E18-The Prevent-Teach-Reinforce FBA/BIP Model for Middle & High School Students

1. E18-The Prevent-Teach-Reinforce FBA/BIP Model for Middle & High School Students Rose Iovannone, Ph.D., BCBA-D iovannone@usf.edu 813-974-1696 Key Words: Tier III, FBA/BIP, High School The contents of this training were developed under grant H324P04003 from the Department of Education

2. Miami, FL Hyatt Regency Miami March 11-14, 2020 For more information, visit: conference.apbs.org

3. Agenda • Overview of PTR and secondary FBA/BIP practices • PTR Process • Step 1-Teaming/goal setting/progress monitoring • Step 2 Functional assessment • Step 3a-Behavior intervention plan • Step 3b-Coaching/Fidelity • Step 4-Monitoring and making data-based decisions

4. Objectives • Participants will: • Describe the multi-step PTR SEC process • Discuss the involvement of the student • Explain the practice-based coaching process to support teachers • Identify the features of PTR-SEC that fit secondary school context

6. Who is Here? Why are you Here?

7. What Makes an Intervention Individualized? • Developed to meet the unique needs of ONE specific student • Assessment to intervention approach, not a packaged program

8. Iovannone’s Critical Features for Individualized Evidence-Based Interventions—the 5 Cs • Collaborative • Comprehensive • Customizable • Coachable • Contextual fit

9. FBA/BIPs and Secondary Schools—The Issues • FBA/BIPs have compelling empirical support • Used infrequently in secondary schools • Punitive strategies increase in use in middle schools (Vincent et al. 2012)--ODRs • In high school, increase in use of exclusionary discipline methods (suspension/expulsion; Flannery et al. 2013) • Secondary issues: • Teachers see more students-lack of relationship • Teaming practices are different in secondary schools compared to elementary • Stakeholders express student issues more complex-FBA/BIPs may not address the multitude of problems

10. FBA/BIPs in Secondary Schools-Rationale • We consider FBA/BIPs to be a first-line core Tier 3 behavioral support in secondary schools • FBA/BIP not intended to address every concern • Pivotal impact of decreasing externalizing problem behaviors: • Increased engagement (for target student and peers; Lannie & McCurdy, 2007) • Increased time for academic instruction (Walker et al. 2003) • Long-term decrease in high risk behaviors (physical aggression, carrying of weapons; Martinez et al. 2016) • Reduction of absenteeism (De Pry & Sugai, 2002) • Reduction of drop-out rates (Noltemeyer et al. 2015) • Addresses key concern of secondary teachers-problem behaviors • 76% middle/high school teachers reported reduction of behavior problems would enhance ability to teach (Public Agenda, 2004) • Considered a complementary approach integrated with empirically supported therapeutic interventions for other concerns

11. What is Prevent-Teach-Reinforce (PTR)? • Manualized FBA/BIP process • Tested with two randomized controlled trials and several single-case designs • Used as the FBA/BIP process in multiple states and districts across the US and internationally • Meets all of the “c” features

12. Differences in PTR and Services as Usual (SAU) SAU PTR Collaboration embedded in each step Manualized Process is the driver Team membership based on knowledge Collaborative teaming processes described Role of coach is to guide the link Role of coach is to guide the link Interventions task analyzed Teacher coaching part of process (BST) Fidelity measures part of process Structured data-based decision making Mechanisms included to use behavior skills training (BST) to train coaches • Often done in IEP meeting or expert driven • Quality contingent upon educator doing the process • Forms drive the process • Team members based on job titles • Less defined teaming processes • Tenuous links between FBA data and hypotheses • Rare link between hypothesis and intervention plan • Lack of intervention details • Rare inclusion of coaching teacher process • Rare consideration of fidelity measures • Ambiguous plans for progress-monitoring and ongoing data-based decision-making • Training typically reviews how to fill out forms

13. Where is PTR in a Multi-tiered System of Supports (MTSS)?

14. Student-Centered Team • coach • Members who know student • Member who know school/district

15. Research Support for PTR

16. Research in PTR • Two randomized controlled trials • Original for kindergarten through grade 8 (5 years to ~ 14 years of age) • Young children (3 years to 6 years of age) • Several single subject studies • Elementary students in general education • Autism • Child care settings • Families • High school students with emotional disorders • High school students with ASD • IBRST validation (3 theses, one dissertation)

