OTS 42: Building A Solid Foundation In RTI For Occupational Therapists

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Welcome to the show notes for Episode 42 of the OT Schoolhouse Podcast.

One aspect of school-based OT that both therapists and administrators alike seem to be reaching for is the development of an effective and organized RTI program. One that allows therapists to have a meaningful difference in the classroom for the students and teachers.

In episode 42, Jayson explains how RTI has moved from being just for teachers to being for service providers as well. He talks about what an ideal RTI system looks like, how he implements RTI, and how to start moving toward an RTI model. Listen in for some excellent tips to get you started!

Plus, don't forget to subscribe to the OTSH Email list below to get your very own copy of the Occupational Profile For School-Based OTs discussed in Episode 41 of the OTSH Podcast!

Links to Show References:

• ​National Survey of Occupational Therapy Practitioners’ Involvement in Response to Intervention
  

  • ​​​​Susan M. Cahill, Beatriz McGuire, Nathaniel D. Krumdick, Michelle M. Lee; National Survey of Occupational Therapy Practitioners’ Involvement in Response to Intervention. Am J Occup Ther 2014;68(6):e234–e240. https://doi.org/10.5014/ajot.2014.010116

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Be sure to subscribe to the OT School House email list & get access to our free downloads of Gray-Space paper and the Occupational Profile for school-based OTs.

Have any questions or comments about the podcast? Email Jayson at Jayson@otschoolhouse.com

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Episode Transcript

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Jayson Davies   

Hey everyone, before we get started today, I just want to give a big thank you to medbridge education.com for giving otschoolhouse listeners $75 off their first year a subscription medbridge education.com offers continuing education for OTs, PTs, speech therapists and many others. And by using the promo code "otschoolhouse" on one word, not only you are getting a 50% discount, but you're also hoping to support the otschoolhouse com podcast and the otschoolhouse.com website. It's a great deal. What I love about it is that you can watch any of the first chapters completely for free before you even decide to go ahead and make a purchase. So check it out at medbridge education.com and let's Cue the intro. 

Amazing Narrator   

Hello and welcome to the otschoolhouse com podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started, here is your host, Jayson Davies class is officially in session.  

