secondary prevention: targeted interventions christine mcgrath davis, ph.d

97
Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D. The May Institute, Inc. SERC Training Middletown, CT 6 September, 2005

Upload: genera

Post on 19-Jan-2016

24 views

Category:

Documents


0 download

DESCRIPTION

Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D. The May Institute, Inc. SERC Training Middletown, CT 6 September, 2005. Overview. Discuss prevention efforts Define the features and purpose of “targeted interventions” Describe targeted approaches - PowerPoint PPT Presentation

TRANSCRIPT

Page 1: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Secondary Prevention:Targeted Interventions

Christine McGrath Davis, Ph.D.The May Institute, Inc.

SERC TrainingMiddletown, CT

6 September, 2005

Page 2: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Overview

Discuss prevention efforts Define the features and purpose of “targeted

interventions” Describe targeted approaches Present research examining these approaches Provide examples Review targeted team process

Page 3: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

The Challenge

Students come to school without skills to respond to instructional and behavioral expectations (Sprague, Sugai & Walker, 1998)

Teachers report that “uncivil” behavior is increasing and is a threat to effective learning (Skiba and Peterson, 2000)

Students who display severe problem behavior at-risk for segregated placements (Reichle, 1990)

Page 4: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

The Challenge

Exclusion and punishment are the most common responses to severe problem behavior in schools (Lane & Murakami, 1987; Patterson, Reid &

Dishon, 1992)

Exclusion and punishment are ineffective at producing long-term reduction in problem behavior (Costenbader & Markson, 1998; Walker et al., 1996)

Page 5: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

The Challenge

Punishing problem behaviors, without a proactive support system is associated with increases in:aggressionvandalismtruancydropping out

(Mayer, 1995; Mayer & Sulzar-Azaroff, 1991)

Page 6: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

The Response

Need a prevention focus• “Schools that are safe, effective, and controlled

are not accidents” (Sugai, Sprague, Horner & Walker, 2000)

Need to build school capacity to support all students

Need a continuum of behavior supportLevel and intensity of intervention matches

severity of problem behavior

Page 7: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Primary Prevention:School-/Classroom-Wide Systems for

All Students,Staff, & Settings

Secondary Prevention:Specialized Group

Systems for Students with At-Risk Behavior

Tertiary Prevention:Specialized

IndividualizedSystems for Students

with High-Risk Behavior

80 - 90% of Students

5-10%

1-5%

CONTINUUM OFSCHOOL-WIDE

INSTRUCTIONAL & POSITIVE BEHAVIOR

SUPPORT

Page 8: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Designing School-Wide Systems for Student Success

Academic Systems Behavioral Systems

Intensive, Individual Interventions•Individual students•Assessment-based•High Intensity

Intensive, Individual Interventions•Individual students•Assessment-based•High Intensity

Targeted Group Interventions•Some students (at-risk)•Rapid Response

Targeted Group Interventions•Some students (at-risk)•Rapid Response

Universal Interventions•All settings, all students•Preventative, proactive

Universal Interventions•All settings, all students•Preventative, proactive

1-5% 1-5%

5-10% 5-10%

80-90% 80-90%

Sugai, Horner & Gresham (2002)

Page 9: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Universal

(All Students)

School-Wide Systems of Support

80% - 90% of Students

Targeted(At-Risk Students)

Individual & Small Group Strategies

5% - 10% of Students

Intensive(High Risk Students)

Individual Interventions1% - 5% of Students

•Individualized, Function-Based Behavior Support Plans•Intensive Academic Support•School-based Adult Mentors•Intensive Social Skills Training•Parent Training and Collaboration•Multi-Agency Collaboration (Wrap-Around)•Alternatives to Suspension and Expulsion

•Intensive Social Skills Training and Support•Self-Management Programs•School-Based Adult Mentors (Check-In)•Increased Academic Support and Practice•Alternatives to School Suspension

•Effective Academic Support•Teaching Social Skills•Teaching School-Wide Expectations•Active Supervision & Monitoring in Common Areas•Positive Reinforcement for All•Firm, Fair, Corrective Discipline•Effective Classroom Management

Page 10: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Discipline is…

The actions parents and teachers take to increase student success (Charles, 1980).