17. Research Outcomes • RCT-Students receiving PTR significantly improved social skills, problem behaviors and academic engagement compared to those who received services as usual (SAU) • Single subject—multiple baseline designs showed PTR improved the dependent variable in all studies • Teachers implemented the interventions with high (e.g., 80% or greater) fidelity • Teachers found PTR to be socially valid • Students (high school) rate PTR as acceptable • IBRST has been shown to be reliable and valid

18. PTR (and related) Publications • PTR Manuals • Dunlap, G., Iovannone, R., Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C., 2010. Prevent-Teach-Reinforce: The school-based model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes. (Second edition coming soon) • Dunlap, G., Wilson, K., Strain, P., & Lee, J. K. (2013). Prevent-Teach-Reinforce for young children: The early childhood model of individualized positive behavior support. Baltimore, MD: Paul H. Brookes. • Journal Articles • Barnes, S., Iovannone, R., Blair, K. S. W., Crosland, K., & Peshak-George, H. (under review). An evaluation of the Prevent-Teach-Reinforce model within a multi-tiered intervention system. Journal of Positive Behavior Interventions. • DeJager, B. W., & Filter, K. J. (2015). Effects of Prevent-Teach-Reinforce on academic engagement and disruptive behavior. Journal of Applied School Psychology, 31, 369-391. • Dunlap, G., Iovannone, R., Wilson, K., Kincaid, D., & Strain, P. (2010). Prevent-Teach-Reinforce: A standardized model of school-based intervention. Journal of Positive Behavior Interventions, 12, 9-22. • Dunlap, G., Lee, J. K., Joseph, J. D., & Strain, P. (2015). A model for increasing the fidelity and effectiveness of interventions for challenging behaviors: Prevent-Teach-Reinforce for young children. Infants & Young Children, 28, 3-17. • Iovannone, R., Anderson, C.M., & Scott, T. M., (2017). Understanding setting events: What they are and how to identify them. Beyond Behavior. • Iovannone, R., Anderson, C. M., & Scott, T. M. (2013). Power and control: Useful functions or explanatory fictions? Beyond Behavior, 22, 3-6. • Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., & Dunlap, G. (2014). Interrater agreement of the Individualized Behavior Rating Scale Tool. Assessment for Effective Intervention, 39, 195-207. • Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009). Randomized controlled trial of a tertiary behavior intervention for students with problem behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders, 17, 213-225. • Kulikowski, L. L., Blair, K. S. C., Iovannone, R., & Crosland (2015). An evaluation of the Prevent-Teach-Reinforce (PTR) model in a community preschool classroom. Journal of Behavior Analysis and Supports, 2, 1-22. • Sears, K. M., Blair, K. S. C., Iovannone, R. & Crosland, K., (2015). Using the Prevent-Teach-Reinforce model with families of young children with ASD. Journal of Autism and Developmental Disabilities. • Strain, P. S., Wilson, K., & Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing problem behaviors of students with autism in general education classroom. Behavior Disorders, 36, 160-171. • Sullivan, K., Crosland, K., Iovannone, R., Blair, K. S., & Singer, L. (under review). Evaluating the effectiveness of prevent-teach-reinforce (PTR) for high-school students with emotional and behavioral disorders. Journal of Positive Behavior Interventions. Manuscript submitted for publication.

19. The PTR Process

20. Step 1: Goal Setting • Purpose: • Identify behaviors of greatest concern to the team and possible replacement behaviors (teach) • Prioritize and operationalize behaviors targeted for intervention • Develop teacher friendly baseline data collection system • Secondary school procedures • Core team and extended team • Select one team member who will be the primary interventionist • Behavior identification and progress monitoring tool be focused for that team member • Other team members provide input/support to behaviors, definitions, progress monitoring and throughout the process

