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Team Driven Tertiary Process: The Prevent-Teach-Reinforce Model. Rose Iovannone, Ph.D. Carie English, Ph.D. University of South Florida. USF Don Kincaid Kathy Christiansen Sarah Donadio Glen Dunlap. UCD Kelly Wilson Patricia Oliver

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Team Driven Tertiary Process: The Prevent-Teach-Reinforce Model

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Team Driven Tertiary Process: The Prevent-Teach-Reinforce Model

Rose Iovannone, Ph.D.

Carie English, Ph.D.

University of South Florida

Developed under grant H324P04003 from the Department of Education.


Don Kincaid

Kathy Christiansen

Sarah Donadio

Glen Dunlap


Kelly Wilson

Patricia Oliver

Ted Bovey

Edy Purcell

Phil Strain



  • Participants will:

    • Describe an individual positive behavior support process for use in the classroom

    • List factors impacting the effectiveness of an individual behavior support process

For high-risk students:

History of severe problem behaviors

Demonstrated resistance to intervention

An intensive system of support is needed

Individualized PBS (Tertiary)



~ 80% of Students

Conceptualizing an Array of PBS Supports


School-Wide AssessmentSchool-Wide Prevention Systems

Classroom Interventions

  • Targeted/


  • Tertiary (Intensive)

Group Interventions

AnalyzeStudent Data


Interviews, Questionnaires, etc.

Simple Student Interventions (ERASE)


Observations and ABC Analysis

Complex Individualized Interventions (PTR)

Team-Based Wraparound Interventions

Multi-Disciplinary Assessment & Analysis

Scott, 2001

Tertiary Supports in Schools

  • Traditional process:

    • Specialist/expert-driven

      • Complete an observation

      • Write a support plan

      • Call me if you have questions

  • Often contextual fit ignored

  • Limited support/follow-up/training provided

Prevent Teach Reinforce Process

  • Team driven process

    • Goals, assessment, intervention plan

  • Support provided by facilitator

    • Direct observation

    • Training and classroom implementation assistance

  • Contextual fit

    • Greater buy-in and likelihood of implementation

Prevent-Teach-Reinforce Model

  • Funded by US Dept. of Education/ Institute of Educational Sciences

  • Randomized control group design

  • Two sites—USF and UCD

    • Three school districts central Florida

    • Two school districts Colorado

  • Compare prescriptive, simple model to “business as usual”


  • 200 students

    • 100 treatment; 100 wait-list control

  • Any student in K-8 grades who exhibit problem behavior

  • Problem behavior criteria

    • Minimum 5 critical events indicated on Systematic Screening for Behavior Disorders (SSBD)

    • Behaviors disruptive, durable (6 months), chronic (at least 1 time a week)

Sample Data Measures

  • Repeated measures at student level

    • Problem behaviors, social skills, academics

  • Mediator and moderators at multiple levels:

    • Student

    • Teacher/Classroom

    • System

*USF site only


  • Standardized approach

  • Five step process facilitated by PTR Consultant

    • Team Development

    • Goal Setting

    • Assessment

    • Intervention

      • Coaching—up to 12 hours

    • Evaluation

  • Manual including information and forms

Preliminary Data Results

Student Demographics by Ethnicity and Gender

Student Demographics by Primary Disability

d = .57

Follow-up N 29/17

p < .000

d = .48

p < .000

NBRCC Report 10-10-07

  • PTR Intervention more effective in:

    • Increasing social skills and decreasing problem behaviors with students having most severe behaviors (measured by SSBD Maladaptive Behavior Scale)

    • Increasing social skills and decreasing problem behaviors of males

NBRCC Report 10-10-07

  • Teachers participating in PTR indicated:

    • High social validity

      • 98% liked PTR

      • 91% felt PTR reasonable

    • High alliance (relationship) with consultant

      • Overall mean = 4.8 (SD = 0.45)

        • Consultant is approachable

        • Consultant and I trust one another

        • Overall, consultant has shown sincere desire to understand and improve the situation

Social Validity Comparison USF—Sample Items


  • Most teams reaching 80% fidelity and maintaining into post-test

  • Quality scores lower than adherence scores

    • Part of the plan implemented although not entirely as plan written

The Process: A Case Study Example

Step 1: Team Development

  • Members and roles identified

    • Teacher

    • Behavior specialist/school psychologist

    • Family members, paraprofessionals, special area teachers

  • Work styles inventory

  • Teaming survey

Case Study—Step 1: Team Building

  • Mike is a 9-year-old male in a self-contained autism classroom

  • Nonverbal—uses signs, Dynamite, and pictures to communicate

  • 1 teacher, 2 aides, and 6 students

Case Study—Step 1: Team Building

  • Teacher-- Ms. Wonderful

  • Aides

    • Ms. Needs Help

    • Ms. Also Needs Help

  • Facilitator—PTR Consultant

  • Results of teaming information indicate a great team that meets regularly to brainstorm

