This mixed method study evaluated the impacts of tiered levels of early intervention and referral for special education evaluation, on at-risk middle schools, using the Multi-Tiered System of Supports framework. Academic, behavioral, and social-emotional interventions were examined, with a special emphasis on the impacts of these strategies on at-risk middle schoolers and the need for initial evaluation for special education educational services when implementing the MTSS framework. Utilizing Bronfenbrenner's Social Ecological Theory, research from a large suburban middle school in Orange County, California was collected and analyzed. Social Ecological Theory states that a person is molded by their surrounding environment (Bronfenbrenner, 2019; cited by Gu et al., 2021). The researcher used convenience sampling to collect secondary research and nesting sampling to collect primary research. Secondary data included grade reports, discipline incident data, small group counseling data, and data from a site-based relationship building activity called the Dots activity. Primary data included an educator focus group, counseling department interviews, intervention observations, and an educator survey. Quantitative data was analyzed using univariate analysis. Qualitative data was collected, recorded, and transcribed through Zoom. The computerized program Delve was used to code interviews and the educator focus group, using open coding and thematic analysis. The key findings were seen surrounding student academic, behavioral, and social-emotional desired outcomes and special education referral. When early interventions were implemented with fidelity, the need for further intervention decreased. A decrease in the referral for special education assessment was also seen from the 2021-2022 school year to the 2022-2023 school year. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]