Presentation on theme: "Tier 2 Interventions: Systems, Practices, Data, and Outcomes"— Presentation transcript:
1 Tier 2 Interventions: Systems, Practices, Data, and Outcomes Lori Lynass, Ed.D.NWPBIS Network
2 Acknowledgments Hill Walker, U of O Doug Cheney, U of WA Kathleen Lane, VanderbiltClay Cook, U of WAJeff Sprague, U of OBridget Walker, Seattle UWendy Iwaszuk, Beach Center, KansasTricia Hagerty, Highline Public School
5 Building the Airplane While Flying It Social and Behavioral Supportfor All Students
6 Factors that Place Children At-Risk Biology/physiologySocioeconomic statusFamily ConflictFamily CompositionParenting StyleLack of health carePoor nutritionFrequent movesTemperamentAcademic failure
7 Mental Health: What Do We Know? The most common conditions includeAnxiety (31.9%)Behavior disorders (19.1%)Mood disorders (14.3%)Substance use disorders (11.4%)Approximately 40% of individuals meet criteria for multiple disorders.(Merikangas et al., 2010)
8 Tier 2 Rationale: Early Intervention is Vital Research suggests that there’s a ‘window of opportunity’ ranging between 2-4 years when prevention is criticalGreat Smoky Mountains Study: Age Between First Symptom and Initial DiagnosisOriginal source: Costello, E.J., Angold, A., Burns, B.J., Stangl, D.K., Tweed, D.L, Erkanli, A., and Worthman, C.M. (1996). The Great Smoky Mountains Study of Youth: Goals, Design, Methods, and the Prevalence of DSM-III-R Disorders. Unpublished manuscript, Developmental Epidemiology Program, Duke University Medical Center, Durham, NC, and the Department of Anthropology, Emory University, Atlanta, GA.Source: O’Connell, Boat, & Warner, 2009
9 What is a Tier 2 Intervention? An intervention (or set of interventions) known by all staff and available for students during the school dayInterventions that provide additional student support in academic, organizational, and/or social support areas
10 Tier 2 Interventions (Hawken, Vincent, & Schumann, 2008). Assumes a Tier 1 School wide PBIS is in place – SET, BOQInvolves a problem-solving focused behavior support teamScreening to identify a % of students non responsive to Tier 1Readily available and easily accessibleUses efficient, available evidence based practicesIncludes data-based progress monitoring & decisionsHave an entry & exit criteria, with non-responders moving to Tier 310
11 Goal of Tier 2 Interventions To Make the Problem Behavior:IneffectiveInefficientIrrelevantUnstable* Some of this occurs through changes to the environment.11
12 Tier 2: Small Group Interventions Social Skills Groups (Redefining Counselor Groups)Check In/Check Out, Check,Connect & ExpectExecutive Functioning Skill GroupsAcademic Support GroupsSelf-Monitoring
13 Why do Targeted Interventions Work? Improved structurePrompts are provided throughout the day for correct behavior.System for linking student with at least one positive adult.Student chooses to participate.Student is “set up for success”First contact each morning is positive.“Blow-out” days are pre-empted.First contact each class period (or activity period) is positive.Increase in contingent feedbackFeedback occurs more often.Feedback is tied to student behavior.Inappropriate behavior is less likely to be ignored or rewarded.SST13 at SWOSERRCSST13 at SWOSERRC
14 Important Notes About Tier 2 Important Notes About Tier 2Do not lose sight of Tier 1Common misperception is that interventions will “fix” the student and the classroom teacher does not need to be an active participant since “specialists” or outside staff are often involved in the interventionSuccessful interventions will require high level of involvement among ALL staff within the school buildingSST13 at SWOSERRC
15 The Tier 2 Team ENTRY, EVALUATE, EXIT Determine & Oversee Referral ProcessReview Students ReferredMonitor Implementation FidelityEvaluate Outcomes and Make DecisionsOngoing Progress MonitoringFidelity of ImplementationSocial Validity
16 SWPBS IMPLEMENTATION DRIVERS Data: For decision makingSystems: To sustainthe implementationPractices: Evidenced-based and doableOutcomes
17 Are We Ready for Tier Two? For Tier Two supports to be most successful, basic components of Tier One should be in place.* Check ClassroomsTime must be dedicated for Tier Two to be implemented.Support from staff and admin must be available.Professional development must occur.
