Multi-tiered Systems of Behavior Support Rob Horner University of Oregon Acknowledge: George Sugai, Tim Lewis, Wayne Sailor, Amy McCart, Dean Fixsen, Karen Blase Sharon Lohrmann Barbara Trader Donald Taylor

Target Audience and Goals Audiences: Families, Educators, Administrators, Policy-makers Goals Describe multi-tiered systems of support (MTSS) and the relevance of multi-tiered systems for students with more significant disabilities Define how MTSS is affected by rise of “evidence-based practices” and “implementation science” Define the core features of effective learning environments that are implementing multi-tiered systems of behavior support

Main Messages Multi-tiered systems of support (MTSS) – Prevention first – One setting: Multiple levels of support intensity – Early intervention – Align academic, behavioral and social support – Collect and use data – Fidelity data – Impact data – Educational Equity – Programmatic and Procedural Technology

Relevance of MTSS for TASH TASH is dedicated to supporting the 1% of individuals with the most significant learning and behavior support needs. Assumptions – Separate systems are ineffective and inefficient – Inclusion is necessary, but insufficient. Inclusion is a strategy not an outcome – The goal is to achieve inclusion with active participation, support, academic gain and self- determination

Three Major Influences on Education: Evidence-based Practices, Implementation Science, Multi-Tiered Systems Performance Assessment (Fidelity) Coaching Training Selection Systems Intervention Facilitative Administration Decision Support Data System Effective Implementation Multi-tiered Systems of Support Evidence-based Practices Implementation Science Adaptive Technical Leadership Drivers Competency Drivers Organization Drivers

Evidence-Based Practices Defined: – Applying the best available research results (evidence) when making decisions about support. Advocates and professionals who perform evidence-based practice use research evidence along with clinical expertise and personal preferences. Why Important: – Among the major challenges in education is the continued investment in and use of practices that are either un-tested or demonstrated to be ineffective. – Educational equity is more likely when schools use evidence- based practices.

What makes a practice “Evidence-based”? Procedures are defined operationally Measure of fidelity Experimental data documenting relationship between use of the procedures and valued outcomes. – Two group design studies – Five single-case studies Descriptive examples are always needed and helpful, but they are insufficient for large-scale investment: e.g. Sensory Integration Therapy

Quick Check Identify Three Evidence-based Practices – Operational; Fidelity; Experimental Evidence Educational PracticeSupporting Evidence First Step to Success ** Manual ** Checklist *Walker, H., Seeley, J., Golly, A., Severson, H., & Feil, E. (2009). The First Step to Success program for preventing antisocial behavior in young child: Update on past, current and planned research. Report on Emotional & Behavior Disorders in Children, 8(1), 17–23. *Seeley, J., Small, J., Walker, H., Feil, E., Severson, H., Golly, A., & Forness, S. (2009). Efficacy of the First Step to Success intervention for students with attention-deficit/hyperactivity disorder. School Mental Health, 1(1), 37–48. Functional Communication Training ** Operational elements ** Fidelity measured through direct obs. *Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, *Durand, V.M. & Carr, E.G. (1991). Functional communication training to reduce challenging behavior: Maintenance and application in new settings. Journal of Applied Behavior Analysis, 24, ?? Your Turn List Practices: Later find Evidence

Implementation Science Main Idea – Valued outcomes require BOTH effective practices and good implementation. Effective practices + Implementation = Outcomes Effective practices + poor implementation = Outcomes

Implementation Science Implementation Matters Scale Impact

© Fixsen & Blase, 2008 Performance Assessment (Fidelity) Coaching Training Selection Systems Intervention Facilitative Administration Decision Support Data System Implementation Drivers Competency Drivers Organization Drivers Leadership AdaptiveTechnical Successful Student Outcomes Program/Initiative/Framework (e.g. RtI)

Multi-Tiered Systems of Support Invest in Prevention First Build Multiple Tiers of Support Intensity Early Access to Support

Multi-tiered Systems Response to Intervention (RtI) – Doug and Lynn Fuchs Multi-tiered Prevention – Hill Walker – George Sugai

