Efforts to implement the Response to Intervention (RTI) framework in middle schools are increasing. Concurrently the number of English Learners (ELs) enrolled in middle schools is growing rapidly, yet little research exists regarding efficacy of the RTI framework for ELs at the middle school level. This study used qualitative focus group methodology to explore middle school English as a Second Language (ESL) teachers’ perceptions of effective instruction and interventions for ELs and to gain insight into their experiences of referring a struggling student to special education services. Specifically, three research questions are addressed: (1) In districts with at least 25% EL populations, how do ESL teachers currently respond to struggling ELs who may need special education services?; (2) What barriers exist that make it difficult to provide support for these students?; and (3) What critical success factors can be distilled from the experience of ESL teachers interviewed? Themes discussed include the challenge of distinguishing struggles related to limited English proficiency from a possible learning disability, the need for more structure and guidance within the RTI process, and support provided by district ESL departments. Implications of these findings are discussed and direction for future research is stated.