Step 2: Goal Setting

  • Identify team consensus on:

    • Academic behavior

    • Social behavior

    • Problem behavior

    • Appropriate behavior

  • Develop and begin baseline data collection







Case Study—Step 2: Goal Setting

Case Study: Operational Definitions of Problem and Replacement Behaviors

  • Screaming—loud, high pitched noise heard outside the classroom

  • Hitting—anytime Mike touches peers or adults with an open hand, fist, foot, or object while screaming or protesting

  • Expressing Frustration—using Dynamite, pictures, or signs to ask for a break or attention

  • Transition to nonpreferred activities—moving to nonpreferred activity and engaging with appropriate verbal expression (screaming level)

Case Study: Behavior Rating Scale With Anchors

Step 3: Assessment

  • Checklist format:

    • Antecedents or Triggers (Prevent)

    • Function(s) of the problem behaviors (Teach)

    • Consequences following the problem behaviors (Reinforce)

  • Assists team to link function of behavior to intervention plan

Case Study—Step 3: PTR AssessmentProblem Behavior

Screaming, Hitting

Case Study—Step 3: PTR AssessmentAppropriate Behavior


Step 3: PTR Assessment—Developing the Hypothesis

  • Prevention data = antecedents or triggers

  • Teach data = replacement behavior and possible function

  • Reinforce data = function and reinforcers

Case Study—Step 3: PTR Assessment Possible Hypotheses



Case Study: Tips on Linking Interventions to Hypothesis

  • Prevention strategies must address:

    • Getting Mike attention more often

    • Changing non-preferred task

      • Particular student

      • How it is done (format)

    • Changing what happens when he makes a mistake

      • Do part of it (rather than all of it) over

      • Allow him to find what is wrong

      • Provide social story

    • Signaling end of preferred activity

  • Teach strategies must address:

    • How to get attention/assistance

    • How to get break/delay appropriately

  • Reinforce strategies must address:

    • Giving Mike attention/help

    • Giving Mike break/delay

Step 4: Intervention

  • Team ranks top three intervention strategies in each of the PTR components

  • Multi-component intervention that teacher states s/he can implement

    • Prevent

    • Teach

    • Reinforce

  • Implementation plan

Case Study: Tips on Linking Interventions to Hypothesis

  • Prevention strategies must address:

    • Giving Paris attention more often

    • Changing non-preferred task

      • Presentation (how it is given to Paris; how it looks)

      • Content (embedding preferences)

    • Changing environment surrounding independent work time

  • Teach strategies must address:

    • How to get attention appropriately

    • How to get a delay appropriately

    • How to access preferred item appropriately

  • Reinforce strategies must address:

    • Giving Paris attention/help

    • Giving Paris a delay

    • Giving Paris access to preferred activities

Case Study—Step 4: PTR Intervention

Coaching of Interventions

  • Training of teacher

    • 1 to 2 hours

    • 80% accuracy on all strategies

  • Assistance in classroom

    • Up to 12 hours

  • Fidelity measures recorded

    • 80% implementation terminates assistance in classroom

Case Study: Training

Case Study: Fidelity

Step 5: Evaluation

  • Data-based decision-making

    • Identifying what is working; what is not and WHY

  • Expanding into other routines

  • Generalization

  • Continuing team meetings

    • Planning time

    • Cohesiveness

Step 5: Evaluation

1 is a lot of screaming, 5 is no screaming

Step 5: Evaluation

1 is a lot of hitting, 5 is no hitting

Step 5: Evaluation

1 is a little appropriate expression, 5 is a lot of appropriate expression

Step 5: Evaluation

1 is inappropriate transition, 5 is super appropriate transition

Step 5: Evaluation Other Outcome Data

Wrap Up:What We Have Learned

  • PTR process may not be enough for all students

    • Some need wraparound

  • Not all students need PTR

    • 3-tiered model of individual support

  • Teachers report the coaching piece and collaborative process to be keys

How to Make PTR Work in Your School

  • Steps are the key components not how your organize them

  • Must create a system that will work for your school or even each student

  • Things to consider

    • Tertiary team

    • Identification/Nomination process

    • Facilitator

    • Set-up of meetings for efficient results

Organizing the PTR Process

  • Is Team Building needed?

    • Small team, team works well together, no paraprofessional

  • If small team or no paraprofessional, skip and start with Goal Setting

  • If well functioning team, combine with Goal Setting

Organizing the PTR Process

  • Few problem behaviors or all in same response class?

    • Same antecedents &/or function

    • Small team

  • Combine Assessment with Intervention Development

  • Condense the steps to meet the needs of your school

Final Thoughts: System Changes

  • Process may require more time up front but less time overall

    • Must provide assistance in the classroom until desired outcomes achieved

    • Will pay off in the end

  • Teams more likely to implement the plan

    • Ownership

    • Fits the class and the student

    • Continued contact


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