Accelerating chronically unresponsive children to tier 3 instruction: what level of data is necessary to ensure selection accuracy?

Response-to-intervention (RTI) approaches to disability identification are meant to put an end to the so-called wait-to-fail requirement associated with IQ discrepancy. However, in an unfortunate irony, there is a group of children who wait to fail in RTI frameworks. That is, they must fail both general classroom instruction (Tier 1) and small-group intervention (Tier 2) before becoming eligible for the most intensive intervention (Tier 3). The purpose of this article was to determine how to predict accurately which at-risk children will be unresponsive to Tiers 1 and 2, thereby allowing unresponsive children to move directly from Tier 1 to Tier 3. As part of an efficacy study of a multitier RTI approach to prevention and identification of reading disabilities (RD), 129 first-grade children who were unresponsive to classroom reading instruction were randomly assigned to 14 weeks of small-group, Tier 2 intervention. Nonresponders to this instruction (n = 33) were identified using local norms on first-grade word identification fluency growth linked to a distal outcome of RD at the end of second grade. Logistic regression models were used to predict membership in responder and nonresponder groups. Predictors were entered as blocks of data from least to most difficult to obtain: universal screening data, Tier 1 response data, norm referenced tests, and Tier 2 response data. Tier 2 response data were not necessary to classify students as responders and nonresponders to Tier 2 instruction, suggesting that some children can be accurately identified as eligible for Tier 3 intervention using only Tier 1 data, thereby avoiding prolonged periods of failure to instruction.

Dermal cysts: a dermatopathological perspective and histological reappraisal.

Dermal cysts constitute an extremely common entity routinely encountered in dermatology and dermatopathology practice. Their ubiquity, overlapping clinical presentation, dermal location, and histologic diversity can engender diagnostic quandary. Though basically defined by the histologic presence of an epithelial lining, cysts derive from a variety of sources including developmental defects, trauma, and tumoral degeneration. Herein, we will discuss the dermatopathologic attributes of the more common dermal cyst entities, updating the most recent and pertinent literature.

Predicting response to early reading intervention from verbal IQ, reading-related language abilities, attention ratings, and verbal IQ-word reading discrepancy: failure to validate discrepancy method.

Additional analyses of a previously published study addressed three questions about growth in word reading during early reading intervention: (1) How well do Verbal IQ, reading-related language abilities (phonological, rapid naming, and orthographic), and attention ratings predict reading growth? (2) How well do language deficits predict reading growth? and (3) How well does Verbal IQ-word reading discrepancy predict reading growth? Univariate analyses showed that Verbal IQ, phonological skills, orthographic skills, rapid automatized naming (RAN), and attention ratings predicted the response to early intervention, but multivariate analyses based on a combination of predictors for real-word reading and pseudoword reading showed that Verbal IQ was not the best unique predictor. Students with double or triple deficits in language skills (RAN, phonological, and orthographic processing) responded more slowly to early intervention than students without language deficits. Verbal IQ-word reading discrepancy did not predict the response to early intervention in reading. Overall results supported the use of reading-related language and attention measures rather than IQ-achievement discrepancy in identifying candidates for early reading intervention.