OTS 192: Applying your Sensory Knowledge to MTSS Tiers 1 & 2
- Jayson Davies
- 6 days ago
- 52 min read
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Welcome to the show notes for Episode 192 of the OT Schoolhouse Podcast.
Dr. Aimee Piller joins the OT Schoolhouse Podcast to explore how school-based occupational therapists can apply their sensory expertise within a Multi-Tiered System of Support (MTSS).
She shares practical strategies for moving beyond traditional IEP-based services to support entire classrooms at Tier 1 and small groups at Tier 2, helping OT practitioners maximize their impact while managing their caseloads more effectively.
Learning Objectives
Identify the three tiers of MTSS (Multi-Tiered System of Support) and how occupational therapy services can be effectively integrated at each tier to support students with sensory processing needs
Describe assessment strategies for evaluating sensory processing patterns at population, group, and individual levels within the MTSS framework
Implement evidence-based sensory interventions at Tier 1 and Tier 2 levels, including strategies for training paraprofessionals and monitoring progress through data collection
Whether you're new to school-based practice or looking to expand your service delivery model, this episode offers actionable insights on implementing tiered sensory interventions. Listen now to discover how you can support more students while staying within your professional scope and managing your time effectively.
Guest Bio
Aimee Piller PhD, OTR/L, BCP, FAOTA
Aimee Piller PhD, OTR/L, BCP, FAOTA is the owner and director of Piller Child Development She volunteers with the American Occupational Therapy Association in various capacities and with the American Occupational Therapy Foundation. She is the author of Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs and has several national and international publications, presentations, and podcasts.
Impacrful Quotes
"Anyone can Google classroom sensory strategies, but they don't have the expertise that we have as occupational therapists to understand the theory behind it and really that interaction between the client and the environment." - Dr. Piller
"We have to be the ones that are saying, 'Hey, we can be here too.' Your MTSS processes are already in place and we know how to do this." - Dr. Piller
"Find the one person who's open to your ideas. There's going to be one, maybe two teachers that really see the impact that the OT makes, especially when we're talking about sensory processing." - Dr. Piller
"Sometimes these kids don't need our services individually. A paraprofessional compared to hiring another OT — that's a huge difference from a budget standpoint." - Dr. Piller
"We can move from three to two to one and not leave our parents or students with no support. We can ease out of that direct intervention." - Dr. Piller
Resources
👉 Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs by Aimee Piller
👉 Piller Child Development
Website: pillerchilddevelopment.com
Episode Transcript
Expand to view episode transcript
Jayson Davies 0:01
Hello and happy 2026 and welcome to episode 192 of the OT school house podcast. I'm your host, Jayson Davies, and today we are addressing sensory processing within a multi tiered system of support, aka MTSS with occupational therapist and newly minted author, Dr Aimee Piller, I'm thrilled to welcome Aimee to the podcast fresh off this publication of her new book for ot practitioners, titled implementing school based occupational therapy services a multi tiered approach to sensory processing needs. Now I've had the pleasure of sitting in on a few of Aimee sessions at a ot a also here in California at OTC, and I'm always impressed by her ability to take ideas within the OT world that are sometimes more focused on the quote, unquote, clinical side, and apply them to school based ot practice, such as the case with sensory integration and sensory processing inside of MTSS. So if you've ever wondered how to support more students with your sensory expertise beyond just the IEP. This is the episode for you. Aimee shares practical strategies for implementing sensory supports At Tiers one and two, helping us shift from only working with individual students to supporting entire classrooms and small groups within those classrooms. We'll discuss assessment approaches for each tier, intervention ideas that don't require more of your time, and how to advocate for your role within your school's MTSS framework. So whether you're brand new to school based ot practice or a seasoned ot looking to expand your impact in the classroom, don't miss this episode. Let's get started.
Amazing Narrator 1:36
Hello and welcome to the OT school house 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, CLASI is officially in session.
Jayson Davies 1:53
Dr Pilar, welcome to the OT school house podcast. It is great to have you, and we're actually have a few episodes with you coming out, this being the first one, and I'm excited to have you on so welcome for the first time of hopefully several, to the OT schoolhouse podcast.
Dr. Aimee Piller 2:09
Well, thanks, Jayson. I'm really excited to be here today and share a little bit about some the book that I wrote.
Jayson Davies 2:15
Yes and congratulations on that a book is never easy. I have had the idea of books for a long time, and just getting started is probably the hardest part. So congratulations, a on getting started and B, completing it. That is a monumentous, or I don't even know how to say that, but a wonderful thing that you have done, and I know it's gonna help so many, not just ot practitioners, but also educators and whatnot. So yeah, actually wanna start with the book, because in the book, you actually shared an experience that is kind of similar to mine, in the sense that you kind of dove head first into the real school based occupational therapy right out of school, out of OT school, you jumped right into, I don't know if it was in the Arizona area where you are now, but you were the only ot practitioner with a team of occupational Are you the only ot with a team of occupational therapy assistants? I just want to let you kind of share how that has shaped your experience, kind of just diving into it head first.
Dr. Aimee Piller 3:12
Well, yeah, so I actually started my ot career in the school system. I worked not in Arizona. I was in the Midwest, and I was a great job. I mean, I was one of those where if I hadn't moved, I probably would still be there all these years later. It was a very supportive environment. I had a great mentor that I can meet with, and now she wasn't on site, but I still was able to meet with her work at the assistants. But what was really nice, I think, is being a young, new practitioner, you kind of are like, you don't really know how it's supposed to look, so you just figure it out, right? And that's how that kind of happened. I was able to just build learn from my assistants. I was able to learn from the teachers. They had not had an OT fully in their building before, or had been many years since the OT had been in their building, and I was able to stay in the building the whole time. So that was a really nice opportunity for me to just kind of get into the classrooms. And then I just started working with teachers in different ways, even though, when I stepped into the role, it was everything was pull out based I kind of was like, I was talking to the teachers, and they're like, one teacher in particular is very open to, what do you do, and how can I support the kids in my classroom? And I was just like, Well, why don't I just come in for a little bit? And then, of course, as we know, caseloads grew, and I was like, why don't I come in for more kids? And so just became a really nice model, as probably many of your listeners have worked for a long time in the profession and done these things that now are part of who we are in this, in our models of school based therapy,
Jayson Davies 4:37
yeah, yeah, absolutely. You know, you mentioned a few things. One, you know, it being a pull out model, and you just kind of maybe didn't know better, and so decided to work with that one teacher. And how awesome is it to have that one teacher? Because I think we all have that one teacher, but we don't always recognize that we have that one teacher, and how important they can be.
Unknown Speaker 4:54
Yeah, I mean, and I talk about that, and when I in the book, when I discuss, you know, kind of, how do you. Get started with changing the model of practice, or what your current practice setting looks like. It's find the one person who's open to your ideas. There's going to be one, maybe two teachers that are really, really see the impact that the OT makes, especially when we're talking about sensory processing and our sensory strategies that we can implement. You know, if you have some great ideas, and the teachers start to see their students doing better, and it's kind of reducing some of that teacher burden, for lack of better word to manage behaviors. So you know, they want you to be in their classroom. They want to know your strategies. And then they talk in the work room, and then in the work room, another teacher says, Well, I'd like that too, or I'd like to know more about that. And that's kind of how it got started, when I was again, not knowing what I was doing, just in there doing it. And the teachers would then she would talk in the work room, and another teacher would come to me, say, can you come into my class? And then it spiraled, yeah, yeah.
