Tier Two Interventions for Escape-Maintained Problem Behavior

1. Tier Two Interventions for Escape-Maintained Problem Behavior Justin Boyd & Jessica Turtura University of Oregon School Psychology Program March 8, 2010 BRB CICO

2. SWPBS Tertiary interventions Secondary interventions w/function-based modifications • Secondary Interventions • CICO • First Steps to Success • Skills groups • Primary Prevention • Tier 1 SWPBS • Second Steps • Strong Kids

3. Secondary Interventions in SWPBS • Secondary interventions should require low effort on the part of teachers and staff • Be consistent with school-wide expectations • Should be able to be implemented quickly and efficiently • Provide increased opportunities for feedback about student behavior and provide multiple opportunities to practice skills • Data-based decision-making is key • Selecting students for the intervention • Progress monitoring An example of an evidence-based secondary intervention is Check-In-Check-Out

4. Addressing Behavioral Function Behavioral Functions

5. Addressing Behavioral Function at the Secondary Level Behavioral function is not always a consideration when placing students into tier two interventions Evidence suggests that interventions may be more effective when they address the specific function of the student’s problem behavior Incorporating function-based components at tier 2 is feasible

6. Check-In-Check-Out • Improved structure • Prompts are provided throughout the day for correct behavior. • System for linking student with at least one positive adult. • Student chooses to participate. • Student is “set up for success” • First contact each morning is positive. • “Blow-out” days are pre-empted. • First contact each class period (or activity period) is positive. • Increase in contingent feedback • Feedback occurs more often. • Feedback is tied to student behavior. • Inappropriate behavior is less likely to be ignored or rewarded.

7. Research Support for CICO • Evidence Supporting its Effectiveness • Increase academic engagement, reduce problem behavior (e.g., Fairbanks et al., 2005; Filter et al., 2007; Hawken & Horner, 2003) • Highly acceptable to teachers, parents, students (e.g., Hawken et al., 2007) • Can be modified for different behavioral functions (March & Horner, 2002; Fairbanks et al., 2005) • but is often done so on an individual basis

8. CICO Limitations • Most effective for attention-maintained problem behavior • Less effective for escape-maintained problem behavior • Modifications required • May be less effective in middle schools • Aversive properties resulting from academic skill deficits • Importance of organizational and study skills

9. Who is CICO indicated for? Mild problem behaviors Student’s who are sensitive to adult attention Student’s whose problem behaviors are maintained primarily by adult attention

10. Addressing Escape-Maintained Behavior at the Secondary Level • Who’s left? • work avoiders • off-task • escape-maintained • students who lack academic or organizational skills • Student for whom adult attention is not highly reinforcing

11. When escape is the prevailing reinforcer • Considerations for Practice • Systematic modifications versus individualized interventions • Mechanisms to address function directly • Appropriateness & “fit” • Elementary • Secondary

12. Our Focus Tier two interventions for students whose problem behaviors are, in part, maintained by escape or avoidance Special considerations for elementary and upper levels Building off an existing secondary intervention

13. Breaks are Better (BrB) BRB Justin Boyd, M.S.

14. Alternative & Replacement Behaviors • An Evidence Based Practice • e.g., Bird, Dores, Moniz, & Robinson, 1989; Brown et al., 2000; Carr & Durand, 1985; Durand & Carr, 1987, 1991; Hagopian, Fisher, Sullivan, Acquisto, & LeBlanc, 1998; Mildon, Moore, & Dixon, 2004; Wacker et al., 1990 • Logic & Examples • Children with communication deficits • Typically developing children (e.g., Stahr et al., 2006; Filter & Horner, 2009) • Typically considered as part of a Tier 3 intervention • Escape-maintained problem behavior

15. BrB Concept • CICO teaches students to recruit adult attention • BrB with CICO teaches students to recruit brief-breaks as a functionally equivalent alternative to problem behavior. • Breaks are Better (BrB) • Implemented in the same way as CICO • Includes the use of Replacement Behavior • Directly addresses escape /avoidance functions

16. Intervention Design Considerations Explicitly teach an alternative/replacement behavior (i.e., break requests) Promote self-management by teaching students to “keep track” of their breaks Establish & Teach teachers (and students) how this will look in the classroom Make it feasible and sustainable for classroom teachers to implement

