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Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior.

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Presentation on theme: "Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior."— Presentation transcript:

1 Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior Supports Rose Iovannone, Ph.D. Kathy Christiansen, MS University of South Florida

2 Objectives  Participants will: Describe a model of individualized behavior support Identify factors that may contribute to effectiveness of PTR

3 The Problem—Evidence-Based  Tertiary supports (i.e., individualized PBS, Tier 3 behavior supports) Evidence-base exists Research method used primarily single subject Limited rigorous, randomized control trials to evaluate effectiveness

4 The Problem - In Authentic Schools  Ingredients Child is the problem - “fix him/her” Absence of uniform policies & practices Form-driven versus process-driven “Expert” versus collaborative approach Contextual fit not always considered Limited support/follow-up/training for teacher provided  Result Many BIPs do not get implemented Behavior problems persist

5 Individualized PBS (Tertiary)  For high-risk students: – History of severe problem behaviors – Demonstrated resistance to intervention – An intensive system of support is needed ~ 80% of Students ~15% ~5%

6 What is PTR?  Research project funded by U.S. Department of Education, Institute of Education Science ( ) University of South Florida—3 school districts University of Colorado, Denver—2 school districts  Purpose: Investigate effectiveness of PTR process vs. “business as usual” Randomized control trial 200 students (100 treatment/100 comparison)

7 Theoretical Framework  Principles of applied behavior analysis Operant learning theory  Positive Behavior Support—foundation  Intervention consists of three core components: Prevent Teach Reinforce  Team/teacher driven process

8 Participants Students in K-8th grade  General or Special Education All cognitive levels All disabilities  Behavioral difficulties Intensity– disruption to the learning environment Frequency— minimum of 1 time per week Duration– minimum 6 months  Teachers volunteered & nominated 1-3 students Top externalizers Systematic Screening for Behavior Disorders (SSBD)

9 Process  Prevent-Teach-Reinforce (PTR) Five steps:  Team development—30 minutes if applicable  Goal setting—30-45 minutes  PTR assessment—30-60 minutes  PTR intervention—45-90 minutes  Coaching support (up to 12 hours)  Evaluation—30-40 minutes Each team assigned PTR consultant (from project) Teams receive manual and assigned activities to be completed in each step.

10 Preliminary Data Results

11 Student Demographics by Disability DisabilityN% Autism208.2 Deaf1.4 Developmental Delay62.4 Emotional Disturbance Mental Retardation197.8 Multiple Disabilities41.6 OHI (not ADD/ADHD)2.8 OHI (ADD/ADHD)83.3 Specific Learning Disability218.6 Speech/Language Disability83.3 Visual Impairment1.4 General Education TOTAL 237

12 Student Description Grade Level K N % Lunch Status Regular Free/Reduced Gender Female Male

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17 The PTR Process

18 Step 1: Form a Team  Identify members and their roles Teacher, special area teachers Behavior specialist/school psychologist Family members, paraprofessionals,

19 Step 1: Team Building— Ensuring a Successful Team  Review the status of the team Work styles inventory Teaming survey  Use a collaborative process Teacher and facilitator relationship Consensus making method

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22 Case Study 1: Mike  9-year-old male  Autism diagnosis  Self-contained autism classroom  Nonverbal—uses AAT (signs, voice output devices such as Dynamite, and pictures to communicate)  1 teacher, 2 aides, and 6 students  Results of teaming information indicate a great team that meets regularly to brainstorm

23 Case Study 2: Jeff  Male  Second grade general ed. student  Retained once  Premature birth  SSBD Scores: Stage 2: 8 Critical Events Adaptive Behavior Score = 33 Maladaptive Behavior Score = 32

24 Teacher/Classroom  Team: Two teachers Current second grade teacher Second grade teacher from previous year  Seventeen students  Teacher experience—4 years at same school

25 Teaming Results  Team respected each other, worked together  Met consistently for planning purposes  Strong communicators and problem solvers  Sharing of roles and responsibilities  Active parental participation encouraged

