1. School-based Mental Health and Positive Behavioral Interventions and Supports and High Schools Maryland Safe and Supportive Schools Initiative A Collaborative Effort of the MSDE, Sheppard Pratt Health System, and Johns Hopkins University
Christina :Who is in the room: counties, roles etc. Intro of ourselves.
Susan Barrett
Director, PBIS Regional TTAC
Sheppard Pratt Health System, Implementer Partner Center on PBIS

2. Interconnected Systems Framework for School Mental Health
Tier I: Universal/Prevention for All
Coordinated Systems, Data, Practices for Promoting Healthy Social
and Emotional Development for ALL Students
School Improvement team gives priority to social and emotional health
Mental Health skill development for students, staff/, families and communities
Social Emotional Learning curricula for all students
Safe & caring learning environments
Partnerships between school, home and the community
Decision making framework used to guide and implement best practices that consider unique strengths and challenges of each school community

3. MDS3 Initiative
Funding: U.S. Department of Education’s Office of Safe and Healthy Students (OSHS)
Number of awards: 11 states (of 33 applicants):
Arizona, California, Iowa, Kansas, Louisiana, Maryland, Michigan, South Carolina, Tennessee, West Virginia and Wisconsin are S3 Grantees in the first cohort
Amount: 13M
Length: 4 years (October )
Partners: MSDE, Sheppard Pratt Health System, Johns Hopkins University A2

4. MDS3 Goals
1) Assess school climate, student engagement, and the school environment, 2) Implement evidence-based programs (EBPs) to meet student needs, based on survey 3) Improve conditions for learning, 4) Reduce school violence and substance use, and improve student engagement and the school environment to support student learning. A2
This initiative provides the opportunity to formally connect student achievement with the other conditions that we all understand are necessary for learning. As my Asst Sup. Says, this is about the elephant in the room….

5. Keys to 10 Year Success
Commitment of leadership at state, district and school levels
Private, public, & university partnership
Standards and Protocols developed and implemented
INFRASTRUCTURE developed to support state and regional
training capacity
State-wide impact:
877 schools in all 24 systems trained
740 implementing Tier 1/Universal PBIS with fidelity
PBIS Maryland WEBSITE and DATABASE, WIKI (

6. Keys to 10 Year Success (cont)
Ongoing Technical Assistance-Coaching Capacity (400 trained)
Ongoing Evaluation/Progress Monitoring
Evaluation Tools
Ongoing Data Collection for Decision Making
IPI (Implementation Phases Inventory), SETs, SWIS, BOQ
Ongoing expansion of Local School System infrastructure as numbers of schools increase—staff designation, coaches for schools, and funding
Federal Grants to support Rigorous Randomized
Evaluation Activity through JHU

9. USDOE’s S3 School Climate Model
Engagement
Relationships
Respect for Diversity
School Participation
Safety
Emotional Safety
Physical Safety
Substance Use
Environment
Physical Environment
Academic Environment
Wellness
Disciplinary Environment

10. Using Lessons Learned to Build Next Phase
Training must be ongoing and connected to previous and
upcoming activities.
High schools require additional supports to successfully
launch PBIS and implement it with fidelity.
Adolescent students with unmet social and emotional
needs create challenges
High schools are often unprepared to implement
Tier 2 and Tier 3 interventions or to address
mental health needs and resources at the local and
state level have been ??
Relatively few developmentally appropriate EBPs
(Greenberg et al., 2001).
Coaching is NECESSARY and supported by evidence (NIRN)
School Liaisons need to have a small school to staff person ratio
(PBIS Plus-6:1; MDS3 3:1)
Need to make the Focus School condition worthwhile for those schools. AA

11. Planning and Launching MDS3
MSDE , Sheppard Pratt and Johns Hopkins participated in the
recruitment of school systems and schools for the Initiative.
JHU developed a sustainable statewide, web-based measurement
system and administered to assess school safety, student engagement,
and the school environment, as reported by students, parents, and
school staff.
Data from the school climate surveys will be used, in combination with
incident data (e.g., suspensions, truancy) from MSDE, to generate a
climate (safety) score, which will be posted and used to determine
the need for tailored interventions and support services.

