Speech-Language Pathologists Misconceptions Related to Multi-Tiered System of Supports (MTSS)

Methodology and Participant Demographics

• Analytical Approach:

  • The authors utilized an inductive approach to review transcribed focus group discussions, citing Braun & Clark (2012).

  • Qualitative summaries were generated to aid understanding and capture essential discussion points for every item, citing Thomas (2003).

  • Goal of Analysis: The primary purpose of the data analysis was to inform a clinical forum regarding misconceptions related to Multi-Tiered System of Supports (MTSS) rather than serving as a traditional research study.

• Participant Data (Table 1):

  • Educational Settings ($n$):

    • Pre-K: $9$

    • Elementary: $15$

    • Middle school: $6$

    • High school: $4$

    • District office: $2$

    • Note: Twelve speech-language pathologists (SLPs) reported working in more than one setting.

  • Geographic Distribution (States):

    • Alaska ($1$), Florida ($1$), Georgia ($1$), Illinois ($5$), New Jersey ($2$), New York ($2$), Ohio ($2$), Pennsylvania ($2$), Rhode Island ($1$), South Carolina ($1$), Virginia ($1$).

Overview of Quantitative Findings

• Agreement Scale: Items were ranked from 1 (Disagree) to 5 (Agree).

• Mean Score Range: The results indicated average agreement ranging from a low of $1.16$ (strong disagreement with the misconception) to a high of $4.63$ (strong agreement with the misconception).

• Ranking Logic: Table 2 presents items in order from "least agreement" (meaning they are least likely to be misconceptions) to "most agreement" (prevalent misconceptions).

Misconceptions: Legal, Expertise, and Service Delivery

• Legal Standing: "It is illegal/not allowed for SLPs in [any state] to be involved with MTSS"

  • Statistics: Mean ($M$) = $1.16$, Standard Deviation ($SD$) = $0.75$.

  • Findings: Most participants agreed there are no legal barriers. Some noted that although they heard of issues in other states, their own state departments of education encouraged involvement.

  • Caveats: SLPs noted that if their caseload hit the mandated number of students with IEPs, MTSS support would be discontinued.

  • Service Environment: One participant warned that pulling a student out of class for MTSS could potentially create an issue regarding the "restrictive environment."

• Professional Competence: "SLPs do not have the relevant expertise to contribute to MTSS implementation"

  • Statistics: $M = 1.26$, $SD = 0.56$.

  • Findings: SLPs felt responsible for assisting in areas where teachers lack extensive training, specifically literacy and creating visuals.

  • Barriers to Participation: One participant noted that many SLPs do not "put themselves out there" due to lack of confidence, discomfort with teachers, being new to the field, or not understanding MTSS.

  • Content Specificity: While confident in speech, one participant explicitly stated, "But math, no, I have got nothing."

• Service Delivery Models: "SLP engagement with MTSS means all services are push-in services"

  • Statistics: $M = 1.58$, $SD = 0.90$.

  • Findings: The delivery model depends on the student's specific needs, school infrastructure, and classroom environment. Participants rejected the "all or nothing" approach to push-in services.

  • Support Roles: SLPs may support MTSS by modeling interventions for teachers/paraprofessionals, sharing resources, or selecting concepts to address rather than providing direct intervention.

Misconceptions: Content Areas and Intervention Efficacy

• Subject Scope: "MTSS only involves academic content areas of reading/math and social–emotional/behavioral practice"

  • Statistics: $M = 2.21$, $SD = 1.23$.

  • Findings: Many districts are still establishing procedures for speech and language. In some cases, speech/language is an "afterthought."

  • Separation of Duties: One SLP described a scenario where teachers call for a screening, but the SLP then works entirely separately from the MTSS team (contacting parents and teachers individually).

  • Integration Example: Another district reported having procedures that successfully include speech and language across all areas, though not always "smoothly."

• Intervention Outcome: "Engagement with MTSS with students performing below grade level just delays the inevitable in most cases"

  • Statistics: $M = 2.21$, $SD = 1.27$.

  • Findings: Positive outcomes were associated with quick interventions, such as articulation drills (e.g., $5\,\text{minutes}$ of practice several times a week in the hallway), which reduced referral and caseload numbers.

  • Gen-Ed Limitations: Some SLPs were frustrated when students did not respond to interventions delivered by general education teachers, leading to the sentiment of "just let me test them and just put them in [special education]."

Misconceptions: Resources, Age Relevance, and Target Populations

• Availability of Support: "Resources for SLPs’ participation in MTSS do not currently exist"

  • Statistics: $M = 2.37$, $SD = 1.07$.

  • Findings: Perceptions varied based on the definition of "resource."

    • Internal Resources: Knowledge of goal setting, data analysis, and instructional strategies.

    • External/Physical Resources: Screening forms, flowcharts for tiered support, books, and independent research.

  • Gaps: Participants noted a lack of specific curricula to follow and "tricky" implementation at the Tier 1 level.

• Educational Level: "As an SLP, MTSS is really only relevant at the preschool and elementary school level"

  • Statistics: $M = 2.37$, $SD = 1.21$.

  • Findings: Most believed MTSS could help anyone at any level. In middle school, the focus shifts to areas like Greek and Latin roots for vocabulary and encoding, and social communication.

  • Foundational Concerns: Some argued the focus should remain on early years to fix problems before children reach 6th or 7th grade.

• General vs. Special Education: "MTSS is an initiative that only applies to general education students and teachers"

  • Statistics: $M = 2.42$, $SD = 1.47$.

  • Findings: MTSS is often seen as a "path to special education." Some districts strictly exclude students with IEPs from the MTSS process.

  • Collaborative Ideal: Participants argued MTSS should involve every educator and support staff because everyone brings different expertise. Instances were noted where students receive special education in one area (Reading) but MTSS in another (Math).

Misconceptions: Workload and Systemic Structure

• Workload Allocation: "MTSS is a way to get SLPs to do more work that does not ‘count’ in their workload"

  • Statistics: $M = 2.74$, $SD = 1.2$.

  • Findings: Perceptions depend on district billing and schedule influence. Some can only report services for children with IEPs.

  • Efficiency: Some viewed MTSS as "frontloading" work to reduce future paperwork and billing associated with large IEP caseloads.

• Time and Population Stress: "Since such a large percentage of children are performing below grade level, everyone needs MTSS and there isn’t enough time"

  • Statistics: $M = 2.89$, $SD = 1.45$.

• System Definition (Most Prevalent Misconceptions):

  • "MTSS is part of the prereferral process"

    • Statistics: $M = 4.47$, $SD = 0.61$.

    • Note: $52.60\%$ of participants agreed and $42.10\%$ somewhat agreed.

  • "MTSS includes several steps that need to be defined so SLPs know when to begin their involvement and when to stop"

    • Statistics: $M = 4.63$, $SD = 0.83$.

    • Note: This was the item with the highest agreement ($78.90\%$ Agree).

Summary Statistical Table of Misconceptions (Table 2)