Prevention

Rules,

Routines,

Arrangements

Reaction

Positive and Negative

Consequences

Scott (2005)

Page 11: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

SYSTEMS

PRACTICES

DATA

SupportingStaff Behavior

SupportingDecisionMaking

SupportingStudent Behavior

Positive Behavioral Interventions & Supports

Page 12: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Emphasis on Prevention

PrimaryReduce new cases of problem behavior

Secondary Reduce current cases of problem behavior

TertiaryReduce complications, intensity, severity of

current cases

Page 13: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

IF...

FOCUS ON...

More than 40% of students receive one or more office

referrals More than 2.5 office referrals per student

School Wide System

More than 35% of office referrals come from non-classroom settings

More than 15% of students referred from non-classroom settings

Non-Classroom System

More than 60% of office referrals come from the classroom

50% or more of office referrals come from less than 10% of classrooms

Classroom Systems

More than 10-15 students receive 5 or more office referrals

Targeted Group Interventions / Classroom Systems

Less than 10 students with 10 or more office referrals Less than 10 students continue rate of referrals after

receiving targeted group settings Small number of students destabilizing overall

functioning of school

Individual Student Systems

Page 14: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Secondary Prevention

AKA:Targeted InterventionsSelected InterventionsYellow Interventions

Page 15: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Interventions:Key Features

Screening and Identification

Functional Assessment

Intervention / Implementation

Evaluation

Page 16: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Screening & Identification

Routine review of individual student data Efficient teacher referral system Parent referral Screening tools Assessment of risk factors

Page 17: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Early Identification / Intervention:Who needs targeted interventions?

Academic SupportDynamic Indicators of Basic Early Literacy

Skills (DIBELS)• http://dibels.uoregon.edu

Curriculum Based Measurement (CBM)• www.edformation.com

Page 18: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Early Identification / Intervention:Who needs targeted interventions?

Behavioral SupportSystematic Screener for Behavior Disorders

(SSBD) (Walker & Severson, 1990)

Office Discipline Referrals

Behavioral Incident Reports

Request for Assistance

Page 19: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Identify Students in Need of Support: A Multiple Gate Approach:

A Multiple Gate Approach is an efficient method for quickly identifying students who might be in need of additional academic and social supports.

Usually employs three “gates” 1. Teacher rating of externalizing and internalizing behaviors. 2. Records review, including attendance, academic performance,

behavior reports. 3. Direct observations of class by trained professional (e.g. school

psych, social worker, counselor, etc..)

Parent Interview & Discussion 1. Meet with parents and discuss opportunity for their child to a

participate in a program that will offer additional supports. 2. Support may include academic tutoring, study skills, social

development, organizational support, etc..

Page 20: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Identify Students in Need of Support: School Data

Summarize Office Discipline Referral data School-Wide Information System (SWIS)

www.swis.org Spreadsheet Program (e.g. Excel)

Develop a referral process All staff trained on process Differentiate behavior handled in classroom vs. office

& Major vs. Minor rule infractions Support referral by teacher, staff, or parent

Page 21: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Efficient Request for Assistance

Process includes description of:(a) the problem behavior,

(b) the problem context or setting,

(c) previously attempted interventions and their outcomes, and

(d) the kind of assistance being requested (e.g., assessment, intervention planning)

Todd, Horner, Sugai & Colvin (1999)

Page 22: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Assessment

Functional assessment that includes analysis of academic, social, and behavioral features of the student’s education.

Curriculum revision is examined to determine the extent to which

(a) student educational responding is occurring and

(b) student educational success is occurring. Focus is on assessment and remediation, not

“diagnosis and placement.”

FACTS

Page 23: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Intervention & Implementation

Proactive: What environmental adjustments will be used to make the student’s problem behavior unnecessary?

Educative: What behaviors (skills) will be taught to replace or meet the same function as the student’s problem behavior and improve his/her ability to function more effectively?

Functional: How will consequences be managed to insure the student receives reinforcers for positive, and not problem behavior?

