Pediatric Therapeutic Services

The Power of Teacher Inservices: Creating Robust Tier 1 Supports for MTSS

Smiling female elementary school teacher stands behind six happy students in classroom with chalkboard and bulletin boards.Research shows a Multi-Tiered System of Support (MTSS) offers a wide range of benefits to students, especially when combined with an integrated approach to related services.1 Training on Tier 1 instructional strategies and curriculum are key parts of school districts’ continuing education programs.

But what happens when you apply that same MTSS model to related services like speech-language pathology (SLP), occupational therapy (OT), or behavioral health?  

In MTSS, Tier 1 strategies are applied to the whole class. Teachers instruct all students with methods that research has shown to be effective, and screen all students to see who are and aren’t responding to those methods.

When applying the MTSS methodology to related services, all teachers need to receive training on the most common, effective strategies therapists use to help students overcome functional issues.

So as a school administrator, where do you start? What kind of topics should you cover in this training?

At Pediatric Therapeutic Services (PTS), we’ve been providing related services in public schools for more than two decades. Over those years, we’ve invested a lot of time collecting data to answer these questions.

Our BudgetWatch™ technology captures data on referrals by type and by building, enabling us to track where students come on and off therapy caseloads. When we see a spike in therapy referrals at a building, we immediately investigate to find out what kinds of concerns are driving that trend. What we discover will tell us exactly what kinds of Tier 1 teacher trainings to make available.

And because we’ve seen, time and again, the dramatic difference Tier 1 interventions can make in preventing unnecessary referrals to therapy, we make those trainings available at no extra cost to our client districts. The more teachers know about how to implement these strategies on their own, the more they free up therapists to work with students who truly need more focused attention and related services—and, just as important, the more good they’re doing for all of the students in their classrooms!

Five Reasons for Referrals (and Reducing Them Through Tier 1 Supports)

We’ve found five key topics address the core reasons for more than 75% of the therapy referrals. Using MTSS Tier 1 supports, you can reduce each one.

1. Handwriting and Fine Motor Skills

Ask most kindergarten teachers about their students’ fine motor and handwriting skills, and you’ll likely get an eye roll!

Students entering schools today have far less exposure to the kinds of writing, coloring, and manipulatives play most of us had as children. Screens are rapidly replacing Legos and color-by-number books, leaving many children with inadequately developed fine motor skills.

Providing teachers with training on strategies to increase hand strength (particularly the pincer grasp muscles critical to handwriting) can be a powerful way to reduce OT referrals. Muscle Strengthening doesn’t occur in an isolated 30-minute therapy session. Teachers need to incorporate these activities into their classrooms’ everyday routines.

Trainings should also introduce teachers to supplemental instructional strategies for achieving goals like proper letter formation and spacing.  

2. Self-Regulation for Focus and Attention

Seven elementary school students sit on classroom floor, raising hands to answer question from smiling female teacher.According to a study from Microsoft, the average human attention span is now down to about 8 seconds, unless the person is highly engaged in the content (for example, bingeing a TV series). Students without well-regulated sensory systems can find their own bodies to be such a source of distraction, and their attention span is even shorter.

Providing in-services on sensory integration strategies is another powerful tool for reducing unnecessary OT referrals. There are loads of easy, free, and fun classroom-based activities and strategies teachers can use to help students self-regulate.

The key is training teachers to identify the signs of a sensory problem and giving them the tools they need to help children in the regular education classroom. By teaching teachers how to incorporate movement activities into their classroom routines, everyone will have better focus and learn more.

3. Articulation Errors

Each school year, we see hundreds of students referred for a speech evaluation due to errors in articulation. Teacher training in this area needs to focus on both developmental norms and effective cueing strategies for improving sound production.

For example, a five-year-old student who can’t correctly pronounce the “R” sound is NOT out of the developmental norm. Almost all children this age need some verbal and visual cues. By giving teachers information on what is and isn’t typical as children develop, you can prevent teachers from over-referring for purely developmental speech issues.

4. Language Development Issues

Students referred for expressive or receptive language issues are often harder for teachers to diagnose. The reasons teachers give for referrals are normally “not following directions” or “not participating in class.” We’ve found trainings on how to stimulate language development to be highly effective.

Strategies are easy to implement, and include such tactics as asking open-ended “wh” questions and using lots of repetition when introducing new vocabulary. When it comes to language development, most teachers have a theoretical framework from their education.  In-service trainings help them apply what they already know to make pragmatic language skills part of their regular instruction.

5. The Functions of Behavior

Managing students’ behavior is one of the greatest challenges teachers face on a daily basis. While most do receive instruction on classroom management in their formal education, many don’t know how to step back and understand the “why” behind behavior.

Training on the functions of behavior helps teachers get perspective on what drives students to act a certain way, and to evaluate how their own responses may increase those behaviors’ frequency. When teachers can do this basic analysis, it can be a game-changer for both them and the students in their classroom.

MTSS Tier 1 Supports with PTS Can Help Your Students and Your Budget

Implementing an MTSS approach for Tier 1 is all about making supports available to all students as part of their general classroom experience. For teachers to be able to provide related services strategies, there needs to be an investment in time, energy, and training.

The results are worth it! We believe so strongly in the effectiveness of Tier 1 trainings, we give them away for free to our clients. Training on therapeutic strategies puts more tools in a teacher’s tool kit, and that’s good for everyone. More students get help faster; more teachers are equipped to handle common classroom concerns; and fewer students are referred for evaluations by related services providers (which is good for the special education budget!).

To learn more about PTS’ MTSS approach to related services, especially how the free inservice training we provide can empower your district’s teachers to help students more effectively right in the regular education classroom, visit our contact us page or email

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