12. Maryland Safe and Supportive Schools (MDS3)
Implementation
“develop capacity in schools
to improve”
Research and evaluation
“sustainable system to
measure”
Administration
“disseminate outcomes to stakeholders”

13. Methodology Participating Schools Design
52 high schools across the state of Maryland
10 districts: Anne Arundel, Baltimore County, Charles, Caroline, Dorchester, Somerset, Washington, Wicomico, Worcester, and Queen Anne’s
Second cohort of up to 8 additional schools possible for spring 2012, for a
total of 60 schools
Design
3 years (spring 2011 through summer 2014)
All 52 schools participated in the data collection activities
29 “implementation schools” who are implementing the MDS3 Initiative
23 schools are in the “focus” or control group
Schools were randomly assigned to these groups
Participating schools were randomly assigned to either the Intervention or Focus condition. Intervention Schools were trained immediately, and Focus schools will participate in annual data collection and receive training at the end of the 4-year grant period.
School Climate Specialists are assigned to Intervention schools and provide assistance in using data for decision making, providing ongoing coaching, training, support, and on-site technical assistance in the implementation of a continuum of evidence-based prevention programs (EBPs).
Ongoing data collection, SCS intervention, District/Community Supports and State supports will contribute to sustainability.
3/11/2012

15. Design of MDS3 Observational Study
Funded by William T. Grant Foundation
4 data points, over 3 years
2 data collectors (1 ASSIST and 1 SAfETy)
25 classrooms per school (≈1500 per time point)
30+ non-classroom locations
Using handheld devices to collect data
Instruments
Assessing School Settings: Interactions of Students & Teachers (ASSIST): Rusby et al. (2001); Cash & Debnam
Praise, opportunities to respond, punishing statements, transitions, supervision, positive interactions, engagement, aggressive behavior etc.
Both event based and global ratings
School Assessment for Environmental Typology (SAfETy): Bradshaw, Lindstrom Johnson, Milam, & Furr-Holden
Features of the school environment that encourage access control, surveillance, territoriality, physical maintenance, and behavioral management (e.g., disorder, substance use, broken windows)

16. Menu of Evidence-Based Programs
Positive Behavioral Interventions and Supports
(PBIS; Sugai & Horner, 2006)
3 tiered prevention model, focused on climate and behavior management
Olweus Bullying Prevention Program
(Olweus, 2007)
Bullying and school climate
Botvin’s Life Skills program
(Botvin et al., 2006)
Substance abuse prevention
Check-in/Check-Out
(Hawken & Horner, 2003)
Mentoring and behavior management
Check & Connect
(Anderson et al., 2004)
Mentoring and truancy prevention
Cognitive Behavioral Intervention for Trauma in Schools
(Kataoka et al., 2003)
Focused on mental health issues (e.g., anxiety, depression)
PBIS- Beth
Olweus- Rebecca- period of time 6 months or up to 1 year. SW/Universal
Botvin’s- Beth- Universal,
CICO- Wayne
Check and Connect- Rebecca
CBITS- Christina- intense intervention lasts for 10 weeks for those who display symptoms of PTSD, Anxiety Depression related to trauma- DV, Nat disasters, violence 10 week session facilitated by a clinical/counselor-school/local MH agency, and student learn of their common ground, and develop coping skills to manage stress to increase their functioning in schools and everyday life.

17. Center for School Based Mental Health Nancy Lever and Sharon Stephan
Link to EBP resources specific to HS
Mobilize student, family, community
CBITS
Community Resource Mapping Manual
Cross train
Common Calendar
Increase ISF awareness, visibility

18. MDS3 School Climate Model: % Time Spent on “Valued Outcomes”
Engagement 42%
Check and Connect
Culturally Responsive Teaching
Relationships
Respect for Diversity
School Participation
Safety 9%
Olweus Bully Prevention
Botvin Life Skills
Emotional Safety
Physical Safety
Substance Use
Environment 47%
Check in Check Out
+ Academic Support
CBITS & Mental Health Awareness
Physical Environment
Academic Environment
Wellness
Disciplinary Environment

19. Evidence-Based Programs Implemented 2010-2011
These are the numbers of schools who implemented PBIS in the intervention group prior to the initiative 16 out of 29 schools.

