{"id":59,"date":"2015-10-29T01:44:23","date_gmt":"2015-10-29T01:44:23","guid":{"rendered":"http:\/\/seekfreaks.com\/?p=59"},"modified":"2020-02-19T21:49:24","modified_gmt":"2020-02-20T02:49:24","slug":"rti-pt","status":"publish","type":"post","link":"https:\/\/www.seekfreaks.com\/index.php\/2015\/10\/29\/rti-pt\/","title":{"rendered":"SEEKER&#8217;S CORNER: Response to Intervention, Multiple Tier Systems of Support &#038; Physical Therapy"},"content":{"rendered":"<p style=\"text-align: center;\">[smbtoolbar]<\/p>\n<p><span style=\"color: #000080;\"><em><b>What is RtI\/MTSS?<\/b><\/em><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Response to Intervention (RtI) is an approach to meet every student\u2019s educational needs in the general education environment through a deliberate process of assessment and intervention including planned, regular monitoring of student progress. RtI relies on data based decisions about the need for and provision of instructional modifications, research-based intervention or increasingly intensified services in order to address a need of a struggling student (<a href=\"http:\/\/files.eric.ed.gov\/fulltext\/ED496979.pdf\">Johnson, Mellard, Fuchs &amp; McKnight 2006<\/a>). <\/span><span style=\"font-weight: 400;\">RtI includes \u201ca multi-tier approach to the early identification and support of students with learning and behavior needs\u201d <\/span><span style=\"font-weight: 400;\">(<\/span><a href=\"http:\/\/www.rtinetwork.org\/learn\/what\/whatisrti\"><span style=\"font-weight: 400;\">RtI Action Network<\/span><\/a><span style=\"font-weight: 400;\">) <\/span><span style=\"font-weight: 400;\">or a multi-tiered system of support (MTSS). This is why in some states RtI may be called MTSS, especially if general education has become involved.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">RtI\/MTSS assessments are not deficit based. &nbsp;The RtI\/MTSS approach is focused on:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">selection of intervention from all options rather than identifying \u201cwhat is wrong\u201d with the student<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">addressing needs of every students, not just those with educational labels<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the responsibility of the entire school community for all students<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">positive outcomes for all students<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">multi-tiered service delivery model with differentiated instruction to meet individual need<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">This approach is built upon some basic fundamental principles:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">school-wide screening for critical skills,<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">high quality instruction,<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">frequent assessment,<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">systematic collection of student performance data<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">a team approach and<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">data-based decision making. &nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In RtI\/MTSS, the team does not wait for a student to \u201cfail\u201d before interventions or modifications are implemented to address his\/her need.<\/span><\/p>\n<p><span style=\"color: #000080;\"><em><b>RtI\/MTSS May Have 3 or 4 Tiers<\/b><\/em><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most states have implemented the 3 tier framework described below. However, it should be noted that in any tier, IDEA 2004 allows parents to request a formal evaluation to determine eligibility for special education. An RTI process cannot be used to deny or delay a formal evaluation for special education.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tier 1: 80-85% of all students are successful in the core curriculum. Students receive high-quality, scientifically-based instruction provided by qualified personnel.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tier 2: Approximately 15% of students are not making adequate progress in Tier 1. These students are provided with interventions matched to their needs on the basis of levels of performance and rates of progress.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tier 3: Approximately 5% of students receive 1:1 interventions that target the individual students\u2019 skill deficits. Students who do not achieve the desired level of progress in response to these targeted interventions are then referred for a comprehensive evaluation and considered for eligibility for special education services under IDEA 2004. Data collected during Tiers 1, 2, and 3 are used to make the eligibility decision.