A teacher sends a frantic email or urgently flags you down in the hallway to say, “So-and-so can’t write their letters, stay at their desk, keep their hands to themselves. I think they need therapy. How do I make a referral?”
Hopefully, you don’t find yourself in this situation too often! While you’re eager to help as many students as you can, having to make a formal assessment every time a teacher requests a referral can actually take time away from doing so. Tier 2 interventions offer a far better way to get more students the targeted interventions they need without adding them to your at-capacity caseload.
The middle level in a Multi-Tiered Systems of Support (MTSS) approach to related services, Tier 2 intervention strategies reduce unnecessary one-on-one therapy referrals, but still power significant progress for students with identified educational needs.
At Kelly Pediatric Therapy, we’ve seen Tier 2 supports help students make measurable and lasting gains in multiple areas. We frequently use resources our own clinicians have developed and refined.
We’d like to share some examples of Tier 2 interventions we’ve found especially effective at accelerating students’ success without increasing pressure on busy therapists like you!
In the special education field, you hear much about MTSS, “RtI” (Response to Intervention), and “RtII” (Response to Intervention and Instruction). We tend to use these terms synonymously as they all refer to a tiered approach in which each step represents a more significant investment of time and resources based on the child’s ability to make progress with various levels of support.
Here’s the overview of how it works:
Some schools skip Tier 2 interventions for therapeutic support. At Kelly Pediatric Therapy, we've seen that when we review new therapy caseloads, it becomes quickly apparent that some intervention—far less intensive—would have been adequate for many of the students who end up on a caseload.
While the MTSS approach is no magic cure-all, it does help clarify which students face significant deficits and which could benefit from the temporary, targeted support Tier 2 affords.
When can Tier 2 interventions prove particularly useful?
Handwriting concerns drive many referrals to school-based occupational therapists in schools. But instead of adding every child with “sloppy writing” to an OT’s caseload, why not form a small-group “handwriting club” that any trained teacher or staff member can lead to focus on pencil grip and letter formation in fun ways?
That’s the goal of our Pencil Power™ small group intervention. Meeting for only half an hour once per week for six weeks, students strengthen their fine motor, visual motor, and handwriting skills, playing games and turning their pencils into superhero “sidekicks” along the way!
Tier 2 supports can also help students who face social skills challenges. Over the course of just eight weeks, our Super Self™ program equips students with key self-monitoring strategies to help them focus as fully as possible on learning in the classroom.
You’ll see how it encourages students to choose and use practical strategies—everything from “silent silly faces” and shoulder shrugs to palm presses and chair pull-ups—for staying attentive and productive in school. Teachers and staff members can also lead these small groups after minimal training from trained clinicians.
Resist the rush to referral! Educate teachers and staff about the power of Tier 2 interventions to deliver “therapy without the therapist,” as we like to say.
By helping the schools you work with implement an MTSS model in related services and working directly with fewer students yourself, you’ll actually be helping more students succeed!
Occupational therapists’ roles in schools extend far beyond individual sessions. By championing MTSS and effectively implementing Tier 2 interventions, you empower the entire team to create inclusive classrooms where every student can thrive.
If you're looking to move forward in your professional career in a way that supports growth, balance, and impact—consider working with us as a school-based therapist.
When you work with Kelly Pediatric Therapy, you’ll enjoy competitive pay, compensation for documentation, access to mentorship, free professional development, and work-free nights, weekends, and holidays.
Learn more about joining our team.