381 META-ANALYTIC REVIEW OF RESPONSIVENESS-TOINTERVENTION RESEARCH: EXAMINING FIELD-BASED AND RESEARCH-IMPLEMENTED MODELS Matthew K. Burns James J. Appleton Jonathan D. Stehouwer University of Minnesota A responsiveness-to-intervention (RTI) approach to diagnosing LD is a leading alternative to current practice. This study conducted a meta-analytic review of research on four existing large-scale RTI models and other models implemented for research. Twenty-four effect sizes and unbiased estimates of effect (UEE) were computed. Results found a larger UEE for studies of existing RTI models than those implemented by university faculty for research, but both were strong. The UEE for student achievement and sys- temic outcomes both exceeded 1.0, but the UEE for systemic outcomes among field-based RTI models was nearly twice as large as for student outcomes. Further, RTI models implemented for research led to an UEE of 1.14 for student outcomes and 0.47 for systemic outcomes. The mean percentage of nonresponders in the studies was 19.8% = SD 12.5), and ( an average of 1.68% ( SD 1.45) of the student population was placed into special education. Implications for practice and future research are included. = Changing current educational practice is a frustrating and discouraging process whereby disagreement is fundamental to success and success is unlikely to occur (Goor, 1995). The mandate for the education of children with disabilities was established in 1975 with the original authorization of the Individuals with Disability Education Act (IDEA). Yet special education has not experienced much substantive and lasting change in the 30 years since its formal inception, despite frequent and meaningful controversies (Ysseldyke, Algozzine, & Thurlow, 2000). An especially intense debate has developed in special education around proposed changes in the reauthorization of IDEA because some seemingly dramatic reforms have been discussed. Perhaps the most notable could be the diagnosis of specific learning disabilities (LD). Although the diagnosis of LD in the schools has a long history of controversy, beginning almost immediately after the initial implementation of IDEA (Aaron, 1997; Meyer, 2000; Myers & Hammill, 1990; Ysseldyke, Algozzine, & Epps, 1983), most states continue to use diagnostic procedures outlined in 1975 (Tomasi & Weinberg, 1999). Alternative procedures discussed as potential federal mandates represent a significant departure from current practice. The President’s Commission on Excellence in Special Education (PCESE, 2001) fueled debate when it endorsed a responsiveness-to-intervention (RTI) diagnostic approach for LD. Gresham (2001) defined RTI as identifying a child with LD only after academic behaviors do not significantly change pre- and postimplementation of a validated intervention. The concept of determining special education eligibility based on a lack of progress is not new (e.g., Fuchs & Fuchs, 1998; Vellutino et al., 1996), and advocates argue that federal special Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 382 always included an RTI component in its definition of LD by mandating learning experiences appropriate for the child’s age and ability levels before assessing for a severe discrepancy. However, a single definition of RTI has yet to be established, and the meaningful differences that exist between the definitions and models that have been presented by various groups have &dquo;inadvertently contributed to the confusion surrounding RTI&dquo; (Fuchs, Mock, Morgan, & Young, 2003, p. 159). Regardless of the RTI model proposed, each generally involves group problem solving, close monitoring of student progress, implementation of researchbased individual interventions, and consideration for special education services only after a student fails to respond adequately (Fuchs et al., 2003). There is a long history of research searching for validated behavioral and academic interventions (e.g., Kavale & Forness, 2000; Shapiro, 2004; Shinn, Walker, & Stoner, 2002; Swanson, 1999, 2000; Swanson, Hoskyn, & Lee, 1999). Previous studies that addressed the use of monitoring progress to responsiveness used norm-referenced achievement tests as postintervention criteria for adequate response (e.g., a standard score of 90 or higher; Torgesen, Alexander, Wagner, Rashotte, Voeller, & Conway, 2001) or the determination of the slope of student growth between pre- and postintervention measures (Vellutino et al., 1996). In recent years, a more common approach to progress monitoring education law has involves the of curriculum-based measurement (CBM) data to determine of responsiveness over a 2-month period (Deno, Fuchs, estimate slopes & Marston, Shin, 2001; Fuchs, 2003; Fuchs & Fuchs, 1998; Fuchs, Fuchs, & Speece, 2002), for comparisons to postintervention benchmarks (e.g., 40 words/minute for reading fluency at the end of the first grade, Fuchs, 2003; reading 50 words/minute in third grade, Burns, Tucker, Hauser, Thelen, Holmes, & White, 2002), or to compare the slope and level of the data to peers (Fuchs, 2003; Speece, Case, & Molloy, 2003). The optimal method of assessment to serve the needs of children is still being determined by ongoing research. Perhaps one aspect of RTI that research has conclusively supported is the effectiveness of a group problem-solving model (Tilly, 2002). Fuchs et al. (2003) identified four group-level problem-solving models that are consistent with RTI, two of which are used to make decisions regarding special education eligibility (see Fuchs et al., 2003, for a detailed description of each): Heartland Agency (Iowa) Model (Heartland; Ikeda, Tilly, Stumme, Volmer, & Allison, 1996); Ohio’s Intervention Based Assessment (IBA; Telzrow, McNamara, & Hollinger, 2000); Pennsylvania’s Instructional Support Teams (IST; Kovaleski, Tucker, & Duffy, 1995); and Minneapolis Public School’s Problem-Solving Model (MPSM; Minneapolis Public Schools, 2001). These four are widely presented as large-scale implementations of RTI currently in practice that have their roots in prereferral group problem solving (Fuchs et al., 2003). A previous review of research on prereferral intervention assistance teams found strong effects for student (e.g., increased task completion and decreased behavioral and academic difficulties) and systemic outcomes (e.g., reduction of referrals to and subsequent new placements in special education), but the average effect size associated with teams that were implemented for research use as an Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 383 than twice as large as those studies that included teams in the field (Burns & Symington, 2002). It was hypothesized already existing that the difference in size of effect was due to inconsistent implementation among the latter group (Burns & Symington, 2002), which could significantly purposes was more hinder future developments in group problem solving (Burns, Vanderwood, & Ruby, 2005). Therefore, a comparison of similar variables between existing RTI models and those implemented for research purposes could suggest whether similar implementation issues affect results. National policy regarding LD diagnosis has widespread implications for children, given that those diagnosed as LD represent over 50% of all children identified with a disability and approximately 5% of the total school population (Lerner, 2002). Thus, whereas some suggest a cautious transition toward an RTI model for eligibility and diagnosis (Fuchs et al., 2003), others generally oppose this transition, considering it a dramatic shift from current practice (Hale, Naglieri, Kaufman, & Kavale, 2004). Although the unknown creates anxiety, school personnel tend to exhibit a somewhat perpetual search for and fascination with that which is new (Ellis, 2001). Therefore, as was the case with many seemingly new educational innovations, RTI has been embraced with enthusiasm among some scholars (Gresham, 2002; Gresham et al., 2004; Reschly & Ysseldyke, 2002), government officials (Pasternack, 2002), professional associations (Fuchs et al., 2003), and many school psychologists (Reschly, 2003). However, important questions remain unanswered, including (a) Do we have validated intervention models and measures to ensure instructional validity (Vaughn & Fuchs, 2003)? (b) Are there adequately trained personnel to implement an RTI model (Vaughn & Fuchs, 2003)? (c) Are parents and others prepared for the noncategorical approach to special education service delivery that will likely be the result of an RTI model (Fuchs et al., 2003)? and (d) How many children would be identified as nonresponders within an RTI model (Hale et al., 2004)? As should be the case in an evidence-based practice, research data are needed to answer these questions and to determine if RTI is worthy of a des- ignation as scientifically based practice (Fuchs et al., 2003). Some of these unanswered questions are being addressed by current researchers, with some having sociological implications (e.g., parental acceptance of a noncategorical approach to special education) that make them difficult to answer before implementation. Kavale and Forness (2000) suggested that meta-analytic research procedures were necessary when considering policy changes in special education. Thus, research on four existing large-scale RTI models could provide data with which some important questions could be answered. However, given the differential effectiveness found between group problem-solving teams in research and in practice (Burns & Symington, 2002), a similar comparison of the effectiveness of RTI models used in research to those that exist in practice seems necessary to determine if the effectiveness of a model differs according to the setting in which it is used and to determine in which settings the models are most effective. Therefore, the purpose of the current study was to review existing research on RTI and the four specific models of RTI currently in practice (Heartland, IBA, IST, and MPSM). This metaanalysis was designed to address three questions: Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 384 the large-scale RTI models currently in practice those as compared developed for research? 2. Does RTI lead to improved systemic and student outcomes? 3. On average, what percentage of the student population was determined to have a disability under RTI? 1. How effective are to It should be noted that although the purpose of meta-analytic research is often to compare different approaches, the current study explored only the effectiveness and outcomes associated with RTI and made no attempt to compare RTI to traditional special education or any other service delivery model. METHOD Data Collection The PsycINFO, ERIC, and Education Abstracts databases were searched for articles between October 11th and 15 th , 2004. This search for articles was not restricted by any a priori specified date range. The following terms were searched for, with the subsequent results listed in parentheses: response (and responsiveness) to intervention (145 hits); response (and responsiveness) to instruction (108); Heartland model (35); Heartland (108); intervention-based assessment (18); instructional support team (137); and Minneapolis problemsolving model (23). Articles that did not directly address RTI or one of the four models were eliminated, leaving 21 total articles. Next, the references of the relevant studies were examined and potentially applicable entries that were not yet identified were collected. This increased the potential pool to 31 articles. Finally, articles identified through the search and reference lists were narrowed by comparing them to the following criteria: 1. The study implemented one an intervention (e.g., intensive remedial al., 2001) or a systemic intervention (e.g., of the four problem-solving models) with children experienc- instruction; Torgesen et ing academic difficulties or identified as learning disabled. 