20. Year 1: Foundation: Applying the Tiered Logic
Continuum of EBP
Fidelity of Implementation
Teaming Structure
Data System
Universal Screening and Decision Rules for Access
Data Base Decision Making Team Problem Solving
Continuous Progress Monitoring

21. Evidence-Based Programs Implemented 2010-2011 and 2011-2012
Current school year, red indicates this schools year and EBPs that schools have been trained in and are planning to implement or are implementing.

22. Evidence-Based Programs Anticipated Implementation for Year Two
Current year, and upcoming what schools are planning to implement next year, proposed plan.

23. MDS3 Data Sources Data for Decision-making:
Web-based school climate survey (students, school staff, parents)
Site visits - Health and safety of school environment
School-level records: referrals, suspensions, attendance, nurse and counselor log, academics
School-wide Evaluation Tool (SET), Individual Student Systems Evaluation Tool (ISSET)
Rebecca
Talk about the project design slide along with…All results are available on-line through a password protected web site
Schools and LEAs received a password to access data
3 Report Options
Quick Report – all data for all schools you have access to
Advanced Report – sorting function
Executive Summary - specific items
From Spring 2011
Students (n=22,389) ; Staff (n=3,842) ; Parents (n=2,063)

24. Spring 2011 MSD3 Student Climate Survey Results
Safety
___% feel safe at school
___% reported being bullied during the school year
___% reported that other students try to stop bullying
___% often or very often feel sad
___% reported that substance abuse is a problem at their school
Would predicting results increase rate of return?

25. Spring 2011 MSD3 Student Climate Survey Results
Safety
83.0% feel safe at school
25.0% reported being bullied during the school year
31.7% reported that other students try to stop bullying
20.2% often or very often feel sad
64.9% reported that substance abuse is a problem at their school
 3 separate slides and make it disappear and click on it.

26. Spring 2011 MSD3 Student Climate Survey Results
Engagement
___% feel they belong at school
___% feel their teachers encourage them to work hard
___% feel their parents are informed when they do well
___% feel students of all races are treated equally
Beth 
3 separate slides and make it disappear and click on it.

27. Spring 2011 MSD3 Student Climate Survey Results
Engagement
67.5% feel they belong at school
81.2% feel their teachers encourage them to work hard
43.9% feel their parents are informed when they do well
57.9% feel students of all races are treated equally
Beth
 3 separate slides and make it disappear and click on it.

28. Spring 2011 MSD3 Student Climate Survey Results
Environment
___% report that disruptions in the classroom get in the way of their learning
___% report the school building is clean and well-maintained
___% report that students who need help with their problems are able to get it at school
Rebecca

29. Spring 2011 MSD3 Student Climate Survey Results
Environment
60.5% report that disruptions in the classroom get in the way of their learning
49.4% report the school building is clean and well-maintained
63.6% report that students who need help with their problems are able to get it at school
Rebecca

30. Stages of Implementation Fixsen
Focus
Stage
Description
Exploration/
Adoption
Decision regarding commitment to adopting the program/practices and supporting successful implementation.
Installation
Set up infrastructure so that successful implementation can take place and be supported. Establish team and data systems, conduct audit, develop plan.
Initial Implementation
Try out the practices, work out details, learn and improve before expanding to other contexts.
Elaboration
Expand the program/practices to other locations, individuals, times- adjust from learning in initial implementation.
Continuous Improvement/Regeneration
Make it easier, more efficient. Embed within current practices.
Should we do it
Getting it right
Implementation is not an event
A mission-oriented process involving multiple decisions, actions, and corrections
Making it better

31. Expanding the SWPBS Implementation Blueprint
ISF Leadership Team
ISF Implementation Team
Systems Coach
Content
Family Community
Implementation Demonstrations

32. Policy: Shapes Adult Behavior
Equal priority to
Social Emotional Health and Wellbeing
Academic Achievement
Academic Behaviors
Organizational Skills
Team Problem Solving
Study Skills

33. Training Activity Based Training WIIFM Resource/Continuum Mapping
Inventory current interventions, practices
Service Delivery Teams- Who?
organization, role and function, communication
from case management to systems planning
assess skills, competencies across staff
Data: Student List, Early Warning Systems, ODR as screening tool
Implementation Snapshots and Practice Profiles

34. WIIFM? Why Am I Here?
How can I use this training to benefit the work I do everyday?
Prioritize which topics align with your district’s mission
With your schools goals
Share your thoughts at your table
Christina
Print these on card stock - Print for all

36. Before you add one more thing….
We plan for systems to support top two tiers .Creating foundations to support the maintenance of those behaviors.

