Universal Screening

1. Universal Screening National PBIS Leadership Forum October 27, 2011

2. Maximizing Your Session Participation • Work with your team • Consider 4 questions: • - What Implementation Phase? • - What do I hope to learn? • - What did I learn? • - What will I do with what I learned?

3. Where are you in implementation process?Adapted from Fixsen & Blase, 2005

4. Mental health and school-age children • One out of ten children between the ages of 8-15, experiences an emotional disorder that has a major impact on daily functioning • ADHD and mood disorders (e.g., depression) are most commonly-occurring disorders Source: Merikangas, 2010

5. Mental health and school-age children • There’s a ‘window of opportunity’ when early intervention can prevent the onset of major emotional problems Great Smoky Mountains Study: Age Between First Symptom and Initial Diagnosis Source: O’Connell, Boat, & Warner, 2009

6. Mental health and school age children • Students at-risk for internalizing disorders (e.g. children demonstrating overly shy, anxious, ’down’ behaviors) typically fly under the radar • A Johns Hopkins University study found that average-performing students with internalizing behaviors received support via special education, or mental health services at lower rates than underperforming students with externalizing (e.g., ‘acting out’) behaviors • Source: Bradshaw, Buckley, & Ialongo, 2008

7. Mental health and school age children • Internalizers are underserved by special education and mental health systems Source: Bradshaw, Buckley, & Ialongo, 2008

8. Universal Screening Defined • “Universal screening is the systematic assessment of allchildren within a given class, grade, school building, or school district, on academic and/or social-emotional indicators that the school personnel and community have agreed are important.” • Source: Ikeda, Neessen, & Witt, 2009

9. Universal Screening Rationale • Universal screening to identify students at-risk of developing behavior problems offers several advantages: • Cost-efficient • Less expensive than special education evaluations • Proactive • Identify students who can benefit from extra supports • Reach students who typically “fly under the radar” • Shy, withdrawn students can also experience poor outcomes: academic failure, social ostracism, heightened risk of suicide • Objective • Help address disproportionality issues

10. Universal Screening Rationale • President’s Commission on Excellence in Special Education (2001) and No Child Left Behind (2001) recommend academic AND behavioral screening • Greater likelihood of altering negative life trajectory associated with early intervention (Patterson, Reid, & Dishion, 1992) • Approximately one out of 10 school-age children and youth are at-risk for developing externalizing (i.e., ‘acting out’) or internalizing (i.e., markedly withdrawn or sad) behaviors • Illinois Children’s Mental Health Act (2003) requires that schools address the mental health needs of students

11. Origins of Illinois Universal Screening Model • The K-I (Kansas and Illinois) Center was formed in 2006-07 school year • Funded by federal grant with the overarching goal of demonstrating how to establish a sustainable, systematic approach to supporting students with complex needs within the SWPBIS framework

12. Origins of Illinois Universal Screening Model • The objectives of the K-I Center were to demonstrate how schools can: • Provide early and effective intervention for behavior • Especially for students at-risk of developing internalizing disorders (e.g., anxiety and depression) • Increase success for students identified with emotional/behavioral disabilities • Decrease reliance on reactive discipline (e.g., suspension, expulsion) by enhancing capacity for data-based decision-making • Install and support efficient teaming structures

13. Origins of Illinois Universal Screening Model • The RtI logic model (Reschly & Ysseldyke, 2002) was the philosophical base for implementation • Use evidence-based instruction and interventions • Emphasize prevention versus intervention • Employ data-based decision-making process to determine need for secondary/tertiary level interventions • Engage in continuous progress-monitoring • Implement universal screening (academic and behavior)

14. Illinois Universal Screening Model • Process reflects RTI logic: • Use a research-validated screening instrument • Administer evidence-based interventions with integrity • Progress monitor (e.g., DPR) • Use data-based decision making to evaluate student response to intervention

15. Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model Tier 1/Universal School-Wide Assessment School-Wide Prevention Systems ODRs, Attendance, Tardies, Grades, DIBELS, etc. Tier 2/Secondary Tier 3/ Tertiary Check-in/ Check-out Intervention Assessment Social/Academic Instructional Groups Daily Progress Report (DPR)(Behavior and Academic Goals) Individualized Check-In/Check-Out, Groups & Mentoring (ex. CnC) Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc. Brief Functional Behavioral Assessment/ Behavior Intervention Planning (FBA/BIP) Complex FBA/BIP SIMEO Tools: HSC-T, RD-T, EI-T Wraparound Illinois PBIS Network, Revised August 2009 Adapted from T. Scott, 2004