2. The study provided measures of either individual student learning, such as postintervention and/or growth assessments, or systemic outcomes (e.g., number of children identified as LD). 3. The study used a unit of analysis that was either the individual students or school buildings. Thus, studies that provided school district or statewide data were not used unless the data could be converted to the school building unit level. 4. The study included at least one between-group comparison and/ or at least one within-group comparison of the outcomes. 5. The study presented quantitative data that could be used to compute effect sizes. Means and standard deviations for both experimental and control groups, or pre- and postimplementation, were necessary. However, the study was also included if enough data were provided to compute the necessary means and standard deviations or if statistical analyses provided enough data to compute an effect size. 6. The study was written in English. Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 385 Of the articles found through various search lists, 21 met the inclusion criteria and erence and by perusing refincluded in the meta- engines were analysis. Categorization Articles of Studies categorized according to three criteria. First, studies were categorized descriptive of one of the four RTI models already in practice (Heartland, IBA, IST, and MPSM, as identified by Fuchs et al., 2003) or of an intervention model developed and implemented for research purposes. Approximately half of the studies (11 of 21 ) addressed one of the existing RTI as were either models, with 2 that addressed Heartland, 3 that addressed IBA, 4 that addressed IST, and 2 that addressed MPSM. The remaining 10 studies examined interventions implemented for research purposes. Burns and Symington (2002) found large effects for prereferral group problem-solving models using various student and systemic outcomes. Given the demonstrated relevance of this distinction, these two categories were also used to assign current studies into one of two groups. Measures that were placed into the student outcomes group included assessments of academic skill, estimates of growth in a particular skill, and observations of time on task and task completion related to academic interventions. Systemic variables included referrals to and/or placements in special education, student time in special education services, and number of students retained in a grade. It should be noted that some studies addressed more than one effect. Thus, some studies received more than one designation, which resulted in 11 (52.4%) being classified as student outcomes and 14 (66.7%) as system outcomes. Finally, data that were aggregated, presented, and/or analyzed with students as the unit of analysis (e.g., average reading score among 138 students) were classified as student units, and those that examined schools as the unit of analysis (e.g., mean number of new placements into special education among the 36 participating school buildings) were classified as school units. Studies could again receive more than one designation if more than one effect was examined. Therefore, 13 (61.9%) were classified as school units and 12 (57.1 %) were classified as student units. Analyses were not conducted based on this variable alone, but these data were used to compute effect sizes within comparable units of analysis. A second person, who was a school psychology doctoral candidate, also coded 66% of the studies in order to assess interrater consistency. The number of studies that were placed into the same category by both coders was divided by the total number of studies. The result of this calculation demonstrated 100% agreement. Effect Size Calculation The statistic of interest in meta-analyses is the effect size Valentine, & Charlton, 2000). Cohen’s d (Cohen, 1988) (ES; Cooper, computed by subthe mean of the control group from the mean of the experimental group, or the mean of the pretest from the mean of the posttest. Next, the was tracting Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 386 product was divided by the pooled standard deviation of the two groups ((SDI + SD2) /2) in order to express the difference between measurements in a common standard deviation (Cooper et al., 2000). Redundancy within studies was addressed by pooling effect sizes among data that represented the same effect. For example, a study may use multiple measures of reading (e.g., phoneme segmentation fluency and oral reading fluency), present means of subscales from the same tool, or present data for referrals to and placements in special education. In these examples, the individual effect sizes were not independent and a mean ES was computed. After computing the ES and the measures of central tendencies for the various groupings, the aggregated data were used to compute an unbiased estimate of