Multi-Tiered System of Supports: An Ecological Approach to School Psychology Service Delivery

An Overview of the Multi-Tiered System of Supports Model

MTSS is a multi-tier, school-wide prevention and intervention model designed to support students’ academic, social-emotional, and behavioral needs (Jimerson et al., 2016). Multi-tier refers to the various levels of support that students may need ranging from typical classroom instruction alone to highly individualized, intensive instruction combined with typical classroom instruction. School-wide means that the assessments and interventions provided through the model are implemented throughout the whole school, are available to any student who demonstrates need, and are coordinated across classrooms and grade levels to increase effectiveness and efficiency.

The school-wide approach also necessitates that all members of the school community participate collaboratively in MTSS implementation and take on new roles (Brown-Chidsey et al., 2009). Principals, support staff, school psychologists, and teacher representatives are often a part of a leadership team focused on school-wide prevention and problem-solving. A key component of successful MTSS implementation is a culture of “shared responsibility” for student success (Brown-Chidsey et al., 2009). General and special education teachers work together to provide instruction and interventions and typically play an important role in the assessment of students. Reading, math, and behavioral specialists also collaborate with teachers to provide more intensive interventions and supports that complement classroom instruction and practices (Brown-Chidsey et al., 2009). School psychologists have shifted from the narrow role of “gatekeeper” to special education services to more proactive roles; they provide direct and indirect services to promote evidence-based and equitable practices for all students. This involves working collaboratively with administrators, teachers, specialists, families, and students. Family-school partnerships that are culturally responsive are also essential to successful MTSS implementation (Garbacz, 2020; NASP, 2019).

A primary focus of the model is the prevention of academic, social-emotional, and behavioral difficulties which is accomplished by frequently assessing school-based functioning so that students who are struggling can be identified as early as possible. Targeted interventions are provided to students who need extra help academically, socially/emotionally, or behaviorally. When selecting interventions, the MTSS model requires the use of evidence-based practices. In the context of education, evidence-based practices refer to instructional strategies and interventions that are chosen purposefully based on their objective evidence, such as findings from educational research (Stoiber, 2014). A final key component of the MTSS model is the use of data-based decision making, a process in which educators engage in continuous data collection and analysis in order to make decisions about specific supports that each student needs to progress toward their goals (Deno, 2016). In a well-functioning MTSS model, all of these components are implemented in a coordinated, systematic way to increase efficiency and effectiveness of service delivery, supporting the academic, social-emotional, and behavioral success of all students.

The History of RTI/MTSS

The MTSS model that is popular today emerged from an RTI model that became popular in the early 2000s. RTI is a model of prevention and intervention with the same structure and components of MTSS but with a primary focus on academics (Stoiber, 2014). At that time, the stage was set for the implementation of a model of prevention and intervention with the reauthorization of the Elementary and Secondary Education Act (ESEA) in 2001, more commonly known as No Child Left Behind (NCLB). The original goal of the ESEA, which was initially signed into law in 1965, was to ensure that all students receive a quality education, with a focus on improving educational outcomes for economically vulnerable students. Under the 2001 regulations of NCLB, schools were required to monitor student progress regularly to provide evidence of effectiveness of school programs and practices (NCLB, 2001). This emphasis on data-based decision making and the use of evidence-based practices contributed to the increased prevalence of RTI models across the country (Stoiber, 2014). Most recently, the newest version of the ESEA, the Every Student Succeeds Act (ESSA), was signed into law in 2015. ESSA continues to contain language that supports the use of a multi-tiered prevention and intervention model in schools, with an increased focus on family involvement, equity, and support for disadvantaged and high-need students. This revision places continued emphasis on the importance of evidence-based practices and research-based assessments (i.e., using measures that have been shown to relate to student learning). The requirements outlined in ESSA can be fulfilled through the use of a well-designed RTI/MTSS model (NASP, 2017b).

Another federal law that contributed to the growing popularity of the RTI model was the reauthorized version of the Individuals with Disabilities in Education Act (IDEA) of, 2004. This law protects students with disabilities and guarantees them appropriate educational opportunities through the public education system. The 2004 revision of this law included language that changed the way that students are evaluated for learning disabilities. Specifically, IDEA 2004 allowed for the use of an RTI process in learning disability evaluations and required that schools document evidence that students who are being evaluated for learning disabilities have received appropriate, high quality instruction in general education. Since evaluating students for learning disabilities is a common practice in any school, these new allowances and requirements pushed schools to build and strengthen their RTI systems.

