Kathleen Lane 1 Three-Tiered Models of Prevention to Prevent and Respond to Challenging Behavior: A...

Kathleen Lane 1

Three-Tiered Models of Preventionto Prevent and Respond to Challenging

Behavior: A Comprehensive & Integrated Approach

Kathleen Lynne Lane, Ph.D., B.C.B.A

Vanderbilt University

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What are the goals for this in-service?

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In-Service Goals

Gain a clear understanding of three-tiered models of the positive behavior support design to prevent learning and behavior problems from occurring and strategies for responding to existing problems

Learn how to design a plan with primary, secondary, and tertiary levels of academic and behavior support

Examine the bridges and barriers of implementing a three-tiered model of prevention.

Learn how to develop a plan for implementing and assessing your three-tiered model of prevention.

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Agenda1. Introduction Why do we need three tiered models of prevention?

2. Primary Prevention Efforts• Overview: Three-Tired Models of Prevention• Establishing Expectations that Meet Teacher Expectations• Incorporating Systematic Screenings• Designing a Comprehensive Assessment Plan

3. Secondary Prevention Efforts

• Overview• Illustration• Resources• Critical Components

4. Tertiary Prevention Efforts

• Overview• Illustration• Resource• Critical Components

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Why do we need a three-tiered plan of prevention?

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National Concern:School Safety & Antisocial Behavior Antisocial and violent behavior in public schools is one of the top

concerns in education today (Walker & Severson, 2002).

Concern for increased violent crimes among school-aged children, especially in school setting (Annual Report on School Safety, 2000)

5% of students between 12-18 years report being victimized during the school day during the last 6 months (NCES, 2005).

Homicides in schools have increased in recent years.

Although number of violent crimes is decreasing, the magnitude and severity is increasing (Walker, Ramsey, & Gresham, 2004).

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National ResponseLegislative & Federal Mandates

Title IV of Improving America’s Schools Act of 1994 and Safe and Drug-Free Schools and Communities Act (1994) spurred a zero tolerance stance on weapons and drugs.

White House issued a mandate calling for schools to be safe, nonviolent settings.

Surgeon General’s Report on Youth Violence (2001) requested the use of evidence-based practices to dismantle antisocial networks by increasing academic success, developing positive school climates, and subscribing to a primary prevention model (Satcher, 2001).

Individuals with Disabilities Education Act (IDEA; 2004) included language to support this call “providing incentives for whole-school approaches … positive behavior interventions.”

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1-5% 1-5%

5-10% 5-10%

80-90% 80-90%

Intensive, Individual Interventions•Individual Students•Assessment-based•High Intensity

Intensive, Individual Interventions•Individual Students•Assessment-based•Intense, durable procedures

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Universal Interventions•All students•Preventive, proactive

Universal Interventions•All settings, all students•Preventive, proactive

Designing School-Wide Systems for Student Success

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Three-Tiered Models of Prevention

Positive Behavior Support (PBS) and Response to Intervention (RtI) ModelsPrimary Level

Prevent harm from occurring

Secondary Level Designed to reverse harm by supporting students who do not

respond to primary prevention efforts

Tertiary Level Reduce harm by supporting students exposed to multiple risk

factors who may have not responded to primary or secondary efforts

(Severson & Walker, 2002; Sugai & Horner, 2002)

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Three Tiered Models of Prevention: A Comprehensive Approach

Primary Prevention

Academic

Behavioral Social

Goal:

Prevent Harm

Secondary Prevention

AcademicBehavioral Social

Goal: Reverse Harm

Tertiary PreventionAcademicBehavioral Social

Goal: Reduce Harm

Address varying responses to intervention.Three-tiered school-base intervention model.

