Prevent-Teach-Reinforce Model: A Tier 3 Behavior Intervention Process

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Prevent-Teach-Reinforce Model A Tier 3 Behavior
Intervention Process

• Rose Iovannone, Ph.D., BCBA-D
• iovannone_at_usf.edu
• Don Kincaid, Ed.D., BCBA
• kincaid_at_usf.edu

The contents of this training were developed
under grant H324P04003 from the Department of
Education
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Agenda

• AM
• PTR Overview
• Step 1Teaming
• Step 2Goal Setting
• Step 3PTR Assessment
• PM
• Step 4aPTR Intervention Plan
• Step 4bCoaching/Fidelity
• Step 5Evaluation
• Questions/Wrap-up
• Next Steps

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Objectives

• Participants will
• Describe the 5-step PTR Tier 3 support model
• Identify the critical components that enhance the
  success of Tier 3 supports
• Apply the principles of the PTR process to a case
  study
• Determine how the PTR process is applicable
  within their setting

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Tier 3 Function-Based Behavior Interventions in
Schools

• Current Issues
• Absence of uniform policies practices
• Form versus a process
• Expert driven versus collaborative effort
• Occasionally contextual fit considered
• Limited support/follow-up/training for teacher
  provided
• Teachers may not be the personnel to facilitate
  FBAs in schools
• Increased focus on school psychologists (Scott
  Kamps, 2007) and other school-based behavioral
  consultants or coaches

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Prevent-teach-reinforce

• The Model

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What is Prevent-Teach-Reinforce (PTR)?

• Research project funded by U.S. Department of
  Education, Institute of Education Sciences
• University of South Florida
• Three central Florida school districts
• University of Colorado, Denver
• Two Colorado school districts
• Purposes
• Answer the call for rigorous research
• Evaluate effectiveness of PTR vs. services as
  usual using randomized controlled trial
• Evaluate effectiveness of standardized
  approach

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Participants

• 200 students100 treatment, 100 comparison
• K-8th grade
• General and Special Education
• All cognitive levels
• All disabilities
• Teacher-nominated top externalizers
• Systematic Screening for Behavior Disorders
  (SSBD)
• Behavioral difficulties
• Duration minimum 6 months
• Frequency minimum of 1 time per week
• Intensity disruption to the learning environment

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Prevent-Teach-Reinforce PTR

• Intervention teams given manual and assigned PTR
  consultant
• Five step process (aligned with problem solving
  process)
• Teaming
• Goal Setting (Identification of Problem)
• Functional Assessment (Problem Analysis)
• Intervention (Intervention Implementation)
• Coaching and fidelity
• Evaluation (Monitoring and Evaluation of RtI)

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PTR Preliminary Outcomes
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Student Demographics by Primary Disability
Disability N Percent
Autism 25 9.8
Developmental Delay 5 2.0
Emotional Disturbance 38 14.9
Mental Retardation 28 11.0
Multiple Disabilities 4 1.6
OHI (not ADD/ADHD) 1 .4
OHI (ADD/ADHD) 8 3.1
Specific Learning Disability 20 7.8
Speech/Language Disability 10 3.9
Visual Impairment 2 .8
General Education 99 38.8
TOTAL 245 245
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Student Description
Grade Level K 1 2 3 4 5 6 7 8 N 34 53 53 41 30 16 7 8 3 13.9 21.6 21.6 16.7 12.2 6.5 2.9 3.3 1.2
Lunch Status Regular Free/Reduced 77 150 31.4 61.2
Gender Female Male 45 200 18.4 81.6
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Outcomes

• Student Outcomes
• Treatment and control group comparison resulted
  in significant differences (p lt .001 moderate
  effect sizes (.44 to .55)
• Intervention students
• Social Skills Rating System (SSRS) Problem
  Behavior scores decreased
• SSRS Social Skills scores increased
• Academic Engaged Time scores increased

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Randomized Controlled Trial Results
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Cross-Over Treatment Results
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Teacher Outcomes

• Fidelity
• Majority of teachers achieved .80
• Mean coaching/training sessions 3.5
• Prevention higher than Teach and Reinforce
• Social Validity
• Modified Teacher Acceptability Rating Form (TARF
  Reimers Wacker, 1988)15 items
• 5-point Likert Scale
• 124 teachers
• Overall4.16 (.52)
• Willingness to carry out plan4.80 (0.42)
• Like the procedures4.46 (0.64)
• Alliance
• Teachers rated PTR consultants highly (4.80 mean)
• Highesttrust, follow-through, collaborative