Jayson Davies 5:52
And before we dive, you know, full head in on MTSS and sensory The other thing that you mentioned in your first answer was talking about a mentor. And you mentioned that your mentor wasn't necessarily on site, so I'm assuming, probably not even working within that district or with the contractor, whatever system you were set up with. But can you just share a little bit about a how you went about finding a mentor? Was this someone you know in your past already, or or someone new, and the impact that that had, like, and how did that work? Yeah.
Unknown Speaker 6:23
So she was just a member of that the, you know, the OT community is very small. Even as a new practitioner, I was kind of working in a more, not a rural area, but a small city. So there was a pretty known on who the pediatric OTs were in the area. I had come back from ot school to where my hometown was, and so I'd heard of this person, you know, before, like, Oh, she's that. They would call her the sensory guru. And I was like, I'd like to be a sensory guru too, right? So that's how I was like, just, you know, I was that, you know, perhaps you'd like to mentor me. We would meet once a week, and we ended up doing things like, we would go on bike rides, and then we had more formal meetings as well. And she was like, I'm happy to mentor you. I had a good mentor, and I wanted to pass that on. And then we became friends, of course, which then just gave us the opportunity to talk about ot all the time, which was invaluable as a new as a new graduate, right? So it was a great opportunity for me, and I have tried to do that now, and my career is to pass that on to other therapists as well, because I was given such a great gift. I want to share that with the next generation of therapists.
Jayson Davies 7:23
Wow, wow. That's, that's very awesome. You mentioned her kind of being a sensory guru. Obviously, your book is now on sensory and MTSS a little bit. What kind of drove you down that route of sensory Why did you want to follow the sensory guru? Why did you want to learn so much about sensory?
Unknown Speaker 7:39
Yeah, and being, I've been in OT for about 20 years now, so things have changed a bit. And sensory was important in OT back then, but not so mainstream as I think it is now. But, you know, I think when I was I knew I always wanted to do pediatrics. It's always been, my passion has always been kids. And I remember studying about sensory integration, I was like, it's so when you're in school, it seems so hard to understand. And I remember, and that's one of those things, but when you see it in practice, it's like, Wow, that really works. But it seems it's hard to learn, right? There's lots of different aspects to it. You need to learn and figure out how to do. But I could see such a difference in kids. And I was like, I really enjoyed studying it too. Is very interesting to me. And then I have found, and I tell my younger therapist now too, like, when you find something that you're interested in and then that you're actually pretty good at, like, that's your specialty area. And so I found myself to be pretty good at sensory and I loved it. And so that's where I specialized Awesome.
Jayson Davies 8:35
Now, something that was also relatively new 20 years ago was MTSS, I mean, it's still relatively new. You mentioned, right that when you got there, I'm assuming most of the OTs and previous OTs were using that pull out model, as you kind of mentioned, and and you kind of started to ask why, and started to think about what the alternatives could look like. When did you start to hear about MTSS and start to think like, hey, this could be a model that ot practitioners or that could apply to OT
Unknown Speaker 9:06
well, I'll admit, it was many years later, not something I knew I was doing at the time, you know. And I think a lot, a lot changed in education since when I was a first practitioner, and continues to change. It's an area that we always have to that molds and modifies as we move along. So I never really put it into that model, until later, when I was like, Oh, wait, this is exactly what I was doing as a new practitioner, and didn't really know about it, you know, I had worked at the, you know, if we identify that level, tier one, as a classroom level, I was able to work at that level. And then I had small groups, and then I had individualized kids too. And it was really something that when I plugged it back in to the MDSs model, it fit so nicely, but it was not a prospective way of treating at the time.
Jayson Davies 9:50
Yeah, yeah, definitely. And I think especially when you come from the background of occupational therapy in general, but then even more specific sensory processing. And you know, whether you've taken a sipped course, whether you've taken CLASI, there, you've gone to the USC program, Star Program, whatever it might be, or if you've never done any of those, and you just know occupational therapy, we know that it is very Client Center. And I use client in the sense of one individual, yes, ot practitioners can support communities, groups and whatnot, but for the most part, we look at individuals, especially in school. So T that's kind of like what we focus on. And the same goes first century, when we're talking like one of the most famous lines, I think, if you go through any of those courses, is it depends, it depends on the client. It depends on the client. It depends on the client. So the question that I'm coming up here, and it's admittedly probably a little bit of a toughy, but when we are taught so much to look at a singular individual, especially when it comes to sensory, how do we start to move this framework to thinking about sensory for a group of Students, or a entire classroom of students?
Unknown Speaker 11:02
Well, it's certainly a big question. That's kind of what most it took a lot to get that model and that mindset to change a little bit, and I'm sure, and I've only touched the surface, right? I mean, so other people will probably do it more justice than I did in the book, but it sensory processing is very individualized to the person, right? Each of us have different sensory processing patterns and preferences, and how we interact with our sensory environment is very individualized based on who we are, but we also function in groups and we function in communities. And so we can look at patterns of the client and the population sense, or the client and the group sense, as well as, as we see the individual within that context, and see that there are patterns. Are there certain areas of and I talked about that in the book, as well as, like, how do we see that? You know, at this time of day, students need to be at this level of arousal, and all students need to be there now. They may need to have different needs to get there, but that's where we need them to be. If it's time to sit down and do quiet reading, that's generally speaking about the same level of arousal for most kids. But how can we incorporate those sensory strategies within that routine, which is really important. I talk a lot about routines in the book, and how to structure routines to help that aspect to switch from Yes, it's an individualized sensory need, but it does fit within the participation of the group.
Jayson Davies 12:26
Awesome. Appreciate that. So I have a little bit of a fault in the sense that I believe that every single person listening to the podcast has listened to all 180 plus episodes of the podcast, which obviously isn't true. And so I know not everybody understands MTSS and all that. And so I want to give you a moment to kind of share how you identify MTSS, how you define it, and the tiers that you kind of when you talk about MTSS, the tiers that you define.
Unknown Speaker 12:55
Yeah, and thanks for that question, Jayson, because I know when you and I first spoke, we found that there are some state differences as everything in education, right? So it's important that I define, and giving thanks for giving me the opportunity to define what I mean in this particular book is that MTSS tier one in this book, I defined it as a population, which could be the entire district, school building or classroom, and then this tier two is defined as smaller groups individuals that have been identified as requiring additional support, but not all the way to the point where maybe they need very individualized support, which would be under the tier three. So those tier two kids are okay. These general population or general strategies the entire school or classroom is using isn't enough support for these clients. They need a little bit more, but maybe not quite individualized. And then the tier three is really what I think our classic thought of OT in the school system is, which is that under the IEP, more individualized services. So that's how I define them in the book Gotcha.
