Targeted and Intensive Supports at the High School Level:

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• Targeted and Intensive Supports at the High
  School Level
• APEX II in New Hampshire
• APEX II Summer Institute
• August 20, 2008
• Maureen Tracey,
• Jonathon Drake
• Alliance for Community Supports

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AGENDA

• Introduction/Overview
• APEX II Model Elements
• School-wide (Universal) Level
• Secondary (Targeted) Level
• RENEW Intensive Model
• The Relationship between Secondary and Intensive
  in a High School
• Case Studies
• Lessons Learned

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Youth with Emotional and Behavioral Disabilities

• 50-60 dropout of high school 10-25 enroll in
  post-secondary education
• 30-58 employed post-school
• High rates of MH utilization, poverty,
  incarceration
• (Alexander, et al., 1997 Kortering, et. al.,
  1998 Lee and Burkham, 1992 Wagner, 1992)

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APEX- Model Assumptions

• School organization and processes are related to
  dropout rates (school-wide issues) (Gottfredson,
  Gottfredson Hybl, 1993 Bryk Thum, 1989 Lee
  Burkham, 2001 Nelson, 1996 Rumberger, 2001
  Rutter, 1979)
• Behavioral problems in school are associated with
  a likelihood of dropping out indicator of risk
• Students with significant emotional or behavioral
  challenges require individualized,
  community-based transition services in order to
  successfully complete high school

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APEX II Model

• To address school-based systems/climate issues
• Positive Behavioral Interventions and Supports
  (PBIS) (Bohanon, et. al., 2004 Sugai Horner,
  1999)
• Student Leadership Development
• To address issues for students most at-risk
• Rehabilitation for Empowerment, Natural supports,
  Education and Work (RENEW) (Eber, Nelson Miles,
  1997 Cheney, Malloy Hagner, 1998 Bullis
  Cheney, 1999)
• 8th to 9th grade transition system and practices

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APEX II GOALS

• Work toward implementing Positive Behavioral
  Interventions and Supports (PBIS),
• Provide leadership in the school-wide systems
  change process and support the dedication of
  staff time to participate in project activities,
• Collaborate with project staff to develop a
  systematic transition from the 8th to 9th grade
  for at-risk students,
• Collaborate with project staff to develop
  individualized school-to-career services for the
  most at-risk students using the RENEW model, and,
• Develop and implement a high school student
  leadership initiative to focus on school climate
  issues.
• 2005 MOUs between districts and NH DOE

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RENEW The Red Zone Component of the APEX II
Project

• For the most at risk students (60 per high
  school)
• Model components
• Personal Futures Planning
• Individualized academic programming (creative
  solutions and Real World Learning
  opportunities).
• Naturally supported employment
• Interagency collaboration and braided funding
• School to Career transition articulation,
  including post-secondary education
• Mentoring

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APEX PBIS MODEL
Tertiary Prevention RENEW Intervention
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Secondary Prevention Specialized Group Systems
for Students with At-Risk Behavior
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Primary Prevention School-/Classroom- Wide
Systems for All Students, Staff, Settings
80 of Students
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COMPARING YEAR ONE AND YEAR TWOGreen Zone has
gone from 42 to 60 (Target 80)Yellow Zone
has gone from 18 to 13 (Target 15)Red Zone
has gone from 40 to 27 (Target 5)
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Franklin HS Benefits of
APEX and PBIS
56 Reduction in ODRS
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Tier 2 PBIS Functional Assessment Outcomes

• Operational Description of Problem Behavior
• Organized by response classes, behavioral
  routines
• Identification of events that reliably predict
  occurrence and nonoccurrence of problem behavior
• Immediate antecedents and setting events
• Identification of Maintaining Consequences
• Hypothesis statement(s)
• Direct Observation Data

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A Functional Approach to Behavior Support

• Behavior Support has Been Redefined
• Behavior support is the design of effective
  environments.
• Effective environments make problem behaviors
  irrelevant, inefficient and ineffective.