During this time frame, another multi-tiered model, with a focus on behavior, was gaining popularity in schools. Positive Behavioral Interventions and Supports (PBIS) is a model that follows the same tiered structure and emphasis on data-based decision making and evidence-based practices as RTI but with a focus on behavior and social-emotional well-being (Stoiber, 2014). In recent years, leaders in the field have advocated for an integrated approach that conceptualizes a service delivery model for the whole child (McIntosh & Goodman, 2016). Integrated models may reduce confusion for stakeholders by using common language and allow for better allocation of school resources. Thus, MTSS has become the leading framework across the United States with 21 state department of education websites describing state-wide tiered service models as MTSS frameworks, 17 describing state-wide models as RTI frameworks, and the remainder using state-specific model terminology (Berkeley et al., 2020).

A Public Health Model of Prevention

The MTSS framework is built upon the idea that prevention is preferable to remediation. It is modeled after the well-known public health prevention model that includes primary, secondary, and tertiary levels of prevention for diseases, illnesses, and injuries (Merrell & Buchanan, 2006). In the field of public health, primary prevention refers to efforts to prevent a disease from occurring. An example of primary prevention for heart disease would be systematic efforts to disseminate information on healthy lifestyles to the general public (e.g., pamphlets at the doctor’s office regarding healthy eating and exercise habits). Secondary prevention refers to efforts to prevent a disease in at-risk individuals or to reduce or reverse early symptoms of a disease. Following the heart disease example, secondary prevention might include early screenings and medical protocols to reduce risk factors (e.g., providing an aspirin regimen to a patient with a family history of heart disease). Tertiary prevention is aimed at reducing the impact and trajectory of an existing disease. An example of tertiary prevention of heart disease may be rehabilitation protocols for heart attack survivors. The same prevention ideas can be applied to the field of education through the MTSS model.

Multiple Tiers of Supports

Most MTSS models adopted a three-tier approach (see Figure 1) in which the first tier (Tier 1) is the equivalent of primary prevention (i.e., supplying information to the general public), with evidence-based practices being delivered to all students (Jones et al., 2012). For example, an evidence-based curriculum is used to teach foundational academic skills, such as reading. Programs that teach social-emotional learning (SEL), or that teach and reinforce appropriate behaviors are implemented with all students in Tier 1. The second tier (Tier 2) reflects the ideas of secondary prevention (i.e., supports provided for at-risk individuals), with interventions being delivered to smaller groups of at-risk students in addition to Tier 1 instruction. For example, a small group of students may receive a targeted intervention focused on appropriate social skills; another small group of students may receive a targeted intervention that provides additional support and practice with math computation fluency as their Tier 2 intervention. The third tier (Tier 3) is akin to tertiary prevention (i.e., provide remediation to individuals in need), with more individualized and intensive intervention being delivered through small group or one-on-one instruction in addition to Tier 1 instruction. For example, a student with significant social-emotional or behavioral challenges may participate in a highly individualized Tier 3 intervention that focuses on learning and using coping skills appropriately. A student who is performing significantly below grade level in an academic area may receive intensive and individualized tutoring to help them close the gap. More examples of interventions in Tiers 1, 2, and 3 across academic, behavioral, and social-emotional areas are provided in Rattan and Furey (2021, Supplementary Figure 1).

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Figure 1.

Tiers of instruction and intervention.

An important feature of the MTSS model is that supports are meant to intensify as you move from Tier 1 to Tier 3. Students who receive Tier 2 or Tier 3 interventions must also receive Tier 1 instruction. That is, Tier 2 and Tier 3 instruction are meant to supplement Tier 1, not supplant it (Fletcher & Vaughn, 2009). Many schools embed an “Intervention Block” in the daily schedule to ensure that adequate time and personnel are available for implementing Tier 2 or 3 interventions. For example, one student may receive small group (Tier 2) counseling on emotional regulation during the intervention block; another student may receive individualized (Tier 3) academic intervention at this time.