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Schools Respond:

Tertiary Prevention

~5%

Secondary Prevention ~15%

Primary Prevention~80%

Goal: Prevent HarmSchool/Classroom-Wide Systems for All Students, Staff, & Settings

Goal: Reverse Harm Specialized Group Systems

for Students with At-Risk Behavior

Goal: Reduce Harm

Specialized Individual Systems for Students with High-Risk Behavior

(Horner & Sugai)

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Positive Behavior Support Program developed entirely by the school and individualized to

its particular needs

Coordinated system of multi-level, strategic intervention designed to address the social and academic needs of all students within a particular setting.

Offers a continuum of support ranging from broad, universal interventions to more individualized interventions

Has demonstrated success at the elementary, middle, and high school levels.

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Three-Tiered Models of Prevention: Focus

More than preventing problem behavior from occurring

Focuses on teaching more appropriate functional skills that will promote success in the school environment and provides a context for the practice and reinforcement of these skills (Lewis et al., 2002; Turnbull et al., 2002)

Goal: Create an individualized school plan based on the faculty’s expectations for their students

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Universal Support

Procedures for Teaching Lesson Plans (Stop-Drop-Teach) Posters Videos Assemblies

Procedures for Reinforcing Tickets or Cards Award Assemblies Prizes (Tangibles & Non-tangibles)

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Targeted Interventions School-wide data are used to determine students who

need additional levels of support

Examples: attendance, discipline, grades, behavior screeners, etc.

Additional levels of support

Secondary Level of Support Small group interventions

Tertiary Level of Support One-on-one interventions

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Primary Prevention:PBS is a framework, not a curriculum

Team-based, data-driven approach Clarify and define expectations Teach all students the expectations Planned and implemented by all adults in the school Give opportunities to practice Reinforce students consistently, facilitate success Rules, routines and physical arrangements Monitor student progress Use school-wide data to identify students who need more

support

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Primary Prevention: Baseplan

PreventionRules

RoutinesArrangements

Remediation

Rules - Tardy “must be inside the room”Routines – warning bell 30 sArrangements – faculty/staff in doorways and hallways providing prompts

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Instructional Approach

Behavioral expectations taught directly like academic skills

Academic engagement & success are maximized

Influence of instructional support is considered

George Sugai, University of Oregon

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A Balanced Approach

Reinforcement (Success)

Punishment (Failure)

4:1

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Underlying Principles of Effective Management

What are the predictable failures?

What can we do to prevent this failure?

How will we maintain consistency?

How will we know if it is working?

2

1

3

4

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Primary Prevention Plan

Logical = would work if done by all Feasible = can be done reasonably by all

What’s the simplest thing that would work?

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What do we do when primary prevention is not enough?

Secondary Prevention Efforts

Tertiary Prevention Efforts

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Limitations of Current Practices

Response to Intervention models utilize curriculum-based measures but not behavioral performance other than office discipline referrals (ODRs)

ODR data suffers from poor reliability if the system used to collect these data is not implemented with strong procedural fidelity

Lack of systematic methods of monitoring behavioral performance

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Primary Prevention

Academic

Behavioral Social

Goal:

Prevent Harm



Goal: Reverse Harm


Goal: Reduce Harm


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Solutions to the Problem

Incorporate systematic screening tools to monitor the level of risk at a given school to identify students whose behavior patterns suggest nonresponsiveness

Available tools: Systematic Screening for Behavior Disorders

(SSBD; Walker & Severson, 1992)

Student Risk Screening Scale (SRSS; Drummond, 1994)

Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997)

Behavioral and Emotional Rating Scale (BERS; Epstein & Sharma, 1998)

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Illustrations

Practical illustrations of how to use these screening tools within a three-tiered model as a part of regular school practices at the elementary, middle, and high school levels.

Used within the context of three-tiered models of support, systematic screening tools: Measure the overall level of risk present in a school over

time, and Identify students who may require more targeted supports in

the form of secondary and tertiary prevention efforts.

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Using the Systematic Screening for Behavior Disorders

Using the Student Risk Screening Scale

An Illustration at the Elementary School Level

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Designing the Primary Plan

A team-based approach: An administrator, two general education teachers, a special education teacher, a reading specialist, a counselor, a parent, and a student attended a year long PBS training series where they developed a comprehensive three-tiered model of support to meet students’ progressive needs.