Page 24: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Evaluation

• Measurable student outcomes

• Formative & Summative questions developed

• System to track students in targeted groups

• Regular review and modification

• Involve all key stakeholders

Page 25: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Interventions: Critical Features

Intervention is continuously available Rapid access to intervention (72 hr) Very low effort by teachers Consistent with school-wide expectations Implemented by all staff/faculty in a school Flexible intervention that is function-based Adequate resources (admin, team)

weekly meeting, plus 10 hours a week Student chooses to participate Continuous monitoring for decision-making

Page 26: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Why do Targeted Interventions Work?

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.

Page 27: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Why do Targeted Interventions Work?

Program can be applied in all school locations• Classroom, playground, cafeteria (anywhere there is a supervisor)

Elevated reward for appropriate behavior• Adult and peer attention delivered each target period• Adult attention (and tangible) delivered at end of day

Linking behavior support and academic support• For academic-based, escape-maintained problem behavior

incorporate academic support Linking school and home support

• Provide format for positive student/parent contact Program is organized to morph into a self-management

system• Increased options for making choices• Increased ability to self-monitor performance/progress

Page 28: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Examples of Targeted Interventions

Academic Support Family Support and Parent Management Training Behavioral Contracting The Behavior Education Program (BEP) Check and Connect Newcomer’s Club Social Skills Training Mentoring

Page 29: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

First Step to Success

(Walker, Kavanaugh, Golly, Stiller, Severson & Feil, 1995)

Page 30: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

First Step to Success

Appropriate for at-risk Kindergarten / 1st Grade Students

Primary goals:Divert antisocial behaviorDevelop competencies needed to build

effective behavioral adjustment

Page 31: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

First Step to Success

Targets three social agents having greatest influence on child: (Reid, 1993)

Parents / caregivers Teachers Peers

Three Modules: Universal screening to detect at-risk students School-based intervention Home-based intervention

Page 32: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Overview of First Step Program Components

Universal Screening Module Evaluate each Kindergarten student in relation to behavioral indicators of

emerging antisocial behavior patterns Identify Kindergarten students who show elevated risk status and could

benefit from early intervention School Intervention Module

30 successful program days Three phases

• Consultant (Days 1-5)• Teacher (Days 6-20)• Maintenance (Days 21-30)

Home Intervention Module Enable parents to build child’s skills/competencies in 6 areas:

• Communication and Sharing in School• Cooperation• Limits Setting• Problem Solving• Friendship Making• Development of Confidence

Page 33: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

First Step to Success: Outcomes

Longitudinal results indicated students in First Step Intervention displayed:Increased academic engaged time (AET)Decreased aggressive behaviors (within the

normative range)(CBCL Aggression Subscale)

Walker, Kavanaugh, Stiller, Golly, Severson & Feil (1998)

Page 34: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Group Supports

For those students who exhibit difficulties despite proactive school-wide prevention efforts

Likely to be student with both academic & behavioral challenges

Approximately 10% of school population

Page 35: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Behavior Education Program

(BEP)

Crone, Horner & Hawken (2004)

Page 36: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Elements of the BEP

Organization/Structure Identification/Referral Contract/Agreement Basic BEP Cycle Functional Assessment Design of Support Data Collection and Decision Making

Page 37: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Organization and Structure

BEP Coordinator • Chair BEP meetings, faculty contact, improvement

BEP Specialist • Check-in, check-out, meeting, data entry, graphs

• Together (Coordinator + Specialist) = 10 hours/wk

BEP Team Meeting 45 min per week• Coordinator, Specialist, Sped faculty, Related Services

All staff commitment and training Simple data collection and reporting system

Page 38: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

BEP Cycle

Weekly BEP Meeting

9 Week Graph Sent

Program Update

EXIT

BEP Plan

Morning Check-In

Afternoon Check-In

Home Check-In

Daily Teacher Evaluation

Crone, Horner & Hawken (2004)

Page 39: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

What each student experiences at start of his or her school day:

• Greeted (positive, personal, glad to see you)

• Scanned (ready to go to class?)

• Readiness check (books, pencils, etc?)

• Gets piece of paper (prompt for positive interaction)

Page 40: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Daily Progress Report

Goals 1/ 5 2/ 6 3/ 7 HR 4/ 8

Be respectful

2 1 0

2 1 0

2 1 0

2 1 0

2 1 0

Be responsible

2 1 0

2 1 0

2 1 0

2 1 0

2 1 0

Keep Hand & Feet to Self

2 1 0

2 1 0

2 1 0

2 1 0

2 1 0

Follow Directions

2 1 0

2 1 0

2 1 0

2 1 0

2 1 0

Be There – Be Ready

2 1 0

2 1 0

2 1 0

2 1 0

2 1 0

TOTAL POINTS

Page 41: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Functional Assessment:Who can benefit from a BEP?

