Why does The National Center on RTI use the term “levels of prevention” instead of “tiers” when describing the RTI framework?

Question: Why does The National Center on RTI use the term “levels of prevention” instead of “tiers” when describing the RTI framework?

Lou Danielson: So, the RTI Center has been asked the question as to why we use the term levels of prevention in our Essential Components document as oppose to tiers of intervention. I’m talking here about primary, secondary, tertiary, and we’re fairly early across the country in implementing RTI models and approaches and we recognize that some states, districts, and schools have been at this for a while and other folks are just beginning and as we developed the essential components document we really wanted to make sure that it captured all of the dimensions and approaches and models that are being implemented across the country, that have been used in research and that it would be kind of robust in its potential use and application and one of the things that we observed is that in some of the existing RTI approaches out there, that at the secondary level for example, they might have multiple tiers of intervention. So, it’s not that the secondary level is just one single approach but there might be multiple approaches, that is that something might be first implemented as a secondary intervention, and if that is not effective for students, that is a student doesn’t respond to that there might be a second intervention that might be implemented or even a third intervention. In fact, I’ve heard of cases where there may be as many as six different interventions that might be attempted at the secondary level. So, we really needed terminologies that both captured this notion of primary, which is normally thought of as core instruction, secondary, and then, for kids who really don’t respond to secondary which might be a small group instruction, tertiary, which sometimes might be individual instruction, clearly, very intensive instruction. So the dilemma was, how do we deal with these multiple attempts within a level which we’ve, in our essential components document, referred to as tiers, and the primary, secondary, tertiary, which we’ve referred to as levels of prevention? So, there’s clearly the need to develop both. I think at this stage we believe there is a critical need for an essential components document. We circulated this widely, got a great deal of input and I think generally people recognize the need for this, the distinction that I’m talking about. In some degree it may be somewhat arbitrary as to whether you call one levels and you call one tiers but we kind of bit the bullet on this and refer to and to my knowledge didn’t receive any concern on the part of people that we refer to one as levels and one as tiers. I think everybody recognized it was critical that we differentiate between the primary, secondary, tertiary, and the multiple attempts at intervention within any one of those levels. We hope that over time, as people become familiar with this use of the terminology, that there will be more and more consistent use of the terminology, maybe less confusion. I think we see that’s maybe one of the roles we can play as the National Center, is to help facilitate the adoption of uniformed vocabulary and to some extent maybe uniformed definitions and conceptions of some of these really critical aspects of the RTI framework.