The primary plan contained academic, discipline, and social skills components specifying student, teacher and parent responsibilities for each component.

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Procedures for Teaching

Three behavior expectations: Respect Best Effort Responsibility

Expectations were taught with: Classroom lessons Posters Skits at assemblies Broadcasts over the intercom in the morning

Setting

Classroom Hallway Playground Cubbies Cafeteria Restrooms

Respect -Eyes on speaker

-Listen

-Follow directions

-Space & materials

-Walk

-Quiet

-Hands off walls

-Hands to self

-Follow game rules

-Respond when called

-Share/include everyone

-Use your own stuff

-Wait your turn

-4 people at a time

-Hands to self

-Low voice

-Eat your own food

-Clean up

-Clean up

-Allow privacy by only knocking on door once

Best Effort -Quality of work is accurate, neat, and complete

-Watch the person in front of you

-Zone Zero

-Walk on 3rd square

-Pick up trash

-Report unsafe objects or behavior

-Help keep area safe and clean

-Eat, then talk

-Stay in seat

-Keep floor clean

-Appropriate use of facilities

Responsibility -Follow Eagle Expectations

-Be on time

-Be prepared

-Observe rules of tattling vs. telling

- Be Aware of personal space

-Report visitors without stickers

-Remind others to be quiet

-Be Aware of personal space

-Follow playground rules

-Play approved games

-Put materials and clothes where they belong

-Unpack all materials

-Know what to order

-Bring lunch/ lunch money

-Get all items

-Raise hand

-Wash hands

-clean up after self and others

-Report messes

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Procedures for Reinforcing

PBS Tickets paired with behavior specific verbal praise

Daily classroom drawings

Weekly school wide drawings

Quarterly assemblies

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Procedures for Monitoring

Procedures for Monitoring Student Outcomes Overall Level of Risk Treatment Integrity Social Validity

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Elementary Assessment Schedule

Measure Quarter 1 Quarter 2 Quarter 3 Quarter 4

Attendance X X X X

SWIS (ODR) X X X X

GEIT & SPED X X X X

IAI Reading & Math X X

STARS Reading X X

TOWL (Writing) X

TCAP X

Tickets X X X X

SRSS & SSBD X X X

Treatment Integrity X X X X

EBS Survey X X

Social Validity X X

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SSBD Screening ProcessPool of Regular Classroom Students

TEACHER SCREENINGon Internalizing and Externalizing Behavioral

Dimensions

3 Highest Ranked Pupils on Externalizing and on Internalizing Behavior Criteria

TEACHER RATINGon Critical Events Index and Combined

Frequency Index

Exceed Normative Criteria on CEI of CFI

DIRECT OBSERVATIONof Process Selected Pupils in Classroom

and on Playground

Exceed Normative Criteria on AET and PSB

PASS GATE 1PASS GATE 1



Pre-referral Intervention(s)

Child may be referred to Child Study Team

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What is the Student Risk Screening Scale?

The SRSS is 7-item mass screener used to identify students who are at risk for antisocial behavior.

Uses 4-point Likert-type scale: never = 0, occasionally = 1, sometimes = 2, frequently = 3

Teachers evaluate each student on the following items- Steals - Low Achievement- Lies, Cheats, Sneaks - Negative Attitude- Behavior Problems - Aggressive Behavior- Peer Rejection

Student Risk is divided into 3 categories- Low 0 – 3- Moderate 4 – 8- High 9 + (SRSS; Drummond, 1994)

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Student Risk Screening Scale(Drummond, 1994)

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Secondary InterventionsSupport Description Schoolwide

Data: Entry Criteria

Data to Monitor Progress:

School wide data? Other?

Exit Criteria

Check, Connect, and Expect

This program involves checking in with a mentor at the beginning and end of the day to receive a performance goal for the day.

