Objective: This study describes perceived levels of involvement in school-based Response to Intervention (RtI) initiatives as reported by occupational therapy (OT) practitioners from different types of communities (i.e., rural, suburban, and urban). In addition, it identifies differences among practice patterns of rural OT practitioners, compared to those from different communities, and provides suggestions for future research and training. Method: A postal survey was sent to a random sample of 1,000 OT practitioners from the American Occupational Therapy Association's Early Intervention and School Systems Special Interest Section. Results: The survey had a 29.5% response rate (n = 295 OT practitioners). Twenty surveys (6.8%) were excluded due to missing or incomplete data. Two hundred and seventy five surveys were analyzed. OT practitioners in rural communities (58.1%; n = 50) were more likely to report participation in early identification of students benefiting from RtI interventions than practitioners in other communities. Practitioners in rural settings were also more likely to participate in universal screenings (33.7%; n = 29) and to cite a lack of resources as a limiting factor to their work in RtI (77.9%; n = 67). Conclusion: OT Practitioners in rural communities may be involved in key RtI practices more often than OT practitioners in urban and suburban contexts. Rural practitioners report this increased level of involvement despite a perceived lack of resources. More research is needed to understand how rural OT practitioners are involved in universal screening and to identify the resources that they believe they are lacking.