The MTSS model indicates that when schools implement their tiered system effectively, they should expect that about 80% of the students will be able to be successful with Tier 1 instruction alone. That leaves approximately 20% of the student population who would need some additional support to meet their learning, behavioral, social, or emotional goals. The students who make up this 20% would participate in Tier 2 or 3 intervention, in their areas of need. We would expect about 15% of students to respond well to Tier 2 instruction and eventually be able to return to Tier 1 instruction and supports alone. The remaining 5% of students will need more individualized and intensified intervention in their area(s) of need. The MTSS model predicts that when students receive high quality, research-based instruction, students should be able to make appropriate gains and meet their educational, behavioral, and social-emotional goals (Fletcher & Vaughn, 2009).

Tier 1 instruction

Considering that the majority of U.S. children attend public schools, schools provide a readily accessible way to promote equity. High-quality, equitable, and evidence-based practices for all students at Tier 1 are the foundation of an MTSS framework (NASP, 2016a). A central idea of the MTSS framework is that all children can learn, and it is the responsibility of schools to provide a positive, inclusive, and effective learning environment (NASP, 2014, 2016a).

Nationally, there is a need to improve Tier 1 academic instructional practices. The latest report from the National Center for Educational Statistics showed that 65% of fourth grade students scored below proficient in reading (NCES, 2020a) and 59% of fourth grade students scored below proficient in mathematics (NCES, 2020b). Academic achievement gaps are even more significant for racially minoritized students, economically vulnerable students, and bilingual or multilingual learners (NCES, 2020a, 2020b). Racially minoritized students and bilingual or multilingual learners have also been disproportionately represented in special education programs (Fernandez & Inserra, 2013; NASP, 2013). There is an especially pressing need to implement high-quality and evidence-based Tier 1 practices following the COVID-19 pandemic, as many existing academic problems and inequities have only been exacerbated. In an MTSS framework, schools do not waste valuable instructional time implementing practices that do not work. Practices that have been shown to work for specific populations are prioritized, and students receive additional help when they need it.

Schools must also be proactive in promoting safe and respectful learning environments in Tier 1. System-wide practices that reinforce positive and appropriate behaviors, and teach constructs such as social-emotional learning and restorative justice play a critical role in improving school climate and reducing behavioral and social-emotional challenges. These practices are necessary for all students, especially students who have received inequitable treatment historically. Racially minoritized students continue to experience disproportionately high rates of discipline in schools, including office discipline referrals, detentions, suspensions, and expulsions (NASP, 2013). Research has also indicated that LGBTQIA+ youth experience significantly higher rates of bullying and harassment in schools, and are subsequently at greater risk for poorer social-emotional outcomes, school dropout, and suicide (NASP, 2017c). In an MTSS framework, it is essential that teachers, specialists, and administrators are committed to inclusive, anti-racist, and nondiscriminatory practices to support the wellbeing of all students. At Tier 1, there is a shared responsibility among all school staff to engage in respectful and culturally inclusive partnerships with students and their families (Garbacz, 2020; NASP, 2019).

It is not uncommon to find that schools have higher percentages of students in the top two tiers of the triangle than is predicted by the MTSS model. For example, it may be the case that 50% of students in a grade demonstrate significant behavioral or social-emotional challenges; or more than half of students are performing below grade-level expectations in a foundational academic skill area, such as oral reading fluency. When this happens, schools often struggle to find the resources needed to provide high quality intervention to these large numbers of students (Brown-Chidsey & Bickford, 2016). This can overload the system, leading to an inefficient and ineffective model. The best defense against a top-heavy tiered system (i.e., one in which too many students are requiring targeted and intensive supports) is to ensure that high quality instruction and practices are occurring at the Tier 1 level (Riley-Tillman et al., 2013). Four questions to examine when evaluating Tier 1 instruction are, (1) Is the curriculum or practice research-based?, (2) Is the teacher using principles of effective instruction?, (3) Is the teacher differentiating instruction?, and (4) Is the teacher following the curriculum with fidelity?

