Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce

1. Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior Supports Rose Iovannone, Ph.D. iovannone@fmhi.usf.edu Kathy Christiansen, MS kchristiansen@fmhi.usf.edu University of South Florida

2. Objectives • Participants will: • Describe a model of individualized behavior support • Identify factors that may contribute to effectiveness of PTR

3. The Problem—Evidence-Based • Tertiary supports (i.e., individualized PBS, Tier 3 behavior supports) • Evidence-base exists • Research method used primarily single subject • Limited rigorous, randomized control trials to evaluate effectiveness

4. The Problem - In Authentic Schools • Ingredients • Child is the problem - “fix him/her” • Absence of uniform policies & practices • Form-driven versus process-driven • “Expert” versus collaborative approach • Contextual fit not always considered • Limited support/follow-up/training for teacher provided • Result • Many BIPs do not get implemented • Behavior problems persist

5. For high-risk students: History of severe problem behaviors Demonstrated resistance to intervention An intensive system of support is needed ~5% ~15% Individualized PBS (Tertiary) ~ 80% of Students

6. What is PTR? • Research project funded by U.S. Department of Education, Institute of Education Science (2004-2008) • University of South Florida—3 school districts • University of Colorado, Denver—2 school districts • Purpose: Investigate effectiveness of PTR process vs. “business as usual” • Randomized control trial • 200 students (100 treatment/100 comparison)

7. Theoretical Framework • Principles of applied behavior analysis • Operant learning theory • Positive Behavior Support—foundation • Intervention consists of three core components: • Prevent • Teach • Reinforce • Team/teacher driven process

8. Participants Students in K-8th grade General or Special Education All cognitive levels All disabilities Behavioral difficulties Intensity– disruption to the learning environment Frequency— minimum of 1 time per week Duration– minimum 6 months Teachers volunteered & nominated 1-3 students Top externalizers Systematic Screening for Behavior Disorders (SSBD)

9. Process • Prevent-Teach-Reinforce (PTR) • Five steps: • Team development—30 minutes if applicable • Goal setting—30-45 minutes • PTR assessment—30-60 minutes • PTR intervention—45-90 minutes • Coaching support (up to 12 hours) • Evaluation—30-40 minutes • Each team assigned PTR consultant (from project) • Teams receive manual and assigned activities to be completed in each step.

10. Preliminary Data Results

11. Student Demographics by Disability

12. Student Description

17. The PTR Process

18. Step 1: Form a Team • Identify members and their roles • Teacher, special area teachers • Behavior specialist/school psychologist • Family members, paraprofessionals,

19. Step 1: Team Building—Ensuring a Successful Team • Review the status of the team • Work styles inventory • Teaming survey • Use a collaborative process • Teacher and facilitator relationship • Consensus making method

22. Case Study 1: Mike • 9-year-old male • Autism diagnosis • Self-contained autism classroom • Nonverbal—uses AAT (signs, voice output devices such as Dynamite, and pictures to communicate) • 1 teacher, 2 aides, and 6 students • Results of teaming information indicate a great team that meets regularly to brainstorm

23. Case Study 2: Jeff • Male • Second grade general ed. student • Retained once • Premature birth • SSBD Scores: • Stage 2: 8 Critical Events • Adaptive Behavior Score = 33 • Maladaptive Behavior Score = 32

24. Teacher/Classroom • Team: Two teachers • Current second grade teacher • Second grade teacher from previous year • Seventeen students • Teacher experience—4 years at same school

25. Teaming Results • Team respected each other, worked together • Met consistently for planning purposes • Strong communicators and problem solvers • Sharing of roles and responsibilities • Active parental participation encouraged

26. Step 2: Goal Setting • Identify team consensus on: • Academic behavior • Social behavior • Problem behavior • Develop and begin baseline data collection

27. Setting Goals: Mike Pre-Test

30. Behavior Rating Scale—Reliability Perceptual rating Behavior recorded at least once daily May be specific to a setting, activity, time of day May be whole day May be combination of both Use anchors on a scale of 1-5

35. Determining the Anchors on the BRS Behavior can be measured using Frequency (times per day) Duration (hours, minutes, seconds) Intensity (how hard, how loud, bruise, etc.) Percent of day Percent of occurrence Percent of opportunity

36. BRS Preliminary Reliability (Psychometric) Results T = Teacher rating; S = PTR data collector rating; PB = Problem behavior; AB = Appropriate behavior * P < .01

37. BRS Preliminary Reliability Results—Kappa Scores

38. Step 3: Assessment • Checklist format: • Antecedents or Triggers (Prevent) • Function(s) of the problem behaviors (Teach) • Consequences following the problem behaviors (Reinforce) • Assists team to link function of behavior to intervention plan

44. Case Study—Mike: PTR Assessment Possible Hypotheses Inappropriate Appropriate

45. Jeff Case Study: Hypothesis

46. Step 4: Intervention • Team ranks top three intervention strategies in each of the PTR components • Multi-component intervention that teacher states s/he can implement • Prevent • Teach • Reinforce • Implementation plan

48. Case Study Mike: PTR Intervention Plan