Jayson Davies 13:55
And for tier two, could that potentially include students that maybe are on a 504, plan, or maybe, like a student study team of some sort that the schools might have?
Unknown Speaker 14:05
Yeah, absolutely. That's a great example of what a tier two might look like.
Jayson Davies 14:09
Okay, perfect. All right, so we're going to dive more into how we can begin to assess these different tiers, or students within the tiers and the maybe even classrooms within the tiers. But before we do that, let's take a quick break. All right, we are back with Aimee, and we are going to begin to talk about assessments within the tiered model. So Aimee really quickly, or maybe not so quickly. It's up to you. It's your response. How does an individualized assessment look very different from maybe a tiered assessment, and we can go deeper into this, but kind of an overarching,
Unknown Speaker 14:47
yeah, and one thing I really want to point out that's important if you're going to be functioning or providing services, especially sensory supports, at a population or group level, is that you do still follow the OT process and do. That assessment piece. I know that can be sometimes we get something in our mind, especially in a school based setting, where it's like, oh, assessment, well, I've got to follow the IEP process. I have to follow that met plan. I have to get the permission. It's like, No, we assess in lots of different ways. Right? As OTs, we're constantly assessing our clients and in various points within the OT process, but assessment is really important for us to make sure that we're tailoring those sensory interventions to what the client needs, whether that is the population or group, and not just providing a blanketed here's a sensory plan like I feel like that's very important for us if you're functioning and working under MTSS model as an OT with sensory integration or sensory processing. What you need to make sure you're doing is providing that high quality assessment, and I'll talk a little bit about some ways to do that well, to provide more tailored interventions that then you can see if they're effective or not. I mean, anyone can Google, send classroom sensory strategies, put them in place, right? But they don't have the expertise that we have as occupational therapists to understand the theory behind it, and really that interaction between the client and the environment and the client sensory processing needs. So it can be it's a little bit different model. I talk a lot about different ways to do it in the book that are effective. I had give some ways to gather the occupational profile. Some of that from the district standpoint, is, you know, what do students have access to outside of school that's sensory related, right? Are there parks nearby? Are there do they have extracurricular activities they're able to engage in? What kind of things are valuable to the school district? What is matters to the district from that kind of occupational profile, and then also looking at the clients themselves, right? I want to know what's important to the student, but I also want to know what's going on and what's important to the students. So I provide some examples of different games that you can play that are like classroom based games. There's a bingo game in the in the book that I talk about, there's kind of a two truths and a lie, just just fun games that you can gather some information and how to do that on their occupational profile, and then ways to look at sensory processing patterns, especially in a population and group. You know, some of that is still looking at the individual processing needs of a student, whether that's just a simple questionnaire or that you can give to the students and the teachers, maybe it's just an observation interviews. I talk a lot about how to do interviews that you can do very either quickly in person or maybe turn them into something electronic, so they can be done at any point in time, rather than having to try to find that face to face time with teachers and students. So there's lots of examples of those and questions that you might ask, so you can really start to see what the sensory processing patterns of each student is the teacher's sensory processing patterns and preferences and the classrooms routines and sensory environment piece.
Jayson Davies 17:49
Okay, so obviously, if we, if we're going into any kindergarten, first, second, grade, third, any grade level classroom, we're going to go in, and we might begin to say, you know, 90% of the students, or 75% of the students, of the students, probably closer to 50% of the students are showing maybe some heightened needs for movement. But then we're also going to see 25% of the classroom that maybe it's the complete opposite, or some variance of a sensory processing need. So when it comes to that assessment piece and we're providing our our findings, I guess my question is like, how do we represent that? And how do we provide recommendations for a classroom that has varied needs? And I'm trying to stick to the assessment piece here, not go too far down the weeds. We'll get to that. But, but how do you explain that in assessment?
Unknown Speaker 18:40
And I think that's an excellent question, because you think, does it all have to look the same? But that actually is your assessment, right? That some of the people in this environment and in this classroom, in this population need this input, and the other part need this input, and that is your assessment, and we have the clinical expertise to make those determinations, as well as designing a population based intervention that provides two types of input, right? And you think, Oh, that could be kind of tricky. I mean, so because we have this mindset of, I'm so used to like the child needs calming input, so I give calming input, right? But sometimes you need calming and someone else needs alerting. So I talk a little bit in the book about how to design different interventions that you can modify it based on the client's needs. It's the same kind of activity, but this group does it calming. This was a more alerting and movement basis. Of course, really common. And then also the environments I talk about how some students, I think when we talk with teachers, they really do a good job of trying to, you know, help students with sensory needs. But there's oftentimes that that mindset of, I can help the students that are hyper reactive to sensory input, and they don't think about those kids who need more stimulation to function at the optimal level. And so helping them design areas in their classroom that are low stimulation, on on sensory input and higher stimulation. And big parts of that too. Especially at the population level, is just observing and assessing that routine of the day, when is the best time for this input to happen for each for the individuals. And then I think one last thing to think about is sometimes you are going to see those clients as you're assessing that population level that really are just not fitting in those patterns, and that's a good indication that now, of course, after progress monitoring and data collection, those are probably clients that might be more appropriate for a tier two okay.
Jayson Davies 20:32
And that's a perfect kind of segue, because I think what we've talked a little bit so far with it, within the assessment world, is like kind of larger picture tier one assessment, and I think for the most part, ot practitioners are relatively familiar with what a tier three in the realm of what you discussed kind of being that traditional IEP assessment might look like, but then we have this messy middle of tier two, and so does a tier two assessment look more like a tier one assessment, where you're being kind of more broad, getting a lot of information from the teacher, or does it look a little bit more specific, like an IEP assessment or the messy middle?
Unknown Speaker 21:09
Yeah, so it's, to me, you're going to start off with that kind of broad based population assessment, but as naturally, we're going to see those clients who don't, kind of who clearly need more intervention, right? We're really good at that. As OTs of picking out. We just know, we know the kids that need the support that we can provide them, right? I don't I think anyone could walk into a classroom, you might be there for one kid, and see two other kids that need you, right? Really need you. And so as you're doing those assessment pieces, especially as you're working with those individual as you're getting individual information on each participant of that population, sensory processing needs. You're going to start to see those clients that have higher needs. Now, in the book, I talk about how to match those clients at that point, since it's a more, a little bit more intensified intervention, you can kind of match those clients so they're those kids that need more input. We can put those in a group and those who need kind of less stimulation, we can put those into a group, and so you can do a little more targeted intervention at a group level, but your assessments are fairly similar at that point. Okay, you
Jayson Davies 22:13
mentioned matching a little bit, and I get that process of matching some of the kids who I pause here because too often, every single person has been guilty of this is putting kids together in a group that have no reason to be in a group together. And so I like that you talk about that matching, because sometimes we just match kids because we need to cut down on our minutes in a day. And so we group a third grader with a sixth grader. That makes no sense at all. So I like how you talked about that matching. To what degree does the other staff have an input when it comes to matching a little bit? And I ask this because sometimes we have kids who maybe are not in the same classroom that might be able to be matched a little bit together. Within that tier two, are we able to potentially see a kid that is in Mrs. Jones class and Mr. Jones's class, or should they be in the same class? Or I think this varies from district to district, but what have you experienced?