Tier 2 intervention

Tier 2 intervention involves targeted supplemental instruction in addition to the core curriculum that is provided in Tier 1. Educational researchers have examined the effectiveness of different components of Tier 2 interventions and found positive outcomes when intervention was provided in small groups of three to five students, delivered for 30–40 minutes three to five times per week, and was designed to target very specific skills (e.g., targeting reading fluency rather than simply providing extra reading time) (Burns et al., 2008). Interventions should include explicit instruction, frequent opportunities to practice skills, and immediate corrective feedback (Gersten et al., 2008; Harlacher et al., 2010).

Tier 2 interventions often use a standard treatment protocol approach. This means that students are grouped based on a general area of need (e.g., math calculation skills, emotional regulation, homework completion, etc.). Then, the same standard intervention program is implemented with those students. These interventions are often scripted or at least contain highly detailed instructions so that the intervention can be provided in the manner in which it was intended by the creators, without the need for high levels of background knowledge or rigorous training (Fuchs & Fuchs, 2006; Marchand-Martella et al., 2007). Using standard treatment protocols and scripted interventions for Tier 2 allows schools to use their resources wisely and allow various professionals in the school to provide the needed interventions. In addition to teachers, individuals such as paraprofessionals, librarians, classroom aides, tutors, and others may serve as interventionists when it is appropriate.

Tier 3 intervention

Tier 3 is intended to provide more intensive supports to students who did not respond adequately to Tier 2 supports or for students who are performing significantly below grade-level expectations and have more intensive needs. Although there are no universally agreed upon definitions of Tier 2 and Tier 3, there are common ways of intensifying interventions for use at the Tier 3 level (Mellard et al., 2010). Tier 3 interventions should be designed to meet individual students’ needs. In order to do this, diagnostic assessments are often used to pinpoint the student’s specific skill deficits (Hosp et al., 2016). For example, if a student was in a Tier 2 intervention group with a focus on building decoding skills (i.e., sounding out words) and did not make progress in that intervention, we would want to understand what specific sub-skills (e.g., long vowel sounds) are challenging the student that can be more specifically targeted in Tier 3. Additional changes that are often made as students move from Tier 2 to Tier 3 include decreasing the intervention group size (or providing one-on-one instruction), increasing the frequency of the intervention, and using interventionists with higher levels of expertise (Brown-Chidsey & Bickford, 2016; Gersten et al., 2008).

Data-Based Decision Making

Data-based decision making is an essential part of an MTSS model. It is important to be able to accurately identify students who are struggling and to track their performance over time in order to see if the interventions are working. There are two main types of assessments that assist in decision making within an MTSS model: screening assessments and progress monitoring assessment (Hosp et al., 2016).

Screening assessments

Screening, or benchmarking, is the process of proactively and systematically using data to identify students who are at-risk and may need additional intervention in one or more areas. Screening of all students should take place at least three times per year (e.g., fall, winter, and spring) (Hosp et al., 2016; Riley-Tillman et al., 2013). The data from screening measures can be thought of as brief indicators of overall knowledge, skill, performance, or needs. It is similar to a doctor taking your temperature or blood pressure at an office visit. These measures do not tell us everything we want to know but give us a quick indication of whether there is a potential concern or not. Just as a doctor would conduct follow up assessments after a high blood pressure reading to try to discover the source of the problem and prescribe the correct treatment, a teacher or member of a child’s data team would gather more information following at-risk scores on screening measures to determine the source of the academic, behavioral, or social-emotional difficulties and provide the correct type of intervention.

Examples of commonly used academic screening tools include Curriculum Based Measures (CBMs), which are brief, reliable, and valid indicators of foundational skills such as oral reading fluency, math computation fluency, and written expression (Hosp et al., 2016). Schools can also use existing data sources such as grades, attendance records, and office discipline referrals to identify students in need of more support. A comprehensive review of academic and behavioral screening tools and their technical adequacy can be found on the website of the National Center on Intensive Intervention (NCII, 2020a, 2020b). Additional examples of screening tools can be found in Rattan and Furey (2021, Supplementary Figure 1).

In addition to using screening data to identify individual students who need more support, MTSS leadership teams also disaggregate school or grade-level data by various subpopulations (e.g., racially minoritized students, bilingual or multilingual learners, students with various disabilities, economically vulnerable students, etc.) to identify Tier 1 issues related to inequity and disproportionality. Reviewing disaggregated school-wide data can shed light on inequitable instruction, practices, or policies that may be systematically disadvantaging subpopulations of students. When a Tier 1 problem is identified at the district level, school level, grade level, or for subpopulations of students, the MTSS leadership team engages in a problem-solving process to clearly identify the problem, analyze the problem, implement an evidence-based plan, and evaluate the effectiveness of the plan.

