1. Diana Joyce, Ph.D, NCSPMelissa Castillo, ME.D. djoyce@coe.ufl.edumcastil@ufl.edu Michelle Portell, EdSLindsey Tropf, B.A. portellm@ufl.edulindseytropf@ufl.edu University of Florida NASP Conference, San Francisco, February 23rd, 2011 Contributor: Nancy Waldron, PhD., NCSP 1 Presentation Materials and the Sample Report are Available at http://www.nasponline.org/ Case examples/data have been altered to mask student identity and for educational purposes.

2. RtI for Behavioral/Social-Emotional 20% of students will experience some type of emotional or behavioral difficulty 10% of students will have a diagnosable disorder during their school years For many, school is only source of behavioral or mental health services (Burns et al., 1995; Giled & Cuellar, 2003; USDHHS, 1999, USDOE, 2010) 2

3. RtI for Behavioral/Social-Emotional E/BD is the 6th largest IDEA classification 3 (29 th Annual Report to Congress)

4. RtI for Behavioral/Social-Emotional Since 1995 students with E/BD lowest graduation rate of any disability group 4 (29 th Annual Report to Congress)

5. RtI for Behavioral/Social-Emotional 6 Percentage of students by educational environments least restrictivemost restrictive Placement (29 th Annual Report to Congress)

6. University Research School K- 12 Enrollment: 1152 students Stable student population Racial/Ethnic Composition 51% Caucasian 24% African American 16% Hispanic 5% Multiracial 3% Asian Free/reduced lunch: 26% Highly trained faculty (78% graduate degrees) Behavioral RtI – 2 nd Year of Implementation 6

7. Tier I Universal – All Students Tier II Supplemental, Targeted, Short- Term Tier III Intensive, Individual, Long- Term RtI Tiered Behavioral Interventions 7 Positive Behavioral Support: Frequent recognition for appropriate behaviors, proximity control, cueing, build-in appropriate movement opportunities (e.g., Kagan Brain Ex.), predictable structure, positively-phrased and highly visible behavioral expectations. Embedded Social Curriculum: Instruction in prosocial behavior/attitudes. Data Screening: School-wide climate survey, ISS/OSS data, incidence mapping, rating scales for emotional risk and social skills (BESS) Observations, FBAs, Behavior Plans: Classroom observations to determine environmental contributors, antecedents, sustaining factors, frequency, patterns across subjects or time-of-day and task demands, self-monitoring or reinforcement plans, DRCs Counseling: Social Skills, Anger Mgmt, Test Anxiety, Friendship Groups Data Progress Monitoring: Tier II data Behavior Plans & Counseling Therapy: Individualized, greater frequency and intensity, often addressing multiple issues simultaneously Multi-agency Plans: Coordinate w/out-side agencies on counseling, behavioral plans, meds, family therapy, juvenile justice, etc. Data Progress Monitoring: Psychological assessment, Tier III data

8. Problem Solving I. Define the Problem Defining Problem/Directly Measure (Achievement/Behaviors) IV. Evaluate Was it Effective? II. Problem Analysis Identify Contributing Variables III. Implement Plan Progress Monitor and Modify if Needed 8

9. School Psychology Services: Best Practices at Tier I –Primary Prevention Screening for children/youth at risk: BESS/SSIS Interpretation of school-wide data for positive behavior supports: Ex: ISS/OSS, location, time of day, etc. Providing embedded social skills curriculum and/or PBS programs RtI resource for parents, teachers, administrators, staff

10. RtI TIER I: Examining School Wide Data – a Fictitious Example Using SWIS https://app.swis.org

11. RtI: Examining School Wide Data NameAbsentSSISBESSISSOSSClass IncidentsParent Contact CommentsSST Decision < 5< 60< 6100 Anna26378005 angry outbursts (red face, mean stares, huffing) over feeling slighted 3Parents describe same behaviors at home with siblings Observations, possible TIER II social skills & anger management group Bernard044 00---- Cialia0504800-3Lacking supplies, homework, appears dirty, no coat on cold days, no lunch, mother hospitalized depression Counselor/Teacher talk with family, possibly provide support resources contact numbers, donate supplies Frederick4653800--Few friends, mildly shyTry friendship group first, possible social skills later if needed Henry0422800---- Indigo7384510Dumped desk contents out on floor & refused to work 1Parent/Student responsive, no more incidents, found out Indigo had bad day because her dog died Isolated incident, monitor attendance Jyrece15425000-1knee surgery – fine now, no more absences - Kevin12757000-0Appears very sad/withdrawn, sometimes no appetite, clings to teacher Observations, parent interview about absences/sadness, possible TIER II counseling, beh plan to increase peer interactions, discuss weight w/nurse, monitor lunch 11 SSIS - Social Skills Improvement System BESS – Behavioral and Emotional Screening System, T-Scores 10-60 Normal, 61-70 Elevated, 71+ Extremely Elevated ISS = In-School Suspension, OSS – Out-of-School Suspension, SST = Student Success Team

