Prevent-Teach-Reinforce (PTR): An Evidence-Based Functional Behavior Assessment/Behavior Intervention Process for Students Needing Tier 3

SupportsR O S E I O VA N N O N E , P H . D. , B C B A - D

I O VA N N O N E @ U S F. E D U

8 1 3 - 9 7 4 - 1 6 9 6

The contents of this training were developed under grant H324P04003 from the Department of Education

AgendaOverview PTR

PTR Process◦ Step 1-Teaming/goal setting/progress monitoring◦ Step 2 Functional assessment◦ Step 3a-Behavior intervention plan◦ Step 3b-Coaching/Fidelity◦ Step 4-Monitoring and making data-based decisions

ObjectivesParticipants will:◦ Describe the 4-step PTR Tier 3 support model◦ Identify the critical components that enhance the success of Tier 3 supports◦ Determine how the PTR process is applicable within their setting

Prevent-Teach-ReinforceTHE MODEL

What is Prevent-Teach-Reinforce (PTR)?Research project funded by U.S. Department of Education, Institute of Education Sciences◦ University of South Florida

◦ Three central Florida school districts

◦ University of Colorado, Denver◦ Two Colorado school districts

Purposes:◦ Answer the call for rigorous research◦ Evaluate effectiveness of PTR vs. “services as usual” using randomized

controlled trial◦ Evaluate effectiveness of “standardized “ approach

Where is PTR in a Multi-tiered System of Supports (MTSS)?

Participants in PTR◦

200+ students—100 treatment, 100 comparison

K-8th gradeGeneral and Special Education◦ All cognitive levels◦ All disabilities

Teacher-nominated top externalizers◦ Systematic Screening for Behavior Disorders (SSBD)

Behavioral difficulties◦ Duration– minimum 6 months◦ Frequency— minimum of 1 time per week◦ Intensity– disruption to the learning environment

PTR ProcessIntervention teams given manual and assigned PTR consultant

Four step process (aligned with problem solving process):◦ Goal Setting (Identification of Problem)◦ Functional Assessment (Problem Analysis)◦ Intervention (Intervention Implementation)

◦ Coaching and fidelity

◦ Evaluation (Monitoring and Evaluation of RtI)

PTR Preliminary Outcomes

Student Demographics by Primary DisabilityDisability N Percent

Autism 25 9.8Developmental Delay 5 2.0Emotional Disturbance 38 14.9Intellectual Disability 28 11.0Multiple Disabilities 4 1.6OHI (not ADD/ADHD) 1 .4OHI (ADD/ADHD) 8 3.1Specific Learning Disability 20 7.8Speech/Language Disability 10 3.9Visual Impairment 2 .8General Education 99 38.8TOTAL 245

Student DescriptionGrade Level

K12345678

N345353413016783

%13.921.621.616.712.26.52.93.31.2

Lunch StatusRegularFree/Reduced

77150

31.461.2

GenderFemaleMale

45200

18.481.6

00.10.20.30.40.50.60.7

Baseline Post-test

AET

rat

ioTime Interval

AET

Treatment n =126

Control n=98

p<..01g = .51

Randomized Controlled Trial Results

Wait-List Control to Treatment Results

0.000.100.200.300.400.500.600.70

Baseline Post-testTime Interval

AET

N = 43p<..05

708090

100110120130140

Baseline Post-testTime Interval

Problem Behavior (SSRS)

N = 47p<..01d = .60

Teacher OutcomesFidelity◦ Majority of teachers achieved .80◦ Mean # coaching/training sessions = 3.5◦ Prevention higher than Teach and Reinforce

Social Validity◦ Modified Teacher Acceptability Rating Form (TARF; Reimers & Wacker, 1988)—15

items◦ 5-point Likert Scale◦ 124 teachers◦ Overall—4.16 (.52)

◦ Willingness to carry out plan—4.80 (0.42)◦ Like the procedures—4.46 (0.64)

Alliance◦ Teachers rated PTR consultants highly (4.80 mean)◦ Highest—trust, follow-through, collaborative

The PTR Process

Tools (handout)Pages 2-3 describe general indicators for an effective FBA/BIP

Pages 4-9 describe specific activities for each step

Teaming (Before the Process is Started) Teaming: A collaborative process

Determine relevant team members

Suggestions—3 levels of knowledge represented:◦ Members ◦ Person with knowledge of student (e.g., Classroom teacher, instructional assistant,

parent)◦ Facilitator—Someone with knowledge of functional assessment, behavioral

principles (PTR consultant, school-based consultant)◦ Someone with knowledge of context (e.g., administrator or designee)

Collaboration Activity-p. 2 Activity Packet

Teaming (PTR Style)•Optional forms (last few pages of packet)

•Best used for situations in which the team may not be collaborating effectively

•Forms for creating an effective cohesive team– Classroom Team Survey– Teacher Work-Style Survey– Paraeducator Work-Style Survey– PTR Work-Style Comparison Sheet (used by facilitator)

•Purposes: To identify potential issues enhancing and impeding effective intervention implementation

Step 1-Goal SettingIDENTIFY THE PROBLEM

Step 1: Goal SettingPurpose: ◦ Identify behaviors of greatest concern to the team and possible replacement

behaviors (teach)◦ Prioritize and operationalize behaviors targeted for intervention◦ Develop teacher friendly baseline data collection system

Areas that can be targeted:◦ Problem behaviors◦ Social skills◦ Academic behaviors◦ Different options/versions on pages 10-14 in PTR Tools handout