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Tier III The Intensive InterventionRENEW
Conceptual Framework
Child Welfare
Education
INTERAGENCY COLLABORATION
SCHOOL-TO CAREER
YOUTH, FAMILY, RENEW
SELF-DETERMINATION
Disability
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RENEW PRINCIPLES

• Self-Determination
• Unconditional Care
• Strengths-Based Supports
• Flexible Resources
• Natural Supports-Community Inclusion

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RENEW IS.

• A flexible, person-centered support
• Driven by the students expressed needs,
  interests, and goals
• A service
• RENEW IS NOT.
• A program
• A classroom or school

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RENEW Goals

• High School Completion
• Employment
• Post-secondary Education
• Community Integration

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RENEW Strategies

• Person Centered Planning
• Flexible education programming
• Individualized School-to-Career planning
• Naturally supported employment
• Wraparound services and supports

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Strategies (cont.)

• Mentoring
• Individualized and flexible resource development
  (paid and unpaid)
• Community inclusion
• Interagency collaboration

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Where are the Boundaries Between Levels 2 and 3?

• We find that many schools identify too many
  students as in need of intensive services- the
  FBA and function-based interventions help
  alleviate the high need.
• Level 2 question What is needed to help the
  student succeed in the school setting?
• Level 3 question Challenges external to school
  are interfering with the students success- what
  is needed outside of school?

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Where are the Boundaries Between Levels 2 and 3?
(cont.)

• Every student should have a career plan the
  RENEW model is a quality of life intervention
  that facilitates the conversation about dreams,
  goals, and objectives in the context of what
  supports are needed

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Amy Profile

• Lives in Rural Area
• Attends Inner City School (starting at grade 9)
• History of Difficulty with Academics
• High rate of academic failure (passed 3/12
  classes)
• In a pattern of Skipping Classes and School
• In a pattern of Detentions and Suspensions
• 2nd Year Freshman (in a freshman homeroom)
• On the track to be a 3rd year freshman
• Claims to belong to the EMO group

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Amys Difficulties

• Challenged by Schoolwork
• Environment
• Inner City School (2500 students)
• 4 buildings
• Large of students in classes
• Difficulty making friends
• Being bullied

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Amys Record Review

• Record Review Revealed
• Difficulty with reading and math since first
  grade
• Received Title I services until 3rd grade
• Identified with learning disability 3rd grade
• Verbal IQ 100 Non Verbal 76
• Behavior started to interfere in 8th grade
• 9th Grade significant decrease in behavior and
  academics

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At the time of referral Amy displayed the
following behaviors

• Skipping Classes
• Shutting Down/Refusal of work completion
• Telling exaggerated and revealing stories

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Manifestation Meeting Possible Suspension or
Expulsions

• Skipping Classes
• Shutting Down/Refusal of work completion
• Telling exaggerated and revealing stories

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Hypothesis of the Function of the Behaviors

• Skipping Classes
• Shut Downs and Works Refusal
• Exaggerated and Revealing stories

• Escape bullying
• Escape Challenging Academics
• Gain peer adult attention

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Interventions Before FBA

• Adults talking to Ashley about behavior
• Detentions
• Saturday School
• In School Suspension
• Out of School Suspension

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Interventions from FBA

• Smaller Environment (class size and school size)
• Pre-Teaching Academics
• Positive Proactive Adult Attention from
  Administration
• DATE that Function-based Interventions Began

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Classes Skipped
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Leaving School Grounds
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Suspensions
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Unexcused Absences
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Amys Data
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Futures Plan Objectives Developed April 10th 2007
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Futures Plan Objectives Developed April 10th 2007
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Amy Competing Behavior Pathway
Desired Behavior Appropriately engages in peer
conversation
Typical Consequences Meaningful positive
relationships (appropriate attention) Stays in
class

Problem Behavior Swears out loud Skips
class
Triggering Antecedents Makes up stories- engages
in negative reactive behavior

• Maintaining
• Consequences
• Gains attention from peers
• Escapes Setting and negative feelings

Setting Events In class with people who are not
in her group

• Replacement Behavior
• Does not engage in
• conversation with
• other students
• Pairs up with one
• Student outside of class

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Amy Competing Behavior Pathway

• Desired Behavior
• Prepares for class ahead of time independently
• Completes Work
• Interacts with teacher in positive way