37. Linking to Outcome/Strategic Plan How do we support adults?
Resource Mapping
Taking Inventory
Linking to Outcome/Strategic Plan
How do we support adults?
How do we make sure we invest in what works with our students/youth?
What data will help keep us on track?
Conversation starter: This is not to be completed, just to get them started and then they can take back.
Materials: Lamenated triangle poster, removable stickers, list of ebp and resources for identifying ebps

38. Practices, Initiatives, Programs for a FEW
Triangle Activity:
Applying the Three-Tiered Logic to Your School , District or State
Tier 3
Practices, Initiatives,
Programs for a FEW
Tier 2
Practices, Initiatives,
Programs for SOME
Tier 1
See workbook
What do you have in place for behavior interventions for all, some, and a few? Think about this on a school-wide level and maybe think about it around one of the top behaviors in your school. Say disrespect or disruption. Think about kids down the road too-who do not respond to universal.
Be sure to make the connections to the pyramid for academics and you will always look to both –the connections. Our work will be looking at what we have, what can we tweak, and what are we missing.
What are the EBPs? How are you monitoring effectiveness with data? Are there any that are really getting significant outcomes?
How will you take your staff through this process?
Practices, Initiatives,
Programs for ALL
George & Barrett (2011)

39. Screening & Feedback Essential to developing effective systems
Effective systems allow for high fidelity of implementation
Often overlooked

40. Activity: Student List
Name
Grade Level
GPA last year
Behavior Referrals
Core Grades
Attendance
Credits
Jana 9
2.2
4 ref
1 D 1 F
82%
On Track
Blake 11
1.3 3F
88% -3
Toby 10
2.8
16 ref 1 S
2D 1 F
84% -2
Carlos .7
22 S 3 S
4 F
62% -4
Yvonne
2.7
2 ref
2 D 1 F
86% -1
Lin
2.3
1 F
90%
Maria 12
1.9
16 ref 2 S
4 D 1 F
74%
Doug
3.1
81%
Tyrone
2.9
10 ref
2 D
89%
Sam
2.4
13 ref
87%
Paul
3.4
1 ref
1 D
Tia
3.7
2 C
60%
Who gets access to an intervention that integrates academic/behavioral support ? Choose 6 students.

41. Activity: Student List
Do you have rules for access?
Do you need to lower the threshold?
Are there other sources of data available?
Can you get access to a data dash board?
What else should we know about the students?
Do any staff in building have relationship with the student?
What are some possible political implications of choosing the students you chose?
Leads to the integration
Reflect on the team dynamics

42. Decision Rules for Access to Advanced Tiers (and decision rules for prevention-if we can predict the trajectories , then we can prevent it from happening)
Youth has 2 Major ODRs
Youth has 1 Suspension
Youth experiences more than ? minutes out of instruction
Youth misses more than ? days unexcused absences
Youth drops GPA by more than ??
Youth – benchmark testing- McIntosh
Youth- incomplete class work/homework
Attendance (look at predictors for drop-out and school completion)
Admin Referral
Teacher/Staff Referral
Family Referral
Other:
Services and Interventions are available as soon as the student demonstrates a need
Flags for discussion
Data Dashboard
Multiple places to get access
data we've used in a couple of
districts. As far as academics go, they're not 100% predictors (i.e.,
not all students with academic deficits end up with behavior
challenges), but people have been using them as flags for discussion. So
if a student is flagged as "at risk" (aka deficit, tier III, red zone),
their name gets raised as a possible student requiring behavior support
as well. Because some students have academic problems but won't ever
need behavior support, it's ok for a team/teacher to veto the need for
behavior support.

43. Screening: Early Warning Systems
Research is clear that ninth grade is a “make or break” year. More students fail ninth grade than any other grade in high school, and a disproportionate number of students who are held back in ninth grade subsequently drop out (Herlihy, 2007).
The most powerful predictors of whether a student will complete high school include course performance and attendance during the first year of high school (Allensworth & Easton, 2005; 2007).
Therefore, systematic collection of student attendance and course performance data can be used to develop an effective early warning system that can also be tailored to local contexts.

