How Can We Use RTI-P to Organize our Jobs and Caseloads?

by Dr. Debra Em Wilson

I’m excited to join Therapro as a guest blogger. I am a reading specialist and the founder of S’cool Moves. I enjoy collaborating and appreciate this opportunity to connect with the Therapro community. I’d like to share a post from my website that I’ve modified to share with you, a Therapro community member.

A physical therapist called me from Ohio wanting to know more about our products, but what she really needed from me were some insights that I’ve gained from doing what I do for the last twenty years. She was a therapist making the huge shift from clinical practice to educational practice in schools. She told me that she was the ONLY physical therapist for the entire district and was spread really thin. Let’s call our therapist Amber. Amber said that the teachers seemed to want to know what they could do in the classrooms for all the students to improve foundation skills. But how was she going to reach all these teachers and satisfy the IEP goals for her huge caseload?

It was interesting. Do you know where my mind went to help Amber create a framework? It went to sharing about the Response-to-Intervention model (RTI). RTI was designed as an alternative to the discrepancy model used to determine if a child qualified for special education services. With RTI, methods of intervention are validated and data collected prior to referring a child for special education testing. Though some report RTI working well, for others it’s a mixed bag depending on how it is being implemented.

What if we could use RTI personally? Let’s call it the RTI-P model. During our conversation, I found myself explaining to Amber how RTI models work and personalizing the model for her. She got off the call with clarity and new tools to help guide her as she navigates her new position.

Today’s thought is, “How can we use RTI-P to organize our jobs and caseloads?” Think in terms of tiers. RTI has three tiers. The first tier includes interventions and strategies we can use with all students in the classroom. The second tier includes modifications we need to make for small groups of students who are having difficulty with the class-wide strategies. The third tier focuses on individual strategies for the most involved students.

In your caseload, what students do you have that you could support in the classroom setting, Tier 1? Are there opportunities for you to present some strategies during staff meetings or on PD days to support teachers and students in the classroom?

Now think about Tier 2. What students need small group support either in the classroom or within designated smaller group environments?

And finally, Tier 3. What students are very involved and need your one-on-one, hands-on support?

Once you create your own personal framework, then you can figure out what materials or products will help you reach your goals, but first create your RTI-P framework.

For instance, Therapro’s Drive Thru Menus works well with all student in a classroom so this could be considered as an important tool for Tier 1 intervention. For small groups of students who are working on improving visual-motor integration, consider

  • Origami Fun for Beginners – 55 fun-to-do projects! Includes 96 sheets of authentic origami paper in a gorgeous array of colors and designs.
  • Letter Treasure Hunt Game – Handwriting fun!
    1. Sail your ship to an Alphabet Island,
    2. Follow Captain’s orders when you draw a card,
    3. Collect your treasure by writing the letter in the Captain’s log.

For students needing one-on-on intervention, add Developing Visual Motor Integration and Trace the Eights to your intervention strategies.

Let me know if the RTI-P makes sense to you and how you’ve used it to be more effective in your job and less stressed!

Thanks for all you do for children, Dr. Debra Em Wilson

Saturday Seminar: Apps for School-Based OTs: BYOD (Bring Your Own Device)

Margaret (Peggy) Morris, OTD, OTR/L, BCP, Tufts University Pediatrics professor, presented the seminar:

    Apps for School-Based OTS: BYOD (Bring Your Own Device)

at Therapro on October, 24th. Peggy shared her extensive experience in school-based practice and how to use Apps for students and Apps for OTs. Peggy’s presentation style was dynamic and interactive. She elicited creative thinking and problem solving from the attendees. Therapists and student OTs eagerly shared tips and tricks that they have gathered in their experience as well.

The audience was mixed between “digital immigrants” and digital natives” who desire to use or are currently using the internet as a therapeutic tool. Peggy guided the group through accessing iPad functions and accessibility functions on their devices, including Screenshot, Zoom, Digital Safety, etc. A few of Peggy’s favorite Apps for Behavior include: Calm Counter by Touch Autism ($2.99), 123TokenMe from 123appsforme ($9.99), and Breathe, Think, Do with Sesame (free).

She highlighted Dexteria by Binary Labs ($3.99) for Fine Motor and several Cause/Effect Apps such as Fireworks (free), Fluidity by Nebulous design (free), and Koi Pond ($.99). Specifically for therapists, Peggy pointed out Tx Tools by Pediastaff (free) which has a stopwatch, and OneNote by Microsoft Corporation (free), which is a digital notebook for anything you want to organize or remember, such as writing treatment notes, recording them, or snapping a photo. A good tip Peggy provided was that OT Advance publishes an App of the Week and reviews Apps at

Peggy offered invaluable advice for the group on navigating the internet while keeping in mind our responsibility for helping students spend quality time while using screen time. It was interesting to know that The American Academy of Pediatrics (AAP) produced revised research-based screen time guidelines in September of this year. She noted that the (College of Optometrists in Visual Development) recommends visual breaks when using digital devices every 20 minutes for 20 seconds. We tried out the recommendation in the seminar as Peggy set a timer to activate every 20 minutes during her talk to give us an idea about how frequently breaks should occur.