Students who score moderate to high risk on the SRSS

Daily BEP Progress Reports

Students who have met there goal consistently for 3 weeks will move to the self-monitoring phase.

Project WRITE

Improving the writing skills of students with behavioral concerns and poor writing skills

Behavior (SRSS: SSBD) and TOWL (<25)

Writing probes

Story elements of 5+ more (stable)

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Tertiary InterventionsSupport Description Schoolwide

Data: Entry Criteria



Exit Criteria

Function-based interventions

Individualized interventions developed by the behavior specialist and PBS team

Students who score high risk on the SRSS

Target and replacement behavior

Students who have met there goal consistently for 3 weeks will move to maintenance.

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Will this work at in middle and high schools?

Lane, Robertson, & Graham-Bailey (2006)

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Changes in Student Risk Status Over Time

Change Status Instructional RatersScreening Status N Percentage

Fall 2004 Fall 2005

Stable 332 80.98Low Low 321 78.29Moderate Moderate 9 2.20High High 2 0.49

Improved 61 14.89Moderate Low 45 10.98High Moderate 4 0.98High Low 12 2.93

Declined 17 4.14Low Moderate 16 3.90Low High 1 0.24Moderate High 0 0

Note. Low refers to Student Risk Screening Scale (SRSS; Drummond, 1993) total scores of 0 to 3; Moderate refers to SRSS total scores of 4 to 8; High refers to SRSS total scores of 9-21.

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Changes in Student Risk Status Over Time

Screening StatusChange Status Fall 2004 Fall 2005 Support Considerations

StableLow Low Responder: Additional Supports Not RequiredModerate Moderate Secondary PreventionHigh High Tertiary Prevention

ImprovedModerate Low Responder: Additional Supports Not RequiredHigh Moderate Responder: Additional Supports Not RequiredHigh Low Responder: Additional Supports Not Required

DeclinedLow Moderate Secondary PreventionLow High Tertiary PreventionModerate High Tertiary Prevention

Note. Low refers to Student Risk Screening Scale (SRSS; Drummond, 1993) total scores of 0 to 3; Moderate refers to SRSS total scores of 4 to 8; High refers to SRSS total scores of 9-21.

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Secondary Intervention Plan

Step 1: Identify your secondary supports Existing and new interventions

Step 2: Determine entry criteria Nomination, academic failure, etc.

Step 3: Identify outcome measures Pre and post tests, CBM, etc.

Step 4: Identify exit criteria Reduction of discipline contacts, academic success, etc.

Step 5: Consider additional needs

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Sample Secondary Intervention Plan

Support Description Method Currently Used to Identify

Students

Schoolwide Data: Entry

Criteria



Exit Criteria

Study Skills Group

Students meet with a paraprofessional 2 days a week for 30 minutes lesson in study skills. Lessons are conducted during the regular school day.

Teacher recommendation

One or more below average grade (C or N); or students who are missing 30% of class work in a give month

Teachers complete a school-home note with the percentage of assignments completed/ participation and an accuracy rating

Students are exited from the program when they have 3 consecutive weeks of 90% or better work completion or participation with 80% or better work accuracy

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Agenda1. Introduction: Why do we need three tiered models of prevention?






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Primary Prevention

Academic

Behavioral Social

Goal:

Prevent Harm



Goal: Reverse Harm


Goal: Reduce Harm


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Primary PreventionPrimary Prevention

Primary Plan Overview Sample Primary Plan Teacher Expectation Survey Results School Expectations and Matrix Building Your Primary Plan

Area I: Academic Area II: Behavior Area III: Social Skills Procedures for Teaching Procedures for Reinforcing Procedures for Monitoring

EBS Survey

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Implementation Features

1. Establish PBS leadership team2. Secure school-wide agreements and supports3. Establish data-based action plan4. Arrange for high fidelity implementation5. Conduct formative data-based monitoring

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What do PBS schools look like? More than 80% of students can tell you what is expected of

them and give behavioral example Taught, actively supervised, practiced, and acknowledged.