effect (UEE) using the formula outlined by Hedges (1982). The UEE is a weighted estimator of effect using d and the sample size for each individual study. Thus, UEE was computed only if the aggregated data were all from the same unit of analysis (school or student). RESULTS As stated above, 25 total effect sizes were computed. These effect sizes ranged from 0.18 to 6.71, with a mean ES of 1.49 (SD 1.43) and a median ES of 1.09. Computing an UEE weighting these results according to sample size was inappropriate at this point given the differing units of analysis (i.e., student = and school). The variance of the 25 effect sizes was examined by computing a Mahalanobis D to identify significant outliers. This examination led to the removal of one effect size that was a substantial outlier in the positive direction. Recalculation of the remaining 24 effect sizes indicated a range from 0.18 to 3.04. The mean ES for these data was 1.27 (SD .94), with a median ES of 1.02. The remaining sections will report results for the data summarized by these 24 effect sizes. Table 1 displays the mean, median, and standard deviations of the effect sizes associated with the variables of interest to the current study. Eight studies examined RTI models designed by university faculty and implemented for research purposes, and 16 presented data from existing RTI models in the field, both of which led to mean effect sizes greater than 1.0, but researchimplemented RTI models led to a median ES of .86. The UEE for studies of existing RTI models was 1.42, and 0.92 for those implemented by university faculty for research. = Table 1 Unweighted Mean and Median Effect Sizes for Categories and Total Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 387 Student and systemic outcomes were also examined and resulted in mean and median effect sizes that ranged from 0.72 to 1.53. The systemic effects were approximately one third larger than the student effects. Unbiased estimates of effect for these two variables were 1.02 for student and 1.54 for systemic outcomes. Thus, the UEE was larger for systemic outcomes at a magnitude that was slightly smaller but similar to d. A further comparison between university-based and field-based RTI models was conducted by examining student and systemic outcomes of these studies. RTI models currently implemented in the field ( n 11) led to a mean ES of 1.73 (SD 0.99) for systemic variables but resulted in a mean ES of 0.62 (SD 0.33) for student outcomes ( n 5). A reverse relationship was noted for RTI models implemented by university faculty for research, with a mean ES of .47 (SD .07) for systemic outcomes (n 2) and 1.23 (SD = .95) for student outcomes ( n 6). UEE was computed for these variables as well. Field-based RTI models resulted in a UEE of 0.94 for student outcomes and 1.80 for systemic outcomes. RTI models implemented for research led to a UEE of 1.14 for student outcomes and 0.47 for systemic outcomes. Concern was expressed that using an RTI approach for LD diagnoses would lead to a dramatic increase in the number of children identified as nonresponders, and therefore labeled as LD (Hale et al., 2004). The current study examined this by recording percentages of nonresponders within the included studies. Eleven studies reported a percentage of children who were classified as nonresponders. The range of nonresponders was from a low of 2.7% to a high of 44.0%, with an average of 19.8% (SD 12.5). This number represents the percentage of children who were identified with learning difficulties and participated in the intervention but did not meet the individual study’s operational definition of adequate responsiveness to the intervention. A 12th study (Torgesen et al., 2001) reported 68.6% nonresponders, but participants were previously identified as LD according to traditional methods and were already receiving special education services. Thus, the results of Torgesen et al. suggest that 31.4% of students already identified with LD responded to an RTI = = = = = = = = approach. In addition to calculating the percentage of nonresponders within the study, four studies that used existing RTI models (IST and MPSM) reported the percentage of the student population within the schools that was referred to or placed into special education. In those studies reporting referral rates, an average of 1.26% (SD 0.65) of the student population was referred for a special education eligibility assessment. In those studies reporting placement rates, an average of 1.68% (SD 1.45) of the population was placed into special education. It should be noted that these studies examined referral to or placement in special education and did not necessarily examine both. Finally, the same four studies also reported the percentage of the student population that was referred to the problem-solving team within the RTI model, the average of = = which was 5.98% ( SD 2.97). Given that approximately 6% of the student population participated in the RTI model and less than 2% were then later considered for special education, it seems that on average just over 4% of the student population benefited from RTI, but the exact extent of the influence of RTI remains uncertain. = Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 388 DISCUSSION study investigated the effectiveness of large-scale RTI models as compared to those developed for research and examined systemic and student outcomes. Both field-based and university-based RTI models led to strong effects, with the former stronger than the latter, but larger effects were found for systemic rather than student outcomes. These results suggest the following answers to the research questions posed. The current 1. How effective pared to those are the developed large-scale RTI models currently in practice as com- for research?