Background: Low levels of numeracy and literacy skills are associated with a range of negative outcomes later in life, such as reduced earnings and health. Obtaining information about effective interventions for children with or at risk of academic difficulties is therefore important.Objectives: The main objective was to assess the effectiveness of interventions targeting students with or at risk of academic difficulties in kindergarten to Grade 6.Search Methods: We searched electronic databases from 1980 to July 2018. We searched multiple international electronic databases (in total 15), seven national repositories, and performed a search of the grey literature using governmental sites, academic clearinghouses and repositories for reports and working papers, and trial registries (10 sources). We hand searched recent volumes of six journals and contacted international experts. Lastly, we used included studies and 23 previously published reviews for citation tracking.Selection Criteria: Studies had to meet the following criteria to be included:• Population: The population eligible for the review included students attending regular schools in kindergarten to Grade 6, who were having academic difficulties, or were at risk of such difficulties.• Intervention: We included interventions that sought to improve academic skills, were conducted in schools during the regular school year, and were targeted (selected or indicated).• Comparison: Included studies used an intervention-control group design or a comparison group design. We included randomised controlled trials (RCT); quasirandomised controlled trials (QRCT); and quasi-experimental studies (QES).• Outcomes: Included studies used standardised tests in reading or mathematics.

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The educational gap between children in out-of-home care and their non-placed peers is well-documented. However, tutoring stands out as a promising intervention to raise children's educational attainment in out-of-home care. This study randomized 105 children in foster care (62% girls, aged 7-15 years [M = 10.3, SD = 2.0]) to the home tutoring program Foster Caregivers as Tutors (FCT) or regular public school services (treatment as usual [TAU]). In the FCT group, the foster caregivers tutored the children for 2.5 h/week for 40 weeks. The program effect is measured in learning and developmental outcomes, including reading and math ability, learning skills, IQ, executive function, and psychosocial function. Follow-up was 17.5 months after baseline. The results show a significant effect over time in both groups on IQ (effect size [ES] = 0.40, P < 0.001), verbal comprehension (ES = 0.29 P = 0.02) and perceptual reasoning (ES = 0.60, P < 0.001) measured by WISC IV. Neither the FCT nor TAU provided any significant academic recovery in reading and math nor progression in executive function, learning skills or psychosocial function. These findings, implications for practice and future efforts to support the schooling of children in out-of-home care are discussed.