APPROPRIATE– Low-level problem behavior

(not severe)– 3-7 referrals– Behavior occurs across

multiple locations– Examples

• talking out• minor disruption• work completion

INAPPROPRIATE– Serious or violent behaviors/

infractions– Extreme chronic behavior (8-

10+ referrals)– Require more individualized

support

• FBA-BIP • Wrap Around Services

Page 42: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

0

20

40

60

80

100

Pe

rc

en

tag

e o

f P

oin

ts

03/07 03/08 03/09 03/12 03/13 03/14Date

Ryan's BEP Performance

2000-2001

Daily Data Used for Decision Making

Page 43: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Daily Data Used for Decision Making

0

20

40

60

80

100

Percen

tag

e o

f P

oin

ts

02/05 02/08 02/13 02/20 02/23Date

Rachelle's BEP Performance

2000-2001

Page 44: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Conduct Brief Functional Assessment

Is the behavior maintained by escape

from social interaction?

Is the behavior related to lack of academic skills?

Is the behavior maintained by peer

attention?

Escape Motivated BEP

Reduce adult interaction

Use escape as a reinforcer

BEP + Academic Support

Increase academic support

Peer Motivated BEP

Allow student to earn reinforcers to share with peers

Crone, Horner & Hawken (2004)

Page 45: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Importance of Functional Assessment in BEP

DECREASE NOCHANGE

INCREASE TOTAL

AdultAttention

3 1 1 5

PeerAttention

1 6 1 8

Escape 2 3 6 11

TOTALS 6 10 8 24

Page 46: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D
Page 47: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D
Page 48: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Weekly BEP Features

Summarize weekly data for each BEP studentPrint graphs from excel file

Prioritize BEP studentsBEP coordinator should choose about 5 students

of concern to prioritize for BEP meetings Make data-based decisions Award reinforcers Discuss new candidates for the BEP Assign tasks (develop action plan)

Page 49: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Quarterly BEP Features

Provide feedback to teachers and staff and to the students and their familiesAcknowledge the right of parents, staff, and

students to be informed about their school or their child

Maintain interest and involvementRecognize and encourage accomplishmentsPoint out needed areas of improvement (new

goals) and achieve collaboration in meeting those goals

Page 50: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Check-in / Check-out Program

Bethel School District (Eugene, OR)

H.U.G. Program (Hello, Update, Good-bye) (Tigard-Tualatin School District, Oregon)

Page 51: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Purposes of Evaluation of the Check-in / Check-out Program

Determine whether “real” schools can implement the check-in/check-out system with fidelity.

Determine whether students are more successful when receiving check-in/check-out support.

Filter, McKenna & Benedict (in-press)

Page 52: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

 

 Yes No Don’t

Know

 a.Do students check in with a designated teacher/ staff in the morning? 

 17

 0

 0

a.Do students take the Check in/ Check out form to each teacher to obtain feedback? 

16 1 0

a.Do students check out with a designated teacher/ staff at the end of the day? 

17 0 0

a.Do parents initial that they reviewed the Check in/ Check out form every day? 

7 6 4

a.Are ongoing results reviewed to make decisions for student supports? 

14 2 1

Check-in / Check-out Outcomes (Eugene, OR)

Table 1: Composite Frequencies of Responses to Implementation Questions in the C/CTSC

Filter, McKenna & Benedict (in-press)

Page 53: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Check-in / Check-out Outcomes (Eugene, OR)

(Average =45% reduction; N = 17)

Major Office Discipline Referrals per Week for Students on Check In / Check

Out Behavior Program

0.21

0.12

0.00

0.05

0.10

0.15

0.20

0.25

Not on Program On Program Filter, McKenna & Benedict (in-press)

Page 54: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Check-in / Check-out Outcomes (Eugene, OR)

(Average = 28% reduction; N = 17)

Figure 2: Minor Office Discipline Referrals per Week for Students on Check In / Check Out