Big Shift Student Deficit Logic – Student limitations lead to lack of success – Goal is to define how the student must change to be successful Systems Deficit Logic – Everyone can succeed under the right conditions – Goal is to define the conditions that must change so the student will be successful

MTSS shifts focus on the System

Different Approaches Darin Challenge: Low Reading, High Aggression Old Process: Assessment: Diagnostic Label Placement: Special Education New Process Assessment: Academic, Social, Physical, Mental Health Support: Intensive Individual, Targeted, Universal

Darin Individualized Support Extra Reading with target skills Wraparound Positive Behavior Support Modified Schedule Check-in Check-out Self-guided schedule checks Peer assisted Reading Predictable, Consistent, Positive and Safe Social Culture Clear expectations Social Network Access to adult support

Building Tier III Supports Support Plans Solution ComponentsAction Step(s) Prevention Modify the schedule/setting/ task to make the problem situation unlikely. Make the problem behavior irrelevant. TeachingTeach alternative skills that make the problem behavior inefficient. RecognitionExaggerate reward for appropriate behavior Extinction Remove rewards for problem behavior so the problem behavior becomes ineffective. Corrective ConsequenceIncrease the “cost” of the problem behavior Safety Strategies Anticipate that the problem behavior will occur again, and define what will be available to ensure the safety of all. Data collection Measure if the support plan is implemented Measure if the support plan is effective (need goal) – Target Area(s): – Goal:

Your Student Tier III Supports Individualized Assessment Math, Reading, Behavior Lifestyle Impact Self-Determination Tier II Supports Regular Check-in Tier I Supports Instructional curriculum Explicit instruction School-wide behavioral expectations Tier III Supports Tier II Supports Tier I Supports

Remember that the multiple tiers of support refer to our SUPPORT not Students. Avoid creating a new disability labeling system. Reading Behavior Math Health

Core Features Core Feature: The aspects of a context (home, school, work place) that make a difference in your valued outcomes Programs vs. Core Features

Tier I PBIS Core Features Consequences for Problem Behavior School-wide Expectations System to Acknowledge Behavior Leadership Team Classroom Systems Data and Decision System Bully Prevention Family Engagement Tier I PBIS

Tier II PBIS Core Features Increased Level of Feedback Increased Structure Additional instruction on Behavior Tier II, III Leadership Team Increased Intensity of Data Collection Increased Family Engagement Tier II PBIS

Tier III PBIS Core Features Individualized Support Assessment Capacity Individual Support Planning Individual Student Team Increased Intensity of Data Collection Increased Family Engagement Tier III PBIS

MTSS Systems Focus on core features is essential Attention to the Systems that Support these Practices will produce sustainable and affordable outcomes. – Policies – Staff selection procedures – Professional development and coaching – Team development and operation – Data Systems

Effective, Efficient, Equitable Schools

The Promise and the Need The promise is an educational system that is effective, efficient and equitable Inclusive education with lifestyle impact The need is for research, demonstration and advocacy documenting that MTSS is possible, effective and affordable.

SYSTEMS PRACTICES DATA Culturally Knowledgeable Staff Behavior Culturally Relevant Support for Student Behavior OUTCOMES Culturally Equitable Academic & Social Competence Culturally Valid Decision Making

School-wide Positive Behavioral Interventions and Supports (SWPBIS) The social culture of a school matters. A continuum of supports that begins with the whole school and extends to intensive, wraparound support for individual students and their families. Effective practices with the systems needed for high fidelity and sustainability Multiple tiers of intensity

Schools using PBIS August, ,278

Number of Schools Implementation SWPBIS (Tier I) by State August, States with more than 500 schools

Proportion of Schools Implementing SWPBIS by State August, States with at least 40% of all schools using PBIS No Tipping Point