44. Early Warning Indicators Office Discipline Referrals
Course Performance in
Core Subjects
GPA
Credits
FCAT/
Concordance
Scores
Attendance
Office Discipline Referrals
Additional
Factors
On-Track Indicators
On-Track
Meeting all graduation requirements
Cs or better in all areas
2.5 or more
Meeting credit graduation requirement for grad plan year
Level 3 or Above or concordant scores within the same school year
4% or less absences per quarter or semester
3 or less Level I and/or minor referrals
Disengagement
No extra curricular involvement
Substance Abuse
High Mobility
Depression
Anxiety
Free/Reduced lunch
Foster/group home
Transient/Homeles s
Parent unemployment Student employment
Changes in behavior/ appearance
More recent traumatic event
Missed guidance appointments
No show for yearbook picture
At-Risk for
Off Track
Lacking 1 graduation requirement
2.0 to 2.49
Behind
1 Credits
Level 2 on FCAT
5% or more absences per quarter or semester
4 or less Level I and/or minor referrals
Level II ODRs per semester
Off-Track
Lacking 2 graduation requirements
Failing 1-3 classes
Less than 2.0
Behind 3 credits
Not passed both sections of 10th grade FCAT or retakes
No concordant scores
10% absences per quarter or semester
5 or more Level I and/or Level II ODRs per semester
Highly Off-Track
Lacking 2 or more graduation requirements
Currently failing 3 or more classes
Less than or equal to 1.5
Behind 4 or more credits
Not passed 10th grade FCAT or retakes
15% or more absences per quarter or semester
5 or more Level II ODRs for fighting/ profanity/ disruption per semester
Extremely
Meeting no graduation requirements
2-3 Years Behind
Less than or equal to 1.0
Not meeting cohort graduation plan
20% or more absences per quarter or semester
Established pattern of severe behavior
Level II & III ODRs
Relationship
Expansion of community data with GPS

45. Critical Features for Implementing Advanced Tiers of Support:
Establish decision rules for access to the intervention
Explore data and “look” for students in need
**Refrain from grouping students with similar life circumstance (divorce/bully etc)
Group based on demonstrated need- response to the life circumstance and the coping skills required
Interventions are linked directly to the SW expectations and/or academic goals
Interventions are always available to students
Monitor progress of student- (outcome with data in and data out)
Staff are trained, receive ongoing support, and are provided feedback.
This is innovation neutral. It could be for academic or behavior – or the two combined.

46. Office referral as a universal screener

47. Types of Coaching: Selection and Recruitment for the “Right Fit”
Coaching for Individual Change:
focus on skill development, support and performance feedback (content specific: academic, behavior)
Coaching for Team/Group Change:
focus on collaboration and facilitation, group dynamics
Coaching for Systems Change:
focus on organizational change

48. Development of the Team/Staff
Level 4 – High Competence, High Commitment – Fluent and experienced with innovation, and comfortable with their own ability to do it well. May even be more skilled than the coach . Level 3 – High Competence, Variable Commitment – Experienced and capable, but may lack the confidence to go it alone, or the motivation to do it well / quickly. Level 2 – Some Competence, Low Commitment – May have some relevant skills, but won’t be able to do the job without help. The task or the situation may be new to them. Level 1 – Low Competence, High Commitment – Generally lacking the specific skills required for the job in hand, but has the confidence and / or motivation to tackle it.

49. Systems Coach Skill Coach for Practitioners Support to Leadership
Systems Change Coach (Facilitator/
Communicator)
Organizational/Systems Change OR The Development of Effective, Productive, Collaborative Systems that create optimal Conditions for Learning
Rebecca

50. Support To Leadership Listen, model
Advocate for School-Wide Support through data
Broker Resources to Include EBPs
Be a “New Pair of Eyes”
Provide an Objective View of a Situation
Lead in the Direction of Sustainability
These are all skills we model in the school even though we are not an appointed leader

51. Skill/Coach for Practitioners
Provide Direct Training, recruit next trainer
Serve as the System Level Interventionist
Promote Common Language That’s Productive
Provide Scaffolding
Model Active Listening
: think FBA language that teachers are not trained in—more integrated approach and overlapping their language and getting on same page with programs

