Module 12

1
Module 12 Using the Wraparound Process In
Alternative Education Settings Lucille Eber Ed.D
Session 1 History and Overview of Wraparound
2
Sources
Eber Keenan (in press). Collaboration with
Other Agencies Wraparound and Systems of Care
for Children and Youth with EBD. In R. G.
Rutherford, M. M. Quinn, S. R. Mathur (Eds),
Handboook of Research in Behavioral Disorders.
Guilford Press
Eber (2003). The Art and Science of Wraparound
Completing the Continuum of School-wide
Behavioral Support. Bloomington, Indiana
Forum on Education at Indiana University. (video
and training manual) www.forumoneducation.com

3
History and Development of the System of Care
(SOC) Concept
Fragmentation, Dissonance and Confusion

• Definitions
• Eligibility criteria
• Policies
• Practices

Results for kids families?

• Relinquishing custody to get services
• Default to juvenile justice system
• Few served dismal outcomes for those served

4
Mental Health Attempts

• Unfunded Mandates
• 1974 CMHC required to provide services to kids
• 1978 Presidents Commission on Mental health
• 1980 Mental Health Systems Act

Did PL94-142 inadvertently slow progress as MH
assumed Education would be a major provider?
(Duchnowski, Kutash Friedman, 2002)
5
Setting the Stage

• 1982 Unclaimed Children (Jane Knitzer)
• SOC needed to be seamless continuum,
• community-based and culturally relevant

1983 CASSP Technical Assistance plan to develop
SOC

• 1986 System of Care (Stroul Freidman)

• Called for collaboration community-based
  services
• Resulted in increments of service development
• (i.e. case mgmt, respite, day treatment, in-home
  supports)
• But not a coordinated system or continuum
• Did not indicate practices needed for a SOC

6
History (cont.)

• 1989-1993 RWJ Projects
• 27 states and local communities
• introduced managed care
• effected state systems in some places (i.e. KY,
  NC)

• 1992-present Comprehensive Community
• Mental Health Services for Children
• Their Families Program
• 85 states local tribes territories
• Decrease use of restrictive placements while
  increasing
• access, satisfaction, and youth/family outcomes
• Systemic change across systems
• Development of state and community structures

7
Concurrent Events in Education Promoting
Interagency SOC

• PL 94-142 (1975)
• Jane Knitzers At the Schoolhouse Door (1992)
• OSEPs SED Agenda (1994)

• SOC/wraparound consistent with Sp. Ed. mandates
• But not consistent with practices that evolved
• Burden of only mandated provider?

8
Wraparound A SOC Tool

• Emerged from practitioners struggling to
• implement SOC (grassroots)
• Keep/bring kids home
• Flexible, creative, non-categorical
• Natural support networks
• Community-based
• Do whatever it takes
• Let families guide service development
• Non-traditional supports and services

9
Changes Required Across Systems to implement SOC

• System Structures
• Program Design
• Practices

• Reposition/retrain staff
• University Training Curricula
• Interagency professional Development

Family involvement in system/policy, program
practice design Family members as trainers,
faculty, service providers,
10
Wraparound

• Emerging Theory of Wraparound
• (Burchard, Bruns Burchard, 2002)
• Social-Ecological (Brofenbrenner)
• Social Learning Theory (Bandura)

• A value-based philosophy, approach
• planning process
• Development of a child/family team a
  comprehensive plan
• Strength-based, need-based, family-centered/drive
  n
• Natural Supports, culturally relevant

11
What is Wraparound?

• Wraparound is a process for developing
  family-centered teams and plans that are strength
  and needs based (not deficit based) across
  multiple settings and life domains.
• Wraparound plans include natural supports, are
  culturally relevant, practical and realistic.