26 Step 2: Goal Setting  Identify team consensus on: Academic behavior Social behavior Problem behavior  Develop and begin baseline data collection

27 Setting Goals: Mike Pre-Test

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30 Behavior Rating Scale— Reliability  Perceptual rating  Behavior recorded at least once daily May be specific to a setting, activity, time of day May be whole day May be combination of both  Use anchors on a scale of 1-5

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35 Determining the Anchors on the BRS  Behavior can be measured using Frequency (times per day) Duration (hours, minutes, seconds) Intensity (how hard, how loud, bruise, etc.) Percent of day Percent of occurrence Percent of opportunity

36 BRS Preliminary Reliability (Psychometric) Results VariableMeanSDPearson’s T PB * S PB T PB * S PB T AB * S AB T AB * S AB T = Teacher rating; S = PTR data collector rating; PB = Problem behavior; AB = Appropriate behavior * P <.01

37 BRS Preliminary Reliability Results—Kappa Scores Behavior TypeUnweighted/ Standard Error Linear Weighting/ Standard Error Quadratic/ Standard Error Problem.38/.08.66/.06.83/nc Appropriate.24/.08.40/.08.53/.14

38 Step 3: Assessment  Checklist format: Antecedents or Triggers (Prevent) Function(s) of the problem behaviors (Teach) Consequences following the problem behaviors (Reinforce)  Assists team to link function of behavior to intervention plan

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44 When….Student will….As a result… Mike is asked to complete non- preferred task (Reading, Math), stop preferred activity or transition to nonpreferred activity, fix an error, or when teacher attending to other students scream and hitMike is able to gain attention and delay the transition/activity Mike is asked to complete non- preferred task (Reading, Math), stop preferred activity or transition to non- preferred activity, fix an error, or when teacher attending to other students express his frustrations appropriately complete the assigned task Mike is able to delay the transition/activity Mike is able to gain attention Inappropriate Appropriate

45 Jeff Case Study: Hypothesis

46 Step 4: Intervention  Team ranks top three intervention strategies in each of the PTR components  Multi-component intervention that teacher states s/he can implement Prevent Teach Reinforce  Implementation plan

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48 Prevent StrategiesSpecific Strategy steps Environmental Support A wait card will be placed on Mike’s desk to assist him in remembering to wait his turn. 1. Prior to group work, tell Mike, “Remember, when it is someone else’s turn, you sit quietly and wait,” while pointing to his card. 2. If Mike calls out, point to his visual to remind him what to do. 3. Use a verbal prompt if the point prompt does not work. 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. 1. Prior to the start of the activity, Mike should review the visual schedule. 2. As Mike completes an activity, he should X off the activity. Case Study Mike: PTR Intervention Plan

49 Prevent 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

50 Teach Strategies Specific Strategy Steps Replacement Behavior Mike will be taught to use his Dynamite to express his need to calm down. 1. Mike’s device will be programmed to say “I need to calm down.” 2. Prior to transitioning to a non-preferred activity or at the end of a preferred activity, remind Mike that “if you start to get mad, you can choose to calm down.” 3. As soon as Mike starts to get upset, prompt him to use his device. 4. Once Mike communicates “I need to calm down”, present him with the choice board of calming strategies and ask him, “What do you want?” 5. As soon as he is calm, praise him. 6. Allow Mike to engage in his choice until he is calm for 1-minute. 7. If Mike does not return to his area, then start having a fun time in that area with those students present

51 Teach StrategiesSpecific Strategy Steps Self- Management Mike will be taught to independently use his calming strategies. 1. A tracking sheet with smiley faces and sad faces will be given to Mike at the start of each day. 2. Role-play with Mike about when he needs to make the choice to calm down. 3. Practice completing the tracking sheet. 4. Set and review the daily goal for using the calming strategies. 5. Prompt Mike to complete the tracking sheet if needed