Experimental Research on SWPBIS Bradshaw, C.P., Koth, C.W., Thornton, L.A., & Leaf, P.J. (2009). Altering school climate through school-wide Positive Behavioral Interventions and Supports: Findings from a group-randomized effectiveness trial. Prevention Science, 10(2), Bradshaw, C.P., Koth, C.W., Bevans, K.B., Ialongo, N., & Leaf, P.J. (2008). The impact of school-wide Positive Behavioral Interventions and Supports (PBIS) on the organizational health of elementary schools. School Psychology Quarterly, 23(4), Bradshaw, C. P., Mitchell, M. M., & Leaf, P. J. (2010). Examining the effects of School-Wide Positive Behavioral Interventions and Supports on student outcomes: Results from a randomized controlled effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, Bradshaw, C.P., Reinke, W. M., Brown, L. D., Bevans, K.B., & Leaf, P.J. (2008). Implementation of school-wide Positive Behavioral Interventions and Supports (PBIS) in elementary schools: Observations from a randomized trial. Education & Treatment of Children, 31, Bradshaw, C., Waasdorp, T., Leaf. P., (in press). Effects of School-wide positive behavioral interventions and supports on child behavior problems and adjustment. Pediatrics. Horner, R., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A., & Esperanza, J., (2009). A randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in elementary schools. Journal of Positive Behavior Interventions, 11, Horner, R. H., Sugai, G., & Anderson, C. M. (2010). Examining the evidence base for school-wide positive behavior support. Focus on Exceptionality, 42(8), Ross, S. W., Endrulat, N. R., & Horner, R. H. (2012). Adult outcomes of school-wide positive behavior support. Journal of Positive Behavioral Interventions. 14(2) Waasdorp, T., Bradshaw, C., & Leaf, P., (2012) The Impact of Schoolwide Positive Behavioral Interventions and Supports on Bullying and Peer Rejection: A Randomized Controlled Effectiveness Trial. Archive of Pediatric Adolescent Medicine. 2012;166(2): SWPBIS Experimentally Related to: 1.Reduction in problem behavior 2.Increased academic performance 3.Improved perception of safety 4.Reduction in bullying behaviors 5.Improved organizational efficiency 6.Reduction in staff turnover 7.Increased perception of teacher efficacy 8.Improved Social Emotional competence SWPBIS Experimentally Related to: 1.Reduction in problem behavior 2.Increased academic performance 3.Improved perception of safety 4.Reduction in bullying behaviors 5.Improved organizational efficiency 6.Reduction in staff turnover 7.Increased perception of teacher efficacy 8.Improved Social Emotional competence

The role of fidelity measures Measure if a practice is being used as intended. “Certify” implementation impact…not trainers or materials Measuring fidelity as a Dependent Variable For research or evaluation purposes Need for high-quality measures of fidelity Measuring fidelity as part of the Independent Variable To assist implementation, sustainability and continuous improvement Need for high-efficiency measures of fidelity

~80% of Students ~15% ~5% Fidelity Measures within SWPBIS

Using Fidelity Data Assessing the extent to which we are implementing what we claim to implement Use of the data for decision-making

Sub-scale report

Sub-subscale report Tier I Teams Implementation Evaluation Tier II Teams Interventions Evaluation Tier III Teams Resources Assessment Support plan Monitoring and adaptation

Item Report

Action Planning 01. Team to propose teaching template and Fall teaching schedule at Feb 16 Faculty meeting. Alan Feb 16

Tier I Fidelity by State TFI, BoQ, SET, TIC 10,705 schools with measured Tier I fidelity Count of Schools Using PBIS Count of Schools Measuring Fidelity Count of Schools Achieving Fidelity

Tier II TFI, ISSET, MATT, BAT 1,670 schools Tier II Fidelity

Tier III TFI, ISSET, MATT, BAT 1,670 schools Tier III Fidelity

Anecdotal Findings Tier III supports are more likely to be implemented and more likely to be effective if delivered with a full MTSS Framework. Individualized supports are more likely to lead to durable, lifestyle change if implemented within a full MTSS Framework.

Research Needs Demonstrate that MTSS is possible Math, Reading, Behavior Demonstrate that MTSS is effective Effective for all students, including those students with more severe disabilities Demonstrate that MTSS is affordable

Goal 2

Thank You Questions/ Comments