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Comprehensive, Integrated, Three-tiered (CI3T) Models of Prevention: Integrating Response-to-Intervention and Positive Behavior Supports. From Screening to Functional Assessment: A Response to Intervention Model. Kathleen Lane, Ph.D. Wendy P. Oakes, Ph.D. Vanderbilt University.
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Comprehensive, Integrated, Three-tiered (CI3T) Models of Prevention: Integrating Response-to-Intervention and Positive Behavior Supports From Screening to Functional Assessment: A Response to Intervention Model Kathleen Lane, Ph.D. Wendy P. Oakes, Ph.D. Vanderbilt University
Project Support & Include Goals • Tennessee State Technical Assistance Grant to support schools in building three-tiered models of prevention • A priority on Positive Behavior Supports and Inclusive practices • To develop and apply an integrated comprehensive model of prevention (behavioral, social, and academic components) in 17 Tennessee Districts. State of Tennessee DOE Technical Assistance Grant
Comprehensive, Integrated, Three-Tier Model of Prevention (Lane, Kalberg, & Menzies, 2009) Goal: Reduce Harm Specialized Individual Systems for Students with High-Risk ≈ Tertiary Prevention (Tier 3) ≈ Goal: Reverse Harm Specialized Group Systems for Students At-Risk Secondary Prevention (Tier 2) PBIS Framework Goal: Prevent Harm School/Classroom-Wide Systems for All Students, Staff, & Settings Positive Action, Social Skills Improvement System, & Others ≈ Primary Prevention (Tier 1) Social Academic Behavioral
Secondary Stand Alones Primary Series Tertiary Series Full Model Series PSI Training Series 2010-2011 12/8/10 1/10/11 1/24/11 2/18/11 3/31/11 4/5/11 3/7/10 2/15/10 9/30/10 11/8/10 6/9/11 1/18/11 3/3/11 5/17/11 1/31/11
Primary Prevention Reinforcing Teaching HERO CERTIFICATE Exchange for time with friends Name:_____________________ Date:______________________ Be Respectful Be Responsible Be Safe Fanning Elementary School Monitoring
Measuring Treatment Integrity at the Primary Level Three Measures of Primary Plan treatment Integrity: Schoolwide Evaluation Tool (SET, Sugai, Lewis-Palmer, Todd, & Horner, 2001) Teacher Self-Report of procedures for teaching, reinforcing, and monitoring from the first day of school until the day completed (winter). Direct Observation from two perspectives (Teacher and RA) for a 30 min observation
School 2009-2010Treatment Integrity Data Goal 80% Teacher Self-Report Observation: Teacher Completed Observation: RA Completed
Limitations of Current Practices 10 Report card grades and teacher judgment may miss students in need of supports(Severson & Walker, 2002) Response to Intervention models utilize curriculum-based measures, but behavioral performance is less often utilized(Severson, Walker, Hope-Doolittle, Kratochwill, & Gresham) ODR data suffer from poor reliability if the system used to collect these data is not implemented with strong procedural fidelity(Sugai, Spague, Horner, & Walker, 2000) Lack of systematic methods of monitoring behavioral performance(Lane, Oakes, & Menzies, 2010) ODRs do not find students with internalizing concerns (McIntosh, Campbell, Carter, Zumbo 2009)
SYSTEMATIC SCREENING:ESSENTIAL QUALITIES procedures for monitoring (AERA, 1999; Glover & Albers, 2007) Screening tools do not identify students with emotional and behavioral disorders. The goal is to identify students at risk who may benefit from additional supports. • Systematic screening tools must evidence strong psychometric properties, including adequate reliability and validity • Produce consistent findings that are repeatable over time • Produce information that is both trustworthy and reflects the construct of primary interest 11
SYSTEMATIC SCREENING:ESSENTIAL QUALITIES procedures for monitoring (Schwartz & Baer, 1991) If social validity is lacking, even psychometrically strong tools are likely to remain unused by practitioners. • 2. Systematic screening tools should evidence social validity: • Feasible to implement • Cost-effective • Compatible with local needs • Readily interpretable • Able to inform intervention responses 12
Data Management Systems for Screening and Progress Monitoring: Academic Outcomes
Elementary School Screening Tools *SSBD; Walker & Severson (1992) *SRSS; Drummond (1994) SSiS; Elliott & Gresham, (2007) SDQ; Goodman (1997) BESS; Kamphaus & Reynolds (2007) Behavior Screening Tools: A Closer Look
Systematic Screener for Behavior Disorders (SSBD, Walker & Severson,1992) • Teacher completed • Validated for the Elementary School • Three Stage screening process • Teacher nomination and ranking • Rating scales (6 students: 3 with internalizing and 3 with externalizing) • Direct Observation • Students who meet the specified criteria for each stage move to the next stage.