52. Facilitator/Communicator
Develop Effective Communication Systems
Facilitate Sharing Different Views and Perspectives
Guide Through:
a. Self-Assessment of Efficiency
Evaluation
Needs Assessment
Use of Data
Critical Features of Systems and Programs
Wayne/Beth

54. Coaching: % Of Time Spent w/ Each Group
% of time across al visits

55. Coaching: % Of Time Spent On Each
Type Of Coaching

56. Percentage Of Time Spent On…

57. Top Small Group Hours

58. Challenges
What is a School Climate Specialist? School leadership opposition Staff buy-in Lack of systems structure “B.D.T.R.B. Syndrome” Been Down This Road Before Involvement of whole staff

59. School Climate Specialists’ School Visits
Wayne/Beth
Don’t get into general situations of support SST etc…just go over the fact that we start where schools are and build from there.

60. Lessons Learned in the School Climate Specialist Role
Support May Look Different From School-to-School
Expect Successes and Challenges
Healthy Debriefing Among Colleagues is Good Practice
Pushback from Schools is not Personal
Flexibility is Key in Maintaining Healthy Relationships with School Teams
Three Schools Seem to Be the Limit for Successful Implementation of EBPs
Serve as a Guide, Facilitate not Direct
Celebrate Even the Smallest of Successes
Remember… You are a Guest in the School
Wayne/Beth

61. Lessons Learned About Evidence-Based Programs
Let Schools Work Within their Own Timeline
For Some Interventions (e.g., Tier 2 and Tier 3), It Is Okay to Start Small and Work the Kinks Out
Utilize Data To Make Decisions about Evidence-Based Programs
Celebrate Even the Smallest Successes
Realize that Program Implementation Will Not Take Place the Day After Training
Work With What’s Already in Place To Formalize or Document EBPs
Don’t just do “IT” to say “we do IT.”
Wayne and Beth
#5 some kids have to go down the river. Have a plan and structure. Not going to happen right away. #6 Some schools are already using EBPs, but need more training and/or to formalize and set up criteria- Becky has example. #7 what George was saying this morning about starting slow, small and doing it for right reasons.

62. Lessons Learned about Stakeholders
Administrator Buy-In is Critical for Success
Make Sure Team is Representative of Staff
Know Who Has the Power in the School and Work Through Them
Gather Student Feedback and Participation
For Sustainability, Business/Community Support is Imperative
Expect Changes in Team Composition Over Time
Recognize school readiness signals in order to advance to next steps
Christina
7. “positive nag

63. Lessons Learned in Implementation Steps
Each school is in a different phase-make sure you are also in that phase.
Each stakeholder on the team has a different agenda and perspective about needs.
Each member of the team will have the “aha” moment at different times.
Implementing step 2 before step 1 will sometimes help you have a stronger team. It is okay to go back.
Staff may need training in the program before they
can commit and commitment is never assured.
Rebecca

64. Year 2 State Integration Team District and Community Team
Community Resource Mapping
GIS (geographic information system) mapping of the locations of the schools in relation to community-based resources (e.g., libraries, churches, hospitals, community centers) and risks (e.g., alcohol outlets, crime). We are also linking the schools with community level census data (e.g., income of surrounding zip codes).
This will allow us to examine some macro-level factors related to the survey data and school-based observational data collected in the project.
  Data will enrich the information available to the schools, as well as the research on community-level correlates of school climate.

65. Year 2: Capacity RENEW CBITS School based team expansion
Implementation Briefs
ISF Facilitation Guides
Funding, Tools, Team
Readiness Checklist for Integration
ISF Consumer Guide
A process that utilizes the strengths of the individual, fosters his/her self determination and builds a system of care around the individual so that s/he will more likely be successful in school and other life domains

66. Share Your Thoughts…Questions?
Acknowledgements “The Elite Eleven” Beth Chatfield, Kim Crawford, Lacey Hentz, Wayne Hickman, Christina Jordan, Christina Knepper, Mike Muempfer, Rebecca Piermattei, Rebecca Philbrick, Morgen Piper, Brian Tureck Patti Hershfeldt, Jerry Bloom, Aniket Joshi, Muriel Smoot Catherine Bradshaw, Katrina Debnam Martha Essenmacher, Mike Ford, Andrea Alexander “No significant learning occurs without a significant relationship." Dr. James Comer
Rebecca and all