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Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

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Page 1: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Tier 3 School-wide Positive Behavior

Intervention and Supports Dawn Miller

MTSS FacilitatorLea Ann Combs and Jamie Wolfe

PBIS Facilitators

1

Page 2: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Training Topics• Team Orientation – TIPS

• Revisiting SIT–Expand scope and clarifying purpose–Application of problem-solving process-whole group to individual– Illustration of problem-solving process – tertiary level

• Revisiting SIT Logistics

• Implementation Efforts: Monitor, Evaluate, Modify –Take TIC–Updating Action Plan–Benchmarks of Advanced Tiers

ACTION PLAN

Page 3: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Elements of School-wide PBIS

• Establish a team interest and commitment• Establish expectations & rules• Develop lesson plans & teach• Create a reward/incentives program• Modify discipline referral process/forms• Establish a data-based decision-making system • Monitor, evaluate, and modify • Refine consequences

Page 4: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Revisit the Triangle

4

Academic Systems Behavioral Systems

1-5% 1-5%

5-10% 5-10%

80-90% 80-90%

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

Intensive, Individual Interventions•Individual Students•Assessment-based•Intense, durable procedures

Targeted Group Interventions•Some students (at-risk)•High efficiency•Rapid response

Targeted Interventions•Some students (at-risk)•High efficiency•Rapid response• Group or individual

Universal Interventions•All students•Preventive, proactive

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

Page 5: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Evaluating Your PBIS Team

Page 6: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

6

Important Structural Components• Regular meetings & regular attendance• The “right” people• The right roles

– Facilitator– Minute Taker– Data Analyst– Active Team Members

• The right information for problem solving & decision making

• Accomplishments – Products of successful meeting– Meeting Minutes (record of decisions & tasks concerning

administrative/general issues)– Problem-Solving Action Plan (record of decisions & tasks

concerning problems identified by team)

6

Page 7: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

7

Organizing for an effective problem solving conversation

Problem

SolutionOut of Time

Use Data

A key to collective problem solving is to provide a visual

context that allows everyone to follow and contribute

Page 8: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Identify Team Roles and Responsibilities• Coach- facilitates meetings, reviews past meeting minutes, keeps

focus of group on agenda, update Action Plan • Record Keeper - writes down the actions and activities • Timekeeper- before meeting gets consensus on time to be spent

on each topic, monitors time for each topic, and gives warnings when time is running out (i.e., “we have 5 minutes left”)

• Data Entry Person- trained to enter and access office referral data and brings the data to the meetings

• Behavior Specialist- a person who has received training in individual positive behavior support

• District Facilitator/External Coach- district-level individual who coordinates coach and inservice trainings, provides link between schools, KU PBIS Trainers, and coaches

Page 9: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Norms for PBIS Team MeetingsSafe •Maintain confidentiality of student

information

Respectful •Listen to teammates contributions without interruption•Respect other’s comments•Show support of PBIS outside of team meeting

Responsible •Arrive to meeting on-time•Conclude meeting on-time•Have an agenda and adhere to it•Open agenda at the end of meeting•Be a model to other staff

Page 10: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

The Problem Solving Process:

The Big Picture

Page 11: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1
Page 12: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

When you think of SIT……..

Page 13: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

STUDENT IMPROVEMENT TEAM AREAS OF FOCUS

STUDENT IMPROVEMENT TEAM

Individual Student Partnerships Organizational/ Systemic

Page 14: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

The SITeam is…

A formalized safety net that uses a problem-solving process to address individual student

needs.

Page 15: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

BELIEF STATEMENT

Educators, community members, parents, and students can generate

much higher levels of student achievement

– can virtually eliminate school failure –

by connecting with students and coordinating the resources they need to

succeed.K I D S

Page 16: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

BELIEF STATEMENT

Educators, community members, parents, and students can generate much higher levels of

student achievement – can virtually eliminate school failure –

by connecting with students, making data-based decisions to match students to appropriate level of intensity of intervention, and coordinating the

resources they need to succeed..K I D S

Page 17: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Our level of data analysis

Intensity or customization

of supports

People or agencies involved

As the magnitude of the problem increases...

Scope of the Plan

Page 18: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Systematic Approach

Request for Assistanceor Extended Problem-Solving

Warranted

Problem Solving Family Involvement

Student Involvement

Follow up/ Monitoring &Evaluation

Intervention Plan Developed or

Tertiary Customization

Resource Connecting

Page 19: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Problem-Solving Process

Strengths/Concerns Identified

What’s the problem?

Why is it happening?

What could we do about it?

How will we know ifit’s working?

Should we keep orchange the intervention?

