as they
moved through the grades.
As we created diagnostic profiles,
Jane and her colleagues detailed the
research-based
intervention
plans
appropriate for
each student.
The result
was similar
to what Dorn
and Henderson
(2010) called
a “portfolio of
interventions.”
Although
Jane’s school
has not fully
implemented
the portfolio of interventions, the results
of the early interventions have been
excellent. By the middle of the second
year of collaboration, every student in
grade 1 who had been identified as most
struggling met or exceeded the standard
on the periodic benchmark assessment
used by the school, and most were
released from intervention. Importantly,
these students did not receive more
intervention than they had in the past;
they simply received more tailored and
focused instruction based on careful
and comprehensive assessment and
the research-based interventions,
confirming what others have observed:
More intervention is not necessarily
better (Wanzek & Vaughn, 2008).
Diagnostic Assessment
Practices
Classroom teachers and reading
specialists may already have excellent
assessment information available to
them collected for screening, periodic
benchmarking, or outcomes evaluation.
In these cases, the challenge is to
adopt systems that permit effective use
of that information for instructional
decision making. Designing data-team
formats and/or profiles can facilitate that
considerably. Other schools and districts
either have few data or have restricted
teachers’ access to the information.
There are two actions that may be
needed: (1) disaggregating existing
data to mine it for insights and/
or (2) planning to gather additional
information. In either event, it is
important to start with a matrix of the
most important component areas of
reading (and writing). These are visible
on the profile planner (see Figure). Of
course, not all information is equally
relevant for all students or all ages/
grades. One of the major difficulties
with a standard protocol approach is
that it may not recognize that there
“The challenge is to adopt systems that
permit effective use of that information
for instructional decision making.”
TRTR_1031.indd 206TRTR_1031.indd 206 11/7/2011 4:05:49 PM11/7/2011 4:05:49 PM

4. DIAGNOSIS: THE MISSING INGREDIENT IN RTI ASSESSMENT
www.reading.org R T
207
are developmental changes in the
relationships between and among
various factors and reading performance
(Valencia et al., 2010).
Whenever possible, it is efficient
to gather observations about multiple
types of reading performance with one
tool. At the very least, this can help
narrow the need for further assessment.
For example, Jane’s school, like many
we work with, uses one of the many
structured inventories or benchmark
assessment systems available (i.e., DRA,
Benchmark Assessment System, QRI-4),
which yields a text level for each student.
Over the past 2 years, the reading
professionals in that building have begun
to examine the results more closely for
evidence of word recognition accuracy,
fluency, and comprehension. Whereas
they had previously used only the text
level to make decisions about student
placements and programs, they now
look more closely at their data. They now
examine (and keep track of) differences
between students’ word recognition
accuracy as distinct from fluency. They
also consider whether students’ accuracy
is affected by phonics decoding, sight
word recognition, or both. Finally, of
course (and especially for older students),
they examine differences between
and among results
in comprehension,
fluency, and word
identification. They have
differentiated instruction
for those students who
were struggling with
comprehension even
though they were quite
fluent and vice versa.
It is important to
examine assessment
results in more than one
way because different
measures can provide
different insights. As
Valencia and her colleagues (2010)
demonstrated, we might get quite a
different picture of a student’s strength
and areas of need with an array of
information than if we relied on only
one score. The student profile form was
intended to encourage teachers to look
at multiple measures to identify areas of
concern that were not at all evident with
only word-level assessment data. This
comprehensive range of information is
important for all struggling readers, but
it is especially important to make good
instructional decisions for older students
and English learners (Klingner, Soltero-
Gonzales, & Lesaux, 2010; Vaughn &
Fletcher, 2010).
Every bit of this diagnostic
information can be gathered during
comprehensive benchmarking events.
Once we have looked at the data, we
can make additional decisions about
both assessment and instruction.
Good diagnosis can sometimes lead
to more assessment. For example, if a
student has made many miscues during
reading, further examination using
a modified miscue analysis can be
helpful (Lipson & Wixson, 2009). If the
student is exceptionally accurate, there
is no need to explore that component.
Similarly, if the student’s comprehension
is strong, we probably do not need
to look to vocabulary. This might
change, of course, if we have evidence
that the student performs less well on
expository text than narrative. Well-
planned diagnostic teaching episodes
can be helpful as well (Fuchs et al., 2007;
Lipson & Wixson, 1986, 2009).
Using Assessment
to Differentiate
We want to emphasize that this type
of closer look, engaging in diagnostic
assessment, is not necessary for
everyone. One of the advantages of an
effective overall assessment system is
that it can identify the students who are
benefitting from classroom instruction
and who are doing well. If we test those
children just a bit less (or use good,
formative assessment effectively), then it
frees up time to assess the students who
really have us worried.
Of course, diagnostic assessment
will not make any difference if it does
not lead to action. Matching students’
needs with instruction by using “if-then”
thinking (Strickland, 2005) is at the heart
of effective and efficient assessment
instruction and is essential if RTI is going
to make a difference. Students who are
struggling for success in the classroom
deserve differentiated instruction in the
classroom and tailored interventions in
supplemental settings. Fortunately, there
is an increasingly strong body of research
that points to the types of instruction
“Of course, diagnostic
assessment will not
make any difference
if it does not lead
to action.”
TRTR_1031.indd 207TRTR_1031.indd 207 11/7/2011 4:05:50 PM11/7/2011 4:05:50 PM