Unknown Speaker 23:10
I mean, ideally, if your district is supportive of that, it is about not just in the classroom. It can be across classrooms like these students have the same needs at about the same time of day. I mean, that's obviously the idealistic world. It doesn't always work out that way, right? But we can advocate for those aspects, especially if we're collecting really good data that's showing this is effective for the students being more successful. And so sometimes it's just maybe I can only do three at a time, and then if, when this occurs, maybe we can form another group that's similar, with different students. So when I talk about it in the book, the tier two does take students from across classrooms, not just from one, if that's available to you at your district,
Jayson Davies 23:49
yeah, yeah. I think that is something that we default to thinking that it's not possible. I know I did when I was first in school based OT, and then I started to realize that if I advocate for it, people are usually actually open to it, so long as we can explain how it connects to MTSS because people typically think that if an OT is doing something, it's an IEP, and therefore everything needs to be on the IEP before you do anything. But if we come at this from an MTSS perspective, people seem to be a little bit more open to it. Does that sound familiar?
Unknown Speaker 24:25
Yeah, I agree 100% and that's sometimes when I'm talking with other OTs about kind of this concept and model. They're like, Well, how do you fit it in? I'm like, well, MTSS is really already laid out for us to put it in. We don't have to come up with new policies or procedures. We just have to embed ourselves within that MTSS process. I will mention, I just think it's just an interesting story is that I was, I was at a school climate conference, and it was all about, you know, promoting social emotional and I happened to go to a class on someone who was, she was in charge of the MTSS program for a very large. District in Southern California, and I just happened to it was great breakout session. And I mentioned to her afterwards, like, so great. I'm always trying to talk to OTs about how we can embed ourselves in tier one and tier two, and we shouldn't shy away from it, and we need to be at the table. And she looked at me very large district, and said, I have never considered asking the OT to com to MTSS meetings, or tier one or tier two. So we have to be the ones that are that are saying, Hey, we can be here too. And here your processes are already in place, and we know how to do this. We can really help students so that then at the end of the day, we have more time for those individual students that need, those that have those higher needs, and we have the time to service them individually. So sometimes these kids don't need our services individually. And I do have a whole section on how that looks. How do you train your staff to get there?
Jayson Davies 25:52
Yeah, I love that, because obviously we're going to maybe talk a little bit about advocacy and implementation at the very, very end, but we might as well like just work it in here, because you're right. We have to kind of speak up and let people know that we can do this. And I think a lot of districts often have two MTSS routes, if you want to call them, there's MTSS a, academics and MTSS B, behavior. And sometimes the academic might be broken down into English, language arts and math, but nowhere in there is there like speech. MTSS, OT, MTSS, ape, MTSS, like it's just not necessarily designed with related service providers in there, because Esso didn't really come around and kind of define a little bit until 2015 everything you know takes some time to implement. So, so we do have to speak up, and that's absolutely important. Thank you for bringing that up. One other question that I get often is, at what point do we need to let parents know that they are receiving some form of occupational therapy support? Obviously, with tier three IEP, they're very informed at tier one or tier two. Do you feel like there or what does MTSS kind of say? What are districts doing in terms of letting parents know that OT is involved?
Unknown Speaker 27:10
Well, and Jayson, I think that's the best part of it. Is that whatever that that procedure is already in place for those MTS kids who are receiving MTSS one or two, there's some procedure already in place in the district on how those parents are notified of that. And so just embedding yourself within whatever that district policy is on, hey, now the OTs involved in this process is the best thing. And so it's not, to me, something that we need to reinvent the wheel of or say, hey, we really need to make sure this happens. Like, what's your current policy? I think that will be fine. Can we just add to it that the OTs is going to be involved in this situation? Obviously, tier two has a little more, you know, kind of communication with parents in that way, and that's all right, but again, it's like, that's our guiding practice for that is going to come from the district, all right?
Jayson Davies 27:56
And one last question, in terms of assessments, you know, we talked about that tier one assessment being a little bit more, I think, teacher centric and larger picture centric. And then as we move to tier two, it is a little bit more about the students. I think people have a difficulty, especially with tier two, in terms of, is it occupational therapy, or is it educational services provided from an occupational therapy perspective. And then either way, what does that mean in terms of, like, what is occupational therapy actually working on? Are we working on a specific quote, unquote goal, as it might say on an IEP? So I guess the first question at tier two, do you think it is intervention, as we move to interventions a little bit, is it occupational therapy for those students, or is it more of educational services provided by an OT if that makes sense, or how do you explain that?
Unknown Speaker 28:52
Yeah, that's kind of a complex question and such a simple question, right? Because, of course, anything that OTs doing is occupational therapy, right? But I can, I think of it more as educate. It's the education from an occupational therapy perspective, and even in the book I present that the OTs probably not doing the actual intervention piece. They've designed it. They're monitoring it. But it's not necessarily done by the OT it might be done by a pair of professional maybe someone else that's doing some of the RTI situations or things like that. And that's why, when it comes down to it, because, of course, we're very busy as practitioners. We have so much to do, not enough time in the day. And so it's, well, how can I add in? That's the question I get. How do I add this? And I'm like, well, you're training someone to do it, and then you're monitoring that progress to see what needs to be changed and what's working what's not working. When do you need to come back in and kind of reassess or remodify the programming? But you the OT doesn't necessarily have to be the one that's implementing it at those levels. Okay?
Jayson Davies 29:54
I'm going to give a second to have a follow up to that, because I know we just lost some people. Because they heard we need more support in some way, and it can't be us and and they love that you said it's not going to be them necessarily, because, yeah, like you said, OTs don't need more work, but at the same time, teachers don't need more work. So I diving into that intervention piece. How does that begin to work? Like we're developing a program and then maybe training a paraprofessional. Is that kind of what tier two in what you've done kind of works,
Unknown Speaker 30:27
yeah, and models that I've worked in, and when I especially, like, when I was that first initial job where I had no idea what I was doing, it just came about. What happened was the teachers were like, This is so great, but Aimee doesn't have enough time, and we don't have enough time. And they were like, they came together as a group and said, We need another paraprofessional to help us with this sensory piece. They came to the because of the effectiveness. And I said, that would be fantastic. Like, I could train her. I can make sure she can kind of not report to me, but in a way, we can always touch base about data. And the school said, Yeah, okay, we're seeing that students are being more successful. We're not having as many, you know, referrals. This is a good thing, and a pair of professional is something that's in the budget. So that was great, because the teachers came to my advocacy, not me, right? Yeah. And so that was excellent. And sometimes it can just be embedded within another program, like, if you've got some of those working on some of those social emotional pieces, can you put some of that sensory piece into whoever's doing that social emotional piece? There's things like that that you can utilize as strategies to try to help get those extra services. And then I also, you know, I know we're getting into this later, but there's an element of, you know, a paraprofessional compared to hiring another OT, that's a huge difference how much budget that is. So if you can really, really show that you're through progress monitoring and data good quality data collection and training, that you a pair of professional can help you. So maybe we don't have to, you know, hire another ot from a budget standpoint, that's what districts want to see, right?