Jayson Davies   

Hey, everyone, and welcome to episode 42 of the otschoolhouse com podcast. For you who don't know who I am yet, thank you for listening. My name is Jayson Davies, and I am a school based occupational therapist here in Southern California, where I work for a school district and I service three schools. So that's who I am. Quick introduction. I hope you'll go back and listen to some of the older episodes and learn a little bit more about me. But to get things started off today, I wanted to say just a huge thank you to all of you for listening, whether this is your first episode or your 42nd episode. I appreciate it. Everything that you all have done for me has been amazing, the emails, the support when I go to conferences and I see you all. I just love doing this. I love being there for you, and I love actually having you guys be there for me as well. Some of the emails have just been amazing, and I love it. But really, I want to say thank you, because this is episode 42 and for 42 episodes now we've been diving deep into occupational therapy, how we can support our students, how we can support the teachers and the parents that we serve. And I don't know. I just love it. I love all the feedback that I get from you all. And I hope you all are enjoying the podcast as well. One of the ways that I do know that, among many ways, one of the ways that I do know that you enjoy the podcast is through downloads, and I can see how many downloads we get over a period of time. And well, I'm excited to say that we're not quite there yet, but as this episode comes out, we will reach 100,000 downloads of the otschoolhouse podcast, which just blows my mind. I mean, we're we're 42 episodes in, and we're already reaching 100,000 downloads, and it comes out to about 8000 downloads a month now that we get and I just want to say thank you so much from the bottom of my heart. Thank you for for for basically making that happen. I mean, I put the info out there and and I bring on guests, but it's you guys who are continuing to listen. And I super like, I just gonna be more appreciative of that. So thank you. I also really, like, I was talking about a second ago. I also just love all the support that I get from you all through the emails going out and seeing you all at conferences. It's amazing. Thank you for just for supporting me honestly and the otschoolhouse podcast. I really appreciate it before we dive into today's episode in the journal that we're going to talk about I also want to give a quick shout out to Vanessa rapier and all the other OTs and OT assistants that will be attending the Utah otschoolhouse com later this week. Vanessa actually reached out to me about sharing the otschoolhouse podcast with her Utah colleagues at the conference, and so we were able to make something happen. And I just want to, again, give her a shout out, as well as all the Utah OT and OTs that will be attending the conference later this week. I hope you have a wonderful conference and that everything goes smoothly, and you just learn a lot of information that you're able to take back to your jobs and implement quickly and effectively. So yeah, I hope you just have a great two days of learning and getting to know each other at this conference. You know, getting to know who your colleagues are and where each other worked, and how you guys can support each other. So take care and have a great two day conference there and be safe. All right, so now we get to jump into today's topic, which is going to be all about RTI. And the reason we're diving into RTI today is because earlier this school year, at the beginning of the school year, I sent out an email asking everyone out there who subscribed to my email is saying, Hey, what are your concerns regarding this upcoming school year? And I was a little surprised when I saw RTI was mentioned by quite a few people trying to figure out how to get RTI into their school, how they can use the RTI model to their advantage, to not only help more kids, but also to potentially help themselves. I think a lot of people are. High on the idea of RTI because of the idea that that they're overworked, and they think maybe RTI can help them with their large caseload. I'm not sure if I already said it, but RTI is Response to Intervention. There's also RTI too, which is Response to Intervention and instruction, or instruction and intervention, however you want to say it. There's also MTSS, which is multi tiered levels of supports and systems, which RTI is basically baked into. But we're going to use the term RTI for today. And like I said, a lot of people are interested in this one, because I think there is that mindset that by by using an RTI method, I can potentially make my life a little bit easier, and ideally that is the case. It should do that. But I'm going to start up and be frank up here, up at the beginning of this is that it's hard to transition when you have a large caseload over to an RTI model. And a lot of times, you know, we think it's going to be the best model possibly, best model possible, and it's just a struggle to get there, and you have to get a lot of people on board to get there. But I'm here to tell you a little bit about what it ideally could potentially look like, and I'm also going to give you what it looks like for me at this point, as well as what it's looked like for me in the past, and kind of where I'm trying to get to with RTI in my transition right now. So I'm going to talk a little bit about that. I hope it'll help all of you out there, at least some of you that are trying to to do that transition as well, from a very heavy, if you want to call it a caseload model, you know, pulling a lot of kids out, seeing them individually, more to an inclusive RTI model. So let's dive into that. So RTI has been around for a little while now, but it wasn't until recent that it started being applied to special education and, more specifically, occupational therapy, speech and language pathology and physical therapy. And so the way that RTI works in an academic or educational model for children in