Enhancing Efficacy of First Step to Success

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Enhancing Efficacy of First Step to Success

• Bruce Stiller, Ph.D.
• Billie Jo Rodriguez, Doctoral Student

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First Step to Success

• First Step to Success (Walker, et.al., 1997) is
  a collaborative home and school intervention
  program designed to divert at-risk primary age
  children from learning behaviors that interfere
  with success in school and life.

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First Step to Success

• Used K-3 for students with moderate to severe
  problem behaviors
• Provides 30 - 60 days of intensive behavior
  support
• Two complementary, primary interventions CLASS
  and HomeBASE
• Key participants Teacher, Parent, Coach, and
  Student
• Outcomes increase social academic success
  decrease problem behaviors

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Philosophical Foundations

• Behavior should be taught (identify the correct
  response differentiate from most common errors
  model prompt reinforce re-teach when errors
  are observed)
• Attention is a powerful reinforcer of student
  behavior. Maximize attention for appropriate
  behavior minimize attention for inappropriate
  behavior

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Tertiary Prevention Specialized
Individualized Systems for Students with
High-Risk Behavior
School-Wide Positive Behavior Support
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Secondary Prevention Specialized Group Systems
for Students with At-Risk Behavior
Primary Prevention School-/Classroom- Wide
Systems for All Students, Staff, Settings
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80 of Students
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CLASS Intervention

• Positive behavior management program
• Implemented by Coach Days 1-7
• Implemented by Teacher Days 8 thru conclusion
• Children learn how to
• Attend to the teacher
• Get along with others
• Participate in activities

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CLASS Procedures

• Target Student earns points on the GREEN/RED card
• GREEN/RED card provides feedback
• Points on GREEN side earn activity rewardfor
  the class

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PLAYING THE GREEN/RED CARD GAME

• Procedures (continued)
• Teacher teaches, coach operates card
• When time is up, debrief with student
• Ask teacher to stop class
• Announce the outcome

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Coach turns card to RED when student is not
attending to the teacher
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Coach shows how many points have been earned.
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The group activity reward should be delivered as
soon as possible after the GREEN/RED card game
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HomeBASE

• Commitment for parents/caregivers
• Weekly meetings with First Step coach 30-45
  minutes
• Complete Check-up lists
• How well do you know your child ?
• Discuss Parent Tips
• Dos and donts of good parenting
• Practice Games to play with child
• Focused on supporting school success
• Daily practice and activities with child 5-10
  minutes

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HomeBASE Lessons

• WEEK 1 Sharing the day
• WEEK 2 Cooperation
• WEEK 3 Limit Setting
• WEEK 4 Problem Solving
• WEEK 5 Friendship Skills
• WEEK 6 Building Confidence/ Self-Esteem

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Common Obstacles to Effective Intervention

• Treatment Integrity is low adult behavior has
  not changed
• Student continues to receive high rates of
  attention for inappropriate behavior
• Feedback is inconsistent (e.g. card is not turned
  to red following problem behavior)
• The student exhibits work avoidance problem
  behaviors that are not responsive to the RED card
• Program does not address academic needs
• The problem behaviors occur primarily in
  unstructured situations where it is difficult to
  provide adequate structure/adult supervision

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Common Modifications to Enhance Efficacy

• Identify specific social skills that can be
  taught as replacement behaviors (e.g. careful
  please)
• Also useful for low frustration tolerance (e.g.,
  take a break or practice self-talk strategies)
• Add an extinction component for escalation cycles
  when the RED card is not effective
• Add an academic intervention (such as
  pre-teaching a key skill) when problem behavior
  is due to low academic skills
• Support teacher implementation via coach feedback
  or technology

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Research Questions

• Descriptive Study Evaluate outcomes
• Interest in weak and non-responders
• Function of Problem Behavior
• Does the reason for students problem behavior
  matter?
• Fidelity of Implementation
• How is the program implemented by teachers?
• Contextual Fit
• Do teachers like the program, feel they have the
  resources to implement, and value its results?
• Experimental Studies
• Relation between behavioral function and outcome
• Impact of specific coach feedback on fidelity

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Descriptive Study
Participants 30 students in 4j
Springfield Students higher risk than typical

• Direct Measures
• Student behavior
• Academic engagement
• Problem behavior
• First Step points
• Fidelity of implementation
• Card visibility
• Praise
• Turning to red green
• Minimize attn when red