52 Reinforce Strategies Specific Strategy Steps Replacement Behavior Anytime Mike “says” “I need to calm down”, his choice board should be given. 1. Praise Mike for communicating (“thank you for telling me.”) 2. Provide his choice board. 3. Allow him to calm for 1 minute 4. Praise him as soon as he is quiet 5. Praise him for returning to the group Self- Management Anytime Mike scores his behavior, attention should be given. 1. When Mike marks his tracking sheet, praise him for doing so. 2. At the end of the day, review the sheet with Mike. 3. Talk about the sad faces. 4. Provide his reward if his goal is met. Waiting Mike will earn a skittle paired with attention if he waits. This will be faded to an intermittent schedule.

53 Reinforce Strategies Specific Strategy Steps Transition Mike will earn stars during Reading Centers if he transitions and completes his work without screaming. 1. A social story will be reviewed prior to Reading Centers to remind Mike that he can earn a star if he comes to centers and works. 2. At the end of each reading center, an adult will review Mike’s behavior with him and ask him if he earned his stars. 3. Provide his stars if earned. 4. During the teacher’s group, Mike can earn 2 stars: 1 for transitioning to the group and 1 for working during group. 5. Allow Mike to participate in his chosen activity if he earned his stars.

54 Jeff: Intervention Checklist Results

55 Case Study Jeff: PTR Intervention Plan Prevent 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 now Steps: 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

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

57 Jeff—Intervention Plan Teach Strategies Description Pro-academic 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. Divide Jeff’s writing task into 3 major sections—starter, details, conclusion 2. 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. Review his self-management checklist/dot total sheet with Jeff. Review each section of the writing assignment (step 1), his goal (time for completion), and academic engaged behaviors. 5. On Monday, a weekly goal should be discussed and set.

58 Jeff—Intervention Plan Reinforce 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.

59 Jeff—Intervention Plan Reinforce 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!”

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62 Coaching of Interventions  Training of teacher 1 to 2 hours 80% accuracy on all strategies  Assistance in classroom Up to 12 hours  Fidelity measures recorded 80% implementation terminates assistance in classroom

63 Case Study Mike: Training

64 Case Study Mike: Fidelity

65 Mike Post-test Video

66 Coaching Checklist Example: Jeff

67 Example of Fidelity—Jeff

68 Number of Fidelity Measures Teacher N%age Total130 Mean # of measures per teacher3.5

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70 Step 5: Evaluation  Data-based decision-making Identifying what is working; what is not and WHY  Expanding into other routines  Generalization  Continuing team meetings Planning time Cohesiveness

71 Step 5: Evaluation - Mike 1 is a lot of screaming, 5 is no screaming

72 Step 5: Evaluation - Mike 1 is a lot of hitting, 5 is no hitting

73 Step 5: Evaluation - Mike 1 is a little appropriate expression, 5 is a lot of appropriate expression

74 Step 5: Evaluation - Mike 1 is inappropriate transition, 5 is super appropriate transition

75 Step 5: Evaluation Other Outcome Data MeasureBaselinePost-testChange SSRS-PB SSRS-SS AET

76 Jeff Data

77 Step 5: Evaluation Other Outcome Data for Jeff MeasureBaselinePost-testChange SSRS-PB SSRS-SS AET

78 Wrap Up: What We Have Learned  Teachers like the process  Teachers identify coaching/support and collaboration as key features  Teachers do not continue the process without support  Systemic change may be necessary for tertiary supports to happen

79 How to Make PTR Work in Your School  Process is the key  Creative resource reallocation may be necessary to find the time  Things to consider Tertiary team Identification/Nomination process Data-based decision making Facilitator Set-up of meetings for efficient results

80 For copies of Forms  or   Manual will be published by Brookes—anticipated date— Summer 09  Two journal articles in 2009 Journal of Positive Behavior Interventions (Jeff will be described) Journal of Emotional Behavioral Disorders  Next steps: Training school-based behavior consultants to do process

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86 Questions?


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