the classroom, again, not talking about OT or PT, is that you have your foundation, your level one, and ideally somewhere between, let's say, 75 to even 85% of the kids in school, both general education and special education, should respond to level one supports. And level one supports really, that is your first best training. And So level one is really sending teachers and other staff to to end services to training, so that they can be the best professional that they can be when they're working with as many students as possible, really. So when you think of like a fourth grade classroom, you know that teacher is going to go and learn English, language arts strategies, they're going to go and learn math strategies. They're going to go and learn science history, all that, even physical education strategies so that they can bring back to their classroom and work with 30 kids to try and make the best possible scenario, or the best possible outcome for those 30 kids. And so that's what level one really is. Also included in level one could be like screenings. So again, those district level academic tests that that districts do you know, each class sets aside a day or a few days once a trimester to kind of go over these tests to see where the kids are, and that's data that's taken for level one RTI, so that way they know when they're planning for next year, hey, where do we need to train our teachers in so maybe math scores are on the rise, but Ela is still not not coming up. Well that way through that screening, that district screening, they know, well, we need to train our teachers more in ELA, so that way we can bring our scores up in that area. And So level one is mostly all about training. It can also be, you know, potentially co-teaching. You know, some teachers get together, and they might co-teach lessons as a way to help a a younger teacher or a less experienced teacher learn how to teach in ELA likewise, transitioning now for for level one, RTI into OT. Occupational therapists can do the same thing at a level one, level one area you know, working with the teachers to train them, providing in services on sensory providing in services on fine motor development, teaching kids, or teaching, sorry, not teaching kids, teaching the teachers the steps to handwriting, or even just giving them the resources, the available resources, so that they may make the best decision on different programs that they can use. We can do trainings at several different levels. We could do trainings at the site level, you know, on their Tuesday afternoon meetings that they meet once a month. We can get in for that. Or you can even do it on a bigger level, at a district level. You know, those Welcome back days or the teacher professional development days. Those are, those are times when occupational therapy can provide a training. Likewise, an occupational therapist could also help to set up a either school or potentially a grade level screening for, let's say, kindergartners, you know, using some sort of screening tool that every kid in kindergarten takes at the beginning of the year, and then maybe six weeks into the year to see if there's been progress with some of those pre writing lines, pre writing shapes, and then steps toward being able to write their name. Those are a way to just kind of keep an eye on all the kids, and again, that helps you then determine where you need to help the teachers help the kids. So maybe all the kids are getting stuck with squares and they're not stopping their lines on time. Well, that's an area that you can then teach the teacher on some strategies so that they can incorporate back into the classroom, all right. And that brings us to level two, and I like to think of Level Two being at a classroom level. And so now in level one, we were looking at an entire grade level, or an entire school, or maybe even an entire district, you know, finding a program that the entire district could use to teach handwriting. But at level two, we're looking more at a classroom, and I'm going to use the I might use the term small group, because in comparison to a school, you know, one classroom is a small group, per se. And so for level two, maybe we are talking directly to that teacher to find out what her specific concerns are, or his specific concerns are for the classroom. And we're going to give the teachers again, give the teacher strategies based upon those specific concerns. So now again, using the square analogy that I was using earlier, or example, you know, maybe the entire school has difficulties with the kids stopping their lines on time when they're making squares, so their squares are looking more like, I mean, squares with lines coming out of all four corners. Anyways, maybe this teacher is having some difficulty with her kids rounding the corners of their squares. And so that's a different problem than the others. Well, now that's a different strategy from what the rest of those teachers need. And so at the level two area, we could potentially go in and co teach with that specific teacher and teaching them how to teaching kids how to stop and start, versus making one long line that ends up making a square look more like a circle, per se. Again, excuse my examples, but I'm just trying to give you guys an idea the difference between level one and level two. The other thing we can also do at level two is go in and do a screening of that classroom. And when I say screening of a classroom, I'm not saying we're going in to screen a classroom, but really we're focusing on one kid that we all know who that kid is. That's not the case here. We really are going in to look at a specific concern that the teacher has in the entire classroom. My favorite way to describe this one is when teachers come to you and say, Hey, dude, I just have, I have this really wiggly classroom this year. You know, I just don't know what to do. They're all really moving and groove in and and they just can't stay in their chairs. What do I do? And you know, this isn't a child specific problem. This is obviously a classroom problem. And so I'm