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Team Driven Tertiary Process: The Prevent-Teach-Reinforce Model. Rose Iovannone, Ph.D. iovannone@fmhi.usf.edu Carie English, Ph.D. cenglish@fmhi.usf.edu 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

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

Rose Iovannone, Ph.D.

iovannone@fmhi.usf.edu

Carie English, Ph.D.

cenglish@fmhi.usf.edu

University of South Florida

Developed under grant H324P04003 from the Department of Education.


Acknowledgements

USF Model

Don Kincaid

Kathy Christiansen

Sarah Donadio

Glen Dunlap

UCD

Kelly Wilson

Patricia Oliver

Ted Bovey

Edy Purcell

Phil Strain

Acknowledgements


Objectives
Objectives Model

  • 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


Individualized pbs tertiary

For high-risk students: Model

History of severe problem behaviors

Demonstrated resistance to intervention

An intensive system of support is needed

Individualized PBS (Tertiary)

~5%

~15%

~ 80% of Students


Conceptualizing an array of pbs supports
Conceptualizing an Array of PBS Supports Model

Universal/Primary

School-Wide AssessmentSchool-Wide Prevention Systems

Classroom Interventions

  • Targeted/

    Secondary

  • Tertiary (Intensive)

Group Interventions

AnalyzeStudent Data

Assessment

Interviews, Questionnaires, etc.

Simple Student Interventions (ERASE)

Intervention

Observations and ABC Analysis

Complex Individualized Interventions (PTR)

Team-Based Wraparound Interventions

Multi-Disciplinary Assessment & Analysis

Scott, 2001


Tertiary supports in schools
Tertiary Supports in Schools Model

  • 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
Prevent Teach Reinforce Process Model

  • 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
Prevent-Teach-Reinforce Model 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”


Sample
Sample Model

  • 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
Sample Data Measures Model

  • Repeated measures at student level

    • Problem behaviors, social skills, academics

  • Mediator and moderators at multiple levels:

    • Student

    • Teacher/Classroom

    • System

*USF site only


Process
Process Model

  • 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





d = .57 Model

Follow-up N 29/17

p < .000


d = .48 Model

p < .000


Nbrcc report 10 10 07
NBRCC Report 10-10-07 Model

  • 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 10 071
NBRCC Report 10-10-07 Model

  • 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



Fidelity
Fidelity Model

  • 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



Step 1 team development
Step 1: Team Development Model

  • 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
Case Study—Step 1: Team Building Model

  • 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 building1
Case Study—Step 1: Team Building Model

  • 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
Step 2: Goal Setting Model

  • Identify team consensus on:

    • Academic behavior

    • Social behavior

    • Problem behavior

    • Appropriate behavior

  • Develop and begin baseline data collection


Social Model

Behavior

Academic

Broad

Decrease

Increase

Case Study—Step 2: Goal Setting


Case study operational definitions of problem and replacement behaviors
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)



Step 3 assessment
Step 3: Assessment Replacement Behaviors

  • 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 assessment problem behavior
Case Study—Step 3: PTR Assessment Replacement BehaviorsProblem Behavior

Screaming, Hitting


Case study step 3 ptr assessment appropriate behavior
Case Study—Step 3: PTR Assessment Replacement BehaviorsAppropriate Behavior

Prosocial


Step 3 ptr assessment developing the hypothesis
Step 3: PTR Assessment—Developing the Hypothesis Replacement Behaviors

  • 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—Step 3: PTR Assessment Possible Hypotheses Replacement Behaviors

Inappropriate

Appropriate


Case study tips on linking interventions to hypothesis
Case Study: Tips on Linking Interventions to Hypothesis Replacement Behaviors

  • 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
Step 4: Intervention Replacement Behaviors

  • 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 hypothesis1
Case Study: Tips on Linking Interventions to Hypothesis Replacement Behaviors

  • 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



Coaching of interventions
Coaching of Interventions Replacement Behaviors

  • 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: Training Replacement Behaviors


Case study fidelity
Case Study: Fidelity Replacement Behaviors


Step 5 evaluation
Step 5: Evaluation Replacement Behaviors

  • 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 evaluation1
Step 5: Evaluation Replacement Behaviors

1 is a lot of screaming, 5 is no screaming


Step 5 evaluation2
Step 5: Evaluation Replacement Behaviors

1 is a lot of hitting, 5 is no hitting


Step 5 evaluation3
Step 5: Evaluation Replacement Behaviors

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


Step 5 evaluation4
Step 5: Evaluation Replacement Behaviors

1 is inappropriate transition, 5 is super appropriate transition


Step 5 evaluation other outcome data
Step 5: Evaluation Replacement BehaviorsOther Outcome Data


Wrap up what we have learned
Wrap Up: Replacement BehaviorsWhat 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
How to Make PTR Work Replacement Behaviorsin 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
Organizing the PTR Process Replacement Behaviors

  • 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 process1
Organizing the PTR Process Replacement Behaviors

  • 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
Final Thoughts: System Changes Replacement Behaviors

  • 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


Questions
Questions? Replacement Behaviors


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