Identification and progress monitoring at tier 3 prevent teach reinforce
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Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce. Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior Supports Rose Iovannone, Ph.D. [email protected] Kathy Christiansen, MS [email protected]

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Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce

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Identification and Progress Monitoring at Tier 3: Prevent-Teach-Reinforce

Presented at 2008 National Forum for Implementation of School-Wide Positive Behavior Supports

Rose Iovannone, Ph.D.

[email protected]

Kathy Christiansen, MS

[email protected]

University of South Florida


  • Participants will:

    • Describe a model of individualized behavior support

    • Identify factors that may contribute to effectiveness of PTR

The Problem—Evidence-Based

  • Tertiary supports (i.e., individualized PBS, Tier 3 behavior supports)

    • Evidence-base exists

    • Research method used primarily single subject

    • Limited rigorous, randomized control trials to evaluate effectiveness

The Problem - In Authentic Schools

  • Ingredients

    • Child is the problem - “fix him/her”

    • Absence of uniform policies & practices

    • Form-driven versus process-driven

    • “Expert” versus collaborative approach

    • Contextual fit not always considered

    • Limited support/follow-up/training for teacher provided

  • Result

    • Many BIPs do not get implemented

    • Behavior problems persist

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

What is PTR?

  • Research project funded by U.S. Department of Education, Institute of Education Science (2004-2008)

    • University of South Florida—3 school districts

    • University of Colorado, Denver—2 school districts

  • Purpose: Investigate effectiveness of PTR process vs. “business as usual”

    • Randomized control trial

    • 200 students (100 treatment/100 comparison)

Theoretical Framework

  • Principles of applied behavior analysis

    • Operant learning theory

  • Positive Behavior Support—foundation

  • Intervention consists of three core components:

    • Prevent

    • Teach

    • Reinforce

  • Team/teacher driven process


Students in K-8th grade

General or Special Education

All cognitive levels

All disabilities

Behavioral difficulties

Intensity– disruption to the learning environment

Frequency— minimum of 1 time per week

Duration– minimum 6 months

Teachers volunteered & nominated 1-3 students

Top externalizers

Systematic Screening for Behavior Disorders (SSBD)


  • Prevent-Teach-Reinforce (PTR)

    • Five steps:

      • Team development—30 minutes if applicable

      • Goal setting—30-45 minutes

      • PTR assessment—30-60 minutes

      • PTR intervention—45-90 minutes

        • Coaching support (up to 12 hours)

      • Evaluation—30-40 minutes

    • Each team assigned PTR consultant (from project)

    • Teams receive manual and assigned activities to be completed in each step.

Preliminary Data Results

Student Demographics by Disability

Student Description

The PTR Process

Step 1: Form a Team

  • Identify members and their roles

    • Teacher, special area teachers

    • Behavior specialist/school psychologist

    • Family members, paraprofessionals,

Step 1: Team Building—Ensuring a Successful Team

  • Review the status of the team

    • Work styles inventory

    • Teaming survey

  • Use a collaborative process

    • Teacher and facilitator relationship

    • Consensus making method

Case Study 1: Mike

  • 9-year-old male

  • Autism diagnosis

  • Self-contained autism classroom

  • Nonverbal—uses AAT (signs, voice output devices such as Dynamite, and pictures to communicate)

  • 1 teacher, 2 aides, and 6 students

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

Case Study 2: Jeff

  • Male

  • Second grade general ed. student

  • Retained once

  • Premature birth

  • SSBD Scores:

    • Stage 2: 8 Critical Events

    • Adaptive Behavior Score = 33

    • Maladaptive Behavior Score = 32


  • Team: Two teachers

    • Current second grade teacher

    • Second grade teacher from previous year

  • Seventeen students

  • Teacher experience—4 years at same school

Teaming Results

  • Team respected each other, worked together

  • Met consistently for planning purposes

  • Strong communicators and problem solvers

  • Sharing of roles and responsibilities

  • Active parental participation encouraged

Step 2: Goal Setting

  • Identify team consensus on:

    • Academic behavior

    • Social behavior

    • Problem behavior

  • Develop and begin baseline data collection

Setting Goals: Mike Pre-Test

Behavior Rating Scale—Reliability

Perceptual rating

Behavior recorded at least once daily

May be specific to a setting, activity, time of day

May be whole day

May be combination of both

Use anchors on a scale of 1-5

Determining the Anchors on the BRS

Behavior can be measured using

Frequency (times per day)

Duration (hours, minutes, seconds)

Intensity (how hard, how loud, bruise, etc.)

Percent of day

Percent of occurrence

Percent of opportunity

BRS Preliminary Reliability (Psychometric) Results

T = Teacher rating; S = PTR data collector rating; PB = Problem behavior; AB = Appropriate behavior

* P < .01

BRS Preliminary Reliability Results—Kappa Scores

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—Mike: PTR Assessment Possible Hypotheses



Jeff Case Study: Hypothesis

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 Mike: PTR Intervention Plan

Jeff: Intervention Checklist Results

Case Study Jeff: PTR Intervention Plan

Jeff—Intervention Plan

Jeff—Intervention Plan

Jeff—Intervention Plan

Jeff—Intervention Plan

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 Mike: Training

Case Study Mike: Fidelity

Mike Post-test Video

Coaching Checklist Example: Jeff

Example of Fidelity—Jeff

Fidelity: Number of Fidelity Measures per Case

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 - Mike

1 is a lot of screaming, 5 is no screaming

Step 5: Evaluation - Mike

1 is a lot of hitting, 5 is no hitting

Step 5: Evaluation - Mike

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

Step 5: Evaluation - Mike

1 is inappropriate transition, 5 is super appropriate transition

Step 5: Evaluation Other Outcome Data

Jeff Data

Step 5: Evaluation Other Outcome Data for Jeff

Wrap Up:What We Have Learned

  • Teachers like the process

  • Teachers identify coaching/support and collaboration as key features

  • Teachers do not continue the process without support

  • Systemic change may be necessary for tertiary supports to happen

How to Make PTR Work in Your School

  • Process is the key

  • Creative resource reallocation may be necessary to find the time

  • Things to consider

    • Tertiary team

    • Identification/Nomination process

    • Data-based decision making

    • Facilitator

    • Set-up of meetings for efficient results

For copies of Forms

  • [email protected] or

  • [email protected]

  • Manual will be published by Brookes—anticipated date—Summer 09

  • Two journal articles in 2009

    • Journal of Positive Behavior Interventions (Jeff will be described)

    • Journal of Emotional Behavioral Disorders

  • Next steps:

    • Training school-based behavior consultants to do process


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