Collect and Use

Data

Page 20: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

SIT Process

PBIS Referral or Request for Assistance Received

Student/Family Conference

Determine and Collect Critical Data Needed to Problem Solve

Team Meeting to Review Data Collected and Begin/Refine Plan Development

Collect Additional Information as Needed

Communicate with the Referring Party about the Status of the Plan

Involve or Inform Person(s) Implementing Strategies

Implement SIT Plan

Monitor Progress of Plan

Follow-Up Meeting

Page 21: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Orbiting the Giant Hairball…

Page 22: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

School

Improvement

Students At-Risk

§ 504 Special Education

Progress is monitored & changes made according to student’s response to interventions

Individualized Plan Student Improvement Plan

§ 504 Plan IEP

Student Improvement TeamA formal support for teachers, parents students,

community members…….

Eligibility Team

If exceptionality suspected based on response to

interventions: Due Process

Page 23: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Perception Check

• It is important that we have a unified purpose with SIT.

• Every staff member needs to • Understand the purpose• Be willing to support the purpose

Page 24: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Purpose

VS.

Page 25: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Activity

Page 26: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Some Differences?

• Resulting plans clearly articulate WHAT will be different in class and in intervention.

• Resulting plans make necessary connections or coordination with resources within school/district and the community.

• People who work with the student leave with a plan that articulates what they will do AND feel confident that the plan has a chance of working.

Page 27: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Teacher BeliefsAll Students Can Learn

Disagree40%

Agree60%

Page 28: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Problem-Solving Process

Strengths/Concerns Identified

What’s the problem?

Why is it happening?

What could we do about it?

How will we know ifit’s working?

Should we keep orchange the intervention?

Collect and Use

Data

Page 29: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

District Connections

Drug/AlcoholPoverty

Cultural AwarenessSpecial Groups (ELL, Minority, Sped)

Social/EmotionalAcademic

Page 30: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1
Page 31: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Social and Emotional Competencies

SelfControl

MakingFriends

Connecting

Resources

Truancy

AngerManagement

Page 32: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

• In SMSD, we have demonstrated to be consistently high in the protective factors of:– Positive learning climate– High learning expectations– Student-teacher relationships

• In SMSD, we have consistently shown a need in building protective factors for:– Suicide prevention– Bullying/harassment

Social/Emotional Competencies

Page 33: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

33

Quick Sort MatrixCheck-In

Check-OutCheck & Connect Social Skills

GroupOrganizational

SkillsNewcomers

Club

Adult Attention X X X X X

Peer Attention X X

Choice of alternatives/activities

* X

Teach replacement behavior

X X X X

Teach problem-solving skills

X X

Increase precorrects and prompts for behavior expectations

X X X

Page 34: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Suicide Prevention

Health Curriculum After School Activities/Clubs

Second StepBully PreventionProblem Solving

Gatekeeper Training

Adult Mentor

Teaching Behaviors X X X X

Targeted Opportunities

X X

Page 35: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Discussion Starters:

List questions you have as a team related to addressing suicide prevention.

List known internal or external resources you know to exist that address suicide prevention.

How are we educating people about warning signs.

Building-based people that went to Gateway Training.

.

Page 36: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Belonging

Connecting

Resources

Drug and AlcoholUse

Drug and Alcohol Issues

Page 37: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Drug and Alcohol Issues• From Shawnee Mission discipline system for 2011

Top of FormProblem Behavior

Bottom of FormFreq

Drug - Related Marijuana: Solicitation/Sale 2

Alcohol - Possession 6Drug - Related 7

Drug - Related Illicit Drug: Solicitation/Sale 7

Drug - Related Illicit Drug: Use 8Alcohol - Use 14

Drug - Related Drug Paraphernalia: Possession 16

Drug - Related Marijuana: Use 21Drug - Related Illicit Drug: Possession 25Drug - Related Marijuana: Possession 26

132

Infractions Students Percent

Grade 6 1 2041 0.05%

Grade 8 20 1947 1.03%

Grade 10 30 2164 1.39%

Grade 12 22 2174 1.01%

Totals 73 8326 0.88%

* Compare with CTC data.

Page 38: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Funding Support for Drug and Alcohol Education and Issues

• District Support: – Science Curriculum, Health Curriculum, Counselors, SRO’s,

Project Alert, Check in/Check out, Individual Student Improvement Team

• Title IV (Federal monies): – Second Step and Signs of Suicide program.

• Alcohol Tax Fund (Local monies): – After school Drug Free Clubs at the elementary and secondary

levels. In four SM high schools two SIT team members with the assignment of utilizing a problem solving model to provide support for students with alcohol and drug related issues.

Page 39: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Drug and Alcohol UseHealth Curriculum Second Step

Resistance Behaviors

Second StepBully Prevention

Social SkillsProblem-Solving

Adult Mentor

Teaching Behaviors X X X

Targeted Opportunities

X X

Page 40: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

SIT Processing:

List questions you have as a team related to addressing drug and alcohol issues .

List known internal or external resources you know to exist that address drug and alcohol issues.

Can we refer for an assessment without being responsible for paying?