Case Study 1Mike◦ 9-year-old male◦ ESE Classification: Autism◦ Placement: Self-contained, autism classroom with 6 students ◦ Nonverbal: Uses signs, Dynamite, pictures to communicate ◦ Team: Teacher and two aides, PTR Consultant

Mike’s Team-Goal SettingBEHAVIORS TO DECREASETarget Behavior:• Screaming• Hitting

• Getting out of seat• Bossing peers

Operational Definition:• Loud, high pitched noise heard outside the classroom• Touching peers or adults with open hand, fist, foot, or

object while screaming

BEHAVIORS TO INCREASE

Target Behavior:• Transition from

preferred to non-preferred activities

• Express frustration using his communication

• Ask for a break or attention

• Initiate peer interactions using communication

Operational Definition:• Moving to non-preferred activity and engaging in

communication at inside voice volume and pitch

• Use communication (voice output device, signs, pictures) to request a break or attention

Case Study 2-Jeff General Education

Retained second grader

Class had 19 students

Team included two co-teachers ◦ both with their own second grade classrooms

Jeff’s BehaviorsBEHAVIORS TO DECREASETarget Behavior:• Disruptive behaviors

• Negative comments

Operational Definition:• Tapping pencil, making loud comments without raising

hand, tapping person seated near him, getting out of seat to sharpen pencil without permission.

BEHAVIORS TO INCREASE

Target Behavior:• On-task behavior

• Independent work completion

• Interact with peers at appropriate times

Operational Definition:• Actively participating in group instruction by raising hand to

speak and looking at teacher; during independent work, keeping pencil moving on paper in a way that gets task completed, letting neighbors work, raising hand to ask for help

• (this is part of on-task behavior-was measured by %age of assignments completed)

Step 1: Progress Monitoring SystemIndividualized Behavior Rating Scale Tool – IBRST ◦ Direct Behavior Rating (DBR)—Hybrid assessment combining features of

systematic direct observations and rating scales◦ Efficient and feasible for teacher use◦ Provides data for decisions◦ Prioritized and defined behaviors measured◦ Requires minimum of 1 appropriate and 1 inappropriate behavior

Components of IBRSTScale—5 point foundation◦ Can be flexible and add or subtract Likert scale points◦ Can be creative and use columns/rows for different time periods/people,

etc.

Key—Vital for teacher ◦ Definition of behavior◦ Directions—over what time period of day will they be rating the behavior?

What do each of the anchor points represent as perceptual estimates?

Practice◦ After setting up, ask teacher to rate student’s behavior from earlier in the

day or previous day◦ Adjust if necessary

Defining BehaviorsNONEXAMPLES

Grabs

Hits

EXAMPLES

•Grabs clothing of peers by pinching and bunching fabric with his fist

•Hits peers and adults on their bodies by slapping with hand (moderate intensity), pinching flesh with fingers (leaves mark), punching by making a fist with hand and making contact with peer/adult bodies

Case Study 1- Mike: Behavior Rating Scale Behavior

Screaming 9+ times7-8 times5-6 times3-4 times0-2 times

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Hitting 8+ times6-7 times4-5 times2-3 times0-1 times

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Expressing Frustration

40%+30-40%20-30%10-20%0-10%

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Transition to Non-preferred

Whimper or squealLouder than indoor voice

Outdoor play voiceLouder than outdoor play

Ear penetrating

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IBRST—Key for MikeScreaming: Loud, high-pitched noise heard outside the classroom. Rate your perception of Mike’s screaming episodes over the entire day. 5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.

Hitting: Touching peers or adults with open hand, fist, foot, or object while screaming. Rate your perception of Mike’s hitting episodes over the entire day. 5 = Terrible day; 4 = Typical bad day; 3 = So-So day; 2 = Good day; 1 = Fantastic day.

Expressing frustration: Using communication (voice output device, signs, pictures) to request a break or attention. Rate your perception of the percentage of opportunities Mike used appropriate communication 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible day

Transition to non-preferred: Moving to non-preferred activity and engaging in communication at inside voice volume and pitch. Rate your perception of the overall intensity of Mike’s transitioning behaviors. 5 = Fantastic day; 4 = Good day; 3 = So-so day; 2 = Typical bad day; 1 = Terrible day

IBRST Inter-rater Reliability (Iovannone, Greebaum, Wang, Kincaid, & Dunlap, 2014)Kappa coefficients of:◦ Problem Behavior 1 (n = 105): .82◦ Problem Behavior 2 (n = 90) : .77◦ Appropriate Behavior 1 (n = 103): .65◦ Appropriate Behavior 2 (n = 56): .76

Agreement of IBRST and Direct ObservationIn recent multiple baseline study, ◦ Problem Behavior-74% of ratings in exact agreement, 16% within one scaled

score◦ Appropriate Behavior-75% exact agreement, 14% within one scaled score.

