Building Fluency with Tier 3 Wraparound

1. Building Fluency with Tier 3 Wraparound National PBIS Leadership Forum Hyatt Regency O’Hare, Rosemont, IL October 9, 2009 Session E-4 Lucille Eber, Statewide Director, IL PBIS Network Susan Bruce, Iowa Department of Education Becky Halbur, East Sac Schools Julie Nadrchal, Prairie Lakes Area Education Agency

2. Individualized Teams at the Tertiary Level • Are unique to the individual child & family • Blend the family’s supports with the school representatives who know the child best • Meeting Process • Meet frequently • Regularly develop & review interventions • Facilitator Role • Role of bringing team together • Role of blending perspectives

3. Individualized Comprehensive Teams/Plans • Who? • Youth with multiple needs across home, school, community • Youth with multiple life domain needs • The adults in youth’s life are not effectively • engaged in comprehensive planning • (i.e. adults not getting along very well) What? The development of a very unique, individualized, strength-based team & plan with the youth and family that is designed to improve quality of life as defined by the youth/family.

4. Individualized, Comprehensive Teams/Plans What Do Tertiary Plans include? Supports and interventions across multiple life domains and settings (i.e. behavior support plans, academic interventions, basic living supports, multi-agency strategies, family supports, community supports, etc.) What’s Different? Natural supports and unique strengths are emphasized in team and plan development. Youth/family access, voice, ownership are critical features. Plans include supports for adults/family, as well as youth.

5. What is Wraparound? • Wraparound is a tool (e.g. a process) used to implement interagency systems of care in achieving better outcomes for youth and their families. • The wraparound process is similar to person-centered planning, the individualized Positive Behavior Support (PBS) planning process.

6. What is Wraparound? • Wraparound is a process for developing family-centered teams and plans that are strength and needs based • (not deficit based) • across multiple settings and life domains. • Wraparound plans include natural supports, are culturally relevant, practical and realistic.

7. Implementing Wraparound: Key Elements Needed for Success • Engaging students, families & teachers • Team development & team ownership • Ensuring student/family/teacher voice • Getting to real (big) needs • Effective interventions • Serious use of strengths • Natural supports • Focus on needs vs. services • Monitoring progress & sustaining • System support buy-in

8. What’s New in Wraparound? • Skill set specificity • Focus on intervention design/effectiveness • Integration with school-wide PBS • Phases to guide implementation/supervision • Data-based decision-making • Integrity/fidelity assessment (WIT) • Tools to guide teams: • Home School Community • Education Information Tool

9. Wraparound Skill Sets • Identifying “big” needs (quality of life indicators) • “Student needs to feel others respect him” • Establish voice/ownership • Reframe blame • Recognize/prevent teams’ becoming immobilized by “setting events” • Getting to interventions that actually work • Integrate data-based decision-making into complex process (home-school-community)

10. Four Phases of Wraparound Implementation • Team Preparation - Get people ready to be a team - Complete strengths/needs chats (baseline data) • Initial Plan Development - Hold initial planning meetings (integrate data) - Develop a team “culture” (use data to establish voice) • Plan Implementation & Refinement - Hold team meetings to review plans (ongoing data collection and use) - Modify, adapt & adjust team plan (based on data) • Plan Completion & Transition - Define good enough (Data-based decision- making) - “Unwrap”

11. Scenario for Activity 5 • You are at a coach’s network meeting and the following questions are asked? • How do we know if were supposed to do complex fba/bip or wraparound? • Follow up Questions? • So what is the difference between big need and function? • How do I go about assessing/determining what a student (and/or family)’s “ big needs” are?