Johnson County Mental Health

Page 41: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty

Language

Registers

SocialSkills

Connecting

Resources

Organization

Page 42: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty

Johnson Wyandotte Cass Clay Jackson Platte0

20000

40000

60000

80000

100000

120000

140000

Number of People in Poverty by Metro Coun-ties, 2010

*2010 Census data

Page 43: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty• Free and Reduced Lunch Count by

Districts

2003-04

2004-05

2005-06

2006-07

2007-08

2008-09

2009-10

2010-11

0

5

10

15

20

25

30

35

Gardner-EdgertonShawnee MissionSpring HillOlatheDesotoBlue Valley

Page 44: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty(Homeless)

Comparison of Homeless Students by District

School Year

School District 2007-2008 2008-2009 2009-2010 2010-2011 As of January 10, 2012

Blue Valley 12 16 19 53

Spring Hill 8 10 27 48

Gardner Edgerton 22 38 96 145

De Soto 13 0 38 64

Olathe 82 202 265 326 500

Shawnee Mission 186 310 301 266 215

Total: 323 576 746 902

% increase from prior year 78.3% 29.5% 21%

Page 45: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty(Homeless)

• Under Federal law identified McKinney Vento students must receive full and equal access to the educational experience.

• Many McKinney Vento students come to Shawnee Mission with academic deficits or behavioral challenges.

• Building leadership and staff are expected to implement the same methods of assistance and intervention for the McKinney Vento student as would be utilized for any other at-risk Shawnee Mission student in the framework of a problem solving model implemented through the MTSS, SWPBS, or the student intervention teams.

Page 46: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Poverty

Resource Analysis Ruby PaynePlanning

Goal SettingLanguage Registers

Mental Models

Basic NeedsBackpack Program

Clothing Center

Mentoring

Teaching Behaviors X X

Targeted Opportunities X X

Page 47: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

SIT Processing:

List questions you have as a team related to students impacted by poverty.

List known internal or external resources you know to exist that assist with issues related to poverty.

How do students qualify as homeless?

How can David Aramovich be involved with our SITeam?

SMSD social worker assigned to work on homeless issues.

SMSD Clothing Center at Arrowhead

Page 48: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Students in Special Groups

Improved

Math

Skills

Culturally

ResponsiveSocialSkills

Basic

NeedsLanguageAcquisition

Page 49: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Students in Special Groups

• ELL• Special Education• Race and Ethnicity • Free and Reduced Lunch

Page 50: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

White non-White

Population 3% 9%

Middle School Students with 4 or more F’s

• 3% of White MS students have 4 or more F’s over Q1 and Q2.• 9% of non-White students have 4 or more F’s over Q1 and Q2.

Page 51: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

No Lunch Support Reduced Lunch Free Lunch

Population 2% 7% 12%

Middle School Students with 4 or more F’s

• 2% of MS students with no lunch support have 4 or more F’s over Q1 and Q2.• 12% of MS receiving free lunch have 4 or more F’s over Q1 and Q2.

Page 52: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

No IEP Gifted Disabled

Population 5% 0% 11%

Middle School Students with 4 or more F’s

• 5% of MS students without an IEP have 4 or more F’s over Q1 and Q2.• 11% of disabled MS students have 4 or more F’s over Q1 and Q2.

Page 53: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Culturally Competent Practices

ELL Support Student Clubs Peer Mediation Challenge Club

Teaching Behaviors X X

Targeted Opportunities X X

Page 54: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Discussion Starters:

List questions you have as a team related to students belonging to special groups

List known internal or external resources you know to exist that assist us with students belonging to special groups

Why can a student be identified as being a student with a disability from an outside agency and not qualify for an IEP?

Are there research-based strategies for certain student groups?

Families Together

Randy Lopez, Migrant, SMSD

Page 55: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Academic Achievement

Improved

Reading

Skills

Improved

Math Skills

PassingClasses

HomeworkCompletion

Page 56: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

PLC Tie In…..

• Four Framing Questions:

Page 57: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

The SITeam Process…A formalized safety net that uses a problem-solving process to address

individual student needs.

Improved

Reading

SkillsBelonging

SocialSkills

MakingFriends

Connecting

Resources

OrganizationTruancy

AngerManagement

PassingClasses

HomeworkCompletion

Page 58: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Referral ProcessRequests Can Come From:

• PLC’s• PBIS Team• Administrators• Staff • Parents• Students• Other Concerned Person

Page 59: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Team Activity:Revisit Referral Process

• What is your current referral process? Form?

• How will your team insure the request is broad in scope, visible, and accessible to all?

• Where will requests be dropped off?

• How will the team ensure confidentiality during the request process?

Page 60: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

PBIS Journey has Provided…• School-wide Prevention Efforts

• Function-Based Intervention Responses

• Data-Based Routines– Building– Group– Individual Student

Page 61: Tier 3 School-wide Positive Behavior Intervention and Supports Dawn Miller MTSS Facilitator Lea Ann Combs and Jamie Wolfe PBIS Facilitators 1

Our level of data analysis

Intensity or customization

of supports

As the magnitude of the problem increases...