17. Suggested Prerequisites • Elementary school • Utilizing SWPBS • Have implemented SWPBS with fidelity for at least 2-years • CICO for at least one year • At least 90% of CICO features on the CICO self-assessment (fidelity)

18. Considerations for “Good Fit” • Exhibiting problem behaviors in academic settings • Nominated by instructional staff as needing additional behavior support for mild disruptive behaviors in the classroom • Brief FBA or informal teacher interview suggests their problem behaviors are maintained primarily by escape (e.g., work avoidance). • FACTS • Guess & Check

19. Implementation Materials • BRB point card (with team defined goals) • Timer (e.g., digital, “hour-glass”) • Team-generated list of acceptable break options

20. Typical CICO Card

21. Breaks are Better Card

23. Implementation Procedures & Considerations • Training of Staff and Teachers • When • After obtaining buy-in • Prior to attempting to implement the program • Day-to-Day Implementation of BrB • Student Training/Orientation (once identified) • Teacher orientation/support • Data review using CICO-SWIS

24. Student Orientation to the BrB Program • Orientation time (additional 12 minutes) • Must explicitly teach the break request & provide opportunities for the student to practice with feedback. • Teaching Script

25. Teacher Orientation to the BrB Program • Must teach teachers how to allow or disallow student breaks • “thumbs up” and “thumbs down” • Preferably this is done school-wide, rather than individually • Teacher Reminders Page

26. Measurable Outcomes (Goals) • Student problem behavior • Individually defined for each student • Academic engagement • Decreases in off-task behaviors and increases in on-task behavior, work completion, etc. • Frequency of Breaks • Appropriate requests to be “off-task” or to engage in behaviors other than what the classroom expectation is at the time. • Brief (i.e., 2-minutes) • Limited number of opportunities to request these breaks

27. Academics and Behavior Check-in/Check-out (ABC) Jessica Turtura, M.S.

28. Challenge Faced by Middle Schools Link between academic and behavioral concerns Increasingly important role of organizational and study skills

29. The ABC Program • Modified version of CICO • Designed to… • Decrease problem behaviors that are maintained by escape and/or avoidance of academic tasks • Increase desired behaviors including work completion and class participation • Provide scaffolding to help students develop effective organizational habits and study skills • Improve communication between home and school around homework completion

30. The ABC program is designed for… Students who engage in problem behaviors in order to escape or avoid academic tasks Students that are often off-task during class Students that have difficulty keeping track of assignments and turning in work Students that lack organizational and study skills

31. The ABC program not designed for… • Students with severe academic skills deficits • Will likely need specific instruction in academic areas of concern • May benefit from the ABC program plus additional support • Students that engage in problem behaviors but for whom work completion and/or organization is not a concern

32. Key components of the ABC Program: Morning check-in • Components • Students receive daily point card and review goals • Coordinator checks: • Are students prepared for the day? • Have students completed all homework due today? • Opportunity to complete unfinished homework • Points earned for being prepared and/or completing homework • Key modifications from CICO • Explicit focus around academic-related behaviors • Points are linked to being prepared for the school day and having homework assignments due that day

33. Key components of the ABC Program: Daily feedback • Components • Daily point card/homework tracker • Goals defined in terms of academic behavior • Points for recording assignments on homework tracker • Key modifications from CICO • Feedback is specifically related to academic behaviors • hand raising, work completion, class participation, etc. • Teacher checks to make sure students have accurately recorded any homework assignments

34. ABC Daily Point Card

35. ABC Daily Homework Tracker

36. Key components of the ABC Program: Afternoon check-out • Components • Rewards and/or feedback • Review homework tracker • Key modifications from CICO • Rewards linked to the function of behavior • examples may include break coupons, homework passes, etc. • Explicit focus on reviewing homework and ensuring that students are prepared to complete that evening’s assignments

37. Key components of the ABC Program: Home component • Components • Home-school communication • Parent meeting • Key modifications from CICO • Communication between home and school about homework completion • Parents gain information about how to best help their children with homework • Parents are better able to track assignments that their children need to complete

38. Preliminary Evidence

39. Troubleshooting • Student buy-in • Communication between staff • Fidelity of implementation • Parent involvement

40. Questions & Discussion • For more information feel free to contact us Justin Boyd rboyd@uoregon.edu Jessica Turtura jhorwitz@uoregon.edu