Positive adult-to-student interactions exceed negative Evidence-based practices are being used Function-based behavior support is foundation for addressing

problem behavior. Data- and team-based action planning and implementation are

operating. Administrators are active participants. Full continuum of behavior support is available to all students

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“Working Smarter” means…

Do less, but better Do it once, but for a long time Invest in clear outcomes Invest in sure thing

www.pbis.org

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Data-based decision making

George Sugai, University of Oregon

Reinforcement Rates Academic and Behavior Screenings Academic and Behavior Outcomes Treatment Integrity

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Primary Plan Components

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Part I: Academic

Part II: Behavior

Part III: Social Skills

Elements

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School-wide Expectations

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School Expectations

3-5 Expectations Clearly stated Taught Reinforced

Expectations should be explicitly defined for each school setting.

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Example

Contra Costa High School’s Expectations

1. Arrive on time and ready to learn

2. Be respectful to both peers and adults

3. Show school pride

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Expectation Matrix

Middle/ High School

Settings

Classroom Hallway Cafeteria Bathroom Bus

Arrive on time prepared to learn

- Be seated in assigned seat before tardy bell- Bring all necessary materials, including the school planner- Make up work when absent- Participate in all activities- Complete all assignments to the best of your ability

- Use a quiet voice- Walk on the right side of the hallway- Keep hands to yourself

- Know your order when walking through lunch line- Have money ready - Find a set quickly and stay with it

- Use facility quickly and quietly,- Return to class promptly

- Be ready when bus arrives- Carry on all personal belongings needed

Be respectful to peers and adults

- Follow the dress code- Use kind words towards others; avoid gossip- Use appropriate ways to show affection to others- Listen to and follow directions- Be truthful

- Keep hands to yourself- Use appropriate ways to show affection to others- Walk in the hallway

- Share lunch tables with others- Follow directions first time asked- Keep food on your plate- Eat your own food- Clean up area

- Take care of your own business- Remain in own stall- Minimize chatting- Keep water in the sink

- Share seating on the bus- Listen to and follow the bus driver’s directions the first time given- Speak in a quiet inside voice- Remain seated after entering the bus

Show school pride

- Keep desk area clean- Use classroom supplies and books appropriately

- Respect materials- Keep the hallways clean

- Keep lunch tables clean- Clear any trash- Recycle

- Keep bathroom clean- Throw away any trash properly

- Keep bus clean- Take off all personal belongings

ELEMENTARY Settings

Classroom Hallway Cafeteria Playground Bathroom Bus

Respect - Follow directions-Use kind words and actions- Control your temper - Cooperate with others - Use an inside voice

- Use a quiet voice- Walk on the right side of the hallway- Keep hands to yourself

- Use an inside voice- Use manners- Listen to and follow adult requests

- Respect other peoples’ personal space- Follow the rules of the game

- Use the restroom and then return to class - Stay in your own bathroom stall- Little talking

- Use kind words towards the bus driver and other students- Listen to and follow the bus drivers’ rules

Responsibility - Arrive to class on time- Remain in school for the whole day- Bring your required materials- Turn in finished work- Exercise self-control

- Keep hands to yourself- Walk in the hallway- Stay in line with your class

- Make your choices quickly- Eat your own food- Choose a seat and stick with it- Clean up after yourself

- Play approved games- Use equipment appropriately- Return equipment when you are done- Line up when the bell rings

- Flush toilet- Wash hands with soap- Throw away any trash properly- Report any problems to your teacher

- Talk quietly with others- Listen to and follow the bus drivers’ rules- Remain in seat after you enter the bus- Use self-control

Best Effort - Participate in class activities- Complete work with best effort- Ask for help politely

- Walk quietly - Walk directly to next location

- Use your table manners- Use an inside voice

- Include others in your games- Be active- Follow the rules of the game

- Take care of your business quickly- Keep bathroom tidy

- Listen to and follow the bus drivers’ rules- Keep hands and feet to self

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Academic Component

Why? Academic performance influences student behavior Teachers’ behavior will reflect students’ behavior

How? Academic expectations should be stated clearly and enforced

consistently Fosters an environment which sets the stage for productive

academic time Consider

High traffic areas Praise: Correction Statement Ratio Entry activities Closing activities

Look at your teacher expectation survey for suggested focus areas (see cooperation).