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The PTR Process
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Step 1 Teaming

• Teaming A collaborative process
• Members
• Person with knowledge of student (e.g., Classroom
  teacher, instructional assistant, parent)
• Someone with expertise in functional assessment,
  behavioral principles (PTR consultant,
  school-based consultant)
• Someone with knowledge of context (e.g.,
  administrator or designee)

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Step 1 Teaming

• Purpose
• Evaluate strengths and weaknesses of team
  functioning
• Outline roles and responsibilities
• Determine a consensus-making process

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Collaboration Activity (page 2 Activity Packet)
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Step 1 Teaming

• Forms for creating an effective cohesive team
• Classroom Team Survey (pg. 18 book pg. 2-3
  blank)
• Teacher Work-Style Survey (pg. 19 book pg. 4
  blank)
• Paraeducator Work-Style Survey (pg. 20 book pg.
  5 blank)
• PTR Work-Style Comparison Sheet (used by
  facilitator) (pg. 21 book pg. 6 blank)
• Purposes To identify potential issues enhancing
  and impeding effective intervention implementation

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Step 1 Teaming Facilitation Tips

• Avoid direct confrontation or fixing issues
• Purpose is for team to recognize potential issues
  that enhance and inhibit problem solving process
• Less talk, more listening and facilitating
• Provide visual summary of results to each team
  member
• Ask them to review the results and reflect
• Ask for their ideas, reactions, input
• Facilitate the discussion

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Step 1 Teaming Case Study

• Mike
• 9-year-old male
• ESE Classification Autism
• Placement Self-contained, autism classroom with
  6 students (wide age range)
• Nonverbal Uses signs, Dynamite, pictures to
  communicate
• Team Teacher and two aides, PTR Consultant

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TEAMING ACTIVITY MIKEACTIVITY PACKET pages 3-5
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Step 1 Teaming Activity Instructions

• Get with a team
• Review the work-style survey responses (page 3)
  and the teaming survey (pages 4-5) from Mikes
  team
• Identify potential issues that may impact how the
  team functions
• Discuss how you would facilitate a discussion
  with the team about the issues

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Step 1 Discussion

• What do you need in order to facilitate Step 1?
• How will you use this step?
• What forms will you be using?

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Step 2-Goal Setting

• Identify the problem

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What Determines Success?

• Analysis of outcomes of 800 consultation cases
  involving elementary students
• Problem identification 43
• Problem analysis plan development 31
• Goal attainment occurred in 97 of cases in which
  a plan was implemented
• consultants successful in identifying problems
  were almost invariably able to solve those
  problems

Bergan Tombari, 1976
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Step 2 Goal Setting

• Purpose
• Identify behaviors of greatest concern to the
  team and possible replacement behaviors (teach)
• Prioritize and operationalize behaviors targeted
  for intervention
• Develop teacher friendly baseline data collection
  system
• Targeted Areas
• Problem behaviors
• Social skills
• Academic behaviors

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Step 2 Goal Setting (pg. 7-9 blank forms pg.
38 book)
Behavior Social Academic
Broad Goal Broad outcomes desired (what is the overall goal to be achieved in each category)? Broad outcomes desired (what is the overall goal to be achieved in each category)? Broad outcomes desired (what is the overall goal to be achieved in each category)?
Short-Term Goal Behavior to Decrease Inappropriate behaviors preventing student from achieving long-term goals (current problem behaviors/deficits) Inappropriate behaviors preventing student from achieving long-term goals (current problem behaviors/deficits) Inappropriate behaviors preventing student from achieving long-term goals (current problem behaviors/deficits)
Short-Term Goal Behavior to Increase Skills to be taught to replace inappropriate behaviors (skills to replace problem behaviors that will achieve broad goal) Skills to be taught to replace inappropriate behaviors (skills to replace problem behaviors that will achieve broad goal) Skills to be taught to replace inappropriate behaviors (skills to replace problem behaviors that will achieve broad goal)
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Case StudyStep 2 Goal Setting
Mike will communicate his wants and needs appropriately Mike will interact with peers appropriately Mike will comply with non-preferred activities and requests
Mike will decrease screaming, hitting, and getting out of his seat Mike will decrease hitting, screaming at, and bossing his peers Mike will decrease screaming and hitting
Mike will ask for a break or for attention when needed Mike will initiate peer interactions using his Dynamite Mike will engage in non-preferred activities and communicate his frustration using his Dynamite or an appropriate tone
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Step 2 Data Collection System