The Art Science of Wraparound Eber, 2003
12
What is Wraparound?(contd)

• Blending perspectives of team members results in
  a variety of traditional and nontraditional
  strategies that are directly linked to agreed
  upon outcomes.
• The wraparound process creates a context for
  effective implementation of research-based
  behavioral, academic and clinical interventions

The Art Science of Wraparound Eber, 2003
13
Understanding Wraparound

• Facilitate wraparound planning process
• Family/student/teacher ownership of plan
• Access full range of school and community support
  services across life domains
• Home, school, community settings
• Individualized academic and behavior
  interventions are integrated into wrap plans

14

• Wraparound is a tool used to implement
  interagency systems of care in achieving better
  outcomes for youth and their families.

The Art Science of Wraparound Eber, 2003
15
Examples of School-based Applications (in Eber
Kennan Chapter)

• Westerly, RI
• La Grange, IL (LADSE)
• Lehigh Valley, PA

See reading list for additional documentation
of outcomes for IL examples
16
Program Evaluation Outcomes Evaluation of the
Comprehensive Community Mental Health Services
for Children and Their Families Program Annual
Report to Congress 1999

• reduced use of restrictive placements
• greater access to broad array of services
• improved social/emotional functioning
  (home/school/community)
• increased family/youth satisfaction
• improved school attendance and performance
• decreased interaction with law enforcement

• Evaluation/Research needs
• Lack of controlled studies
• Defining integrity/fidelity of intervention

17
IL EBD/PBIS NetworkAGGREGATE WRAP EVALUATION

• FY03 Pilotof Wraparound
• in PBIS Schools

For complete narrative report see FY03 PBIS
End-of-Year Progress Report (appendix L
pgs129-140) at www.ebdnetwork-il.org
18
FY 2003 EBDAGGREGATE WRAP EVALUATION

• Student Referral Form
• Education Form
• Youth and Family Checklist
• Parent Satisfaction
• Youth Satisfaction

For copies of tools, see wrap evaluation tools
at www.ebdnetwork-il.org
19
FY 2003 EBDAGGREGATE WRAP EVALUATION

• 11 students with data
• 11 students with baseline and time 2
• 9 students with time 2 and time 3
• 7 students with time 3 and time 4

20
FY 2003 EBDAGGREGATE WRAP EVALUATION

• Typical Student in this pilot study
• -Caucasian male
• -10 years of age
• -5th grade, Special Education Student
• -Primary Diagnoses of Multiple Disabilities
• -Referred for Social Skills, Academics, Behavior,
  Emotions
• -Home Placement Not At-Risk Not in DCFS Care
• -School Placement at Risk of Failure

21
Primary Reasons for Referral for Service Planning
22
Type of Primary Disability by Student
23
Is School Placement At-Risk
24
FY 2003 EBDAGGREGATE WRAP EVALUATION

• EDUCATION FORM
• Improved findings Baseline to 3 Months
• -Appropriate behavior with peers
• -Appropriate behavior with adults
• -Participates in extracurricular activities
• -Academic performance
• -Performance commensurate with abilities

25
FY 2003 EBDAGGREGATE WRAP EVALUATION

• No change or slight decrease Baseline to 3
  Months
• -Pays attention in class
• -Works independently
• -Attends school
• -Completes homework
• -Participates in classroom discussions

26
Relationship Between Behavior Problems and
Academic Needs?
Data suggests that as need for additional
behavior support decreases, (i.e. behavior
improves),need for additional academic
assistance increases.
Does this mean that as behavior improves,
academic needs (which were possibly there all
along) become noticeable?
27
FY 2003 EBDAGGREGATE WRAP EVALUATION
Requires behavior support beyond what other
students require Requires academic support beyond
what other students require
28
FY 2003 Aggregate AnalysisYouth and Family
Checklist Home
29
FY 2003 Aggregate AnalysisYouth and Family
Checklist School
30
FY 2003 Aggregate AnalysisHigh Risk Behaviors
31
FY 2003 Aggregate AnalysisParent and Youth
Satisfaction
32
Wraparound Case Studyin school implementing
Universal Positive Behavior System Lamar