Jayson Davies 32:01
Yeah, see, this is, this is, like, the exact reason why I wish we were posting this on YouTube, because, like, I don't know if you can see, but I'm like, thinking like crazy right now, like, because you got me thinking, like, we think about all the things that we do, and we often try to say, Man, if only I had another occupational therapist, if only I had another ot a to help with this. But we rarely think about, man, what if I just had a three hour paraprofessional, like, even, not necessarily even, like five days a week, even if it was just a few days a week and and I think that kind of goes back to that very first question that we talked about assessments where you talked about doing a tier one overall assessment of maybe it's the entire first grade level team, or, like, the entire school, but you could show in that quote, unquote assessment, where 15 hours a week of paraprofessional support could make a life a lot easier for every single person at that school,
Dr. Aimee Piller 33:02
Yeah, correct. And it really comes down to that aspect. And when you're going to advocate for things, is to really make sure you have your data right. I mean, if I because data and data is not just hard data, I mean, that's part of it, but those teachers were huge for me to get that paraprofessional right. She was a part time person. Just came in. I think she was there four hours a day, four days a week. It was great, though, right? So that the teachers are a huge source of that data as well, but as you're gathering those data too and making sure that, and I talk about strategies, and I give really good methods and ways to make sure your staff is well trained so that you can keep that fidelity of intervention. But I've utilized that model, and I'm I utilize it in schools even now. I work in clinic based but I still consult and contract with some schools, and I utilize that model a lot, because I can't be there every day, right? And I need to make sure that they're that some of these students are working, have really high sensory needs, that the staff is trained well, they're able to gather the data. I need to make determinations on if that's effective or ineffective, or if we need to make changes, and then also seeing the improvement within that setting. And so we can sometimes think other people can do certain things we do if we train them correctly and and teach them how to gather the data we need to to know to make decisions.
Jayson Davies 34:20
Yeah, and I think I'll just kind of put the quote, unquote disclaimer out there, like some states kind of lay out, what an occupational therapy, not an assistant, obviously, not an OT a but there is another term I don't even know, because I've never really been there, but I I don't know if that has to be really looked At here, if we need to think of them. Obviously, they're not an OT, a they're not an occupational therapy practitioner in any way, but to some degree, they're supporting you, and I think that's something that the district needs to look into. And as well as the OT, if they're the ones implementing this program, like, what can and cannot that person do? Just to make sure everyone is staying in compliance with licensure laws and all that so but yeah, no, I love the idea. It's got me thinking a lot like you could do
Dr. Aimee Piller 35:07
that's really very important to consider too when you're putting the programming in place, Jayson, is that if this person is a teacher or a paraprofessional, you're not going to provide anything more than what maybe would be as part of a home programming, like what you would give to parents. And so I think that's a real important distinction, because if I'm going to be doing like, real ot based interventions under that model, where it's an I'm working towards, you know, a specific goal, and it's skilled intervention that's you need to abide by your licensure laws. These are more and supports of participation, which is something in any setting, we give teachers all the time, we give to parents all the time, right? So that's the kind of modeling that that you would want to use.
Jayson Davies 35:50
Yeah, yeah. Awesome. All right. Well, let's talk a little bit about the interventions. And I kind of want to, I think we're just go through all three, well, at least the main two, obviously, when we get to tier three, as we've talked about, that's more IEP specific. We can talk a little bit about it. But when it comes to tier one, you do that assessment a little bit that you talked about earlier. After every assessment, we tend to have, like these goals. So when it comes to tier one, what are some things that you might be looking to as a goal? Are you looking and I say that with goal being loosely, it may not be a SMART goal, right, but at the end of the day, you're doing an assessment with an outcome. And so what is that outcome that maybe you might try to look at and kind of say, well, this is here we are, and this is what we could work toward. Obviously, it would be different from a district to a school to an individual classroom. But what are some things that you've used as as outcomes?
Dr. Aimee Piller 36:44
Yeah, well, again, you know, I try not to reinvent the wheel. What? What goals to the district have, per se, you know, are we looking at, are we looking at number of referrals for behavioral difficulties? Are we looking at test scores? Are we looking at teacher retention? Like all those things can be indirectly related to how the students perform in the classroom, right? So I sometimes will look and see like, that's where it goes back to that assessment process, your occupational profile, what's important to the district? What's important to the classroom? If the teacher is really like, I need my students to be, you know, participating in a certain time of day, or I need them to make sure I'm having trouble getting the students to pay attention at this time. That's the goal of that classroom. And so those still can be semi individualized. And I give some examples of goals in the book, and some of them, I do try to provide SMART goals if possible, but I think you make a good point that sometimes it's just an outcome, what's our what's our desired outcome, and it can just be that, you know, sometimes it is like the teacher can report that she doesn't, you know, she feels less stressed at the end of the day. That's not a bad outcome either.
Jayson Davies 37:49
Yeah, yeah. And, and, I just want to say, like, that's one of those. It depends responses. Like, everybody hates that response to hear, Oh, well, you know, what is the district worried about? And like, but that's absolutely like what you should be doing here. Like you've said several times, don't reinvent the wheel. Like, I think, especially when it comes to tier one, some of your most valuable tools are looking at your school's website, looking at your district website, seeing what their What's that called like, the plan that they have to create, like a school site plan or district level plan. And like, what is their mission? What are their values? What are they trying to actually accomplish? What are they telling every parent in their district that their kids will achieve? And how can you support that? Like, that is a great way to develop an outcome. So I love that answer. It's not the one that people often want to hear, but I think it is a great response. So, yeah, okay, so based upon that, what are some wonderful intervention kind of ideas at tier one? What are some easy go to things that you often share with ot practitioners that are relatively simple to kind of get started with?
Dr. Aimee Piller 39:01
Yeah, I talk a lot in the book about designing simple sensory environments within the classroom. I also talk about how that's so important to know the students needs, but also the teacher's needs as well, and teachers preferences and meeting the teacher where they are as well. I don't want to come into their classroom. It's like, what do you have that's working for you? How can we provide some supports for different students. I provide a lot of examples, of course, of that movement base. There's just lists of different movement based and heavy work activities that we all are using all the time, right? But how do I put them within learning environment and structure within that routine? Is really what that chapter is focused on in the book. I also talk about some things when it comes to like, do we need extra tools for, maybe tactile input or proprioceptive input? How do we create, creating a lending library of sensory equipment so that then you can also, you know, get some of that data. Let's try some of this equipment. Is it working? Well, maybe we can advocate, then for a budget to get a little bit more and how to, how to establish a. Sensory lending library. What does it look like? How do you put in a referral for a piece of equipment? So all that's in the book too, because I know we're all working on budgets, and we don't all have endless Some districts have lots of money and some don't have hardly any money. And so how can we, you know, provide the support? And of course, like I said, as we know, sensory processing changes all the time, right? Like sometimes our kids have different needs in the second quarter than they did the first quarter. So if I advocate to purchase something, it may not be good for that classroom for the whole year. We might need to change that. So utilizing things like a lending library to do some of these activities can be really effective. And I also have a little section on the importance of and how free play and allowing opportunities for free play is so key to the sensory piece for our kids, and how to advocate for that recess time. And what does it look like to allow students to have the free play opportunities at recess, not just structured play time. And so there's a little bit on in the book, if you are advocating for recess time in your district, that might be helpful. Awesome.