Progress monitoring assessment

Students who are not successful with high-quality Tier 1 practices receive additional Tier 2 or Tier 3 interventions promptly, and their progress is monitored concurrently. Progress monitoring is a type of formative assessment that allows us to determine the effectiveness of instruction and interventions on a regular basis. Progress monitoring data is typically graphed on a line graph so that it is easy to visualize trends over time (see Figure 2 for examples). Frequent assessment is beneficial because it allows educators to ensure that students will not be kept in interventions that are not working for long periods of time, nor kept in interventions that worked to get them up to grade level expectations but are no longer necessary (Hosp et al., 2016). Regular review of student data allows educators to make the best data-based decisions for students by ensuring that they are getting the correct type and amount of instruction to meet their needs (Burns & Gibbons, 2012). As students’ level of risk increases, so should the frequency of progress monitoring. Those receiving Tier 2 and Tier 3 interventions should be monitored between twice per week and once per month depending on level of risk and the sensitivity of the measures being used (Hosp et al., 2016; Riley-Tillman et al., 2013).

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Figure 2.

Progress monitoring graphs for tier 2 or tier 3 interventions: Reading and behavior examples.

Evidence-Based Practices

There has been a big push in education in recent years to use evidence-based practices (EBPs) in schools for all areas of instruction and intervention (Brown-Chidsey & Steege, 2010). Federal laws such as ESSA (2015) and IDEA (2004) that require or emphasize the importance of EBPs are partly responsible for their increased prevalence in schools. This increase is also due to a growing body of research on effective practices in many different areas of education. Using practices that have a strong research base give us a higher probability of effectiveness over practices with little or no research support (Brown-Chidsey & Steege, 2010). In other words, we want to use methods that have been effective with similar populations for similar concerns. However, not all research is created equal. What does it really mean to say something is “evidence-based?”

There are a number of variables to consider when reviewing available research on an educational practice. Different professional organizations (e.g., Council for Exceptional Children, American Psychological Association, Division 16) have created criteria by which to judge a practice’s evidence base. Although there are no universally agreed upon criteria, there are some general quality indicators that are consistent across various professional groups.

Some critical traits to look for when evaluating the evidence base for a practice include: the peer-reviewed research uses sound experimental or quasi-experimental design, there is detailed information available about the participants and procedures used in the research, the research includes rigorous data analysis (including effect sizes), and replication of positive outcomes are present in the research (Brown-Chidsey & Steege, 2010; Cook et al., 2009).

A useful resource for determining the evidence-base for a particular program or practice is available online from the What Works Clearinghouse website (www.whatworks.ed.gov). This initiative of the Institute for Education Sciences within the U.S. Department of Education presents summary research findings on a vast array of existing intervention strategies and programs in thorough and easy-to-understand reports. Additionally, the National Center on Intensive Intervention website provides academic and behavioral intervention tools charts that list and summarize the quality of evidence for various academic and behavioral interventions (NCII, 2020c, 2020d).

Fidelity of Implementation

Fidelity of implementation, also referred to as treatment integrity, is an important component of MTSS that must be addressed in order to have confidence in the decisions that are being made within the system (Keller-Margulis, 2012). When using an evidence-based practice, the practice can be expected to deliver the intended results only if it is used in the same way in which it was originally tested. In the case of an evidence-based intervention, the effectiveness of the intervention would have been evaluated under carefully controlled conditions, so deviating from the original procedures is problematic. If a student does not make adequate progress in an intervention, but the intervention was not delivered with fidelity, it is difficult to know if the lack of progress indicates that the student needs additional support or if the lack of progress can be attributed to poor implementation fidelity (Brown-Chidsey & Bickford, 2016). Fidelity can be measured directly through observation, or indirectly through self-report or a review of work products completed during the intervention period. It is beneficial to consider both quantitative feedback (e.g., the interventionist included 4 out of 5 elements of the intervention) as well as qualitative feedback (e.g., the interventionist did a nice job engaging the students by keeping a quick pace and delivering instruction with an enthusiastic tone) to make any adjustments to the intervention implementation. A more detailed description of methods that can be used to measure fidelity can be accessed in Rattan and Furey (2021, Supplementary Figure 2).

