Tier 2 Interventions: Systems, Practices, Data, and Outcomes

Lori Lynass, Ed.D.Tricia Robles, M.Ed.

Building the Airplane While Flying It

Social and Behavioral Support for All Students

“I Feel Like I Am Taking Chem 102 & 103 Before I Have

Completed Chem 101”

Systems, Data, Practices, Outcomes

Tier 2 Interventions(Hawken, Vincent, & Schumann, 2008).

• Assumes a Tier 1 School wide PBIS is in place – SET, BOQ• Involves a problem-solving focused behavior support team• Screening to identify a % of students non responsive to Tier 1• Readily available and easily accessible• Uses efficient, available evidence based practices• Includes data-based progress monitoring & decisions• Have an entry & exit criteria, with non-responders moving to Tier 3

Tier 2: Small Group Interventions

–Social Skills Groups (Redefining Counselor Groups)

–Check In/Check Out, Check, Connect & Expect–Executive Functioning Skill Groups–Academic Support Groups–Self-Monitoring

Are We Ready for Tier Two?• For Tier Two supports to

be most successful, basic components of Tier One should be in place.

* Check Classrooms

Tier 1 Consistent, Predictable, Safe and Positive

• Have ALL Staff been Trained in Your Tier 1 System for PBIS?

• Have Teachers Received PBIS in the Classroom?

• Do Parents Know About Your Program?

Are We Ready for Tier Two?• For Tier Two supports to

be most successful, basic components of Tier One should be in place.

* Check Classrooms• Time must be dedicated

for Tier Two to be implemented.

• Support from staff and admin must be available.

• Professional development must occur.

It Starts With The Team

Functions of The Tier 2 Team• ENTRY, EVALUATE, EXIT

• Determine & Oversee Referral Process• Review Students Referred• Monitor Implementation Fidelity• Evaluate Outcomes and Make Decisions

– Ongoing Progress Monitoring– Fidelity of Implementation– Social Validity

Establishing the Tier 2 Team

• May be part of the existing PBIS leadership team.

• May be an extension of the existing PBIS leadership team.

• May be a stand alone team, often these teams look at Tier 2 & 3.* Such a team may already exist in your school -

SIT team, Care team, MDT team.

Tier 2 Team Members

• Tier 2 Coach• PBIS Coordinator• Counselor • Psychologist• Teachers• Administrator• Other Para-professionals

Tier Two Team

Analyzing Possible Team Structures: Making the Pieces Fit

RTI/PBIS Team Structure

Developed by The School District of Osceola County

3-Tiered System of Support

CICO

SSG

Exec Func Skills

Complex

FBA/BIP

Problem Solving Team

Tertiary Systems Team

Brief

FBA/BIP

WRAP

Secondary Systems Team

Plans SW & Class-wide supports

Uses Process data; determines overall

intervention effectiveness

Standing team; uses FBA/BIP process for one youth at a time

Uses Process data; determines overall

intervention effectiveness

Sept. 1, 2009

UniversalTeam

Universal Support

Derby Ridge Elementary Teaming Structure

Grade Level Teams

Discussion – Tier 2Teams

• With a partner(s) discuss possible Tier 2 team formats.- What are the benefits and drawbacks of the various structures?

• Who would be on your Tier 2 team?• When could this team meet?• What needs to happen to create a Tier 2 team?

15 Minutes

Establish Entry Criteria

• A team agreed process should be established for how students enter Tier 2 programs. Common entry criteria:– Office Referrals– Teacher Nomination - Through Process– Counselor Nomination– Screening Results

Office Referral Information

But Who Are We Missing?