Jayson Davies 41:06
Yeah, no, absolutely. And I thought you were going to go even a little bit further to where I was going to go right now. And I want to ask you about this, because it is something that ot practitioners frequently come across, and that is the use of sensory rooms within a school. And I guess the first question is, A, have you and or your schools utilize sensory rooms on campus?
Dr. Aimee Piller 41:27
Yeah, I've worked with schools. And then, of course, you know, my first, my that first job, again, had a sensory room, which was also my room, right? Or I didn't get to design it, but I had to treat in there, yeah, yeah. So sensory rooms are sometimes available, and I think they're really good for a tier two because you have access to more equipment. Most of the interventions provided in the book for tier one are things that are just really can be done in the classroom. This is the idea of it, right? Is that we're working at that population base level. If we do have access to a century room, and you can bring the whole class and great, but that's, I don't know that that's feasible for everyone, and since tier two tends to have a little more intensified needs, sometimes that that sensory room can be a better option, or space for those interventions and groups to take place.
Jayson Davies 42:15
Yeah, and that's kind of where I wanted to go with because the question with people who, a already have access to a sensory room, or B are thinking about, you know, asking their district, their school, to have a center room, or maybe they've even been funded for one, but don't know where to start. What have you seen that works best? Or does it not work for tier one and sensory rooms? Do you think that? I mean, I don't see many cases where an entire classroom can go into a sensory room, but to what extent could a small group from a tier one like and, and I guess, what would you want to do to set up to make sure that it's actually helpful and not harmful?
Dr. Aimee Piller 42:56
Yeah, and, you know, ways that I've utilized kind of a sensory room, or the idea of a sensor room in the past, is that more like kind of when they have their independent work time or center work time, that's a great time for them to this group goes to the sensory room for 15 minutes, or this, you know, these are we're doing independent work time. So this section of the class gets to go do those sensory based activities in the sensory room. And so I know that sensory rooms look very different depending on where you're at. So I will be honest that I didn't write the book necessarily from the perspective of sensory room, since they I wrote it more on based on, like, what equipment, wherever that may be located in your in your district or school, so that you can put that together either in a more structured, formal way, like a sensory room, in which case I would probably make sure that I had access to, alerting equipment, calming equipment, and then kind of making sure that I'm guiding those students to the place they need to be when they return to the classroom. So that goes back to that routine pace of like, when they go back, what are they doing? Is it time for them to then sit down and do their independent work? Or are they finished and they're going to lunch? So where are they in that routine base, too, changes your activities.
Jayson Davies 44:02
Yeah, yeah. I've just heard so many different stories with sensory rooms. Like we had a child using a sensory room at our school, the teacher, I believe, had taken the student in there, and there were multiple students. Student was on a swing, fell, broke their arm. Obviously not a good situation. And it ended up being that, basically the school decided only the OT can use the sensory room with one on one or small group services. And I've been at another school site where we basically, these were, every student had an IEP in the classroom, but we would write up on the wall, like Johnny a. These are some activities that Johnny a can do, Johnny or, you know, Sophia, these are some activities that Sophia can do when they're in here. So in that sense, they came in in small groups, and they had more of a defined routine for that for each child. So there's several ways to do it, but yeah, it's always a tricky situation that I also try to. OTs that it's not only on you, like that sensory room is for the entire school, and it should, in my opinion, be the entire, you know, the players that need to come up with the rules. So it's everyone's responsibility, not just the OTs responsibility.
Dr. Aimee Piller 45:12
No, I think that's a great point, and that's really the importance too, of like, when you're working at the MTSS level, the making sure and advocating so that you have the opportunity to train staff so that they know is that the right piece of equipment, is that that right activity for the this group, or these these students, and then how to do it, but it is absolutely everyone's responsibility to make sure kids are safe and their needs are met, and you have the expertise from a sensory standpoint as an OT on how to help them make sure those needs are met.
Jayson Davies 45:41
Yeah, yeah. All right, I'm gonna ask you an either or question, and feel free to completely shut it down. But would you rather have a sensory library or a sensory room?
Dr. Aimee Piller 45:52
I'd rather have a sensory library really? Yes, I just am such a and I think that's one thing that's important to me, and one a big reason I wrote the book, besides the fact that I thought, you know, so many kids need sensory supports these days, right? We know that many times we can provide these good, quality sensory supports without having to be direct intervention, but we really still need to be the one that's assessing and guiding that intervention. And I'm such a proponent too, of like, when you're at like, if you can be in the classroom more, of course, that's what we want to do, is be in the classroom more. And so I love that aspect of if I can provide sports supports and what this class is already doing, that's the ideal aspect, not always possible. And sometimes it's great to have that separate environment where I can go out and get the sensory needs met. And that's a great thing too, but if I could only have one or the other, I'd take this at the library.
Jayson Davies 46:48
I appreciate you going with it and picking one like I know not many people do that. They're always like depends. That's the OT answer. So no, appreciate you doing that. All right, we're gonna take one final break, and when we come back, we're gonna talk a little bit about tier two interventions and some data collection as we move over to tier two. All right, we'll be right back. All right. We are back with Aimee to wrap up this episode, and we just talked a lot about tier one, what the outcomes might look like, what the intervention itself might look like as we transition into tier two, I first want to ask you during that tier one, what might data look like? What are you how are you collecting data? Are you having the teachers fill out a Google Form? Are you using pencil and paper, maybe just a few things that you might be wanting to track? What does that look like? Yeah. I mean, any
Unknown Speaker 47:39
of those methods are great. I prevent I prevent I present a couple of different ones in the book. So some are paper pencils. Some are, you know, something virtual, like, easily, Google form, like Likert scales. Sometimes it's you making sure you're coming into the classroom every so often, and checking those progress and goals, you know, once a month, or something along those lines. So there's lots of ways that you can monitor that progress, and you're still track. I mean, you really do want to try to write goals that you can measure in some way. So sometimes it's just like, if you're looking at, well, how many students have you had for a behavioral referral this month? It's like, well, that's a pretty hard piece of data, yeah. So that's just a quick ask to a teacher, so easy to do on those Yeah.
Jayson Davies 48:19
And you can do that classroom by classroom, by classroom, or you can do it by grade level, or you could do it entire school by how many visits to the vice principal or assistant principal's office. So, yeah, cool. Okay, so then moving forward into tier two, how are you deciding which students need that tier two to tier three? We did talk about assessments a little bit earlier. Would you say you're doing more of an assessment piece here, or is it more based upon that data collection that you got from tier one? How does that work?
