School-Based Occupational Therapy in MTSS: A Call to Action.

School-based occupational therapy practitioners (SBOTPs) are called to move beyond reactive services for students with identified disabilities and contribute to preventive, inclusive supports for all learners. The Every Student Succeeds Act and the adoption of Multi-Tiered Systems of Support (MTSS) create a timely opportunity for SBOTPs to expand their role as Specialized Instructional Support Personnel within school-wide systems. However, current implementation remains limited by conceptual confusion, inconsistent definitions of MTSS tiers, insufficient data collection and progress monitoring, and fragmented service delivery. These challenges restrict SBOTPs' ability to participate fully in school-wide prevention and intervention efforts and perpetuate a narrow view of occupational therapy (OT) as primarily a direct service linked to special education eligibility. This call to action argues for the development of a clearly defined, stakeholder-informed, and evidence-based model for OT practice within MTSS. It also offers recommendations for coordinated action across research, education, and practice to strengthen role clarity, professional preparation, and implementation support. Together, these efforts are essential to advancing inclusive, preventive, and educationally relevant OT services that support participation and success for all students.