• Behavior Rating Scale BRS (pg. 10 blank forms
  pg. 39 book)
• Direct Behavior Rating (DBR)Hybrid assessment
  combining features of systematic direct
  observations and rating scales
• Efficient and feasible for teacher use
• Provides data for decisions
• Prioritized and defined behaviors measured
• Requires minimum of 1 appropriate and 1
  inappropriate behavior

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Step 2 Behavior Rating Scale (BRS)

• Behavior recorded at least once each day
• Specific time period/routine
• Whole day
• Combination of both
• Anchors scale of 1-5
• Measure options
• Frequency
• Duration
• Intensity
• Percentage of opportunities

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BRS Guiding Questions

• In which routine(s) will you be rating the
  behavior?
• What would be the easiest way to track the
  behavior?
• How often it occurs?
• How long it lasts?
• How intense it is?
• What is your estimate of the behavior happening
  on a typical day?
• Problem behavior 4
• Appropriate behavior 2
• What would the behavior look like on a great day?
• Problem behavior 1
• Appropriate behavior 5

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Case Study - Mike Operational Definitions

• Problem behaviors
• Screamingloud, high pitched noise heard outside
  the classroom
• Hittinganytime Mike touches peers or adults with
  an open hand, fist, foot, or object while
  screaming or protesting
• Replacement/Appropriate Behaviors
• Express frustration appropriately using Dynamite,
  pictures, or signs to ask for a break or
  attention
• Transition to non-preferred activities Moving to
  non-preferred activity and engaging with
  appropriate verbal expression

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Case Study- Mike Behavior Rating Scale

Behavior
Screaming 9 times 7-8 times 5-6 times 3-4 times 0-2 times 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
Hitting 8 times 6-7 times 4-5 times 2-3 times 0-1 times 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
Expressing Frustration 40 30-40 20-30 10-20 0-10 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
Transition to Non-preferred Whimper or squeal Louder than indoor voice Outdoor play voice Louder than outdoor play Ear penetrating 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
01/15

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BRS Psychometrics (Preliminary)

• Kappa coefficients of
• Problem Behavior 1 (N 105) .82
• Problem Behavior 2 (N 90) .77
• Appropriate Behavior 1 (N 103) .65
• Appropriate Behavior 2 (N 56) .76
• Iovannone, Greenbaum, Wei, Kincaid, Dunlap (in
  review)

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Other Uses of BRS

• Systemic data tracking method for Tier 3
• Sample system created by
• Cindy Anderson
• School district in Florida

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Secondary Level Modifications

• Teams with 3 or more members
• Select one team member who will be the primary
  interventionist
• Behavior identification and BRS development will
  be focused on that persons situation
• Other team members provide input/support
• If desired, other team members can record BRS
  data in their settingsrating descriptions can
  stay the same or minor modifications can be made
• Each row of BRS can represent a different teacher
  OR
• Each teacher can keep own BRS
• Consultant/coach collects all BRS ratings at
  specified times

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Step 2a Activity Developing a Behavior Rating
Scale (BRS)
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Step 2 BRS Group Activity

• Setting up a Behavior Rating Scale
• One volunteer
• Identify a behavior of concern
• As a group, walk through the steps to set up the
  scale

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BRS Problem Behavior Group Activity
Behavior Anchors
5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
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ActivityStep 2b

• Activity PacketPage 6

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Step 2 Activity Instructions

• Watch the video of Paris
• Identify one problem behavior
• With your team, agree upon an operational
  definition of the behavior
• Write it on the goal form, second row (decrease)
• What would you target as a replacement behavior?
• Clearly define the behavior and write it on the
  third row (increase).