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: center;\"><span style=\"font-weight: 400;\">(Sources:&nbsp;<\/span><a href=\"http:\/\/www.rtinetwork.org\/learn\/what\/whatisrti\"><span style=\"font-weight: 400;\">RtI Action Network<\/span><\/a><span style=\"font-weight: 400;\">&nbsp;and <a href=\"http:\/\/www.nasdse.org\/Portals\/0\/Documents\/Download%20Publications\/RtIAnAdministratorsPerspective1-06.pdf\">RtI NASDSE &amp; CASE White Paper on RtI<\/a>)<\/span><\/p>\n<p><span style=\"color: #000080;\"><em><b>Can students that already have an IEP receive RtI services?<\/b><\/em><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Yes. \u201cThere is nothing in IDEA that prohibits children with disabilities who are receiving special education and related services under IDEA from receiving instruction using RTI strategies unless the use of such strategies is inconsistent with their individualized education programs (IEPs).&#8221; (<a href=\"http:\/\/idea.ed.gov\/\"><span style=\"font-weight: 400;\">IDEA<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/span><\/p>\n<p><span style=\"color: #000080;\"><em><b>How can federally-funded physical therapists provide services to students without an IEP?<\/b><\/em><\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are different funds (federal, state, local, Medicaid reimbursement, etc.) that administrators use to pay the salaries of staff, including physical therapists. Often, their salaries are comprised of a variety of these funding sources. Because federal special education funds only pay for work with <\/span><i><span style=\"font-weight: 400;\">students<\/span><\/i><span style=\"font-weight: 400;\"> with an IEP, other funding is what allows physical therapists to collaborate or consult in RtI and other general education initiatives. In this way, a physical therapist can work with a <\/span><i><span style=\"font-weight: 400;\">team or teacher<\/span><\/i><span style=\"font-weight: 400;\"> to meet student needs prior to establishing eligibility for special education and related services. We can assist the team with our expertise for modifying classrooms, suggesting learning strategies or approaching challenges faced by teachers in the general education classroom.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another way related service providers, including physical therapists can be funded to work in RtI is through use of early intervening services (EIS). EIS are special education funds earmarked for preventative efforts; some districts are required to use EIS, all districts can choose to use EIS.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, some schools and school districts have found related service providers so valuable to the RtI process that building principals\/general education administrators \u2018buy back\u2019 time of these providers to spend on RtI initiatives. &nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In all cases, PTs should remember that in RtI, our client is the teacher, not the student.<\/span><\/p>\n<p><em><span style=\"font-weight: 400;\">So, SeekFreaks, you are probably asking how does RtI work in real life. Read RtI Part 2 for sample applications and RtI references.<\/span><\/em><\/p>\n<p><span style=\"color: #000080;\"><em><b>Examples of PT participation in RtI\/MTSS<\/b><\/em><\/span><\/p>\n<p>We hope you find the following examples of how PTs can support teachers and students in general education at the various tiers helpful:<\/p>\n<p><span style=\"color: #0000ff;\"><b>Tier 1: Universal Intervention<\/b><\/span><\/p>\n<ul>\n<li>Provide in-services to teachers on typical development, appropriate expectations for age\/development<\/li>\n<li>Assist with environmental design, provide ergonomic assessments and other suggestions to enhance engagement and performance<\/li>\n<li>Provide administration, teachers, and other staff members information about:\n<ul>\n<li>current research regarding movement<\/li>\n<li>the influence of movement on learning<\/li>\n<li>learning by incorporating movement activities into instruction<\/li>\n<li>teach strategies to promote engagement- allow changes in posture (standing, swaying, sitting\/bouncing on cushion or disc, kneeling, laying), movement breaks, scheduling challenging content immediately after PE or recess, and so on.<\/li>\n<\/ul>\n<\/li>\n<li>Provide in-service to school administration on benefits of including PE and recess into the school day<\/li>\n<li>In-service staff on PTs role in RtI\/MTSS and provide resources &amp; guides<\/li>\n<\/ul>\n<p><span style=\"color: #0000ff;\"><b>Tier 2: Targeted Intervention<\/b><\/span><\/p>\n<p>For students who continue to struggle after Tier I, Universal Interventions, the therapist may:<\/p>\n<ul>\n<li>Participate in school grade-level teacher meetings to problem solve addressing classroom challenges<\/li>\n<\/ul>\n<ul>\n<li>Suggest alternative approaches to promote participation and engage all students<\/li>\n<\/ul>\n<ul>\n<li>Explore environmental barriers, potential accommodations or supports for desired behaviors and engagement in school routines (e.g. bathroom adaptation, extra set of textbooks, preferential seating, movement breaks, adaptive seating\/work space, early release or extra transition time, peer partners, etc.)