12. Wraparound (T300+): Youth with multiple needs across home, school, community & life domains Youth at-risk for change of placement The adults in youth’s life are not effectively engaged in comprehensive planning (i.e. adults not getting along well) Deciding Which Tertiary Level Intervention is Most Appropriate Complex FBA/BIP (T200): • Brief FBA/BIP was not successful AND • NONE of Wraparound criteria are present

13. Big Need The underlying reason preventing successful experiences/interactions in multiple settings/contexts/routines When a big quality of life need is unmet, it impacts perception/judgment, often resulting in chronic problem behavior. Family voice is necessary to identify the Big Need for the school setting. Once Big Need is identified, it takes a while to achieve and involves action planning across multiple life domains. Meeting the big need always involves multiple Child & Family Team meetings. Function • The purpose/reason for demonstrating a specific type of behavior within a specific context/routine. • Specific behaviors have been strengthened by consistent reinforcement. • Family voice is not necessary to identify function of behavior in the school setting. • Once Function is correctly identified, putting a plan in place can produce rapid behavior change. This can be accomplished in a single meeting.

14. Big Need Big needs are identified through open-ended conversation and use of SIMEO tools with those engaged with the youth on a regular basis. Big Need statements motivate a family to participate on the team (know we are working on something ‘bigger’ than specific behaviors). If met, the need will improve quality of life for the youth or those engaged with the youth on a regular basis (e.g., the family, the teacher). Function • Function is identified through structured interviews focusing on the problem behavior, antecedents, consequences, and setting events • Focus is on developing function-based support plan (replacement behavior, antecedent, consequence, and setting event supports). • When achieved, situations improve for the youth or those engaged with the youth on a regular basis (e.g., the family, the teacher).

15. Big Need: “Andy needs to feel like he belongs at school” • School Behaviors: Aggressive with peers, excessive absences/tardies, history of academic failure • Other indicators: Family frequently relocated, lack of home school communication, community support needs Starting with FBA would not have been an effective approach—why? • Discussing problem behaviors would not have motivated family to participate on team. • Probably not the first time schools have approached family in this manner (“let’s talk about behavior”) • Open-ended conversation and use of SIMEO tools helped engage family • Bigger needs to work on to improve quality of life for youth and family

16. Scenario for Activity 6 • You are at a coach’s network meeting and the following questions are asked: • What if the family or teacher does not want to engage in wraparound? • Follow up Questions: • How do I use the SIMEO tools to engage them? To keep the team going? • Wraparound seems really hard, why should we spend so much time?

17. Why Do Wraparound???

18. Points to Remember:Engaging Families • Apply RtI to Family Engagement: don’t keep doing what hasn’t worked up • If engagement didn’t happen, how would you change your approach to effectively engage? • Professionals don’t get to choose or judge how families raise their kids. • Always start with a conversation (not a meeting) with the family, getting their trust and permission before talking with others.

19. Points to Remember: Engaging Professionals • Apply RtI to Teacher Engagement: don’t keep doing what hasn’t worked. • Just like we do for kids and families, recognize teacher strengths and needs. Teacher voice in the plan will ensure better outcomes. • Always start with a conversation (don’t hand off data tools). Teachers need to be prepared for the wrap meeting and kept “in the loop”. • Use data to bring teacher and family together.

20. Using Data to Drive Decision-Making with Wraparound • More efficient teams, meetings and plans • Less reactive (emotion-based) actions • More strategic actions • More effective outcomes • Longer-term commitment to maintain success

21. Wraparound: Data-based decision-making Baseline Data - • Enhances the initial conversations with family and team members. • Creates more efficient team meetings. • Takes the emotion out of team meetings. • Gives us a starting point for planning. • Helps us plan across all environments – Home, School and Community • How have you used baseline data?

22. Wraparound Case Study “Ozzie” cont.Getting to Strengths and Needs at Baseline Using Data and Voice & Choice

23. Wraparound: Data-based decision-making Follow-up Data (Time2, Time 3…) • Helps us CELEBRATE progress • Shows us small increments of progress that can be missed. • Helps us progress monitor – remember, if the plan is not working, re-work the plan! • Helps us get buy-in from staff, administration, and skeptical team members. • How have you used follow-up data?

