The No Child Left Behind Act, Individuals with Disabilities Education Act, and the Race to the Top Initiative increased pressure to support academically below grade level students. Schools with large academically below grade-level students often have large Response to Intervention (RTI) groups. Large group sizes present challenges for high-quality instruction, as RTI is ideally a small group with intensive support. This study took an innovative idea- the Flipped Classroom model- and shifted it to meet the needs of sixth-grade students who are academically below grade-level in math and enrolled in Response to Intervention (RTI) class. The study examined how a Flipped RTI approach impacts students' sense of self-efficacy and anxiety as determined by a modified Mathematics Self-Efficacy and Anxiety Questionnaire (MSEAQ). This study also explored how a Flipped RTI approach impacts students' math growth as determined by the Measures of Academic Progress (MAP) test. The primary purpose of this initiative is to provide more information to the educational community about how to support middle school math students who are below grade level. Results from this study reveal that in this middle school mathematics setting, Flipped RTI positively affects students' math growth, with students scoring significantly higher during Cycle 2: Flipped RTI than Cycle 1: Traditional RTI. However, self-efficacy and anxiety levels did not vary significantly between Cycle 1 (4.19 average MSEAQ score) and Cycle 2 (4.22 average MSEAQ score). If researchers are interested in determining the statistical significance between self-efficacy and math achievement, expanding the study for a more extended period and to more participants would be necessary. [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://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]