Millions of US students suffer from the effects of low achievement. These include students in low reading groups, low track classes, and special education categories such as learning disabled. This article reviews research on solutions for such students. In particular, recent research on one-to-one and one-to-small group tutoring by teaching assistants has shown very positive impacts at costs far less than those of previous tutoring programmes, and use of the best of these, and other proven approaches, may enable schools to greatly improve the reading and mathematics achievement of struggling students, with important positive consequences for entire schools and school systems.