<’ One readily apparent finding in this research is the consistently strong effects of RTI implementations currently in practice (field-based). Whether calculated using Cohen’s d or UEE, field-based efforts consistently demonstrated stronger effects than university research-based efforts. These results seemingly contrast with the stronger university-based results noted by Safran and Safran (1996) and subsequently supported by meta-analytic research (Burns & Symington, 2002). Previous research hypothesized that stronger universitybased results were probably due to infidelity in implementation (Burns & Symington, 2002). One possible suggestion for the current finding is the longer duration of implementation for these field-based efforts as compared to the university-based models. These increased effects may reflect refining of the RTI process at these sites over this extended period and could suggest that implementation and refinement over a period of years could increase the likelihood of success. Implementation was used to hypothesize as to why university-based prereferral teams were more successful than field-based teams and why fieldbased RTI models led to stronger effects than university-based models. Thus, implementation appears to be a critical issue, but these are merely hypotheses that require additional empirical scrutiny. Another explanation of these findings may lie with the quasi-experimental design of the studies. Such designs allow for threats to the internal validity of studies that when not controlled may produce effects that can be confounded with the effects of the experimental stimulus (in this case, field-based RTI models) (Campbell & Stanley, 1963). Illustrating the importance of randomized controlled trials (RCT) in establishing causal validity, well-constructed RCTs are listed as providing the best evidence of effects and included in the What Works Clearinghouse category of studies &dquo;meeting evidence standards,&dquo; whereas even the best-constructed quasi-experimental designs are unable to attain this level of prominence (What Works Clearinghouse, 2004). A tangible example of uncontrolled confounding effects would be if schools that chose to implement RTI models were composed of staff already more committed to prereferral intervention. 2. Does RTI lead to improved systemic and student outcomes? This study clarified that sites implementing RTI had both improved systemic and student outcomes (UEE 1.54 and 1.02, respectively). An examination by type of study and outcome revealed that field-based efforts had slightly = Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 389 smaller improvements in student outcomes (but still substantial at UEE 0.94), but systemic outcomes that were over three times larger than research-developed efforts (UEE 1.80 vs. 0.47, respectively). Finding that both systemic and student outcomes improved with an RTI model in use is a promising sign. The tremendous difference in systemic outcomes between field-based and researchbased efforts may, again, be a function of length of implementation. Given that student outcomes are comparable, it would appear that researchers should focus on this difference in future examinations by gathering data to clarify potential explanations for this finding. Cohen (1988) classified an effect size of .80 or larger as representing a strong effect. All but two mean and median effect sizes exceeded .80, with one being .72. Thus, the RTI models previously researched demonstrated strong effects in improving student learning and systemic variables. Although there is some controversy regarding the RTI approach to identifying LD (Fuchs et al., 2003; Gresham et al., 2004), the strong effects noted in the current study suggest reason for optimism. = = 3. On average, what have a disability percentage of the student population was determined to under RTI? An additional variable of interest to the study is the percentage of the student population who were identified as LD within an existing RTI model. On average, less than 2% of the student population was identified as LD among studies examining field-based RTI models. Previous estimates of LD prevalence concluded that 5% of the student population experienced a learning disability (Lerner, 2003). The Twenty-Fourth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act (United States Department of Education, 2002) reported that 2,887,217 school-aged children were identified with a learning disability, which equals 5.7% of the total estimated student population in this country. Although it is difficult to predict the effect a federal mandate for RTI would have on LD prevalence nationwide, it seems that large-scale implementation of various RTI models led to fewer students identified as LD. Thus, concerns about large numbers of children identified as nonresponsive leading to dramatic increases in LD (Hale et al., 2004) were not validated by the current data. However, the definition of nonresponsiveness could have varied between models, and conclusions based on these data should be made cau- tiously. Vellutino et al. (1996) presented data relevant to the LD prevalence question. In attempting to elicit the academic characteristics of 118 students who emerged as reading disabled using exclusionary criteria only, Vellutino et al. found that early and labor-intensive intervention effectively discriminated between difficult-to-remediate and readily