Great progress has been made in learning how to provide more responsive instructional and behavioral supports to students through efforts in Response to Intervention and Positive Behavior and Intervention Supports. This article presents information and data on a longitudinal study designed to accelerate first graders at-risk for reading difficulties until the end of third grade. Interventions are described along with outcomes following students across this time including data on students' progress across each year and information on how many continued to need instructional supports. The paper finishes with a discussion on students continuing to demonstrate significant reading difficulties even after this level of intensive support. Lessons learned and reflections are provided on how these efforts may have been improved through more coordinated academic and behavioral supports with implications for implementing Multi-tiered Systems of Support (MTSS).