18 Is Tier One in Place in the Classrooms? Classroom-wide positive expectations taught, encouraged & reinforced and match school-wide expectationsTeaching classroom routines & cues taught & encouragedRatio of 4-5 positive to 1 negative adult-student interactionDo Staff Agree with and Understand Classroom and Office Managed BehaviorsActive supervisionRedirections for minor, infrequent behavior errorsFrequent pre-corrections for chronic errorsEffective academic instruction & curriculum
19 Knowing Function of Behavior to Determine Intervention
20 “Can’t Do versus Won’t Do” Can’t Do or Don’t Know When To Do- Skill Deficit- Performance Deficit- Perception DeficitWon’t Do- Function of Behavior
21 Can’t Do: Skills Building Social Skills GroupsAssertion Skills, Anger Management, Friendship Skills, Empathy SkillsExecutive Function Skills GroupsOrganization Skills, Emotional Control, Time ManagementAcademic Skills GroupsContext Reading Skills, Math Skills
22 Three Functions of Behavior Problem BehaviorEscape/AvoidSocialActivityPeerAdultObtainTangibleAutomatic
23 We Also Have To Think Functionally When Choosing Interventions “Problem Behaviors” are functional skillsInterventions must consider the purpose of behavior (from student’s perspective)Seek a match from intervention menu for the needs of each individual student
25 Functions of The Tier 2 Team ENTRY, EVALUATE, EXITDetermine & Oversee Referral ProcessReview Students ReferredMonitor Implementation FidelityEvaluate Outcomes and Make DecisionsOngoing Progress MonitoringFidelity of ImplementationSocial Validity
26 3-Tiered System of Support Secondary Systems Team Universal TeamSecondary Systems TeamProblem Solving TeamTertiary Systems TeamUses Process data; determines overall intervention effectivenessUses Process data; determines overall intervention effectivenessPlans SW & Class-wide supportsStanding team; uses FBA/BIP process for one youth at a timeCICOUniversal SupportBriefFBA/BIPSSGComplexFBA/BIPWRAPExec Func SkillsSept. 1, 20092626
27 Derby Ridge Elementary Teaming Structure Special Education TeamTier 3 TeamTier Two TeamCORE PBIS TeamGrade Level Teams
28 Establishing the Tier 2 Team May be part of the existing PBIS leadership team.May be an extension of the existing PBIS leadership team.May be a stand alone team, often these teams look at Tier 2 & 3.* Such a team may already exist in your school - SIT team, Care team, MDT team.
29 Tier 2 Team Members Tier 2 Coach PBIS Coordinator Counselor PsychologistTeachersAdministratorOther Para-professionals
30 Team Uses Problem Solving Format Instructional Support Team VideoRichland School District (Process Example)
31 Discussion Tier 2 Team10 MinutesWhat Tier 2 team format might work best for your school?Who would be on your Tier 2 team?When could this team meet?What would need to happen to create a Tier 2 team?
33 Establish Entry Criteria A team agreed process should be established for how students enter Tier 2 programs. Common entry criteria:Office ReferralsTeacher Nomination - Through ProcessCounselor NominationScreening Results
34 How most schools determine student need for services Office discipline referrals & Teacher/Staff referrals are commonly usedOnly 2-5% of schools screen all children for mental heath reasons (Romer & McIntosh, 2005)