• Status when brought up to targeted intervention
  team
• Male, age 9, minority
• General Ed classroom 100 of day
• Disruptive classroom behavior
• Received an in-school suspension
• Decrease in grades
• Academic Performance 60-69
• Recent Transfer to School District

33
Wraparound Case Study Lamar

• Reasons for Referral to Schools
• Targeted Intervention Team (Oct.02)
• Lying stealing behaviors
• Disruptive behavior in class
• Disrespectful towards adults and peers
• Poor peer interactions
• Academic Difficulties

34
Wraparound Case Study Lamar cont.
First Attempts

• Parent conference at school Oct 02
• behavior concerns (lying/stealing, disrespect)
  shared
• school reports parent didnt respond seemed
  passive
• baseline strengths/needs data collected from
  parent
• parent indicated concerns with lack of community
  interaction
• school provides parent with list of resources
  for Lamar
• Lamar begins targeted group intervention
• (check and connect) Nov. 02
• PBIS Coach encourages wrap process Nov 02
• School feels parent didnt respond enough to
  participate

35
Wraparound Case Study Lamar cont.

• Outcomes of first attempts
• Problem behavior continues
• Lamar brought up again at schools targeted team
  Feb 03
• PBIS Coach encourages consideration of wrap
  process
• Referral for CSE for Sp.Ed. ( possible BD
  discussed)
• Mom is engaged in wrap process during a home
  visit Feb.03

36
Wraparound Case Study Lamar cont.

• Strengths identified through wrap process
• Has a friend at school
• Attends homework lab
• Enjoys going to grandmas house
• Likes playing basketball
• Plays guitar and piano
• Enjoys bike riding
• Has a caring mother
• Enjoys learning karate

37
Wraparound Case Study Lamar cont.
Issues/Needs Identified through Wrap Process

• need peer/social contact for boys at
  home/community
• mom feels Lamar too isolated from peers
• mom needs support due to visual disability
• Lamar tells exaggerated stories about his life
  (lying)
• takes supplies from teachers and peers
  (stealing)
• decreasing academic performance
• mom reports Lamar feels helpless about his life
  circumstances
• eye exam was recommended for Lamar but he hasnt
  had one

38
Interventions, Supports and Services
Wraparound Case Study Lamar cont.

• Curricula adaptations March 03
• Increased prompts, instruction, reinforcement for
  respectful words and voice
• Community connections initiated for mother March
  03
• After school open gym transportation provided
  March 03
• Eye exam transportation provided March 03
• Visit new school to help in transition April 03
• PBIS coach met with new wrap team to ensure that
  gains in social and academic behavior continue
  April 03

39
Wraparound Case Study Lamar cont.
Outcomes

• happier, popular with peers, interacts
  appropriately
• uses respectful tone and voice
• academic performance increases (70-79)
• Learning disability identified through CSE
• Successful in regular classroom with academic
• behavioral interventions
• Mother seeking community supports through
  agencies
• Problem behavior reappears when anxiety about
  mothers
• deteriorating eyesight increases
• Transition wrap team to 4th grade center to
  prevent
• Re-occurrence of behavior/academic problems

40
YOUTH AND FAMILY CHECKLISTBehavioral
Functioning Home/Family
Strength High
Strength Somewhat
Need Somewhat
Need High
41
CLASSROOM FUNCTIONINGData from three points in
time (10-02 to 5-03)
ALWAYS
FREQUENT
SOMETIMES
NEVER
42
YOUTH AND FAMILY CHECKLISTBehavioral
Functioning School
Strength High
Strength Somewhat
Need Somewhat
Need High
43
Interventions, Supports and Services
Wraparound Case Study Lamar cont.

• Curricula adaptations March 03
• Increased prompts, instruction, reinforcement for
  respectful words and voice
• Community connections initiated for mother March
  03
• After school open gym transportation provided
  March 03
• Eye exam transportation provided March 03
• Visit new school to help in transition April 03
• PBIS coach met with new wrap team to ensure that
  gains in social and academic behavior continue
  April 03