Cohen’s Kappa = 0.70 (p<0.001)

Barnes, 2015

Secondary Level ModificationsTeams with 3 or more members◦ Select one team member who will be the primary interventionist◦ Behavior identification and IBRST development will be focused on that

person’s situation◦ Other team members provide input/support◦ If desired, other team members can record IBRST data in their settings—

rating descriptions can stay the same or minor modifications can be made◦ Each row of BRS can represent a different teacher OR◦ Each teacher can keep own IBRST

◦ Facilitator collects all IBRST ratings at specified times

Variations of the Individualized Behavior Rating Scale Tool (IBRST)

Facilitation TipsHave team members submit the goal setting table as homework

Have a visual that summarizes all of the input

Do not reword input—wait until meeting to have team provide clarification

If step is conducted during problem solving meeting, use group processes to ensure all team members participate◦ Use post-it notes or index cards and provide several to each team member◦ Use 2 minute thinking time, have team members write input on notes/cards◦ Use round robin to get input from all

TroubleshootingIBRST Data Collection

Decide upon a method of prompts to remind teachers/team to:◦ Rate the behaviors on the IBRST daily (or frequency determined by the team)◦ Have data ready for analysis at ALL meetings related to the student and the plan◦ Identify a key person (who likes Excel or other spreadsheet/data chart software) who can

transfer the scores into a graph

Too many behaviors identified

Ask teachers/team if they could select one problem behavior that, if reduced, would make each day at least 50% better for everyone (student, school, family)

Defining behaviors

If teachers/team have difficult time using words to define the define the behavior, ask them to demonstrate the student doing the behavior. Write down the motor movements, verbal communication, other key features that define the behavior.

Practice TimeSetting up a behavior rating scale◦ One volunteer◦ Identify a behavior of concern◦ As a group, walk through the steps to set up the scale

Behavior Ratings

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Key:

Activity—Step 1

Step 1 Activity 2b InstructionsPage 3 of ACTIVITY PACKET

Watch the video of Paris

Identify one problem behavior

With your team, agree upon an operational definition of the behavior

Write it on the goal form under problem behavior

What would you target as a replacement behavior?

Define the behavior in measurable/observable terms

ParisFirst grade student in general education

Team included teacher, school psychologist, guidance counselor, and special education coordinator

School was considering referring Paris for special education eligibility assessment due to behavior problems

Paris Baseline Videos

Step 2: Functional behavior assessmentANALYZE THE PROBLEM

Given 60 seconds, use 4 straight lines to connect all of the dots without lifting

your pen (PAGE 4 ACTIVITY)

Child

A box to think outside of:

Step 2: PTR Assessment (FBA)Problem Analysis

PTR Assessment (FBA) ◦ Prevent: Antecedents/triggers of problem behavior◦ Teach: Function(s) of problem behavior, possible replacement behaviors◦ Reinforce: Consequences associated with problem behavior, possible

reinforcers

Assessment form completed by each team member

Facilitator summarizes input on Assessment Summary Table and develops draft hypothesis

Team reaches consensus

Facilitator has conducted at least ONE direct observation of student and context prior to this step

57

Several Versions of PTR AssessmentElementary Version (pp. 18-23)

Secondary Versions (pp. 24-30; 31-36)

Student Version (pp. 37-42; 43-48)

Learned Functions of BehaviorsGET◦ Obtain

◦ Activities, people, tasks, tangibles, sensory, pain attenuation

GET OUT OF◦ Escape/Avoid/Delay

◦ Activities, people, tasks, tangibles, sensory, pain

NAME THAT FUNCTION!

Are Power, Control, Jealousy, Revenge Functions?

IOVANNONE, ANDERSON, & SCOTT, 2013

Completing the PTR Assessment Organization Table (pp. 48, 49)

Step 2: Case Study – MikeAssessment Summary Table of Problem Behavior

Antecedent/Prevention Data Teach/Function Data

Consequences/ Reinforce Data

Non-preferred tasksReading, Math—when in a group

Other students upset/madTeacher attending to othersTransition

Preferred (one-one) tonon-preferred (group

reading/math)Change in schedule

Denied item, told no, or tofix something

Gain attentionPeers, adults

Delay

Access to items

RedirectedReprimandedCalm/soothe

Personal spaceLater must

complete task

Loss of or delay in reinforcement

Scre

amin

g, H

ittin

g

Step 2: Case Study – MikeAssessment Summary Table of Absence of Problem Behavior

Antecedent/ Prevention Data

Teach Data Reinforce Data

Independent workOne-on-one

attentionSpecials

Peer interactionGetting attentionRaising handSharing attentionConversation skillsTaking turnsWaitingSelf-managementAsking for breakExpressing emotions

Treasure boxMovieAttentionHelping teacherGoing to media

centerGoing outsideWalkFood

Abse

nce

of S

crea

min

g,

HItt

ing

Mike’s HypothesesWhen…. he will As a result…1. Mike is asked to complete non-preferred tasks in small groups (Reading, Math), stop a preferred one-one activity or transition to a non-preferred group activity, or fix an error, or

2. The teacher is attending to other students,

scream and hit.

scream and hit

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and peers

1. Mike is (a) asked to complete non-preferred tasks in small groups (Reading, Math), stop a preferred one-one activity or transition to a non-preferred group activity, or fix an error, or

2. The teacher is attending to other students,

(a) express his frustration appropriately and (b) transition from preferred to non-preferred tasks

Ask for attention

Mike (a) delays the transition or non-preferred activity and (b) gets attention from teachers and peers

Mike gets attention from teachers and peers

Inap

prop

riate

App

ropr

iate

Jeff’s HypothesisWhen…. he will As a result…

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing,

Walk around the room, talk to and touch peers, put his head down, tap his pencil, and not initiate writing

He avoids/delays non-preferred tasks

Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing

Be academically engaged and independently complete tasks within the time assigned

He avoids/delays non-preferred tasks

Inap

prop

riate

Appr

opria

te

Step 2 Activity: Paris

Step 2: Activity InstructionsPage 5-6 ACTIVITY PACKET

Review the PTR Assessment Summary for Paris (page 5)