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Activity (page 7 Activity Packet)

• In your teams, identify one student you know with
  serious problem behaviors.
• As a team, identify one behavior you would like
  decrease for this student
• Define it in clear, measurable terms
• Identify a behavior you would like to see
  increase that may replace the problem behavior
• Define it in clear, measurable terms

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Facilitation Tips

• Have team members submit the goal setting table
  as homework
• Have a visual that summarizes all of the input
• Do not reword inputwait until meeting to have
  team provide clarification
• If step is conducted during problem solving
  meeting, use group processes to ensure all team
  members participate
• Use post-it notes or index cards and provide
  several to each team member
• Use 2 minute thinking time, have team members
  write input on notes/cards
• Use round robin to get input from all

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Step 2 Discussion

• What do you need in order to facilitate Step 2?
• How will you implement this step?

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Step 3 Functional behavior assessment

• Analyze the Problem

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Given 60 seconds, use 4 straight lines to connect
all of the dots without lifting your pen (Page 8
Activities)
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A box to think outside of
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Step 3 PTR Functional Assessment

• PTR Assessment (FBA) (pp. 56-61 book 9-13
  activity 12-16 blank forms)
• Checklist format
• Prevent antecedents
• Teach function, possible replacements
• Reinforce consequences, possible reinforcers
• One form completed for each problem behavior by
  each team member
• Information leads to hypothesis

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Step 3 Prevent Section (First 2 pages of
Assessment)

• Read the questions
• Be prepared to discuss the questions in this
  section

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Step 3 Activity (pages 9-10 Activity packet)

• Practice using this section with regard to a
  student you know.

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Step 3 Teach Section

• Read and discuss the questions in this section

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Step 3 Activity (Pages 11-12 Activity Packet)

• Practice using the Teach section with regard to a
  student you know.

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Step 3 Reinforce Section

• Read and discuss the questions in this section

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Step 3 Activity (Page 13 Activity Packet)

• Practice using the Reinforce section with regard
  to a student you know.

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Step 3 PTR Assessment Table(pg. 18 blank forms,
pg. 62 book)

• Used by consultant to summarize all information
  from PTR Assessment
• Responses organized and categorized
• Information requiring clarification listed
• Draft hypotheses developed
• Cheat sheet (page 17 blank forms page 16
  Activity Packet)

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Learned Functions of Behaviors

• GET
• Obtain
• Activities, people, tasks, tangibles, sensory,
  pain attenuation
• GET OUT OF
• Escape/Avoid/Delay
• Activities, people, tasks, tangibles, sensory,
  pain

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Step 3 Case Study MikeAssessment Summary
Table of Problem Behavior
Prevention Data Teach Data Reinforce Data
Non-preferred task Reading, Math Other students upset/mad Teacher attending to others Transition Preferred to non-preferred Change in schedule Denied item, told no, or to fix something Gain attention Peers, adults Delay Access to items Redirected Reprimanded Calm/soothe Personal space Later must complete task Loss of or delay in reinforcement
Screaming, Hitting
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Step 3 Case Study MikeAssessment of
Appropriate Behavior
Prevention Data Teach Data Reinforce Data
Independent work One-on-one attention Specials Peer interaction Getting attention Raising hand Sharing attention Conversation skills Taking turns Waiting Self-management Asking for break Expressing emotions Treasure box Movie Attention Helping teacher Going to media center Going outside Walk Food
Prosocial
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Step 3 Developing the Hypothesis
When. Student will. As a result
Inappropriate Behavior
Appropriate Behavior

• Prevention data antecedents or triggers
• Teach data replacement behavior and possible
  function
• Reinforce data function and reinforcers

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Step 3 Case Study Mike Hypotheses
When. he will As a result
Mike is asked to complete non-preferred tasks (Reading, Math), stop preferred activity or transition to non-preferred activity, fix an error, or when teacher is attending to other students scream and hit Mike is able to gain attention and delay the transition/activity
Mike is asked to complete non-preferred task (Reading, Math), stop preferred activity or transition to non-preferred activity, fix an error, or when teacher attending to other students express his frustrations appropriately complete the assigned task Mike is able to delay the transition/activity Mike is able to gain attention
Inappropriate
Appropriate
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Facilitation Tips

• Team members complete for homework
• During meeting, use as an interview
• During meeting, give each team member 15 minutes
  to complete. Give 15 minute break to allow time
  for facilitator/coach to synthesize information
  in Assessment Organization Table
• Secondary May want to change forced choice
  options to make appropriate for secondary
  environments

