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Research

Empirical findings on the effectiveness and implementation of multi-tiered systems of support, with a particular focus on single-case research.

International research landscape

The research starts from a systematic review following PRISMA guidelines (Nitz et al., 2023a). From 8,041 identified articles, 40 studies were included after multi-stage screening — all examining MTSS with behavioural interventions in primary schools. 72.5% of studies come from the USA, followed by Australia, Canada, Finland, Germany, New Zealand, Taiwan and Norway. Quasi-experimental designs were used most frequently (65%), followed by single-case studies (15%), RCTs (7.5%) and mixed-methods designs (12.5%). A key finding: single-case studies deliver more detailed results than large-scale studies — they allow intra-individual trajectories to be mapped and analysed at a fine-grained level.

In addition to the review itself, a systematic compilation of existing review studies (as of March 2024) shows which areas of MTSS have been researched internationally:

Research area Review studies
Tier 1 interventions Allen-Meares et al. (2013); Estrapala et al. (2020); Grasley-Boy et al. (2020)
Tier 2 interventions Blair et al. (2021); Bruhn et al. (2013); Mitchell et al. (2017); Wanzek et al. (2016)
MTSS in preschool settings McLaughlin et al. (2011); Shepley & Grisham-Brown (2019); Shepley et al. (2020)
High school & secondary education Estrapala et al. (2020); Freeman et al. (2019); Guest (2011)
General effectiveness Charlton et al. (2020); Öğülmüş & Vuran (2016); Solomon et al. (2012); Lee & Gage (2020)
Professional development & implementation Briesch et al. (2019); Castillo et al. (2022)
Challenging behaviour Walker et al. (2023); Simonsen et al. (2013)

Across studies, positive effects are found for externalising behaviour, school climate (Charlton et al., 2020), academic achievement (Lee & Gage, 2020), prosocial behaviour (Öğülmüş & Vuran, 2016) and teacher stress (Aasheim et al., 2018; Stephan et al., 2015). Research gaps include adaptation to non-US education systems, systematic learning progress diagnostics, and stakeholder involvement.

Multimo — tiered support in German primary schools

The Multimo research project (Hanisch et al., 2019) developed and tested the first MTSS for the prevention and intervention of externalising problem behaviour in inclusive primary schools in North Rhine-Westphalia. The following effectiveness studies form the empirical core of the research.

All studies use single-case designs in a multiple-baseline framework (Kratochwill et al., 2012; Wilbert et al., 2022): classes or schools begin the intervention at staggered times, so each unit serves as its own control (Levin et al., 2018). Behavioural changes are recorded via daily Direct Behavior Ratings (DBR) and analysed using multilevel models. Key metrics are level effects (immediate change), slope effects (rate of change over time) and Non-Overlap of All Pairs (NAP; Parker & Vannest, 2009), supplemented by PND, PAND, PEM and Tau-U (Chen et al., 2016; Lenz, 2017).

Tiers 1 & 2 (Nitz et al., 2023b): 29 students from 18 inclusive primary schools in NRW, seven-month duration. The GBG (Tier 1) led to a significant reduction in disruptive behaviour. The DBRC (Tier 2) showed a further decrease in trend effect, though less pronounced. The combined use of both interventions proved effective overall. The study was implemented via a multiplier concept (Behr et al., 2020; Pearce et al., 2012).

Tier 3 (Nitz, 2024; Nitz et al., 2024a): A subsample of eight students shows heterogeneous results: 50% medium effects (NAP 66–79%), one small effect, three children with no detectable effect. A distinctive feature: what is measured is an indirect effect — the SCEP coaching primarily targets the teacher (Hanisch et al., 2020). In supplementary interviews, seven teachers rated the coaching consistently as "successful". 67% of coded statements highlight changes in teacher behaviour and self-reflection. Key effectiveness factors: problem-solving, motivational clarification and relationship quality with the coach — consistent with Grawe (2000).

GBG in isolation (Hagen, Nitz et al., 2023): In four Year 3 classes (N = 20), the GBG showed significant level effects for disruptive and on-task behaviour. Positive effects were also found outside the game phases — indicating transfer effects. The NAP ranged from 32% to 97% (Flower et al., 2014; Leidig et al., 2022).

DBRC in isolation (Nitz, Volpe et al., submitted): Ten Year 2 students showed 40% strong and 60% moderate effects. Multilevel analysis confirmed significant level effects for general disruptive behaviour and specific goal behaviour — and a significant relationship between both variables (Volpe et al., 2013).

Implementation, critique & outlook

Implementation quality is a decisive success factor (Berkeley et al., 2009; Fox et al., 2021). A qualitative study with nine teachers from eight primary schools (Nitz et al., 2024b) identified key challenges: inadequate staffing, insufficient professional development, lack of time, oversized classes, poor parent cooperation, and teacher overload. Success factors: higher staffing levels, needs-based professional development, smaller classes, training in school-based diagnostics and active support from school leadership (McIntosh et al., 2009).

Betters-Bubon et al. (2022) and Mayes & Byrd (2022) criticise the culturally neutral implementation of MTSS and call for anti-racist reflection, cultural competence and examination of the school environment (Fallon et al., 2021). For the adaptation of German MTSS, this must be considered given comparable structural disadvantages (Knauer, 2019; Molela Moukara, 2023). Methodologically, there is a need for regression-discontinuity designs (Baird et al., 2024), qualitative supplements and adapted instruments for measuring implementation fidelity in the German-speaking area.

Outlook: multimo5–7

The follow-up project multimo5–7 extends the concept to the transition from preschool to the end of Year 1. At four primary schools in the Mettmann district, an MTSS for early identification and support of children with learning or behavioural risks is being implemented — for the first time with close integration of school-based and family-based support structures. Alongside tiered school interventions (Tiers 1–3), preparatory parent–child sessions are conducted before school entry. The approach is based on two needs analyses that systematically capture each school's challenges. The accompanying research examines both the effectiveness of the measures and questions of feasibility and acceptance under real-world conditions.

The core finding of the research so far: the development, implementation and delivery of tiered support in Germany, specifically in the inclusive primary school setting, is possible and effective. With multimo5–7, this approach is now being extended to the school transition — further studies in different settings and federal states are needed to ensure transferability (Nitz, 2024).

Sources

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