Advocating for the Expansion of OTP's Role in Multi-Tiered Services in the School-Based Setting

My purpose was to advovate for the expansion of OTPs role in multi-tiered services in the school-based setting under the Every Student Succeeds Act (ESSA)

Student Name: Sarah Rhoads OTD
Name of Mentor(s): Melissa Redington OTR/L and Laura Peregoy OTR/L
School: Washington University School of Medicine
Setting and Location: Large, public school-based setting and private outpatient pediatric practice in St. Louis, MO, and Sullivan, MO
Format: Hybrid

Method/Design/Approach: I conducted a Needs Assessment to identify:

  • OTPs current level of involvement in multi-tiered services
  • barriers and enablers to facilitate that involvement
  • the need for multi-tiered services from the perspective of OTPs and teachers

Results/Outcomes: The survey delivered as part of the Needs Assessment found that over 90% of OTPs at the school district were interested in providing more multi-tiered supports. Barriers frequently reported include: limited time in schedule, high number of IEP minutes to meet each week, and limited understanding of OTPs role. Over 80% of the teacher respondents indicated they are willing to work with an OTP on a Tier One and Two intervention to address common classroom needs, including self-regulation, functional communication, and executive function skills.

Conclusions: OTPs role in multi-tiered services is evidence-based, best practice, and within the law.

Ideas for next steps to build on this topic: Some ideas for future steps include: implementing a Tier One or Two program at a school district and measuring pre/post outcomes, contributing to current evidence-based literature, increasing OTPs and other professionals’ knowledge of ESSA and its implications, and seeking out opportunities to collaborate with school-based administration on expanding OTPs role within the school district.

2-3 tips for students undertaking a similar project:
1.) I would recommend researching the legislation and policy that affects school-based practice beforehand to gain a better understand of the affects of policies on OTPs role in the school-based setting.
2.) I would also join the ESSA OT Advocacy Network organized by Dr. Susan Bazyk.

Deliverables (link when applicable):

My e-portolfio can be found at this link.

The Google Drive containing resources for school-based OTPs can be found here. This Drive contains pre-made presentations that can be used for educating administration and others on our full scope, pre-made Tier One and Two intervention ideas for early childhood-1st grade, and other resources.


Wow! What a timely capstone for us! Thank you for sharing, @sarah63! My first question is where we can join the ESSA Advocacy Network? I just Googled it and couldn’t find it!

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Email Dr. Bazyk at to join the email list and attend meetings with OTPs focusing on this issue nation-wide.

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I’m moving Dr. Bazyk up on my list of possible future guests :slight_smile: I want to see if she wants help making this list more accessible :wink:! It is such an important topic!


Actually, @sarah63, is this the list you would get on? This website is amazing!

Yes, that is a wonderful resource!

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Hi Sarah,
In my district in Massachusetts, the teachers participate in IST. As part of IST the Occupational, Speech and Adaptive Phys Ed. teacher is involved in short-term intervention sessions that run 6,8,or 10 weeks with periodic check-ins. These are for the students that can be remediated quickly and without needing an IEP. In some cases it has worked well, in others is has shown what students were not able to make sufficient progress and need to move forward to the team process.

Speaking of Dr. Bazyk, I love the domain wheel on page 3.
I’ve used it countless times to explain what OT is in a simple screenshot to friends and family.

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Oh wow, @pj1 !! I’ve never paused and looked at that wheel before- but it is really good!! I’ve been wanting to do a collection of OT clip art and info graphics in 2023. I’d love to riff on this circle and design an OT explanation in similar vein! If you have any tips for me, let me know!


What does IST stand for?