Middle school students continue to fall below the Proficient level of state standards in the area of literacy. Response to Intervention (RTI) was introduced to provide teachers of all grades and subject areas the necessary steps to aid at-risk students in their classrooms. Due to the lack of specific guidelines for RTI, some teachers implement the process, some do not, and some try, but are unsuccessful. It is imperative middle school language arts teachers implement the RTI process, specifically research-based intervention strategies, with at-risk students to help bridge the achievement gap. This qualitative single case study examined the instructional and intervention methods 3 middle school teachers used in the area of reading with at-risk students through the lens of 3 research questions: What instructional methods do teachers use to instruct at-risk students in the areas of reading and comprehension?; How do teachers adapt their instructional methods for at-risk students if a particular strategy proves to be ineffective with particular students in the areas of reading and comprehension?; and How do teachers implement RTI with at-risk students in the areas of reading? The theories and approaches framing this study include the Social Cognitive Theory, the Direct Instruction approach, the Information Processing Theory, and the Constructivist Learning Theory; all of which are interwoven throughout the study. Data were collected through individual interviews and individual classroom observations over a period of time. Multiple forms of coding and pattern matching were used as well as the creation of an Affinity Diagram to help determine major and minor themes. Themes included the use of a variety of instructional methods with at-risk readers that aligned with specific theories and approaches and the uncertainty of how to properly implement the RTI process and the accompanying tiers of intervention. The implications of this qualitative single case study's findings noted middle school language arts teachers are using a variety of Tier 1 strategies with at-risk students in the area of reading including one on one conferences, small group instruction, and guided practice. Recommendations for future research include more studies to be conducted with middle school teachers as the sample population and use participants from multiple schools in multiple districts, thus creating a multiple case study design. It is recommended future research also include at-risk students in the sample population in order to track progress based on the tiered inventions being used.