<\/li>\n<\/ul>\n<ul>\n<li>Consult with the teacher to differentiate routines, activities and expectations (e.g., providing breaks during extended writing tasks, providing more time for responses, using written in addition to verbal directions, breaking down tasks)<\/li>\n<\/ul>\n<ul>\n<li>Lead a small group or station during classroom instruction (note: review your local and state policies to ensure that this is permissible)<\/li>\n<\/ul>\n<p><span style=\"color: #0000ff;\"><b>Tier 3: Intensive Interventions<\/b><\/span><\/p>\n<p>For students who continue to struggle after Tier II, Targeted Interventions, the therapist may:<\/p>\n<ul>\n<li>Participate in the problem-solving process at the individual student level<\/li>\n<li>Provide suggestions that can improve an individual student\u2019s performance (see suggestions under Tier 2 and apply on an individual basis)<\/li>\n<li>Conduct a PT assessment as part of the comprehensive special education evaluation under IDEA<\/li>\n<\/ul>\n<p style=\"text-align: center;\"><em>~~~~~~~~~~ 0 ~~~~~~~~~~<\/em><\/p>\n<p><em><b>Suggested Resources:<\/b><\/em><\/p>\n<p style=\"padding-left: 30px;\"><a href=\"https:\/\/cpsmail.cps.k12.il.us\/exchweb\/bin\/redir.asp?URL=http:\/\/www.rti4success.org\">www.rti4success.org<br \/>\n<\/a><a href=\"https:\/\/cpsmail.cps.k12.il.us\/exchweb\/bin\/redir.asp?URL=http:\/\/www.rtinetwork.org\">www.rtinetwork.org<br \/>\n<\/a><a href=\"https:\/\/cpsmail.cps.k12.il.us\/exchweb\/bin\/redir.asp?URL=http:\/\/www.studentprogress.org\">www.studentprogress.org<br \/>\n<\/a><a href=\"https:\/\/cpsmail.cps.k12.il.us\/exchweb\/bin\/redir.asp?URL=http:\/\/www.learning-styles.online.com\">www.learning-styles.online.com<br \/>\n<\/a><a href=\"http:\/\/www.thelearningweb.net\/personalthink.html\">www.thelearningweb.net\/personalthink.html<br \/>\n<\/a><a href=\"http:\/\/www.ideapartnership.org\/\">http:\/\/www.ideapartnership.org\/<\/a><\/p>\n<p style=\"text-align: center;\"><em>~~~~~~~~~~ 0 ~~~~~~~~~~<\/em><\/p>\n<p><strong><em>Freakishly Fast Poll<\/em><\/strong><\/p>\n<p style=\"text-align: center;\">[democracy id=&#8221;5&#8243;]<\/p>\n<p style=\"text-align: center;\"><em>~~~~~~~~~~ 0 ~~~~~~~~~~<\/em><\/p>\n<p><strong><em>Seeking Your Views<\/em><\/strong><\/p>\n<p style=\"padding-left: 30px;\">I know what you are thinking, RtI is trickier for PTs than for OTs or SLPs. This is where our creativity should shine!<\/p>\n<p style=\"padding-left: 30px;\">How do you implement or participate in RtI in your schools?<\/p>\n<p style=\"padding-left: 30px;\">Some therapists are concerned about liability issues of teaching non-therapists (i.e., teachers and teacher aides) to implement PT suggestions. Are you concerned about this? Why or Why not?<\/p>\n<p style=\"text-align: center;\">&nbsp;~~~~~~~~~~&nbsp;0 ~~~~~~~~~~<\/p>\n<p style=\"text-align: left;\">Readers of this article also read these:<\/p>\n<p style=\"text-align: left; padding-left: 30px;\"><a href=\"http:\/\/seekfreaks.com\/index.php\/2015\/11\/19\/seekers-corner-4-pillars-of-school-based-pt-assessment-1\/\">The 4 Pillars of School-based PT Assessment<\/a><\/p>\n<p style=\"text-align: left; padding-left: 30px;\"><a href=\"http:\/\/seekfreaks.com\/index.php\/2015\/09\/13\/role-of-sbpt\/\">Role of School-based Physical Therapy<\/a><\/p>\n<p style=\"text-align: left; padding-left: 30px;\"><a href=\"http:\/\/seekfreaks.com\/index.php\/2016\/03\/23\/iep-4-0-using-data-collaboration-to-develop-a-clear-plep\/\">IEP 4.0 &#8211; Using Data and Collaboration to Develop a Clear PLEP<\/a><\/p>\n<p style=\"text-align: left; padding-left: 30px;\"><a href=\"http:\/\/seekfreaks.com\/index.php\/2015\/11\/05\/review-teacher-preterm\/\">Article Review: Do Teachers Know the Impact of Preterm Birth?<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>[smbtoolbar] What is RtI\/MTSS? Response to Intervention (RtI) is an approach to meet every student\u2019s educational needs in the general education environment through a deliberate process of assessment and intervention including planned, regular monitoring of student progress. RtI relies on&#8230; <a class=\"more-link\" href=\"https:\/\/www.seekfreaks.com\/index.php\/2015\/10\/29\/rti-pt\/\">Continue Reading &rarr;<\/a><\/p>\n","protected":false},"author":2,"featured_media":747,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[2,1],"tags":[],"class_list":["post-59","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/posts\/59","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/comments?post=59"}],"version-history":[{"count":13,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/posts\/59\/revisions"}],"predecessor-version":[{"id":100886,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/posts\/59\/revisions\/100886"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/media\/747"}],"wp:attachment":[{"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/media?parent=59"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/categories?post=59"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.seekfreaks.com\/index.php\/wp-json\/wp\/v2\/tags?post=59"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}