1. EDUCATIONALLY RELATED MENTAL HEALTH SERVICES (ERMHS) PROCESS AND WRITING OF BEHAVIORAL GOALS Behavioral Health Team

2. INTRODUCTIONS Behavioral Team: Amil Alzubaidi Kelly Cohen Jessica Conquest Beth Haile James Holmes Lara Pasce Neha Saluja

3. TWO TRACKS Special Education Student with Non-Threatening Behavior Special Education Student with Threatening Behavior

4. TRACK ONE Special Education Student with Non- Threatening Behavior

5. FIRST STEP Present Levels of Performance (PLOP) note behavioral concerns Behavior Goals associated with PLOP baselines Tier II Behavior Plan (SEIS-Document Library-Tier 2 Behavior Support) If the student is not demonstrating anticipatory progress to the intervention as determined by progress on goals and/or team input (typically for 4-6 weeks) schedule an IEP meeting to discus next steps.

6. SECOND STEP Functional Behavioral Analysis/Assessment Schedule an IEP meeting and provide the parent/guardian with an AP for a Functional Behavior Assessment (FBA). In the interim, update the Tier II behavior plan until the assessment is complete. Once the assessment is complete, schedule an IEP meeting to review the FBA and determine need for BIP. If team determines need for BIP then develop; otherwise, update the Tier II behavior plan with the new found information. Implement either the updated Tier II behavior support plan based on the data from the FBA or the new BIP. Please also update accommodations and goals If the student is not demonstrating anticipatory progress to the intervention as determined by progress on goals and/or team input (typically for 4-6 weeks) schedule an IEP meeting to discus next steps.

7. SECOND STEP WHY A BIP (Determined by the FBA) 1. If we are to effectively address the maladaptive behavior we need to know the following The Function of the behavior What changes in the environment are necessary for the student How to effectively reinforce the student Reaction strategies to implement should the primary intervention fail 2. Our BSLC/BCS teams require this information for the following: Should the student be triggered and escalated, the BIP is the team’s primary plan to assist in returning the student back to baseline Should the primary staff be out then the BIP serves as a plan to support the student for those staff who are not familiar with the student 3. Regardless of the student being diagnosed with a Mental Health condition a FBA and BIP are necessary to support the team in addressing the needs of the student

8. THIRD STEP Counseling provided by the School Psychologist Schedule an IEP meeting and document rationale for counseling support provided by the School Psychologist. Schedule a follow up IEP and have the School Psychologist present recommendations to the IEP team for DIS counseling services that are directly related to the behavioral goals. The recommendations will be implemented for a period of time (4-6 sessions). If the student is not demonstrating anticipatory progress to the intervention as determined by progress on goals and/or team input (typically for 4-6 weeks) schedule an IEP meeting.

9. CONSULT Please consult with ERMHS Coordinator prior to drafting an Assessment Plan! Amil’s cell 951-813-5078

10. FORTH STEP Educationally Related Mental Health Assessment Therapeutic Services After consulting with ERMHS Coordinator diagnostic sessions may be added to gain input/insight of the student and utilize information from the FBA/PBIP to develop baseline and related goals to support need for ERMH counseling. Placement Conducted by the therapist If Social Emotional Assessments are older than one year, the school psychologist will concurrently update social/emotional assessments with the ERMHS assessment.

11. FORTH STEP What is in an ERMHS Assessment 1. Reason for referral 2. Educational History 3. Mental Health History 4. Development and Health History 5. Relationship and Family Dynamics 6. Prior Treatment 7. Classroom Observation 8. Clinical Interview and Observation 9. Summary 10. Treatment Recommendations Goals Services Placement

12. FIFTH STEP Placement If the ERMHS assessment recommends placement in BSLC 1. The BSLC team will be notified and a pre-staffing must be held. Documents will be provided to the BSLC team to include Psych report ERMHS report Current IEP Attendance Discipline 2. BSLC representative will be invited to attend IEP meeting if recommendation is a change in placement

13. TRACK TWO Special Education Student with Threatening Behavior Self-injurious Assaultive behaviors Behaviors causing property damage which could lead to suspension/expulsion Pervasive Maladaptive behavior resistant to other attempts at behavior modifications (i.e. elopement, verbal threats)

14. FIRST STEP Present Levels of Performance (PLOP) note behavioral concerns Behavior Goals associated with PLOP baselines Provide the parent with an assessment plan for an FBA Schedule an IEP meeting within 24 hours (if the student does not already have a BIP for the behavior). Develop a Tier II for the interim (if one does not already exist) until the FBA is complete.

15. NEXT STEP Proceed with steps three to five previously addressed in the section of Special Education Students with non-threatening behavior.