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School Behavior Plan

Two-Fold1. Reactive

- Schoolwide consequences for inappropriate behaviors

2. Proactive- Clearly stated expectations- Explicitly teach expectations- Model expectations- Give students opportunities to display

expectations- Provide feedback and reinforcement- Monitor behavior

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Elements of School-wide Behavior Plan

1. Common approach to discipline

2. Clear set of positive behavioral expectations

3. Procedures for teaching expected behavior

4. Continuum of procedures for encouraging expected behavior

5. Continuum of procedures for discouraging inappropriate behavior

6. Procedures for on-going monitoring and evaluation

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Social Skills Plan

Use schoolwide data to identify primary concerns within school EBS Survey

We will use these results to identify common concerns across faculty.

Concerns may include Bullying Prevention Programs Social Skills Instruction Conflict Resolution Instruction Violence Prevention Programs

Examples of Schoolwide Programs Bullying

The Bully Prevention Program Olweus, 2000 $200 per school, $65 per teacher for materials Phone: 303-492-8465

Steps to Respect Committee for Children, 2001 $649 (currently 50% off -- $325) www.cfchildren.org

Bully-Proofing Your School Garrity, Jens, Porter, Sager, and Short-Camilli, 1994 $449.49 for entire program, additional materials $20 + www.sopriswest.com

Violence Prevention The Second Step Violence Prevention Program

Committee for Children, 1992 $159 per grade (Elementary, Middle, High School, Families, Spanish) www.cfchildren.org

Social Skills LIFT

Eddy, Reid, and Fetrow, 2000 Social Skills Intervention Guide *

Elliott and Gresham, 1991 $92.99 (includes 43 lessons) http://www.agsnet.com/ *Edited version

http://www.cfchildren.org/

http://www.sopriswest.com/

http://www.cfchildren.org/

http://www.agsnet.com/

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Procedures for Teaching

Posters

Lessons

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Procedures for Reinforcing

Tickets Prizes/Drawing

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Procedures for Monitoring

Attendance (Tardy; Absence Rates)Discipline Contacts (SWIS)Behavioral Performance (Behavioral Screeners)Referrals (SPED, GEIT, S-Team)Standardized Test Scores (IAI; TCAP; Gateway)Ticket Distribution/Turn-InTreatment Integrity (SET, Observation, Self-Report)

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Measure Aug Sept Oct Nov Dec Jan Feb Mar Ap May

Report Cards and Progress Reports X X X X

Writing Assessment X X X

Curriculum-based Measures (CBM) X X X X X X X X X X

State-wide Assessment X

Office Disciple Referrals (ODR) X X X X X X X X X X

Student Risk Screening Scale (SRSS; Drummond, 1994)

X X X

Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992)

X X X

Attendance X X X X X X X X X X

Counseling Referrals X X X X X X X X X X

Bullying Referrals X X X X X X X X X X

Social Validity Survey: Primary Intervention Rating Scale (PIRS; Lane, Robertson, & Wehby, 2002)

X X

School-wide Evaluation Tool (SET; Sugai, Lewis-Palmer, Todd, & Hornet, 2001)

X X

Treatment Integrity: Self-Report and Direct-Observations by an Outside Observer

X X X X X X X X X X

Rate of Access to Reinforcement (PBS Tickets) X X

Effective Behavior Supports (EBS; Sugai, Horner, & Todd, 2000)

X X

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Agenda1. Introduction Why do we need three tiered models of prevention?






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Primary Prevention

Academic

Behavioral Social

Goal:

Prevent Harm



Goal: Reverse Harm


Goal: Reduce Harm


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Thank you for your timeQuestions? [email protected]

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