Date Presented 03/31/2022

The purpose of this study was to understand the experiences of public school teachers who work with OTs who provide support in a multitiered system of support (MTSS) framework, also known as response to intervention (RtI). A qualitative study with a transcendental phenomenological approach was conducted with 13 teachers from four different regions of the United States. Teachers described their experiences with OT MTSS as satisfactory, efficient, and effective.

Primary Author and Speaker: Lou Ann Hintz

Contributing Authors: Tina Fletcher

Every Student Succeeds Act of 2015 names occupational therapists as Specialized Instructional Support Personnel, and gives them the opportunity to participate in schoolwide systems of support (Cahill & Bazyk, 2020). Yet there are a limited number of studies available in the occupational therapy literature regarding occupational therapists involvement within this type of service delivery. The purpose of this qualitative phenomenological study was to describe the lived experiences of teachers who received multi-tiered support services (MTSS) from occupational therapists. This study contributes to a better understanding of teachers’ perceptions of effective solutions and potential barriers for occupational therapists who deliver service within an MTSS framework. This information will help guide future decision making for school-based occupational therapy practitioners who are providing service within the MTSS framework or who wish to be participating in MTSS. The study design for this research was a qualitative transcendental phenomenological approach. Purposeful sampling technique was utilized to target teachers who have worked with occupational therapists who provided service through an MTSS framework. Teachers were recruited by flyers posted on social media websites. Inclusion criterion was for teachers who worked with occupational therapists participating in MTSS, had a minimum of 2 years teaching experience in the general education setting and had taught early childhood or elementary grades. There were 13 teachers from four different regions of the United States who met the inclusion criteria and participated in this study. Instruments utilized in this study included a 10-question survey and 11 semi-structured interview questions. The researcher asked teacher participants to share any documentation related to their experience with occupational therapy MTSS. These methods produced three sources of data for triangulation which were survey data, verbatim transcribed interviews and documents. The survey yielded data regarding teacher participants’ educational background, years of experience, geographic location and brief statements regarding their experience. The data from verbatim transcribed interviews was analyzed following Creswell and Poth (2018) and Moustakas (1994) guidelines for transcendental phenomenology. This included horizonalization which led to textural descriptions then structural descriptions. The textural and structural descriptions were integrated to create overall themes of the essence of the teacher participants’ experiences. The request for documentation from teachers revealed there was a lack of documentation. The results of this study indicated that teachers’ experiences with occupational therapists who provide service within the MTSS framework were positive overall. Themes that emerged were collaborating, receiving a variety of strategies, utilizing frequently and ongoing, learning from and feeling comfortable approaching occupational therapists. The teachers described the experience as an efficient use of their time with effective solutions which led to student progress. Some barriers identified in this study were a lack of documentation, and a lack of teachers understanding on the scope and role of occupational therapists. Overwhelmingly, the teachers expressed the need to have more occupational therapy support within the MTSS framework, but understood the occupational therapists’ heavy caseloads. In conclusion, teachers stated their experience with occupational therapists who participate in MTSS was efficient, effective and satisfactory. School-based occupational therapists must be producing evidence of this service through documentation and sharing with stakeholders.


Cahill, S. & Bazyk, S. (2020). School-based occupational therapy. In O’Brien, J. & Kuhanek, H. (Eds.), Case-Smith’s occupational therapy for children and adolescents. (8th ed., pp. 627– 658). Elsevier.

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches. (4th ed). Sage Publications.

Moustakas, C. (1994). Phenomenological research methods. Sage Publications.