12. RtI Tier I: Examining Class Wide Data (Sample) November Baseline Data Collection System for Teacher - Tier I Student Average Class Average Points Above Average Ms. Smith Place a 1 in the box for each day that the student ends the day on a color "less than" green - indicating negative behavior. 9/229/239/249/259/289/299/30Total Target Student1 11 11571.4%25.6%0.458647 Student 1 114.3%25.6%-0.11278 Student11 1 342.9%25.6%0.172932 Student 00.0%25.6%-0.25564 Student 00.0%25.6%-0.25564 Student 111 342.9%25.6%0.172932 Student 00.0%25.6%-0.25564 Student 00.0%25.6%-0.25564 12

13. RtI TIER I: Examining Class Wide Data – a Real Example Using Classroom Behavior Management Data (Portell & Tropf, 2011)

14. Class GraphBaseline Data Collection System for Teacher - Tier I Ms. Smith Averages by month for the Target Student and Class Averages for how often students end the day on a color "less than" green - indicating negative behavior. SeptemberOctoberNovemberAverage Target Student Average71.4%31.8%47.1%50.1% 14

15. Behavioral RtI TIER I Resource Examples TIER I Screening Measures Data Analysis: School Wide Information Systems (SWIS - www.SWIS.org) Social/Emotional Screening: Behavioral & Emotional Screening System (BESS - www.pearsonassessments.com) TIER I Intervention Programs Positive Behavioral Support (SWPBS - www.pbis.org) Second Step: A Violence Prevention Curriculum (www.cfchildren.org) TIER I Intervention Programs that Include Screeners Signs of Suicide Prevention Program (SOS - www.mentalhealthscreening.org) Social Skills Improvement System (SSIS - www.pearsonassessments.com) Olweus Bullying Prevention Program (www.OLWEUS.org) (*Additional resources provided in table at end of presentation.) 15

16. Tier II (Small group, supplemental, short-term) Student Success Team Define the Problem – Problem Analysis Records review, observations, interviews, parent conferences Implement the Plan Small group counseling (6-8 weeks) Individual counseling (12-16 weeks) Social skills, anger management, anxiety, self-regulation Behavior plans Evaluate Pre-observations for baseline, repeated observations Pre- and post-counseling BASC, SSRS SUDS data Behavior plan data analysis 16 School Psychology Services: Best Practices at Tier II

17. Tier II Data Sample #1 Behavior Plan (1 nd grade)

18. 18 Tier II Data Sample #2 SUDS: Subjective Units of Discomfort Scale Middle School ScoreFeelingThoughts 10.Total Freak Outcant breathe, cant think 9.Scaredsweaty palms, feel like crying 8. WorriedIm gonna fail this! 7. AnxiousThis is hard, what if I dont do well? 6. ConcernedWonder how Ill do on this? 5.OkAlright 4.CalmLets go, Im not stressed. 3.RelaxedI am in the zone 2. Easy/BreezyPiece of cake 1.AcesIm gonna Ace this

19. Behavioral RtI TIER II Resource Examples TIER II Assessment/Progress Monitoring Measures Behavioral Assessment Scale for Children (BASC II – www.pearsonassessment.com) Reynolds Childrens Manifest Anxiety Scale (RCMAS – www.mhs.com) Childrens Depression Inventory (www.mhs.com) Subjective Units of Distress Scale (SUDS) TIER II Intervention Programs The Coping Cat: Cognitive Behavioral Therapy for Anxious Children (Philip C. Kendall, Ph.D. I Can Problem Solve (www.researchpress.com) Aggression Replacement Training (www.agressionreplacementtraining.org) Skill Streaming (www.skillstreaming.com) Second Step: A Violence Prevention Curriculum (www.cfchildren.org) (*Additional resources provided in table at end of presentation.) 19