Even though the iPad is a relatively young device that has been in existence for only about 5 years, it is now an integral part of our lives. Peggy noted that as of May of this year, an astounding 80,0000 apps were labeled as “educational”! It is our obligation as therapists to use this technology that is available at our fingertips wisely in our pediatric practice. She recommended reviewing apps through various sites including AOTA where they are grouped into practice areas; and from websites such as The digital age is exciting and evolving almost hourly. We need to jump in and use this tool wisely and responsibly in our OT practice.

Peggy’s seminar was well received, as you can see from the comments below:

“There are many conferences for academic apps, but not OT driven. Helps with evidence-based practice.” Margaret S., Occupational Therapist

“I learned so much. I got so much more knowledge from this meeting than I expected. I highly recommend it to anyone.” Olivia S., Occupational Therapy student

“Peggy was an excellent speaker and had a lot of relevant information to share regarding iPad use and applications.” Anonymous OT

“Great current info & collaborative presentation style.” SMR, Occupational Therapist

Thank you, Peggy!

Filomena Connor, MS, OTR/L

Self-Care with Flair! Goes International… Read on!

By Bhanu Raghavan, MS, OTR/L & Ginger Mc Donald, OTR/L

We were lucky to experience Occupational Therapy on an international level when we were invited to present Self-Care with Flair! at the annual conference of the College of Occupational Therapists (the educational arm of the British Association of Occupational Therapists) in Brighton, England this past summer. We applied to present at the conference over a year before, hoping to spread the word about our book, Self-Care with Flair!, and were thrilled when our proposal was accepted! We immediately began to adapt our presentation to our British audience. Our presentation was well received, and we enjoyed the interaction with our British cohorts. In general, the Brits showed their trademark politeness and hospitality. We had several OTs stop to talk with us when they saw our Therapro name tags to tell us how much they enjoy Therapro’s products.

What we didn’t realize is what an educational experience it was going to be for us! We had a wonderful time roaming the Expo Hall, and learning about the technology and solutions that British OTs have devised for the same problems that we grapple with in the States. Because of the expense involved in shipping over the Atlantic ocean, many of the companies whose booths we visited do not market their products in the USA. Of course there were many products we see in our catalogs in the US, there is so much stuff out there that we don’t know about! We saw an ingenious sling that allows parents and teachers to strap pre-toddlers to their legs, to give them some weight-bearing experience as they learn to. We saw canvas and PVC “quiet rooms” built over beds, much like a tent, meant to give a child having a sensory meltdown a place to safely calm down. Another very brilliant invention was the weighted and huggable beanbag chair. Weighted should pads and lap pads made us “melt away” and say “ahhh..this is life!” We spent time in the BAOT booth just chatting and comparing how our “health care systems” differ.

The educational sessions were fabulous. We attended a general session describing an exciting study co-conducted by British and Dutch OTs that was able to come up with figures for how much money OTs save the health systems in their countries per year. In their socialized medicine systems, the numbers were in the millions! Our system, with private insurance, figures our costs differently, but the potential savings are obvious. The study is not completed, but when the results are fully published, the American health system will notice OT! Ginger attended informative sessions on new evidence about the usefulness of hip precautions (the Brits are slowly dropping them), a company that builds elevators in tiny British homes, and together we attended a fabulous session on night time positioning to prevent the many orthopedic issues with individuals with multiple handicap.

As much as we joked and laughed about our differences, our new OT friends agreed with us that we OTs are very much alike. The emphasis on function and purposeful engagement in meaningful occupations is the foundation of our profession in every country. We were honored to be asked to pose for a photograph featuring the “international therapists”.

Many therapists that attended our presentation emailed us about their thoughts (see below some comments from the participants). Thanks to Self-Care with Flair! we felt the kindred spirit as OTs due to our global emphasis on balance and meaningfulness to life regardless of whether or not one has a disability.

Since we were going to go such a long way for our two hour presentation, we decided to make good use of our time in Europe to visit old friends in England and Scotland, and to tour Budapest, Vienna and Prague. Every country with its own charm kept us hopping!

Bhanu and Ginger
Authors of Self-Care with Flair!

Comments From Participants

“Thank you for visiting England and sharing your Self-Care with Flair – your session at the conference was fabulous.” – Sally Townend, Children’s Occupational Therapy

“Firstly thank you so much for a wonderful presentation on Self Care with Flair at the recent COT conference in Brighton. I could have listened to you all day, it was fascinating and I really enjoyed the session. I love the whole concept of your innovative program, it’s so simple yet effective, I loved your rhymes and only wish I had invented it as you must have had so much fun making them up. Thank you once again for a brilliant talk and may I congratulate you on an inspired and very useful OT tool.” – Janine Hackett, University of Derby

“I must say I am super happy that I had the wonderful pleasure of meeting both of you and learning something new and wonderful too!!! Your presentation was FANTASTIC!!!!” – Vlada Poliakov

“I thoroughly enjoyed your interactive workshop at the COT conference last week and I learnt a lot so thank you!” – Nicole Tee