Screening

• Use of a Validated Screener:– Six-Eight (Oct-Nov) weeks after school begins & in

Spring– At the end of the year if desired (provides

information for planning)– As a new student enters if needed

* Academic Screening Data Also Considered

How Most Schools Determine Student Need for Services

• Only 2% of schools screen all children for mental heath reasons (Romer & McIntosh, 2005)

• Office discipline referrals & Teacher/Staff referrals are commonly used

Why Universal Screening benefits schools

• Establishes a schools risk level and allows for monitoring of responsiveness through shifts in this risk level (Lane, Kalberg, Bruhn, Mahoney & Driscoll, 2008)

• Informs the use of Tier 2 & 3 interventions - where to target limited funds

• Preventative supports reduce the need for more intensive supports later (Cheney & Stage, in press; Walker, Cheney, Stage, & Blum, 2005)

• Monitor overall effectiveness of the three-tiered model

• Promotes early intervention in place of “wait to fail” (Glover & Albers, 2007);– Of the 20% of school-aged children who experience

mental health difficulties, only 30% receive services (US Public Health Service, 2000).

– 65% of students identified for EBD are 12 years or older (US Dept of Ed, 2001)

• A reduction in over-representation of children of color– African American students are twice as likely to be

identified as EBD than White students (Alliance for Excellence Education, 2009)

• Addresses the issue of under-identifying girls and students with internalizing issues (Hosp & Reschly, 2004)

Why Universal Screening benefits students.

Choosing A Universal Screener

• Choose a Screener that:1. Is appropriate for its intended use and that is

contextually and developmentally appropriate and sensitive to issue of diversity

2. Has Technical Adequacy3. Useable - efficient, feasible, easy to manage

- Calderella,Young, Richardson & Young, 2008

Systematic Screening for Behavior Disorders (SSBD; Walker & Severson, 1992)

• Originally normed K-6, recently normed for middle and Jr High (Calderella,Young, Richardson & Young, 2008)

• Multiple gating procedures following mental health & PBS model

• Externalizing and Internalizing dimensions• Evidence of efficiency, effectiveness, & cost benefits• Exemplary, evidence-based practice

• US Office of Special Education, Council for Children with Behavior Disorders, National Diffusion Network

SSBD: Sample Questions

• Critical Events (Behavioral Earthquakes):– Sets Fires, – Vomits after eating, – Exhibits painful shyness

• Maladaptive Behavior– Requires punishment before s/he will terminate behavior.– Child tests teacher imposed limits.

• Adaptive Behavior– Is considerate of the feelings of others.– Is socially perceptive.

Multiple Gating Procedure (Severson et al. 2007)

Teachers Rank Order 3 Ext. & 3 Int. Students

Teachers Rate Top 3 Students on Critical Events, Adaptive & Maladaptive Scales

Gate 1

Gate 2

Pass Gate 1

Classroom & Playground Observations

Gate 3Pass Gate 2

Tier 2,3Intervention

Tier 3 Intervention or Special Ed. Referral

Student Risk Screening Scale (Drummond, 1994)

• Originally normed at elementary level, recently normed at middle and high school (Lane, Kalberg, Parks, & Carter, 2008)– Classroom teacher evaluates and assigns a frequency-based, Likert

rating to each student in the class in relation to seven behavioral criteria

– Score indicates the level of risk (low, medium, high)

• Scores predict both negative academic and behavioral outcomes

• Effective, Efficient and Free

Student Risk Screening Scale (Drummond, 1994)

– lies, – cheats, – sneaks, – steals, – behavior problems, – peer rejections, – low achievement, – negative attitude, – Aggressive.

– Rated on a 4-point Likert scale (never, seldom, sometimes, frequently)

SRSS

Student Internalizing Behavior Screener (SIBS, Cook 2008)

• Nervous or Fearful• Bullied by Peers• Spends Time Alone• Clings to Adults• Withdrawn• Seems Sad or Unhappy• Complains About Being Sick or Hurt

– Rated on a 4-point Likert scale (never, seldom, sometimes, frequently)