20. TIER III Tier III (Individualized, intensive) Define the Problem – Problem Analysis Formal FBA Updated review of work & interviews Parent conferences with developmental history Implement the Plan Behavior management plans, Behavior contracts, Daily or weekly behavior report cards to home More frequent individual counseling (Solution-focused, CBT, Psychoeducational) May require multi-agency collaboration Evaluate Pre-observations for baseline, repeated observations Pre- and post-counseling BASC, SSRS SUDS data 20

21. Tier III Data Sample 3 Sample Intervention Data Tier I-III Tier II Group Counseling Teacher Behavior Plan Tier III Individual Counseling FBA Driven Behavior Plan

22. Tier IV Eligibility for E/BD State of Florida Eligibility Criteria Aligning with RtI Problem-solving model Assure not lack of appropriate instruction Team decisions Evidence-based interventions have been implemented Evaluation includes: FBA (if not already completed) Social/Dev Hx Observations Interviews Review of interventions Review of academic performance Assessments to identify contributing factors Medical eval if precipitating E/BD 22 Full copy of the Florida New Rule Developments for RtI: http://www.fldoe.org/ese/

23. Tier IV Eligibility for E/BD State of Florida Eligibility Criteria Aligning with RtI 23 Internal Factors: sadness, mood swings, erratic behavior or fears, phobias, excessive worrying, thoughts/feelings inconsistent with actual events, withdrawal or External Factors: inability maintain personal relationships, chronic disruptive, physical aggression etc. and Must be present 6 months (not temporary, less than 6 weeks reactions to crisis or life event) Manifest in two or more settings Student needs special education

24. Risk Factors Genetic Inherited Autism, schizophrenia, bipolar, ADHD Biological Abnormalities central nervous system – e.g., intrauterine exposure to alcohol/cigarette smoke, injury, infection, poor nutrition, toxins Strong influence for: PDD, early-onset schizophrenia, social phobia, OCD, Tourettes Environmental Triggers Trauma, parental discord, parental psychopathology, economic hardship, attachment, abuse, neglect Can predispose conduct disorders and antisocial personality 24 (Algoe & Fredrickson, 2011)

25. Genetics may load the canon, but lifestyle lights the fuse, and intervention can redirect the power. 25

26. Resiliency Factors Worry less about uncertainty Dismiss threats that do not materialize Embrace opportunities for growth Recognize own emotions Learn to regulation own emotions Learn to generate positive emotions Self-monitor balance of positive emotions/thoughts 3:1 26 (Algoe & Fredrickson, 2011)

27. Matching Interventions (Kendall 2006) ADHDAnxietyDepressionOCDODD/CDPhobias Beh ModXX CBTXXXXXX Org SkillsX Coping SkillsXX Beh Self- Control Therapy X Exposures, Response Prevention XX MedicationX Parent Training XXX Anger MgmtX 27

28. Lessons Learned Importance of building capacity & professional development Generally enough needs to continuously have small groups targeting: self- regulation, anxiety, anger management etc. Behavioral problem-solving team meetings may need to be more readily available than typical quarterly SST Importance of including parents Establish a system for data management Intervention guides the type of data collected Behavioral RtI is a marathon, not a sprint

29. Resources (Reports) Questions? 29

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33. References Algoe, S. B., & Fredrickson, B. L. (2011). Emotional fitness and the movement of affective science from lab to field. American Psychologist, 66(1), 35-42. Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M. Z., & Erkanli, A. (1995). Data watch: Childrens mental health service use across service sectors. Health Affairs, 14, 147-159. Giled, S. & Evans Cuellar, A. (2003). Trends and issues in child and adolescent mental health. Health Affairs, 22 (5), 39-50. Kendall, P. C. (2006). Child and adolescent therapy. New York: Guilford Press. U.S. Department of Education (2010). Twenty-ninth annual report to Congress on the implementation of the individuals with disabilities education act. Jessup, MD: U.S. Department of Education. http://www2.ed.gov/about/reports/annual/osep/2007/parts-b-c/index.html U.S. Department of Health and Human Services. (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services. http://www.surgeongeneral.gov/library/mentalhealth/chapter1/sec4.html#chap3 33