Ask the Experts

Generally, the consensus is that tertiary level services should be more intense and include fewer numbers of students than secondary level services. The particulars on tertiary level services, though, vary with viewpoints.

I don't see tertiary level services as only for students in special education with identified disabilities. Students with disabilities might be included in some tertiary level interventions as IEP goals might be appropriate for tertiary level services. Configuration of the RTI framework will help districts make these determinations. Unfortunately, I don't think state education agencies are providing much guidance on these points.

Schools and districts need to make decisions about the service providers for tertiary services. Because I see tertiary level services as being the most intense intervention level and serving the students with the greatest needs, the service provider most likely needs to be very skilled as instructional and formative assessment skills and knowledge of curricular materials are very important. While the instruction might start with a standard treatment protocol, the instructor/clinician will need skill in knowing how to alter the instruction (based on formative assessment data) to improve the students' responsiveness. One might think of the instruction as a dynamic assessment situation in which students' responses inform the instructor on how well the instruction is working. Strong clinical skills seem important.

Placement in Tier 3 would include students who have not been responsive to secondary level interventions or whose needs are so obviously apparent and high that those students would go directly to tertiary services. The parallel is that some patients in a hospital's emergency room are so severe that they immediately go to surgery and intensive care units.