Pediatric Therapeutic Services

School-Based Therapy Costs: How to Save Time and Money by Implementing an MTSS Approach

We know that you want to create a school climate that is inclusive and supports the needs of all students. However, with already-packed therapist caseloads and a budget to keep in mind, time and money may sometimes seem like a barrier to providing students with the supports they need to access their education and interact with their peers. Fortunately, this doesn’t have to be the case.

By adopting a Multi-Tiered Systems of Support (MTSS) approach to your related services, you can make sure that only the right students are on your therapists’ caseload.

If you want to learn how Pediatric Therapeutic Services takes a hands-on approach to maximizing the supports you offer your students without increasing your budget or caseloads, contact us!

Reduce Costs per Student Receiving Services on an IEP by 19%* over Four Years While Maximizing Student Supports

School-Based Therapy Costs: How to Save Time and MoneyOne of the simplest ways to save time and money for your school-based therapy programs is to make sure that you have the right students on caseload. The truth is, not every student who is referred to for an evaluation necessarily has a disability that requires direct service. An MTSS model can reduce referrals to your related services program. Reducing these referrals does some very important things:

  • Provides classroom-based supports for struggling students without the need for a full multi-disciplinary evaluation
  • Reduces unnecessary testing and the associated costs
  • Allows therapists to focus more time and energy on students who truly need therapeutic services
  • Reduces disproportionality using inclusive practices

Ensure Only the Right Students Get on Caseload by Adopting a Multi-Tiered Systems of Support Approach to Related Services

You’re likely already familiar with utilizing an MTSS approach. You may even already be using it for the students who need extra supports to help them succeed in academic subjects like reading and math.

As a refresher, an MTSS approach involves providing increasingly targeted supports to students in three tiers:

  • Tier 1: Supports delivered to all students via the general education classroom
  • Tier 2: More specialized supports and services delivered to small groups of students who don’t respond to Tier 1 interventions
  • Tier 3: Highly targeted, individualized support services delivered to students who are not yet on caseload

This same system can also be used to save time and contain costs in your special education program. It can be used with any type of related service—including behavioral health, occupational therapy, physical therapy, and speech-language pathology—to empower teachers, support students, and reduce unnecessary referrals.

By offering these therapeutic strategies at the general education level, they’ll be made available to all students—which means that more students can benefit.

For example: As a Tier 1 intervention, teachers can respond to behavioral concerns at the classroom level by working quick movement breaks into the classroom routine. This can help students release pent-up energy. It will help the students who have trouble self-regulating, and it benefits all students by improving attention and focus.

Teachers can incorporate fine motor activities into lessons, such as manipulatives, like Legos, to teach counting, colors, or fractions. Putting them together and pulling them apart helps students to exercise their hands and build muscle. Students who need a bit more support can participate in short term, small group, handwriting clubs to practice their writing and fine motor skills.

We have some excellent, therapist-designed Tier 2 programs for handwriting, articulation, and self-regulation available at  We provide these tools at a discount to clients, but they are available to everyone, so you can help get your therapists up and running.  Contact PTS for more ideas for how your teachers and staff can implement Tier 1 and Tier 2 supports in the classroom to reduce unnecessary referrals to related services—which can save your program time and money in the long-run.

How to Implement an MTSS Approach in Your School to Save Time, Contain Costs, and Support More Students

School-Based Therapy Costs: How to Save Time and MoneyImplementing an MTSS approach starts with reviewing the referrals you’re already receiving so you can focus Tier 1 and Tier 2 interventions where they will have the most impact. What are the most common reasons students are being referred? Are the majority of referrals coming from a specific school or grade?

Use this information to identify where you can train teachers to provide supports at the classroom level.  Getting teachers’ time for continuing education can be a real challenge, so consider doing therapist tip-times during faculty meetings where they get practical strategies to address common functional and behavioral concerns.  Because the cost of trainings can be an issue, PTS offers free in-service trainings to our partnering schools who want to invest time into implementing an MTSS approach to their related services program.