16. COMMUNICATION How do I get a hold of Amil? 951-813-5078 If Wraparound services are recommended what do I do? BCS will present findings at IEP meeting and provide release of information to various NPA’s Forward signed IEP consenting to WRAP services to Amil Amil will forward IEP and releases to NPA’s NPA’s will review and notify acceptance (about a 2 week process excluding weekends and holidays) Once approved IEP will need to reconvene to add WRAP services Who should I speak with in navigating next steps? Program Specialists Amil Behavioral team What if I have a student who is actively ……..? Call Amil Can I fast track or skip steps in the process? Depends on the individualized needs of the student! Call Amil

17. GOAL WRITING First Step Gather your data in relation to behavioral/Social/Emotional and possibly Replacement/extinction concerns. Review standardized behavioral ratings and look for pattern or heightened areas of concern. Interview staff to cross reference standardized measures. Enter the information in the PLOP’s Social Emotional section and area of goals developed.

18. GOALS Second step Develop clear and measurable baselines What is the area of concern How long has the behavior been observed to interfere with the student’s educational performance Where is the behavior of concern occurring? What is the student actually doing? How often is the student engaging in the behavior of concern? Is the student consistent or inconsistent with his behavior? How often are staff prompting the student and is it verbal or gestural How was this information determined

19. GOALS Second Step: Anger/ frustration Joe has been displaying these behaviors for the last 4 months Joe’s math teacher and support staff Joe has been slamming his fists on the table and telling staff and peers to shut up and leave him the hell alone Joe has been engaging in this behavior in 9 out of the 10 whole group discussion and 7 out of the 10 small groups Joe’s Math teacher has reported that this has been area of concern each time she either begins a whole group lesson or when working in small groups with support staff. Staff have prompted the student 7-10 times to take a break Teacher input on the behavior al rating scales, interview with teacher and staff

20. GOALS Developing the Goal: S = Specific Write a goal in a targeted behavioral area (coping skills, boundaries, anger management), include clear descriptions of the skills being observed (DO NOT WRITE IN A METHODOLOGY), and level of attainment (to age level, without prompting, with what number of verbal or gestural prompt) M = Measurable how progress will be measured, direction of behavior (increase, decrease, maintain) and what environment progress will be measured (LA class, PE, in the counseling session). Must use numbers and they must be meaningful. It is important that the baseline measurement is comparable to the goal measurement, this way we can see how much progress has been made in a year. A = Action words/Attainable (verbs) In drafting the goal bare in mind what the child may be able to achieve with the appropriate services and supports. Remember, if the student exceeds expectations and meets their goal early, you must schedule an IEP meeting and review the goal and determine if another goal is warranted. R = Realistic & Relevant (achievable) Although we often pull from a goal bank, it is important to modify and individualize the goal to address the unique needs and disability of that particular student. The goal should measure outcome not activity! T = Time Limited Start by considering the baseline and present levels of the student, then decide what exactly they need to be able to do after one year of special education services and supports. You must be able to progress monitor goals at regular intervals (progress reporting).

21. GOALS Third Step What do you want the student to do! Focus the goal to be measurable, positive and the setting in which the goal will be measured. Please incorporate the duration of time the goal will be measured. Attributes Perspective Communication Interaction Minimize the use of drafting decreasing negative behavior as a goal. Ex: Joe will use negative statements about his peers during language arts in 3 out of 5 consecutive interactions as measured by teacher generated data sheet. Minimize the use of 100% or 5 out of 5 as a desired outcome Note: if the student is engaging in self harm thoughts and/or behavior then the focus should be in 5 out of 5 or 100% as a desired measure.

22. GOALS Third Step Part one: Area of Focus Part Two: By When (specify date) Part Three: Who (specify student’s name) Part Four: Will do what written in a positive, measurable and objective format Part Five: At what level of proficiency and when to measure Percentage or number of times Consecutive or non- consecutive trials Part Six: Under what conditions Setting: Classroom Therapy room Prompts: Verbal Gestural Times Part Seven: How will staff measure & Who will measure (only use staff titles)

23. GOALS Step Three Anger Management 3/31/2016JoeWill ask for a break when he begins to tighten his hands into a fist In 4 out of 5 consecutive interactions During small or whole group instruction in the math directed studies class. As measured by staff generated log over a two week time period

24. EXERCISE Please review the following goal and answer the following questions: 1. What is the goal targeting? 2. Is the goal clear, measurable and objective? 3. In what setting is the goal to be measured? 4. Does the baseline directly correlate to the goal?

25. EXERCISE Goal Examples: 1. Baseline: Joan inconsistently engages in concealed purging behaviors and will make suicidal statements when reporting frustration, agitation or anger in 4 out of 5 observed interactions. 1. Goal: By 11/30/2016, when reporting thoughts of self-harm or suicidal ideation, Joan will seek a trusted staff member and identify at least 2 positive coping strategies developed between Joan and therapist with a trusted staff member in 5 out of 5 opportunities over a two week data collection period with no more then 2 verbal prompts.

26. EXERCISE Goal 1 1. What is the goal targeting? Safety 2. Is the goal clear, measurable and objective? Yes why? 3. In what setting is the goal to be measured? MISSING 4. Does the baseline directly correlate to the goal? Yes why?

27. GOALS Goal Bank Google Docs

28. THANK YOU A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove... but the world may be different because I was important in the life of a child. Forest E. Witcraft