The Pyramid Framework within Early Intervention Programs:

1. The Pyramid Framework within Early Intervention Programs:  Promoting the Social Development of Infants and Toddlers

2. What we hope to accomplish in this webinar • Provide rationale for Teaching Pyramid • Explain why the Teaching Pyramid is a useful model for thinking about social emotional development of infants and toddlers. • Examine some of the key features of model as applied to very young children and their families. • Talk about some of the promise and the challenges of such an approach.

3. The Teaching Pyramid: Promoting Social and Emotional Competence and Addressing Challenging Behavior Treatment/Focused Intervention Intensive Interventions Individualized Intervention Focus on Caregiver-Child Interaction Prevention High Quality Supportive Environments Universal Promotion Nurturing and Responsive Relationships

4. Key Ideas Underlying Multi-Tiered Models • Pyramid provides a tiered intervention framework of evidence-based intervention for promoting the social, emotional and behavioral development of young children. • Model describes 3 tiers of intervention practice: • Universal promotion for all children. • Secondary prevention to address the needs of children at risk for social-emotional challenges. • Intensive or tertiary intervention for children with persistent challenges.

5. Strong foundation is important in all multi-tiered systems of support. • Foundation: If this is in place, most children won’t need more intensive interventions. • In Teaching Pyramid, Foundation is: • Nurturing and Responsive Relationships • High quality Environments

6. CSEFEL Pyramid Model: Promoting Social Emotional Competence in Infants and Young Children Intensive Intervention Systematic approaches have preventive and remedial effects on social emotional develop- ment. Targeted Social Emotional Supports  • Supportive, responsive relationships among adults and children are necessary for promoting social emotional development • High quality environments promote positive outcomes for all young children Nurturing and Responsive Relationships AND High Quality Environments

7. The Teaching Pyramid – Key Ingredients for Supporting Social Emotional Development • Focus on promotion and prevention rather then reactive procedures • Positive interactions • Consistency and predictability in the classroom routine • Clearly defined expectations • Engaging activities • Focus on intentional teaching of social skills and emotional competencies • Acknowledging the relationship between social skills and challenging behavior • Understanding the function of children’s behavior and matching our strategies to the function of behavior • Teaching across the day rather then in response to challenging behavior • Giving children strategies that they can use in a variety of situations

8. Program Perspective Benefits of the pyramid approach

9. Benefits: Stronger Relationships • Teacher/child interactions are more intentional & meaningful. • Teaching staff understand what “trips their trigger” and how their reactions can escalate challenging behavior. • There is a real partnership between the family and the teaching staff. They build a relationship. • Families have said that they have learned to like their child again!

10. Benefits: Improvements in Staff Morale, Confidence, and Teamwork • Staff satisfaction has increased. • Staff turnover has decreased. • Staff feel confident in their consistent use of PBS strategies. • Staff have more time to teach because they are better prepared for the children. • Staff work better as a team.

11. Benefits: Staff Empowerment • Staff are implementing the Teaching Pyramid with fidelity. • Staff are better able to track children’s challenging behavior and respond proactively. • Staff have hope! • The focus is on prevention instead of intervention.

12. Benefits: Child Outcomes • There are fewer referrals to external experts, we know what to do. • Children are improving in their social emotional competence over the program year. • Children are having fewer problems across the year. • Children are improving when they receive intensive behavioral interventions.

13. Tier One The foundation of the pyramid

14. Tier 1 in Infant-Toddler Classrooms • Primary caregiving • Routines are individualized based on the needs of each child • Adults use routines to interact socially with infants and toddlers • Adults interact verbally with children mapping their activities and emotions • Adults respond to children’s signs of distress

15. Tier 1 in Infant Toddler Classrooms • Adults support interactions between toddlers • Adults redirect children who are engaging in challenging behaviors

16. The Pyramid Infant Toddler Observation System (TPITOS) • Importance of translating theory to practice • Measuring implementation • Using information for professional development • Structure of the TPITOS • Classroom Design/Key Adult Variables • Red Flags • Current status of TPITOS

21. Finding children needing more than the foundation The importance of universal screening

22. Infant/Toddler S-E Screening • Child social-emotional development and functioning • Environmental support for child social-emotional behavior and development (center/classroom and home) • Key adult-child interaction behaviors that predict important child social-emotional outcomes