willing to go in, observe the entire classroom, and then meet later and talk with the teacher. And so maybe it comes down to, I try and keep it a little simple. So, you know, I try and find the three most likely things that that we could implement to affect the classroom, and oftentimes it is, you know, finding the right size chair, the right size tables, and then providing some sort of movement breaks. You know, they're trying to have them sit down for 30 minutes at a time in a kindergarten class, and that just isn't going to happen, right? And so trying to suggest different types of movement problems, you know, animal walks in between centers, or using goat noodle or something like that. But that's kind of an that is a level two strategy, and many of you are probably already doing this. You just don't realize it's a level two strategy. It's talking with a teacher about their specific concerns in the classroom and trying to find a solution for that, because if we don't do that, then, well, what's going to happen to several of those kids? They're going to end up being referred, potentially for special education, even though all they needed, potentially was a correct size chair desk and maybe some movement in the classroom that you're now providing. All right? So level two, just to kind of sum it up, it's really working directly with the teacher, a specific teacher, really, because level one is working with several teachers at a larger level. Level two is getting it down to like one specific teacher or one specific group of children, all right? And that brings us to. Level three of the RTI system, and level three, again, I'm going to kind of start off with the academic side of this. What it looks like with teachers and the way that they do things. RtI level three is for those students that have received good instruction, maybe an educational specialist has come into the classroom to co teach with that teacher on ELA strategies, and there's still a small group of kids, two to three kids, in that classroom, that still aren't getting it. Well, now those two to three kids, maybe they go with two to three kids from other classrooms that are still struggling in ELA after the same after getting the same supports. So now those kids are going to go into a learning center or some type of small group that has a focus on English language arts or the area that they are struggling on. I hope that kind of makes sense. So basically, you're taking the kids that still aren't getting the work or still aren't understanding the topic that they're being taught, even though they've had, they've been taught at several different ways, are now going to a smaller group with a focus on that area. So now, as I transition now to OT, but what this looks like for OT? Again, I'm going to stay with the square, because we've already done it for level one and level two. At level one, you know, we had several kindergartner teachers saying, my kids aren't getting the square right. And then at level two, we had one teacher who say, All right, it's getting better, but they're still rounding all their corners. And so maybe we gave her some strategies, such as using stickers or something as a way to outline stop and start points. But as she did that, she realized, you know, there's still a few kids in my classroom that just don't get it. I mean, even when we give them stickers, they they don't get it. We've tried highlighting, nothing's working. All right? Well, I happen to have a pre writing skills group, potentially, that I'm working with, and she's going to send those two or three kids that are going to come to me, along with two or three kids from Mrs. Hernandez's class or whatever, and we're all working on this one or this area, that even after all the instruction that the kids have had in the regular classroom, still aren't necessarily getting as far as fine motor development, visual motor development. And in that case, this isn't an individualized education plan. We are not working on those student specific goals. We are working on the skills that these kids need in the classroom that they just haven't gotten, and it's just a little area that they're missing a little bit. And so that group that they're coming to, it's not designed based upon, I guess you could say that child's individual needs, but because we have this group, they're able to come to that group and hopefully get the needs that they need met. I hope that makes sense. Another example of this could potentially be like a social skills group for a handful of kids who are just having difficulty at recess, communicating, understanding, feelings, stuff like that, and are getting into maybe some trouble, or, you know, they're just showing high risk behaviors at recess. Well, maybe as an occupational therapist, you could provide a a social skills group that has lunch together and then after lunch, and talking during lunch and and going over different possible scenarios, role playing, stuff like that at lunch. Well, then they go out to recess and try to implement the strategies that are worked on. And again, this isn't an IEP based decision. This is a decision that the teachers and or parents have kind of understood. Hey, this program exists for all kids who may may need it, and so they are sent to that program as a way to just to get some of those skills. And I want to remind you, this is for kids, both on or off in IEP. You know they don't necessarily need to be diagnosed, not diagnosed. Sorry, they don't necessarily need to qualify for one of the 13 conditions to get an IEP in order to be a part of this. We're not saying the kid has a specific learning disability, and that's why they're not understanding how to get the square. We're just saying that this happens to be a difficult topic for this kid to pick up. Maybe they're doing a circle or, I mean, all the other things, great, but you're seeing that they're not getting that square, and that square is impacting their ability to move move ahead onto more difficult letters and whatnot. And so they need to get that and so that's why they're coming to you