Ways of Working: Multi-Tier System of Supports (MTSS) Occupational Therapy

 

Occupational therapy (OT) plays a vital role within the Multi-Tiered System of Supports (MTSS) framework, enhancing student support across academic, behavioral, and social-emotional domains.


Occupational Therapy promoting participation

Understanding Multi-Tier System of Support

MTSS is a triage-based way of designing support to all students--according to needs--across educational programs. The three levels of support are described in this way:

Tier 1: Universal supports for all students, focusing on creating inclusive environments and effective teaching strategies that benefit the majority of learners.

Tier 2: Targeted interventions for students who require additional support, often delivered in small groups or through specific strategies tailored to their needs.

Tier 3: Intensive, individualized support for students with significant challenges, which may involve specialized interventions and more frequent monitoring.

 

Role of Occupational Therapy in MTSS

Occupational therapists contribute to each tier of the MTSS organisation:

Tier 1: Firstly, Occupational Therapists provide training and resources to educators on topics such as classroom ergonomics, sensory processing, and strategies to promote engagement and participation for all students. This proactive approach enables support for the learning environment--tailored to the needs of the whole population of students. Occupational Therapists plan the approach with school leaders and target areas of need and evaluate the results using outcome measures.

Tier 2: In this tier, Occupational Therapists collaborate with teachers to develop small group therapy for students who are struggling with similar issues. This may involve collaborative sessions with teacher and therapist implementing specific strategies to address fine motor skills, self-regulation, or social skills. Observations of student functioning is used to assess and revise the approach, and measure outcomes.

Tier 3: For students requiring intensive support, Occupational Therapists conduct individualized assessments to identify specific needs and develop individualized therapy plans for each student. Therapists may work directly with students or coach teachers and staff on implementing strategies that are supported by research as effective.

Benefits of Occupational Therapy in MTSS

The integration of occupational therapy within the MTSS approach offers several benefits:

Holistic Approach: Occupational therapists consider the needs of the school community and the whole child, addressing not only academic needs but also behavioral and social-emotional aspects that impact learning. Socio-cultural demographics are considered when designing the approach.

Data-Driven Interventions: Occupational Therapists measure occupational performance in a variety of environmental situations; utilize data to inform their practices, ensuring that individual and group programs are effective and tailored to needs.

Collaboration: By working closely with educators and other support staff, Occupational Therapists contribute by enhancing the overall effectiveness of the MTSS approach, leading to improved outcomes for students. The human resources are applied more effectively to target: the whole school, classes, small groups, or individual levels.

In summary, occupational therapy is a crucial component of the MTSS approach, providing valuable support that enhances the teaching and learning for students. By addressing diverse needs through a tiered approach, Occupational Therapists enable inclusive and effective learning environments. The multi-disciplinary collaboration is important for communication of all stakeholders who are involved with students. Parent consent is requested for therapist participation in educational programs.

References

Breithart, Devon  (2025) What school-based OTs should know about RT-1 and MTSS  https://devonbreithart.com/school-ot-role-rti-mtss/

Bushell, Moira P How OT fits into MTSS for schools  https://www.aspireoted.com/blog/aspire-occupational-therapy-blog-multi-tier

Hinze, Lou Ann & Fletcher, Tina (2022)  Teachers experiences with OT multi-tiered systems of support: A qualitative study. American Journal of Occupational Therapy. https://research.aota.org/ajot/article/76/Supplement_1/7610510221p1/23408/Teachers-Experiences-With-OT-Multitiered-Systems

Reducing OT referrals using MTSS and RTI-2 to better assist you  https://www.otschoolhouse.com/single-post/RTIMTSS

 

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