Date of Award

4-20-2026

Degree Type

Capstone Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Kim Schrebe, OTRL

Second Advisor

Holly Grieves, OTD, OTRL

Abstract

The Multi-Tiered System of Supports (MTSS) is designed to provide levels of support with differing intensity that align with student needs. Tier 1 is universal instruction provided to all students in the classroom. Students who do not demonstrate adequate progress may receive Tier 2 interventions, which are primarily small-group and, when appropriate, individual interventions that are skill-specific, time-bound (6–8 weeks), and include progress monitoring. Students who do not respond to Tier 2 may require Tier 3 supports, which are intensive, individualized interventions. Many school systems lack consistent, structured Tier 2 supports, particularly in Occupational Therapy-related skills, such as fine motor skills and handwriting. A SWOT analysis and needs assessment at Cedar Trails Elementary identified the need for a structured Tier 2 system to strengthen the identification of student needs and Tier 3 referral decision-making. The capstone project developed Tier 2 interventions centered on Fine Motor Skills and Alphabet tracks, organized into 6-week programs that target fine motor precision, visual perception, visual-motor integration, and letter formation with functional application. Outcomes include a structured Tier 2 system within the MTSS framework designed for implementation, streamlined use of student data to inform MTSS decision-making, and materials organized into a centralized database to support the consistent delivery of interventions.

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