for a short time again, not saying that they necessarily have a a condition or a disorder, or anything like that, that they would need an IEP for. We're just saying that they have a few skills that need to be cleaned up so that they can get back into the general education on that same area and continue to progress. So to really sum up, level three of the RTI, I just want to say, you know, this is a targeted group intervention, and it's specific skill. Or skill area. And these kids, they are identified by the staff or the parent, and again, they may not be on an IEP, the groups that we're putting together, they're not individualized. They're more skill based versus individualized based. We are giving them the strategies to help mate meet that skill and I guess I'll get into it right now by the end of RTI level three, if they're still struggling, that's when the team, or the teacher, the parent, even yourself, if you're part of that team, working with that student, may want to think about referring for special education if they're still not getting it after they've had this much support. And again, maybe this is a once a week group or or twice a month group, I don't know, but it's not part of the IEP. And so that kind of sums up level three. And now I want to get into some specific examples of what level one, two and three interventions or supports could look like all right, so let's jump back into level one of RTI. If you remember, I did say that providing trainings was a good way for level one, either doing screenings at a school or maybe a specific grade level at the school is another good level one activity, as well as conducting centers or co teaching on more of a larger scale. When I say larger scale, I'm saying getting into all of the programs, maybe all three of the first grade classrooms, or all three of the kindergarten classrooms, rather than one specific kindergarten classroom. So I want to start off by saying I just kind of brainstormed a little bit, and I think these would be wonderful types of trainings that occupational therapists could do for teachers at either a school level or district level, and that could be maybe working with teachers, paraprofessionals or even bus drivers on understanding what autism is and how it may impact that specific area, whether it be, you know, out on the playground or in the classroom or on the bus, I highly recommend that if you're going to do something like that, get in touch with an active person in that area. Get in touch with another teacher and a paraprofessional or even a bus driver and work together, because you're going to need some of their input. You can't just go and present to a bunch of people without having their input. And so pair up with one of those, those people and put together a training, and then provide that training to that that group of people. Another area you know, that teachers would love to have information on is sensory processing. 101, you know, just a very broad overview of what vestibular, tactile and the proprioceptive senses are, and how they impact so many of the skills in the classroom. Again, you don't need to teach them about what sensory integration, everything that it is and how to treat you know, that's not their role. They're not there to treat the kids in sensory integration. They're just there to know a little bit about it and kind of say, okay, you know what? Understand that when you're saying, Oh, he's over regulated, what does that mean when that gets under regulated? What does that mean and why you're not giving a kid who's over regulated a trampoline that's gonna even raise that kid's arousal level even more. You know why you're trying to give them deep pressure, things like that that can be tangible and helpful. They really go a long way when you're working with those those teachers. Another one, you know, fine motor development and its relationship to handwriting, that could be a really simple training, you know, 30 minutes to an hour that you could provide after school. And then another one that I thought of was simple tricks to keep your kids on task. You know, maybe you're going over a little bit about ergonomics, a little bit about movement, you know, simple things like that, and how to incorporate movement throughout the day to help the teachers keep their kids on task. Also in that level, one area is screening. This isn't something that I have done. I've never been able to conduct a screening at the kindergarten or first grade level. That's probably where I would do it, maybe preschool. I've never had the ability to do that because it does take a lot of work. It really does, and it's hard when you have a full caseload. But what I have done is been able to work with teachers and administrators to identify a tool, and in this case, it happened to be Handwriting Without Tears or or learning without tears, as it's now called, but I helped them to identify that tool and how it could be used. And eventually, all the kindergarten and first grade teachers were using that tool, and they were doing the screenings at the beginning of the year. So it was fantastic. And again, all I had to do was kind of put together a little bit of a training and let them know the options that were available, and the teachers, you know, they had the data showing that their kids weren't progressing in handwriting. So it was really easy for the teachers and myself, working together to share with the administrator and say, Hey, we need this program. And then the last area that for level one, again, was conducting centers on a larger scale. Scale. And again, when I say larger scale, I mean kind of doing it across an entire program. If you're doing it for one specific classroom, then it's more level two. But if you're going into each kindergarten class, you know, once a week or twice a month to work on just some developmental skills in there, that's still considered a level one activity, because you're reaching all the kids at that level. You're not only reaching a handful of them. You're not just reaching the ones on IEPs. You're reaching all the