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Step 3 Activity Paris

• Activity Packet Pages 14-15

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Step 3 Activity Instructions

• Review the PTR Assessment Summary for Paris (on
  page 14)
• Develop a problem behavior and appropriate
  behavior hypothesis (use form on page 15)
• Feel free to use the cheat sheet (page 16)
• Be ready to share

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Step 3 Activity (Page 17 Activity Packet)

• Practice using the PTR Assessment Organization
  Table to organize your PTR Assessment information
  you completed on the child you know and develop a
  draft hypothesis.
• Use the cheat sheet on page 16 to assist.

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Step 3 Discussion

• What do you need in order to facilitate Step 3?
• How will you implement this step?

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Step 4 PTR Behavior Intervention Plan

• Implement Behavior Interventions

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Step 4 Behavior Intervention Plan

• Team selects interventions from each component
  (P-T-R) (pg. 19 blank forms pg. 102 book page
  20 blank forms secondary version)
• Detailed behavior plan developed (template pp.
  23-24 blank forms pp. 104-105 book)
• Consultant provides training and on-site
  assistance with plan implementation
• Implementation fidelity evaluated

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Step 4 Using the Intervention Checklist

• Record each team members rank on the checklist
  (pp. 21-22 blank forms pg. 103 book)
• Develop a list of preferred interventions
• Mean of ratings
• Interventions rank ordered 1
• Number of people selecting specific intervention
• Be sure to make note of interventions ranked
  highest/selected by teacher

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Case Study Tips on Linking Interventions to
Hypothesis

• Prior to selecting interventions, guidelines
  provided to participants
• Prevention strategies should
• Get Mike attention more often
• Modifying non-preferred tasks
• Changing what happens when he makes a mistake
• Signaling end of preferred activity
• Teach strategies should address
• How to get attention/assistance
• How to get break/delay appropriately
• Reinforce strategies should
• Give Mike attention/help
• Give Mike break/delay

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Step 4 Intervention Checklist Summary

• Discuss interventions selected by the team
• Team gains consensus on the interventions to be
  implemented
• PTR consultant ensures interventions
• Agree with hypothesis
• Can be done in the classroom

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(No Transcript)
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Step 4 Writing the Intervention Plan

• Task analyze each step of the plan
• NOT give student choices
• YES Prior to the start of independent reading,
  tell the student we have 2 worksheets today
  (show worksheets). Which worksheet would you
  like to do first?
• If teachers do not know how to do it, they will
  not implement the strategy.