We give trainings away to our clients because providing teachers with the knowledge and skills to identify which students need what kinds of support is a such a critical component of our model.  Our trainings empower teachers to think like therapists so that they can offer additional supports to students who need them.  We know that many students don’t necessarily have a disability that qualifies them for related services, but they still need some supplemental instruction or intervention to succeed.  Empowering teachers with some basic tools for the most common reasons for therapy referrals helps reduce referrals and builds capacity with front-line educators.  Because Tier 1 and 2 interventions are short-term, they foster independence, not dependence, for both students and teachers.

While many schools have some kinds of Tier 1 interventions in place, short-term small group activities to support students that need more targeted support at Tier 2 are often skipped.  To address this gap, PTS created a toolkit of activities that your teachers can implement in the classroom to help students practice certain skills and behaviors—what we like to call “therapy without a therapist”. Because these activities are implemented in small groups, vs. individually, the cost is marginal compared to the impact. 

For example, our data shows that 66% of students who complete our Pencil Power Handwriting program never need an OT evaluation.   10 students can complete the program for less than the cost of ONE student on the OT caseload.  Some of our most popular programs are:

Pencil Power
This short-term, small group handwriting program helps first- and second graders learn therapeutic strategies to strengthen fine motor, visual motor, and handwriting skills in just six weeks. This program also includes a supplemental board game.

Power Moves
Our Power Moves card game is a fast-moving game that gets everyone on their feet and practicing gross motor skills like balance, coordination, and sensory motor skills. This is ideal for kindergartners, first graders, and second graders. It can also be modified for older students.

Artic Blast™
Artic Blast™ is a board game that makes it fun to strengthen foundational skills required for speech. Students will progress up the mountain every time they successfully produce the target sound. The first to the top, wins! This is a game for four children, but adults are encouraged to join in.

I Know What to Do!
Students who need to practice learning appropriate social responses can do so with our I Know What to Do! card game. This is ideal for students with impulsivity concerns or students who need social stories and scripts. During gameplay, students will match responses to the potentially challenging social scenarios.

Ask us how to use any of these activities in our toolkit to support your students.  You can find all of these on our online store at

How Administrators Can Play a Role in Adopting an MTSS Approach to Related Services

Making sure your teachers and staff are informed and equipped is vital in ensuring the appropriate implementation of an MTSS approach.  Incorporating this framework into your related services program will allow you to support more students while helping you control your budget, short-term and long-term. We know from experience that this requires a strong partnership between your providers and your administration, but the results are well worth it.

Here are a few things that administrators can do to ensure a smooth transition to an MTSS model:

  • Establish a school-wide commitment to intervention designed to meet the needs of all students
  • Develop building-level procedures and interventions that teachers will be trained and supported on
  • Schedule comprehensive trainings for teachers and staff so that they have the tools and experience they need to intervene at the classroom level
  • Identify the roles and staff who will lead Tier 2 and Tier 3 interventions
  • Ensure that teachers and staff have the time and tools they need to provide successful intervention techniques while also teaching to the curriculum
  • Have a clearly defined process for eligibility for Tier 2 and 3

In addition to supporting your teachers, administrators should collect and track the data on how resources are allocated across you program. PTS does that at no cost for our clients using our proprietary BudgetWatch™ software. Because our system tracks costs by building, by discipline and by student, you’ll know exactly where your referral “hot spots” are, so appropriate supports can be put in place.

Our Clinical Directors can then analyze that data in our BudgetWatch™ Program Summary Reports to help you make budget forecasts, pinpoint where teachers need additional training, and compare trends from year to year. This allows us to identify where adopting an MTSS approach has helped to save time and contain related services costs, as well as identify where improvements are needed.

PTS Can Help You Save Time and Money in Your School-Based Therapy Program—Contact us Today!

An MTSS model for related services is good for students and your budget.  PTS can show you how. Request your free Related Services Audit where we can help you identify opportunities to improve your program and your budget.

Implementing an MTSS model to serve your students doesn’t have to be hard. PTS sticks with you every step of the way, helping to manage the day-to-day of your program while you focus on bigger-picture issues.

If you want to do something great for your students and your therapy budget, contact us today!


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