remediated readers. In addition, the use of response to early intervention to distinguish readers resulted in only 3% of students from the population scoring below the 30th percentile after one semester of remediation versus 9% using exclusionary only criteria (Vellutino et al. ) . Moreover, a subsection of the group identified as poor readers not only improved their reading as a function of the intervention but also neared normal levels of reading and consistently performed at this higher level relative to Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 390 other groups of poor readers. These findings suggested not only that RTI would not increase the number of students receiving special education services but could also serve to reduce those numbers. Likewise, the Vellutino et al. findings seemed to indicate that RTI did this by elucidating group differences among poor readers, thereby supporting those readers who are capable of performing at near-average levels to do so. These data also suggest an entwined relationship between student skill growth and LD diagnosis. Limitations Several limitations should be explicated regarding this study. As one might expect, some searches using derivations of problem-solving model names (e.g., problem solving) produced extremely lengthy and seemingly irrelevant lists (e.g., 8,748 records for &dquo;problem solving&dquo;). Researchers conducted cursory examinations of these lists but reserved closer examinations for searches using complete model names or partial model names with more manageable lists of records (e.g., &dquo;Heartland&dquo;). It is possible, but not probable, that a relevant study could have been found within the lengthy results of such a search and not within a search using the full model name. In the current analysis, two of the field-based models use RTI as a prereferral process (Ohio and Pennsylvania), whereas the other two models (Heartland and Minneapolis) use RTI to determine special education eligibility. The current examination of a wide range of field-based RTI models combines outcomes that may provide other useful information if evaluated separately. None of the articles and data used in this meta-analysis was solicited per se, but relevant unpublished data referenced in articles were requested from those researchers. Whereas this effort was an attempt to offset any &dquo;file drawer&dquo; research shortcomings and did result in the inclusion of unpublished data, researchers could extend this effort by actively soliciting unpublished research. Finally, some caution should be exercised when interpreting these data given the relatively large standard deviations for the effect sizes. Removing outlier data reduced the size of the effect sizes, but two standard deviations were still as large as the median effects. Therefore, conclusions from those two categories should be made carefully. Moreover, there was a relatively small number of studies for some variables (e.g., four studies examining incidence levels for LD), which suggested the need for caution when interpreting those findings as well. Suggestions for Future Research Perhaps the most important result of any research is to point out the need for additional research. It seems that the effect of RTI on LD prevalence needs additional empirical scrutiny using controlled rather than quasi-experimental studies. Moreover, controlled studies of systemic outcomes in general appear warranted. Specifically, RCT studies are needed to examine the effect of RTI implementation on referrals to and placements in special education, student time in special education services, and number of students retained in a grade. Finally, implementation fidelity remains a crucial aspect of any intervention or system of interventions. Therefore, the effect of fidelity in implementation on RTI appears to be crucial data. Downloaded from http://jpa.sagepub.com at UNIV OF UTAH on August 12, 2008 © 2005 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution. 391 As stated earlier, almost three million children in this country are diagnosed with a learning disability and there is a long history of controversy surrounding the diagnosis. It is difficult to speculate how such a controversial approach was implemented or what would happen if it changed. Scriven (1983) stated in his response to Glass’s (1982) meta-analysis of special education research, &dquo;I cannot say what I think the pessimist could say about our research and our practice in special education at this point, but I think the optimist could say that we have a wonderful opportunity to start all over&dquo; (p. 84). That statement was made over 20 years ago and although starting all over again may be an extreme position, it seems the current reauthorization of IDEA presents an unprecedented opportunity to examine current practice and reform as needed. However, reforms should occur only after extensive research regarding proposed initiatives is conducted. This will help ensure that new approaches will not experience the same level of controversy as their predecessors. REFERENCES marked with an asterisk indicate studies included in the meta-analysis. Aaron, P. G. (1997). The impending demise of the discrepancy formula. Review of Educational Research, 67, 461- References 502. Burns, M. K., & Symington, T. (2002). A meta-analysis of pre-referral intervention teams: Student and systemic outcomes.Journal of School Psychology, 40, 437-447. H. M., Valentine, J. C., & Charlton, K. (2000). The methodology of meta-analysis. In R. Gersten, E. P. Schiller, & S. 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