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Step 4 Case Study Mikes BIP
Prevent Strategies Specific Strategy steps
Environmental Support A wait card will be placed on Mikes desk to assist him in remembering to wait his turn. 1. Prior to group work, tell Mike, Remember, when it is someone elses turn, you sit quietly and wait, while pointing to his card. 2. If Mike calls out, point to his visual to remind him what to do. 3. Use a verbal prompt if the point prompt does not work.
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Mikes Intervention Plan
Prevent Strategies Specific Strategy steps
Environmental Support Mikes visual schedule will be modified to detail the number of and type of activities he is to complete during non-preferred activities. For example, if math involves listening to a lesson, doing a hands-on activity, and completing a worksheet, his visual schedule will list each activity under math using either a picture of the type of activity or using numbers that correspond to a number on the worksheet. 1. Prior to the start of the activity, Mike should review the visual schedule. 2. As Mike completes an activity, he should X off the activity.
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Mikes Intervention Plan
Prevent Strategies Specific Strategy steps
Curricular Modification Mike will be given an easy, independent activity, such as a worksheet, to complete upon transitioning to a non-preferred activity or an activity that requires him to wait, such as group activities
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Teach Strategies Specific Strategy Steps
Replacement Behavior Mike will be taught to use his voice output device to express his need to calm down. Steps Mikes device will be programmed to say I need to calm down. Prior to transitioning to a non-preferred activity or at the end of a preferred activity, say If you start to get mad, you can choose to calm down. As soon as Mike starts to get upset, prompt him to use his device (hierarchyhand-over-hand, gesture, verbal). Once Mike communicates I need to calm down, present him with the choice board of calming strategies and ask him, What do you want? As soon as he is calm, praise him (e.g., You made a good choice.. Allow Mike to engage in his choice until he is calm for 1-minute. If Mike does not want to leave his choice, then start becoming animated with students in the non-preferred activity.
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Teach Strategies Specific Strategy Steps
Self-Management Mike will be taught to independently use his calming strategies. 1. A tracking sheet with smiley faces and sad faces will be given to Mike at the start of each day. 2. Role-play with Mike about when he needs to make the choice to calm down. 3. Practice completing the tracking sheet. 4. Set and review the daily goal for using the calming strategies. 5. Prompt Mike to complete the tracking sheet if needed
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Reinforce Strategies Specific Strategy Steps
Replacement Behavior Anytime Mike says I need to calm down, his choice board should be given. Praise Mike for communicating (thank you for telling me what you need.) Provide his choice board. Allow him to calm for 1 minute Praise him as soon as he is quiet Praise him for returning to the group
Self-Management Anytime Mike scores his behavior, attention should be given. When Mike marks his tracking sheet, praise him for doing so. At the end of the day, review the sheet with Mike. Talk about the sad faces. Provide his reward if his goal is met.
Waiting Mike will earn a skittle paired with attention if he waits. This will be faded to an intermittent schedule.
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Reinforce Strategies Specific Strategy Steps
Transition Mike will earn stars during Reading Centers if he transitions and completes his work without screaming. A social story will be reviewed prior to Reading Centers to remind Mike that he can earn a star if he comes to centers and works. At the end of each reading center, an adult will review Mikes behavior with him and ask him if he earned his stars. Provide his stars if earned. During the teachers group, Mike can earn 2 stars 1 for transitioning to the group and 1 for working during group. Allow Mike to participate in his chosen activity if he earned his stars.
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Discuss PTR Intervention Plan

• How is the PTR intervention plan and level of
  detail different from current BIPs?
• How will the level of detail make a difference in
  implementation and effectiveness?

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Step 4 Activity Paris Intervention Plan

• Activity Packet Page 18

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Step 4 Paris Activity Instructions

• Look at your hypothesis developed for Paris.
• Identify one or two prevent, teach, and reinforce
  strategies you might want to try with Paris
• One for each component (prevent/teach/reinforce)
• For the Teach strategy, make certain one behavior
  you are teaching is a replacement behavior.
• Develop the specific steps (task analysis) of the
  TEACH replacement behavior intervention for Paris
  (page 18).

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Step 4 Coaching Support-Teacher Training on BIP

• Provide opportunity to practice the plan with the
  teacher (team) without the students present
  (30-90 minutes)
• Role play, Q A, Discuss
• Evaluate teacher accuracy on each step prior to
  teacher implementing plan with student
• Coaching Checklist used by PTR for training
  evaluation (pp. 25-26 blank forms pg. 106 book).

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Case Study Sample Coaching Checklist for Mike
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Step 4 In-Class Support

• Provide support to teacher in implementation
• Be present on first day of implementation
• Determine when to debrief
• Measure fidelity
• Discuss and modify if necessary

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Step 4 Intervention Fidelity

• Measure teacher implementation of plan (pg. 107
  book)
• PTRTwo fidelity measures
• Adherencedid they do it?
• What is the most important part of intervention
  to be implemented to ensure intervention happens?
• Qualitydid they do it correctly?
• What are all the parts that need to be
  implemented completely and correctly?

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Case Study Fidelity
90
Other Methods of Collecting Fidelity
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Teacher Fidelity Self-Assessments

• Daily Fidelity Self-Check (sample pg. 27 blank
  forms)
• Teacher has major steps of intervention
• Provides them with nonintrusive prompts
• Weekly Fidelity Self-Check (pg. 29 blank forms)
• Aligned with Behavior Rating Scale
• Can be used with Excel Spreadsheet

92
Activity 4b Coaching/FidelityPg. 19 Activity
Packet

• Develop a fidelity measure for the replacement
  behavior intervention your team developed for
  Paris

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Step 4 Facilitation Tips

• Secondarymodify menu of interventions to include
  those appropriate for middle/high school
• Teams can select interventions for homework or
  can select during team meeting
• Focus on one routine, class, subject for
  developing intervention
• If meeting time is limited, break up strategies
• One meeting, focus on full development of
  Prevent, next meeting develop Teach/Reinforce OR
• First concentrate on Teach/Reinforce next
  meeting develop Prevent.
• Fidelity measurements can be done once or twice a
  week rather than daily
• One form can be used for training and fidelity
• Use technology (video, Skype, Wiki, Facebook) to
  provide support to teachers

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Activity (page 24-25 Activity Packet)

• Brainstorm ideas on possible prevent, teach, and
  reinforce interventions that would be appropriate
  for your students hypothesis
• Begin to task analyze the interventions

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Step 4 Discussion

• What do you need in order to facilitate Step 4?
• How will you implement this step?