kids. All right, so level two, again, remember, as I said earlier, going a little more specific, a little more small group. And so when I say small group, again, I'm meaning like individual classrooms. I guess the best way to really describe this is when those teachers come up to you in the break room and say, Man my classroom, like, I just, they have something about their classroom, right? Like, man my classroom, they just, they just can't space. They they can't put spacing in between their words. Or, man, my class this year, they just, they're moving all the time. I can't keep them in their seats or, man, this year my class, I mean, you know, it's just, that's the perfect opportunity for this, you know, they say, Man, my class is having so much difficulty spacing. Well, that's the perfect time for you to offer, hey. Well, you know what? I understand that, you know, maybe there's some areas that I could potentially help As occupational therapists, you know, I can, I can break up the analysis a little bit and see where I might be able to help you out. And so you go into the classroom and you observe them, obviously, during a time where they're working on this specific skill or a task that includes that skill. And then you debrief with the teacher a little bit later, you know, you say, Well, you know, I was watching during writing time, and no one's using their finger to space. Or, you notice that a few kids, maybe they're left handed, and when they're copying, they can't see what they're copying because their left hand covers it up. And so simple strategy, you know, put that give them two worksheets so that they can have one on the right so that they're copying from the right hand side. Simple Strategies like that, you know that that they don't affect just one kid, they affect an entire classroom, and it's based upon your observation of that classroom. The other thing that usually that follows that as well, as, you know, debriefing with the teacher a little bit later or a consultation, is you could then also potentially co teach with that teacher, or do a small group in that classroom a center, and again, that typically needs to follow some sort of observation, so you know what help they need. And maybe so for a few weeks, you go in there and you work on that spacing. You know, every kid comes through your center in the morning, and you work on spacing for four weeks straight, and then you go back and observe again on the fifth week and say, Hey, we now have some data, or maybe they use that screening tool, and we have some data now that says, yes, that four weeks of centers did make a difference, and those kids are now progressing and spacing out Their words a little bit better. So yeah, level two, those are some decent strategies I think you could implement pretty easily, but I understand again, there are some concerns as far as time, and we're going to get into that in just a minute, but first we need to review level three. And I'm going to admit level three is the trickiest, and it's one that I have yet to master, or really even take on completely, because it's tricky, in the sense that it almost looks like what we're already doing when we pull out small groups, because it is working with a small group. However, the difference between an IEP small group and an RTI level three small group, is that in an IEP, we have evaluated the students. We have seen the specific areas in fine motor development, visual motor development, visual processing, sensory we know the specific areas that these kids need assistance with, and so we put them in a group with other students that have the same type of difficulties, and we're working on those, those skills, sometimes from a top down, sometimes from a bottom up model, but in an RTI level three group, we're targeting a specific skill in the sense, going to go back to using the spacing right Now, the spacing in between words. Now these kids, we know they're coming to us because their teacher, their parent, the administrator, whatever, said, Hey, this kid has some difficulty spacing, spacing their words still, even after we'd done so much with them. And so they're coming to this group specifically for spacing. And now we haven't assessed them. We don't know what their visual motor abilities or visual spatial skills look like, but we know they're having difficulty with the spacing of the words, and so now we have, you know, five kids maybe that we're working directly on that, and we're using a very task oriented, top down approach, you know, we're just trying to hit that one skill, because that's the area. Area that they really been identified in as needing help with. And so that's kind of how it's a little bit different. But again, you can kind of see how it looks similar and how it can be a little difficult to interpret. I guess. You know, my kid is not on an IEP, but they're going to a small group out of the classroom. You know, that doesn't necessarily always appear Correct. I guess you could say so. It is a tricky one. It is one that I have not mastered. I do think it is something that could potentially help with eliminating unnecessary referrals, per se for occupational therapy. But I do think, because your your groups need to be tailored to, you know, the screening tools that were done in level one, how else are you going to know what, what type of program to run? You need to have a screening tool. So if you don't have a solid foundation and RTI for levels one and two, then level three isn't really going to ever happen, because you have to go through level one and level two to get to level three, and so it's hard to develop a level three or even get to where you're doing level three, RTI, if you don't have a solid foundation of level one and level two. And I think that's part of the reason that I've never gotten there before, is because, yeah, I've dabbed into level one. I've helped kids and teachers in the classroom, co taught like a handwriting type of program for a few weeks, but it was never consistent and solid enough that we were able to kind of move up the ladder and eventually