Develop a problem behavior and appropriate behavior hypothesis (page 6)

Feel free to use the cheat sheet

Be ready to share

Facilitation TipsTeam members complete for homework

During meeting, use as an interview

During meeting, give each team member 15 minutes to complete. Give 15 minute break to allow time for facilitator/coach to synthesize information in Assessment Organization Table

Secondary: May want to change forced choice options to make appropriate for secondary environments (although very few words need to be changed)

Family version of PTR Assessment available

Categorizing/aligning: Ensure that your pathway/table is aligned (e.g., triggers are categorized, function is identified for each set of triggers)

TroubleshootingTeam select all options/boxes after question◦ Ask them to select the top 3-5 that they have 100% confidence is related to the

behavior occurrence◦ Example—Prevent Question 4 almost all boxes selected◦ Say to the team, “If I came into your classroom tomorrow and would give you $1 million to make

Sarah’s behavior happen, which of these would you do first to get the money? Second? Third?

Not sure of function◦ First, separate antecedents/triggers by categories (e.g., triggers related to

demands to do non-preferred tasks, triggers related to peer interactions, etc.). ◦ Ask team what function seems to best fit with these categories (e.g., non-

preferred tasks—is behavior’s purpose to delay/escape the non-preferred task or to get attention)

◦ If not sure between escape/attention, probe the team further◦ For example, if the child was doing a preferred activity, would the behavior still occur? If yes, it may be

attention. If no, it may be escape.

Step 3: PTR Intervention PlanDEVELOPING AND IMPLEMENTING AN INTERVENTION

Behavior Intervention Plan Development: Essential FeaturesBehavior interventions selected by team from PTR Menu (elementary, secondary, student, and newest version on pp. 50-53)

Intervention scores/ranks compiled by facilitator (pp. 54-55; 56-57)

Team/teacher provides description on how interventions will look in classroom setting

Facilitator guides the team/teacher by using ABA principles to develop most effective intervention that matches the team/teacher context

Each intervention selected is described in detail by task-analyzing steps, providing scripts, describing adult behaviors, NOT student behaviors (page 58-59 template)

After plan developed, time is scheduled to train the team/teacher the strategies prior to implementation

Plans for training students and other relevant individuals

Support provided once plan is implemented

Which One Will More Likely be Consistently Implemented?

Provide choices of where to sit

Give preferential seating

Provide proximity control

Intersperse preferred and non-preferred activities

Use a visual schedule.

Provide Choices: The teacher will provide Don with a choice immediately after assigning him independent work in class. Choice options are: (a) materials to use for assignment; choice of leadership activities; (b) where to sit; (c) who to do the assignment with

Steps for Provide Choices:

1. Immediately after giving the class the independent math assignment, go over to Don and present him with a choice option.

2. When presenting him with a choice, say “Don, where do you want to sit? X or X?”

3. After Don makes his choice, say, “Thanks for making a great choice”and release him to his choice.

BIP-Prevention Strategies BIP-Prevention StrategiesOR

Replacement BehaviorsFunctional Equivalent vs. Alternate SkillFUNCTIONAL EQUIVALENT (EXAMPLES)Escape functions◦ Ask for a break◦ Ask to wait◦ Ask to terminate

Access attention functions◦ Ask for attention◦ Ask for a hug

Access specific object or activity◦ Ask for an object◦ Ask for a specific activity

ALTERNATE SKILL (EXAMPLES)

Raise hand for help or answering questions/participation

Independently complete work

Appropriately transition from point a to point b

Be academically engaged

Initiate social interactions

Make appropriate social comments

Linking Hypotheses to Interventions Each component of the hypothesis has an intervention

The “when” (antecedent, setting event) = prevention intervention

The “behavior” (what happens when the antecedent is present) = Teach intervention (i.e., replacement behavior teaching steps)

The “function” (the outcomes the student gets by doing the problem behavior) = reinforcement

Example

When Joey is asked to transition from a preferred (e.g., free time) activity to a non-preferred activity (e.g., academic activity)

He will scream loudly and run in circles

As a result, he gets to delay the non-preferred activity. (consequences-teacher verbally redirects, reprimands, puts him in time-out)

WHEN OR ANTECEDENTS

BEHAVIOR FUNCTION

Matching Interventions to HypothesisWhen Joey is asked to transition from a preferred (e.g., free time) activity to a non-preferred activity (e.g., academic activity)

Which Prevention interventions will directly modify the trigger/antecedent of ‘asking Joey to transition from preferred to non-preferred activities?

Providing Choices

Transition Supports

Environmental Supports

Curricular Modification

Stay Close

Classroom Management

Setting Event Modification

Peer Modeling or Peer Reinforcement

Joey’s Prevention InterventionPreventionIntervention Strategy

Description/steps Comments

Transition Supports

A transition support will be used when Joey transitionsfrom preferred to non-preferred activities.STEPS FOR TRANSITION SUPPORT INTERVENTION FROM FREE-TIME TO WORK1. The visual timer will be set for the amount of time

free time lasts (e.g., 5 minutes).2. The teacher will set a timer (potty watch or phone)

to buzz when it is 2 minutes before transition.3. Immediately after hearing the 2-minute timer, the

teacher will give Joey a transition cue by saying “Joey (and rest of the class), we have 2 minutes until (name of activity).

4. The teacher or assistant will then go over to Joey immediately after the transition cue and say “Time to clean up” while showing Joey the “first-then” card and pointing to the First and the Then.

Matching Interventions to HypothesisHe will scream (behavior).