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Step 5 Evaluation

• Is it working?
• BRS and/or other data measures
• Is it being implemented consistently and
  accurately?
• Fidelity ratings
• Are more data needed?
• Does the plan need to be modified or expanded?
• How can the team maintain the interventions?

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Step 5 Mike Evaluation
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Step 5 Evaluation
99
Step 5 Evaluation
100
Step 5 Evaluation
101
Step 5 Evaluation Mike Outcome Data
Measure Baseline Post-test Change
SSRS-PB 123 112 -11
SSRS-SS 87 102 15
AET .34 .57 23
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Social Validity (pp. 30-31 blank forms pp.
120-121 book)

• Social validityAcceptance and effectiveness of
  intervention
• Highly correlated with intervention
  implementation and maintenance
• Provides data on functionality of intervention
• Can be a pre-post measure

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Teacher-Consultant Alliance (page 32 blank forms)

• Provides data on relationship between facilitator
  (e.g., school-based behavior consultant) and
  implementer of interventions (e.g., teacher)
• Can be used as pre-post test measure
• Provides core behaviors valued in
  consultant/teacher relationship
• High correlation with teacher willingness to
  implement interventions

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Step 5 Activity Instructions

• Review the graphs and outcome data for Paris
  (Pages 20-23 in activity packet)
• As a team, what decisions would you make?
• Continue with intervention
• Modify or change intervention
• Gather more data
• Other????
• Justify your responses.

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Step 5 Facilitation Tips

• When fading interventions, do so systematically.
• Consider Multi-tiered System of Supports (access
  to Tiers 1 and 2)
• Make all decisions on data
• ALWAYS review fidelity data
• ALWAYS review BRS data (or other child outcomes)
• Have decision rules (e.g.,3 consecutive data
  points at or above goal line, fidelity score
  necessary to consider adequate implementation,
  etc.)
• Remind team this is a dynamic process and
  behavior is never fixed.

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Step 5 Discussion

• What do you need in order to facilitate Step 5?
• How will you implement this step?
• How will you use the BRS or other evaluation
  measures to make data-based decisions?

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Review PTR Process

• Five-step team-based process
• Teacher/team driven
• Prescriptive/manualized process
• Support provided to teacher/team to implement
  interventions
• Every intervention plan includes 3 components
• Prevent
• Teach
• Reinforce
• Plans are task analyzed

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References

• Manual
• Dunlap, G., Iovannone, R., English, C., Kincaid,
  D., Wilson, K., Christiansen, K., Strain, P.
  (2010). Prevent-Teach-Reinforce A school-based
  model of individualized positive behavior
  support. BaltimorePaul H. Brookes
• Journal articles
• Iovannone, R., Greenbaum, P., Wei, W., Kincaid,
  D., Dunlap, G., Strain, P. (2009). Randomized
  controlled trial of a tertiary behavior
  intervention for students with problem behaviors
  Preliminary outcomes. Journal of Emotional and
  Behavioral Disorders,17, 213-225.
• Dunlap, G., Iovannone, R., Wilson, K., Strain,
  P., Kincaid, D. (2010). Prevent-Teach-Reinforce
  A standardized model of school-based
  behavioral intervention. Journal of Positive
  Behavior Interventions, 12, 9-22
• Iovannone, R., Greenbaum, P., Wei, W., Kincaid,
  D., Dunlap, G. (in review). Reliability of the
  Individualized Behavior Rating Scale-Strategy for
  Teachers (IBRS-ST) A Progress Monitoring Tool. 
  Manuscript submitted for publication.
• Next steps
• Facilitating schools to scale up
• Training key school staff and team members to do
  process

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Questions?