16. Illinois Universal Screening Model • The Illinois PBIS Network recommends a ‘multi-gate’ process for implementing universal screening for behavior • Efficient: • Takes approximately one hour, maximum, per classroom to complete process • Less expensive and more timely than special education referral process • Fair: • All students receive consideration for additional supports (gate one) • Reduces bias by using evidence-based instrument containing consistent, criteria to identify students (gate two)

17. Illinois Universal Screening Model Multiple Gating Procedure (Adapted from Walker & Severson, 1992) Teachers Rank Order then Select Top 3 Students on Each Dimension (Externalizing & Internalizing) Gate 1 Pass Gate 1 Teachers Rate Top 3 Students in Each Dimension (Externalizing & Internalizing) using either SSBD, BASC-2/BESS, or other evidence-based instrument Gate 2 Tier 2 Intervention Pass Gate 2

18. Examples of Externalizing Behaviors: Displaying aggression toward objects or persons Arguing Being out of seat Not complying with teacher instructions or directives Source: Walker and Severson, 1992

19. Examples of Internalizing Behaviors: Not talking with other children Being shy Timid and/or unassertive Avoiding or withdrawing from social situations Not standing up for one’s self Source: Walker and Severson, 1992

20. Teacher ranking form: Externalizers

21. Teacher ranking form: Internalizers

22. Illinois Universal Screening Model: Selected Instruments • Systematic Screener for Behavior Disorders (Walker & Severson, 1992) for grades 1-6 • Validated by the Program Effectiveness Panel of the U.S. Department of Education • Six research studies confirm the SSBD’s ability to systematically screen and identify students at-risk of developing behavior problems • Universal screening with the SSBD is less costly and time-consuming than traditional referral system (Walker & Severson, 1994) • Inexpensive • Manual= $ 131.49 (includes reproducible screening forms) • Quick • Entire screening process can be completed within 45 minutes to 1 hour per classroom

23. Illinois Universal Screening Model: SSBD Administration • Teachers complete Critical EventsIndex checklist for top three internalizers and externalizers • Internalizers with four or more and externalizers with five or more critical events immediately pass gate two and are eligible for simple a secondary intervention (i.e., CICO)

24. Sample of SSBD Critical Events Form

25. Illinois Universal Screening Model: SSBD Administration • Teachers complete the Combined Frequency Index scale for internalizers and externalizers who did not initially pass gate 2 • Students who subsequently pass gate 2 meet the following criteria: • Internalizers with Adaptive scores of ≤41 and Maladaptive scores of ≥; Externalizers with Adapative scores of ≤30 and Maladaptive scores of ≥35

26. Sample of SSBD CFI Form

27. Illinois Universal Screening Model: Selected Instruments Behavioral and Emotional Screening System (BESS) (Kamphaus & Reynolds, 2007) Developed as a school-wide (Universal) screening tool for children in grades Pre-K to 12 Similar to annual vision/hearing screenings Identifiesbehavioral and emotional strengths and weaknesses Externalizing behaviors (e.g., acting out) Internalizing behaviors (e.g., withdrawn) Adaptive skills (e.g., social and self-care skills)

28. Illinois Universal Screening Model: BASC-2/BESS Administration • Teachers complete scantron forms (‘bubble sheets’) for each student in their class • Or, for top three internalizers and externalizers if using a multi-gate approach • Takes approximately five minutes, or less per student to complete ratings

29. Illinois Universal Screening Model: BASC-2/BESS Sample

30. Illinois Universal Screening Model: BASC-2/BESS Administration • The BASC-2/BESS uses T-scores to communicate results relative to the average (mean=50) • Identifiers and percentile ranks are provided for ease of interpretation • Normal risk level: T-score range 10-60 • Elevated risk level: T-score range 61-70 • Extremely Elevated risk level: T-score range ≥ 71

31. Illinois Universal Screening Model: BASC-2/BESS Administration • Students who score within the Elevated, or Extremely Elevated risk levels would be considered as eligible for simple secondary intervention (i.e. CICO)

32. Illinois Universal Screening Model: Implementation • Recommended Implementation Process: • Secure district-level (e.g., superintendent) commitment to universal behavioral screening • Build capacity for secondary practices (e.g., CICO, CnC, SAIGs) • Provide building level overview • Identify and train building level staff person to lead and manage universal screening process and data • Distribute informational letters to parents/guardians • Conduct universal behavioral screening • Secondary teams meet with universal behavior screening coordinator to review results • Contact parents to obtain permission for intervention • Upon receipt of parent/guardian permission, quickly place students into simple secondary-level intervention (e.g., CICO) • Use data to progress monitor students’ response to intervention • Share results with staff, families and students supported with simple secondary-level intervention

