1 | INTRODUCTION Samuel is easy to miss, seated in the back row of the classroom, often with his head down. He entered U.S. schools in fifth grade and is now an 11th grader, completing his seventh year as an English language learner. Scraping by with a GPA of 1.4, Samuel's advisor worries that Samuel might not complete the requirements for graduation. He persists in school, attending almost every day, but has a very difficult time finding a place where he feels comfortable. His oral language is strong, but reading in English is very difficult for him, and he experiences great anxiety when asked to read aloud in class. Samuel always thought he wanted to graduate from high school-his family certainly wants that for him-but he has serious, growing doubts as to whether coming to school is the best way for him to spend his time. As the days in the school year wear on, he becomes nearly invisible to his classmates and teachers, sitting quietly in the back recesses of his classes. Medicine Given that English learners (ELs) comprise one of the fastest growing populations in PK-12 environments, long-term English learners (LTELs) form one subgroup that provokes particular concern. This article explores current understand-ings of the LTEL designation and discusses diagnostic processes and assessment tools for determining English language proficiency. Complexities of referring ELs/LTELs for special education are then probed with regard to drawing the careful line between language proficiency processes and special education needs. Finally, the authors present possible interventions for LTELs, including the Internationals Network as a large-scale intervention model, followed by smaller scale interventions made on behalf of LTELs in existing schools. The article concludes with strategies and suggestions toward better outcomes for LTELs in school.