Intervention for Dyslexia - The British Dyslexia Association

2 Intervention studies in the US and
the rest of the world
2.1 Stages of intervention in the USA
In the United States, three-tiered public health models have been applied to education.
Tier 1 refers to the provision of high-quality initial literacy instruction with regular
benchmark assessments to identify children who are not responding appropriately to
that instruction (Vaughn & Roberts, 2007). Some researchers have also included
universal screening within Tier 1 in order to identify individuals for preventive treatment
(e.g. Berninger, Winn et al., 2008; Fuchs & Fuchs, 2007). Tier 2, often referred to
generically as ‘secondary intervention’, corresponds to the provision of more intensive
instruction given individually or in groups to failing readers in the early years (i.e. grades
K–3). 4 ‘Tier 3’ or ‘tertiary intervention’ refers to the most intensive special education
given from grade 4 onwards and typically delivered 1:1 (Fuchs et al., 2008). The terms
‘secondary intervention’ and ‘tertiary intervention’ have been adopted in this review
because they are considered to be the most appropriate and are also the terms most
generally encountered in the international research literature. However, it is important
not to confuse the term ‘secondary intervention’ with ‘intervention in secondary school’
nor to confuse the term ‘tertiary intervention’ with intervention given at the tertiary
stage of education, i.e. further and higher education.
Syntheses of the research literature on the effects of different instructional methods on
children with dyslexia, learning disabilities (LD), severe reading difficulties and children
at risk of reading failure conclude that persistent deficits in word recognition and
comprehension are amenable to remedial training (e.g. Foorman et al., 1998; Lyon
Fletcher, Fuchs & Chabra, 2006; Swanson 1999; Torgesen, 2005a, 2005b; Vellutino and
Scanlon, 1991). For the sake of clarity, research studies on secondary intervention and
tertiary intervention will be considered under separate subheadings in this review.
2.2 Secondary intervention studies
There have been several important reviews and meta-analyses of the impact of
secondary intervention, of which the following have been identified as being particularly
noteworthy and therefore are summarised in this section: Swanson (1999), Scammacca
et al. (2007), and Vaughn and Roberts (2007). In addition, research studies that are
most pertinent to the present inquiry have been individually summarised in appropriate
places in the text.
4 Grades in the US school system start with Kindergarten (K) at age 5–6; Elementary school
grades range from grade 1 (age 6–7) to grade 5 (age 10–11); Middle school grades range from
grade 6 (age 11–12) to grade 8 (age 13–14); High school grades range from grade 9 (age 14–
15) to grade 12 (age 17–18). When making chronological age comparisons adding one to the US
grade will give the corresponding UK school year.
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