Behavior Program

0.65

0.47

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

Not on Program On ProgramFilter, McKenna & Benedict

Page 55: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Check and Connect

Winston School District (Palatine, Illinois)

Page 56: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

ODR's for Jr. High Check and Connect

66

42

0

20

40

60

80

100

Before Intervention After Intervention

# O

DR

'sCheck and Connect Outcomes (Palatine, IL)

Bowers

Page 57: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

GPA for Jr. High Check and Connect

1.94

2.05

1.881.9

1.921.941.96

1.982

2.02

2.042.06

Before Intervention After Intervention

GP

ACheck and Connect Outcomes (Palatine, IL)

Bowers

Page 58: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Change in # ODR's for Jr. High Check and Connect

21

8

0123456789

Increased Remained Same Decreased

Nu

mb

er o

f P

arti

cip

atin

g

Stu

den

tsCheck and Connect Outcomes (Palatine, IL)

Bowers

Page 59: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Change in GPA for Jr. High Check and Connect

5 5

1

0

1

2

3

4

5

6

Increased Remained Same Decreased

Nu

mb

er o

f P

arti

cip

atin

g S

tud

ents

Check and Connect Outcomes (Palatine, IL)

Bowers

Page 60: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Next Steps Is the BEP (Check and Connect) system

appropriate for you?• Are there more than 10 students with chronic patterns

of problem behavior?• Is a school-wide system in place• Is there faculty commitment to work with tougher kids?• Are in-school resources available to implement?• Are district resources available to support start-up?

Build Action Plan• Review and present current data• Administration/Faculty commitment• Action steps within a doable timeline.

Page 61: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Newcomers Club

Newcomer

Page 62: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Newcomers Club

Highly transient school population • 450 students• Turnover brings in 260 new students during the

course of the year.

Solution: PBS team developed Newcomers Club

• Welcome and support new students• Teach school wide expectations

Page 63: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Fast Track

www.fasttrackproject.org

Page 64: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Fast Track (Coie, 1994)

Comprehensive, long term study of child-family-school intervention for diverting young children from a path leading to anti-social behavior.

Designed to forge home and school partnerships to address the needs and problems of at-risk students and their families prior to escalation into crisis situations.

Page 65: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Fast Track: Phase One

Elementary School Phase (Grades 1-5)Teacher-led Classroom Curricula (PATHS)Parent Training GroupsHome VisitsChild Social Skills Training Groups

(Friendship Groups)Child Reading TutoringClassroom Friendship Enhancement (Peer

Pairing)

Page 66: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Fast Track: Phase Two

Adolescent Intervention Phase (Grades 6-10)Academic TutoringMentoringSupport for positive peer group involvementHome visiting and family problem solvingLiaisons with school and community agencies

Page 67: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Fast Track: Outcomes Compared to control group,

Children in Fast Track:• Improved social-cognitive skills• Improved academic outcomes• Less aggressive behaviors in classroom, on

playground, and at home• Fewer special education placements

Parents of children in Fast Track:• Reduced use of harsh discipline

Page 68: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Social Skills Training

Page 69: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Group Social Skills: Critical Features

Student selection Curriculum Training social skills instructor Group Management Effective Instructional Model Planning for generalization Evaluation

Page 70: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Social Skills Instruction

Direct InstructionSkill based approach

Social Problem SolvingStrategy based approach

Opportunistic TeachingPrompt students who have missed an

opportunity to practice a skillProvide correction when skill is incorrectly or

inappropriately demonstratedDebrief when student used inappropriate

behavior in place of appropriate social skillNewcomer

Page 71: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Assessment

Critical for:Selection of appropriate skills to be taughtDesign of appropriate lessonsSelection or modification of a curriculumStudent selection and groupingEvaluation of effectiveness

Page 72: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Plan for Social Skills Instruction

Curriculum and materials Instructor fluency Schedule Student group/membership Generalization strategies

Page 73: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Plan for the Group

Behavior management Teach group expectations

Group rulesRole play rules

Reinforcement procedures Consider size of group

Page 74: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Generalization Strategies

Communication! Communication! Communication!

