Through the process of problem solving, it may become clear that additional resources and services are needed to address the student concern. At this level, special education services may be considered. If in agreement, parents will be asked to sign for permission to evaluate their child to determine the eligibility and need for special education services. However, the goal of the process is to intervene early, so that a student will not need special education.

The following steps should be taken when moving a student to Tier IV:

The RtI team completes an analysis of Tier III research-based interventions. The documentation is reviewed for the following:
  • Documented modifications/discontinuation of the intervention or implementation of a new scientific research-based intervention.
  • summary of conference(s) with parents, school staff, and the problems solving team.

Based on the review the following three options are considered:
  1. Option 1: Modify the interventions and return the student to Tier II; or
  2. Option 2: Modify Tier III intervention (frequency, intensity, duration, or content) and implement the modifications; or
  3. Option 3: Move the student to Tier IV.

If option 3 is chosen, complete the following steps:
  1. The RtI team completes the Intervention Fidelity Checklist. If the fidelity of the model has not been followed, then adjustments must first be made to Tier III. If it has been shown that the fidelity of the model has been followed;
  2. Complete the Tier IV form.
  3. The completed file then goes to the IEP team.
  4. An IEP meeting is called to review the case. Based on the review, the following two options are considered: Option 1: Modify Tier III intervention (frequency, intensity, duration or content) and implement the modifications: or Option 2: Complete referral (DEC 1) for special education. If option 2 is chosen receipt of the completed referral for special education by school personnel begins the 90 day timeline and requires that informed parent consent for evaluation be obtained. NOTE: Write on the form that no additional testing or assessment is needed. NOTE: It states when you check option 2 that you also complete the eligibility worksheet. Do not complete the worksheet at this time. The worksheet will be completed at the eligibility meeting after you get the report back from the school psychologist. Until we are more comfortable with this new model, this will be one of the treatment fidelity measures. Option 3: Conduct evaluation is considered if the student meets one of the following criteria: a.) Flatline rate of improvement in two or more areas with indicated concerns about adaptive behavior. b.) There is current (within past year) psychiatiric or medical information that warrants further evaluation by school psychologist. c.) There are other concerns that indicate a possible need for further evaluation by school psychologist (this should be discussed with the psychologist first)
  5. The entire file is then sent to the county office to your assigned EC program facilitator to be reviewed and given to the school psychologist for review. After reviewing all the data, if the psychologist and/or EC program facilitator sees a concern about entitlement, s/he will report this to the EC Director. If it is determined that something is missing, it will need to be taken care of very quickly, since the 90-day timeline started with the signing of the DEC 1.
  6. The psychologist will write the report.
  7. Once the school receives the completed report, an IEP meeting will be called for consideration of entitlement/eligibility.
  8. After the eligibility determination, students will be randomly selected for a full evaluation to check for additional fidelity. The central office EC department will handle contacting the parent and getting permission for evaluation on those students selected. Before meeting with parent to review results, a meeting will be held with the RtI team to review both sets of data and to look for correlations and discrepancies. If there are discrepanices, a plan of action will be developed. Afterwhich a meeting will be held with parent to review results of evaluation.

Activities at Tier IV include:
  • Making the decision to refer for consideration of special education
  • Team works together to define the problem
  • Progress monitoring data becomes baseline data
  • IEP (intervention) is developed based on data collected
  • Progress monitoring occurs during implementation
  • Program modification or exit criteria is established
  • Long term and short term objectives are developed

To learn more, review the following PowerPoints & PDF documents


Psychological Report
Note: Report is called Responsiveness to Instruction Student Report. You would only called it Psychological Report if psychological testing is included in the report.

(open in word)
Tier IV (English)

Tier IV (Spanish)

Checklist for Tier Components