What will we teach Joey to do (Teach interventions) instead of screaming? What are some appropriate behaviors and strategies for teaching?

**Replacement BehaviorFunctional Equivalent Ask to wait

Alternate Skill (desired) Transition from preferred to non-preferred

Specific Academic Skills

Problem Solving Strategies

General Coping Strategies

Specific Social Skills

Teacher Pleasing Behaviors

Self-Management

Independent Responding

Increased Engaged Time

Joey’s Teach InterventionsIntervention Strategy

Description/Steps Comments

Alternate Skill: Transition appropriately from point to point

Joey will be taught appropriate transition behaviors. The transition behaviors are:• Clean up area• Put his stuff in his pockets• Get up• Go over to his schedule• Walk to seat or assigned areaSTEPS FOR TEACHING TRANSITION APPROPRIATELY FROM POINT TO POINT1. At the beginning of each day, an adult will read a PPT book

with Joey, discussing each of the appropriate behaviors.2. While the transition is occurring, the teacher will use

Modeling. For each transition behavior (e.g., clean up area, put stuff in pockets, etc.), the teacher will perform the behavior and verbally comment/state the action while performing it. (e.g., “We’re cleaning up the area.” “We’re putting our stuff in our pockets.”).

3. After the model, if Joey does not immediately perform the modeled behavior, the teacher will provide Joey a verbal prompt to have him engage in the transition behavior by saying, “You’re turn to clean up the area.”; “Your turn to put your stuff in your pockets.”).

Make PPT Book

Joey’s Teach InterventionsIntervention Strategy

Description/Steps Comments

Functional Equivalent Replacement Behavior-Askto Wait

Joey will be taught to say “wait” if he chooses to delay the transition.STEPS FOR TEACHING JOEY TO COMMUNICATE “WAIT”1. If joey does not perform the appropriate behavior of

cleaning up the area after the transition support is delivered (or after the verbal prompt following modeling), the teacher will prompt him to use his communication behavior “wait”.

2. Initially, the teacher will say to Joey, “Joey, it looks like you want to wait. Say “wait”.”

3. As soon as Joey says “wait”, say “Okay, you have 2 minutes to wait. You can wait (neutral area).

4. The adult will set the timer for 2 minutes. As soon as the 2 minutes are up, the transition support cue will be provided to Joey.

5. Repeat steps 1-4 until Joey engages in appropriate transition behavior.

Matching Interventions to HypothesisAs a result, he gets to delay the transition from a preferred to a non-preferred activity.

How can Joey be reinforced with his function (delay) for performing his replacement behavior(s)? Will he need other (artificial) reinforcers?

**Reinforce Replacement Behavior**Function DelayAdditional

**Discontinue Reinforcement of Problem Behavior

Joey’s Reinforce InterventonsIntervention Strategy

Description/Steps Comments

Reinforce functional equivalentbehavior-saying “wait”

STEPS FOR REINFORCING JOEY SAYING ‘WAIT’1. Each time Joey says “wait” when a transition is occurring, the

teacher will provide a positive comment (e.g., “You said you need to wait. Thank you for letting me know that. You have 2 minutes to wait in the (neutral) area.”).

2. Release Joey to wait.

Reinforce alternate(desired) behavior-transition appropriately

STEPS FOR REINFORCING JOEY FOR TRANSITIONING APPROPRIATELY FROM POINT TO POINT1. Immediately after Joey performs an appropriate transition

behavior, the teacher will provide a positive comment by saying “You did a great job cleaning up.”; “You put your stuff away.”).

2. When Joey completes his appropriate transition, the teacher will show him 2 reinforcer choices and allow him to select one. The teacher will say, “You transitioned the right way. You earned a reward. Which do you want (showing him the 2 reinforcers)?” Examples of reinforcers are Goldfish crackers, gummies, cookies

3. Immediately after Joey makes his choice, the teacher will provide him the reinforcer and say “You earned a/an X for transitioning correctly. Yay!”

Prevent Strategies

Specific Strategy steps

Environmental Support

Mike’s visual schedule will be modified to detail the number of and type of activities he is to complete during non-preferred activities. For example, if math involves listening to a lesson, doing a hands-on activity, and completing a worksheet, his visual schedule will list each activity under math using either a picture of the type of activity or using numbers that correspond to a number on the worksheet.Environmental Support Steps:1. Each week, an adult will review Mike’s schedule and activities and

ensure that the visual schedule matches the activities.2. Before a non-preferred activity, the teacher will review the visual

schedule with Mike and the tasks he will do by reviewing the visual schedule and pointing to each task while describing it.

3. After reviewing the schedule, the teacher will ask Mike some questions to make sure he knows the order of activities.

4. The teacher will remind Mike that after he finishes each activity, he will put an X over it to show it is finished.

5. After Mike completes each activity, the teacher (initially) will prompt Mike to place an X over the activity on his schedule.

Mike’s Intervention Plan

Mike’s Intervention PlanPrevent Strategies

Specific Strategy steps

Curricular Modification

Mike will be given an easy, independent activity, such as a worksheet, to complete upon transitioning to a non-preferred activity or an activity that requires him to wait, such as group activities.Curricular modification steps:1. At the beginning of each week, the teacher will identify the

transitions that would be appropriate for the curricular modification strategy.

2. Immediately after the transition signal for the specified transitions, the teacher will say “Mike, how about doing this __ first before going to __?”