get to level three. So again, I started this podcast not to say that I am the greatest ot in the world, but to share with you my struggles and what I've learned throughout my school based ot career, and it's difficult, and it takes a tremendous teamwork, and you really have to work with your administrator as well as the team, including your teachers and even your parents, to get there. So that's my talk about level three real quick. But I do want to now dive into what I'm doing right now, as far as trying to help myself eventually transition into more of an RTI based model, because right now I do have a very caseload heavy model. I have kids that are once a week, some kids that are twice a week, and they're individual. And when your schedule is completely full with individual sessions all week long, you know, from bell ring to Bell, bell ring to go home, then you can't sit in RTI. And so I'm going to share with you just a few tips or a few things that I'm doing right now to try to kind of flip that upside down a little bit and get myself some more time. So stay tuned. All right, so it sounds like I'm in the same boat as many of you. You know, we have a caseload that, like, as mentioned a second ago. I'm seeing kids from the time the bell rings to the time the bell rings, basically for the kids to go home, start Bell, to finish bell. And that makes it obviously, very difficult to do. RtI level one, you can still do because you can do trainings, right? And a lot of that can occur after the kids have gone home. You can put together a training after the kids have gone home. You obviously will be presenting your training after the kids have gone home, or during a non pupil day, or whatever. But other than that, level two, level three, I mean, you have to have the kids in school to be doing level two and level three, even parts of level one. And so you kind of have to to work towards your caseload. I don't want to say reduction, because that's not the that is not the case. But in the long term, you have to be thinking that RTI is going to help reduce your caseload, in the sense that if you're doing RTI, hopefully you're going to be able to prevent occupational therapy referrals, right? And so that's kind of the goal, is to get to kids before they before they might need a referral for occupational therapy. And so have a few strategies here that we can use in order to try to work our way toward using more RTI and spending more time on RTI to be effective, so that we can do that prevent, prevent referrals. And you know, the ones that may take up more time than they actually take up to help the student. But before we get into that, I want to take a quick moment to take a break. I'm getting a little restless. Over here, my dog, TJ, over here, is also getting a little restless. He's shaking his toys and wants me to play with him. So let's take a quick break right here. Move about a little bit. Get your wiggles out if you need to press pause, take a break. Check the social media I really appreciate it. If you left me a positive review wherever you are listening to this podcast. If you're able to do that on Apple podcast or some of the other networks, really appreciate that. Or just shoot me a social media message real quick and give me a fist bump or thumbs up or something and say hi. But. Yeah, just take a quick brain break, and then we'll get back into it right now with a few strategies that you can use to facilitate progressing in your own RTI program. So all right, let's get back into it. My first strategy here is start with educating. Figure out, you know, one or two teachers that understand what OT is, and they find you as being a valuable member to, if not the IEP team. But they they just personally believe in what you have to say. They think that everything you have to say is a good idea. They've taken your strategies and use them and implemented them, and, you know, try and take it to the next step, see if they'll let you come in and observe their classroom and consult a little bit and talk together, talk together afterwards, and see if there's not some strategies that make may even better help them. I mean, right there, that in itself, right there is a tier two, tier one strategy, you know, getting into the classroom, observing and then collaborating and consulting to find out where we can improve even a step further from that. I mean, it's a level one strategy, but see if they're willing to work with you on creating an in service, you know, maybe a teacher and yourself, especially if it's like a special education teacher who has to do a lot of behaviors, maybe they're willing to do a sensory and behavior in service for other special education teachers with you, that'd be great, right? And there you go. You're starting that level one process, and by observing in their classroom, you're starting that level two process, right? Another thing you can do as an IEP team member is identify the students that are making progress and can be seen in the classroom. And I understand that we're going, you know, we're trying to talk about RTI here, but again, we're trying to flip our caseload in a way, right? And so find the kids that you can see in the classroom, that you can work with in the classroom and make progress toward their goals. That way you are getting into the classroom, you'll be able to befriend those teachers and show them the value that you do have, or that you can provide in helping those students, and not to mention, but you'll also be in the classroom, and so you can see the other struggles that kids are having, you can see the struggles that the teacher is having, and you can continue to build those relationships with those teachers By pulling the kids out of the classroom. And I'm not saying that's a bad thing. There are definitely kids that need to be pulled out for therapy services, but we miss a lot of the context that they get when they're in the classroom. And so if we can push in, not only can we potentially help that kid, but also we get to see the dynamics of the individual classrooms on campus and get to