Frameworks, Models and Curtent Wendsin School Based Occupational Therapy Practice in the United States The first level of the Response to Intervention (Rel) prevention model is concemed with the universal sereening of a child's level of academic performance by the child’s teacher and use of evidence-based methods of instruction. All children are to receive progress monitoring, ie, formative testing with data graphs updated every few weeks to document progress. Students are to receive evidence-based instruction with the expectation that highly qualified teachers follow curriculum instruction fidelity. It is generally acknowledged that approximately 80-90% of children will succeed with evidence-based instruction and highly qualified teachers (NASDSE, 2010: National Center on Response to Intervention. 2010), At the second level of Rel, 10-15% children who are not progressing in the general instruction and alternate curriculum, programs receive modified instruction in targeted groups addressing specific needs. The third level of Ril for the remaining 5% of children. including children who do not succeed with instruction in targeted groups, includes individualized assessments and focused ‘accommodations and intervention offen leading to referrals for special education, Occupational therapists are becoming involved at all levels of the Response to Intervention (Ril) process. providing "universal screenings, adaptations, "enrichment. targeted group instruction ‘iduslized asessments (AOTA, For example. occupational therapists collaborate with teachers to provide universal design for learning, handwriting screenings (AOTA & Post, 2010: Ohl et al., 2013) and co- teach handwriting in classrooms (Case- Smith, Holland, Lane, & White, 2012), Occupational therapists are becoming more involved in overall school and classroom design. providing evidence that an environment comfortable for the body and senses improves leaming (Kinnealey et al., 2012; Mailloux. 2012; Mailloux, 2014; Shapiro. Roth, & Marcus. 2001), Occupational therapists work with teachers io design targeted group instructional strategies. adaptations and modifications to meet the needs of children at the Tier 2 level. Children who are not making academic progress at tbe Tier 2 level through targeted instruction can be referred to the occupational therapist for more individualized assessments and strategies ot the more intensive Tier 3 level. Qeeupation-Centered! Educational Related Assessment and Intervention Under DEA, the initial special education eligibility evaluation conducted by the school psychologist. teacher. speech therapist, school nurse, and if needed. the occupational therapist and other related services, isto determine whether 2 child has a disabitity and the mature and extent of the special education and related services that the child needs (34 CFR ‘The initial qualifying evaluation for special education may cor may not inelude an OT as part of the team, depending on the areas of concer