3. Wait for Mike to complete the activity. During this time, provide minimum attention (e.g., limited talking, eye contact)

4. At the end of the activity, prompt Mike to transition (if he does not transition) or prompt him to use his replacement behavior (I need to calm down). 89

Mike’s Intervention PlanTeach Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Mike will be taught to use his Dynamite to express his need to calm down.Replacement Behavior Steps:1. An adult will program Mike’s AAT device to say “I need to calm down.”2. A choice board will be built into the device by identifying 3-4 options from

which Mike can select as his activity to calm down and identifying buttons to represent those choices.

3. One minute before transitioning from a preferred to a non-preferred activity or at the end of a preferred activity (if the timer has not gone off), the teacher/adult will remind Mike to use his replacement behavior. “Remember, If you start to get mad when you go to X, you can tell us you need to calm down.”

4. At the first sign of Mike beginning his screaming behavior (initial squeal), redirect Mike to use his replacement behavior by prompting him (most-to-least hierarchy) while saying “What do you need?” For example, initially the teacher will use physical prompting (hand-over-hand) to guide Mike in telling the adults that he needs to calm down.

5. Once Mike communicates “I need to calm down”, present him with the choice board of calming strategies and ask him, “What do you want?”

6. As soon as he is calm, praise him by saying “thank you for telling us what you need to calm down.”.

7. Allow Mike to engage in his choice until he is calm for 1-min.8. If Mike does not return to his area, then start having a fun time in that area

with those students present

Reinforce Strategies

Specific Steps

Replacement Behavior:

Appropriately express his need to calm down

Whenever Mike ‘says’, “I need to calm down”, give him the choice board, praise him for using his communication, and release him to his choice.1. Immediately after Mike indicates he needs to calm down, ask him “What do you

want?” while showing the choices.2. Immediately after Mike makes his choice, say “Thank you for telling us what you

need.”3. Depending upon his choice, release him or provide him with the selection.4. When he makes his transition, praise him (with a warm tone) for returning to the

group; “thank you for coming over.”

Discontinue reinforcing problem behavior

Minimal attention will be provided to Mike when he is calming down and when he is starting to scream.Steps:1. As soon as Mike begins to show signs for screaming, the adult will immediately

prompt Mike to say he needs to calm down by presenting the device and saying “What do you need?”.

2. If necessary, provide physical or partial physical prompting to have Mike say what he needs.

3. Immediately after Mike says “I need to calm down”, present the choice board and ask him “What do you want?”.

4. Provide positive praise for Mike saying what he needs, “thank you for telling us what you need.”

5. Allow him to engage in his choice for one minute.

Mike’s Intervention Plan

Jeff: PTR Intervention Plan PreventPrevent Strategies

Description

Choice-Making Using a choice matrix, decide upon the choice that will be offered to Jeff each day with his writing assignment. The following choices will be rotated: (a) Within—writing tool to use (pen/pencil), color notebook paper, color of eraser, topic; (b) Who—peer for writing partner; (c) Where—Robin’s room, round table, desk; (d) When—part now, part later, whole task nowSteps:1.Right before giving the writing assignment to Jeff, decide upon the choice to be offered. 2.Once the choice is determined, present it to Jeff by saying, “What do you want to use for writing today? The pen or the pencil?”3.Praise Jeff for making the choice—”Thank you for making a choice.” and honor the choice

Jeff—Intervention Plan PreventPrevent Strategies

Description

Environmental Support

Visual Timer: Set a visual timer for the amount of time agreed upon with Jeff to complete the writing assignment.

Steps:1. At the beginning of the writing period and while reviewing Jeff’s

self-management writing chart for the day, and before providing Jeff a choice, either call Jeff to the teacher’s desk or go over to Jeff.

2. Discuss the goal for completing the writing assignment. Say, “I think you can complete the assignment in ___ minutes. What do you think?”

3. Set the timer by saying, “Jeff, let’s see if you can beat the timer. Today, you have ___ minutes (time from step 1) to complete the writing. Ready, set, go.”

Jeff— Teach Intervention PlanTeach Strategies

Description

Incompatible Replacement Behavior—Academic Engagement

Jeff will be taught how to remain engaged on a writing assignment. Engagement is defined as: working on a task without disrupting by raising hand to speak, keeping pencil upright, and letting neighbors work

Steps:1. Each day, divide Jeff’s writing task into 3 major sections—

starter, details, conclusion2. Initially, tell Jeff that for each section completed, he earns a

“dot” that he should place in the envelope hanging at the side of his desk.

3. Inform him that he can use the dots later to get out of work and to get special rewards for himself and the rest of the class.

4. Each day after giving the writing assignment to Jeff, review his self-management checklist/dot total sheet. Review each section of the writing assignment (step 1), his goal (time for completion), and the academic engaged behaviors.

5. On Monday, a weekly goal should be discussed and set.6. Immediately after reviewing Jeff’s goals and expected

behaviors, provide him a choice and set the timer.

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Reinforce Pro-academic Replacement Behavior—Academic Engagement

Jeff will be reinforced for academic engagement and meeting his daily goal with allowable/earned escape represented by the dots. Jeff can use his dots to get out of doing work/problems during independent work times.

Steps:1. At the end of the writing period or when Jeff completes his writing

(whichever event occurs first), review Jeff’s self-management checklist.

2. For each behavior on the checklist, discuss with Jeff whether he performed the activity. If yes, place a check in the box. If no, place an “x” in the box. For each check, Jeff should be given a dot. When reviewing, say, “Jeff, did you write a starter sentence?”… Did you stay on task? Did you meet your goal?” When giving dots, say “Jeff, how many checks do you have today? How many dots do you earn?”