Multi-Tiered System of Supports in Action: A Case Study

To aid the reader in understanding what MTSS “looks like” in action, a case study is provided in Rattan and Furey (2021, Supplementary Figure 3). The case study focuses on a first-grade student in a school that implements an MTSS model successfully. This example demonstrates how all of the essential components of MTSS are integrated to support a student’s learning process. The case highlights the implementation of an ecological perspective, in which various team members and family members consider all aspects of the child’s environment to help the child succeed. As demonstrated in the case study, the school psychologist plays an essential role in supporting student outcomes through the MTSS model.

The Role of the School Psychologist in Multi-Tiered System of Supports

With the introduction of MTSS came many opportunities for school psychologists to expand their roles, taking on new and different responsibilities in a variety of domains. For example, whereas the school psychologist practicing before the implementation of MTSS may have worked primarily with students requiring evaluation or counseling services, the school psychologist practicing within an MTSS framework has opportunities to provide direct and indirect services to support equitable practices for all students (NASP, 2016a). School psychologists are trained to be critical consumers of research and, therefore, can be an important asset in determining the quality of the research support for an instructional method or intervention with various subgroups of students (e.g., bilingual learners, students with learning disabilities, etc.).

Additionally, school psychologists are especially well positioned to lead school-wide data-based decision-making processes regarding screening and progress monitoring (NASP, 2016b). The induction of MTSS has provided increased opportunities for school psychologists to fulfill leadership roles as schools have implemented new processes and systems that require training and oversight. School psychologists are experts in supporting diverse learners academically, behaviorally, socially, and emotionally. They are trained to work collaboratively with families, schools, and communities to promote equitable and culturally responsive practices (NASP, 2019, 2020). School psychologists are uniquely poised to undertake leadership positions within the MTSS framework given their training in consultation, interventions, assessment, and data analysis (NASP, 2020).

The roles and duties of a school psychologist vary greatly depending on the school or district in which one is employed. The MTSS model has only broadened the potential differences of the role among schools. School psychologists are encouraged to advocate for proactive, equitable, and evidence-based services in schools, and to broaden their role to support an MTSS process (NASP, 2016a). In a school that is implementing MTSS, a school psychologist may be called upon to fill any number of roles including, but certainly not limited to researcher, student evaluator, consultant, data analyst, leader, liaison, fidelity monitor, and program evaluator (Stoiber, 2014). School psychologists’ reflections on their roles within the MTSS models in their schools are included in Rattan and Furey (2021, Supplementary Figure 4), and the various roles of school psychologists in an MTSS model are summarized in Supplementary Figure 5 of Rattan and Furey (2021).

Currently, the ratio of school psychologists to students far exceeds the 1:500 ratio recommended by NASP (2017a). Therefore, it is not possible for one school psychologist to provide direct services to all at-risk students in a school. In an MTSS framework, school psychologists are leaders who promote systemic, evidence-based, and culturally responsive practices. An ecological model such as MTSS addresses long standing systemic inequities that have only been exacerbated by the COVID-19 pandemic. By broadening their role and supporting the implementation of systematic and evidence-based practices in schools, school psychologists play a crucial role in proactive practices that greatly reduce or even eliminate problems in the areas of academic, social-emotional, or behavioral success.

Conclusion

It is important for undergraduate students, with an interest in psychology, to have an accurate understanding of the career options that are available to them. Many undergraduate students are not aware of the field of school psychology and what the role of the school psychologist entails (Bocanegra et al., 2015). Considering the national shortage of school psychologists today (NASP, 2017a), it is especially important for undergraduate psychology students to have an up-to-date understanding of the field. Teaching undergraduate psychology students about the MTSS model allows them to see how school psychologists and other school-based professionals can apply research-based, data-driven, and culturally responsive practices through an ecological approach to service delivery. Psychology students should be provided with an accurate understanding of the contemporary role that school psychologists play as school leaders in promoting the academic, social-emotional, and behavioral well-being of all students.

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