Coordinate classroom lessons connected to targeted

group social skills

Public posting, skill and skill steps• Schoolwide• Classrooms

Page 75: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Results were better when…

Monday Memo: Skill of the Week

Discussed Skill of the Week during staff meetings

Reinforcement tickets weekly, skill connected to school-wide expectations (include skill steps)

Frequent feedback to staff/student connected reinforcement tickets

School-wide video

Page 76: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Social Skills Group - Comparision Between Years

0

2

4

6

8

10

12

14

16

Student 1 Student 2 Student 3 Student4*

Student 5 Student 6 Student7**

Student 1 Student 2 Student 3 Student4*

Student 5 Student 6 Student7**

01- 02 02- 03

Referrals Days Suspended

*Student 4 dropped from group after J anuary - Student choice**Student 7 - 2 Referrals 1st semester while in group. Parent did not sign for group to continue until 3-11-03. 6 of the referrals while out of group.

AverageDecrease

49%

Average

Decrease

63%

Page 77: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Mentoring

Newcomer (Missouri Schools)

Page 78: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Mentoring

Identify Students Data decision rule Teacher

recommendation Function-based

Identify Mentors Teachers Administrators Counselors Secretaries Cooks Custodians Volunteers

Page 79: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Program Evaluation (Newcomer)

Decreases in: Meetings with counselor Office referrals Time outs Suspensions Detentions

Increases in: Student attendance Work completion Academic performance Homework completion Parental involvement Positive student-teacher

interaction

Page 80: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Pals - Discipline Referrals Sept-J anYR2 vs. YR3

5

4

2

4

8 8

6 6

2

0

2 2

0

9

4 4

0

1

2

3

4

5

6

7

8

9

10

Student A* Student B Student C Student D* Student E Student F Student G Student H

Nu

mb

er

of

Beh

avio

r R

efe

rrals

YR2

YR3Average Percent Decline46%

00

* Student Receiving SSD Services

Page 81: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Decrease in Referrals - Mentor Intervention

0

2

4

6

8

10

12

14

16

18

20

BT BB BK BD Cca CR CC DD DJ FA FD HK LD PS RJ RJ M SC SB ST TT

Student

Fall 2000 Fall 2001

AVERAGE PERCENT DECLINE IN REFERRALS

62%

Page 82: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

AMOUNT OF TI ME PER WEEK

SPENT WORKI NG DI RECTLY WI TH STUDENT

9

6

3

0

0

0

10 minutes or less

10 to 20 minutes

20 to 30 minutes

30 to 40 minutes

40 to 60 minutes

More than 60 minutes

NUMBER OF TEACHERS

Page 83: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

How is Systematic Support Different Than Other “Behavior Card” Interventions

A Targeted Intervention Implemented Within a School-Wide System of Behavior Support Behavior Cards typically support existing classroom expectations.

Implemented in all settings, throughout the school day All teachers and staff are trained & aware of

expectations Students identified proactively & receive support quickly Team uses data for decision making to determine

progress

Page 84: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Team Process:When should student be referred to the “Yellow Team?”

When teacher reports indicate that a student is on the verge of failure, despite school-wide, classroom and targeted strategies and procedures.

When school-wide data documents academic or behavioral problems that consistently distinguish a student from his or her peers.

When existing interventions need to be more effective.

Page 85: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Targeted Team Process:How does it happen?

Through a commitment to supporting all students in a building, including those with problem behaviors.

Through a building-based intervention team. Through the use of an effective problem solving

process ~ Functional Assessment Through the design of interventions that

emphasize the creation of environments where students can experience success and progress can be built from there.

Page 86: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Why establish a Targeted Team?

To provide a building-based system that will ensure supports are provided to students for whom school-wide practices have not facilitated success.

To provide a structured problem solving process that will ensure effective intervention practices are implemented for each student or issue brought to the team.

Page 87: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

D e v e lo p B e ha v io rS u p p o rt P la n

P la c e in T a rge te dG ro u p Inte rv e ntio n

S a tis fa c to ryim p ro v e m e nt in

b e ha v io r?

M o nito r p ro gre s s a ndm o d ify re gu la rly

S ta rt

C o nd u c t F u nc tio na lA s s e s s m e nt

H igh d e gre e o fc o nfid e nc e inhy p o the s is ?