24. Transition Planning for “Jacob”Using Data to get buy-in from the new team

25. Becky Halbur, MS School CounselorInternal PBIS CoachEast Sac County Elementary SchoolsJulie Nadrchal, LISWSchool Social WorkerExternal PBIS CoachPrairie Lakes Area Education Agency

26. What we learned… • PBS in Iowa • We needed to beef up our tier 2 interventions • Implemented Check In Check Out • Implemented Check and Connect • Tier 3 Team Developed

27. What we learned… • The power of Phase 1: Initial conversation • “Cinder” family …listening to the story • Identifying strengths through soft data • When we prove that we heard the parent, they will listen to us. • What was different about wraparound • Moving from the expert model to Voice and Choice of the family.

28. What we learned… • Re-engagement is sometimes necessary • Mental Health Advocate for Sherrie • Everyone needs to leave the meeting with a job • Everyone’s job needs to be connected with the big need • Mental Health Advocate • Wraparound facilitates partnership between agencies, school, and family

29. What we learned… • The power of data • Using the HSC tool • Using SIMEO data at a team meeting • The power of co-facilitators

30. SIMEO Strength Data on HSC Tool

31. SIMEO Needs Data on HSC Tool

32. We’re still learning… • Need to have a systems approach • Understanding and using the behavior pathway • Blake’s story • Tier 2 and Tier 3 teams meeting monthly

33. What’s working Iowa’s Project LINCS

34. Implementation Evaluation • Sites visits • 3 to 4 hours • Interviews • School team • Parents/caregivers • Students • Parent Informed Consent Document

35. Visit format • Case Study/Focus Group • Iowa DE group and Full Wrap Team • Interviews occurring simultaneously • One team interviewed student and reviewed student materials • One team interviewed parent and reviewed team notebook /materials • DE Team discussion • Focus Group and exit briefing

36. Interview Case Study QuestionsSchool Staff What about the implementation is working? What about the implementation is not working? What do you need to improve the implementation of wraparound? What do you view as the indication of greatest success to date?

37. In regard to the wraparound training and materials: • What do you see as most valuable? • What do you see as least valuable? • What access does the wraparound team have to community mental health services? • In regard to services provided to your student: • What community resources were utilized prior to the implementation of wraparound? • What community resources are now being utilized?

38. Good things Not so good What did we find out from the school staff? • Develop relationships • HSC Tool - initiating conversations • SIMEO user friendly • TA – DE and Lucille • Strength based • Positive change in parent attitude • Increased use of community resources • Student success Getting all to attend meetings Conference calls with other schools Communication with community resources Use of all the forms

39. Parent Interview What supports, services or activities are working well for your child? What supports, services or activities are not working well for your child? What do you think your school needs to improve supports, services or activities for your child? This school year, what do you view as the indication of your child’s greatest success?

40. What access do you and your child have to community mental health services? • In regard to services provided to your child: • What community resources were used prior to the implementation of wraparound? • What community resources are now being used with the implementation of wraparound?

41. Good things Not so good What did we find out from parents? • Team working together toward same goal • Feel like a valuable, equal member • Strength based • Additional supports (therapists, CICO) and resources • Child’s success is obvious

42. Student Interview What at school is working well for you? What is not working well for you? What do you think the school needs to do to improve your success at school? This school year, what do you feel has been your greatest success? What new supports or people have you decided to work with?

43. Good things Not so good What did we find out from students? • Teachers support behavior plans • Like CICO • More friends • Help with personal issues • Less angry • Mom and dad are more helpful • Feel good about doing better CICO can be embarrassing Peers behaviors don’t change

44. Overall Themes Wraparound was positive for school, parents and students and resulted in a new way to work together. Enhanced relationships and increased trust. Increased communication, improved transitions and decreased duplication of work involved. Greatest indicator of successful implementation was student success. Strength based focus and increase of effective strategies put in place to help student succeed.