35 Office Referral Information But Who Are We Missing?
36 How Are We Currently Screening For Social Behavior?
38 Screening Use of a Validated Screener: Six-Eight (Oct-Nov) weeks after school begins & in SpringAt the end of the year if desired (provides information for planning)As a new student enters if needed* Academic Screening Data Also Considered
39 Choosing A Universal Screener Choose a Screener that:Is appropriate for its intended use and that is contextually and developmentally appropriate and sensitive to issue of diversityHas Technical AdequacyUseable - efficient, feasible, easy to manage- Calderella,Young, Richardson & Young, 2008
40 Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992) Originally normed K-6, recently normed for middle and Jr High (Calderella,Young, Richardson & Young, 2008)Multiple gating procedures following mental health & PBS modelExternalizing and Internalizing dimensionsEvidence of efficiency, effectiveness, & cost benefitsExemplary, evidence-based practiceUS Office of Special Education, Council for Children with Behavior Disorders, National Diffusion Network
41 Multiple Gating Procedure (Severson et al. 2007) Teachers Rank Order 3 Ext. & 3 Int. StudentsGate 1Pass Gate 1Teachers Rate Top 3 Students on Critical Events, Adaptive & Maladaptive ScalesGate 2Tier 2,3InterventionPass Gate 2Gate 3Classroom & Playground ObservationsTier 3 Intervention or Special Ed. Referral
42 SSBD Screening Internalizing Behaviors Externalizing Behaviors ExamplesNot talking w other childrenActing in a fearful mannerNot participatingAvoiding or withdrawingNot standing up for one’s selfNon-examplesInitiating social interactionsHaving conversationsJoining in with othersExamplesDisplaying aggressionArguingDefying the teacherBeing out of seatDisturbing othersNon-examplesCooperatingSharingWorking on tasks
43 SSBD: Sample Questions Critical Events (Behavioral Earthquakes):Sets Fires,Vomits after eating,Exhibits painful shynessMaladaptive BehaviorRequires punishment before s/he will terminate behavior.Child tests teacher imposed limits.Adaptive BehaviorIs considerate of the feelings of others.Is socially perceptive.
45 Student Risk Screening Scale (Drummond, 1994) Originally normed at elementary level, recently normed at middle and high school (Lane, Kalberg, Parks, & Carter, 2008)Classroom teacher evaluates and assigns a frequency-based, Likert rating to each student in the class in relation to seven behavioral criteriaScore indicates the level of risk (low, medium, high)Scores predict both negative academic and behavioral outcomesEffective, Efficient and Free4545
48 Student Internalizing Behavior Screener (SIBS, Cook et al. 2008) Normed K-12 Grade. Rates on 7 Items:Nervous or FearfulBullied by PeersSpends Time AloneClings to AdultsWithdrawnSeems Sad or UnhappyComplains About Being Sick or HurtRated on a 4-point Likert scale (never, seldom, sometimes, frequently)
49 BASC- Behavior and Emotional Screening Scale (BESS, Pearson Publications) Based on BASC by Reynolds & Kamphaus, 2002Universal screener with norms for preschool & K-12,Includes teacher, parent, and self-rating forms grades minutes per form. Completed on all students in class.Hand scored and scannable forms (in spanish too), ASSIST software availableProvides comprehensive summary of student scores and teacher ratings across the schoolAssessment of a wide array of behaviors that represent both behavioral problems and strengths, including internalizing problems, externalizing problems, school problems, and adaptive skills.4949
51 Administration & Scoring Criteria The BASC-2/BESS uses T-scores to communicate results relative to the average (mean=50)Identifiers and percentile ranks are provided for ease of interpretationNormal risk level: T-score range 10-60Elevated risk level: T-score range 61-70Extremely Elevated risk level: T-score range ≥ 71
58 Sample List of Students Identified Through Schoolwide Screening How could this information help you determine where your limited support resources should focus?Bridget Walker, Ph.D.5858
59 Monitoring Effectiveness and Fidelity of Tier 2 Interventions A good plan implemented poorly…is a bad plan.Monitoring Effectiveness and Fidelity of Tier 2 InterventionsFidelity Checklist
60 Monitoring Progress In Tier 2 Each Student Should Be Monitored Weekly and Discussed Twice Monthly to Determine :If they are responding to the interventionIf the intervention is the correct interventionIf the intervention needs to be adjustedIf the student is ready to exit
64 Monitoring Fidelity of Tier 2 Interventions Core features of interventions should be adhered to.The fidelity of Tier 2 programs should be monitored by the Tier 2 team.Look over the Tier 2/3 Tracking Tool and Systems-Response Tool.
66 Tier 2: Summary of The Big Ideas Do the easy stuff first (efficiency is a major goal)Processes are as important as practicesUse of Evidence Based Practices based on Behavioral ScienceTeaming is criticalAdministrative support is criticalData Based Decision Making