Unknown Speaker 48:51
I really kind of, again, function, put it, embed it right under the MTSS model. Let's start with the least amount of intervention. Gather the data on that, do that progress monitoring, and then if we are showing that that's not effective, and we've even changed interventions, or whatever we need to do, is it time to add in more support? And I that's where that data comes in. Because one, you need it. It's a it's part of the MTSS model. You have to have the data for that. But two, it's going to also give you the information on what kind of groups do you need, like, how often do these groups need to meet? Do I have enough for you know, one group, two groups, three groups. What does that look like? What types of sensory interventions do they need to implement? And a lot of times, these groups don't have to be very extensive or long periods of time, 510 minutes can sometimes be just enough. Maybe after recess, we got five students that need to go do some extra calming input before they come back to the classroom. That's that's real easy to embed in a in a day, but still kind of functions under that tier two model. Yeah.
Jayson Davies 49:50
So I'm just going to play what the listeners thinking right now, because we just talked about data collection, and we talked about maybe one of the examples we gave was referral. Right? Referrals to the teacher giving us data, the assistant principal may be giving us data, or the entire first grade team giving us data. So how do we go from that data? That's more about like this month I had 30 referrals versus last month, I had 25 referrals. And pare that down into Okay, well, these are the kids that need that additional support?
Unknown Speaker 50:22
Yeah, and that's a great question, because then it becomes like, are you seeing patterns of the same students as those students have been repeated? Do you have students that you might be concerned with that these interventions don't seem to be helping out? Right? That's a question that I'm going to ask teachers, like, Who's Who do you feel like these are not being effective for and those are then you can come in and take another look at that, rather via observation, talking to the students themselves, things like that, to see if that's something that's matching the data that you're collecting a lot of times too. Once the intervention might start going at that kind of tier one level, I might ask teachers to just kind of make note of specific students that seemed to what I would I just put I make it so easy for them, as easy as I possibly can. It's a plus or minus. It was plus it was they seem to have a pretty good inner response to it. Minus. It didn't seem to work, you know. So if I have a lot of those kind of like, Who are these? Minus kids, can I come in and take an extra look at them? Or what kind of things are you noticing? Do you think they might need a little more support things like that. Yeah.
Jayson Davies 51:23
So you've got your larger data set, but then sometimes might have to look a little bit deeper. And then, even then, I can imagine that's where you might need to do a little bit of an assessment to kind of determine why the other approaches, the tier one approaches, weren't necessarily working to to update what tier two might look like, all right? And then, so let's dive into tier two. We talked a little bit about it briefly, being like more small group, but what does that actually look like day to day?
Unknown Speaker 51:51
Yeah. So again, these are a little more our targeted, designed interventions. But you know, depending upon your setting and where it may be, these are things that you've trialed with the students that you know are going to be the right intervention. You've done a good quality assessment. You know what their sensory needs are. Hopefully you've paired them, kind of based on their sensory processing needs, the best you can with what you have. And so that you've designed these interventions. And I often would suggest that ot does those group interventions a few times as she's training whomever will take that to do those again, they don't have to be long, be 510, minutes at a time, sometimes longer, but they don't have to be so can to make sure that that's the right intervention for that group, or that that's the right mix of students together as well. You know that's important piece to consider. I even had the colleague of mine was explaining how she implements tier two with her tier she has her one of her tier three students lead the yoga group for the tier two, which is, like, just a fun way to kind of incorporate some social, pro social participation with the tier three student. And then the tier two is getting extra input. She's there guiding and getting minutes for taking care of everyone. So just a fun idea.
Jayson Davies 52:59
Yeah, and earlier, we talked a little bit about that, like, paraprofessional support. How has that looked like? And one of the questions I kind of have with that is, are you creating the programs, or are you even finding programs that already exist, or a mix of both, yeah.
Unknown Speaker 53:16
I mean, a little bit mix of both, right? We know that there is just a laundry list of sensory, you know, activities, right? You can put those together in your own programming based upon what a student needs. You can pull a little bit from things you've done in the past. We know that that vestibular piece is really important, proprioceptive, tactile, especially deep pressure, tactile. All of those are going to be in a mix of whatever you want the student to do, whether that's that kind of, I need to increase my alertness level. I need to decrease my alertness level. What's my match for that? And again, this tier one and tier two, from that standpoint, really does focus mostly on that reactivity side of sensory processing. And I didn't mention that before. It's not a lot on that kind of, that more motor aspects or motor planning pieces. It's more about like, is this child getting the sensory needs met so that they can participate in the classroom? So I wanted to make that distinction too. So once you're kind of getting the that programming in place, it's going to look very routine based after that. And that's a great time to pass that on to the pair, or whomever can can help implement that.
Jayson Davies 54:18
Yeah, yeah. I really like that. And, and, I mean, when you were working with a with a pair of professional sounds like you had about four hours a day or so with that paraprofessional, what did their day kind of look like? Was it kind of going from class to class to class and implementing these for a few minutes in each class? Yeah.
Unknown Speaker 54:33
So what would happen every morning she would come in and we just touch base, kind of like, make sure we had a plan for the day. What's she gonna do? Anything didn't go great yesterday, if I didn't get to touch base with her, you know, whatever it may be. And then she had a schedule. She had a schedule of students that some needed more intensive. And she did a lot of the tier two, mostly, and tier three. But then she also during her extra time, which was what was great, is she was there in the classrooms with the teacher, so not all of her four hours were filled with one. What I needed her to do, she got to float around the classrooms and help them out. And since she had, like, a little bit more training and sensory she could always implement that within the within the classrooms. So it was really great model, and she was a fantastic, you know, pair, but the teachers just found it so valuable. So when she would come in, we'd touch base, she'd go implement she'd give data trackings. I would check those every day or often, you know, if I could, and then anything that seemed awry, that would be a flag for me that I need to go in and see what's going on with that kid, or I need to maybe take a peek at that group that you're working with. So it's real easy to identify when I needed to go in there and take a peek at it.
Jayson Davies 55:36
Yeah, and we haven't talked much about tier three, because we already identified that's like the IEP, but I'm assuming then you're talking about looking at the data from that paraprofessional. That's the data that you would look at to then maybe make a determination if a student needs to go to tier three. Oftentimes, within the MTSS, there are periods of time, typically eight to 12 weeks or so. People often talk about every eight weeks, every 12 weeks, needing to look at the data to determine to move up or down. Is that kind of what you use, or is it just kind of, when you see the data, that makes sense? Yeah.
Unknown Speaker 56:11
I mean, a little bit of both, right? You want to make sure you're at least checking that, you know, usually every other month. But, you know, I try to check a little more often than that, if I can. And I do also want to mention and just because it's something that I don't think we always think of with the MTSS, but I don't know about everyone, all of your audience, but I know sometimes parents get a little bit nervous when services are discontinued from the tier three level. And so that's something that I think is a very valuable if you're working in a district that has good supports at a tier two and a tier one. Yeah, we can move, you know, from one to two to three, but we can move from three to two to one and not leave our parents with, like, our students, with no support. There's still support tier for you. You know, we can ease out of that direct intervention, because I know sometimes parents get kind of nervous student, my child's finally doing well in school, and now, you know, you're saying he doesn't need it anymore.