2009 Bridget Walker, Ph.D.

Kdg A Sam Spade

Kdg B Frederico Latica Charles Brown

Grade 1 A Lina Ruis Char Beyer Rana Wilcox Renny Linquist

Grade 1 B Jack Jonson

Grade 2 A Kim Signorelli Mike Majewski

Grade 2 B Lin Wu Monico Leon

Grade 3 A Howard Muscott Doug Cheney

Grade 3 B Peggy Hunt Pat Harrington

Grade 4 B Tim Leary Peppermint Patty

Grade 5 A Scott Stage

Grade 5 B Kelli Jane Paula Seabright

Grade 6 A Alex Tapps Shin Ji Lauren Anderson Dave Drobek Jerome Garcia

Grade 6 B Robert Weir Chris Norman Kate Davis Dennis Chipp Rashan Lincoln

Names listed in blue are students who have passed Gate 2 of SSBD. Names listed in red are students who have been identified with academic issues Names in green are students who have been identified by both academic screening & SSBD. The Support team is meeting to determine appropriate supports for each group

Sample List of Students Identified Through Schoolwide Screening

How could this information help you determine where your limited support resources should focus?

Bridget Walker, Ph.D.

In Addition to Screening Consider:

• Teacher/Counselor/Parent Request Forms• Office Referral Data• Academic Data• Classroom Minor Data• Attendance

Discussion – Entry Criteria

• With your table discuss:– How do students get into current supports?– Is there a consistent process?– Based on what you have heard today, what

changes might need to occur?

10 Minutes

10 Minute BREAK

We Have Our List of Students Now What? Picking the Right

Intervention.

• Check-in and Check-out – BEP, Check, Connect and Expect

• Social Skills Groups• Drug/Alcohol Groups• Executive Functioning Groups• Self-Monitoring

Knowing Function of Behavior to Determine Intervention

“Can’t Do versus Won’t Do”

• Can’t Do or Don’t Know When To Do- Skill Deficit - Performance Deficit - Perception Deficit

• Won’t Do- Function of Behavior

Can’t Do: Skills Building

• Social Skills Groups– Assertion Skills, Anger Management, Friendship

Skills, Empathy Skills• Executive Function Skills Groups

– Organization Skills, Emotional Control, Time Management

• Academic Skills Groups– Context Reading Skills, Math Skills

Wont’ Do – Function of Behavior

FunctionsProblemBehavior

Obtain/GetSomething

Escape/Avoid

Something

SocialTangible/Activity

Adult

Stimulation/Sensory

Peer

Pos Reinf Neg Reinf

Guiding Principles

• Behavior is predictable.

• Behavior is changeable.

• Human behavior occurs within an environmental context, not in a vacuum.

• Human behavior is learned and can be taught by manipulating aspects of the environmental context--Behavior is a function of the environment

Source: Crone , D.A. & Horner, R.H., 2003

Function Based Matching Process

• Information Collected & Reviewed by Tier 2 Team– Screening– Majors (Office) & Minor (Classroom)– Academics & Attendance– Function (Observations, Screening Data)– Strengths

• Tier 2 Team Determines:– Summary of Problem – Replacement Behavior– Student Goal

• Tier 2 Team Selects Intervention– Progress Monitoring Method– Action Plan– Follow Up Date

Discussion – What is happening?

• How does your school currently determine if a student has a can’t do or won’t do issue?

• Does your school consider function when deciding interventions?

10 Minutes

Monitoring Effectiveness and Fidelity of Tier 2 Interventions

Fidelity Checklist

A good plan implemented poorly…is a bad plan.

Monitoring Progress In Tier 2

• Each Student Should Be Monitored at Least Twice Monthly to Determine :– If they are responding to the intervention– If the intervention is the correct intervention– If the intervention needs to be adjusted– If the student is ready to exit

Monitoring All Interventions

Monitoring Individual Interventions

Monitoring Fidelity of Tier 2 Interventions

• Core features of interventions should be adhered to.

• The fidelity of Tier 2 programs should be monitored by the Tier 2 team.

• Look over the Tier 2/3 Tracking Tool and Systems-Response Tool.

Discussion – Monitoring Student Progress

• How does your school currently monitor student progress in behavioral interventions?

• For your Tier 2 interventions, who will be monitoring the progress which should be done at least every two weeks?

10 Minutes

Tier 2 Assessment

• Complete the Tier Two Action Plan Checklist

15 Minutes

Final Q & A