• Typical
• Consequences
• Stays in class
• Positive interaction with Teacher

• Problem Behavior
• Shuts down
• Argumentative
• Skips class

• Triggering
• Antecedents
• Difficult Math Concept
• Lack of proper materials

• Maintaining
• Consequences
• Escapes Setting
• Escapes Negative feelings/interactions

Setting Events Math class- more likely if
unprepared

• Replacement Behavior
• Have adult help
• organize before class
• Go to Resource Room
• or trusted adult for help
• Complete 50 of work

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Jay Background

• Involved in sports and school clubs
• Likes to work
• Excels in math
• Takes leadership roles
• Cares deeply about friends and others
• Lower socioeconomic status
• No high school completion in family history
• Second year freshman
• History of failure
• Family drug use
• Divided family
• Criminal record
• History of fights with other students
• Domestic violence
• Injured last fall in a major car accident

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Jay In School Supports

• Check and Connect with teacher
• Mentor with police officer
• Universal teacher support
• Medical accommodations
• Updates on academic standing

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Check Connect Self Monitoring Checklist

• Checklist for Keeping Grades Up Goal
• 1. Concentrate 75-80 of the time
• 2. Be patient with teachers
• 3. Be patient with classmates
• 4. Be cooperative
• 5. Do 70 to 80 of the work for all classes
• 6. Talk in class only when necessary (need help,
  told to talk, called on)
• 7. Study (for at least 30 minutes) before taking
  tests
• 8. Study hard (for at least 10 minutes) for
  quizzes
• 9. Bring what I need to for class
• 10. Will receive a C average or better for all
  work
• For a successful week, at least 8 out of the 10
  tasks above will be completed and goal number 10
  must be fulfilled.

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Jay- Personal Futures Plan Review
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Jays Personal Futures PlanNew Objectives
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Rich

• Background
• Alternative school student
• History of mobility
• Repeated freshman year
• History of academic failure
• History of office discipline referrals
• Divided Family
• Low economic status
• History of drug use
• Relates well with most adults
• Very active, loves martial arts and exercising
• Street smart
• Takes leadership roles

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Rich (cont.)

• Primary Problem Behaviors
• Disrespect to high school staff (not alternative
  school)
• Does not do work/apathetic
• Frequent problems with rough housing with other
  students
• Distracting to other students

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Richs Competing Behavior Pathway
Desired Behavior 1. Always comes to class on
time 2. Engages in class work and student
interaction appropriately/ productively
Maintaining consequences Learns from class
experiences, develops social appropriate behaviors

Antecedent Asked to do work, Group work, When
transition begins between classes or activities,
interactions with certain peers
Problem Behavior 1. Skips classes 2. Wrestles
with others, engages in off task behaviors
Setting event Group Work, Transitions, Missing
medication
Function Peer attention, Escape from Work, Adult
attention
Alternative Behavior 1. Comes to class 80 of
the time 2. Engages productively in group
activities for the 1st 10 minutes. 3. Take
breaks when he starts feeling the need to exert
physical interactions with peers.
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Rich

• Date that Interventions Began 2/2007
• Interventions Included
• Preteaching serves the need for adult attention.
• Check in with teacher on progress, rewarded with
  time off on Fridays serves the need for adult
  attention, escape from work, and peer attention
  during the time off.
• Private reminders on expectations does not
  reinforce the undesired behavior by putting
  student in the spotlight in front of peers.

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Richs Function-based Plan
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Richs Function-based Plan
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Rich Personal Futures Plan

• Goals for 1st plan
• Pass classes
• Make an effort to do work
• Take charge of own curriculum with help for his
  teacher
• Wrestle with friends outside of school
• Get his license
• Think about a career (massage therapy)
• Goals for 2nd plan
• Pass the rest of his classes
• Get an adult diploma

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Rich Personal Futures Plan Review
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Student Reflections

• The facilitator really listened to ME and to
  what I want
• I trust him/her
• I like the flip charts- it helps me to stay
  organized

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Going Forward

• Develop a more organized system for referral and
  screening for RENEW services
• Develop a RENEW training manual and data
  collection system
• Develop the capacity to provide RENEW services in
  many different settings