Jayson Davies 57:05
Yeah, yeah, definitely. And that's kind of what I tell tell practitioners as well. Like, it's always nice when you have the MTSS program embedded, because then you can say, Look, you know, we're still gonna be even though the students not receiving an IE or OT on the IEP anymore, they will still definitely have access to supports from the occupational therapy team that that does help a lot. All right, really quickly, talking a little bit about barriers and ways to get around them, a little bit you talked earlier about working with that one teacher that is that's willing to support you. But what are some of the other barriers, and how to overcome those barriers that you've experienced or have heard about others experiencing.
Unknown Speaker 57:45
Yeah, and you know, time is always a big barrier for us as OTs, right? We're just busy people, and we really, really care about our clients, and we want to give them the best services that we can. But oftentimes there's just not enough hours in the day. So I do talk a lot in the book about how to, like, read, redistribute your time, how sometimes you can put a little extra time in at some point to get Freer time, and it pays off in the end. So not being afraid like I used to go and attend the meetings with the staff, not every time, but sometimes like that, I was a familiar face then right and then I knew what was going on. I knew what was important to them as teachers and staff, I knew that. I knew what was important to the department. So all those things paid off in the end, even though it took a little extra of my personal time and the beginning, it paid off in the end. So thinking about that aspect too is something that when you're considering time, and at the end of the day, if I can provide supports for more students and have more time to give that individual, that student who needs that individualized I'm less stressed as a person. More kids get help. It's just a better match if you can get put the groundwork in. The other aspect I already did talk about is that sometimes they just don't think of us as part of that plan, like that the MTSS is not thinking of the OT as part of that plan. So we might have to insert ourselves as part of that. And I provide some ways in the book, a very formalized proposal that you can present to your administration, how to actually write that to have the data and information that's meaningful to administrative staff, that's might look different than what's meaningful to us and so that, but that but that can get their attention. Sometimes they're just like, I need to have a meeting with you, or I want to meet with you, but for not speaking their language, or may not give us the opportunity to tell them how great we are, how much we can help them.
Jayson Davies 59:32
Yeah, absolutely. And there are team meetings happening without us even knowing about them. And and we won't know about them unless we ask, unless we, you know, do some digging on the website to determine that some sort of group called Ice BD do whatever, like MTSS like, even exist in our district, and we have to figure it out. So, yeah, no, definitely, we have to be a part of those teams. I have one final question for you, and hopefully it's a little bit of a fun one and idealistic question. In if you were, you know, just kind of, let's just assume you have one school in that school. How would you first start, like, tier one? What would you want to do for tier one? If you're just starting a brand new job today, and you're like, you can do anything, everyone's on board. What would you do at tier one? First, like, the first thing
Unknown Speaker 1:00:19
you would do that's when I would set up sensory programming for the whole school, but I would probably do it at a classroom level. So I would train my staff really well to understand what sensory processing is. How does it impact it? And then I would embed, since it's idealistic, I would help them to learn how to teach in a was sensory, right? That would be like my ideal classroom. I have a I have a degree in elementary education as well, and so just to combine that sensory piece with the academics and create this beautiful curriculum that would be my ideal world. Obviously not really feasible, but that's because I think if you can teach, if you can embed sensory in the learning process every it's just more effective for everyone.
Jayson Davies 1:01:06
Yeah, yeah. And then obviously, moving kind of on to tier two. Then how much time do you think you might have to dedicate to tier two?
Unknown Speaker 1:01:16
You know, hopefully, if you're if your tier one is looking really good and it's doing a lot for those students, your tier two shouldn't be a lot of time, right? And you know, because it's just they need a little more, a little different, but they're already getting all this great sensory in tier one anyway, so it's just a little bit more or a little bit different, maybe a few more frequency and during the day, yeah.
Jayson Davies 1:01:37
Okay. And then obviously, tier three, we have IEPs, which we can't always control, versus where they come from, but hopefully we are with tier one, tier two, we're able to limit the need for that tier three, although I will ask you, what are some of the things that you mentioned a little a moment ago, about how everything that we talked today is More about sensory regulation, not that motor piece and whatnot. So what are some things that if you see you almost kind of instantly think you know what? Maybe we need to move toward that tier three. Yeah, I mean,
Dr. Aimee Piller 1:02:11
and from a sensory standpoint, that's a great question, because if I see a kid that has significant kind of motor planning or Praxis that's related to that sensory processing, I know that that's going to impact everything they're doing in the day at school, right? So that's a and that's a whole different intervention, right? It's a completely different type of sensory intervention, and it's very individualized and should be serviced under a tier three versus like a child who's just kind of, maybe just needs a little, you know, having trouble paying attention or sitting down or following directions, but with some added support, does Okay, and can participate in those classroom routines. So the motor plate, the motor planning, or then that sensory integration and processing piece is really key, or just those kids who have really, just really high sensory needs, right? So I'm not going to be able to embed a two minute movement activity, and that's going to be enough for that kid. That if a child has really high movement needs, then that's obviously something that's going to be needed, needing to be serviced under a more individualized approach, absolutely.
Jayson Davies 1:03:12
Well. Aimee, thank you so much. It has been a pleasure, and please remind us where we can find both yourself and your book.
Dr. Aimee Piller 1:03:18
Yeah, so you can. I have a website that's my company, pillar, p, i, L, L, E, R, child development.com There's resources on there that'll take you to the book. The book is published by Routledge press, and so if you go on to their website, they will have a link to that book, and you can purchase that for your own use.
Jayson Davies 1:03:36
Yeah. And that is implementing school based occupational therapy services, a multi tiered approach to sensory processing needs. Aimee, thank you so much. It has been a pleasure, and I look forward to having you on the show very, very soon. Thanks again. Great. Thanks, Jayson. All right. That wraps up our conversation with Dr Aimee Piller on implementing sensory strategies within an MTSS framework. I want to extend my sincere thanks to Aimee for sharing her expertise, of course and practical insights on how we can support more students through a tiered approach to sensory processing. I think it's also super important that we are helping the teachers, because those teachers will go on to support many students that we will never even come across. Now, if you found this episode valuable and you want to dive deeper into implementing these strategies that Aimee shared in your practice, I encourage you to check out her book implementing school based occupational therapy services a multi tiered approach to sensory processing needs, which is available through Rutledge press as well as on Amazon. We will be sure to add a link to to the book in the show notes, and for those of you looking to connect with other school based ot practitioners and access additional resources, not just related to sensory processing, but all of school based occupational therapy. I invite you to join us at the OT schoolhouse collaborative. The OT school house collaborative is where our community comes together to share ideas, solve problems and grow professionally. You can learn more and become a. Member at ot schoolhouse.com/collab thanks again for tuning in, and I hope you have a great start to 2026 I'll see you next time.
Amazing Narrator 1:05:09
Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now, head on over to OTs schoolhouse.com Until next time, class is dismissed you.
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