5. DIAGNOSIS: THE MISSING INGREDIENT IN RTI ASSESSMENT
208
The Reading Teacher Vol. 65 Issue 3 November 2011R T
and intervention that can help to prevent
reading disabilities and/or improve
students’ abilities during later years.
REFERENCES
Aaron, P.G., Joshi, R.M., Gooden, R., &
Bentum, K.W. (2008). Diagnosis and
treatment of reading disabilities based
on the component model of reading: An
alternative to the discrepancy model of LD.
Journal of Learning Disabilities, 41(1), 67–84.
doi:10.1177/0022219407310838
Connor, C.M., Morrison, F.J., & Katch, L.E.
(2004). Beyond the reading wars: Exploring
the effect of child-instruction interactions
on growth in early reading. Scientific Studies
of Reading, 8(4), 305–336. doi:10.1207/
s1532799xssr0804_1
Dorn, L. J., & Henderson, S. C. (2010). The
comprehensive intervention model: A
systems approach to RTI. In M.Y. Lipson &
K.W. Wixson (Eds.), Successful approaches to
RTI (pp. 88-120). Newark, DE: International
Reading Association
Fuchs, D., Fuchs, L.S., Compton, D.L.,
Bouton, B., Caffrey, E., & Hill, L. (2007).
Dynamic assessment as responsiveness to
intervention. Teaching Exceptional Children,
39(5), 58–63.
Fuchs, D., Mock, D., Morgan, P.L., & Young,
C. (2003). Responsiveness to intervention:
Definitions, evidence, and implications for
the learning disabilities construct. Learning
Disabilities Research & Practice, 18(3), 157–
171. doi:10.1111/1540-5826.00072
Johnson, E.S., Jenkins, J.R., & Petscher, Y.
(2010). Improving the accuracy of a direct
route screening process. Assessment for
Effective Intervention, 35(3), 131–140.
doi:10.1177/1534508409348375
Klingner, J.K., Soltero-Gonzales, L., & Lesaux,
N. (2010). RTI for English-language learners.
In M.Y. Lipson & K.K. Wixson (Eds.),
Successful approaches to RTI: Collaborative
practices for improving K-12 literacy (pp. 134–
162). Newark, DE: International Reading
Association.
IRA Books
■ RTI and the Adolescent Reader by William G.
Brozo (copublished with Teachers College
Press)
■ RTI in Literacy—Responsive and Comprehensive
edited by Peter H. Johnston
■ Successful Approaches to RTI: Collaborative
Practices for Improving K–12 Literacy
edited by Marjorie Y. Lipson and
Karen K. Wixson
IRA Journal Articles
■ “Response to Intervention (RTI):
What Teachers of Reading Need to Know”
by Eric M. Mesmer and Heidi Anne
E. Mesmer, The Reading Teacher,
December 2008
■ “Responsiveness to Intervention: Multilevel
Assessment and Instruction as Early
Intervention and Disability Identification” by
Douglas Fuchs and Lynn S. Fuchs,
The Reading Teacher,
November 2009
MORE TO EXPLORE
Koretz, D. (2008). Measuring up: What
educational testing really tells us. Boston:
Harvard University Press.
Lipson, M.Y., & Wixson, K.K. (1986). Reading
disability research: An interactionist perspective.
Review of Educational Research, 56(1), 111–136.
Lipson, M.Y., & Wixson, K.K. (2009). Assessment
and instruction of reading and writing
difficulties: An interactive approach (4th ed.).
New York: Pearson Education.
Scanlon, D.M., & Anderson, K.L. (2010).
Using the interactive strategies approach to
prevent reading difficulties in an RTI context.
In M.Y. Lipson & K.W. Wixson (Eds.), Successful
approaches to RTI (pp. 20–65). Newark, DE:
International Reading Association.
Strickland, K. (2005). What’s after assessment?
Follow-up instruction for phonics, fluency,
and comprehension. Portsmouth, NH:
Heinemann.
Valencia, S.W., & Buly, M.R. (2004). Behind test
scores: What struggling readers really need.
The Reading Teacher, 57(6), 520–531.
Valencia, S.W., Smith, A.T., Reece, A.M., Li,
M., Wixson, K.K., & Newman, H. (2010).
Oral reading fluency assessment: Issues
of construct, criterion, and consequential
validity. Reading Research Quarterly, 45(3),
270–291. doi:10.1598/RRQ.45.3.1
Vaughn, S., & Fletcher, J. (2010). Thoughts on
rethinking response to intervention with
secondary students. School Psychology
Review, 39(2), 296–299.
Wanzek, J., &Vaughn, S. (2008). Response
to varying amounts of time in reading
intervention for students with low
response to intervention. Journal of
Learning Disabilities, 41(2), 126–142.
doi:10.1177/0022219407313426
Wixson, K.K., & Valencia, S.W. (2011).
Assessment in RTI: What teachers and
specialists need to know. The Reading
Teacher, 64(6), 466–469.
TRTR_1031.indd 208TRTR_1031.indd 208 11/7/2011 4:05:52 PM11/7/2011 4:05:52 PM

6. Copyright of Reading Teacher is the property of International Reading Association and its content may not be
copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.