know the teachers a little bit better. Another opportunity to take advantage of is during IEPs. That can be an opportunity to show not only what we have done for a student, but what we can do for a student, and potentially even a group of students or an entire classroom. And you know, it can be difficult to show our administrators what we can do. Oftentimes, they kind of know what we're supposed to be doing, but they don't know how we do it, or what we do in the in the classroom or in the therapy room. To make that happen. So take advantage of your IEP meetings and let them know what you've been doing and what you can do and what you could even do in the future, given more responsibility in the classroom, working with the teachers. And the final strategy that I have for right now is to go to staff meetings. And I want to share a little story about that, because I've been in OT now for seven years, and I think last week was the very first school staff meeting I have ever gone to. I have obviously gone to special education meetings. I've gone to hundreds of IEPs. I've gone to occupational therapy meetings. I've gone to district level meetings, and when I was at a different district, but I think in seven years, this was the first time I went to a a school site staff meeting for teachers, and I took a lot away from it. You know, you can't know what the school is focusing on unless you're going to meetings like these, and you need to know what the school is focusing on, to know what, how you can help in that focus. And you know, if, if the entire school is focusing on math, and here we are trying to focus on, you know, language arts. Well, we're already a kind of a step behind because, you know, they're trying to focus on math. And so this week, I found out my school's really focusing on positive behavioral intervention strategies this year, PBIS, in fact, they're kind of moving from tier one, potentially up into tier two. And so I was like, hey, well, first of all, they're already talking about RTI, right? And secondly, it's, it's about behavior, and OT is inherently intertwined with behavior. And so now I know going forward, I know the topics that I need to talk about, and the areas where I. Can help out with behavior and sensory and potentially using different type of mindfulness activities and stuff like that to influence behavior, and I can have an impact on that. And so I think you guys have probably heard me say, you know, I don't I try not to bring work home, but this time, it was totally worth it, because I went to a staff meeting and I learned a lot about my specific school, or one of my three schools, and it was worth bringing work home this today because or this weekend, because now I know going forward what more I can do at the school site to help them and to, you know, kind of catch their ear on different things, how I can help them with So, yeah, that's what I have today about RTI. I hope that gives you a better understanding of the three tiers of RTI. There are some people adding more tiers, tier four. Some people do say that RTI tier three is an IEP. I think I said earlier, I don't necessarily agree with that. I think it's it's before an IEP, or I shouldn't say, before an IEP, but it is not part of an IEP. It is a general education function still. And I think OT is just getting into RTI, but I think it is where our role is going to be going even more so more on the consult slash collaborative side, versus the individual treatments, there's such a push to keep kids in the general education classroom as much as possible, and through the RTI we could potentially, through the RTI method, we could potentially do that and help out the teachers to have more strategies for the kids, and even if we're going into the classroom. I mean, you think about it, this is what RSP teachers and aides do often. They go into the classroom and they work with the kids in the classroom in their natural environment, right? Isn't that what we're all about, natural environment? And so I think that's something as OTS that we should be looking forward to and figuring out how we can provide a more supportive role in that aspect. So yeah, this is my episode on RTI, and sure, we'll talk more about it in the future, but I know we've talked a lot about it in the past, but we hadn't really, like dove into it deep to figure out exactly what RTI is. And so I hope you enjoyed that. I am really looking forward to hearing the email responses from this. I know you guys are going to have questions. I know you guys are going to have more wanting more specifics. And so I'm working on something for that, and I'll let you know more about it, but feel free to email me, let me know if you have any specific questions about this. And, yeah, just keep on going. I mean, right now I'm working on a presentation that I'll be presenting in December for my teachers. Again, it's going to be kind of that sensory processing 101, type of training for all the special education teachers, I think, at two or three schools. So that's one way that I'm doing level one, and I'm hoping to continue to build off of that. It was more at my previous district that I got to do some more level two type of the stuff, but I'm trying to get that going here. And one way, like I kind of talked about earlier in the way that I'm flipping it, is I'm looking for those students that I know that I can be assistance to them inside the classroom versus pulling them out. And by doing that, I'm going to be in the class more making progress with those students, but also seeing the concerns of the teacher and the other students and the paraprofessionals, and working with them to help the kids in the classroom on a daily basis. So yeah, that is my 40 minutes or so on RTI, I hope you all enjoyed it. This has been a great episode. 42 I appreciate you all listening. Thank you so much for helping me reach 100,000 downloads in just over 600 days. It's been fantastic, and I look forward to many more. Take care and have a great rest of your week. Bye bye.  

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