33. Illinois Universal Screening Model: Implementation • A note on recommended screening frequency • Academic screening (e.g., Curriculum Based Measures-CBMs-for reading difficulty) typically occurs during fall, winter and spring benchmarking phases • Screening twice annually (in fall and early winter) is optimal for behavioral screening • Screen transfer students • Additional progress monitoring of students identified during fall screening

34. Illinois Universal Screening Model: Implementation Summary • The initial plan was to begin implementation in three schools in the three federally-funded demonstration districts in year I • Expand implementation to include three additional schools in each district in years two and three increasing to a total of 27 schools in years three and four of the grant • Simultaneously, the IL-PBIS Network implemented universal screening in three additional Illinois school districts

35. Illinois Universal Screening Model: Implementation Summary • Ultimately, the number of schools implementing universal screening was expanded to over sixty schools • In the 2010-11 school year, 61 Illinois schools screened approximately 28,000 students representing a diverse demographic profile: • White, 32% • Black/African American, 20% • Hispanic/Latino, 38% Source: ISBE 2011 Fall Housing Report

36. Illinois Universal Screening Model: Universal Screening Results

37. Illinois Universal Screening Model: Universal Screening Results

38. Illinois Universal Screening Model: Universal Screening Results

39. Illinois Universal Screening Model: Universal Screening Results

40. Contact Information • Jennifer Rose, M.Ed., Tertiary Research & Evaluation Coordinator-Illinois PBIS Network: jen.rose@pbisillinois.org

41. Leadership Team Action Planning Worksheets: Steps • Self-Assessment: Accomplishments & Priorities • Leadership Team Action Planning Worksheet • Session Assignments & Notes: High Priorities • Team Member Note-Taking Worksheet • Action Planning: Enhancements & Improvements • Leadership Team Action Planning Worksheet

42. Systematic Screening within the Context of Comprehensive, Integrated, Three-Tiered (CI3T) Models of Prevention Prepared By: St. Louis City School District

43. Comprehensive, Integrated, Three-Tier Model of Prevention (Lane, Kalberg, & Menzies, 2009) Goal: Reduce Harm Specialized Individual Systems for Students with High-Risk ≈ Tertiary Prevention (Tier 3) ≈ Goal: Reverse Harm Specialized Group Systems for Students At-Risk Secondary Prevention (Tier 2) PBIS Framework Goal: Prevent Harm School/Classroom-Wide Systems for All Students, Staff, & Settings Social Skills Improvement System (SSiS) - Classwide Intervention Program ≈ Primary Prevention (Tier 1) Social Academic Behavioral

44. The Importance of Accurate Decision Making It is important reliable, valid tools be used within CI3T Models (Lane, Oakes, & Menzies, 2010) Information from behavior and academic screening tools can be used to Examine overall level of risk in schools Look for students for who primary prevention efforts are insufficient and then place them in Tier 2 and Tier 3 supports Lane, K. L., Oakes, W. P., & Menzies, H. M. (2010). Systematic screenings to prevent the development of learning and behavior problems: Considerations for practitioners, researchers, and policy makers. Journal of Disabilities Policy Studies, 21, 160-172.

45. Behavior Screening Tools • Serve as a screening practice for identifying students who may require additional supports. • Early Screening Project (ESP; Walker, Severson, & Feil,1994) • Social Skills Improvement System: Performance Screening Guide (SSiS; Elliott & Gresham, 2007) • BASC2 Behavioral and Emotional Screening System (BESS; Kamphaus & Reynolds, 2007) • Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) • Student Risk Screening Scale (SRSS; Drummond,1994) • Systematic Screener for Behavior Disorders (SSBD; Walker & Severson, 1992) Lane, K. L., Menzies, H. M, Oakes, W. P., & Kalberg, J. R. (in press). Systematic screenings of behavior to support instruction: From preschool to high school. New York, N.Y.: Guilford Press.

47. What is the SRSS? The SRSS is 7-item mass screener used to identify students who are at risk for antisocial behavior. Teachers evaluate each student on the following items - Steal -Low Academic Achievement - Lie, Cheat, Sneak -Negative Attitude - Behavior Problems -Aggressive Behavior - Peer Rejection Student Risk is divided into 3 categories Low 0 – 3 Moderate 4 – 8 High 9 + (SRSS; Drummond, 1994)

48. Student Risk Screening Scale(Drummond, 1994)

49. An Illustration Using the SRSS to examine Behavioral Risk: Snap shots in Time

50. Behavior Screeners – SRSS School Time Point Percentages n = 32 n = 14 n = 88 n = 64 n = 288 n = 245 Students with unrated items: Fall – 33 Spring – 118 Total students enrolled at time of screening: Fall – 441 Spring – 441 n= 408 n= 323