23. Social-Emotional Development & Functioning Ages and Stages Questionnaire- Social-Emotional (ASQ-SE; Bricker et al.) Caregiver report 10-15 minutes to complete Provides a cut-off score for social-emotional concerns

24. General Environment Support of Social-Emotional Behavior & Functioning The Pyramid Infant Toddler Observation Scale (TPITOS) 14 Red Flags 24 Classroom design and behavior items Rated on a 4-point scale (exemplary practice to not observed) Home Observation for Measurement of the Environment (HOME IT; Caldwell & Bradley) 45 items completed during home interview 6 subscales related to the home environment (parent involvement presence of appropriate materials and opportunities)

25. Considerations for Selecting & Implementing Repeatable Brief Easy to use and score Inexpensive Reliable and valid Capable of telling programs: When there is a concern What intervention needs to zero in on Whether intervention is making a difference

26. Recognizing Infants & Toddlers Needing more than Universal Intervention

27. Externalizing Concerns • Severe tantrums • Hitting, kicking, biting • Difficulty accepting guidance • Screaming no, throwing toys and materials

28. Internalizing Concerns • Withdrawn • Unengaged with people or materials • Sad, anxious, irritable • Have a hard time being comforted

29. Dysregulation Concerns • Difficult to read signals • Hard to recognize when they are happy or upset • Rapidly changing signals • Move quickly & with little warning to unconsolable crying • Difficulty calming • Difficulty with routines • Falling asleep, staying asleep • Feeding

30. Screening Identification • Parent or teacher report (ASQ-SE) • HOME • TPITOS

31. Tier Two Greater focus on individualization

32. Tier 2 Intervention • Intervention becomes more individualized • Involves a closer look at teacher-child interaction in the classroom • Focusing in on a child’s signals • Looking at adult behaviors that foster positive child behavior • Looking at adult behaviors that get in the way of supporting child positive behavior • Identifying specific ways that teachers can respond to a child’s individual signals to: • Support and build on positive signals • Reduce stress in response to negative signals

33. Indicator of Parent-Child Interaction IPCI (Baggett, Carta, & Horn, 2003) Brief rating scale following observation of authentic interaction activities at home/center Adult behaviors that facilitate child social-emotional development Adult behaviors that interfere with child social-emotional development Child engagement Child distress

34. IPCI Use • Completed for children for whom Tier 1 concerns are identified • ASQ-SE • HOME • Classroom Environment • Teacher-child interaction • Classroom supervisor • Lead teacher while observing assistant teacher-child interaction • Parent-child interaction in the center or home • Completed by a home visitor (teacher, family advocate, social worker)

35. Tier Three Intensive intervention

36. Who might need intensive intervention? • Children who are not showing progress in response to Tier 2 intervention. • Children whose development and behavior is identified as extremely off-track and teachers are unable to manage their behavior or support them without intensive supports.

37. Purpose of Tier 3 • No change as a result of your prevention strategies and intervention strategies at the lower levels of the pyramid. • Behaviors escalate.

38. Tier 3 • Team based process • Functional assessment • Individualized behavior support plan • Prevention strategies • Replacement skills • Adult responses to children’s behavior • Implemented across environments • Linked to services beyond the classroom as needed

39. Critical role of families in the infant-toddler pyramid

40. Role of Families in the Pyramid • Families are involved from the very beginning of the model. • If additional support is needed for a child, staff work directly with the family. We will go to their home or they can come to the center…family choice. • Training in Positive Behavior Support is available to families. • The family is considered the “expert” on the child. They play an important role in any planning process. • Families are taught to take Behavior Incident Reports.. Their observations are very valuable for planning.

41. Partnerships • Family support plans are an option. • Mental health partners are in the centers regularly to work with parents and staff on prevention strategies. • Mental health partners are available for consultation in the home, at the center or in their office…family choice. • The staff and the family are a team. We share results of our observations and compare our data. • We use specific praise with parents as well as children and each other.

42. We make it a point to celebrate small successes.

43. Summary and Conclusions • Some of the same features of the original Teaching Pyramid can be applied to programs serving infants and toddlers. • Strong foundation equals prevention. • We need to ensure fidelity of implementation of the foundation. • Families are a central feature of Infant-Toddler Teaching Pyramid. • Measures are available for carrying out universal screening to determine which children might need more intensive supports. • Measures for monitoring progress of children in their interaction with caregivers. • Successful implementation of the model will depend on the strong collaboration with community partners.