SSBD Screening Process Pool of Regular Classroom Students TEACHER SCREENING on Internalizing and Externalizing Behavioral Dimensions 3 Highest Ranked Pupils on Externalizing and on Internalizing Behavior Criteria PASS GATE 1 TEACHER RATING on Critical Events Index and Combined Frequency Index Exceed Normative Criteria on CEI of CFI PASS GATE 2 DIRECT OBSERVATION of Process Selected Pupils in Classroom and on Playground Exceed Normative Criteria on AET and PSB PASS GATE 3 Pre-referral Intervention(s) Child may be referred to Child Study Team
Stage 1: Rank order students who most closely match the description of each behavior pattern. Mutually Exclusive Lists
Stage 2: Externalizing - Teacher rating for high intensity low frequency behavior • Critical Events Index completed for students ranked 1, 2, and 3 on Stage 1 for Externalizing • So, 3 students per class • 33 items mark as presence for absence
And lower intensity, high frequency behaviors • Combined Frequency Index for Adaptive and Maladaptive Behavior • 12 items – Adaptive • 11 items – Maladaptive • 5-point Likert-type scale • 1 = Never to 5 = Frequently
Stage 2: Internalizing -Teacher rating for high intensity low frequency behavior • Critical Events Index completed for students ranked 1, 2, and 3 on Stage 1 for Externalizing • So, 3 students per class • 33 items mark as presence for absence
And lower intensity, high frequency behaviors • Combined Frequency Index for Adaptive and Maladaptive Behavior • 12 items – Adaptive • 11 items – Maladaptive • 5-point Likert-type scale • 1 = Never to 5 = Frequently
SSBD: Risk Status for Nominated Students: Externalizing and Internalizing Winter 2007 - 2009 Externalizing Winter 2009 Internalizing Winter 2009 Winter 2008 Winter 2008 Winter 2007 Winter 2007 47 13 46 17 55 13 57 9 60 6 63 7 6.8% 4.4% 2.17% 2.78% 1.44% 1.5% Note. The numbers represent totals for the students for whom the SSBD was completed.
Winter 2009-2010 Critical Need Comparison by Grade Level * Students missing
Winter 2009-2010 Critical Need Comparison by Grade Level * Students missing
Student Risk Screening Scale(Drummond, 1994) • No-cost, brief systematic screening tool originally designed to identify K-6 elementary-age students at risk for antisocial behavior • Teachers use a one-page instrument to evaluate students on 7 items using a 4 point Likert-type scale: - Steals - Low Academic Achievement - Lies, Cheats, Sneaks - Negative Attitude - Behavior Problems - Aggressive Behavior - Peer Rejection • Student Risk is divided into 3 categories: • Low 0 – 3 • Moderate 4 – 8 • High 9 - 21
SRSS Fall 2007 to Fall 2010 Percentage of Students Screened n=714 n=675 n=636 n=654 2 Students were not rated
Low Intensity Behavioral Support Enrichment/ Behavioral Support Reading Instruction/ Behavioral Support
Student Risk Screening Scale(Drummond, 1994) How reliable and valid is the SRSS for use at the elementary school?
Elementary Level Results: ROC Curves Externalizing .952 1.0 AUC = 0.952 0.8 0.6 Sensitivity Chance = 50% 0.4 0.2 0.0 0.0 0.2 0.4 0.6 0.8 1.0 1 - Specificity
Elementary Level Results: ROC Curves Internalizing .802 1.0 AUC = .802 0.8 0.6 Sensitivity 0.4 Chance = 50% 0.2 0.0 0.0 0.2 0.4 0.6 0.8 1.0 1 - Specificity
Middle School Screening Tools *SRSS; Drummond (1994) SDQ; Goodman (1997) SSiS; Elliott & Gresham, (2007) BESS; Kamphaus & Reynolds (2007) Behavior Screening Tools: A Closer Look
Student Risk Screening Scale(Drummond, 1994) • No-cost, brief systematic screening tool originally designed to identify K-6 elementary-age students at risk for antisocial behavior • Teachers use a one-page instrument to evaluate students on 7 items using a 4 point Likert-type scale: - Steals - Low Academic Achievement - Lies, Cheats, Sneaks - Negative Attitude - Behavior Problems - Aggressive Behavior - Peer Rejection • Student Risk is divided into 3 categories: • Low 0 – 3 • Moderate 4 – 8 • High 9 - 21
INCREDIBLE! PBIS – That’s the ticket! SRSS Behavior Screeners Over Time Middle SchoolFall 2004 through Fall 2010 n =7 n = 32 n = 488 Percentage of Students These numbers are based on the total number of students screened. X students were not screened. (Fall 2010) n=534 n=502 n=454 n=470 n=477 n=476 n=527 Screening Time point Data represent the information completed on: 10/11/2010
Student Risk Screening Scale(Drummond, 1994) How reliable and valid is the SRSS for use at the middle school?
Middle School Study 1: Behavioral & Academic Characteristics of SRSS Risk Groups (Lane, Parks, Kalberg, & Carter, 2007)
High School Screening Tools *SRSS; Drummond (1994) SSiS; Elliott & Gresham, (2007) SDQ; Goodman (1987) BESS; Kamphaus & Reynolds (2007) Behavior Screening Tools: A Closer Look
SRSS Winter 2008 to Winter 2009 (2nd period Raters) 39(2.29%) 20 (1.12%) 169 (9.94%) 99 (5.54%) 1492 (87.76%) 1667 (93.34%) *These numbers and percentages are representative of the students rated.
SRSS Winter 2008 to Winter 2009 (7th period Raters) 60 (3.41%) 19 (1.06%) 159 (9.04%) 75 (4.17%) 1539 (87.54%) 1703 (94.77%)
Student Risk Screening Scale(Drummond, 1994) How reliable and valid is the SRSS for use at the high school?
High School: Behavioral & Academic Characteristics of SRSS Risk Groups Using SRSS Time 1 to Year 2 Instructional Rater (Lane, Kalberg, Parks, & Carter, 2008)
High School: Behavioral & Academic Characteristics of SRSS Risk Groups Using SRSS Time 1 to Year 2 Non-Instructional Rater (Lane, Kalberg, Parks, & Carter, 2008)
High Schools: Behavioral & Academic Characteristics of SRSS Risk Groups Winter Year 1Screening Predicting Year 1 2nd Period Raters (Lane, Oakes, Parks, & Cox, in press)
High Schools: Behavioral & Academic Characteristics of SRSS Risk Groups Spring Year 1 Screening Predicting Spring Year 2 7nd Period Raters (Lane, Oakes, Parks, & Cox, in press)