21. Meets less frequently • Provide input and support to teacher implementing intervention • Make broader data-based decisions (tiered support needs, expanding/generalizing plan Extended Team Student Other teachers Referring Teacher Other Staff Family Coach Core Team • Meets frequently with coach • Is the focus of the what, where, how • Is the recipient of direct active coaching • Makes immediate data-based decisions about plan Coach Referring Teacher Student

22. Note About Student Involvement • Each student case is unique • In general, student input is gathered by an adult trusted by the student • Not typically included in the actual meeting

23. Collaborative Process • NOT coach telling the team the behaviors to target • INSTEAD coach guides the team to consensus on behaviors to be targeted

27. Step 1: Progress Monitoring System • Individualized Behavior Rating Scale Tool – IBRST • Direct Behavior Rating (DBR)—Hybrid assessment combining features of systematic direct observations and rating scales • Efficient and feasible for teacher use • Provides data for decisions • Prioritized and defined behaviors measured • Requires minimum of 1 appropriate and 1 inappropriate behavior

28. IBRST Inter-rater Reliability (Iovannone, Greebaum, Wang, Kincaid, & Dunlap, 2014) • Kappa coefficients of: • Problem Behavior 1 (n = 105): .82 • Problem Behavior 2 (n = 90) : .77 • Appropriate Behavior 1 (n = 103): .65 • Appropriate Behavior 2 (n = 56): .76

29. Agreement of IBRST and Direct Observation • In recent multiple baseline study, • Problem Behavior-74% of ratings in exact agreement, 16% within one scaled score • Appropriate Behavior-75% exact agreement, 14% within one scaled score. • Cohen’s Kappa = 0.70 (p<0.001) Barnes, Iovannone, Blair, Crosland, & Peshak-George, (in review).

34. Step 2: PTR Functional Behavior Assessment Analyze the Problem

35. Step 2: PTR Assessment (FBA) Problem Analysis • PTR Assessment (FBA) • Prevent: Antecedents/triggers of problem behavior • Teach: Function(s) of problem behavior, possible replacement behaviors • Reinforce: Consequences associated with problem behavior, possible reinforcers • Assessment checklist completed by each team member • coach summarizes input on Assessment Summary Table and develops draft hypothesis • Team reaches consensus • coach has conducted at least ONE direct observation of student and context prior to this step 35

36. Several Versions of PTR Assessment • Secondary Version • Teacher versions • Student versions • Each relevant team member completes a PTR Assessment for targeted behavior(s) to be decreased • Student is interviewed • Coach conducts at least one observation

37. Learned Functions of Behaviors • GET • Obtain • Activities, people, tasks, tangibles, sensory, pain attenuation • GET OUT OF • Escape/Avoid/Delay • Activities, people, tasks, tangibles, sensory, pain

38. NAME THAT FUNCTION!

39. Are Power, Control, Jealousy, Revenge Functions? Iovannone, Anderson, & Scott, 2013

40. Completing the PTR Assessment Organization Table

43. Step 3: PTR Intervention Plan Developing and implementing an intervention

44. “The problem is not that people resist change, but they resist being changed.” Michael Kim, Founder and CEO of Habit Design

45. Behavior Intervention Plan Development: Essential Features • Behavior interventions selected by team from PTR Menu • coach guides the team/teacher by using ABA principles to develop most effective intervention that matches the team/teacher context • Team/teacher provides description on how interventions will look in classroom setting • Each intervention selected is described in detail by task-analyzing steps, providing scripts, describing adult behaviors, NOT student behaviors • After plan developed, time is scheduled to train the team/teacher the strategies prior to implementation • Plans for training students and other relevant individuals • Support provided once plan is implemented

50. BIP-Prevention Strategies BIP-Prevention Strategies Which One Will More Likely be Consistently Implemented? OR • Provide choices of where to sit • Provide Choices: The teacher will provide Don with a choice immediately after assigning him independent work in class. Choice options are: (a) materials to use for assignment; choice of leadership activities; (b) where to sit; (c) who to do the assignment with • Steps for Provide Choices: • Immediately after giving the class the independent math assignment, go over to Don and present him with a choice option. • When presenting him with a choice, say “Don, where do you want to sit? X or X?” • After Don makes his choice, say, “Thanks for making a great choice” and release him to his choice.