• Indirect Measures
• Semi-structured interview (FACTS)
• Social Skills Rating Scale (parent and teacher)
• Contextual fit survey
• Daily teacher behavior rating
• Social validity

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Behavioral Function Outcomes
n 30
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Descriptive Fidelity Components
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Descriptive Contextual Fit
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Descriptive Trends

• FS is most effective with children emitting
  (adult) attention-maintained problem behavior.
• Fidelity teachers whose students respond tend
  to implement with higher levels of consistency
• Mechanism needs to be examined
• Teacher improves fidelity, so students respond OR
  responders less likely to punish implementation?
• Contextual fit emphasizes need to limit energy
  and time demands on teacher
• Initial differences in fit suggest high level of
  contextual fit may be important for success

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Experimental Studies

• Study 1
• Does modification of First Step to Success based
  on why student is emitting (ie. function) problem
  behavior improve student outcomes?
• Study 2
• Does adding a coach feedback intervention
  component improve fidelity of teacher
  implementation?

Russell Horner, in press
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Noah Intervention Summary Function-based re
gular

• Morning check in daily note home
• Specific pre-correction class rewards for
  ignoring
• Class earns points for ignoring peer problem
  behavior
• Target student earns points that he can then
  award to another student
• Extinction peers teacher ignore problem
  behavior head down/time-out for more intense
  problem behaviors

• No morning check in and only first step cards
  sent home
• Standard First Step introduction to class
• No class points for ignoring peer problem
  behavior
• Target student earns points based on
  pre-determined First Step intervals only and does
  not earn time with a peer buddy
• Teacher corrects student for inappropriate
  behavior

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Study 1 Results Implications for Practice

• Results
• Enhanced First Step showed greater decreases in
  problem behavior than regular First Step
• Fidelity varied across teachers
• Implications
• FBA prior to implementation of First Step may
  allow interventionists to more efficiently adapt
  interventions to align with each students unique
  needs
• Implementation of First Step should focus on two
  goals
• Implementing core program components with
  fidelity
• Identifying and providing necessary adaptations
  for potential non-responders

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Study 2 Improving Fidelity

• Utilize coach time differently
• Structuring coach support for improving teacher
  implementation
• Observing and supporting critical features
• Allow time for problem solving
• Verbal written feedback
• Data
• Following up after (versus during) student
  honeymoon phase

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Study 2 Fidelity Feedback Card

• Observation
• Was the Red/Green card visible to the student?
• 0-30 31-69 gt70
• When the card is green, does the implementer
  provide positive feedback (e.g. thumbs up, pat on
  back, smile, comment) to the child during the
  game?
• 
  
• None 1 - 3 times 4 or more times
• Following instances of problem behavior, did the
  implementer turn the card to red?
• 0-30 31-69 gt70 N/A
• When the child engages in problem behavior, does
  the implementer refrain from interaction w/child?
• 0-30 31-69 gt70 N/A
• When the implementer turns the card to red for
  inappropriate behavior, does s/he turn the card
  back to green for appropriate behavior within 30
  seconds?
• 0-30 31-69 gt70 N/A
• If the child earned a reward activity, what was
  the activity provided? (may be observed or
  emailed by teacher)

• Student Date
• School Time
• Observer Activity
• Teacher Feedback
• Review of student behavior
• Ask for ( note) implementers perception of
  intervention strengths/weaknesses.
• Positive(s) observed
• 1.
• 2.
• Areas needing work
• 1.
• 2.
• Additional Positive(s)

Fdbk Study
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Study 2 Results Implications for Practice

• Results
• Teacher integrity of implementation can be
  improved using coach feedback
• Additional studies needed to better understand
• Implications
• Focus on critical features of intervention
• Meaningfulness of feedback increased when teacher
  has opportunity to implement (i.e. student shows
  some problem behavior)
• Implementation of First Step should focus on two
  goals
• Implementing core program components with
  fidelity
• Identifying and providing necessary adaptations
  for potential non-responders

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Summary

• First Step is effective for many students
  (Walker, et al., 2005 Golly, et al., 1998
  Walker, et al.,1998)
• First Step package will likely be enhanced by
• Functional behavior assessment suggested
  modifications
• Fidelity component
• Assessment of contextual fit

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First Step to Success

• Sopris West, Inc. (A Cambium Learning
  Company)
• www.sopriswest.com
• 1-800-547-6747
• Starter Kits are 163.49 - 3 applications
• Re-Supply Kits are 39.95 each

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• Questions?