C o nd u c t fu llF u nc tio na l A na ly s is

D e v e lo p b e ha v io rs u p p o rt p la n

Y E S

Y E S

N O

Y E S

N O

O R

F u n ctio n -B asedT argeted G ro u p

an dIn d ivid u al S tu d en t S u p p o rt

P lan n in g

Page 88: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Systems to Support Implementation Integrity

• Teaching • Coaching and feedback• Scripts for adults to follow • Data Collection• Follow-up support meetings• Follow up data evaluation

Page 89: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Why Do Interventions Fail?

Bad data for decision making Unmeasurable outcome objectives Low quality plan Poor implementation of plan Lack of regular & sustained monitoring Inadequate support for implementers Failure to implement/adopt function-based

approach

Page 90: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Working With Teams

Guiding Problem Solving and Development of Targeted Interventions

Page 91: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

SYSTEMS

PRACTICES

DATA

SupportingStaff Behavior

SupportingDecisionMaking

SupportingStudent Behavior

Positive Behavioral Interventions & Supports

Page 92: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

P R A C TIC E S

S u p e rv is io n

R e info rc e m e nt

C o n t in u u m o fC o n s e q u e n c e s

In s t ru c t iv e"D is c ip l in e "

In s t ru c t io n a lL e s s o n s

R o u tine s

In s t r u c t i o n a l fo c u s o nS c h o o l - w i d e e xp e c t a t i o n s

5:1 P o s itive:C o rrec tio nR atio

T angib le Intangib leIntrins ic Extrins ic

P rac tic e with F eed b ac k

Ac ro ss S ettings

C las s ro o m M anaged

O ffic e M anaged

F unc tio n-b ased

F o rmal Lesso n P lans

Direc t Ins truc tio n

P rac tic e with F eed b ac k

C l e ar l y d e fi n e de xp e c t a t i o n s fo r ad u l t s

S c hed ule

T ro ub le S p o ts

Page 93: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

S Y S T E M S

Le a d e rshipT e a m

E v a lu a tio n

C o a c hing& T ra ining

C o m m u nic a tio n

P o lic yD e v e lo p m e nt

F u nd ing

P ro fes s io nalDevelo p ment

F BA T raining

P BS T eam T raining

Emb ed d ed F ac ulty& S taff T raining

S o urc es Id entified

Ac c ess

P ro c es s &P ro c ed ures C o d ified

P ro c es s to trans lated ec is io n to p o lic y

F ac ulty M eetings

Bulletins &Anno unc ements

Data P resented inUsab le F o rmat

P arent News letters

Ac tio n P lan& G o als

F o rmative Q ues tio ns

P reventio n &R eferrals

S ummative

R egularly S c hed uledM eetings

T eam R o leAss ignments

S truc tured Agend a

Page 94: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

D A T A

S W IS o r C e ntra lD a ta S y s te m

S y s te m a ticD a ta E ntry

E ffic ie nt R e fe rra lF o rm

C o m pre he ns iv e

M u ltip le D a taS o u rc e s to Id e ntifyS e c o nd a ry /T e rtia ry

T eac her referralS c reening, etc .

O ffic e Disc ip lineR eferrals

T ime-o ut,Bud d y R o o ms , etc .

Detentio n

IS S

G rap hicd emo ns tratio n

M ultip le teammemb ers trained

M ultip le rep o rts(d aily average)

M atc hes Data Entry

C o mp rehens ive

C hec klis t

Defined p ro c ess

Daily

Page 95: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Big Ideas

Schools need different systems to deal with different levels of problem behavior in schools.

Targeted group interventions like the BEP are efficient systems for supporting students at-risk for more severe forms of problem behavior.

Up to 30 students (depending on school size/resources) can be served using a targeted group intervention.

Some students are going to need more intensive support than targeted interventions can provide.

Page 96: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Summary

Targeted interventions are Less time intensive, more cost effective.Best for low level problem behavior (e.g. talk-outs,

minor disruption, task completion)Efficient because they use a similar set of strategies

across a group of students who need similar support

Effective because they focus on decreasing problem behavior in the classroom thereby increasing academic engagement and decrease office referrals

Page 97: Secondary Prevention: Targeted Interventions Christine McGrath Davis, Ph.D

Presenter Information

Christine McGrath Davis, [email protected]