3. Jeff uses dots by sticking it over a problem/question he doesn’t want to do and showing the teacher when he uses a dot. He can escape as long as he has dots in his envelope.

4. If Jeff uses a dot to get out of work, immediately say “You used a dot to get out of ____. You earned it!”

5. If Jeff meets his weekly goal, he can go to his brother’s kindergarten class and read a book to them.

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Group Contingency (Modified)

If Jeff meets his daily (time) goal for completing his writing assignment within the time agreed upon, the class earns a bonus letter toward the mystery reinforcer of the week. When Jeff earns the class this letter, the class provides attention to Jeff by thanking him and celebrating (clapping hands, saying “Yeah”.

Steps:1. After reviewing Jeff’s self-management sheet, ask him, “Did you

meet your goal today?”2. If yes, “You did meet your goal. Let’s tell the class they’ve

earned a letter for the mystery reinforcer.” 3. Tell the class, “Jeff met his goal today. We get another letter on

the board.”4. Prompt the class to thank Jeff (if they haven’t done so

spontaneously).5. If no, “You worked hard and tried. You’ll do it tomorrow!”

Jeff—Reinforce Intervention PlanReinforce Strategies

Description

Discontinue reinforcement of problem behavior

If Jeff gets disruptive (disengaged) during academic tasks, redirect him to his replacement behavior.

Steps:1. At the first sign of Jeff starting to get disengaged, calmly walk

over to Jeff and gesture to his self-management chart by pointing to it. Provide no or minimal verbal comments.

2. If Jeff continues to be disengaged, calmly redirect him to use one of his dots (if he has any) to escape. Say “Jeff, it looks as if you need to use one of your dots to get out of some work.”

3. If Jeff continues to be disengaged and doesn’t use one of his dots, walk over to his desk, pick out one of his dots out of his envelope, and say “It looks as if you need to use one of your dots to get out of some work. Where should I put the dot?”

4. Continue to use dots if Jeff continues to be disengaged.5. If all of the dots are used, calmly remind Jeff how he will earn

dots to get out of work.

Step 3 Activity: Paris Intervention Plan

Step 3 Paris: Activity InstructionsPAGE 7 OF ACTIVITY PACKET

Look at your hypothesis developed for Paris.

Choose a replacement behavior to teach Paris-raise hand, request attention, or academic engagement

Develop the specific steps (task analysis) of the replacement behavior intervention for Paris

Additional ConsiderationsWhen developing the behavior intervention plan, ask the team how they will do the following:◦ Pre-teach the student the plan◦ Prompts they will need to use in the initial stages◦ Fading prompts

Coaching/Fidelity

Teacher CoachingTeacher and Staff Training◦ Initial training with no students present

◦ 30 -90 minutes

◦ Model, Role Play, ◦ Q & A, Discussion

Coaching/Fidelity Checklist (page 60-61 Handout Packet)◦ Used by PTR Consultant for training evaluation ◦ Evaluate teacher accuracy on each step prior to implementation with

student◦ Comfort and competence measured◦ Can also be used as fidelity measure after intervention is implemented

Coaching StepsCore components of each behavior intervention strategy listed on coaching/fidelity form. (alternative form)◦ Primary adult behaviors (physical or verbal actions) & materials ◦ If applicable, student behaviors included.

During coaching session, facilitator gives teacher behavior intervention plan and coaching form.

Facilitator introduces coaching form, ◦ e.g., “We’re going to go over the steps of the behavior plan strategies to

make sure they are still making sense to you and are things that can be done by you in your classroom. If there is anything that you feel isn’t going to work, we can make changes today.”

Coaching StepsSeveral methods for coaching the teacher.

Can choose one method, combination of two, or all three◦ Discussion—facilitator asks teacher to verbally describe (in his or her own

words) each of the interventions. ◦ Ensures teacher describes each step of the intervention◦ Teacher can refer to coaching form to cue core steps

◦ Q & A—facilitator asks teacher questions about strategies. ◦ For example, choice-making “When are you going to offer the choices to X?”; “What kind of

choices will you offer X?”; etc.

◦ Role Play (preferred method)-facilitator plays role of student and asks teacher to perform plan steps as they would with student.

Coaching StepsCheck ‘Y’ or ‘N’ whether teacher demonstrated competence with plan steps

Remediation: For any step teacher did not demonstrate correctly or skipped,◦ Review step with teacher◦ Provide another opportunity for teacher to demonstrate competence◦ If successful, coaching session finished◦ If unsuccessful, choose from the following:

◦ Provide more opportunities to review and practice step◦ Ask teacher what features make step difficult and adapt to make feasible ◦ Select different intervention checked on PTR intervention Checklist that matches hypothesis.

◦ Schedule another meeting to develop new intervention ◦ Schedule another coaching session

Coaching StepsSuccessful training: ◦ Decide who else needs to be trained (e.g., student, other school staff,

parent)◦ Try to be there when teacher trains student or offer to train student

Determine start date of intervention plan◦ Can choose to implement the intervention in phases.

◦ Prevent first, then teach/reinforce◦ Teach/reinforce first, the prevent

Training checklist can be used as fidelity measure rather than developing separate checklist

Mike: Coaching/Fidelity

Jeff Coaching/Fidelity Plan

Step 3: In-Class Support Provide support to teacher in implementation◦ Be present on first day of implementation◦ Determine when to debrief◦ Measure fidelity◦ Discuss and modify if necessary

Step 3: Training/Fidelity ChecklistCase Study - ParisGroup Activity:

Look at the task analysis for Paris’ replacement behaviors◦ Select the core strategies you would include on a coaching/training and

fidelity measure

112

Paris’ Fidelity Checklist

113

Teach Intervention Strategy Fidelity

Replacement Behavior: Y/N/NA

Step 3: Facilitation TipsTeams can select interventions for homework or can select during team meeting

Focus on one routine, class, subject for developing intervention

Make sure the facilitator is asking guiding questions-allow the teacher to describe how the intervention will be in their classroom

Step 3: Facilitation TipsIf meeting time is limited, break up strategies:◦ One meeting, focus on full development of Prevent, next meeting develop

Teach/Reinforce OR◦ First concentrate on Teach/Reinforce; next meeting develop Prevent.

Fidelity measurements can be done once or twice a week rather than daily

One form can be used for training and fidelity

Step 3: Facilitation TipsUse technology (video, Skype, Wiki, Facebook) to provide support to teachers

Fidelity observations and coaching sessions should NEVER be used as teacher evaluation tools

Fidelity and training are coaching supports

Trust is essential for coaching and fidelity to work as intended

Step 4: Progress Monitoring

Step 4: Evaluation Progress MonitoringData-Based Problem-Solving◦ What is working? What is not working?◦ What changes need to be made?◦ Is more data needed? (additional data collection measures)

Implementation Fidelity Data◦ Is the plan being implemented consistently and accurately?

Student outcome data◦ Is the problem behavior decreasing? Is the replacement behavior

increasing?

Expanding the plan◦ Routines, times of day◦ Generalize across settings and/or staff

Steps for Evaluating OutcomesMake sure you have both fidelity measures (self and/or observation scores) AND student outcomes (IBRST measures)

Decision rules◦ What constitutes adequate fidelity? 80%, 70%, something else?◦ What constitutes adequate student progress? (e.g., 3 or more consecutive

ratings at or above goal line?)

Primary Decisions

If Fidelity scores are inadequate, determine the reasons (intervention too difficult, not feasible, not described adequately….)◦ Retrain/coach the teacher/implementer◦ Modify the interventions so that they are feasible, simpler◦ Select different interventions that match the hypothesis

If student outcomes are in the right direction (decision contingent upon outcome trend)◦ Maintain intervention◦ Modify intervention◦ Fade intervention components◦ Shape behavior outcomes to become closer approximations of desired

behavior◦ Expand the intervention (additional people, additional settings or routines)

Primary DecisionsIf student outcomes are remaining flat or data are showing that behavior problems are increasing and fidelity scores are adequate:◦ Intensify intervention◦ Modify intervention◦ Conduct another FBA if hypothesis is suspect, team has new data, or context

has changed◦ Conduct a functional analysis◦ Expand team to include other experts

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Step 5: Evaluation

Step 5: Evaluation Mike Outcome Data

Measure Baseline Post-test Change

SSRS-PB 123 112 -11

SSRS-SS 87 102 +15

AET .34 .57 +23

Jeff Data

Review PTR ProcessFour-step team-based process

Teacher/team driven

Standardized/manualized process

Support provided to teacher/team to implement interventions

Every intervention plan includes 3 components◦ Prevent◦ Teach◦ Reinforce

Plans are task analyzed

PTR PublicationsPTR Manual

◦ Dunlap, G., Iovannone, R., Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C., 2010. Prevent-Teach-Reinforce: The School-Based Model of Individualized Positive Behavior Support. Baltimore: Paul H. Brookes.

Journal Articles◦ Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009). Randomized controlled

trial of a tertiary behavior intervention for students with problem behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders, 17, 213-225.

◦ Dunlap, G., Iovannone, R., Wilson, K., Strain, P., & Kincaid, D. (2010). Prevent-Teach-Reinforce: A standardized model of school-based behavioral intervention. Journal of Positive Behavior Interventions, 12, 9-22

◦ Strain, P. S., Wilson, K., & Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing problem behaviors of students with autism in general education classroom. Behavior Disorders, 36, 160-171.

◦ Iovannone, R., Greenbaum, P., Wang, W., Kincaid, D, & Dunlap, G. (2014). Inter-rater agreement of the Individualized Behavior Rating Scale Tool (IBRS-T). Effective Assessment for Intervention, 39, 195-207.

◦ Sears, K. M., Blair, K. S. C., Iovannone, R. & Crosland, K., (2013). Using the Prevent-Teach-Reinforce model with families of young children with ASD. Journal of Autism and Developmental Disabilities, 43, 1005-1016.

◦ Iovannone, R., Anderson, C., & Scott, T. (2013). Power and control: Useful functions or explanatory fictions? Beyond Behavior, 22, 3-6.

Questions?

Including strands specifically designed for our Mental Health, Juvenile Justice, and Family/Community

Partners!

PBIS: Systems for Enhancing Climate & Culture

Donald Stephens Convention CenterRosemont, IL

This two-day forum for school,state, district and regionalLeadership Teams and otherprofessionals has been designedto increase the effectiveness ofPBIS implementation.

Sessions are organized by strandsthat support initial throughadvanced implementation inelementary, middle, and highschools as well as juvenile justicefacilities:

PBIS FoundationsClassroom Applications

Tier 2 Systems & Practices Tier 3 Systems & Practices

Aligning SystemsJuvenile Justice

Mental Health IntegrationEquity

Applied EvaluationSpecial Topics

Visit the Upcoming Events page at www.pbis.org for more

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2016 National PBIS Leadership Forum